Around the middle of 2004 I found myself sitting at a desk in a huge hall with about five hundred other people. They fidgeted and sweated and nervously chatted amongst themselves. I tried not to get sucked in, but I was nervous too. You see, it was the first of several rounds of testing that I had to undergo to be employed as a paramedic.
The three-part exam was unsurprising. There was a maths component, an English-language literacy component, and a short essay. I was told that the essay was designed to test my ability write coherently, but the topic suggested that there was more to it: “Why do you want to be a paramedic?”
I knew what I was meant to say – I was meant to bang on about how I wanted to help people or something to that effect, and so away I went. I wrote three pages on healing the sick, comforting the wounded, and generally being Nightingale-esque. It was a little cynical, but it got me the job.
Recently I brought this event up in conversation with a very senior and experienced paramedic. He told me that when he started it was completely normal and routine that people would apply to work for the ambulance service chiefly because they wanted to serve their community. He told me that the idea of service was people’s key motivation when he started, and that idea was reflected in my exam paper.
The idea of community service as a main motivation seems quite exotic now, and my colleague’s concern was that junior paramedics are now far more ego-focussed and selfish than they used to be. I can’t comment on that directly, but he also made the point that mainstream values have sharply shifted away from communitarianism towards individualism over the course of his career, and that it makes sense that junior paramedics internalise those values.
That may or may not be true (I suspect that it is), but I want to make the point that even though it’s unfashionable, service to one’s community is absolutely critical to your career as a paramedic. It is what will keep you functioning when you’re in hour 13 of your shift and are desperate for sleep. It will keep you turning up, week after week when you’re not feeling it. It will keep you from dreading Mondays. Service and duty will allow you to function in a difficult job, even when things aren’t going your way.
Service is not only at the core of what we do, it’s at the core of how we keep ourselves sane. Our work has intrinsic value independent of the money we are paid or the prestige we believe ourselves to have. Without a feeling that you’re helping your patients, you might as well be working a customer service job – the hours are better, after all. The worst times of my career have been when I have lost sight of the idea of patient care and have felt myself to be an ambulance robot, going through the motions. I became unmoored from the purpose of my work, and had to try to find it again.
Service is hard. No-one is denying that. You will have to make decisions about how to spend your limited time and emotional resources. But, for better or for worse, a feeling of service to the community and a focus on patient care is what will buy you longevity and happiness as a paramedic.
This may seem like harnessing a communitarian value for your own individual psychological benefit and that this might be somehow dishonourable or dishonest. But isn’t that the core of all community work? Regardless of motivation, both the individual and the community benefit. Think about the unhappiest people you know; I would lay money on the idea that they are also the people who have the least engagement with the people around them.
Did I believe all that when I wrote that exam paper? Not really – I was mainly motivated to gain employment in a job that excited me. But after I sat that exam I went home and had a big think about why I wanted to do the job. I hadn’t felt that I’d told an untruth but I felt I needed to refine my ideas more. When the time came for me to be interviewed for the job, I was asked the same question.
My reply was this: “I want to be a paramedic because I want to work in a job where even if I only treat one patient, I am able to go home at the end of the day feeling that I left the world better than I found it”. Then and now, it remains the truth, and I hope that if that ever changes I’ll find something else to do with my time.