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I'll spell that to you because it's not as you
think, T -E -A -M -B -U -I -L -D -R .com. Welcome
to the Behind the Shield podcast. As always,
my name is James Gearing, and this week it is
my absolute honor to welcome on the show flight
nurse and author Eric Usher. Now, in this conversation,
we discuss a host of topics from Eric's journey
into the world of nursing, pre -hospital medicine,
the idiosyncrasies of flight medicine, cadaver
labs. using children's books to educate our children
on what we do in the police and fire uniforms,
and so much more. Now, before we get to this
incredible conversation, as I say every week,
please just take a moment, go to whichever app
you listen to this on, subscribe to the show,
leave feedback, and leave a rating. Every single
five -star rating truly does elevate this podcast,
therefore making it easier for others to find.
And this is a free library of well over 1 ,000
episodes now. So all I ask in return is that
you help share these incredible men and women's
stories so I can get them to every single person
on planet Earth who needs to hear them. So with
that being said, I introduce to you, Eric. usher
enjoy well eric i want to start by saying thank
you so much for taking the time and coming on
the behind the shield podcast today Honestly,
the thanks are all on my end. You did an amazing
job. I think I told you this in private, you
know, after we dialogue, I feel like I have imposter
syndrome because the caliber of people you have
speak and the stories you get out of them are
fantastic. So the pleasure is all mine, really.
Thank you for taking the time. No problem at
all. So where on planet Earth are we finding
you today? I am in beautiful Davis Islands in
Tampa, Florida. Fantastic. So let's start at
the very beginning of your timeline because I
know it takes you all over the place. Tell me
where you were born and tell me a little bit
about your family dynamic, what your parents
did, how many siblings. If I get wordy, rein
me in. You're all the time in the world. Born
in Bristol, Connecticut. It's a small town. Right
now it's known for ESPN's headquarters in Bristol.
Before that, it wasn't known for much of anything.
Born there in 73. grew up there until I was about
10 years old. The reason we made a move to Terryville,
Connecticut, where really the bulk of my life
has been before I left, is my parents, my father
was a machine shop worker. No collegiate education,
no formal education. My mother was a secretary.
And so they did a lot to make ends meet, multiple
shifts. So we didn't... grow up in the most affluent
environment. I didn't spend the same year in
a school until middle school, which would have
been seventh grade. Every year was a different
school just because we couldn't afford the rent
or the checks would bounce. So we just moved
house to house to house. And then at age 10,
we lived pretty close to a more dilapidated and
crime -ridden part of Bristol. And I was jumped
while I was on my bicycle by about five or six
guys. And my parents were like, okay, we're moving
to Terryville. It's safer. It's a smaller town.
And so we moved to Terryville, which was great.
Terryville is a very small town. I think there
was maybe 4 ,000 people in the town. My high
school had less than 400 people in the whole
school, but I was afforded some opportunities
there that I would never have been afforded in
Bristol. So I have one brother, Carl, he's older,
a couple of years, two and a half years. The
kind of fast forward to like where I became infatuated
with EMS started with my brother. He was dating
a girl and. That girl's mother was a nurse at
Bristol Hospital. She was the educator. And she
convinced my brother that he should go and be
an EMT. So he went to EMT school. And of course,
there's always sibling rivalry. So I would poke
fun at him all the time, you know, look at you
riding the ambulance. And then he said, you know,
well, there's no way you could ever even pass
that test. I bet you couldn't even, you know,
make it in halfway through the class. So my career
in EMS started on a bet with my brother. So the
small town it was, I had a volunteer ambulance
service. I went to Bristol Hospital. And while
I was in middle school, I was in the beginning
of high school. I was 15 years old when I started.
So every Friday night, I would go to EMT school,
which was atypical for that age group. Small
town, you know, you're out partying and having
a good time. Not that I didn't do that. But anyway,
I got my EMT and... uh the very first call i
had was a cardiac arrest and i can describe that
like it's happened right in front of me now i
mean rolling up this three -story home and the
screams were the first thing i heard you know
this this man's daughter was just screaming and
crying and i was 15 years old and just had no
idea really what was going on so uh Ran the cardiac
arrest up on the third floor. He was, you know,
wedged between a toilet and a wall. And I'm just
taking it all in going, how are we even going
to get this guy down? And the medic's like, Eric,
get on the chest. And so I get on the chest because
that's about the only thing that I could do.
And then he's like, hey, jackrabbit, slow it
down a little bit, you know. So all this adrenaline
is coming out and I'm mimicking my heart rate
with each compression. But we get the guy down.
We get him to the hospital and, you know. It
wasn't a save. There was no rosk. But like digesting
this whole thing that happened in front of me,
the sights, the sounds, the smells, it was captivating.
And I couldn't process why it was captivating.
But that kind of launched me into being thankful
to be in this small little town because the high
school was two houses down from our ambulance
corps, our volunteer ambulance corps. So when
I was 16. I was able to run ambulance calls all
four years of high school. I carried a pager
that kept my GPA. Pager would go off, leave class,
hop out the window, go over to the ambulance
corps and go run calls and come back with a Dunkin'
Donuts coffee and some McDonald's. And it was
it was pretty cool. I don't think many places
you can do that, you know, with that. But it's
a double edged sword growing up in a small town
like that when you're doing EMS. I mean, you
know. You see the seedier side of behind the
closed door. And in a small town, you know, you're
seeing things you shouldn't see of people you
go to school with. You know, there was a point
one time where I had to even call Child Protective
Services on classmates after running a call.
And it just creates a weird environment. But
anyway, that's how I got an EMS. And that's,
you know, born in Bristol, raised in Terryville.
Went to nursing school. Again, didn't have a
lot of funds and got a few scholarships, but
went to a two -year diploma program at St. Francis
High School School of Nursing. No longer exists.
I was there for like 100 and something years.
Phenomenal education. And then I started being
a nurse and still ran EMS. And I don't know how
far you want me to go. Well, firstly, what happened
to the nursing school after such a legacy? It
was a diploma program. So I'm sure you're aware
of, you know, magnet status and the push for
the bachelor nurse. And, you know, a diploma
program was the was the best nursing schools.
I mean, I'll say that debatably, but, you know,
within week two, you're doing clinical. So it
was OJT. Education, you know, your hands on clinical
from day one, you're carrying full assignments
by your graduation. And, you know, it was just
targeted nursing education. But the demise of
all those diploma programs was the proliferation
of, you know, the ideology that you have to have
a degree to be better. And I disagree with that
on many levels. And, you know, there's some of
the smartest people I know don't have initials
behind their name. The push for that kind of
negated that whole diploma program. So it's gone.
That's so sad to hear. And it's funny because
in the fire service, there's been a big push
for degrees when it comes to promotion. And if
higher education created better leadership, then
we wouldn't have a recruitment crisis. And we
wouldn't be losing first responders left, right,
and center to physical and mental health issues.
So clearly, a degree alone is not the be -all,
end -all when it comes to EMS or first responder
professions. No, no, you're 100 % correct. So,
but yeah, I mean, and what else do you want to
know about that part? Well, let's go back to
volunteering because I've had a few people on
now that volunteer EMS specifically. Yep. Firstly,
as we sit here now in our 50s and you have a
pretty mature journeyman's lens in the whole
world of EMS, what is your perspective of people
that young entering, especially kind of fire
EMS side and then getting to kind of witness
some of the horrors that we do at such a young
age? Yes. So I do have quite a kind of a bipolar
view of that in the fact that one, for me. It
offered opportunities that never would have arisen.
I have no idea what I would have done. It gave
me a channel and an outlet and a group of friends
that got my sense of humor or did my sense of
humor develop out of those group of friends.
You know, it's it gave me camaraderie. It gave
me purpose, particularly in a small town. That's,
you know, people can get stuck in a cycle. But
you're 100 percent correct. I mean, just just
Sunday. um the bitter side of a young internet
field is we're sitting outside it's beautiful
weather easter sunday my wife and i are waiting
for our daughter to arrive and i'm like i saw
my first gunshot wound in fatality and i was
15 years old on easter sunday left upper chest
like that's not normal no you know and and here
i am 51 and that just pops into my head and then
so it takes a toll does it mature you I guess
mature is a weird word, but it definitely exposes
that that seedier side of the world that most
people are shrouded from. So it takes a toll.
I'd lie to you if I didn't. So I think it's I
think the volunteer aspect is great. It's sad
that it's dwindling, but there's got to be a
better way. I feel like at that age. That's a
beautiful time for a mentorship type program.
So you're exposed to the profession without being
front and center of these unending traumas. But
when you listen to the neuroscientists, the developing
brain, I mean, I would argue that 18 is too young
for a fire and EMS, to be honest. Law enforcement
does 21. I think that would actually be a better
one because then that gives a young person three
years to whether they want to go further their
academic. journey or spend a few years in the
trades and get some kind of life skills under
them first. But yeah, I mean, when we know now
that the brain is simply not developed yet to
pour on the level of trauma that we see in a
lot of cities and suburban communities, I think
it's really irresponsible now that we have the
knowledge. I agree. And the downside is when
we talk about how do you cultivate and mentor
someone into a position without exposure to the
trauma? And there's the side of that where it
says, okay, I'm grooming you for this, but I'm
not letting you peek behind the curtain yet.
And now you might have someone who's convinced
that's what they want to do. And then they get
there and they feel maybe it's too late to back
out and find something different. I don't think
there's an easy answer to that, but you're right.
I mean, neuroscientifically, it's proven. We're
just not ready. Well, I think we can apply the
same thing even to any crew. Like, for example,
I wrote about it in my first book, but I had
one of the deadliest days was my last shift in
Orange County. And it wasn't why I left. I'd
already put my papers in. But the second of the
three was a homeless woman that was missing for
a few days. And we start going through the woods
in Orlando and get to a point like, OK, that
smells like someone who's been missing for a
few days. So everyone else, I'm like, I'll go
check. You guys just go back. And the same thing
happened to me when I was a young firefighter.
The whole crew doesn't need to see it. And I
think you could apply that. Yeah, there's going
to be some scenes where a younger person maybe
might get exposed to it, but you work as a mentor
to minimize that. If there's a horrific fire
or something, no, you're not going in to go look
at the crispy critters inside. You're just going
to stay out here. But I think that's a good philosophy.
It doesn't matter if it's your first day on the
job or the last day on the job. There's no medals
for seeing the most shit. There just aren't.
But there used to be. These unspoken, I'm going
home with blood on my, if my uniform isn't bloody,
it wasn't a good shift. And it's nice to see
that that's changed. It's changing. But yeah,
you're right. I mean, you can't unsee those things.
And more importantly, how many people see those
things that aren't ready for them and don't have
the ability to process that or know how to process
it or find someone to process that with? And
then it just eats away at them. And we've seen
that all too often. Absolutely. Well, staying
on your small town before we progress through
your career. Another thing that I never experienced,
really, because I never really lived in the actual
neighborhood that I served, even the closest
I was still about. 15 miles away and then most
of the time i was 70 miles away but you know
i still when i visit those towns i'm like oh
yeah that was the dead hooker and dumpster and
yeah that was a gangbanger hanging out of his
car and we've all we all know what that feels
like but when you hear the volunteers you have
two things firstly the the spouses or the family
members of volunteers have said well when the
pager goes off we don't know what they're going
to or if they're going to come back whereas when
we go to work on a shift you know we're not responding
to a call In a quiet department, you may not
even get a call. Unlikely, but it's possible.
But the other thing is you're running on your
friends. You're running on your teachers, on
your sports coaches, on your pastors. So when
you look back now, let's just kind of be a voice
for the volunteers and other people that work
in those small communities, because I think that's
another layer that most of us don't experience
that live outside where we work. Yeah, it's tough.
um after volunteering i'll get back to your question
in a half a second is once i became a nurse and
i worked in a big inner city trauma center i
thought i would never work in a hospital that
was the same place that i live because of that
you know it it particularly if you're younger
and volunteer and you know when you do cpr in
somebody's grandfather or father or you go into
domestic violence it's very difficult on any
given day to kind of process that but when you
repeatedly see these people i think there needs
to be a very healthy mental health aspect of
it or more importantly like a deep more formalized
debriefing process you know in granted this was
quite a time ago but that volunteer agency didn't
have those debriefs if they did it was for something
that was profoundly catastrophic But I think
those happen, need to happen more often, particularly
in a small volunteer community where it's okay.
You know, you're going to run into these people.
You're going to see them, like you said, at the
grocery store, at schools, at the gas station.
And initially it's this kind of, you know, avoidance.
I don't want to, but there needs to be mentorship
and guidance on how to approach that. You know,
there's the HIPAA. And it blurs in small towns
when volunteerism happens. I don't have the answer
for you of what's the best way. I do know that
turning a blind eye to it for those volunteers,
those explorer programs, educating them up front
that this is the reality of it, that there has
to be a way that we need to openly discuss this.
We have a hotline. Let's do whatever the case
is. you know in the town i grew up in it was
a a segregated volunteer fire volunteer ems so
um it almost had this little underscore of uh
tension and betterment of either but more of
that cohesive let's talk about that car accident
together you know let's Yeah, there's just the
debriefing process of being OK, openly discussing
in a private manner. And how do we deal with
that moving forward? Because we're going to run
into something. Absolutely. Yeah, I've said this
many times, the ego that is involved, that the
person or the department, really the person we're
talking about, you know, people that have created
a culture where all cities better than county
or we don't talk to PD. In an environment where
the only way that you're going to serve your
community properly is to have interagency relationships
is unacceptable. And then you think about, well,
if that culture is proliferated as far as looking
down your nose at other departments, then what
is it like when it comes to the mental health
conversation? I guarantee you, if you've got
an arrogant fire department, you're going to
see a very toxic culture when it comes to mental
health. And then if you look behind the curtain
at the alcoholism and the addiction and the suicides.
I guarantee you there's a linear relationship
there. 100 % agree with that. Yes. In my career,
I've worked medical device for several different
companies, and I had really the honor to go behind
the scenes of a lot of fire departments, huge,
small, rural, inner city, and seeing that little
peek behind the curtains of other departments
and the cultures and how it follows. yeah you're
right spot on so what was it that took you towards
the nursing side as opposed to the paramedic
side um opportunity and money so in the state
of connecticut back then which i actually enjoy
that process you had to be an emt for x amount
of time before you can be an emt intermediate
before you can take your paramedic so you know
you've gained experience along each way and then
you were kind of culminated in where you can
take a paramedicine course and and get that paramedic
certificate um right out of high school i could
go and in two years be an rn making more money
from a two -year diploma program than the graduated
paramedic program and then as a nurse i can sit
for the paramedic exam so it there That kind
of unfolded along the way, but the catalyst was,
you know, I don't have a nest egg. I'm 18 years
old. I need to make money, move out, and nursing
was a very, very, very viable career route. So
that was what led to it, you know, and pretty
ballsy at the time. You know, St. Francis was
the school to apply to, and it was the only school
I applied to. Luckily got in. So, but yeah. And
then afterwards, you know, that EMS side doesn't
leave you. Like it's there. I remember working
in the trauma center at Hartford at St. Francis
Hospital and just still looking at the medics
coming and going, I'm here all night. They're
going to go back. They're going to go, you know,
it's just a different, I don't regret my nursing
background at all. And that's why I continued
and went. you know, paramedicine and was lucky
enough to combine both of them in flight. And
that was, that was phenomenal. So what was your
experience in the trauma side? Because you've,
like you mentioned, you're from a smaller town.
Um, you know, we all know that a lot of the bad
stuff comes to the trauma center and you're exposed
to a lot more of the dark side of society through
that, that route as well. So talk to me about
that experience. Yeah, country mouse gets to
the city. That's exactly what that was. The only
time I went to the big trauma centers are if
I was lucky enough to ride in, you know, as like
a third party where they're, you know, taking
someone in. Or I got to fly in one of the helicopters,
Lifestar, when we had a motorcycle crash, you
know. But it was just, you know. And it's chaos
when you go in there and you open your eyes and
you don't, you know, I'm used to the small little
hospital where everyone knows everybody. And
so when I got the job there, it was mind blowing.
It was mind blowing, not only to see the true
knife and gun club, if you remember that book
from way back in the day, like it was, I mean,
that hospital had 96 guards. two attack dogs
it had a full -time officer in triage um it had
gone through several periods where riots happened
uh or staff members got assaulted you know it
was it was a time that you know they couldn't
take the attack dogs into the hospital because
they can't differentiate staff from perpetrator
or whatever it was just as weird dirty and i
worked 9p to 9a it was a horrible shift so you
saw everything. But a lot of the themes I think
you have is about mentorship. And I had a phenomenal
mentor. So I had this nurse, Candy Fusco. She
was phenomenal. She was just as, I don't know
how to say it delicately, seasoned. She was seasoned,
but newer stuff, down cold. And that was my mentor.
And I remember I started, I'm like, I really
don't like pediatric patients. You know, it's
not my strong suit. Every single pediatric patient
that comes in, Eric gets them. I don't care if
it's a sniffle sneeze. I don't care if it's multi
-system trauma. Eric gets every pediatric patient.
And I did relentlessly until the point where
I'm like, all right, another kid. Cool. You know,
I'm okay with pediatric patients now. But she
could identify where my deficits were from not.
seeing that side of the world you know and um
also being you know male nurses are a subset
of the population of nurses so being the male
nurse at night granted I'm all a five six on
a good day I'm not very intimidating but you
know you're still called when when that happens
you know um I had two guns pulled on me in that
emergency department that was uh that was new
You know, I've never felt so helpless and angry
at the same time. Like, how dare you take that
away from me? And I have nothing to do. You know,
I did break one of the guy's thumbs. I feel a
little bit bad about that. And it was just out
of malice because he had a gun in my face and
that could have ended me. But there was a lot
of growing up quickly in that particular trauma
center. The experience was... unparalleled to
this day it was great but eye -opening i can
imagine what was the environment like then i
came into the fire service in uh 2004 into hialeah
which is basically one of the suburbs of miami
so again country mouse goes to the city um and
uh just insane. And you were holding the wall
for hours and hours and hours. And the irony
is when COVID happened, people were acting like
that was a thing that only happened in COVID.
I'm like, whoa, timeout. Have you listened to
the people that work in the inner cities, in
the hospitals? But that was more recently than
you're talking about. Back then, was that still
an issue as far as waiting for beds and that
kind of thing? Yes. Yes. So the commonplace,
as it is sadly today, is the hall bed. And the
ongoing – I poke fun at the rivalry, the ICU,
ED nurse, the thousands of memes that are out
there. But just because I had a four -bed assignment
didn't mean I still didn't have five hall beds.
And if you had the trauma room or the code room.
So it happened a lot. It was paper charting back
then, too. We just started to get EHR. So it
was a whole different world. And the ideology
that the nurses eat their young, it was very
true there. You, for lack of a better term, you
man up or you get out. And the shift that I worked
and how relentless it was, I remember walking
in and at 9 p .m. in an inner city on a weekday
or weeknight doesn't matter it's packed to the
gills and i remember every shift i walked in
and someone would invariably look at me you don't
want to be here you don't want to be here i know
i don't want to be here but that's not the first
thing i want to hear when i walk in you know
except for one nurse mary and she would smile
and say i'm so glad you're here to help but there's
always a little ray of sunshine in there somewhere
but yeah it was still the same jam -packed fighting
for beds What was the culture back then? You're
in a profession that is usually more female,
so you have a little bit of that feminine kind
of input. When it comes to the mental health
conversation, was there more empathy back then
or did it parallel what we saw in first responder
professions? I think it's a little different.
I think as a male nurse, the perspective is a
little bit different, too, because, you know,
you go in and regardless of the nurse that you
are, you're new in an environment. They're unsure
of you. What's your skill set? Are you the gossiper?
Are you the helper? Are you you know what? Who
are you? First off, are you competent or are
you lazy? Or, you know, once they figure that
out, you know, we had a really, really tight
knit group in that emergency department that
worked nights. So. I mean, the commonplace was
we almost developed this unofficial post -shift
debrief. We would all go to this diner and we
would sit down and we would discuss generically
the night. And it was usually the physician was
there and the entire nurses. So it was as hard
as it was, it was very nurturing at the end too.
So we did a lot of group activities, which today's
difficult to do with. And I don't know why it's
so difficult to be honest with you. I just don't
see it as much. Maybe I'm blinded to it, but
it was like, it was a, that was your family.
It's like you're, you're on shift for 24 hours
in a fire department. That's your family or your
helicopter or whatever, you know, and this, it
was, it was like having an extended family and
then we would do weekend events together and
support each other. So yeah, it was very supportive.
It was very supportive right up into the time
I said, I'm going travel nursing. And then it
was like cold steel. Is that heresy in the world
of nursing then? I guess so. Yeah, there was
a lot of resentment when I said I was leaving.
Kind of moving forward a little bit. Have you
seen the show on HBO Max, The Pit? It's come
out. Yes. Yes. Talk to me about it. I mean, I
think it's phenomenal. I think technically it's
been great and it's certainly brought a lot of
the issues to the front. But what's your perspective
of it? It is the most true to life show out there.
Down to the procedures, the thought processes
behind them. Granted. My wife doesn't necessarily
like. I'm sure like you, you're probably like,
okay, well, they're going to do this. They should
do that. Why are they putting him on iPad? He's
going to have a pneumo. But the light on the
behind -the -scenes stuff, the administration,
the push for press gaming scores, the violence
that's so prevalent yet so overlooked, it's spot
on. And that show taking place now. it's like
i'm back at work at saint francis in 1997 it's
it hasn't changed sadly yeah this is this is
i just did a video today um i think we're talking
about before we record and it was on cowardice
and you know how and i'll put it on our generation
we've just kind of rolled over when it comes
to all the things that need to be fixed that
haven't Whether it is simply courage in a fire
department to change the work week so our men
and women stop dropping like flies, or whether
it's having the courage to stand in the middle
and say, hey, during COVID, obesity was kind
of a big contributing factor. Are we going to
address the national obesity crisis? But yeah,
but the fact that as you're talking about now
and in the fire service, the mandatory overtime,
when I worked at Orange County, I was hit with
it all the time. That was almost 20 years ago.
So this is you know, these are powerful perspectives
now. And the pit did such a great job of showing
that and even touching on the Freedom House,
the original paramedic out of Pittsburgh that
were African -American. That was great. Yeah.
So, you know, I think it's phenomenal. And this
is why I'm going to make kinder into a show,
because now it's like, all right, well, who are
these people that are bringing these patients
in? Let's go into their world now, you know,
and then expand because they touched on the mental
health a little bit. but a very, very superficially.
So I feel like now we're beautiful. Let's take,
you know, jump in with both feet and talk about
the mental health side in all these professions,
including doctors and nurses. So I guess in feeding
on that, let's talk about that one episode briefly
where, you know, the charge nurse, she gets physically
assaulted. And I guess what I was hoping to see
out of that was, yes, it was addressed. You need
to go home, but then. She just picks up and keeps
on working like nothing happened. And I guess
I look at that from two different viewpoints
is, okay, yep, I got it. The duty, the job's
there. The patient is just still coming in. And
then you have this horrific mass casualty. Take
that out of it. But there was a – I don't think
there was more enough to say, look, let's talk
for a second. let's you're exactly right like
that could be a whole episode of itself of how
do we deal with that is it right to stay is it
wrong to stay you know there's that oh that that
was an interesting what was your take on that
yeah i mean the thing and also like you said
the takeaway is like oh you should just suck
it up and stay at the er rather than no no no
this guy needs to be hunted down right now she
would do a police report if she had the injuries
they suggested she had she physically would not
be able to carry on with the shifts you know
so there was that and of course it's you know
it's uh what they call it um poetic license in
the same way as they're relaying all the procedures
they're about to do i i get that but at the end
it was like oh i've got a counselor you should
talk to him oh okay open spear right now it's
like okay we can we can definitely build on that,
but you didn't need to go there in that show.
That show was such a great, you know, entry to
all these other conversations now. So I thought
it was absolutely phenomenal. And then technically,
like you said, I was actually like, Oh, okay.
I got that right. Cause you know, like you, you
know, you were saying, Oh, you shouldn't do that.
It's going to cause this. And then I turned to
my wife all proud and she doesn't give a shit,
but, but I called it. That was cool. So, yeah,
I guess when you look at a show, Let me ask your
advice on this. So if you have a show that's
so true to life, there are some inaccuracies,
and they do have post -cut, you know, talks with
the actors. Do you think it would behoove producers
of a show like that to say, look, here's a real
ER doc and a real ER nurse that work in a situation
like that. What's your perspective on this show?
And they can say, this is right, this is great,
but... you know, realistically, this probably
should happen. You know, I don't know. Does it
detract from the sensationalization or do you
pepper in reality? So that's what I'm hoping
to do with Kinder, is there will be two things.
There'll be the actual story and then there'll
be something parallel that will have real people.
So it goes, you know, you get pulled in like,
hey, that wasn't fiction, what you were watching.
But here's real people and it's, you know, it's
more raw and it's infusing hope in all these
issues that we brought up. you know, overcoming
obesity and addiction and all these other areas.
Like here are people struggling. Here are solutions.
Here's where they're doing now. So I think, yeah,
there's an amazing opportunity to blend. Like
some of these behind the scenes documentaries
are amazing. Like The Fall Guy. Have you ever
watched that with the stunts? awesome great great
documentary and it's like oh now i really appreciate
the stunts that i saw because now i understand
what it took to to do them whilst they went through
covid by the way yeah yeah so so yeah so i think
that's it is if you can blend the two together
whatever your storytelling is if there can be
a kind of all right now that was you know that
was the story but let's talk exactly let's talk
to the real people you know then i think that
it really pulls people in even more and then
it it stops them from just going okay that was
fun That was a fictional journey. Now let me
get on with my life. It's like, oh, no, no, no.
It's the hospital down the road that you're hoping
the bed is open when you have a stroke. That
is what that's going to be like. And you might
be sitting in the hallway with a medic for two
hours. Yeah. I guess that's why I do miss the
show Trauma Life in the ER because when that
came out back in the day, I remember the first
episode that I watched, I was working night shift
in the trauma center. And I felt exhausted after
watching the episode. I'm like. you know his
pager goes off again and you know you've ran
shifts like that where you just get okay all
the paperwork's done i'm all in bed back again
it just you know it's that one more it's that
one more um yeah it where it showed the kind
of raw element so great job with you coming up
with that i think it'll be great yeah well hopefully
um all right well you talked about announcing
to to your fellow nurses that you were going
to start traveling and that was you know you're
out of the tribe by that point so where did that
adventure take you so it all started with you
know the typical words I met a girl so she was
a travel nurse and my wife now Sharon but she
was in She's working in one of the units and
she had a friend in the emergency department
that was a travel nurse also. So we were introduced
a couple of times. And every time she came in
to see me, we were like, had a fresh trauma coming
in. So I'm gloved, I'm gowned, I'm masked, I'm
ready for it. I'm like, hey, you know, I don't,
hi, it's not, I didn't, it wasn't the right time.
But she perceived it as, this guy's just a dick.
You know, every time I come down, it's this brush
off wave. Who are you trying to? And then one
night we went out and just hit it off and, you
know. I just I was young. I was 23, 22. I just
built a house. I was living in that. And then
she's Canadian. So she's like, let's go travel.
I'm like, let's go travel. And that was a huge
step for me because I never left Connecticut.
You know, like I my family was there. It was
almost like you don't leave your family. You
know, I was making good money as a nurse. I was
supporting my parents a lot. so when i left it
it created a ripple effect not only at work with
you know with the tribe so to speak once they
found that i was leaving it it was you're dead
to me you you know all for a girl you're gonna
regret it yeah but my family took it hard because
the meal ticket was lead um which It's just a
whole other story on that one. But, you know,
so my wife, my now wife and I went and just did
travel assignments. I remember the first travel
assignment we did was at Pocono Medical Center
in the Poconos in Pennsylvania, East Stroudsburg.
And if you've ever been there, it was the old,
you know, that's a fun in the sun in the Poconos.
And it was the honeymoon place. It was different
back then. Small emergency department. And I
remember I was shitting bricks. And my wife.
Back then, she's looking, she's like, what the
fuck are you doing? Like, I'm studying. I got
all my books over. I'm like, I got to be on my
head game. I mean, you know, I'm leaving St.
Francis. I don't know these people. They don't
know me. And it takes such an anxiety on me that
I would underperform at this emergency department
that I didn't know anybody at. And she's like,
stop. And then it hit me. I'm sitting there one
night and I'm going, well, let's wait a minute.
So if somebody comes in with CHF. I'm going to
do X, Y, and Z at St. Francis. Somebody comes
in with CHF. I'm going to do X, Y, and Z in the
Poconos. Okay. Okay. I'm doing it to myself.
But then I realized too, and you've probably
seen this from different fire departments, different
agencies, emergency departments. So I get to
this department and like everyone's the same.
There's the same personality with a different
name and face. Oh, you're candy. Oh, you're joking.
Okay, I get it. There's the dynamics. I got it
now. Let's go on our way. And then we traveled
for two and a half years and got to Las Vegas.
She wanted to get married in Vegas. I wanted
to get married in Vegas. We said, let's do a
travel assignment out there, and we'll just invite
a small group of family and friends, come, have
a big party in Vegas, no gifts, and then we'll
have a great time. Travel nurse in an emergency
department there, Sunrise Hospital. The flight
crew came in and I had a stroke patient, had
a lateral uncle hemorrhage. And I'm giving the
assessment. I'm doing a Babinski and saying,
I can see it's a right, you know, uncle hemorrhage
there. You can see this, this, blah, blah, blah.
And the flight nurse went back to her boss and
said, you need to call this guy. Back then, that's
how it worked. And a bulk of the flight programs
is you either recruited from in or you saw them
in the emergency departments. And then that's
how two kids, two dogs, and five years later,
we were in Vegas. So talk to me about that transition
then. I mean, the role of a flight nurse now
very, very different than an ER with all the
experts and equipment around you. It was amazing.
It was amazing, again, to go back to mentorship.
So the program director was Dave Eshay, and she
was one of the founders of Colorado's Flight
for Life program. She was the OG flight nurse
back in the day. And she used to always say,
you know, I haven't been on a helicopter in years,
but, you know, you give me enough morphine and
value, I can intubate anybody. Is that for her
or the patient? A little of each. But they put
us through a residency program, which was really
phenomenal. So they had a ground critical care
transport program and the flight program that
were kind of separate. So the ground critical
care worked for AMR. So you did the critical
care transport, but when you were not doing a
CCT transport, you were thrown into the 911 system.
So you're doing 911 calls and you're, you know.
But you got to operate at the level of a flight
nurse. So you can do chest tubes and central
lines and all this stuff. But even before you
got on there, we went through months and months
of this residency under the medical direction
and the tutelage of Dr. Tom Zinowitz. So Tom
Zinowitz was awesome. He was like this big bully
from high school that was smart. So he went to
med school, but he still just kind of thought,
knew his shit. But he was awesome. He was so
in favor of raising the bar on nursing standards.
So he picked the physicians we would go to. When
we were in the hospital, we as the crew members
would do every central line, every intubation,
every chest tube, anything invasive, we did.
We had to catalog those every month. And if you
couldn't get them, again, this doesn't exist
in the world, and I'm not sure if it was quite
legal back then. the uh the corner was right
across the street so we had this little tackle
box and we go over there we had this relationship
with them the medical examiners would teach us
you know anatomy in theirs but in reciprocation
we would be able to do all these invasive procedures
in in the backhand of that of getting them blood
samples from the central lines and whatever so
We have a phenomenal amount of experience that
hands -on, that repetitive motion of being able
to do a chest tube in the dark, you know, the
minimal equipment that you need and practicing
all those skills. And then when you're in the
hospital, you're doing your trauma rotations
with the trauma surgeon, the OB, like everything
was just months and months and months of that
before they said, okay, you're ready. Then they
threw you on the ground. Then they threw you
in the helicopter. and it was it was awesome
i mean you know a good year of my life i sat
up you know in that bunker at night going i gotta
be ready for the call gotta be ready for the
call and then there's that old mantra that's
echoing in the back it's it's not your emergency
it's their emergency that you're going to be
part of and help but that transition was um was
it was awe -inspiringly overwhelming so i think
the uh la chief got that little mixed up when
she was saying was it's his fault getting himself
in the fire i think she she misquoted that a
little bit but you're right if you have to think
of it that way you know you're there to help
in an emergency you can't get consumed by the
fact that it is one yeah and that was a tough
pill to swallow um but then you know Talking
to the flight crews out there, and especially
now when we transition, I remember we had a new
flight nurse in Tampa. We'll get there. But,
you know, it was a couple of weeks in and I said,
well, let's go over some scenarios. She goes,
I've been doing this for two weeks now. I'm sorry,
professor. You know, that was the mindset. Like,
I've been doing this for two weeks now. Like,
it should be a good year before you feel comfortable
with that amount of. our for good and evil when
you give this advanced scope to somebody so but
yeah what was some of the career calls you remember
in that role in las vegas which is just in the
flight program full stop oh i mean so there's
there's the calls that people want to hear when
they ask you tell me about your calls you know
i think um one of the most horrific scenes actually
how do you how do you quantify horrific so one
of them was uh this woman was wrapped in a towel
a blanket poured a gasoline lit on fire by her
boyfriend and kicked in the front lawn and we
land on scene and she's still smoldering and
she's third degree she's she's full thickness
burn head to toe her fingers are burned off her
toes are burned off she's just full eschar on
her face she needs an airway she needs access
she needs medication and she's just sitting there
and i put in a subclavian line and We were orienting
a new medic and he needs to get the airway. And
as he's getting that prep and I got the line
and she's just going kill me, kill me just over
and over. And these are one of those calls. I
use it for an ethics call course that I'll talk
about. So I can't feel a pulse. I can't get a
blood pressure. I got a subclavian line in and
I empty every narcotic and benzo that I have.
Right or wrong? Don't know. Got an airway. Was
she breathing? Don't know. She's paralyzed. And
I gave her everything. So I always put that question
back on whoever I'm talking to. Is that the right
thing to do or the wrong thing to do? Is there
a right or wrong in that? And how do I defend
that when my medical director asks? Or how the
family asks? So that's one of the most horrific
calls because it blurs the lines of not only
technical ability. How do you process someone
begging you to die, but you want to make them
as comfortable as possible, knowing no matter
what you do, kind of like that pit call with
that burn patient, you're going to die. Like,
this is 100 % burn. I'm going to make them as
comfortable as possible. So that one stands out.
I had a very similar call. It was the same day.
I had three deaths that day, the third one. I
don't know if it was a suicide attempt, arson
gone wrong, but there was a fully involved house,
a young man came running out, still on fire.
The first unit that got there, they actually
put the guy, actually, I think it was a neighbor,
put him out with a hose. The first medic that
got there, he was leaning, steaming against a
chain link fence. And I actually heard on the
radio him asking for help. So rather than go
to the fire itself, we went around the back and
met the other medic. And, you know, end up doing
a standing takedown on the backboard, getting
him over this fence. I jumped in the back with
the other medic and off we went. And the trauma
center was literally not even 10 minutes around
the corner. And so I'm ready to intubate and
we don't do RSI or didn't in that county. So,
you know, assuming that he's out and my partner
almost out of habit, you know, like we always
do. So, you know, what's your name? And the guy
replied as clear as day. And I just to reiterate.
His nose was gone. His tongue was gone. Fingers,
genitalia, like three third degree burns from
head to toe. Just the soles of his feet weren't
because that's what he was standing on and spoke
to me clear as day. And you talk about helpless.
You got a guy that burned. All I can do, and
I think we put an IO in the end, but all you
can do is put a burn sheet over him and a non
-rebreather because he's talking to me and I
can't do RSI. But I've never seen an example,
and I wrote about this in my first book, I've
never seen a more powerful example of when, if
people believe in the soul, when the body is
dead and the soul doesn't realize it. So we wheel
him into the ER, and you can imagine the looks
when we've got this burn patient with a normal
breather, like, what the fuck are these people
doing? And I'm like, ask him something. And he
said the same thing, clear as we're talking now,
and just everyone's jaw dropped. And, you know,
the poor guy passed about an hour later, but
it's that, that feeling of helplessness, you
know, what, what can we do? And I think we, we
definitely, you know, got an IO. I believe that
we pushed, um, I don't know if we even pushed,
pushed, uh, painkillers because I don't think
we're even able to get a, a, um, a pressure on
them, you know? So it was just one of those things
where like, all right, let's just get, get them
to the hospital where they can do, you know,
an internal one and they can make the right decision.
And we don't kill this guy, you know, even more
than he's gonna, he's gonna pass away. But it
is, it's. Absolutely. You know, it's the same
with those cancer patients or the 90 whatever's
that you're working and you're crushing their
ribs. Like, should we be doing this? Where is
that line between all the booklets says this
and the actual compassionate, empathetic human
being says, actually, we should probably do that.
Yeah. Yeah. Tom Zinowitz, that medical director,
he was always very supportive. And he again,
it's what always stuck in my head is. He's like,
I don't care what you do. You better be right.
But more importantly, whatever your actions are,
you have to be able to explain that to the family.
And if I can explain that to the family, then
I know I did the right thing. And that's, I think,
those are the conversations that need to be mentored
for new people getting into this industry, regardless
of what it is, is exactly what you said. How
long ago was that burn call for you? That was
2013. And it eats away at you today because you
felt helpless and what could you do like that?
It's not the calls that I did everything and
I did. It's it's did I do enough? How how do
I sleep at night knowing? Should I have given
something? Should I have not? So those are those
are those existential questions that also eat
away that contribute to those, you know, all
the downstream issues. So, yeah. Yeah. I had
a cardiac arrest on a plane just over a year
ago. I was in London about to fly home and we
were on the tarmac about to push off to the runway.
And the last patient kind of shuffled over and
then just collapsed in the aisle. And very long
story short. Unlike all these news stories where
there was 20 cardiologists coming back from a,
no, zero. No one had even any emergency medicine.
So I ended up running this code, but the poor
crew is Virgin Atlantic. They had to ask permission
for every single piece of equipment to be released.
So the AED, the BVM, oxygen, and their oxygen
only went up to, I think it was like six liters
a minute. Yeah, I mean, it was like nothing.
There was no med bag. I mean, it was just crazy.
So, you know, working it and then the London
Fire Brigade came on and they're not big on the
EMS side. They're very, very basic first responders.
And then the medics showed up, ended up dragging
them to the galley, carrying on working them.
But that was the biggest one of like not being
able to do enough because if it'd been my crew,
this orchestrated, rehearsed, you know, symphony
of things would have happened simultaneously.
But now I'm on my own. with no equipment, you
know, wondering all the compressions, right.
You know, I've got no capnography. I've got nothing
that's going to really help me if we're doing
it. And then at the end, all right, you know,
I'm going to go wash my hands and go back to
my seat. So that I would say of my whole career
was the most jarring one, because we could have
done more. We didn't have the ability really
to do it, but were the compressions, you know,
fast enough, were they, you know what I mean?
All these things. You did everything you could
as a good Samaritan by that point, but the professional
paramedic in you is like, we could have done
so much more. I think he wouldn't have made it.
He had that look. I'm the Grim Reaper. Every
single code I ever had never made it. I'm just
that guy. But that being said, like you said,
if the code went well and you lost them, mentally,
that's a much better place. But when you know
that there were things that should have been
done that weren't, that's a horrible thing to
take with you. Yeah, it's there. It's another
little piece. plucked out of your soul um so
i'll i'm gonna pepper in something please about
it's kind of the opposite of that so i was on
a flight from fort lauderdale to atlanta and
i was working for the easy io and i was in my
scrubs because that's you know we run run to
the airport and you go i was large territory
so i'm sitting up toward the front of the plane
and you know we're in flight and there's this
kid next to me just Just every bit of a shitty
kid, you know, jumping, hopping, throwing, biting,
spitting, screaming. And the mother just do -do
-do -do -do. So I'm like, oh. And then you hear
over, you know, is there a nurse or doctor on
the plane? There's got to be. There's got to
be. You know, and here I am in a set of scrubs.
And then it comes over again. Is there a nurse
or a doctor on the plane? Like with much more.
impetus in the voice because usually it's something
that's you know benign someone's nauseated someone
threw up somebody spilled something and then
i'm like all right i'll get away from this kid
anyway so i hit the call bell and the flight
attendant came over to me and she's like like
something's wrong you know there there's something
so i go walk over and this woman is unconscious
unresponsive in the seat and just before this
flight i was working with i think a legion air
some one of the flight they were looking to see
if they should get pulse oximetry on these things
they have an eemk are you familiar with an eemk
is i am not no well a lot of people aren't so
an eemk is on every american commercial flight
it's an enhanced emergency medical kit it has
everything to run a cardiac arrest uh anaphylaxis
like iv everything um and i was completely unaware
of what an emk was just until like the week before
so and here's the funny thing because you're
saying you know virgin atlantic or they're they're
asking permission for everything and apparently
if you just speak authoritatively enough and
you know an acronym acronym like so i go over
and i just stand up and i look at the flight
and i go give me the emk stat new med bags appear
out of nowhere part blanche open them up And
I ask anyone around, is anyone in medicine, nurse,
and I'm in nursing school. Here's an IV. Do you
know how to spike an IV? Okay, spike that. I
find it. I get stuff to start an IV. I'm looking
around. I look at the, assess the patient. Airway's
open, shallow respirations, got the oxygen on.
Pinpoint pupils. I'm like, ah, it's an overdose
most likely, but let me rule out the others.
So I go to the, I start an IV. I get some blood
and I look at the flight attendant. I'm like,
can you call over the intercom and say, ask anyone
if they have a glucometer. Okay, glucometer.
So she gets on, does anybody have a glucometer?
So I just, you know, big teacher voice. Does
anybody have a glucometer? Checking their sugar.
Like three appear. Check the sugar. It's fine.
Most EMK kits either have Narcan or they don't.
This one didn't have Narcan. Patient stops breathing.
I get an Ambu bag. I start bagging from behind.
And the flight attendant comes over and goes,
the pilot wants to know if we can divert, if
we need to divert. I'm like, how long can we
get to Atlanta? Because this is where I know
is a little bit of a piece of shit and traveling
too much. I'm like, I don't want to divert. Nobody
wants to divert. It's an airway problem. I can
maintain the airway. We can bag. Good pulse.
Everything else is good. We got good vitals.
She's like, we can be on the ground in like 12
minutes. Probably acceptable time. No, no, just
go. Priority clearance. I'm like, yes, probably
travel to Atlanta. Just a piece of shit. I hate
myself that I know that. So anyway. The woman
signs up coming around. She took too many Percocets.
Her father had died. So she is overdosed a little.
We'll find them coming back. So Atlanta Fire
comes on board. And I got a line, oxygen, all
this stuff. And he's like, I can't replace all
your medical supplies. I'm like, mine? They're
the airlines. They didn't know that they had
them. So they escort the lady, take her to the
hospital. So the crew's like, hey, can you talk
on the phone here? This is our medical director.
They kind of want to know what's going on. So
I just tell him exactly what I did. And he's
like, oh, OK, good. Hang up. And I give him my
business card. I was working for Vitacare and
they were out of Texas at the time. But, you
know, I lived in Atlanta then. And I remember
getting a card in the mail weeks later and it
was from Vitacare. And I open it up and there's
an envelope in there and it's from the Delta
Crew 1739. We want to thank you for your efforts
in this call. Enjoy the basket. So then there's
another envelope. It's from the secretary at
Vitacare. Hey, Eric, here's the card from Delta.
We ate the basket. So they sent like a meat and
cheese basket. I don't think that would happen
this day and age, because I think now it requires
a lot more due diligence to release that, much
like what happened with you. Yeah, yeah. But
actually, the EMK, I had a syncopal patient,
basically. and he dropped and it was funny because
when people say is there a doctor there's a lot
of different professions where you have the title
doctor doesn't mean you actually understand emergency
medicine. And I witnessed that not being arrogant.
I didn't get up at first because all these doctors
showed up. Now I realized they were probably
podiatrists and proctologists and had no idea
what they were doing with emergency medicine
or philosophers maybe. So I ended up doing a
full assessment again, but that time they did.
And I had epi, I had, I mean, everything, like
the whole gamut. And ironically, when it was
actually a cardiac arrest, when I needed all
that stuff, it was nowhere to be found. Yeah.
So. I actually I applauded the crew. They were
phenomenal. They really were. I mean, every we
had bystanders helping. Let me be very clear.
They just weren't, you know, like ER nurses or
doctors or anything. But and then the crew after
that, a couple of them went home and I told them,
that's amazing. Good for you for knowing where
you stay, where you're at now. And then the rest
of them carried on and served people after as
one. She had 28 years as a stewardess that never,
never had a cardiac arrest. And that was one
of the last ones that she had, I think. I think
she kind of transitioned out after. So, yeah,
getting to talk to them and let them offload
a bit. But, yeah, I mean, it was crazy. It really
was. And good for you for doing that. It reminds
me, there was an old episode of the show Scrubs.
And it was a comedic, you know, thing. But the
head guy, who's really a pain in the ass, and
he's looking at this doctor through the window,
explaining to this family that their loved one
is dead, that, you know. Despite all of modern
medicine and their best efforts, there's nothing
they can do to that patient to survive. He's
like, and that family is going to be devastated
the whole day. And none of them are going back
to work. But that doc is going to come out. That
medic is going to come out. That flight attendant
is going to come out and just go about their
day. Like that's – there's not a lot of professions
where they do that. So to underscore even on
an airline level, you're right. That's a horrific
event. You know, when that football player dropped
and they did CPR and it affected the whole country.
Oh, my God. It was so traumatizing. Yeah. Yeah,
it is. It sucks. It is. It sucks. Now watch,
rinse, repeat, and then go to the next call or
go to the next room and put on the smile and
go, hey, Johnny, how's the kidney? You know,
it's, yeah, we're the best directors in the world,
I think. Absolutely. Well, you mentioned earlier
about, you know. Practicing on cadavers. One
of the best trainings I had in the last place
I worked was we did a cadaver lab. Did a bunch
of crikes, you know, a bunch of needle decompressions.
And it's bizarre. If anyone has done it before,
I had a torso who the face was wrapped and then
it stopped right where the ribs were. So very,
very eerie. No arms, if I remember rightly. So,
yeah, it's quite an interesting thing, but invaluable
for. I mean, they use it a lot more in natural
physicians and that kind of thing. But from a
paramedics point of view, and this is towards
the end of my career, it was incredible just
to go over and over and over again on a real
person. It's practice changing. So when I worked
for VitaCare, that even when they sold the Teleflex,
we did national cadaver labs. And I've been fortunate
enough to have been part of that for almost a
decade and hundreds and hundreds of these labs.
And I'm all about. educating up. And just, you
know, I don't care if a chest tube is not in
your scope of practice. I'm not teaching you
to be competent on the chest tube as a nurse
or a paramedic. But while you're helping someone
who's doing it, now you understand why it might
be difficult. You anticipate what needs to be
next. But more importantly, how else and where
else were you going to be able to operate in
an environment of zero consequence? Make the
wrong cut. Put the airway in the goose. Try a
new blade. Try a new technique. It's consequence
free. And that taking that away versus I'm in
the OR, I got to get the intubation the patient
needs, you know, get it in the goose. Try one
of the goose in there. Try stuff you wouldn't
do. And I agree with you. Some of the most fulfilling
moments of my life have been teaching those cadaver
labs because I always learn something, you know,
and yeah, I agree. I'm happy that it's more and
more available. for paramedics, nurses, and not
just the physicians. I'm seeing a push now where
I think even chest tubes are being presented
as a possibility for medics in the field. But
that's what I found when I got to that point
is like, okay, well, what's next? Like, how can
we increase our skills? I'm having Dr. Antevi,
the guy behind the Antevi system. He's coming
back on again. We're talking about whole blood.
I mean, there's all these innovations, but my
career, it was kind of like, no, this is all
we do. This is our scope of practice. But then
where are areas, you know, what are, I mean,
even like field amputations. I know it sounds
crazy, but who is there at the time while the
person's in track? It's the medics. You allow
us to cut people's throats open, you know, then
give the education so you can safely, you know,
remove a limb so you can get that person out
to the hospital before they bleed to death. So
I love these conversations where they're pushing
the parameters out in the paramedic world. I
spoke about this before with someone else. So
with Antevi and Shepke and Paul Pepe and all
the eagles. So, I mean, you're familiar with
that group. They're medical directors of all
kind of the big EMS agencies. So they get together
once a year and they really try to have this
evidence -based push, just what you're saying.
whole blood was kind of a baby of the Broward
County medical director and it's usually born
out of tragedy you know he lost his niece uh
in an accident in Florida and she was just over
salinized and it really hurt him so he's like
whole blood whole blood and and that eagle network
helps each other's initiatives. And you're right.
What starts out as this blasphemous thing, you
know, only a nurse, two nurses and double verification
and, you know, to get this blood, it doesn't
exist anymore. You know, there are safety parameters,
but why? Why were we neglecting some very smart
people because they didn't have the right initials
after their name? But the training is there.
The evidence is there. And you're right. That
stigma is going away. But more importantly, it's
difficult to replicate that. So you can have
Broward County's carrying whole blood. But how
do I get, you know, Bartow Fire to do that? You
know what I mean? They don't have the budget
to do that. Their medical direction is not unified.
Their medical director might be more of a paper
medical director than an involved medical director
and may not want the legalities of that. That's
the bigger question that I have is how do we
take these phenomenal ideas and these practices,
finger thoracotomies, you know, just what you
say, and how does that become standard of care
financially and legally? I think, I mean, even
when you talk about a lot of deliveries of service
or even say, you know, having a nutritionist
and a strength and conditioning coach, if you
are in Miami -Dade or LA, yeah, you're going
to have multiple because you've got the budget,
you've got the number of people. Let's say now
you're in, you know, like you said, a smaller
area where it's more, you know, towns and that
kind of thing. Well, then it's when you come
together. And I think Anaheim. When I worked
there in California, they had networks. So where
we train was called North Net and that was Anaheim's
training tower. But we were trained with Fullerton
and Orange and all the surrounding departments.
And so, yeah, if you yourself aren't big enough
for this thing, then again, we're talking about
humility. So as a medical director, have the
humility to actually work with the agencies around
you so that you can share blood. Like one of
the people I was talking to recently said the
blood is actually on the helicopters where they
are. So, you know, it doesn't have to actually
be on every rig. If you can't make that work
in your municipality, then get it on all your
helicopter transport. So at least as soon as
they get there, now you can start giving blood.
OK, that's another great alternative if you're
not in a highly dense population. Right. But
have a backup when it's bad weather and they
can't fly. Oh, 100 percent. The contingence on
that. Yeah, it's yeah. And the critical care
paramedicine has really, really. um legitimized
I think EMS you know um in in a great way so
I don't I don't mean to detract from that but
yeah you're right the whole blood initiative
and and and educating up I'm glad it's happening
like that's a great thing about EMS is it's not
stagnant you know it it keeps evolving in a good
way and yeah and ego's a bastard you're right
the ego has killed a lot of patients and it's
not it's not the the clinician's ego it's yeah
someone higher up the chain that's afraid or
doesn't whatever the whatever the motive is to
not propel forward not an early adopter a late
adopter or a non -adopter i know you worked in
the kind of you know medical equipment side as
well before we jump into some of the innovations
that you're excited about What is your perspective
on backboarding? Because there's just some things
that are true. Like, for example, a car fire
is a class B fire. It's oil, it's tires, it's
plastic seats. That should not be water. That's
foam or smother it. But yet, since I was taught
in school, it was always just flow water. Makes
no sense to me. And then backboarding, we all
know that when you strap someone to a board,
they slide around like a Russian on an ice rink.
And it just doesn't make any sense. It just does
not make any sense. And then they're uncomfortable.
You got the elderly with the scoliosis and then
positionally, some of them can't breathe. So
that's what I've seen observationally through
my career. And you've heard even that there was
no real research to support backboarding in the
first place. So what has been, you've got a much
longer career than I had. What is your perspective
on immobilization in EMS? I think there are certain
situations where it necessitates immobilization.
Hands down, cardiac arrest on the third floor,
fourth floor, whatever. So take that out of it.
Where you can clear a C -spine in the field,
fine. I don't see why that's not, like you can't
do that, why there's not more of a case. I honestly
think it's also perpetuated because that's just
the way that it's been done. That's the cool
thing in medic school and ENT school. Let's strap
you to the board and hold you upside down. And
we got all these clips and, you know, it's part
of it. So I guess I'm not a big fan of backboarding.
For all the aforementioned things that you'd
said, yes, they create these pediatric boards
that scoop up the head, but there's nothing for
the obese patient. There's nothing for, you know,
it makes intubation difficult. There's so many
more. benefits to being able to have somebody
mobile particularly and let's go way back you
know 48 minutes ago and we're talking about sitting
in the emergency department in the hallway you're
on a backboard you know how long before the decubity
starts it is uncomfortable and if they have to
pee and how efficacious is it what is the risk
benefit of doing that physically emotionally
and mentally for your patients so yeah and what
the i don't have the right answer Well, it's
just interesting what the physicians do to clear
them. Like you said, it's not medical level stuff.
It's basic stuff. It is a physical assessment.
So if they don't have the mental capacity to
pass that physical assessment, yeah, I can argue
with using it. You're erring on the side. But
where do we draw that error? Well, I think it
goes back to courage, like we were talking about
before, that paralysis by analysis, this fear
of litigation that's paralyzed in a lot of agencies,
a lot of medics. I was like, you know what? Like
you just said earlier, if you're doing the right
thing and you can explain it to the patient,
then you shouldn't be terrified of some court
case or whatever. If you did everything that
you were supposed to do. then you're good. But
this whole fear of, oh, what if? We've got to
take everyone to the hospital because what if
there was this one time? It's like, all right,
but then they can call us back if things get
worse. But right now, they don't want to go and
we're not seeing anything that warrants an ER
visit. So I'm good with it. They signed the signature,
off we go. Even though, again, those tough book
signatures can stand up in court. An articulated,
educated response to why and they agreed with
you. But yeah. What if, and this is always how
we've done it, are just daggers out there? Because,
again, it's courage. Like an agency saying, if
you do everything right and someone comes after
you, we've got your back. And we don't hear that.
We don't. Not enough. No. No. All right. Well,
let's talk about medical innovation. So you've
worked with that for a long time. What are some
of the innovations that you've seen that you're
really excited about? So I have to go back to
my baby, which is the EZIO. So when I was flying
in Florida, my wife does research for her work.
She got recruited to Emory for neurology research.
And she had some family there. And I'm like,
absolutely. You supported me through my career.
Let's go up there. I can pick up a flight job
there. I'll still fly in Florida. But as the
stars aligned, the chief flight nurse I was working
with here in Tampa. She was working with Dr.
Larry Miller and VitaCare and this handful of
first, you know, people hired for the development
and hopefully the perpetuation of the easy IO.
But you got to understand, back in then, I started
with 2006 with them. IO was a blasphemous word.
It was the last thing you ever did for a dead
or dying kid. That's it. Or you have some jockey,
you know, military guy doing a sternal IO. Because
it's, you know, like it's got a shock factor
to it. But it was not remotely standard of care
unless it was a pediatric patient. And it's the
last thing you ever did. So Michelle asked me,
her name is Michelle Moe, smart, smart woman.
But she asked me up in Atlanta, she needed an
educator. So I came on board. And yeah, like
before that, we were just doing peripheral lines.
And if you were lucky enough in a flight crew,
you can do a central line, which was not very
common. But other than that, you just poked and
poked and poked and prayed that you can get vascular
access. If that wasn't the case, you know, again,
out of tragedy comes innovation. And that's what
led Dr. Miller to develop the EZIO is he had
a friend who was a fire chief in Texas who just
insanguinated because they couldn't get vascular
access. And it dug it into the core that he lost
his friend because they just couldn't get an
IV. So he found a drill in his father's workshop
and toyed around with it, and that's where that
came from. But when I got brought on board, there
was about 15 of us, and trying to convince the
country to drill a needle into your bone or into
the bone of a person, adult or pediatric, there
was a lot of naysayers out there. There was a
lot of shut doors. There was a lot of people.
I've had physicians say, I will sue you. for
child abuse, like it was crazy, but that's what
it was. And then AHA changed their recommendations.
We had enough evidence -based to support the
efficacy of it that IO became part of the AHA
algorithm. IO, then IV, identical to subclavian
and central access for pharmacokinetics. We held,
which is not, you know, animal labs are always
polarized. just because of the nature of animals.
But, you know, back in the early days, we had
these animal labs where we had goats and we would
show the pharmacokinetics. We'd have an ION and
we would do atomized aerosolized epi down the
tube and there would be no response. And then
we would put a quarter of that into an IO and
you'd see tachycardia within two seconds and
hypertension, like the physiologic effects of
those pharmacokinetics. You can't, you know.
You can't debate that. It works. So then it became
just educating and expanding from pre -hospital
to emergency department to ICU to in -hospital
code carts. And I think you'll agree, IO has
really just become standard of care throughout
the world. I mean, it's been literally life -changing
for patients. So I was fortunate enough to be
on that early access to that and to see that.
And then the company was sold to a larger company.
And then it was time to just step away because
I was there for nine years. And I think I was
on 645 Delta flights in that time. So I just
lived on an airplane. Yeah. The travel was excessive.
It's an amazing innovation. I mean, it spanned
my career. Before it was no IO. There's a few
things that actually came in, which is what I
say to people now is like, you know, fire an
EMS. We're standing on the shoulders of giants.
Our generation, my generation, really the next
thing that we can do that's really going to make
a massive change is change the working environment.
Give our responders rest and recovery. Talk about
mental health. Put in fitness standards. Look
at the individual in the uniform. But as far
as fire, for example, they already invented the
SCBA. The Halligan is pretty perfect. You know
what I mean? The extrication tools are phenomenal.
Now their battery, even better. And even in EMS,
it's not that often where something really, really
good comes in. But the EZIO, the MAD device for
a needle, it's amazing too. Everything you don't
want a needle around, it replaces. Right, these
supraglottic airways, the ability to create better
care for your patients easily. And it's funny,
when you start creating, when I say you, when
the industry starts creating these innovators,
these devices that make the job easier, it's
not always well -received because some people
pride themselves. I can get, I'm the only one
who can get every IV. Well, if you take that
thing that makes you special away, it's not always
well -received. It's ego. It's ego. It's crazy.
It's out there. Mechanical CPR. I mean, I can
tell you, well, that's what my rookie's for.
Yeah, but your rookie's inconsistent. you know
you have something regardless of device that
you use that that metronautically gives consistent
compressions why wouldn't you use that it's not
going to call out sick its back's not going to
hurt it's not going to need you know a day off
so things like that that make make it easier
make it better for the patient's outcome that
are innovative so those devices yeah i'm sorry
please No, no, I was just going to say those
are the vices. And then there's, I'm sure, tons
more that I'm not aware of. You know, I'm not
riding in a rescue anymore. We had, I think it
was Zoll. I don't want to misquote, but it looked
like a boogie board. and then it had scraps the
auto pulse that was it yeah that was a pain in
the ass i i mean they taught us well and everything
that didn't seem to work but the lucas is the
one for three years oh did you i was the yeah
i was the clinical in sales for that device yeah
it uh you know they've redesigned it but you're
you're right it if you if if the job is harder
to me even though it worked better it perfused
better and scientifically there's it's it didn't
make the medic's life easier if you're not going
to make somebody's life easier or they have doubt
they're not going to use it yeah but you're right
you're exactly right yeah absolutely but the
lucas is what they took the dude away off the
plane in the end but that one is the one i hear
most these days it seems to be well received
yeah yeah i mean it's it's it's consistent it
does its job So, and you're talking to the guy
who sold the competitor. There we go. You know,
the auto pulse physiologically worked better
because I don't want to piss everybody off. It
really did. The problem is, is it, it had issues
with replicating the ease of applying it and
using it. Yeah. They just seem to malfunction.
It seems to kind of. And they'll come out of
place sometimes, especially, again, when you're
actually in the back of a rig that's swaying
and breaking. It's hard to overcome doubt. Yeah.
Right, because there's always going to be doubt.
What if I put it on and it doesn't work? And
then that goes back to what we were talking about
earlier. Should I have taken it off? Should I
have been playing around with it? Or should I
have just jumped on the chest? Absolutely. So
all those things come into a decision in a quarter
of a second. It's funny. while we're talking
about that and something i've been talking about
recently and it's interesting um i like i said
was the grim reaper medic like pre -code lots
of saves yeah when you went into cardiac arrest
and i was your medic the just you know you're
you're off to go see the good lord it's just
gonna happen so i reflect on the moral injury
piece and when you think about how we're trained
if we in the fireside you know we go do our little
um burns in the burn building and you do a right
-hand search and you find the baby and you come
out and you put the fire out and yay, good job,
James, you did it right. Here's your certificate.
And then in the EMS side, you have a mega code.
Okay, here's your initial rhythm. Oh my God,
they got into asystole, whatever. You work all
these different codes and algorithms and then
you get them back. And what I realized is we
do a huge disservice to our young firefighters
and MTs and paramedics because we don't weave
in the fact that the likelihood of ROSC. on a
cardiac arrest is extremely low. And should we
actually, in the testing, should we weave some
things in where they do everything right and
they still die? You test them on if they did
everything right, but then you expose them to
they died, and then maybe you've got to go talk
to the family as well within this test. And I
think that would set us up a lot better. Yeah,
your podcast with Diana spoke about that. And
you're right. I don't want to say I didn't enjoy
ever giving the bad news, but I would prefer
I gave that bad news because I've seen it so
many times done wrong that there's a way. And
you're right. They don't teach that. I was teaching
nursing school for a BSN program here. And one
of my duties was I ran the high -end simulation.
And that's what I would do. Every situation was
black and white, but I made them all gray because
I want to know what you do. Like one of them,
okay, let's – and they're based on real circumstances.
So I have a kid come in, and he's 18 years old.
He's diabetic. He's hypoglycemic. They identify
it. They give him the glucose. He comes around.
As he's coming around, I would pick up the phone
and call in and say, yeah, this is Jimmy's dad.
Is he in there? Oh, yeah, yeah. Tell me about
what's going on with Jimmy. Oh, yeah, what room
is he in? Okay, oh, yeah, diabetic. Okay, good,
good, good, good, and hang up. And then I go
over to the microphone. I'm like, as the kid,
dude, was that my dad? Was that Jimmy? Dude,
don't, that's not my dad. Like, he tried to kill
me. I got a restraining order against him. And
so the kid's 18, so he's an adult. But to have
these students process in real time, oh, shit.
I shouldn't have given that information. Now
what do I do? So now I wait to see, do they call
security? How do, what parameters do they put
in place? Like, it's okay to make that mistake.
Now you have to fix what you made. And I got
more enjoyment discussing the gray area than
the black and white, which I think goes back
to what you said. I don't think it's done enough.
Yeah. Well, I think that's where the critical
thinking happens too, whether it's that kind
of scenario or just any call. And again, this
being shackled by the fear of litigation is the
enemy of critical thinking. I had an amazing,
medically amazing call. This young woman, clearly
a multitude of drugs that she'd ingested were
on the way you know lights and sirens gave her
narcan um and in this very short transport every
body fluid that could came out of every orifice
that it could come out of at that point so i'm
just cleaning up red bagging all kinds of stuff
as we're trying to go there but um ultimately
what happened is she was actually in ketone acidosis
Um, so the cruise moles kept her alive from the
respiratory suppression of the opiates. So medically
it was an amazing case. So you, you, you address
one. Okay. Now, but I've still got a bunch of
things going on, but if you're a cookbook medic,
you're like, all right, check. I did it. And
now, you know, now you're done. So, uh, yeah,
I mean, just, just the ability to think laterally,
not only on, on the medical side, but this, the
compassion side, I've made mistakes. I've been
too callous on calls with family around. Sure.
The frustration. Yeah, exactly. But, but yeah,
I don't even know what was going with that, but
I think it's just important to, to understand,
you know, to, to be taught to think laterally
rather than this very rigid algorithm that you're
taught by, you know, whatever it is, your powers
clause or your ACLS. Yeah. So I have this thing,
whenever I oriented new staff members, flight
nurses or medics or whatever is. it's a concept
that if you're confident in your competence,
you can pay attention to the small things. So,
and that's one thing when somebody asked me,
like, you know, what do you do when you roll
up on scene? The first thing I do, I don't care
what it is. I slow my step down to a half step.
I walk up and I look for the most scared person
in that room on that scene. And I go up to, I
know I can intubate the patient. I know I'm going
to get a line. I know I'm going to do that medically,
but I go up to him. I'm like, you did a great
job. Thank you. Thank you for whatever. You know,
you did a good job. The ET2 is in the anus. It's
at 22 with the sphincter. We're going to put
it in the airway. Trauma center is weird today,
but whatever the case is. And just like now I
control the room. Now I control and I can see
where, and once you take that high level stress
person down, everything settles down a little
bit. And now it's a time to move smoothly, which
is faster and better. And one of the calls we
had, it was a partner and I, Scott, we worked
very well together. We flew out for a motorcycle
accident and we had an Orientia new flight nurse.
And we get on the grounds in Hernando County
and we get in the back of the rig and they got
like an alternate airway in. But the medic is
there just white as a ghost. And I paralyzed
him like he was so combative. I paralyzed him.
I couldn't, I just put the supraglottic in. Is
that okay? Like I paralyzed him. And our flight
nurse is down there, the orientee, and he's getting
the airway and sucking it out and putting the
tube down and he gets it in. And, you know, Scott
and I are, we're taking the whole situation.
Again, lateral thinking. And I spoke with the
medics. He did the right thing. That's the right
call to make, you know, preventing secondary
injuries. You got an airway in, we'll get a permanent
one. That's fine. It's okay that you paralyzed
and sedated that patient. Good job. So we get
back. We're debriefing with this new nurse. And
he said, yes, the tube. I got the tube. I'm like,
dude, that's your job. Like you did your job.
That's your job. You missed the most important
part of that call was how afraid and scared that
medic was that they made the wrong decision.
And they just needed someone to verify that they
did the right course of action. Even if it wasn't
perfect, it was right. And we as a team can make
it back. You totally missed that. And that was
the educational opportunity of that call, not
putting a tube between the cords in the hole
closest to the nose. I'm glad you did that. That's
what we're training for. But this is the bigger
picture, taking in that, what you said, just
lateral thinking, looking around and going, okay,
what needs to be taken in on this? That's not
necessarily linear algorithmic to a patient.
Absolutely. Well, kind of shifting the conversation
a little bit. As you progress through your career,
when did you start writing? Was that early on
in your life or was it something that you kind
of learned into later? So everything's on a bet.
I have trouble saying no. So when I was stopped
working for VitaCare, there was a nurse friend
of mine and she was down in New Orleans. And
her friend was an editor and asked her to write
a trauma textbook. And she's like, I don't have
time for that. It's not my specialty. So she
calls me up and I went back to flying full time
at this point. She's like, Eric, do you want
to write a book? Sure. Okay. What is it? So I've
never written a textbook before. I've written
journal articles. I've written, you know, chapters
of books, but never an entire book cover to cover.
She goes, it's a 19 chapter textbook on trauma.
Here's the editor. And I'm like, okay. I had
no guidance, very little. And writing an evidence
-based medical textbook is exhausting when you
don't know what to do. you know i'm driving to
the library the medical school i'm trying to
and i realized there's easier ways to do this
i can do a lot of this online i need to get more
up -to -date research i need to get the evidence
so once i figured that out but then okay i got
these three chapters in and then i'm dealing
with you know content editor copyright editor
and then they have peer reviewers so i'm on chapter
five i'm getting chapters one two and three back
it was I'm trying to get permissions for photos
I want in the book that underscore whatever topic
I'm talking about. I'm trying to get permissions
for like the Wong Baker chart. Like I have to
get in touch with her and the fees for that.
And just like I vowed I would never, ever, ever
do it again. Never. So 12 textbooks later. But
once I finished that. Like, it was awesome. Like,
that's cool. Like, I wrote a book. And then they
asked me to write smaller books. And then I realized
if I take my own pictures, I don't need to get
permissions. You know, if I can streamline the
way. I got it down to the point where the last
book I wrote, I was negotiating the contract
price on it. It was another trauma textbook.
This one was 19 chapters also. And as I'm negotiating
the contract over the weekend. They gave me another
book on pediatric abusive head trauma that I
did in two days. I gave that back to them because
I can create my own charts. I know how to work
the system now. Then that final book from signing
the contract until I had it in hand was six months.
That's pretty cool. I put my kids in the book.
I put coworkers in the book. I had a lot of fun
with it. I took my own photos. if you don't know
how to do it it's taxing but once you do know
how to do it it's it's really fun you know you
get into a rhythm um and then the one thing i'd
say to peer reviewers have you ever been a peer
reviewer james oh no no i haven't be kind because
in about chapter three the peer reviewers are
i know more than this person you know unanimously
and then there's like little digs it's just it's
it's empiric evidence You may not have ordered
it that way. I might have used an Oxford comma.
You didn't, you know, it's, it becomes, it's
not a tit for tat. This is, it's a, it's a holistic
thing. So be kind if you're going to do peer
editing, peer reviewing. So, but that's how I
got into writing. It was just literally, I can't
say no. So what about what you're doing now though?
So the children of fallen first responders and
people in the medical profession, how did that
idea come about? Was there an origin story? Then
let's talk about what you've created. So I would
love to say that there was this beautiful moment
where it all culminated. It really, I was sitting
at a stoplight and I'm looking at this mother
and her baby. And in my mind, she was a spouse
of a first responder. I'm like, yeah, we fucked
up our world. Like there's gotta be some point
that that kid's gonna look at mom and go, why
isn't dad home tonight? Or why is mom not home
tonight? And not every profession does that.
And then there's a lot of professions that do
that that don't get the recognition for that.
You have to – how do you answer that question?
So then I'm like, you know what? I got some downtime,
and I got unbridled ADHD. So let me buy a – I
saw a YouTube video on how to make a children's
book, and I had a lot of trouble. like trying
to create characters i'm using like ai to do
the illustrations and it wouldn't be consistent
and then i'm like well it's a caucasian family
then why isn't it an african -american family
why isn't it you know why isn't it diverse so
then i i got canva that i'm working with them
like in looking through characters i'm like i'll
make them bears like they're bears what's the
flack i'm gonna get why isn't it a panda they're
bears i throw a tie on one it's a dad i throw
a bow on one it's a mom you know it's that easy
but that takes that out of it and then i just
create the scenes and and just talked about you
know what would what would that first responder
want their kid to know at night yes i think about
you you know i have a picture of you you know
i used to have pictures of my kids on my flight
helmet like it's i do think about you even if
it's the worst call or something that i wish
i was there to help with homework like it it
you're there so and this is what that our mom
does in a nice way. It's always helpful. Even
in the book for law enforcement, there's no guns.
There's no on the belt. There's nothing. It's
always the helpful side of it. And we see this
in you. So I wrote those books and a friend of
mine out of Broward Sheriff's Office, Chief Heath
Clark. So he was running the aviation side and
he calls me and he's like, hey, there's this
lady down here. Dawn Witherspoon, she runs the
Fort Paul Foundation. She really helps first
responders and EMS, particularly EMS. Her husband
was killed in the line of duty. He was a paramedic
down there, hit by a drunk driver. And she wants
to know if you'll collaborate. Why would I say
no to that? And oddly, I did write a book about
line of duty death. But just a cursory, just
to kind of... I think something needs to be addressed,
but why would I want to sell a book like that?
I don't have an outlet for that. It's macabre,
but it's also therapeutic. But anyway, so I call
this woman Dawn, and then literally 20 minutes
later, I said, send me what you want to relay
in these books. What themes do you want? She's
like, I want the theme that there's an extended
family, that this EMS community, they're always
part of them, that there's going to be part of
their parent. that's with him some way or another.
So I took her themes and wrote them out, wrote
the book, and then created the imagery and the
illustrations with the Canva. And oddly, very
therapeutic for me to go through that. And like
you, I've lost a lot of friends in this career,
too many. More to suicide than accidents in line
of duty. But this was great. So then, you know,
I put her daughter's name in the book because
she wanted something for her daughter. So it
was her daughter was the character. And so I
gave her that book and she loved it. And then
an airplane went down. She's like, we have to
do a book for the airplane people for flight.
So I said, you're right. fix the book around
and then in between this i get a instagram message
from a guy who's a state trooper in illinois
who runs a got your six foundation and he's like
hey i came across your book like i have this
where i help fall in state troopers families
you know i lost two really good friends can you
this book is great but it doesn't quite work
can you rewrite it or say so let's just start
anew so wrote a whole new story for him addressing
that and he's like well you know the part of
your book says you know like in the back there's
some pages that they can draw pictures of dad
at work or mom at work or pictures or photos
of me and my dad or me and my mom he's like this
baby was wasn't born when they died so he took
that out you know just so that was very different
for me um because And these foundations take
the books. There's no charge for them. They donate
them to these families. And I wrote him. I don't
really know. You don't see the back of, are they
helping? Is it good? And then I get a text from
someone. He asked to remain anonymous and said,
this is a picture of this child who lost their
parent. And this is the first time they wanted
to talk about it through the book. the wife called
me crying because now it's a nighttime ritual
um the fallen flight you know the helicopter
recently like the books were presented to the
flight crews and the honor guard all signed them
and they wanted more and more people to sign
them and so they asked if i would add more pages
to the book for for people to write you know
so this whole thing has taken off and like i
got goosebumps talking about it because like
i get no benefit out of this but to know that
it's helped people i mean like your books they're
they're words they're your emotions but until
you see an impact of what that does it's just
awesome like it's awesome you know i i don't
know what else to say i i'm very happy that they
reached out and allowed me to be part of this
um even if it's out in anonymity they're they're
out there you know it helps it helps it's amazing
You mentioned earlier about your family losing
the breadwinner when you kind of transitioned
out of the home and then obviously losing people
and then all the calls that you've had and then
this writing being somewhat cathartic. When you
reflect back now, what have been your lows and
what have helped you kind of climb out of that
dark place? I think. One, my wife is a nurse.
And so she's never worked flight or paramedicine.
She's done recovery and open heart. But having
a medical background where I can say X, Y, and
Z, she understands that. Huge, huge. co -workers
and friends, more the co -workers that are my
friends. You did a podcast, I think, way back
in the 300s with Ray Norton. Yes. And Janelle.
So Ray and I were partners for many years. And,
you know, Ray and I were the A -team, man. And
Ray is very open about, you know, the impact
it's had on him, the careers. So the highs and
lows have been shared. And I think that's important
to understand that, you know, you're going, the
bad calls, somebody's worst day of their life
and their family, you're part of that. Your team
is part of that. It's okay to sit with your team
and say, that was fucked up, right? Like, you
understand that, that wasn't normal. And then
we'll crack a bad joke about it. But then, like,
it's so important. lately and this is going to
sound silly what helps me is talking to a lot
of my friends even they're all retired none of
us are flying well some of them are but the power
of dude i love you man like we've trauma bonded
over a lot of things and i really need you to
know i love you like a brother like a family
member like you've helped me and it's okay the
bro code is gone that the ability to to share
that emotion it helps me through the lows just
to know that that they're they're there for me
you know and it's not the daily call but there's
calls you know how are you today what's going
on more importantly what can i do to help and
those have gotten me through the lows it's the
family it's the friends or educating people that
when you go up and this is not my words i've
heard it when you ask me tell me about the worst
call of your life Well, you're asking me to relive
really horrific moments, and what you want to
hear is the blood and the gore where the most
horrific calls in my life took such an emotional
toll on me. That, yes, there might be blood and
gore associated with it, but when I'm walking
down the street and I get glimpses of this tarp
that blows open from the wind and there's eight
or nine dead children, I'm not touching because
there's nothing I can do for them. It's haunting.
So, you know, educating your loved ones that
there's going to be moments that I might be like,
oh, and when's the moment you knew? I think it
affected me. I'm asking you that, James. Do you
know the moment? Like, was there a defining moment
where you said, yep, this affected me? I always
go back to this one we had, and it was early
in my career, and it was interesting because
that was the one that took my breath away, put
it that way. Now, it didn't stop me from moving
forward, but we had a horrendous car crash. The
passenger was killed in the front. I don't want
you to relive the story. I'm asking you now what
I just said not to. I guess you're more than
welcome. I would love to hear the story. But
is there a moment in your life where you realized,
yep, I'm not on a call, but this affected me.
And I would love to hear the call if you choose
to share it. I'm not asking you to relive that
moment again. Yeah, no, I mean, this is what's
weird is I've been okay. And again, I think this
is so important to people to talk about. Some
of us had stuff happen when we were young that
was shoved down by circumstance and buried. And
some of us were just. super fortunate that what
happened when we were younger, there was some
other things that helped you start working through
it at the beginning. And that's the only difference
between me and so many of these people that I've
had on the show that have been in this deep,
deep, dark place. The only thing. We're both
people. We're both paramedics. We're both firefighters
or cops or whatever it is. So it was a very long
story short. It was a decapitated three -year
-old. Actually, the engine company had covered
the body. So it was actually really just this
distorted silhouette and then the little... legs
poking out the bottom but where I had an insight
into wow this is something that we carry is years
later I was at Disney with my my wife I hate
Disney but that's how much I love her um and
uh it was so hot that someone had a blanket over
their child and the same kind of little you know
aged feet were poking out with the similar shoes
and I had this wave of adrenaline this massive
rush. And I told my wife, I'm like, babe, I just
need to sit down for a sec. And that was it.
So even then was that as, as, you know, they
have the same magnitude as me not being able
to sleep. Cause I keep getting these things replaying
in my mind and the drinking. No, but that was
just a real punch in the gut. Like, wow. It was
almost, it gave me more compassion and empathy
because I was like, wow, if I'm doing okay. And
that flashback sucked that much. I can't imagine
what it must be like to get it over and over
and over again. That was around the time I was
starting to be an advocate for all these things.
I think I'd just transitioned out. So that was
really where I realized, yeah, because up to
that point, everything really was just in the
back of my mind, even that burn patient and that
horrific day. None of them bother me. None of
them haunt me. But is it in there? Is it taking
a toll? Of course it is because you can't see
that shit and it not change you. And it's changed
me. There's no question. But yeah, that was the
real physiological gut punch where I was like,
oh shit. Yeah, that's in there lurking. That's
still in there. Thank you for sharing that. I
guess that's, I think that's important. That's
why I asked that because it does manifest in
weird ways sometimes. And it's not always just
what you said, that textbook, I'm not sleeping
in this. oh okay i wasn't expecting that to come
and yeah and what you're talking about is before
about you know people being exposed at different
ages you know i'm just under the philosophy of
this everybody's broken everybody is some of
us just have access to better glue and that is
important the glue's there some of it got it
earlier some of it got it later but everyone's
a little bit broken and and the share of this
helps underscore that So, man, yeah. Yeah, I
agree 100%. And this is just it. I mean, the
hope in the fact that there are tools out there,
especially today as we sit here, everything from
equine therapy through to psychedelics and everything
in between, everyone's own personal toolbox is
available to them. But you've got to give them
hope. If they don't believe that they're going
to get there, if the person who's gone to the
doctor's office and they were just given statins
and they didn't have a conversation about, hey,
you know, you can reverse this. If you change
the way you eat and move more, there's no hope.
Like, oh, they told me I'm going to be on this
forever. So getting people to understand that
post -traumatic growth is a real thing and that
you will be different, will always be different.
You can't unsee the shit that we've seen, but
you will be a stronger version of yourself. You
will. And then you become a beacon of light for
other people. And as that kind of... A parable
goes, the guy's stuck in the hole and the doctor
goes by and he asks him for help and he goes,
oh, okay. And he writes him a prescription and
throws it down there. And then the priest goes
by and then he rips out a piece of the Bible
and drops it in there. There you go. And then
a guy goes by and he jumps in the hole and he's
like, what are you doing? This is his friend.
He jumps in the hole and he said, it's okay.
I've been here before. I know the way out. This
is the thing. That's what you become. You become
the person that can help other people. So there's
so much hope in that. And then understanding
that, yeah, it doesn't matter what your own accumulation
of tools is, you can start moving that way, but
you have to believe that you can. It's awesome.
That is a great personification of using that
story. That's awesome. Yeah. It's a humbling
career. Yeah. It is. But I mean, incredible human
beings. This is why I've been out now almost
seven years out of the job. This is why I'm fighting
for them, because what a beautiful profession.
I mean, they are arguably the real leaders that
we need to be seeing front and center. So that's
one of the I love educating and teaching for
that for that element alone. And when you share
that, it's OK. And you share the experiences.
And if you're willing to share them and how you.
cope with them or how you deal with them or who
your support system is and help them identify
that. It's really important. Absolutely. All
right. Well, I want to transition to some closing
questions and then we'll get to where people
can find the books. Very first one, is there
a book or are there books that you love to recommend?
It can be related to our discussion today or
completely unrelated. So, yes. So there's one
called – let me get the exact title here. So
excuse me for a second. It's Maxim's. It's from
Tom Gordon. He is the Commandant of the Citadel.
And I want to get the exact title for you. Marine
Maxim's. So Tom is a friend of mine and was a
neighbor, and he – uses kind of there's a lot
of books out there from the military and special
forces or whatever but what he uses is these
little idioms and axioms throughout the the career
and how to apply them in every day and i think
that's important you know we can we can learn
a lot from these militaristic mantras and and
knowing that sometimes when you reframe what
you're doing and you reframe it, that it's good
for you. The challenge isn't always negative.
There's a positivity that comes out of that.
So that's a good one to have. I just don't really
have a full library of stuff. I like to read
a myriad of different things. A lot of it's geeky
stuff. I read a lot of medical stuff. I wish
I had more wisdom to... partake on that um i'm
sorry i don't no no problem at all what about
films and documentaries oh yeah uh the documentaries
i like are the ones that just show um what we
were talking about earlier like there there's
there's a sensationalized view of things but
when you peel back those layers and you see the
motives and what's going on you know kind of
behind those you know the everyday things i mean
you can take it from and there are lots of different
ones if you take it from you know uh you know
serial killer ones and you look and you start
looking at these different backstories and how
to identify that uh upwards of you know these
documentaries about say you know a tsunami and
that coming through or the volcano eruptions
and you see the real stories behind them and
i like to see that true grit that comes out of
it like you're in in in these cases and it's
easy to sensationalize that but when you show
the real people that are there during this this
avalanche or there was one and you know the grit
and determination to find that one and you think
they're dead you know the the real human gut
comes out like a you can't replicate that in
a movie until you see that raw emotion come out
and you know and they're choking up and you feel
them you know at that the lowest point and how
they overcame that like i love those type of
documentaries and they're sadly associated with
tragedy but i like that yeah i saw the avalanche
one recently too it was incredible yeah really
just yeah absolutely All right. Well, speaking
of amazing people, is there a person that you'd
recommend to come on this podcast as a guest
to speak to the first responders, military and
associated professions of the world? So I do.
There's an old neighbor of mine. He is a retired
SEAL Team 6 disabled veteran who I think has
a phenomenal story. Very articulate. He's approachable.
And more importantly to me, I mean, this man
has overcome his time in the military and is
so relatable. It's not easy transition to be
there and then to come into a corporate world
or regular world where you're not doing these
sensational things every day. He does a very
good job at it. His name is Dave Sears. I would
recommend him. He's a very knowledgeable and
well -spoken and he's got a lot of backstory.
And he also applies that to his life, you know,
and helps his kids and helps. He's just a very
understanding man. You look at him and go, wow,
I wouldn't have known. So I like that unassuming
humbleness that people portray like that. Beautiful.
I'd love to get him on if you're able to help
them. Yeah, sure. I can do that. Fantastic. All
right. The other one. No, please, please. Oh,
I see. There's another guy, Ken Williams. Ken
Williams was a pilot I flew with in Las Vegas.
He used to fly for the movies, but he's also
flown for Ventura County, and now he flies for
L .A. County. He flies the Firehawk helicopters.
Ken's had an amazing career over the last 30
years. Ken saved my life. on more than one occasion
but he i call him my hero for a reason he he
saved my life in a helicopter um but you know
i was able fortunate to go fly with him a few
years ago out in la um that's another one that
would i think be a great person to have on beautiful
let's make that happen too i mean not only the
the fire side but the movie side obviously i've
got the the stunt connection too so yeah Awesome.
All right. Well, then the last question before
we make sure everyone knows where to find you
in the books, what do you do to decompress? Oh,
so I love to play music. I'm not great at playing
music, but I like to play the guitar. I like
to play the piano. And I just like to spend time
with my family. I know that's a trite phrase,
but my wife and I, my kids are grown and gone.
I love my kids immensely. But now it's my wife
and I and the two dogs and the power of just
family. I think a lot of it can be taken for
granted these days. We were affected by one of
the hurricanes. So what you see here is the trailer
we're living in while our home is still trying
to be rebuilt. But it's okay. That stuff puts
it in perspective. We decompress by understanding,
yeah, it kind of sucks right now, but that's
okay. There's a lot of people who have it worse,
but we decompress by going for walks, by... playing
with the dogs and just it's nothing profound
you know i i wish once we get out of this situation
we used to go for bike rides a lot it's just
difficult to do it's difficult now to do what
we used to do to decompress but uh we'll get
back to it what's the timeline on getting your
home built that's a fantastic question it's been
a it's been six months since the storm a little
bit more um it's been 160 days today since our
contractor still hasn't gotten us a permit so
our home is uh as of last week they finally cleaned
out debris but there's no walls there's so if
we get a permit hopefully maybe four months I
don't know but it's it's a good it's humbling
it's amazing how little you can get away with
living um and then how little things can make
such a big difference you know fortunate enough
we have a pool it was disgusting it was full
of seawater and crustaceans so we opted to take
some money and get that pool fix and now every
day we take a little moment bring the dogs in
just to enjoy something that's not disaster when
you look at it and just uh yeah it's good to
reframe it's not all bad absolutely All right.
Well, for people listening, where are the best
places to find the books? And then what about
yourself personally on any sort of social media
or website? So the books are just on Amazon.
You can type in Eric Usher, E -R -I -K, U -S
-H -E -R, and it's all the kids' books on there.
The medical books, they're outdated by now. Every
three years, they'll need to be. Aside from the
LinkedIn and Instagram account, I don't have
any social media platforms. So, yeah, no, like
I said, I'm just happy that, again, imposter
syndrome to be on board here. But amazing that
you asked me. Well, thank you so much, mate.
It's been such an amazing conversation from,
you know, obviously the volunteering in EMS,
the nursing and then the medical innovations
and the cadaver labs and the books. It's been
incredible. So I want to thank you so, so much
for being so generous with your time and coming
on the Behind the Shield podcast today. I appreciate
it. I look forward to finishing your book too,
man. Keep it up. Good job, man. What you do is
it needs to be done. So thank you for doing that.
Very passionate about it too. It's awesome.