EMS Things I Wish I Didn’t Know by John McKay, the Paramedic-Firefighter I spent a bit over 25 years in or directly adjacent to EMS, and another 10 as an EMS Chaplain. I learned a lot over that fairly long career, but what keeps me awake at 3:00AM these days isn’t all the things I learned, but the things I wish that I didn’t know that I learned along the way. I wish I didn’t know how the tone and pitch of a dispatcher’s voice was a big clue as to how terrible the call was going to be. I wish that I didn’t know that people who never worked in emergency response really don’t want to know “the worst thing I have ever seen.” I wish that I didn’t know just how loud and high pitched badly burned patients can scream, and how the deep silence of a severely injured child is so very much worse. I wish that I didn’t know what the screams of a mother finding her son dead by suicide sounded like. I wish that I didn’t know why a minorly injured person was sobbing so heartbreakingly in the back of my ambulance while I was checking them out, and how so many other people also walk around with such heavy loads that they cannot allow themselves to grieve over. I wish that I didn’t know what a forgotten street person smelled like when they were found two weeks after they died, alone, in a nasty, trash filled basement. I wish that I didn’t know that almost everyone gets very quiet and downright peaceful right before they die. There was never any of the highly dramatic screaming and crying and begging you see in the movies in any of the ones I attended. I wish I did not know what some women do to their own babies when they decided they didn’t want to be a mother anymore. I wish that I did not know what it felt like to watch a person bleeding out and not be able to get to them. I wish that I didn’t know so many random family details, from patients who had literally no one else to talk to. I wish that I didn’t know exactly how many people I realized were taking their last ambulance ride, and who would be gone by the time I went on shift again. I wish I didn’t know how consistently I would be told of horrific parental abuse by prostitutes and strippers, in invariably monotone, flat voices, when they felt the need to unload their trauma on me in the back of ambulances. I wish that I didn’t know how tightly wound too many EMT’s and Paramedics are, every day, every shift, who keep doing it only because they are the ones who still can. I wish I didn’t know what it felt like to wake up the next morning on a bench seat of our favorite “choir practice” bar, after decompression from the last shift took more time and alcohol than usual. I wish that I didn’t know the look of absolute, sheer horror one specific young girl had from being too close to a particularly gory public suicide, before her equally horrified mother could whisk her away from the scene. I wish that I didn’t know incredibly different a city is at night from the way most people see it in the daytime. I wish that I didn’t associate so many streets, intersections, and addresses with terrible things that had happened there. I wish that I did not know how essential black humor is in simply surviving shift after shift of horrible and terrible things. I wish that I did not know how triggering so many entertainment movies and TV shows can be. I wish that I did not know how terribly thin the veneer of civilization we live in truly is. I wish that I did not know how utterly futile it was to promise someone that they would not die. I wish that I did not feel so ashamed of the reasons I went into EMS to begin with, and how hard those feelings died away. I wish that I did not know how much worse the psychological pain of being stabbed in an attack hurts than the wound itself. I wish that I did not know and understand why so many Firefighter’s, EMT’s, and Paramedics turn to suicide to escape the demons. I really wish that I did not know that there are things, many things, that are far worse than death.