The Midlife Medic: Your Mileage May Vary

I am not 50 years old, but I can see it from here. Despite my aching joints and the ridiculous amount of silver in my hair, I am not ashamed of my years and get a kick when my age and/or experience takes someone by surprise. Including all of my experience I have been in EMS for 30 years, most of that in a high-volume system in Newark, NJ. I have a round, relatively unlined Irish face and a talented colorist on retainer. In my off time I avoid all things uniform and can blend into the crowd at retail outlets or flea markets, depending on if I’m wearing the dressy yoga pants or not. It is easy to assume I am nobody of significance or experience. That is just fine with me.

EMS, like many other physical jobs, is considered a young person’s field. It is a tiring job that is physically and emotionally exhausting. Providers enter the field in far better shape than they leave it. Years of shift work, too little sleep, too much garbage food and spikes in adrenaline are a damaging combination. It is possible to counteract that by keeping in shape, but age is the great equalizer. We all erode, just at different rates.

People get into this field for a number of reasons. What happens when someone chooses EMS as a second career, or comes to it later in life? The same thing that happens to younger people—they go through the same training, frustrations and successes anyone else does. They may be starting their day with Motrin instead of orange juice, but they still get out the door. By the time they get to work they look just like you do, only older. With age comes wisdom, right?

Not quite. With age comes arthritis, but it does not offer a natural increase in critical thinking skills or the ability to perform prehospital medicine in a high-pressure environment.

Unfortunately because we often attribute experience to age, it is easy to overestimate the abilities of older providers and their patient contact time. We believe them to be stronger or more capable practitioners and expect them to perform at a standard above that of a novice provider. We assume they know more or have done more than they have, so we do not pressure them to learn or practice more.

Age makes a good force field. Generally the older you get, the easier it is to deflect assessments of your abilities. I had a terrible time getting evaluated back East. I would stand on the other side of a table from a young instructor and they would say, “You know this already. What could I possibly show you?” To be fair, in all likelihood I had taught them at some point so I can understand this.

When I took a position in Alaska earlier this year, I had a clean slate. Absolutely nobody knew me when I started. Although I had the mixed blessing of the fact that Alaska is a lot like Madagascar, it is isolated and cut off from the lower 48 so my background meant nothing.

In uniform I am no longer camouflaged. That singe of silver in my hair and the lines around my eyes say that maybe I’ve been around awhile. It means I have age; it does not mean I have experience. The fact that you’ve been doing this job for 20 years means you can read a schedule, not an EKG. A good clinician should be up to date and always refining their process. I learn so much from the younger medics every day. The curriculum today challenges me to revisit concepts and strategies that once provided the foundation of my practice. I spend a fair amount of time secretly Googling things they show me, peering down at the screen through my bifocals and hoping I can keep up with them.

The older provider brings maturity. They have a frame of reference and perspective that can be invaluable in facilitating the care of people in a broader generational range. We get their jokes, and can support a valuable argument when it comes to deciding just what qualifies as “classic rock.” What we need from younger providers is recognition that we have a lot to learn about this field too and not to assume that because we creak when we get out of the truck we know the answers to all questions. (Unless that question is about classic rock.)

People are surprised by my experience because I do not look my age. I can be equally surprised by your lack of experience; do not let me assume something when you need my help. Communication is the way to make sure everyone, including the patient, gets the most benefit out of our combined years of experience, EMS or otherwise.

Tracey Loscar, NRP, FP-C, is a battalion chief for Matanuska-Susitna (Mat-Su) Borough EMS in Wasilla, AK. Her adventures started on the East Coast, where she spent the last 27 years serving as a paramedic, educator and supervisor in Newark, NJ.  She is also a member of the EMS World editorial advisory board. Contact her at taloscar@gmail.com or www.taloscar.com.