This Isn’t What I Signed Up For, But It’s What I Do

There’s a clarity that comes from being kicked in the mouth; an alertness and awakening that not even the strongest stimulant can rival.

As her foot connected with my jaw, it’s like time slowed down and I gained the ability to look back at all of my choices and wonder how exactly I ended up here.

This isn’t what I signed up for.

I signed up to put out fires. I became a fireman to crawl through the heat and the darkness of a burning building, not to change smoke detector batteries at 3 a.m.

I signed up to save lives. I became a paramedic to restart hearts and stop bleeding, not to watch children die and chronic drug users walk away unscathed yet again.

I signed up for the brotherhood and camaraderie, not to bond over our shared trauma or to sit down as a crew and fill out exposure paperwork for the fentanyl smoke we accidentally inhaled together.

I signed up to make a difference, to be the calm in the storm, to make my family proud. Instead I struggle to turn off the hyper vigilance. I struggle with coming home after a long shift and to be present with my loved ones. I’m distant and short with my family; their problems feel small compared to the things I witness on a daily basis, things no man should have to witness.

I have these thoughts and more as time begins to speed back up. I react quickly to the foot touching my chin—I grab her leg under one arm, and press her face against the cot with the other.

This isn’t what I signed up for. I didn’t sign up to fight the people that society has left behind, the ones who require the kind of help that 911 can’t provide. The kind of help that a broken system has failed to give them.

Graduating paramedic school and the fire academy makes you feel like a hero. Your head is full of hopes and dreams of cutting injured drivers from their cars and delivering happy and healthy babies in living rooms. It’s a propaganda designed to mask what the job is really like. The job truly exists to clean up society’s mess. To deal with the problems that the average person is unwilling or unable to figure out on their own. The opportunity to make a true difference is few and far between.

This was supposed to be a routine call. A well intentioned bystander noticed a woman down in an alley and called 911 before driving off. They never stop to check on their fellow man themselves. Like most transients we encounter, she was intoxicated. Common sense says leave her alone; she’s not bothering anyone. But local protocols and rules say you can’t be unattended if you can’t prove competence.

Through her slurred speech she couldn’t even recall her name, let alone argue her case to be left alone. Just a routine ride to the hospital, a safe place for her to sleep it off without the danger of stumbling into an oncoming car.

She was cooperative enough as we gathered her belongings and sat her on our cot, even laughing once in a while at jokes we made. All was well and good, until it wasn’t.

At some point, something changed. Maybe the bright ambulance lights killed her buzz, maybe the under maintained shocks jostled her too much. Whatever the reasons, she decided it was time to fight.

It started with yelling—yelling that claimed we violated her medical rights—an incorrect fact that could have been explained to a sober and competent person. But if she was a sober and competent person we wouldn’t be here now, would we?

No amount of verbal de-escalation, a polite form of mental manipulation, could stop what came next. First was a swing of the fist in the direction of my nose; this I quickly blocked. With a well-practiced motion, honed on many a combative patient, I pinned her wrist and began to restrain her arm.

My student (yes, over the years I had somehow become an example to the next generation of firefighters and medics) did his part to restrain her other arm. His eyes wide, a quiver in his voice, he asked what’s next. What medication do we give? Do we need more help back here?

Her legs, I say, with the calm of someone who’s been here a million times. Too many times. Restrain her legs, then we’ll talk about medication.

This is when the foot comes. It comes fast, and seemingly from out of nowhere. It comes over her shoulder and hits me where I stand behind the stretcher, like a soccer player kicking a dramatic winning goal over their head. I taste blood as I grab her leg, pinning it under my arm, pressing her face to the cot with the other. She screams like a trapped animal. As I expected, she begins to spit; they always spit. Her head is pressed to the side, her spit flying harmlessly into a cabinet. She screams about being attacked, as if her unprovoked assault on me hadn’t started the whole ordeal. She screams about how she needs help, and I calmly agree with her.

My jaw aches as I tell the hospital our tale. She continues to scream, her cries ignored by the nurses and doctors as they devise a sedation plan. They know her; this is a regular visit, and not the last they’ll have together.

My student stands in the corner, frozen. The thousand-yard stare tells me he too is questioning his choices.

This isn’t what I signed up for, but it’s what I do. It’s what I do because it needs to be done. Somebody needs to get kicked in the mouth so that you can go about your day, blissfully ignorant that outside of your safe and familiar life there exists a whole dirty world that you know nothing about.

This isn’t what I signed up for, but it’s what you need me to do.