My Butt Isn’t Hurt – Defending EMS’s Public Image



Although my waistline wouldn’t necessarily agree, I have long said that “A healthy ambulance shift begins with an unhealthy breakfast” and for years I acted upon that philosophy by beginning as many of my shifts as possible by stopping at some local greasy-spoon diner for some fried breakfast goodness. Here in the Midwest this is easy to find. There are tons of small restaurants that all pretty much serve the same fare. You want eggs, bacon, corned beef hash, eggs benedict, biscuits and canned sausage gravy, and/or pancakes? Great. We’ll top it off with hash browns and wheat toast.

These days I have all but stopped this practice in favor of keeping my wallet filled and my coronary arteries less-so. Spending $6 to $8 dollars on a bad for me breakfast adds up quickly and bringing food from home is much cheaper. This also helps to avoid the specter of “Paramedic Aspect Ratio Drift” that affects so many of us as we age in this profession. It’s my aim to avoid tipping the scales too much as I continue getting older and I’d prefer not to have to have to huff hits from my own oxygen tank after walking upstairs to see a patient. So there’s that.

However, there have been other issues in the past that periodically put me off of my breakfast philosophy. Mainly, they’ve been caused by whomever I happened to be partnered up with combined with my own personal comfort zone.

I generally try not to swear. I prefer to let my biting sarcasm and sparkling wit emerge through words that wouldn’t make a 14 year old giggle however I am quite good at swearing if the situation calls for it. My upbringing and sense of public decency will rarely allow me to utter profanity in public and only then with a requisite sense of shame quickly following the utterance. I make every effort to avoid it and when I do or when I am in the company of others who do, it makes me very uncomfortable. Some situations with public swearing are less uncomfortable for me than others but should I or someone else swear around children, families, or other polite company it makes my skin crawl. It just isn’t appropriate and I do not approve. In fact, while I am usually not one to correct the behavior of others or judge someone harshly, people who swear publicly and especially around children are not generally my friends.

So when I occasionally had partners or other ambulance people who would choose to publicly break out the potty talk, I would be uncomfortable enough to not want to be seen in public with them. They could otherwise be exceptional people who I had and have developed long-lasting friendships with but I cannot get past how uncomfortable I am when someone does this. Especially, absolutely, and unequivocally I cannot condone swearing or speaking inappropriately while in uniform and in the public eye. This includes openly speaking about subjects inappropriate for polite company whilst in public as well.

You may think that I am being overly harsh however if someone is offended by my aversion to inappropriate conduct in the public eye then I really don’t put much weight on their opinion. If someone chooses to be in some type of EMS uniform or is otherwise represent themselves as an EMS person and then proceeds to behave badly in public I do not approve. They are hurting our profession and are helping to perpetuate a lot of the things that bring us all down, such as lack of public respect, low wages, poor working conditions, and more.

Fair or not, perception might as well be reality and it affects the public support we need to do our jobs. Since most people interact very seldom with EMS providers they mostly form their perception of our profession through seeing us during non-patient care occasions. Most people never need an ambulance for themselves nor their loved ones and the vast majority of those who do only call one or two times in their lifetime. If someone is one of those EMS people who say “I always treat my patients with the utmost respect” and then proceeds to act like six shades of a fool while in the public eye, they’re not really walking their talk. If the vast majority of people who see you only see you acting badly, then their trust in you and all those who dress like you and do what you do has been eroded. Bad behavior in public hurts me, too.

“But” You say, “I don’t do that. I am a pillar of good public behavior and respect and my personal hygiene is impeccable. I understand that the profession of EMS deserves my personal respect and I know that when I am identified as an EMS person it is one of my duties to represent myself in a way that brings respect to myself and my peers.” To that, I say “great!” I appreciate and thank you for doing this. We need more of us like you out there.

But what about your online presence?

I am pretty active on Facebook, maintaining a personal account and an account for Life Under the Lights. I have a pretty good amount of friends and contacts spread out over both accounts and participate in a number of online forums. I also “like” many of the EMS related Facebook pages.

And most of the Facebook EMS pages make me weep for my profession.

As Kelly Grayson said in his seminal work ”EMS: The Low Information Voters of Healthcare” there are some dumb people out there and some of them work for EMS agencies. A lot of them use social media too, and well… it’s both shocking and appalling for people who are truly trying to make EMS the profession it deserves to be. I’m not saying that I’m perfect. In fact I could very well be accused of doing the same thing from time to time, but I’d like to think that I’m not as blatantly, willfully, ignorant and bigoted as some of the people who make internet comments happen to be.

Once you start looking critically at the comments on some of these Facebook posts, the horror of some of the views some people expound is impossible to ignore. Is this really how we want to represent ourselves? Is this really how we want to represent our profession? I have seen unprofessional behavior glorified, willful ignorance defended, and honest-to-goodness bigotry and hate spewed forth by the bucketful. It’s distressing and depressing. One of the worst things is that a lot of those who are new to our profession participate in these discussions where bad behavior is celebrated and held up as being “normal.” Are our profession’s newest and most impressionable members being indoctrinated into believing this kind of stuff? Are they going to go put it into practice out there on the streets?

If you swear in public or discuss patients in a less-than-flattering light with your partner while you’re sitting in a restaurant eating breakfast, you have the possibility of offending a handful of people and ruining their perception of EMTs and Paramedics. Even if you magnify that behavior over time, you’re probably only offending a few hundred or few thousand people. However, when you do it online on your social media profile that is plastered with every cheesy EMS slogan under the sun you have the opportunity to offend tens of thousands of people in minutes to hours.

People are quick to shout down people with my opinion. It’s not popular. In fact, on many an occasion where I’ve offered my opinion that perhaps people should tone their rhetoric down a bit I’ve been told that “I’ll never make it in this profession if I don’t develop a sense of humor” and that I’m just “butthurt” or some meaningless similar phrase. I assure you that my personal sense of self-worth and career progression have not been affected by this. I am quick to use humor as a defense mechanism to protect myself against the negative things we’re exposed to and I am very good with dark humor when it’s called for. I believe in the fact that once a person can laugh at something, they have mastered it.

What I do not support is carrying this to the extreme. Everything is a pendulum. EMS providers need compassion, respect, and honor to make it in this business just as much or more so than they need the ability to laugh through pain.

There are things that I take seriously, I am just not one of them. In over 15 years of full-time EMS that philosophy has not let me down.

When you’re in the public eye, every single thing you do shapes people’s perception of you. This is not fair. It is never going to be fair. However, it is true. When you’re behaving badly and you’re known to be an EMS provider you’re reflecting poorly upon all of us. You’re eroding the public’s trust of our service and you’re cheating people of their right to trust the people sworn to protect them.

Please think of that the next time you click “post.” All of us are in this together.

  • Midwest Medic

    I used to follow a handful of the EMS Facebook pages. I have also since un-followed all of them. Most of those people aren’t fit to represent any profession, let alone one that has a high level of public trust. The thing that finally turned me off entirely was when I would notice a good, solid response to a scenario or “what would you do” question shouted down in a wave of bad medicine and/or bad treatment of humans. I’ll take the wealth of informative blogs and Horton’s Facebook page (ambulance porn, yay!) and keep my name away from the glory boys.

  • Ambulance_Driver

    Well said, sir.

  • LadyMedic

    Very apropos.

  • Photofloozy

    You mentioned in this blog some time ago about the concept of “splashed sadness.” I think negativity can be “splashed” too, and when that happens, it certainly has a ripple effect, which, in the long run, ultimately brings *everyone* on the planet just a little bit lower. The importance of staying positive, even in the face of negativity, simply can not be stressed enough. Not sure I realized that till I met you. Thank you. That’s a lesson I needed to learn.

  • Much agreed, my friend. I might add that appearance goes right along with behavior. One of my biggest issues with many of us in EMS, is that we seem to not care about how we present ourselves to the public. It’s rather embarrassing at times. I have always felt that the law enforcement community sets a good example when it comes to professional appearance.

    I think if we are ever going to be recognized as professionals, we need to act and look like them. Unfortunately, I think we have a long way to go.

  • Mr618

    I agree 150%, and have said the same thing — albeit not as well — on various EMS blogs as well as on my own. If we are going to accept a paycheck from the taxpayers, either directly through Big City Fire/Rescue or indirectly through the Borg, even if it’s “nominal compensation” for gas, we are, in fact, public employees. It is incumbent upon us to act in a manner that reflects that responsibility. It nauseates me when I see some of the racist, bigoted spewing that passes for commentary. All one has to do is see the hysterical shrieking on so many of the fire/EMS blogs (and I mean generically, not the Fire/EMS group) denigrating African-Americans, lesbians, gays, Hispanics, etc. How in God’s name can we claim to be public safety professionals when our comments make it abundantly clear we’re somewhere to the right of George Wallace?!?

  • Christopher Updike

    I am happy to see this post, because it is something that you and I both know (at a former employer) existed on an enormous scale. One of the best ways I’ve learned to combat this is to get rid of employer affiliations all together unless you have a page specifically dedicated to your work career, and maintain the professional image you present. In the meantime, I will maintain my “CVA IT” license plate and keep the “patient-centered” chatter in house.

  • Mr618

    I think another thing that hurt EMS — at least in New England — was the cheating scandal a couple of years back, when something like 200 EMS “professionals” (mostly paramedics) had their licenses suspended for cheating on continuing education and recertification courses. These guys knowingly submitted false training records, indicating that they had attended classes that they did NOT, in fact, attend. One of these guys later posted on his blog that it annoyed him when EMS personnel complained about training. Umm, dud, if you’re going to complain about others’ training records, make sure YOURS are legit, m’kay?

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