Chapter 3 rewrites, and developmental edits.

This is the rough draft and in developmental editing. Many of us fear talking about what we see everyday as weakness, seeking help is weakness. I am here to tell you that it isn’t. In Fact, it makes you brave. It makes you courageous, and it makes you not only the hero your community sees, but human. Once we zip our boots many believe we are invincible and many believe we can handle anything, until you can’t.

You don’t have to carry the weight alone.

If you’re struggling with stress, trauma, or burnout, please reach out. Help is always available.

National Suicide & Crisis Lifeline: Dial 988 (Press 1 for veterans)

Safe Call Now (Confidential, for first responders): 1-206-459-3020

First Responder Support Network

Code Green Campaign

Your mental health matters. Asking for help is a sign of strength.

#FirstResponderSupport #MentalHealthMatters #YouAreNotAlone

Before you begin this chapter, please be aware that it contains detailed descriptions of traumatic experiences, including emergency scenes, death, addiction, and the psychological toll of service. These reflections are raw and personal, drawn from real-life events that may resonate deeply with those who have served. If you are a veteran, firefighter, EMT, Paramedic, or anyone who has experienced trauma in the line of duty, please proceed with care. Your well-being matters—take a break if needed, and know that you’re not alone.

Chapter 3: The Quiet After the Sirens

I remember the call that cracked something in me. It wasn’t the most violent or grotesque. It wasn’t the kind of call that ends with blood-soaked gloves and a sense of finality. No, it was subtle. Quiet, almost. And that’s what made it dangerous. That’s what made it stick.

A child. Blue-lipped. Limp. In the arms of a mother whose scream didn’t come from her throat—it came from somewhere ancient and bottomless. She was crying out his name like the universe would listen if she just said it enough. Like God could be shamed into showing up.

He’d been seizing, she said. He stopped breathing in her arms.

I was the EMS Lieutenant with the fire department, still technically a volunteer, even though I spent more time in that uniform than I did in my own skin. I also worked full time at the ambulance company, running rig after rig, call after call, sleep-deprived and hollowed out by shift work and repetition.

When I arrived, it was one of my ambulance coworkers already on scene, holding the child like something fragile and burning. He saw me, his face tight with fear trying not to look like fear, and said, “I’m so glad to see you.”

The kid wasn’t breathing.

“Give me that kid,” I said, without thinking. It was instinct. Muscle memory trained from years of CPR drills and real-world calls where the stakes were always real. I flipped the child onto his side and gave a hard back blow with my open hand—sharp, purposeful, the kind of strike you second-guess until it works. And it did. A shallow breath turned into a gasp, and then a wail. The kind of cry that normally makes people wince, but in that moment, it was the most beautiful sound in the world. The mother dropped to her knees sobbing. We carried him to the ambulance like we were cradling the future. A paramedic met us en route. The kid was going to make it.

That should have been the end of it. A win. A save. Something to log under “good outcomes,” pat ourselves on the back, and move on.

But I didn’t.

I couldn’t.

That night, after the rig was cleaned and the gear restocked and the paperwork filed, I went home and laid in bed staring at the ceiling like it had something to say. I closed my eyes, and I saw that boy’s face. Not just the moment he came back, but the moment he was gone. That blue-lipped stillness. The void in his mother’s voice. And behind it all, something else—Fallujah. Dust. Gunfire. A scream turning into a siren.

Two different wars fused into one nightmare.

They don’t tell you that happens. That the traumas don’t stay in their neat little compartments. That sometimes, the mother screaming in a living room in Upstate New York can become the widow wailing in Iraq twenty years ago. That sometimes, your hands are back on a tourniquet in the desert, even though you’re kneeling on a Lego-strewn carpet in a suburban home.

I’d been on the ambulance for about a year at that point, though I’d done nearly a decade as a first responder with the local fire department. Green, still, in some ways. But seasoned enough to know when something was sinking into me. When a memory wasn’t going to fade with a shower and a joke.

Because that’s how we try to wash it off, isn’t it?

We go back to the station. We sit in the bay, boots unlaced, uniforms half-undone. We eat cold pizza. We talk shit. We laugh too loud. Make jokes about things we shouldn’t joke about. It’s not cruelty. It’s survival. It’s gallows humor forged in diesel fumes and fluorescent lights. It’s a valve, and without it, we’d explode.

But when the lights go out and the laughter fades, the silence is deafening.

That’s when I hear the voices. Patients I couldn’t save. Some I did, but their stories stayed anyway. A dozen ghosts lined up in my memory, playing their final scenes on repeat.

There’s the old man whose wife of fifty years kept telling me, “Just keep him breathing. Please. Just until the grandkids get here.” And I couldn’t. He died with his eyes open. She held his hand like he was still in there.

There’s the overdose. The twenty-three-year-old girl who still had glitter on her cheeks and a needle in her arm. I did compressions until her ribs cracked and the glitter smeared into a mess of blood and mascara. She didn’t come back.

There’s the teenage boy impaled on a steering wheel, eyes wide open like he was waiting for someone to tell him it wasn’t real. And then there’s the quiet ones. The suicides. The hangings. The gasping phone calls that end in silence before we ever arrive. PTSD isn’t just flashbacks. It’s rot. It’s a slow leak in the soul.

It’s waking up at 3 a.m., drenched in sweat, heart hammering like a trapped animal. It’s smelling burnt flesh when there’s no fire. It’s hearing silence and feeling it press on your chest like a collapsed roof. It’s rage that comes out of nowhere. Grief that won’t leave. Shame that sticks to your skin like soot.

I dream of fires. But not the kind you can put out with water. Fires in rooms with no exits. Fires in the eyes of the people I couldn’t save. Fires behind my own ribs—anger, guilt, fear, helplessness—all sparking against each other until I wake up choking.

I wore my uniform like armor. The patches and the badge like talismans. But the truth is, I was cracking beneath it. Held together by routine and caffeine and the next call, the next call, the next call.

There’s no pause in EMS. No intermission to process. The pager goes off, and you go. Doesn’t matter if you just zipped up a body bag. Doesn’t matter if you just watched someone die with their hand in yours. There’s another patient waiting. Another life dangling. You compartmentalize, or you fall apart.

And I did compartmentalize—until I couldn’t anymore.

There were nights I sat alone in the bay, long after everyone else was asleep, listening to the hum of the vending machine and the ticking of the overhead light. And I’d replay the day’s calls in my head like a movie I couldn’t stop watching. Voices echoing. Sirens fading. The tone of a mother’s scream. The smell of metal and blood. The weight of a child in my arms.

No dialogue. Just thoughts. Just memory. Just ghosts.

That’s what no one tells you. That sometimes, the worst part of this job isn’t what happens in the moment—it’s what you carry with you afterward. It’s how death follows you home. How it seeps into the quiet moments. How it makes you stare too long at your own reflection, wondering who you’ve become.

This job changes you. It chisels away at who you were until all that’s left is someone who flinches at silence. Someone who can’t fully enjoy joy because he’s always waiting for the next call. Someone who measures sleep in 90-minute windows between tones.

I know now that what I felt wasn’t weakness. It was grief. Delayed. Compressed. Unspoken.

But back then, I thought I was losing it.

So I buried it. I buried it under dark humor and sarcasm and caffeine. I buried it under “I’m fine” and “It’s part of the job.” I buried it so deep that I forgot what it felt like to feel anything at all.

Until I couldn’t anymore.

Until the dreams started clawing through the cracks.

Until I looked at a child and felt nothing but fear.

Until I looked at myself and didn’t recognize the man in the mirror.

And that’s where healing begins—not in forgetting, but in facing it. In saying the names. In writing the stories. In honoring the pain by not letting it define you.

I’m still learning. Still walking through the fire. But now I know I’m not alone.

And that makes all the difference.

PTSD isn’t just flashbacks. It’s rot. A corrosion that starts somewhere quiet, somewhere deep inside. It’s a slow leak in the soul—a steady drip of poison that doesn’t kill you outright but seeps into everything. It clings to the insides of your bones and stains your memories with smoke and sirens. It turns your silence into a scream, muffled beneath the surface.

Some nights I’d wake up gasping, drenched in sweat like I’d been pulled from a flood. My chest heaved like I’d run through a structure fire, bunker gear soaked, SCBA failing, trapped in a stairwell filling with black smoke. There were nights the dreams came with heat—so real I could feel my skin peel. Other nights it wasn’t fire that woke me. It was absence. The total void after a chaotic scene. That unnerving stillness when the screaming stops and you’re left with the hush of loss. Silence so loud it pressed down like a roof collapse. I’d sit up in bed with my hands clenched, nails dug into my palms, heart racing like I was coding someone all over again.

The dreams weren’t always linear. Trauma doesn’t come with a storyline. It’s a mosaic of moments—shards of memory sharp enough to cut even in sleep. Sometimes it was the smell—burnt flesh, diesel exhaust, blood soaked into wet pavement. Sometimes it was a face. A boy with half a skull. A woman who clutched my hand as her pulse disappeared. A firefighter I knew, crushed beneath debris. The worst ones weren’t even the bloody scenes. They were the ones where I failed. Or thought I did. Or didn’t know if I had.

I kept dreaming of fires. Not the kind you fight with hose lines and air packs. Not the textbook kind with flames and smoke. These were different. Fires in rooms with no exits. Fires behind the eyes of patients who looked at me and knew I couldn’t save them. Fires in the wreckage of my own mind—rage, grief, guilt, shame—all tangled like old wires waiting to spark. Each dream was a hallway I couldn’t get out of, a siren I couldn’t turn off, a heartbeat that faded no matter how hard I pushed on that chest.

You carry the dead with you. Not just the faces. The decisions. The mistakes you think you made. The ones you fear you made. The “what ifs.” What if I had started CPR fifteen seconds sooner? What if I’d checked the airway again? What if I hadn’t missed that bruise? What if I had spoken up louder? What if I’d never signed up for any of this?

You take a deep breath and try to clear your mind, but once you open your eyes, you question it all over again.

What if I’d caught it sooner?

What if I hadn’t hesitated?

What if I’d called for backup two minutes earlier?

What if I hadn’t become an EMT at all?

They say your uniform is armor. That’s what the world sees. Patches, badges, boots polished to regulation. But the armor starts to crack. And when it does, it doesn’t split—it crumbles. Quietly. Bit by bit. I wore mine like it could still protect me, like it could keep the memories from leaking out. But underneath it, I was coming apart. I learned to smile at families and hand off patients while hiding the quake in my gut. I joked with my partner in the rig to keep from screaming. I learned to breathe through the weight on my chest because hyperventilating in front of a patient doesn’t look professional.

Some nights I’d wake up with the taste of blood in my mouth—not real blood, but the metallic ghost of it. I’d smell diesel and think of rollover crashes. Smell antiseptic and think of nursing homes and pale skin gone blue. The nightmares weren’t just nighttime things. They followed me into daylight. Shadows in the corner of my vision. A siren on a street I wasn’t even working on, and suddenly I was back there again. Back in that room. Back on that call. Back holding someone’s last breath in my hands.

Sleep didn’t feel like rest anymore. It felt like a gamble. Would tonight be the night I woke up screaming? Or the night I didn’t sleep at all? The exhaustion piled up like wreckage. I’d stare at the ceiling, eyes burning, afraid to close them. My mind wouldn’t stop rewinding scenes. Car wrecks. Cardiac arrests. Suicides. Children. God, the children.

You learn not to talk about it. Not really. You don’t want to be the one who brings down the crew’s morale. You don’t want your partner to think you can’t handle it. So you joke. You throw out gallows humor like sandbags against a rising tide. And everyone laughs. Because they get it. Because it’s easier than crying. Because no one wants to be the first to admit that maybe we’re all bleeding a little on the inside.