Not long before I spoke to Nate Boyce, he had just tried to save a man who had fallen 60 feet while rock climbing and was "the definition of broken." The guy was in the middle of nowhere in Colorado, where Boyce works as a paramedic, and it was the job of him and his team to give the patient pain meds through an IV, wrap him in a blanket, carry him to their all-terrain vehicle, and drive to someplace where a helicopter could pick him up.
That's far more dramatic than most days the 25-year-old has, but Boyce's job carries with it the possibility of life-and-death moments that most of us just see on TV. He's worked as an emergency medical technician (EMT)—an entry-level position that requires the completion of a certification course—since 2013, and cut his teeth driving an ambulance in Boston, where he's from. Last month, he officially became a paramedic, a more advanced position that carries with it the responsibility of interpreting a patient's vitals, putting them on a heart monitor or giving them breathing tubes, and administering powerful medications.
I recently spoke to Boyce, who now works in a rural area near Colorado Springs where the staff is limited, about how he handles the most gut-wrenching parts of the job and the common misconceptions people have about paramedics.
VICE: Does it scare you seeing someone who is as badly hurt as that guy who fell? How do you respond to something like that emotionally?
Nate Boyce: I just look at what happened and I try to put together a plan. And as soon as I have a plan for how I want to treat the patient, that's just what I do. We were fortunate with this guy that I actually got to talk to him for a while cause it took us so long to get him out. I had a much longer conversation than I do with most patients. He was a student who had just moved here from New York and also went to the same school as me.
Honestly, it was the most personal connection I've ever had with any of my patients. I've definitely crossed the line from empathy to sympathy in the past. But obviously our goal is to never have emotions affect the way you do things. That's like a tenant of medicine: You treat everyone the same way regardless of your connection to them. We talk about that and we try to stress its importance, but obviously we can't guarantee that.
When you were starting as an EMT what was the first serious situation you had to deal with?
I remember starting and not running any good calls for six months probably. You know, calls where we could do anything. The very first serious call I went on was a guy who shot himself in the head. He was so dead that we didn't even go inside. The cops were already there. They were like, "You can just leave." I was pretty freaked out at the time because I didn't know what to do next. There was a hysterical family and I was just totally underprepared to deal with them. And I just kind of stood there awkwardly and looked, and I didn't know what to say to them. It takes years to learn to tell someone that someone they love is dead. That is a true statement for sure.
It takes 140 hours to get your EMT license. That's really minimal, and it doesn't teach you that much. I think that was the most surprising part for me—how unprepared I was to be dealing with all of these things, and yet everybody I worked with was totally fine with all of it. If you work in finance and you have a business degree, you probably show up on your first day with some amount of knowledge of what your job is going to be like. That just totally isn't the case here.
Were you often afraid at the start of your career?
When you're new, you're staring at the patient afraid and you're not really sure what to do, or even what you're afraid of. Mostly, you're afraid of being awkward, you're afraid that they know you're new. When you're really new you're afraid that everyone in the ambulance is gonna die, or take a turn for the worst. And that's just totally not gonna happen. You know, it's just not how it works. Most people are not that sick. But when you first start you're feeling is that, like, I'm on an ambulance—this is life and death stuff . It could be any second that this person who just called me for leg pain just drops dead! Over time you get over that because it just doesn't happen like that very often, and you realize that it's just two people in the back of the truck by happenstance. Why not take advantage of that and talk to them?
Do you feel personal satisfaction about giving back in this way?
Yeah, but I would never do this for free. It's very much a job. It's my job, and it's a job I happen to really enjoy. But if tomorrow they said, "It's gonna be on a volunteer basis," I would be out of there. I can't emphasize how terrible the pay is. I mean, I live a very comfortable life because I'm a non-married, mid-twenties male. But I also work, on average, 70 hours a week to do that. It's a problem, and it's not sustainable. My solution of picking up overtime or having other jobs for different ambulance services could totally fall apart if I wanted to have a family. And we just haven't been able to figure out how to change the pay. And that's a problem as well because we have so many people leave the industry who are good at their jobs. They interact with the rest of healthcare professionals who are well-compensated, and they're like, "Shit. Why shouldn't I just go to nursing school and make twice as much money for significantly less responsibility?"
"The surefire way to get someone in my industry riled up is to call him or her an ambulance driver."
So a lot of people quit these jobs?
According to the federal government, the national average length for a paramedic's career is three and a half years to five. Not an EMT—a paramedic who went through an associate's degree program to get there. Even after all that investment into themselves, the average paramedic works for less than four years before doing something else.
I can count on one hand the number of paramedics [I know] that are over the age of 50. It just doesn't happen. People have to move on because they work really hard. They run 12 calls in 12 hours; they're stuck in the ambulance all day. It breaks most people after a while, and I'm fortunate that my full-time job is at a place that doesn't run so many calls, has a station, and has a boss that try to take care of us as people. It's extremely rare to see people retire from this job, though.
Are there any misconceptions about your job and industry that you'd like to address?
People who are paramedics are true healthcare professionals and I think a lot of times that's kind of lost. The surefire way to get someone in my industry riled up is to call him or her an ambulance driver. Yeah, I drive the ambulance, but I do a whole lot more than that. That's a small part of my job. We provide surprisingly advanced care. Not only do we have the ability to treat really life-threatening illnesses, but we make people feel better. Treating people's pain is awesome, you know? Also, chances are you're not gonna die in front of me. You just feel like shit. And I'm here, so let me help you. Most all of the time we are able to make things better, and that's where most of my satisfaction comes from.
An unidentified person is moved to an ambulance after four people were shot, resulting in one fatality in Chicago's South Side (November, 2013).
Photo by Brian Jackson/Chicago Tribune via Getty Images
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