My Ambulance Education. Joseph F. Clark

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       In this era when terrorism and disasters are very real threats to all of us, we have a new awareness and appreciation for the services provided by emergency medical service (EMS) personnel. Yet for more than 40 years, EMS personnel have toiled diligently to take care of people in their hour of need. One patient at a time, these unsung heroes have placed the interests of others before their own and saved countless lives.

      My Ambulance Education by Joseph Clark is a testament to the challenges that EMS personnel everywhere face daily. Whether they are assisting a patient who is having difficulty breathing, treating someone’s pain, or merely providing safe transport to the hospital for a psychotic patient, they must always be prepared to help the next person for whom they are summoned. They do this willingly and seldom with any accolades.

      Despite the personal rewards that EMS personnel often receive from all of this, their jobs exact an emotional toll—a big one. There is an emotional strain that is often overlooked and rarely discussed for fear that this would be perceived as weakness. My Ambulance Education is more than a collection of experiences. It’s more than an accumulation of intense life events that most of us will never encounter. It is a daring and open debriefing session, a necessary unburdening of an emotional weight that would crush most of us. This book’s bold approach reaches a balance that many books attempt, but few achieve. It is frightening yet humorous, disheartening yet inspirational. These are just a few of the emotions in the complex mix that our EMS personnel are expected to manage every day. Joe Clark was no exception. Now, his shared experiences offer us a peek into the nonstop challenges of this job. His delivery is natural, genuine and brutally honest.

      Prepare yourself for a roller coaster ride of emotions as you enter a world of psychological stress and physical challenge. Some people, such as EMS personnel, will find it liberating to share “war stories” and (finally) openly confess the emotional strain that they, as heroes, have endured for so long. But everyone can learn from the experiences recorded in these pages.

      Todd Crocco, MD Chair, Department of Emergency Medicine West Virginia University Morgantown, WV I started working on an ambulance when I was 18 years old and in high school, and I actually considered making it my career. But I headed to college as a chemistry major instead. This ended up being the ultimate double life, because the student lifestyle is very insular and not an accurate reflection of reality. In college, if you make a mistake in a test there may be a final or makeup so you can do it over. But in life, and on the ambulance, there is no such thing as a do-over. The ambulance life is excessively harsh and contains more reality than most people should have to deal with. When I was faced with the choice of making a career as a paramedic on the ambulance or heading toward another destiny by being a college student, the choice was easy. Today, I am still in college—as a professor.

      One of the few harsh realities of being a student is that college costs money. I did not have the money for tuition, and the ambulance was willing to pay me. People need ambulances 24 hours a day, seven days a week. So I could go to classes during the day and work nights and weekends. There was no shortage of shifts, and it meant a steady income to cover college fees. I put in 36 to 48 hours almost every weekend during term, and worked full-time during breaks. Full-time on the ambulance was 60 to 100 hours a week. If things were slow, I could even study while working a night shift. Although I pulled a lot of all-nighters on the ambulance, I never stayed up all night studying for an exam or preparing a paper. Sleep was too valuable to lose because of a test. I decided to write this book because paramedics and EMTs deserve more recognition for the service they provide to the public and the hospitals they serve. The tragedies of September 11, 2001 highlighted the importance of emergency services. The heroism and dedication seen on that day and in the months that followed were not a surprise to those on the job, but the appreciation and thanks from the public was long overdue. Paramedics receive as many as 3,000 hours of training, enabling them to make early assessments of patients and treat many medical emergencies. They are highly skilled professionals who are able to apply the latest medical research to give every patient the best possible chance of surviving.

      I firmly believe that public health would be greatly improved by doing research that leads to better therapies for the patients on the ambulance while they are in the critical first minutes after a life-threatening event. By bringing the emergency room to the ambulance, a paramedic can save lives before patients even get to the hospital. Although I do not plan to work on the ambulance again, the people still on the job have my respect, my sincerest admiration and even my sympathy. We all have defenses that enable us to deal with the job. This book is my ultimate defense system.

      The events portrayed in this book are based on fact, though I have changed the names and altered the order of some events. These stories are a distillation of about eight years of working on three ambulances and two emergency rooms in New York and Michigan. These experiences have shaped, and are still shaping, my career as a university professor.

      I do not recommend doing what I did to pay university tuition, but neither would I trade the memories for anything.