Never Lose Your Humanity

The mental performance of a first responder isn't just about what happens on the call. It's about how you prepare for it, respond to it, and return to yourself when it's over.

For four years, I worked as an Critical Care Transport (CCT) EMT and Field Training Officer (FTO).

Some shifts were quiet enough that you could sit around with your crew, watch a show, scroll through your phone, work on schoolwork, grab something to eat, or—if you were lucky—get some sleep.

Other shifts seemed to never stop.

Twenty-four hours is a long time to be responsible for other people's lives. Your body isn't designed to operate at its highest level for that long without rest, but the shift doesn't stop simply because you're tired. A call can come at any moment, and the call that sounds simple over the radio can become something entirely different once you arrive.

That reality taught me something about mental performance that I didn't fully appreciate at the time:

You have to learn how to be present without ever forgetting that you need to be ready.

Always Ready

Mental preparation as an EMT didn't always look like sitting quietly and visualizing the next emergency.

Sometimes, mental preparation was simply finding a way to relax between calls.

The important part was not spending all of that downtime wondering what the next call would be.

You couldn't know.

New EMTs often arrived nervous for their first calls. And how could they not be? You're entering a profession where you don't always know what you're going to encounter, and much of your expectation may come from training, television, movies, or stories you've heard from other people.

As an FTO, I saw this firsthand.

One of the calls that made many new EMTs particularly nervous was a 51/50 psychiatric hold. The label alone could create anxiety.

I'm picking up a mentally unwell person. What am I walking into?

Sometimes, the situation was relatively calm. It might be a college student who had a terrible day, said something alarming to a friend, and ended up being transported because that friend was concerned.

Other times, the situation could involve a mentally unwell individual with Suicidal or Homicidal Ideations (SI/HI).

The point wasn't to predict which one you were going to get.

The point was to prepare yourself to respond to whichever one showed up.

That distinction matters far beyond EMS.

Preparation isn't about predicting the event. It's about preparing your response to uncertainty.

When You're Running on Empty

Fatigue creates another challenge.

There were plenty of times when I was exhausted but still needed to be alert. Different people found different ways to manage it. Some relied on caffeine. Some found opportunities to sleep. Some had routines that helped them stay engaged.

For me, mindfulness became one of the most useful tools.

Sometimes, it was nothing more than taking a few deep breaths when I could feel fatigue setting in and deliberately bringing myself back to the moment.

That might not sound like much.

But when you're exhausted, attention can become something you have to intentionally reclaim.

And mindfulness doesn't necessarily have to look like sitting cross-legged with your eyes closed.

It can be taking a moment to breathe. Listening to music. Taking a nap when the situation allows it. Eating something that helps you feel better rather than worse. Finding a routine that lets your brain settle between calls.

The skill is less about what the routine looks like and more about whether it helps you reset, refocus, and remain present.

The Call Ends. But You Still Have to Go Home.

One of the most important transitions I learned was the one between being an EMT and being a husband and father.

After a long or particularly difficult shift, I sometimes needed time to decompress before jumping back into family life.

My wife understood that. She would give me some space to rest and reset before the kids needed Dad again.

And then, once I was ready, I tried to be present with my family.

I'd play with my kids. Spend time with them. Be Dad.

If I'd had a particularly difficult call or shift, I'd sometimes talk about it with my wife. Obviously, there were details I couldn't share because of confidentiality, and there were things I didn't need to describe simply because they were too graphic.

But sometimes saying, "That was a really difficult one," was enough.

Getting it out helped me put it down.

That transition matters.

Because the person who walks into the house after a difficult shift is still carrying the person who was on that ambulance.

And eventually, you have to learn how to put the uniform away without putting your humanity away with it.

Never Lose Your Humanity

One of the most important things I tried to teach new EMTs as an FTO was simple:

Never lose your humanity.

I've seen people who worked in EMS for years become so accustomed to difficult situations that things that would once have affected them barely seemed to register anymore.

Sometimes, that's part of learning how to do the job.

You can't fall apart every time a call becomes difficult. You have to be able to function.

But functioning doesn't mean you stop being human.

I remember transporting a patient with an intracranial hemorrhage. The call initially seemed straightforward: get the patient to another hospital.

As we arrived, things changed quickly. The patient deteriorated, and we had to begin treating them while getting them into the hospital and into the hands of the hospital staff. Shortly after we transferred care, the patient went into cardiac arrest and ultimately passed away.

It was the first time I had witnessed a patient code in front of me.

I remember expecting that experience to affect me much more than it did. Instead, my immediate thought was simply, This is part of the job.

Over time, I learned that difficult experiences don't all affect us in the same way.

One experience that stayed with me much more deeply was witnessing a newborn child dying in an emergency department.

That one was harder to digest.

But it didn't make me afraid to live. It made me appreciate life.

It reminded me that things can change quickly and without warning—and that the people we love deserve our presence while we have the opportunity to give it.

I didn't become afraid to let my children be children. I didn't try to eliminate every risk from their lives. Instead, I became more aware of how precious those ordinary moments are.

That's an important distinction.

Resilience doesn't mean that nothing affects you. It means you develop ways to experience difficult things without allowing them to dictate everything that comes next.

The Next Call

That idea became particularly important to me as an FTO.

A first responder can experience fear, frustration, grief, anger, helplessness, or exhaustion on one call—and then be expected to show up for the next one.

There may not be much time between them.

And sometimes, there isn't a mistake to correct. Sometimes, it's simply a feeling that needs to be acknowledged before you move forward.

This is where I see a strong connection between first responder performance and athletics.

A basketball player throws an errant pass out of bounds. The mistake creates disappointment or frustration. The ball is inbounded. The next possession begins.

The player doesn't get to replay the previous possession. They have to decide what they're going to do with the next one.

First responders face their own version of this.

You can do everything correctly and still have an outcome you didn't want. You can follow the procedure, communicate with your partner, provide appropriate care, and do everything within your control—and still lose the patient.

That doesn't mean the response was a failure.

Sometimes, the outcome simply isn't yours to control.

What you can control is how you respond to what happened and how you show up for what's next.

Event + Response = Outcome.

The event may not be yours to choose.

Your response is where the opportunity for development begins.

You Don't Have to Do It Alone

There is another part of first responder performance that I think deserves more attention: the people beside you.

Your partner matters. Your crew matters. The people who understand what you're talking about without needing the entire story explained to them matter.

When I witnessed my first patient code, I wasn't alone. I was with my EMT partner and our Critical Care Transport nurse.

Our nurse had years of experience and had witnessed multiple patients code. He understood what my partner and I were experiencing because he had been there before.

He reminded us that we had done everything we could to care for that patient. More importantly, he helped us recognize that we had done our jobs well.

That mattered.

There are experiences that people outside of EMS, fire, law enforcement, or other first responder professions simply may not understand in the same way.

That doesn't mean you should isolate yourself from people outside the field.

It means there is tremendous value in having people who get it.

Sometimes, resilience is individual.

Sometimes, resilience looks like sitting beside someone who understands.

Train Before the Moment

Mental skills don't have to wait until something goes wrong.

First responders can practice them before the difficult moment arrives.

Visualization or imagery can help you mentally rehearse challenging situations. Self-talk can help you review procedures, reinforce confidence, or remind yourself what you know how to do. Mindfulness can help you settle your nervous system, sharpen attention, or deliberately return your focus to the present moment.

And these practices don't have to look the same for everyone.

For one person, mindfulness might mean a few minutes of breathing. For another, it might mean listening to music before a shift. For someone else, it might be taking a nap when the opportunity presents itself.

The goal isn't to find the perfect technique.

The goal is to develop skills you can actually use when you need them.

And that's where mental performance becomes more than simply having the right mindset.

It's about developing awareness, practicing responses, and building routines that make it easier to perform when the pressure arrives.

Being Human Is Part of the Job

First responders are often expected to be the calm ones.

The capable ones.

The people who know what to do when everyone else doesn't.

That expectation exists for a reason.

But beneath the uniform is still a person.

A person who can be tired. A person who can be scared. A person who can grieve. A person who can be proud. A person who can laugh at something ridiculous with a partner five minutes after a difficult call.

A person who eventually goes home to a spouse, children, parents, friends, pets, or simply a life outside the job.

You don't have to become emotionless to do this work well.

You don't have to pretend difficult moments don't affect you.

And you don't have to carry everything by yourself.

Sometimes, the strongest thing you can do is acknowledge what happened, talk about it with someone you trust, allow yourself to feel what you're feeling, and then decide how you want to respond to what's next.

And sometimes, that means talking with a peer. Sometimes, it's a spouse. Sometimes, it's a trusted colleague. Sometimes, it's a qualified mental-health professional.

Knowing when you need support isn't weakness. It's part of knowing yourself.

Because the goal isn't to become less human.

It's to become better prepared to be human when the moment gets hard.

That, to me, is mental performance.

And perhaps the most important lesson I carried with me from the ambulance was the same one I tried to give every EMT I trained:

Never lose your humanity.

Mental Performance is the Vehicle. Human Development is the Mission.