Overcoming Adrenaline Addiction

This week I saw a Facebook post by a longtime friend and colleague, Kip Tietsort.  Kip and I met about fifteen years ago, when we practiced martial arts together.  He is an experienced paramedic, and also has a law enforcement background, but he’s done something else that has set him apart, and will eventually make him legendary.  He founded DT4EMS, a company that teaches emergency responders and hospital personnel how to avoid being injured by patients who become violent.  For years, Kip was a lonely voice shouting his message from a deserted mountain.  The culture in those professions was one of resignation – professionals simply accepted that they would be attacked and even injured as just part of the job.  Hospitals either provided no support or actively prevented employees from pressing criminal charges if they were assaulted.

Kip did not accept that, and due to his tenacity,  DT4EMS and its Escaping Violent Encounters program is on the cusp of becoming a national phenomenon, changing the way hospitals and professionals approach violence in the workplace.  He now has a stable of qualified instructors and teaches programs all over the country.  Kip is changing the profession, changing the culture, changing history.

Kip is not a writer, by his own admission.  However, what he wrote this week was an outpouring of the heart – pure, raw emotion, that stated so clearly how many of  us in the medical profession feel about the job we do.  I share it today with Kip’s permission…

Kip

It was “cool” to be called a Junkie until I became one.

When I first became an EMT, the worse (disgusting/traumatic/horrific) the call the better.  When I became a (para)medic, the more intellectually challenging the call the better.  No one really told us how it was.  We left school seeing EMS though rose colored glasses, clinging to the belief that beneath our regular uniform was a skin tight suit with a giant letter “S” on our chests.  We would save the world.

The culture in emergency medicine wanted (expects) you to witness the most gruesome scenes and try to one up the others with the story, to earn your special badge of belonging to what is supposed to be an elite group.  Elite, maybe…if we didn’t eat our young.

The job was chaos with a hint of control.  Adrenaline is a drug.  Once I truly tasted it, I needed more and more to get the high.  Like an addict of any other drug, I became dependent on action to feed my need to feel…alive.  When EMS couldn’t provide enough, I became a police officer to supplement the addiction.

I needed “it” so bad I never took time off. When I was not at the PD, I was at the ambulance base.  I responded to domestic abuse calls, car crashes, fights in progress, robberies, rapes, shortness of breath calls, strokes, foot pursuits…as well as all the other calls.  The wail of the siren, flashing of the lights, and anticipation of the unknown worked…for a while.

I did it so much that eventually I became the burnout. Not burnt to the point of not caring – but burnt that I cared too much and could no longer separate empathy and sympathy.  I began to “feel” hurt and pain when dealing with patients.  I began to dislike doing anything that would cause additional pain, such as starting an IV line.  I began to feel real, visceral anger when dealing with victims of a crime.

As with any addiction, the low after each high starts to feel deeper and deeper.  When the lows got bad enough, I started avoiding people, crowds, functions, and friends.  I became paranoid, needing not just a simple awareness of my surroundings, but a purposeful knowledge.  I scanned every restaurant, church, intersection, or parking lot I was in.  I was operating “in the orange,” and I did it for years.  It wasn’t healthy.

So how does one go from being a cop’s cop or a medic’s medic to being one afraid of “The Job”?  It’s easier than you think.   For me, it was subtle and took time, but caring for the health of everyone else and neglecting my own well-being was the path to it for sure.

In trying to help and control the emergencies of others, I had lost who I was as a person.  I had found that the absolute hardest part of public service was holding onto the ability to care for humanity in general.  I went from being a guy that LOVED making decisions under extreme pressure to a guy that HATES to be tasked with more than one process at a time.  I used to love running at critical mass – now I have to check my anger when I am engrossed in a task and the phone rings.  I am not cured – I am in recovery.

After nearly 25 years  of dealing with death and dying, I no longer bear the burden of things I can’t change.   It isn’t because I don’t want to, it’s because I can’t.  My days of working the road are behind me.   It is now up to those younger people to carry the load – but I want to prepare them better for provider well-being – more than what was done in the past.  I have dealt and am dealing with my demons, but that is another story, which you can read about here.

Kip is being modest – maybe he has realized he can’t save everyone, but even if he says he doesn’t care – that just isn’t so.  He has taken up a larger cause, and fueled it with the stubborn passion of one who insists on rowing against the tide.  As a result, the tide is changing.   It is that type of effort which forges great men, great men who create things much larger than themselves.

Check out DT4EMS and hear Kip’s message – then learn more about attending an Escaping Violent Encounters (EVE) class near you.

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