My head and chest are pounding. The pressure is rising, gathering. Stalwart tears refuse to fall. Something is wrong. I think I’m healing. And I’m scared.
He died four years ago, and now I’m home once again. I want to slow down. I feel love, steady and unwavering, from her. It doesn’t make sense, but it feels right.
The frozen grass crunched beneath my boots this morning. The sun was rising; the air was cool. The sunrise guided me to work pink and blue.
I tried to push you away, trying to protect what’s inside something fragile, something mean and only partially tamed. Begging for a collar but still biting the hand. Fur matted with dirt and frost, longing for the warmth of a companion.
I am spinning, intoxicated by the unknown. It’s an intimate waltz. I’m waiting for the lights to come back on, yet I want to be present for the dance, too. Why is it so hard to hold your hands and sway in the moment?
The mountains and rivers are stored in a small chest inside me. The smell of wet sage after high desert rain. The crystal blue river compared to the cedar water of home. The people, the culture, the silence. The lonely exile that brought us here to experience life together.
I listened to Survival of the Fittest while reading A Thousand Naked Strangers.
Earlier that afternoon, I left home and watched the clouds descend over the hillside, wisps of cotton at first, then something more alive, like an ancient beast clawing its way downward to claim the trees and sagebrush.
I leave for Italy in a week. A small break from the chaos. I wondered how it might change me. Lately, I’ve been consumed by work, the endless motion, the calls, the quiet moments between. People die around the city as I look on from my rig, radio humming in the background. I wait for word from the job I interviewed for, more medicine, more miles, more pines. Back to where I was born.
Is there a story here? Maybe it starts with this: paramedics are human first.
To understand what it’s like to be one, I share how I try to stay that way.
Not every day is life or death. So far, we’re four hours in. A little old lady in A-fib RVR, nothing to call home about, heart running 140 but pressure’s solid, mind sharp. She jokes about her Chicago days, we reminisce about the arboretum. I start an IV and hang a bag of what some like to call “isotonic crystalloid.” I hate that term. Just call it saline. Or NS. We’re blue collar, man.
Outside, the clouds finally give in and spit on the high desert. Rain. Rare here. The air cools. The day moves on…
She screamed at me over the top of her husband’s body. Fresh. Freshly dead, freshly placed on hospice. No DNR. “Don’t look at me like that!” she yelled.
Well, what look was I supposed to have? You just handed me a terrible situation. I don’t want to do CPR. You don’t want me to do CPR. Even the ghost of your husband doesn’t want me to do CPR.
I can’t remember exactly what I thought, just that her tone hit me like a slap. All her frustration, her anger, her grief, they landed on me. For a moment, I was everything wrong in her world.
Fuck you.
I was trying to preserve this man’s dignity. Maybe I hesitated, maybe I stared half a second too long, trying to weigh my responsibility and the next step. And this was the reaction. Her pain erupting into mine. Have your grief. Have your trauma. Have your life. But why did you have to throw it all at me? I just showed up because you called…
You ever been so focused you want to cry? So in tune with yourself that you finally start to think? EMS makes that kind of reflection hard. If I focus inward too long, I start to feel the weight of it all. If I don’t, if I just drift through shifts without that internal mirror, life feels manageable, at least for a while.
But how do you choose the long term when the present is pain?
I have pain I ignore, deny, and fear.
He asked me once, “How do you do it? How do you keep showing up?”
This was after his first arrest. He’d gotten the IO, done compressions, achieved ROSC. We used the CareVent and prepped a presser to keep the demons at bay.
Pressors constrict the veins, think of a garden hose as a kid. It dribbles at first, but press your thumb over the spout and it becomes a weapon, something powerful, something desperate…
I crave the sirens.
This could be my last week on the ambulance for a while. The past year and my change as a medic, a human, is closing out. So is my time on the West Coast.
Love, dates, Cass, walks to Idlewild. The dog, Boonie Guy, or as I call him, Mister Brown. Happiness, connection, self-discovery.
And fear. Especially the fear of confrontation.
The radio crackles. Call comes in. Lost the thought. Lift assist…
Code 50. Sixteenth floor of the casino.
She died in bed. The room was tidy, just a med or two on the nightstand. From the window, we could see the pool below, the shimmer of summer. Swimmers laughing, floating, alive. David and I watched for a moment before remembering why we were there.
It was a welfare check. Big room. I learned that these suites are usually reserved for the high rollers, people who win just enough to forget what losing feels like.
Then, maybe her daughter called. Or a friend. Hard to say now.
Anyway.
King-sized bed. Her body rotting quietly under the covers. We’d already called time of death. The scene was calm, almost peaceful.
Then her phone started ringing.
And it didn’t stop.
Endless ringing.
It sat there on the bedside table, buzzing with a steady pulse that felt wrong. I thought about answering it. Talked to security, my supervisor. We all agreed to wait for verification.
So we stood there, friends in a suite overlooking the pool, studying the marble bathroom, the clean sheets, the view. The phone kept ringing. Someone on the other end knowing, but not knowing.
We were cradled in death, and all they wanted was to hear her voice.
How do you capture the essence of EMS, of paramedicine? When it lives in moments no one sees? In the silence after a call. In the ringing phone beside the dead. In the laughter between runs, the rain on the windshield, the ache that follows you home.
The human parts we carry, and the ones we leave behind.
I spoke with Mike the other day about my grandfather, about how I still don’t really know how to grieve with him gone. He watched me grow up, always believed I’d amount to something, that I’d find my way. I started my career in EMS, and a year later he was gone. I cried after earning my Firefighter I and wished he could’ve been there for my paramedic graduation. I just wanted to share those moments with him. But I couldn’t. I couldn’t hold his hand or hear his voice anymore.
I made my first friends in Reno after a plane crash. I remember sitting in the Whitney Peak, for a new friend I barely knew, but who somehow made an impact. I sat there watching all the love he cultivated with the friends he had. I told myself that moving forward, I wanted to live like him, to find the courage to find friendships like that too.
Now, talking with Mike, I’ve realized something, even though I don’t have my grandfather anymore, and even though distance will soon separate me from the friends I made here, I don’t need to be sad.
How lucky am I to have people worth grieving over? How lucky am I to have tears to shed in the first place?
I wouldn’t trade the heartache for anything.
I think life is measured by the times you laugh so hard you cry, surrounded by the people who make it all worthwhile.
I’m not ready to say “see you later,” but every autumn, the leaves keep falling, and life keeps moving.
So thank you to everyone in Reno who mattered to me. Who made life a little easier when it felt impossibly hard. For the tough calls, the solid support, the cheap beers, the birthdays, the river days. All of it.
I love you guys and I’ll be back soon. I just have something I need to do in the meantime.
Love you, Poppop. There will always be more moments I wish I could share with you. But how lucky am I to have had you at all. To have someone who made life feel so full in the first place.
A part of me has always lived within this house, quiet, untouched, waiting to be renewed.
No more goodbyes.
Weekend football games, ear piercings at the mall, the echoes of laughter and hide-and-seek drifting through these rooms.
The dogs are muddy again, and their hair clings to my jacket. The wool catches every strand, like a reminder of how I’ve missed these small, ordinary days, missed growing older alongside you all.
How grateful I am that I no longer have to say goodbye after a few short days. I still have the letters, sent from your mother, spanning birthdays and baptisms, kept safe, never thrown away.
Just waiting. Ephemera. Waiting for this moment, to be here, not watching from a distance.
Homecoming. Week one. And here I am, finding my way back, piece by piece.
Catharsis and purification. Themes that keep me healthy. Resilience isn’t just taking a hit and forcing forward. True resilience lives in the prevention of being weighed down. We don’t just wear our waders; we patch the holes, store them right, and check them often so they’re ready when we bushwhack through bramble and thorns.
I pulled the stretcher with your body. Crushed. Protocols carried you to the hospital. I never saw your face, but I heard it was full of blood and broken teeth. I wiped your blood from the stretcher, detailing the railings like a man spot-cleaning his car. Fresh sheet, another patient. Your friends waited in the bay, asking if you were alive. Was the motorcycle worth this?
It’s the small things that make life worth waking up tomorrow: beers and breakfast, church in a cheap bar, laughter and bullshit. Being human. Connected with humans. In a world that often doesn’t feel human at all.
You ask how the job is crazy. I ask how to keep my humanity within it.
The small moments my life is grounded in them. Our lives are grounded in them.
I keep wondering about the meaning of it all. Not whether life holds inherent meaning I don’t know if it does.
And.
We, as humans, cultivate meaning to live vividly, vulnerably. It’s not a requirement, I won’t judge what gets you through the day-to-day. But for me I want meaning. I want to wash myself anew in it.
Maybe it’s coping. Maybe it’s survival. Maybe it’s my scream into the void that my life is worth something, if not for someone else, then for me.
This job can be challenging, surreal, dark and gorgeous. I write this in a time of struggle. Life is tension, as it goes.
And in that tension in the blood, the bones, the devastation of cancer, the old COPD’r who pulls Poppop back to me. The young girl who remembered my name during my initial assessment, her voice reaching for me again, asking if I was still there, grasping for something steady.
There’s a profound quietness.
In the chaos, the wailing siren, the deep sorrow, the small moments of hope, whether real or simply comforting the quietness is beautiful.
Two choices in my mind, in my mind. Devastation, or bloom.
I am exactly where I should be.
We hiked Lassen, where wildfires are as natural as wildflowers rising from ash. We watched butterflies drift through the trees, like coffee pouring through a filter. You know the smell the fresher the coffee, the larger the bloom.
Do we allow sorrow to wallow, to overwhelm, to sink us to the depths of cursing humanity? I rage against that thought. No. I say no.
To blossom to recognize the pull of sadness, and lean into the growth that tragedy offers.
I think of the child. The death map. Does it define me? No. It is part of me.
I am exactly where I should be. This journey is mine alone. Each day is its own. We are not required to “move on” from tragedy. We are human, and sadness is not the enemy it is part of our experience.
Two choices. Devastation, or bloom.
I choose to bloom. To accept the growth cultivated, the resilience drawn upon, layered and added to. If such horror can exist, so too can such beauty.
On earth, we are briefly gorgeous. What a thought.
The hunger gnaws. The insecurity swallows. Play explodes in, out, in, out imperfect, off-tempo. Fade. Rage against the fade.
Remember. Explore. Transcend from belief into conviction.
See-saw. It hurts, and it heals.
We find others who motivate, who remind us of our why, and how it adapts.
Vulnerability. Share it. Hold tight to our core wounds, find those worthy of navigating the storm. Warm arms to comfort us. The rain pours, then the sun shines.
Impact small influences that ripple outward, quiet and profound.
Insanity. How do you cope? I answer, honestly: “I do not know.”
Your peaceful death is rare. I come home to the dog and lie on the floor, sink into his fur and drool. Warmth.
“What could have been” repeats. Heartbreak becomes routine, another memory filed under work.
I am myself, but also just another passerby bringing forth news of the end.
Sometimes you’re on the phone a state away. Sometimes you’re already in the house, on the couch, holding their mother as she folds into herself on the floor; or you’re the first one out the door, asking if we can help you help yourself, the one who called.
I’m in the parking lot, talking with coworkers about “infinities.” I showed up tired. You woke up expecting normal.
False angel. Angel of death. Inside me, just a child trying to maintain my innocence.
Will your death be peaceful today?
Trout, hidden in the river somewhere. Boy on the asphalt, missing the cedars somewhere. Couch with blood on the floor, unknown problem man down somewhere.
Dead in the bathroom, back room, casino. Lost at first sight, no chance, as I cut their pants. Arguing chaos quickly controlled, bystanders watching from within the bathroom stalls. A spectacle, zoo, on stage once again. Once again, another, under 30, couldn’t save them.
Trauma leaves thoughts unfinished. Stuck. Hiding. Why can’t I tap in? One day it overwhelms, takes over. At the award dinner: “You did a good job watching them die.”
This work is both privilege and perspective. Imperfect, yet striving for finding grace, self-validation, trying our best. Trying to be better, to find peace, to welcome more joy. Tears of connection remind me we’re moving in the right direction.
Fishing teaches me: to catch a trout we study ecology, play with entomology, apply knowledge to water. In play, we learn stewardship, the responsibility of conservation.
I fished mountain streams with trout hidden in pools. Feasting on the seams where their food flies by and my spirituality is born.
Bass fishing carries tradition. Generations chasing the strike. My heart aches, past and present, but the river whispers: let your indicator drift; surrender to nature’s mercy.
Where to go, where to be? Questions circling endlessly. Control and release blur together. Do we ever control a bent rod, or merely influence the fight toward shore?
Hard work, burnout, exhaustion. Coping with old trauma while new pain buries it deeper. Alcohol is a broken crutch. It strains the body further. Create movement: get outside, keep going. Yet the hardest part is always the first step, putting on our shoes and walking forward.
Skull cracked against the asphalt as onlookers look on through their cell phone camera lens. They record lost movies of lost souls made by selfish people watching selfish acts Blood and brain matter. Bloody tears streaming from your eyes.
Death Maps 