An Interview With Steve Berry on the Role of Humor in EMS

“Laughter is the best medicine.” —Anonymous

“Humor is just another defense against the universe.” —Mel Brooks

If there is anything that EMS is well acquainted with, it’s stress. Providers are bombarded with stress from a multitude of sources. Besides the nature of the calls we respond to, our interactions with patients, patients’ families, coworkers, other emergency responders, supervisors and hospital staff can be fraught with conflict. Compound this situation with working long hours for low pay, in less- than-optimal working conditions at times, and it can seem like the non-jaded among us are the strange ones. Finding levity under these circumstances is a talent. But to be able to get the rest of us to step outside the moment and find humor in these truths about EMS is a gift.

For this month’s column, I spoke with Steve Berry, NREMT-P, a paramedic, educator and humorist who is regularly featured in a variety of EMS trade journals. Author of numerous columns and the cartoon book series I Am Not an Ambulance Driver (Volumes I–IX), Steve regularly shares his often-irreverent inside view of EMS through cartoons and personal commentary at national, state and local conferences. His presentations on the need for laughter in our day-to-day routines are funny, honest, thought-provoking and—most important—healing.

When did you start using cartoons to illustrate deeper points about the world of EMS?

I began playing—or should I say doodling—with cartoons in the late ’80s as a means of dealing with the daily stresses that are inherent in our profession. There was no initial intent to distribute or share them beyond our ambulance bay doors. But I quickly observed the impact they had on the crews, and discovered humor to be a powerful means of communication. The cartoon characters themselves (unknowingly modeled on those with whom I had worked) possessed the ability to safely express what we were all thinking but might hesitate to say. EMS was crying out for humor and I was just lucky enough to find a path to that doorway.

Your background as an educator includes a great deal of work with the hearing-impaired. Do you think that learning an alternative way to communicate enhanced your abilities as either an EMS provider or EMS humorist?

Most definitely—on both counts. Proficient communication skills are an essential part of an EMS provider’s job description, but, unfortunately, are rarely emphasized in our curricular training. The primary modes of communication for the hearing-impaired are dependent on sight, so the deaf are keenly aware of how we initially present ourselves on scene.

Initial perceptions are based on our professional dress, body language, gestures and facial expressions. This is true of our hearing patients also, but it’s my work with the deaf and hearing-impaired that has helped me to be sensitive to how I present myself visually within the first 15 seconds of meeting a patient. Visual gestures and sign language can also be incorporated when dealing with any patient who does not speak English, as well as with patients who have lost the ability for speech, due to head and neck trauma, stroke or any other reason.

As far as creating my EMS cartoon world, focusing on the sense of sight has been helpful there as well. Creating a drawing that works without words, communicating volumes regardless of the viewer’s culture or language, is the highest compliment I can receive as a cartoonist.

You have shared in your presentations that at one point in your EMS career you were “burnt out.” What caused you to “reconvert” and retrieve your positive outlook?

I hit rock bottom just after six years of being a paramedic. Regardless of what I had invested in EMS, the thrill was gone. My philosophy became “You call, we haul, that’s all.” But it’s funny how life gives you a teacher when you least expect it. For me it was a patient who went by the name of Wava Smith. It began as a standard transfer of a non-ambulatory cancer patient to her doctor. Little did I know that she would become my mentor and good friend for the next several years, until her death.

This fine lady told me on the day I met her, “People don’t care how much you know until they know how much you care.” It knocked me for a loop. Slowly, and with her guidance, I began to realize that EMS wasn’t about the tubes and IV lines—that there would never be enough good calls to feel good about myself. Her honesty was blunt and at times harsh (a painful pill to swallow for an arrogant paramedic like myself). But being terminal, Wava told me she had no time for games and would speak whatever was on her mind…and boy, did she. Bottom line, she told me to live like I was dying, and that I shouldn’t take my—or any other person’s—imperfections so seriously. Wava laughed a lot, too, and I desperately wanted to laugh again. Despite the heartache that EMS can bring, it is not in our nature to feel bad all the time. Wava forced me to dig back into the past for what I knew as a child—that with humor, I could survive anything.

Is it difficult to come up with new ideas month after month? What is your source of inspiration?

The key is to not force it. Humor is most often spontaneous and unplanned—just like our calls. I may not draw for days or weeks at a time, while other times I will lock myself away and scribble on for hours. Sometimes I have to force myself to say “no” to requests for cartoon work so I can refocus on why I started drawing to begin with—to ease stress, not create it.

The great thing about EMS is that it can create an arena full of cartoon material by its very nature. It’s all there to be borrowed. One just needs to keep an eye out for it. I come to work. Report the facts. Believe it or not, those trained in prehospital care are funny people. Add to this the unpredictability of our patients and you’ve got a perfect setup for comedy. Of course, sometimes just pulling the caps off the colored markers and taking a good whiff can be inspirational.

Is there any EMS-related topic you would not feel comfortable addressing in one of your illustrations?

It’s my hope that people realize I am not laughing at tragic events themselves, but rather, attempting to poke fun at situations EMS providers are often placed in. In spite of an emergent event, funny things will happen. Healthy humor does not have a victim; nor does it rejoice in the suffering of others. The safest kind of humor, I think, is when we laugh at ourselves, and that’s why I make myself the brunt of most of my cartoons. Though some believe when it comes to humor nothing is sacred, I find one situation I will never approach from a cartoon perspective is the harming of a child by an adult.

How important do you feel humor is in assisting EMS providers in coping with cumulative stress from situations we encounter?

Numerous studies support the use of humor during stressful events—everything from the physiological benefit of lowering one’s blood pressure and heart rate to acting as a psychological buffer during tragic events. For us, it can be a great bonding tool; it has a tendency to put things in perspective and allows us not to take our imperfections too seriously. Simply put, “When we feel good, we tend to do good.”

Sometimes we laugh out loud—warning: Watch out for the accidental audience—but most of the time it’s an inner chuckle that tells us: We will get through this. This is an important coping mechanism, allowing us to prepare for the next call, which may be only minutes away. Those outside emergency medicine will probably never understand or appreciate the value of this kind of gallows humor, but you know, that’s okay. It belongs to us and it’s our own private means of communication. As one medic put it, “It keeps me sane in an insane place.”

I would add that this kind of humor must be “earned and learned” by those entering the field. Many tears may have to be shed before this kind of humor can be appreciated and integrated. There is a balance, and laughing does not negate the need for crying. Not everything is a joke. Timing is everything. Most important, one should not apologize for their tears. It’s proof that you’re emotionally alive, and not just in it for the tubes and IVs.

Steve Berry will be presenting the Closing Keynote at EMS EXPO 2005, scheduled for August 23–27 in New Orleans, LA. For more information, call toll-free 877/EMS-EXPO, or visit www.emsmagazine.com.