Alison Stewart: You are listening to All Of It on WNYC. I'm Alison Stewart. In a new memoir, a paramedic of 15 years reflects on the best and worst parts of her career. Throughout the years, she recorded in her observations and the things she witnessed in private notebooks, on scraps of paper, the back of gloves, wherever she could. In the book, she tells us stories about laughing at jokes with drunk patients to responding to a call from an apartment for a family experiencing COVID symptoms. The book is titled A Real Emergency: Stories from the Ambulance, and it's out now. Author Joanna Sokol is here with us today. Hi, Joanna.

Joanna Sokol: Good morning. How's it going?

Alison Stewart: It's going well. Hey, listeners, have you ever worked in emergency medical services? We want to hear from you and your stories. What moments from the jobs have stayed with you? Tell us something you enjoyed about the job. What part did you find the most challenging or exciting? Give us a call at 212-433-9692, 212-433-WNYC, or you can reach out on social media @AllOfItWNYC. First of all, what drew you to work for emergency medical services?

Joanna Sokol: I had always loved science and medicine and thought that I would do something along those lines in college, but it turned out I was very bad at sitting still. I think that's kind of a common story for emergency medical workers. I tried to go to a traditional university and study science, and I couldn't sit still in the library. I ended up taking an EMT class at a community college. I just fell in love with it and never really looked back. It's very hands-on. It's adrenaline. You never really know what you're going to get into for the day. Sometimes you get to help people.

Alison Stewart: Did you know what you were getting yourself into?

Joanna Sokol: No, I had no idea.

Alison Stewart: [laughs]

Joanna Sokol: Absolutely not. Not even a little bit. I thought the work sounded fun and exciting, but like a lot of EMS workers, I got into it and found out it was something really, really different than that. We run on really, really scary life-or-death, immediate emergencies every once in a while, but the vast majority of the work is really different than that. It's a lot of minor medical complaints. We work with the elderly, the homeless, a lot of mental illness. We're really providing a social safety net for folks that don't have anyone else to call. It's a very different type of work than advertised, and I fell in love with that part of the job, too.

Alison Stewart: What have you come to realize about humans after working on this job?

Joanna Sokol: [laughs] Humans are a mess. [laughs] We're a big, fat, complicated mess. We're bad at being an animal, but there's a lot of love and joy and humor in it, too. It's complicated. It's confusing.

Alison Stewart: What kind of people are drawn to that kind of work, to working for EMS?

Joanna Sokol: Like me, I think there's a lot of people in the job who really like problem-solving, who like puzzles, who like a lot of changes, and who have a hard time sitting still and focusing on one thing for a long time. There's many people in the work who tried to do another line of work and ended up in EMS. Then there's some lifers who grew up in an EMS family. They had nurses and firefighters and paramedics for families. Yes, a lot of us are people who, at our hearts, want to help, but we don't always know how. We're just bumbling along, doing our best.

Alison Stewart: When you were writing the book, what was one myth about EMS workers that you wish people would get rid of? You wouldn't want to hear it again. What is something that you wanted to make sure people understood about working with EMS?

Joanna Sokol: The book's not just in my voice. I actually interviewed a bunch of other EMTs and paramedics. I looked back into history. I found old stories. One thing that almost everyone I interviewed said some version of was, "I just want them to see us as people. I want them to know that we are human. We get tired. We have good days. We have bad days. Sometimes we actually need to eat food or go to the bathroom or drink water."

I think in the movies, we're portrayed as very heroic and very noble, and often very dumb. We're really one-sided. We just swoop in and save the day, and then swoop back out. The truth is that the job is really different than that. The people who do it are really different than that. We try to have compassion, but we really run out of compassion sometimes. We get cranky. We get tired. We get thirsty. We're still going to do our best no matter what, but it's tough. It's a complicated job. We are actually humans just like everyone else.

Alison Stewart: We're discussing a paramedic's reflections on the best and the worst parts of her 15-year-long career. My guest is Joanna Sokol. The new memoir is titled A Real Emergency: Stories from the Ambulance. Listeners, have you ever worked in emergency medical service? We want to hear your stories. Our numbers, 212-433-9692, 212-433-WNYC. What is something you enjoyed about the job? What was something that you found challenging? Give us a call, 212-433-9692, 212-433-WNYC. Just so I'm clear, what's the difference between emergency medical technician, an EMT, versus a paramedic?

Joanna Sokol: Oh, that's a great question. A lot of people don't realize that it's actually two different jobs. The words get used interchangeably. They're very similar jobs. They're in the same field. We work together. EMT is basically, usually about a semester of school. You learn really basic assessment. You learn how to do CPR and give a handful of meds. Then if you like the work and you want to continue to go on in it, a lot of people will pursue their paramedic license. That's going to be more a year and a half, two years of school. It's a much bigger scope of practice. A lot more medications. A lot more assessment. We work closely. Often, on an ambulance, there'll be one medic and one EMT, or sometimes two medics, sometimes two EMTs, but they're really just different. They're different levels.

Alison Stewart: Something you talk about in the book, which is fascinating, is that you don't always use lights and sirens when you respond to each event. There are different codes. What's the difference between a Code 2 and a Code 3, for example?

Joanna Sokol: Yes, so I touched on this earlier, but the vast majority of our calls are actually not lights and sirens, Code 3 emergencies. A Code 3 call is when we turn on the lights. We turn on the sirens. We say, "Oh no, this guy's going to die if I don't blow through all these stoplights and get them to the hospital right away." A Code 2 call means that we don't have the lights. We don't have sirens. We follow traffic laws.

Those are actually really, really common. We do that all day long. Grandma's got a stomach ache. Little Timmy's got a fever. We don't have a primary care doc because our insurance changed. We ran out of our prescription. We just need to get someone to dialysis. Those are all Code 2 calls. We go. We do our best to help. We end up giving somebody a ride somewhere, but we often don't have the lights and sirens on.

Alison Stewart: For example, you know about people who don't necessarily need emergency care right away. There was a guy with itchy feet. Would you tell us a little bit about that story? [chuckles]

Joanna Sokol: Yes, absolutely. One thing that's really amazing about 911 is that when you call 911, they send you an ambulance. You don't have to give them a credit card number. You don't have an interview to find out if you deserve an ambulance. You don't have to jump through hoops. They just send one, and so that's really amazing. It's really cool, but it also means that we get a lot of people who just call us for whatever.

I know a lot of Americans are really worried about the ambulance bill. The ambulance's bill is so expensive. Why would you call the ambulance bill? The thing is that the bill is really expensive if you plan on paying it, but there's a whole bunch of people who do not pay their bills. They don't plan to, and they're not going to. We don't cut them off from service. We keep sending them rigs.

You don't go to jail if you don't pay your ambulance bill. You end up in debt. It can mess up your credit if you're trying to buy a car. We get a lot of people, especially homeless folks, folks with mental illness and the elderly, who call us all day, every day. They call us three times a day, four times a day. People just want a blanket. Maybe they just want a ride home because it's cold outside. They don't want to pay for a taxi, or maybe they have itchy feet.

Alison Stewart: What's your relationship with the people who are "frequent ambulance riders"?

Joanna Sokol: Yes, it's really complicated. At a certain point, you get to know them almost like family members. We have our regulars who we show up on them so many times that we're like, "Oh, hey, Billy, how's it going? Getting a ride again today?" We get mad at them the same way that you get mad at family members. Sometimes we're like, "Come on, man, we're really busy today. There's cardiac arrest going out. We can't deal with them because we're here with you."

Sometimes we're really affectionate. You get to know them really well. Some of these people, you really watch them get sick. You watch them go through good times and bad times. You really do form a bond. You see when they're having good days and bad days. Yes, you get mad. You laugh with them. You joke with them. You help take care of them. You get sad when they get sicker, and you get happy when they get better.

Alison Stewart: My guest is Joanna Sokol. Her new memoir is titled A Real Emergency: Stories from the Ambulance. I wanted to ask you a little bit about writing the book because someone sent this interesting text that said, "To your guest, if you had a hard time sitting still at school, tell us what your process of writing a memoir was like."

Joanna Sokol: [laughs] That's a great question. I got up and went for walks a lot. [laughs] I have one of those desks that goes up and down. It was a lot easier for me to do this now than it would have been when I was 20. That was a really big part of it. I'm 39 now, and I move a lot slower than I did in my 20s. It is a lot easier for me to sit still. Yes, parts of it, it was really challenging sometimes to sit there and bang out a draft and keep working, even when I got frustrated. It was a really different challenge than I've ever faced before, but it was a lot of fun.

Alison Stewart: We'll have more with my guest, Joanna Sokol. Her new memoir is titled A Real Emergency: Stories from the Ambulance. This is All Of It.

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Alison Stewart: You're listening to All Of It on WNYC. I'm Alison Stewart. My guest is Joanna Sokol. Her new memoir is titled A Real Emergency: Stories from the Ambulance. We're discussing her career as a paramedic. Okay, so you started writing stories on almost anything you could get your hands on. When did you realize that you wanted to write a book?

Joanna Sokol: Pretty recently, actually. I took notes and kept journals basically my whole life, but it really turned up a notch once I was working on the ambulance, just because of all the stuff I was seeing. For a long time, it was very private. I have a really good friend who worked for a magazine. From time to time, she and I would talk about my job. She would say, "Oh, my God, that's really interesting. You should write an essay about that."

She actually helped me. We wrote a couple of essays together for a magazine called Hazlitt, and it was really fun. I loved hearing people's reactions to it, and I loved especially the people I worked with. I was really nervous that they wouldn't like it, that they would be like, "Oh, who does she think she is talking about our world?" It was actually quite the opposite. People were really stoked on it.

They thought it was cool to have some parts of our story out in the world and to counter some of the misconceptions about what our job is like. Over time, I just felt like I was carrying around this pile of stories that was getting heavier and heavier. I felt like I really had something I wanted to say to the world about what this work is like and what it does to you and what that means.

The more I talked to other paramedics and the more I learned about the history of ambulances, it all started to come together. It was really in the last few years, once I had all that extra context, other people's experiences, interviews, history, different stories from different places that I was like, "I really think that this is a story that we can tell, and hopefully maybe it actually helps some people."

Alison Stewart: This is an interesting text. It says, "I was a physical therapist and trained as an EMT to volunteer in Long Island. The story I remember the most was that I was actually was on a call that was a physical therapy patient of mine, and sadly didn't make it. I worked on him during CPR." I'm curious for you. Was it hard revisiting some of these more difficult cases that you remember?

Joanna Sokol: It's interesting that that's the example because for me, personally, a lot of our CPR cases were not actually the hardest cases for me, because I did the work for long enough that I've run a lot of CPR calls. I would say, I don't know, maybe low hundreds. Sooner or later, we all come to the end of our life. We're all going to do it. For me, the calls that were really challenging were often the ones for people who had really poor quality of life. They were really disabled, or they were in a lot of pain, or they were very sick.

There was nothing I could really do to help them. During the writing process, it was actually really, really surprising to me how much I still did care. There were calls that I thought about that happened to me 8, 9, 10 years ago, that I thought I was over. I had talked about them. I had written about them. I thought I was totally fine. Then trying to really dig deep and write about them and bring those emotions back really took me for a ride. I did not know that I still had that many deep feelings inside. Then, again, we actually recorded an audiobook, which was really fun. I hope that people enjoy listening to it.

When I read the audiobook, here were calls that not only had I remembered a hundred times and I talked about a thousand times, and I'd written about it already, and then, again, when I was re-recording the audiobook. I had a great director. You really have to go down and pull out the emotion you were feeling at the time of the call. It just hit me all over again. Then I was like, "Oh, God, again, really?" You're absolutely right. There were feelings all the way deep down that I didn't realize I still had that I had to work through again.

Alison Stewart: Could you share one with us?

Joanna Sokol: Yes, sure. One of the calls in the audiobook that really hit me was it was during COVID. Actually, the call itself wasn't during COVID. The call was years before. I had brought in this guy, who was having what's called AAA, abdominal aortic aneurysm. It's a call that develops really quickly. You can't always see it coming. The guy had what seemed like regular back pain. Then, in the last few minutes, it became very clear that he actually was dying. He was bleeding out.

I was scrambling to try to help him out and get him into a hospital. The hospitals in San Francisco, where I spelt the bulk of my job, are really busy. They're really understaffed. They're really overworked. We're at the ER doors. I'm trying to get him into a bed. I'm trying to get a nurse's attention, but they're just too busy to deal with me. I'm basically just watching this guy die on my gurney while trying to get somebody's attention to help me out. We're just standing in a hallway.

That sucked. The guy did end up dying, unfortunately. We did get him into a room, and then he died very quickly. I buried it. Then years later, in the middle of COVID, we're back at that same hospital. Everything's crazy because it's COVID. The nurses are ignoring us, and our parking's all messed up. The emotion from that guy just boils up out of me. I get really mad at this nurse for just no reason, totally stupid reason, because it's really about that guy that died on me years before.

Then, again, I thought I had dealt with it. Then we're doing the middle of the audiobook, and the director is like, "Okay, what were you feeling when this happened? What emotion is this? Can you take us back there?" I had to read through that whole passage again, and I totally lost it. I had to take a break and walk out of the room and go sit in a stairwell for a minute. That was years after this thing happened. It just builds up after a while. It's cumulative.

Alison Stewart: What was something that you learned about yourself as you worked through this book and when you finished the book?

Joanna Sokol: Well, we were just talking about some really heavy stuff a second ago, but one thing that happened to me throughout the writing process that was actually really amazing is it brought back a lot of the joy and compassion. When I first stepped out of the field and started writing full-time, I took a break to write. [chuckles] My first draft was so angry. My mom actually read it. She's always an early reader. She said, "Jo, no one's going to read your book if it's 300 pages of cynicism and diarrhea." [chuckles]

Alison Stewart: God love moms.

Joanna Sokol: [laughs] Oh, she's great. She cuts right through it. She was absolutely right. I was so mad. I was so burned out. I was so tired. I was just dumping all my trauma. Then I wrote more and more. We had all these conversations, both my mom and my editor, Haley, who's amazing. They were like, "You did actually really love this work," and I was like, "Yes, I know. I loved it. It was totally worth it." "Tell us some of the things that you loved."

I had to reach down even deeper than the anger, and there were. There's hilarious stories. The people that I worked with are the loves of my life. They're incredible. They're so funny and they're so resilient. I wanted to bring some of that. Over the process of writing and of finding those funny stories and remembering the humor and the compassion, I found the joy again.

It was like, "Oh yes, this thing happened, and that thing happened." I was able to really come back around full circle. I'm teaching now. I'm still very involved in EMS. I teach EMTs and paramedics. Unfortunately, I got too injured to be in the field anymore, which is pretty common for those of us who make it to our late 30s in this work, but it's been really great to get back into it and teach and work with the next generation and find the joy again. It's been really fun.

Alison Stewart: The name of the book is A Real Emergency: Stories from the Ambulance. It's by Joanna Sokol. Thanks, Joanna.

Joanna Sokol: Thank you so much.