Q&A with Lisa Carney

Cowboy in the City is a fast-paced fiction novel that appeals to readers who love action/adventure stories splashed with a bit of humor. The book is based on author Lisa Carney's 15 years as a paramedic in the Springfield, Massachusetts, area and has been well-received by the local EMS community. Now a retired firefighter/paramedic, Carney hopes her stories will engender new respect for her friends and colleagues who are still working in EMS. At the very least, she says, maybe people will at least be more diligent about pulling over when they see an emergency vehicle approaching with lights and siren. Cowboy in the City is available on Amazon.com and in soft cover in Kindle format. Lisa Carney can be reached at tenspeed99@comcast.net.

Where did you get the idea for this book?

The idea came just from working in EMS, which is like a story every day. You sit in the back of an ambulance and watch the world go by, and you think to yourself, "Somebody should be writing this down." So working in EMS is what motivated me. I've had people say it's like having me tell them about a day at work.

You compare EMS to religion, and the chapter headings, which are written like Bible verses, are very funny and clever. Why do you think of EMS as a religion?

EMS is not just a regular job. You get into it and think you're just starting a job where you'll work hard and work lots of hours without getting paid a lot, and you suddenly realize you've become absorbed by it. It starts to not only affect your work life, but it takes over your everyday life. It begins to change the way you think about the world, which is what religion is supposed to do. It makes you open your eyes and say, "Oh, everything isn't what I was taught. Now that I've started to make my own observations on life, things are suddenly a bit different than I was told in the beginning." EMS changes your philosophy and how you see people, and I think it affects how people see their own religion and their spirituality. There's a lot of life and death in EMS and lots of emotion, and that adds to the religious feel of it. It's hard to come home from work, take off your uniform and be done with it. It stays with you; it infiltrates your dreams and personal relationships and completely takes you over.

The book is fiction with some pretty strong language and unflattering portrayals. Is that a picture of EMS you really wanted people to see?

My original inspiration for writing the book was that so many authors don't get it right when they portray us. In fictional books we walk around and cry a lot. On TV, you see someone who had a bad call sitting in the hospital parking lot crying and saying "I can't believe how awful things are." What I found when I got into EMS was that it's more about "Here I am at work. This is the stuff I know is going to happen, and I'll do the best I can to live with it and just keep going." We tend to do things that provide a mechanism for dealing with the bad calls, and I wanted to present the different ways we "deal." Some of the characters in the book use illicit drugs and some of them drink to get past a bad call. In the book, I did a 50/50 split, where half of the characters do things like getting drunk or stoned to avoid dealing with their emotions, and the other half aren't the least bit interested in those ways of coping. But I wanted to show that we are not perfect human beings and we don't always deal well with the things that affect us. If anything, I wanted to give talking points. It was my hope that the book can be used not only for entertainment, but for teaching new EMTs just coming into the field. To let them know nobody can prepare you for exactly what your experience will be, but this is a general overview and these are your choices. You can learn to deal with the stuff you see, or you can push it down inside yourself and it's probably not going to go well. What I'm really hoping for is that people will talk about it--get conversations going. If the book can do anything for people in EMS it's to say, "Let's start talking about things. Let's start dealing with things positively."

You self-published the book. Why?

It was a combination of things. You've already mentioned the strong language and writing style, which don't conform to a predictable publishing format, and I didn't want to change the format. I put a lot of thought into how it was written, and I guess I didn't want to compromise. The other thing is that the publishing experience can be very long and drawn out. If it had been traditional fiction with traditional characters, I probably would have gone the route of being patient and hoping I'd find a publishing agent, but I was confident I had a ready-made audience in EMS. I know there's not a lot of fiction out there about people in EMS, and I really believed if I could get the word out and people got the book in their hands it would sell itself. So instead of waiting and being told I couldn't write the book the way I wanted, I decided to take a leap of faith and do the work myself.

And has that worked out as you hoped?

I am thoroughly enjoying it. I've had lots of new experiences because of this book. I get asked to speak, and I've designed a two-hour EMS stress management continuing education class around Cowboy in the City, so I get to talk to all kinds of folks in the business. I love having people tell me they found the book very powerful and were moved by it, and I get thanked for finally putting our thoughts on paper. A lot of people have told me it's hard for them to explain to their families and friends what they do for a living. They say, "Your book puts it all into a succinct little package that I can hand my family and say, 'Here. Read this and understand me.'" I haven't had one regret any step of the way.

Excerpt from Cowboy in the City: Chapter 11- A Baptism of Fire

...now Moses was tending the flock of Jethro his father-in-law...and he led the flock to the far side of the desert...there the angel of the LORD appeared to him in flames of fire from within a bush…Moses saw that though the bush was on fire it did not burn up...so Moses thought "...I will go over and see this strange sight...why the bush does not burn up..." When the LORD saw that he had gone over to look...God called to him from within the bush "...Moses...Moses...do not come any closer..." God said "...and for God sake's...if your tunic catches on fire…stop...drop...cover and roll..."

So months went by and I knew right away that I liked working with Ariel. I saw patience and compassion in her little wiry self and she could read a monitor like nobody's business. I believed she could help me become a better paramedic…maybe even a better person. I wasn't sure at first what she thought of me. I mean right away I was a new medic and that was going to make me annoying to be around. I was constantly asking questions, maybe even sometimes coming off like I was questioning her. It was all just so overwhelming at first. I knew I had Ariel to fall back on but who knew how long it would be before I'd have to work with someone else. The rumor was that NAA didn't want to pay for double medic trucks so they were going to pair medics up with basics. It pounds on the medics because they have to do all the patient care and paperwork but who the hell cared about that? Medics...like paper towels…are disposable. If I was going to have to work with a basic I wanted to be able to live up to the patch on my sleeve and be a whole paramedic.

One sunny spring Sunday...St Patrick's Day, as a matter of fact...Ariel and I both showed up at work with wicked chest colds. It's no wonder we were both sick. We'd had pneumonia patients coughing in our face for a month. So there we were sitting in dispatch with our bottles of juice and Puffs tissues ready to face the day. We both agreed that we each looked like crap...felt like crap and didn't want to hear any complaining from patients who weren't as sick as us. Dispatch appreciated that we hadn't banged out and left them short a medic truck on the weekend and so in return promised not to beat on us if possible.

The morning went by and all we had to do was a few "Mrs. Fletchers." "Mrs. Fletchers" were the little old ladies or men who had fallen and couldn't get up. Our job was to pick them up...prop them up and make sure they were okay to stay by themselves. They never wanted to go to the hospital and waste what little time I have sitting in that emergency room with winos and whores? And since we really couldn't blame them or argue with them we usually just got refusal forms signed and we went on our merry way. In keeping with the day I called that Irish Dessert...Piece O'Cake...

At lunchtime we got designated dispatch's lunch picker-upper truck and that took us out of the rotation again. We headed up to Leonardo's to pick up the bulk order of grinders...onion rings and French fries. I pulled up to the door and Ariel ran in with the money. Five or ten minutes had gone by when this old style Mercury came barreling up into the parking space next to mine and screeched on the brakes.

"...are you working?..."

"...yes I am..." great...now here comes the lecture about parking in the handicap spot…I was about to begin my speech about us being exempt from the law and being able to park there. Besides...if you needed an ambulance would you want to have to wait for us to run across the parking lot to our legal parking space...blah blah blah...when she interrupted.

"...'cause this house up the street just exploded and there's people in there..."

My first reaction was to say "...oh my god are you kidding me?..." so it was a good thing Ariel had just come out with the order and caught what was going on.

"...what's the street address of the house?..." oh my god...what a great question to ask.

"...I don't know the number but it's up there on Scott Street...near the intersection with Clinton..."

"...okay...we got it..."Ariel sent the civilian along. "...call dispatch...let 'em know where their lunch is going to be..."

We knew right away where Clinton and Scott intersected but it wasn't as easy as you'd think to find the house on fire. The fire department wasn't there yet and it wasn't like there were flames blasting out the windows. We actually drove by it a couple of times before we noticed a small amount of smoke coming out of a back window on the third floor of a three-family.

Reports on scene indicated there were people inside and a cop already had tried to get in but intense heat beat him back. It's a good thing too because unlike in the movies where people run in burning buildings all the time without gear and the fire department thanks them, in real life you will absolutely get your ass handed to you for becoming a useless ball of human flesh that the firefighters now have to step over or carry out...not a good career move at all...

There wasn't any work for Ariel and me to do yet so we just stood by and watched as two engines and a ladder rolled on scene. Hose lines sprang full...ladders got thrown and a crew smashed down the front door and disappeared into the thick...brown...choking smoke. My heart was pounding a mile a minute. I had never been this close to a real house fire. I was actually standing so close to the captain that I could hear the guys on the inside of the house talking on their portable radios. They had commenced with a search of the first two floors while another crew who came in the backside of the house made their way up to the third floor and the assumed seat of the fire. The crew with the hose line reported intense heat coming from the third floor. The captain began to tell them to hold off and wait for external ventilation when all of a sudden the third floor window on the front of the house blew out. It made an awesome movie-explosion sound and spewed glass and wood splinters over everyone's head including mine and Ariel's. I got a strange sense of excitement and nearly lost my mind not having anything to do. I felt like running laps to get rid of the adrenaline that was building up inside me. I looked over at Ariel to see how much fun she was having. She had a nauseous look on her face and was ducking behind the ambulance...she wasn't enjoying this much at all...Immediately following the explosion there was some intense screaming over the radio. All I could make out was "…flashover…" and "...guys coming out burned..."

A quick second passed and a firefighter stumbled out the front door. He looked hurt so I rushed over to him. "…are you alright?...where are you hurt?..."

He ripped his facemask off and snarled at me "...get off me I'm fine...there's worse than me coming out..." His anger stunned me because I could see he was burned on his neck and ears but he wouldn't let me near him. He whipped his helmet off the ground and let himself fall to his knees while repeating "...motherfucker..." over and over.

Then I heard more ruckus by the front door and three firefighters appeared. They were screaming for us "...medic...over here...medic..." Two of the guys were actually holding up the third. He was holding his hands oddly in front of him and I noticed his gloves were hanging off in shreds.

"...oh my God..." I heard Ariel say as she ran up behind me "...those aren't his gloves...that's the skin off his hands..." And she was right. The skin had been burned right off and was hanging in strips. He was in tremendous pain.

"...what is it with us and hands?..." I thought back to that guy who had cut himself out of the tree that day in the region a hundred years ago.

Ariel half shrugged. "...I don't know...let's get his coat off..." We struggled to cut his thick firefighter coat off because we obviously couldn't pull his arms through but we had to start cooling the burns and step one was to get his hot jacket off. The sight of one of their own injured sent the usually calm and swaggering firefighters into a frenzy and they started crowding around us like an unruly mob. While Ariel and I struggled with cutting through the bulky jacket...trying to be efficient but also cautious of moving our patient's hands too much...they yelled and demanded to know why we weren't moving him to the ambulance yet. We had our reasons but there was no talking to these guys. A couple of times they even started dragging the poor guy by his half cut-off jacket inducing bloodcurdling screams and pleadings to knock it off. And I thought I got why they were upset but they still made an already difficult job much more difficult. Bottom line though was that they were firefighters and it wouldn't be cool or right to directly call them out. Fortunately Travis...our supervisor...rolled up on scene and got a cop to help us settle things down. Actually...all the cop did was get the captain to come over and remind these guys that they still had work to do behind them ......

Once the jacket was off Ariel and I split up. She went to the ambulance to call for orders for morphine and I worked to continue the cooling process by cutting the tops off bags of IV saline and pouring them on his burns. His skin was so hot that when the saline made contact it made the sound of a sizzling fajita. I asked the firefighter what his name was and through his winces he said "...you wouldn't believe me if I told you..."

"...why?..."

"...my name is Pat...Pat Murphy and I usually love St. Patrick's Day..."

"…not so much today though...huh?..."

"...yeah...no..." TA SSSSSSSSSSSSSSSSSSS "....AHHHH BITCH..."

Travis helped us get Pat on the stretcher and into the ambulance and asked if we needed anything else. I barked "...bags of saline..." and Ariel said "...a basic to drive us to the hospital...I want Casey in the back with me..."

Ten milligrams of morphine later and Pat was still in enormous pain. I kept dumping bags of saline but there wasn't much more we could do. Sometimes the ride to the hospital is really long. Obviously it's far worse for the patients but it sucks when there just isn't anything you can do to make something better. In those cases the person driving is the true hero. I looked up front to see my old friend Bill navigating the city side streets and he was doing a fine job.

"...remember when you worked at Six Flags as a lifeguard?..."

"...yeah..." Ariel seemed puzzled at my segue. But the only explanation I offered was to point at the floor that was about two inches deep in saline solution.

"...wave pool..." Ariel smirked and drew up more morphine.

** Later at the emergency room Ariel and I got all the attention deserved by the two people who had done the best call of the day so far. Everyone wanted to know the story and we got to tell it over and over. Soon I found myself laughing with Mahan about almost crapping myself when the window exploded. I looked up and saw two basics scurrying by on their way up to the floor to do a transfer. That's when it hit me...I had arrived...I was thriving post-adrenaline rush...I was talking shit while a basic cleaned my truck...

...I was a cowboy in the city...

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