EMS providers are trained and dutifully bound to help people experiencing major losses in their lives. We aren’t amateur comfort-givers. We may not like it, but we’re prepared for it. Seldom do we talk about, define, or even make mention of our own feelings about having to give the most devastating news a surviving family member will ever hear. Maybe it’s because we view death as therapeutic failure, or that we’re afraid to admit death does indeed impact us on a personal, non-clinical level. Or maybe we detach ourselves from death because it reminds of us of our own mortality and the fragility of life. Either way, we avoid it until we’re in the midst of a personal loss.
Tragically, EMS providers are often deprived the opportunity to experience the fullness of their bereavement when that death involves a fellow colleague or partner in the field of prehospital care. So much so that even after the last bagpiper has played “Amazing Grace,” bereaved co-workers are often supposed to resume their street medicine and carry on within days of their loss. I resent having used the word co-worker here, because our losses aren’t just co-worker deaths; the EMS community, like other close-knit public safety industries, views its fallen as brothers and sisters.
Our friendships, our medicine and our shared experiences are bonds forged in fire. They may be bendable but certainly never broken or severed—even in death. And yet, as one EMS provider wrote to me years earlier after losing his partner, “As the initial numbness began to wear off, I really begin to feel the depth of the pain and loneliness of my deceased partner.
The irony is, by that time most of my friends and family outside of EMS had already gone back to their routines completely baffled by my overwhelming grief and anguish. Even my fellow co-workers stopped saying his name for fear it would hurt me further. And so, I mourn alone and in silent torment, offering only faked smiles and the words, ‘I’m fine.’”
It would be naïve to think those outside EMS could ever fully comprehend or appreciate the basis of our work, thereby making it difficult for them to help a prehospital provider reconcile the untimely passing of one of their own. This includes professional counselors who are unfamiliar with our work on a personal level.
“Everyone’s extraordinary is our ordinary,” a medic once told me. But there’s nothing ordinary about a sudden passing of an emergency medical provider, especially when a line of duty death is involved. It’s our extraordinary that can devastate an EMS community and leave it reeling emotionally.
There’s little training for helping a fellow colleague or EMS community in mourning. We live in a microwave society in which everyone wants things fixed or provided for immediately, much like our profession. But the reality is grief is a painstakingly slow process which, for some, may require more time and resources than what local critical incident stress debriefing (CISD) teams are capable or able to provide.
Riding for Recognition
For half a decade now, I’ve been a passionate advocate for the National EMS Memorial Bike Ride (NEMSMBR).
It’s mission: To honor emergency medical service personnel by organizing and implementing long distance cycling events that memorialize and celebrate the lives of those who serve every day, those who have become sick or injured while performing their duties, and those who have died in the line of duty
Many of you have asked me, “Why Bicycles? Why Spandex? Why so many miles?” To be honest, six years ago I would have asked the same exact questions – specifically in regard to the creepy synthetic elastic diapered shorts wedged within the confines of a narrow saddle.
Like most of you, at the age of 16 I traded in my bike for the convenience and utter total awesomeness of an automobile—never thinking I would ever return to the handlebars of my Schwinn.
And even later, I was been turned off by how the bicycle industry seemed to embrace an attitude of snootiness toward anyone who didn’t wear creepy clothes and space alien designed helmets or didn’t own a state of the art, high-dollar ride that was still void an engine. Bicycling, in my opinion, had become a competitive sport, no longer the simplistic, mechanized wonder of self-propelled joy that I had known as a kid.
Strangely enough, shortly after hearing of my partner’s death, I found myself reaching for my dusty bike. After frantically searching for a pump to re-inflate the neglected tires, I immediately sought out the steepest and longest hill of my mountain community and pedaled up it until my lungs spit fire, my throat burned of acid and my thighs screamed for mercy.
It was agonizing. I now know I was attempting to displace and inflict this incomprehensible mental pain into something physical—a pain that was familiar and recognizable. I also understand I was searching for something I had lost. In hindsight, it was probably my partner or some physical sign that would show me she was still here and that this had all been a terrible mistake or a bad dream that I would soon awaken from. What’s more, I know I was searching for an answer to the unanswerable question of why it happened. I was lost, alone and afraid that I would not survive the devastating loss.
It’s a wonderful gift when friends you never thought you had suddenly appear to support you during the worst moments of your life. The best medicine is to know that people care. One such friend recommended I participate in the NEMSMBR, which was started in Boston in 2002 by a group of EMS providers as a way to support each other in their sorrow, and celebrate and honor the passing of their fallen.
A bicycle seemed like an unlikely ally at the time of such sadness, but I did know even then that my partner would have wanted me to celebrate her memory and not wallow in self-pity. I decided to take this emotional energy I had invested in my fallen comrade and reinvest it into something positive—a bicycle.
True, I did initially make reference to my bike as a tool for shifting my emotional pain into something physical, but what I didn’t tell you was how the return trip home on my bike gave me brief amnesty from my emotional and physical pain. Oddly enough, the mountains seemed more majestic and the air more fragrant as the sensation of unrestrained weightless flight guided me back down the mountain.
Maybe it was because the darkened sadness that had enclosed me had circuitously made everything else around me seem brighter. I vividly remember that briefest of moment when the pleasure of my bike gave me hope. It’s true what they say, “It is hard to be melancholy on a bike.”
This Year’s Ride
Five years and six NEMSBR rides later, I still find this whole pedaling event surreal insofar as what this ride has come mean for so many in our profession. EMS has waited a long time to honor itself and pay homage to those who have made the ultimate sacrifice. Who would’ve thought something as simple as a bicycle would play such a large role in the healing process?
During this year’s EMS Week, three separate legs of riders—some starting in Vermont, a few in Kentucky and a large contingency in Maine—pedaled more than 550 miles through 14 states to Washington, D.C., to immerse themselves in an event filled with compassion, sympathy and celebration. In all, 117 riders and 14 non-riders who provided support and guidance registered from 30 states and Canada. The riders spent more than 66 hours in the saddle challenging themselves to a reconnect to a world beyond the confines of glass and steel walls.
Many called us heroic for committing ourselves to so many miles. But many riders will tell you that it doesn’t feel heroic; they’ll tell you that it feels poetic. The topography of open farmland, shaded back roads, wooded hills, streams and open meadows is a far cry from the interstates and strip malls, fast food chains and gas stations we see daily from the confines of our ambulances.
A police escort through Times Square in New York City; a private tour through the battlefields of Gettysburg, Pa. during an early morning sunrise; blocked intersections with local and state police giving pause to traffic with their sirens so that all must stop for you and only you; meals and refreshment provided by local EMS and fire houses while their local leaders officially declare that this day be yours to honor our fallen; brief ceremonial stops to stations who have had a recent LODD to offer a moment of silent support; the ever-present posters of our fallen, whether they be line of duty or had experienced the so called quiet death that stole them from us while they were off duty; the proud chill you feel as bagpipers play and honor guards standing at attention while bystanders applaud on the side of the road after being made aware of your mission.
This is life’s poetry forged by the legacy of our sacrifices.
The Colorado Leg
On June 25, Colorado introduced its first annual NEMSBR event in support of the National EMS Memorial Service’s new permanent location in Colorado Springs, Colorado. This one day 85 mile event attracted over 83 riders and over 100 SAG registrants.
The riders began their day at the AirLife Memorial park in Littleton, Colo., where a 1977 helicopter crash devastated the aero-medical community. More than 60 percent of the line of duty deaths inducted onto the National Tree of Life Memorial are air-medical personnel. The members of the NEMSBR believed it was time that the prehospital ground transport industry and medical air transport unite in its effort to honor and make others aware of the sacrifices given by those who paid the ultimate price.
It was a positive step to see riders together because EMS is an often-fragmented industry. The ride was completed that same day in a Colorado Springs park, where bikers aligned themselves and their bicycles in silent reverence along both sides of the park’s sidewalk to greet arriving families and friends of those who were to be inducted onto the tree of life. Words fail me to impress upon you the expression of their faces, specifically their moistened appreciative eyes as they more often than not stopped to shake our gloved hands while making their way down the sidewalk and into the park.
I’m convinced our silent tribute made an important contribution to their healing just as it had ours—uniting us if only briefly in our shared loss. Many riders and support staff remained in Colorado Springs to attend the first National EMS Memorial Service.
In the coming years, we hope to see the Colorado ride expand in days and miles with other states linking their riders to ours, as is done out east.
There’s also talk of creating an EMS Safety Conference for those who don’t want to ride but support the ride’s mission. The two-day conference would conclude on the day of the National EMS Memorial Service. Conference attendees would then attend the service following the conclusion of the classes with the idea of also filling the church which in years past our profession has embarrassingly failed to do.
We also include an annual one day NEMSMBR event in Louisiana in September and promote and participate in a one-day event in Skiberreen, Ireland every July. The NEMSMBR anticipates more legs being created throughout the U.S., while this year’s seven Canadians riders vowed to create their own leg within the next few years.
My main goal for writing this is to recruit new riders. Christopher Morley once wrote, “It is when you come back to bicycling, after long dispractice, that you realize how exquisite a physical art it is.” But that’s the trick isn’t it? How do I convince you to replace your gas pedals with bike pedals and become an accomplice rather than a neutral observer? Granted, you’ll probably get rained on a few times, you may swallow a bug or two (high in protein), your skin will warmly warn you if you didn’t put on enough sunscreen, your leg muscles will protest to your arm muscles while your arse will have no sympathy for either of them, the sun will always rise too early, and certain hills will seem longer than what route coordinators promised. Indeed, you will be pedaling outside your comfort zone.
We promise you homemade, locally prepared meals and revitalizing nourishment by EMS and fire services that share your mission. We have dedicated guardians of the road who will guide you safely from dawn to dusk until you arrive at your hotel with a hot shower and a warm bed.
This ride, this passport to healing, isn’t a race and you’re never asked to give more than you have. But, we will set you in motion while your fellow Muddy Angels push and help you move to become that creature of the road (not road kill) you once knew as a child.
Still not persuaded? Maybe you’ve come to believe your personal hour glass is a lot weightier on the bottom than the last time you saddled up. Time and weight (literally) can do that. My mother once told me “Everyone’s hour glass is glued to the table. You can’t turn it over whenever you #!&@ well feel like it. So make it count.” Our fallen, I’m convinced, would whisper something similar in our ears, “Look over your shoulder one more time for the places you see, for I cannot be there. Do this in memory of me.”
Coming back to that intimidation, let me reassure you it’s not … OK. It IS intimidating. But even if you don’t know the language of cycling, you do know the language of EMS. Besides, there are plenty of highly skilled, non-snooty Muddy Angel cyclists to help guide you along if you need it. I even had four of them change my flat tire a few rides ago while I just stood there with my arms crossed, supervising like a seasoned paramedic is suppose to do.
A cyclist once told me, “Don’t buy upgrades, ride upgrades.” You’ll need a proper fitting road bike in good condition, but it really comes down to training. Each Muddy Angel wears two dog tags with the single name of an engraved fallen EMS provider. Whether it be from the list of those to be inducted onto the Tree of Life or from a personal loss that happened years earlier, the rider doesn’t take the dog tags off until the conclusion of the ride. At that time, they give one of the tags to a surviving family member. I personally put out a challenge for our registrants to take one of those names and from the onset of your training make it a part of you until the conclusion of the ride.
Make that name your motivator, not only for the ride’s sake, but for safety’s sake. It has helped remind me to buckle in whenever possible while riding in the back of my ambulance. I’m more vigilant for the safety of our own local air medical service and more cognizant of the reasons we launch them. Lastly, wear the name to remind you to celebrate life’s gifts and why you should look over your shoulder one more time for the things they can’t see.
(Sigh) Still not convinced? I’d like to introduce to you a few Muddy Angels:
Dr. Ken Turner, from Virginia, who pedaled alone through 2 inches of rain that fell within 30 minutes. 5 inches over five days through the mountainous regions of Kentucky and Virginia. Though they had to shut down the ride eventually due to extreme weather conditions, he continued to ride and complete the 200 miles he set for himself.
Mark Hawkins, from Texas, who was injured prior to the East Coast ride and unable to cycle, He came anyway to become the rides full time bike-mechanic, often replacing bicycle parts and pieces at this own expense. A month later, Mark came to Colorado and rode the one day event in its entirety.
Ashley Foxworthy, of Colorado, who is paralyzed from the mid-chest down, hand pedaled her specialized bike while leading the Muddy Angels through the last 15 miles of their leg to meet the 2010 National EMS Memorial Services inductee families and friends.
Wayne Reisner, from Virginia, who rode and did support for the east coast ride and a month later strapped his bicycle to the back of his hog motorcycle and, 2,000 miles later, arrived in Colorado to cycle in their event.
Dave Page, of Minnesota, who is a rider, route coordinator and EMS paramedic instructor. He requires his students each year to provide support and gear (SAG) for the riders and attend the National EMS Memorial Service, instilling in them at the onset of their careers the importance of being safe, living healthy and honoring the sacrifices of those we’ve lost in EMS.
Andy Turcotte, from Maine, who never quit providing support all week for the Muddy Angels despite riding in SAG vehicles that greatly aggravated his nausea secondary to his ongoing chemotherapy.
Keep the Faith
These are but a small fraction of the stories behind each pedal, which may partially explain why we try to create long distance cycling events. Each story is worth hearing. But it takes time, distance and sometimes a few tears to reach your pace before the final destination.
Washington Irving once said, “There is a sacredness in tears. They are not the mark of weakness, but of power. They speak more eloquently than 10,000 tongues. They are the messengers of overwhelming grief, of deep contrition and of unspeakable love.”
The National EMS Memorial Ride’s mission, when it comes right down to it, is an act of faith and hope. But if you don’t feel you have any hope right now, ride anyway. Act out being alive beyond your walls.
Maybe along the way hope will find you.
Visit us. Then join us at www.muddyangels.org.
Author's Note: Funds raised by NEMSMBR in excess of its operating expenditures go to the Fallen Angel Fund, which funds academic scholarships for children of EMS providers who died while providing prehospital care.