I’ve been anxious about this day since January. That’s when I promised to publish an early, unpolished draft of a Life Support column—the journalistic equivalent of walking around the block in my underwear. (Am I the only one who has nightmares about that?) I wanted to demonstrate how we sometimes overhaul content and structure to support an evolving theme.
I decided to dissect November’s Life Support, a piece about EMS roles, principles and attitudes. It’s a good candidate because I made major changes to the original manuscript. Click here to read that column, “Untitled,” if you haven’t already. Then have a look at the first draft, below, followed by my annotated comments:
During my prior life as an engineer, I interviewed for a management position with a global consumer products company. My interrogator—the head of the firm’s U.S. branch—began our session with a deceptively simple question: “Who are you?” Not wanting to be confused with candidates who wanted less money, I replied, “Mike Rubin.”
“Who is Mike Rubin?” came the VP’s retort, followed by “What is Mike Rubin?” when the earlier question elicited a noncommittal stare from me. Without the slightest idea where this was headed, I answered, “Engineer, father, son.” Although that sounded profound in an ’80s sort of way, I had to concede that others—family, friends, coworkers—were better qualified to say what I was and wasn’t.
Often I compare my experiences in EMS to other events in my life. That works when the analogy is clear, or when the reader already knows what I’m writing about. Neither was the case in my original opening. I tried to introduce my theme with an anecdote about a corporate job interview I had 25 years ago, but the connection to EMS—diverse perceptions of roles and responsibilities—was unclear. I think I fixed that by posing an EMS-oriented question to readers, then swapping my interview vignette for a story about a confrontation I had with one of my EMS instructors. There’s a much better chance readers will identify with troubles in medic school than a meeting with a flaky executive in a Manhattan office tower.
I didn’t get that job, possibly because I couldn’t characterize myself without using a title. It was like me telling you I’m a paramedic. What would that say about me as a person? That I drive an ambulance? That I see dead people? That I’ll work for less than bartenders make in my city? I know what I’d want you to think, and it’s none of those things. The way I see myself—the way I want you to see me—has a lot to do with how I feel about my job.
I wanted to express my frustration at outsiders’ superficial views of EMS; instead I almost ended up lecturing you, my colleagues. Not cool. I softened the tone by involving you (third person) rather than challenging you (second person), then moved the edited text to the middle of the column, where it became two paragraphs about public misconceptions (“Classifying caregivers…”).
I’ve embraced the notion of essential services as noble occupations since I signed up for my first EMT class. The word noble is making me a little nervous, though. Does it still mean what I thought it meant when I started in EMS? I looked it up because I read somewhere that columnists are supposed to take responsibility for our language.
Here are the parts of Webster’s definition I like: high moral qualities or ideals, greatness of character, excellent qualities. I still think those are important traits for caregivers. The part about “ideals” reminds me we don’t always meet those objectives. No excuse, other than walking upright and having opposable thumbs. That same pedigree encompasses free will, though, which means we can adopt higher standards despite inexperience or prior failures. EMS is an ideal environment for those who want to do better.
That last sentence, “EMS is an ideal environment for those who want to do better,” means…what? I haven’t a clue. At some point it must have made sense to me. Now it’s an example of pseudointellectual prose that tests negative for substance. I deleted it.
I’m not too happy with eminence, renown, fame, illustrious, grand, stately, splendid, magnificent, aristocratic. Those terms imply superiority. I wouldn’t want to be that kind of noble. Is there a worse way for a medic or EMT to be perceived? I doubt it. We’re supposed to relate to our patients. More important, our patients have to feel comfortable with us. It would be hard to establish bedside connections if healthcare were about the providers.
Morality, greatness, excellence—if not achieved by us, then by whom? I don’t think my efforts to meet those goals in other industries contributed much to anyone except the people signing my paychecks. Is there a higher calling than caring for others—especially in tense or tragic settings—without expectation of material gain to compensate for risk? Not in my experience.
Job-related chauvinism got the better of me in this paragraph. I sound like I’m running for president of EMS. Not only am I indicting unnamed industries as merely profit-chasing entities, I’m also exaggerating EMS providers’ willingness to work for subsistence-level wages. It’s not that we’re willing to do it; we have no choice.
I don’t care very much whether you consider me a technician or a professional. Those words mean different things to different people. Besides, I don’t see how an arbitrary classification of our occupation would improve the quality of life for us or our patients. Our standards of care are based on curricula that are blind to conventions about professions requiring some form of higher education. And public perception of our worth is going to be driven mostly by economics. Large-scale initiatives to improve EMS providers’ standard of living that fail to consider supply and demand have no more chance of succeeding than efforts to portray actors, athletes or rock stars as overpaid.
I know what happened here: I call it topic creep. I’m ranting about two issues, neither of which should be part of this, or any other paragraph in “Untitled.” Are we technicians or professionals? I don’t know, and I’m certainly not going to resolve that in four sentences. It’s a topic that merits its own essay. So is our inequitable standard of living, the subject of my last two sentences. I’ll save it for another rant.
If I’m less confused about my identity today than I was during that interview 25 years ago, it’s because now I provide services of unambiguous value to end users. I know my role, whether you call me paramedic or EMT, technician or professional. I still worry about how others see me, but I have much more control over how I see myself. I deal with the latter by striving for excellence. Part of that process is to progress from doing my job because I have to, to doing my job for its own sake, to recognizing the role of my work within society, to enhancing that role through continuing education, broader experience and innovative problem-solving.
The first sentence had to go because I deleted the anecdote about that corporate job interview. I like the line about “unambiguous value”; that’s the only part of the paragraph that made the cut. The stuff about how others see me and how I see myself is true, but I’d already covered it in the paragraph beginning, “I know what I want my patients to think…” The last sentence, a tribute to job enrichment, is another example of topic creep.
There’s nobility in that.
Nice closing—if I were writing about nobility.
I can’t take credit for all of the above improvements; some of them were suggested by my editor, who has the tact and talent to help me figure out what I’m trying to say. Both of us understand that whatever is written can always be better, and that good editing is part of good writing.
To me, writing and EMS are similar: Failure and fulfillment are never far apart. Some days our biggest challenge is to show up for more. No author expresses that better, I think, than Ernest Hemingway: “There is no lonelier man than the writer when he is writing… Nor is there any happier nor more exhausted man when he has written well. If he has written well, everything that is him has gone into the writing and he faces another morning when he must do it again. There is always another morning and another morning.”
Thanks for following The Write Stuff. Don’t forget to e-mail me a copy of your manuscript by the end of the year if you want to be eligible for complimentary one-on-one assistance. We’ll pick three submissions for special treatment.
Mike Rubin, BS, NREMT-P, is a paramedic in Nashville, TN, and a member of EMS World’s editorial advisory board. Contact him at email@example.com.