Q&A with Janice Ballenger

Excerpt from Addicted to Life & Death

On October 2, 2006, milk truck driver Charles Carl Roberts IV walked in to the West Nickel Mines School, a one-room Amish schoolhouse in Lancaster County, Pennsylvania. Roberts pulled a gun, barricaded the door and took 10 girls, aged 6 to 13, as hostages. As law enforcement and EMS responders gathered outside, he started shooting. He murdered five and wounded the others before committing suicide.

As a deputy coroner for Lancaster County, Janice Ballenger had the unenviable task of responding to the scene and processing its young victims. EMS readers can imagine what came with that. Ballenger was later captured in a Washington Post photograph, seated on the altar steps of a church, head buried in her arms--an iconic portrait of America's horror and grief.

That experience alone could have made for a compelling book or movie, but Ballenger wasn't interested in exploiting it. Instead, her book, Addicted to Life & Death: Memoirs of an EMT & Deputy Coroner, provides a full-spectrum look at a career that began as a vehicle rescue technician and included time as an EMT. It doesn't ignore or downplay the events of 10/2/06, but presents them in the context of a journey spanning both the depths of despair and highs of insight, compassion and grace. Addicted is a reflection on the emotions of a career and the author's journey among them. It is available from Masthof Press and Bookstore.

You had planned to write memoirs and collected materials for that throughout your career. What sorts of thoughts and ideas did you want to communicate?

My original plans were to write my memoirs as an EMT. Actually, I started as a VRT, a vehicle rescue technician, with a rescue company. And when I would return home in the evenings, I just needed a way to release my thoughts. So my brother bought me a journal, and he said writing down your thoughts is a good way to release your emotions. So I actually began keeping journals years and years ago, and planned years ago to do this book upon my retirement.

You kept the West Nickel Mines incident to a relatively small part of the book. Why was that?

I had planned to write a book all along, but when I began in the emergency services, I had no idea I'd be thrust into the limelight by the Nickel Mines tragedy. I believe that's why I kept that section to just basically the one chapter and the follow-up: It was never my plan to write a book about Nickel Mines. I was contacted by agents asking me to write a book specifically and only dealing with that tragedy, but I declined those offers, because that was never my intention at all.

It wasn't a difficult decision. There was no way I had any desire to exploit the day at Nickel Mines; I think that's fairly obvious. So I had to turn those offers down, but obviously everybody was very, very hungry to hear all the details.

What's the emotional and psychological benefit of filtering your experiences onto paper? Is it therapeutic?

Definitely. I'd really highly encourage it for anybody who really does not want to, say, speak with a peer or a counselor, but needs a way to release their feelings. Writing is a valuable, underrated tool. It's an excellent means of releasing your emotions.

It was also very interesting to go back years later and reread some of those journal entries. Some of them I honestly had forgotten about. But reading them, I'd think, Oh, wow, that was a horrible day! So today really wasn't that bad.

I've found it very helpful in many ways.

How did you go about shopping your proposal and finding a publisher?

I submitted my proposal to several agents, and that's where I began encountering difficulties. It took me two years to write the book, and I would have agents say, 'Well, we're interested in the Nickel Mines day, but only the Nickel Mines day.' I had another tell me, 'I'm very interested, but you need to take this out and put in more of that.' I got that kind of feedback from a lot of agents. I finally just decided that I wanted to be able to say what I wanted to say, which is why I decided to go with self-publishing [through Masthof]. It was a family-owned business, and I was extremely pleased with the help they gave me.

What kind of reaction from readers have you gotten, particularly those in the emergency services?

It's been absolutely overwhelming, it really has. There was some feedback on the Barnes & Noble website that the book tells it like it is, and for anybody who's anticipating becoming an EMT, it's a must-read. And that's truly what I hoped to do for people who are anticipating becoming an EMT or think it's all just glory. It's not--it's gut wrenching. It tears your heart and soul apart. It's extremely hard. I wanted people to know that we get scared. We're not these people who just go in and take care of the sick or prepare a body. We put our heart and souls into it, and it takes a toll on us. I don't think most people realize that, and that's what I wanted to get across.

Any advice for others in the emergency services with unique or profound experiences, or just day-to-day thoughts and feelings they want to set down on paper?

Just keep writing--it's an excellent way to release your thoughts. Don't ever feel that you're alone. That was a large obstacle I had to overcome when I began as a VRT. I would come home and feel all alone. I felt there was nobody else experiencing the feelings I was going through: Should I have done something different? Could I have done something better? You need to just have faith in yourself, and I think writing is one way of kind of solidifying that you did something constructive that day.

Contact Ballenger at janiceballenger@yahoo.com.

Excerpt from Addicted to Life & Death

I have learned that too often, "What seems to be, is not always what seems to be."

While I wrote this book with what appears as confidence, and the ability to walk away from each incident unaffected, that truly is not the case. Many emotions are left unattended.

But I don't want anyone to think, "Oh, she's just doing her job." It's never like that. In one sense, you have a job to do, but to think it doesn't affect us emotionally and physically is not near the world "we" live in.

We learned to cope, and to somehow deal with what we witnessed.

Don't think we're not as human as you are.

Don't think our lives are not distraught by what we see.

Don't think there aren't calls, during or after, that we don't think, "Why am I doing this? Will this be my last call? Will I be able to sleep tonight?" I've seen people come and go because they can't handle what we see.

When I am asked why I continue to do the work I do, I always say the same thing, "Someone has to do it, and I feel I was given the ability to do it and still remain sane."

Only those involved in emergency services, nursing, or hospital arenas can share and appreciate our sense of humor. I think how disgusted some people would be if they ever overheard us talking after a call.

This is not in disrespect, but rather, our only way of finding something other than somber and sadness in many calls.

The acronyms I wouldn't even share with my parents. Ask a firefighter or EMT what "fubar" means. That's your first clue as to their level of experience, or lack thereof.

One of the hardest things for me to do is to return to an empty house. I've been given suggestions of ways to cope with this. Leave a radio playing, so you don't walk into a quiet house. Leave lights on. Get a pet.

I have a light on a timer, so I always return to a lighted room in the evening. I have lots of nightlights. I don't leave a radio on. I have a pet.

My stuffed dog, "Bif," is on my bed. He's the perfect pet. Very low maintenance, always listens to me, never interrupts me, and he's always there.

Bif's name has more meaning than just being his name. I was on a window-shopping spree one afternoon, after an extremely trying day. I saw him sitting on a shelf, it was like he was saying, "Take me home with you, rescue me!" So I did. Earlier in the day, I had tried to tune out the foul ramblings of a coworker, whose name started with a B. Hence the name BIF. Bill Is Foul.

By now I had applied to Ephrata Ambulance. I was so eager to use my new medical knowledge. I worried I would cross the line and become a "whacker."

My application was approved. It was one of the most rewarding decisions I have ever made.

When you begin at Ephrata Ambulance, you are a "Trainee." I have made so many friends at Ephrata Ambulance. I can't imagine my life without it. I signed up to run whenever I could. They have paid crew on during the day, from 6 a.m. until 6 p.m. Volunteers run from 6 p.m. until 6 a.m., in addition to weekends and paid crew holidays.

I began to understand why they often said to us, "This is the way you would do it for the test, but this is the way you would actually do it on a call." I learned there is no textbook standard in the life of an EMT.

I was blessed to have a crew chief, Deb, take me under her wings. She showed me, with unrelenting patience, how to do trip sheet reports, and all of the tricks of the trade. Deb reinforced that what seems to be, is not always what seems to be. She taught me to look and think outside of the box.

Although Deb is no longer a volunteer at the ambulance, I still saw her now and then. But on October 2nd, 2006, I saw Deb at a place I never imagined I would see her. She was in Bart Township, at the Amish schoolhouse murders. She walked up to me, and it took me a minute or two to realize it was Deb.

That day, everything was so out of proportion. It still is, in a lot of ways.

Often our ambulance crew arrives to hear the same question, "What took you so long?" I'm certain this question is asked by many of the same people who fail to pull over for my blue light while I'm attempting to get to the station for an emergency call. Or the same people who have their radios so loud they don't hear the sirens from our rescue vehicles, or they're in so much of a hurry to get where they're going that they just ignore us.

What seems to be forever, isn't always what seems to be.

Then there are calls that seemingly should be a relatively, easy call. My tones went for an emergency transport from our local hospital to another hospital. I was hurrying too much to hear the other hospital.

I pulled into the ambulance parking lot, and was met by a guy going off duty. He told me, "You might want to put your windows up. Do you know where you're going?"

I said, "No, I only know it's an emergency transfer." He told me that it was to John Hopkins Hospital, in Baltimore, Maryland. I put my windows up. Okay, so this will be a longer call than I expected.

We loaded our patient and headed towards Maryland. Our patient had received a kidney transplant there, and they needed her to return, due to complications she had developed.

As we got closer to John Hopkins, our driver, Mike, asked if one of us could read the directions to him. I agreed to do this. As I was climbing from the back of the rig to the front passenger seat, I heard Mike mumble something about the rig not running right. As the minutes ticked away, he appeared more concerned with the engine noises. I wasn't hearing them. I was only hearing our sirens, and seeing too many cars for my comfort.

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