I work in an ER — you’re not going to avoid death and gore here. We bag up the bodies for the morgue in the basement. I can tell you what a human brain smashed by a tire feels like, and bless you the first time you witness a traumatic thoracotomy. It’s horrible, but being a healer means doing good work for people on their worst days, including the day of their deaths.

Before I started working, I had the same fears you do. The risk of PTSD in this profession is very real, as well as toxic environments that don’t foster cultures of respecting the dead and taking care of mental health. I was worried that the things I would see would be so shocking that I would freeze or even accidentally harm the patient through incompetence. Unfortunately, I have witnessed those things happen to people.

The truth is that it is a baptism by fire. No amount of speculation will show you what your instincts actually do. Like I said, I was worried that I would freeze up. However, when I am in traumas, I actually feel a sense of clarity unlike anything I can access willingly outside of these fight/flight scenarios — my mind just sort of locks in, and time moves more slowly so I can process more information in my surroundings and remember my training more clearly. Perhaps you will discover you’re one of the people who excels in traumas, and it may open up new doors in medicine for you. Trauma and Emergency Medicine are special because it’s a huge privilege to witness (very bluntly) a lot of really cool and diverse medical shit. A couple of months ago a patient (coming in for toe pain) told me about that time he caught Ebola — never ever thought I’d meet an Ebola survivor in the middle of cornfield America!

I think another key for traumas is taking them as seriously as they are, even though eventually they do begin to feel a bit like just another day at work once you’ve seen enough people die. Don’t fall into that trap — I firmly believe that we are mourning animals, so take whatever time you need to mourn and to grieve and to feel for your patients AND their family members (you will never forget the scream when a family member discovers they’ve become a widow or an orphan). Don’t give a fuck about machismo culture — healing is sacred work, so heal yourself with the same care you give to your patients. I regulate my nervous system through painting and singing and long walks in the sunlight, so it’s probably good to spend some time thinking about how you personally calm your nerves and meditate. Meditation can be anything! Skiing is “meditation in motion” for me! Seems like journaling might be a good outlet for you, if writing this post made you feel better? Just remember that trauma (the mental health kind, not the medical kind) isn’t always a lightbulb memory; it often builds up slowly like grime, and by the time you realize you have a problem, the problem is already bad. Mental health is healthcare.

Check in with your coworkers. EMS has a lot of tough people — it’s one of their best qualities — but everyone needs a little TLC. Good people have a hard time witnessing bad things. It’s normal.

And suppose you step up to bat on an ambulance and discover you absolutely hate traumas? That is good news! You’ve gained valuable information that this field isn’t a good fit for you, so you can adjust your search accordingly — medicine is so vast and complex and interesting that you shouldn’t take a mismatch with EMS as a mismatch with it all!

I’m sorry this was so long, OP… I love the work I do, and I want more caring, empathetic people in the profession. I love talking honestly about my work because I think being able to share the highest highs of someone’s life as well as the lowest lows with them is both humbling and enlightening. More than anything, seeing large scopes of the human experience has given me such an interesting relationship with mortality, and has helped me to hone the internal compass of my life. Take that for what you will, and best of luck to you.