Today I saw an industrial psychologist. The visit stemmed from a work-related injury and an extended stint of “light duty” (end of April to mid September). In other words, the injury kept me “off the street.” Prior to being barred from doing my job, I failed to see how the job defined me. It became an expression of my worthiness and kept me feeling important. For those not in EMS, any restriction – lifting or otherwise – essentially keeps a paramedic away from working normal duty. During the therapy visit, a conundrum made itself evident to me regarding EMS and us. It has to do with retention, possibly unrealistic expectations of those entering the field, and feelings of both over and under appreciation. The session was fortuitous because I was reconsidering “thank you” and “you’re welcome.” And yes, these are tied together in certain ways.
Allow me to go back a few days. I had been struggling to write a blog post on accepting appreciation. Converting disassociated thoughts to text helped me parse the topic. But I had no convenient way to express thoughts. Marshall Goldsmith is an executive coach and wrote What Got You Here Won’t Get You There (2007; Hyperion). One of the factors he identified keeping people from gaining the next ladder rung is “Habit #17 Failing to express gratitude” (pg. 88). In Goldsmith’s estimation people fail to say “thank you” to a compliment. Unqualified, unmodified thank you; full stop. In my opinion, so many people pay EMTs and paramedics compliments without explicitly saying thank you I don’t even notice. Regardless if I or anyone else notices, too many compliments and heartfelt expressions of gratitude go unappreciated. And payers of compliments go unacknowledged or worse, minimized.
If I ask you what’s your reply to someone who says: “You must see so much. I couldn’t do what you do.” Did you think/say “It’s nothing” or something similar? I do… or used to as of last week. Goldsmith explains anything other than “thank you,” minimizes the desire of the person paying the compliment. It may even dissuade them from complimenting others (and you in the future). Even those whose intention is to only solicit a gory story from making a question out of a statement (“You must see some gross stuff?”) are enthralled with the profession and happy you do it and not them. Those who live vicariously through others often do so because they can’t.
In my observation, co-workers who strive to get recognition and adulation are well outnumbered by those who eschew awards, recognition and fanfare. That’s fine. No one is making you take a damn stork pin. But the same anti-recognition person may gripe about how they are not recognized for doing their job. Having been one of those in the majority, I was blind to the hypocrisy. Why is it unreasonable to get a pin or certificate suitable for framing when you birth a baby or return someone’s circulation so he or she can walk out of the hospital in two days, but not being acknowledged because you completed the start-of-shift rig check every shift? To prevent myself swinging like a pendulum, I’ll go halfway and say both should be recognized. No, I don’t think doing even the minimal tasks of the job on a routine basis requires a ceremony; just a compliment in passing or noted on the annual review would be nice.
So, I have adopted a new strategy. Give an unqualified “you’re welcome” when someone says thank you. People thank others for various reasons, but mostly because the other was helpful or did something they couldn’t do. Such as patients or family members who resorted to calling 911. Realize it or not, you did something important to the patient. Sure it is your job, but you performed it well enough that someone is appreciative of your efforts. Your choosing to the job.
When someone pays a compliment in cryptic messages, like “you must deal with a lot of stuff,” there is no need to minimize EMS or your role. I’ve made a history of saying, it was nothing or “I just cover it up.” To me this is truth and expresses a way to avoid distracting injuries or bodily fluids. But to the nonEMS professional, it diminishes EMS in the minds of others. Likely this person has a specific, personal encounter in mind when they offer a veiled thank you. They aren’t thanking you as an individual for expert care in their situation, rather they are thanking you for being a part of a profession that means greatly to them.
It is similar to thanking a vet or police officer. “Thank you for your service” shows appreciation for their role and general duty, not a specific task or operation they conducted. Being familiar with deflection of appreciative comments, when a vet replies “I didn’t go over seas” or denies taking part in combat, I am forced to reinforce my appreciation. They don’t know it, but I don’t care if they sat behind a desk or drove a forklift stateside. I recognize the loss of choice and control one experiences when signing up or being drafted. I commend vets (in my mind) for not taking credit for missing stress-inducing warfare, I am not only looking to thank combat veterans.
So back to today and my visit with the therapist. After a recounting of my injury and all the trials and tribulations that go along with work comp, he paid me and EMS a compliment. I nearly stopped the psychologist as he was going to say “you are saving lives.” My knee-jerk reaction is to downplay the life saving aspect of EMS because it happens less than often than it does no television. I made some convoluted comment to this effect, to which he thought he may have found therapy gold. “Do you not like working in EMS?” No, I said. Inside I thought, what would give him that impression? Well, the impression I portrayed downplaying the activities that go on in EMS.
He doubled down on his appreciation of EMS and our job and its duties. After recanting the efforts I made to diminish EMS, I explained EMS means so much to me. And thanked him for his appreciation.
And so it dawned on me. I had to think outside of myself and my profession. Experts don’t self-deprecate to clients, those who are reliant on their expertise. Self-deprecation is for families and cohort; it is not decreasing the status in the eyes’ of the public. We may spend 800 hours a year with uninjured elderly patients who fall, get that non emergent g-tube replacement, or transport the runny nose person who refuses to go to primary care. These take up the majority of a shift, day-in and day-out. And this is what I think of when I reply to a thank you or suggestion that EMS must be difficult given what we deal with on a daily basis. So, when I reply “naw” or offer some other qualified answer, the profession is brought down a few notches in their mind and I’ve diminished their gratitude.
From now on I will say thank you to direct compliments. And to admiration for doing my chosen profession, I will say something along the lines of “it is satisfying” or “I am glad to help people.” And ask if EMS has helped them or their family. My goal is to elevate EMS and have some self respect.
UPDATE
My Fitness for Duty test was occurring today. This is the physical agility test “permitting” me back to work after a prolonged absence. In thoughtful consideration, my wife wished me good luck on the test. My first reply was “I’ve already passed several of the exercises. It’s no big deal.” Instead of saying thank you to my wife, showing gratitude for her concern and wishes I do well, I effectively told her her input does not matter. Her reply was a question to the effect of what happens if you don’t pass. I had not concerned myself with this because I was confident in passing the test. Now, not only was I forced to consider a poor outcome, but we were put in a place to ponder more time on light duty. A heartfelt well wish turned to a focus on possible worst case scenario.
Not even 24 hours after writing and posting my intention on correcting my conduct, I failed. Thankfully I did not fail the test! But now, my wife may pause before wishing me luck or showing support. My retort and lack of a simple thank you showed I did not respect her concern. By not accepting her support I counter her unconditional hope that I achieve something important to us; downplay her appreciation of my efforts; or positive thoughts to quell her apprehension.