When Johnny Met Rosie--Women in EMS Part 7: Parenting from the Abyss

This month's offering is not truly gender-inclined, but has to do with EMS providers as parents. Since everyone has a mom, I think it qualifies as a topic that women in EMS can relate to.

I recently had the privilege of speaking at the Kansas EMSC Symposium. It was a great opportunity that allowed me to visit a part of the country I had never seen before, and I met some absolutely fantastic people who believe very strongly in what they do and the quality that goes into how they do it. When they contacted me about the opportunity, I was asked to prepare three topics. The third topic caught me off-guard: Do EMS parents overprotect their children based on the nature of their personal experience in their career choice?

Basically I was being asked to explain how our jobs might cause us to bubble wrap our children to prevent them from being exposed to risk because of things we deal with in our jobs. Truthfully, it does make sense. Considering the average EMS provider in his or her career sees a true range of the worst life and disease has to offer, it is not such a stretch to think we would reflexively work that much harder to protect those closest to our hearts. Considering that I have four children, and they're all still alive--despite their best attempts to the contrary--I sat back and evaluated what I permit as far as risk goes.

It became very clear in short order that I was the wrong person to ask about this.

Parenting Research Begins

Many people like to joke about being the "Addams Family," but I have yet to meet one that truly meets that bar...except for mine. There is a full-sized replica of Blackbeard's flag flying from my garage and a 10' quarantine sign becomes visible when the door goes up. My children can explain the mechanics of a trebuchet and even my five-year old girl wields a small battleaxe with some measure of expertise. Heck, over the summer, my stepson took first place in a tomahawk-throwing competition at a black powder festival in Alaska. We have multi-generational aficionados of the zombie genre and our version of a fun family trip usually involves a ghost tour. We are "that house"--you know the one I mean, every neighborhood has one.

Afraid to use myself as a fair parameter, I began to research parenting from an EMS perspective. I found there is very little out there (i.e., practically none) about issues that have to do with having an emergency provider as a parent, and if there is any difference in how they treat their children. Perhaps it just isn't a subject considered to have any long-term value or impact, or perhaps as a young profession nobody has gotten around to it. Regardless of cause, it makes it difficult to try and assign any real data boundaries to the subject.

So I hit the beat and began asking questions. I went in person, talked on the phone, sent texts--to almost all EMS, with some firefighters and police for sprinkled in for good measure--all asking the same thing. "Do you overprotect your children?" The answers all followed a similar vein and were almost completely unanimous: no.

Again I was taken by surprised. I honestly expected a little bit of a mix in responses--from those who believe in a Darwinian approach straight through to those who might construct a germ-free, rated-G environment with an almost fanatic quality. But the answers remained the same, or similar. As far as EMS parents went, they did not feel they went to any extremes beyond other parents when it came to protecting their children. However, when you looked at everyone's response, I did notice a few trends I feel were unique to us as parents.

Taking the Familiar in Stride

It isn't so much what we protect our children from, but rather what it is we are actually afraid of that sets us apart from "normal" parents.

There may be no image as more heartrending than that of a seriously ill or injured child. Parents who view one immediately call to mind images of their own children, a natural fear that blossoms in the pit of their stomach as surely as if someone punched them. It is, of course, a fear for any parent that their child might succumb to a disease or get seriously injured, but it is not the greatest fear.

On the whole, EMS parents do not "freak out" over illness or injury. In fact, they may even seem to take additional measures to play it down so it doesn't develop into an "emergency" they may feel is of unwarranted proportions. I know of very few EMS parents would willingly enter the 911 system from the wrong end, so to speak. The only caveat to this, by the way, is that they have to be around at the onset. When the parent is not present at the onset, woe unto thee who blocks the way between the EMS parent and finding out what happened.

Why is that? The medical arena is a mystery to most people. It is a world filled with harsh lights, indecipherable acronyms, unfamiliar words and anonymous practitioners in scrubs. They must invest a little blind faith that the person taking care of their child will do the right thing, at the right time, and that they have the best experience or skill to do that job. Therefore illness or injury, especially when it requires intervention, can become a confusing and frightening ordeal for both the child and parent.

EMS parents, however, navigate that world with relative ease. In an area where most folks have little or no control over outcome, we have our niche. You do not last in this field without being a little bit of a control freak. Nowhere is this more obvious than as patients, or as a patient's parent or spouse. We don't hold as much fear because we can follow along. Physicians and nurses can speak "medical" to us and we will understand when things are, or are not, going well. Illness and injury, while scary, are things we foolishly feel we have some measure of control over, thus it is not as frightening to us.

My children will be the first to tell you unless they are febrile enough to perhaps seize, they are going to school. Yes, my stepdaughter had to go to her dance recital with a freshly broken arm since her legs were fine! We monitor what they eat and they see doctors regularly, but we are not going to prevent them from being children. And children are filthy, dirty little creatures who need to explore the world around them.

Which leads to another trend I noticed with EMS parents: participating in risk behaviors. Quite the opposite of bubble wrap, most parents I spoke with had no trouble allowing their children to engage in traditional high-risk activities. One paramedic was telling me how proud he was of his twin boys for skiing black diamond (one a double) on their recent vacation. They are seven years old.

Considering what we see in our career, one might think we'd go the opposite direction and discourage them from doing high-risk activities, but we don't. What we DO do, however, is be absolutely implacable about safety precautions. Helmets are non-negotiable. Every necessary pad or precaution is put into place, and on the whole, we are darn sure we haven't skipped anything before letting them "run along and play."

The Greatest Fear

So, other than the fact we're not as easy to upset by illness or injury, and we're more likely to let our kids have a piranha instead of a goldfish, were there any other notable differences? Yes, there was one thing that stood out as universal. Again, it is something every parent fears, but I found that fear to be much more profoundly displayed by EMS providers: stranger danger--the fear of abduction or harm to our children by a person unknown to them or us.

When polled, this is what respondents indicated was the biggest cause of fear, anxiety and/or humorous anecdotes of accidental assaults on hapless Disney store employees. As more and more people reported this, I gave it some serious thought and I have to agree. If my children are not in full view of me at a public venue pretty much at all times, I suffer from escalating levels of anxiety. Given that most of my panic muscles have long since atrophied, the amount of anxiety is quite significant. Parent after parent reported similar responses about how they scan the crowds to look for out-of-place people, about how one will walk a step or two behind their spouse and children to look and see who is looking at the children. It was almost frightening listening to how intense some people were about protecting their children from strangers. This is where, after all the people I talked to, you can see where the impact of our jobs comes into play as parents.

One of the inherent risks of working in EMS is that you not only see the worst of the illness, but you see the worst of what people can do to one another. Even if you do not work in a high-volume system, if you do this long enough you will eventually bear witness to the "evil that men do." You will have to care for the wounded and show compassion to casualties and perpetrators alike. See it or hear it enough times and eventually your perspective shifts, whether you realize it or not.

Friedrich Nietzsche said: "He who fights with monsters might take care lest he thereby become a monster. And if you gaze for long into an abyss, the abyss gazes also into you." Many of us spend the better part of a lifetime working in the abyss. Eventually we think everyone else lives there, too.

And we'll be damned if we let anyone else from there near our kids.

The Advantages of EMS Parents

It's not all doom and gloom though. There are definitely some advantages to having us as parents. Children of emergency service providers tend to be less intimidated by the process or the figures involved. Yes, children love a shiny truck with lights, but when it comes to a crisis, at the end of the day they are kids, and will likely be frightened and often just as afraid of those same shiny trucks and the people manning them. However, EMS children have exposure from an, often frighteningly, early age to the big trucks with the bright lights, uniforms, badges and squawking radios. It makes them friendly, not strange and mysterious.

We tend to prepare our children a little more thoroughly. I know at my home, and with many of my friends, 9-1-1 is a rehearsed procedure. From the time they could repeat it back, kids learned their names, addresses and phone numbers. We practice calling 9-1-1 like the script from a play. It is a hopeful attempt that, should they ever have to do it, they will at least be able to get through the first couple of minutes, just enough to be able to call for help. I cannot tell you how many children I've picked up older than my own who could not tell me simply where they live.

Then there are the learned behaviors. If we accept the fact that due to our chosen profession we are in many ways not wired normally, it is not a stretch to say our children will inevitably pick up on at least some of those behaviors. Several years ago, a small fire broke out in our oven. My stepdaughter, who was eight years old at the time, became very upset and started to cry. Calmly her father and I explained to her how panic doesn't help anyone, and we went on to explain how we were going to put out the fire. We did so while we were having the conversation. Fast forward several months and during a summer get-together it happens again. Food dripped down and ignited in the base of our oven. As we all went to the kitchen, my firefighter guests vented the room and there was a buzz of activity. In the middle of it all, in strolls my stepdaughter. She looks at the fire, looks at my guests and says, "Close the door silly. It will deprive it of oxygen and put itself out." She then walked back outside to play in the sprinklers without a backward glance. My neighbors just stared after her and then stared at us.

The abyss exists. Nobody knows that better than the people who must navigate it on a daily basis. However, we do not have to remain there. My children are my lifeline out of it. When I am surrounded by sickness, neglect, violence or otherwise tragic events, I look to them to remember there are better people and better days out there. My only hope is they are surrounded by both, and I will do what I can to ensure that.

Until next time, signing off from the edge of the abyss.

Tracey A. Loscar, NREMT-P, is the training supervisor in charge of QA at University Hospital EMS in Newark, NJ. She is also a featured speaker at the 2011 EMS World Expo, scheduled for August 31-September 2 in Las Vegas, NV. For more information, visit www.emsworldexpo.com. Contact Tracey at taloscar@gmail.com.

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