BDNH Storytelling Project: Rural EMT Worker
A Zine and Audio Story
Storyteller: Anonymous
Zine Art and Design: Kruttika Susarla
In this story, a rural EMT worker handles a rapidly escalating situation between a patient and medics, centering patient care and cultural competency.
This story is part of the Beyond Do No Harm Network’s Storytelling Media Project, which seeks to highlight and amplify the actions individual medical providers are already taking to interrupt criminalization in the context of care, in the hopes of increasing awareness of the harmful impacts of criminalization within the medical system and inspiring others to take action at multiple levels.
Check out the zine, audio, and audio transcript below!
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Rural EMT: Anonymous
I’ve been an EMT with a small rural EMS department for almost five years. Pretty much all the folks I work with are good people who genuinely want to serve our community & provide good care for folks. It’s in the nature of EMS, however, that we operate alongside police departments, and some of that culture is also present in our department. By that culture, I mean uniforms and power; military hierarchy in the form of protocols and chain of command; and a streak of good ol’ boy camaraderie.
Recently we were paged out to an unclear emergency: someone seemed to be having a mental-health crisis, or possibly a heart problem, and “law” was sent to clear the scene for EMS. We staged nearby, and once given the all-clear by the cops, approached the patient — a Latinx woman in her early 20’s who seemed distraught. (Our team — cops & EMS — was all white, and, except for me, all cis men.) We asked for permission to treat her, and she said “yeah, who cares, do whatever you want,” and climbed into the ambulance. Inside, it was me, another EMT, and a substitute paramedic I didn’t really know. The cops were visible standing around just outside. The patient, instead of lying down on the gurney, was moving around a bit, which was clearly making the medic nervous.
The EMT taking notes asked the patient her name. She had a slightly uncommon name, and said it with obvious pride. I paid total attention, picked it up, and used it constantly and with respect, which she clearly appreciated. But my co-workers kept getting it wrong, and asking her to repeat it, which agitated her — she leaned over to the white board where we write down our restock list, grabbed the marker, and scribbled her name across the board while angrily spelling it out loud. The medic was obviously afraid of her. He started giving her orders, and the tension in the tiny space started to escalate fast. “You’re not in charge here, I am” — stuff like that. He demanded she put back the marker, she threw it, and then the medic started threatening to have her arrested.
At this point I focused both on trying to maintain my connection with the patient, while also attempting to get the medic (the fuck) out of the ambulance. He kept making threats, while slowly moving toward the door; she waved her hand dismissively at him; and in the small space I was very concerned that her hand would graze him, and that would be it — the cops would pile in, she’d get assault charges, etc. So I positioned my body as best I could between them until he was at last out the door.
After that it was much easier to engage. I could see that she was moving around, naming what she saw out the window, and doing other things in order to calm herself, so I didn’t intervene. I tried out a bit of light touch, which she allowed, so I checked her pulse manually and asked her some questions about what was going on. I didn’t rush her, or push too hard to get my questions answered. We built a bit of a connection, and she shared hints of just having lost her job, and some childhood abuse feeling very present, and being afraid of how her heart felt. We agreed that there’s no clear line between having a medical problem and just trying to be okay in the face of multiple traumatic experiences and memories. The EMS lieutenant poked his head in several times, to hurry us along, but I calmly resisted his pressure. Luckily the EMT in the rig with me was cool enough to stay quiet and take notes. I sat with her. She let me check her glucose and other vital signs to see what we could rule out; eventually she decided to take herself to the hospital to get checked out. She hugged me and then leaped out the back door and took off.
When the call ended, I was suddenly exhausted. Why should it be so difficult, and potentially dangerous, for someone in crisis to get the support they need? Why is it structurally normalized that the person escalating the situation is often also the person with the most power? A person in crisis needs to be met with warmth and care, not threats.
Instead of allocating resources toward punitive methods of coercion, strengthening networks of care rooted in a life-affirming value system can actually meet our basic needs for connection and safety. While we move toward these broader social transformations, those of us on the front lines of care can simultaneously create small support networks in our daily work. As we grow our daily skills around de-escalation, develop practices to check our own triggers, ground in a harm reduction framework that respects the autonomy of our patients, and lovingly challenge our co-workers to do the same, together we are building into a world in which we provide each other with the best chances to thrive.
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Kruttika Susarla is an illustrator and cartoonist from Andhra Pradesh, India. Her practice ranges from making comics about dogs, crows, and leeches to side hustling in the gig economy to making picture books and designing books and toolkits for community-based organisations and advocacy groups. Learn more about Kruttika and explore her work here.
