April 29, 2026 • 24 mins
A lot of people assume first responder stress is mostly about what you see on calls. Emma Irwin, a UK paramedic who worked both London and Kent, helps us name the other half of the story: the system you work inside. We compare how ambulance “trusts” operate, what shifts when call volume spikes, how response targets change the feel of a day, and why a 30-minute transport can be a big deal when it reshapes decisions about hospitals versus community care. If you care about EMS leadership, paramedic wellness, or first responder mental health, these details are the difference between surviving a career and being quietly worn down by it.
We also get honest about mental health services and the messy middle between “help exists” and “help works.” We talk NHS talking therapies, long waiting lists, and why people sometimes miss appointments or struggle to engage even when support is offered. From there we move into therapy fit, trust, and what happens when your options are limited, whether you live in a rural area in the US or a crowded city with overwhelmed providers.
The conversation turns deeply personal as Emma explains how cumulative exposure builds over time, especially for clinicians who began during COVID, and how one unexpected call can flip the switch into PTSD. We don’t treat trauma like a headline. We treat it like a real nervous-system response that deserves real follow-up care, not just emergency crisis intervention and a quick return to duty.
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Episode Transcript
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SPEAKER_00 (00:01):
Welcome to Resilience Development in Action
with Steve Bisson.
This is the podcast dedicated tofirst responder mental health,
helping police, fire, EMS,dispatchers, and paramedics
create better growthenvironments for themselves and
their teams.
Let's get started.
SPEAKER_03 (00:29):
Well, hi everyone, and welcome to episode 248.
If you haven't listened toepisode 247, it was with Kimmy
Sadler.
She was a former supervisoryspecial agent in the U.S.
State Department.
And she is on her way walkingaround Europe in order to
support the first responders outthere.
So having said that, I havesomeone we met through online,
(00:49):
and I was like, oh, this isgreat.
I want to meet her.
And we kind of connected fairlyquickly, and she's finally on
here.
When I hear England, I've had afew people from England, I and I
think that it's important for usto have a first responders
perspective from England becausesometimes it is the same yet
different.
And for the record, I did lookat this beforehand, and I'm not
(01:11):
this is just because somethingsomeone else triggered me
because oh, it's different inEngland, it's easier.
And I'm like, well, the suiciderates of first responders in
England are pretty much the sameas the one in the United States.
So it's different, but the same.
That's how I perceive it.
But Emma Irwin, welcome toResilience Development in
(01:32):
Action.
SPEAKER_01 (01:32):
Thank you.
Thank you for having me.
SPEAKER_03 (01:34):
It's always good to have someone like talk about
what they've done when theyretired, because one of the
things that I talk about all thetime is that get ready for your
retirement because it's a lossof role, and a lot of people
forget to get ready for thatretirement.
But I don't think we're going tojump down that right away.
I feel like I read a little bitof your bio.
Obviously, we met throughonline.
So I want to learn more aboutyou.
(01:54):
So tell me a little more aboutyourself.
SPEAKER_01 (01:57):
Tell you about myself.
Well, I'm 33 years old.
So I've retired in the sensethat I've given up that position
on the front line, butunfortunately, I can't afford to
tie from working at this age.
I still need to work.
So I moved into like I'm stillworking as a paramedic, but in
an office role.
So very much not frontline.
I'm now assessing disabilitiesfor benefit systems.
(02:18):
So that's what I'm doing as aclinician.
But I was born in south east ofEngland in Kent in a little town
called Seven Oaks.
And then we moved to thesoutheast of London.
So I grew up around around Kentand London.
SPEAKER_03 (02:33):
Okay.
SPEAKER_01 (02:34):
And I went to university and did a degree in
criminology.
And I wanted to be a policeofficer initially.
That was so I always wanted tobe in the emergency services,
and my dad was an inspector inthe Metropolitan Police in
London.
Most of my family come from somesort of emergency service.
My mum's a dentist, so she'smedical.
So yeah, I think I was destinedfor some sort of frontline role.
(02:57):
My brother's a firefighter, sowe've got it all going on.
But yeah, I did a degree incriminology, and then I don't
know, I just stepped away fromthat.
And a position came up in theLondon Ambulance Service for
like an apprenticeship role.
So I joined as a technician andI was trained up as a technician
(03:18):
and then through the ambulanceservice, they sort of funded a
degree to become a paramedic andtake that extra step join there.
So while I was doing that, Imoved down to Ashford in Kent.
I've got two dogs.
SPEAKER_03 (03:30):
Okay.
What's your name?
Kevin and Phoebe, we better I'mI'm gonna I'm gonna make sure we
get some pictures so I can putthat on.
SPEAKER_01 (03:39):
Of course.
Don't mess with Kevin.
Kevin's a golden retriever.
SPEAKER_03 (03:42):
Okay, yeah.
Well I'm always a Labrador.
SPEAKER_01 (03:45):
He's oh, he's terrifying.
Yeah, absolutely terrifying.
He's a nightmare.
You might hear him in thebackground at some point
demanding attention.
But yeah, now I live, I'm about20 minutes from the sea, which
is nice.
I really like living down here.
And yeah, I moved to SoutheastCoast Ambulance Service from
London Ambulance Service.
So it's it's amazing howdifferent ambulance services
(04:06):
are, even in well, one localarea of of England, even totally
different to work for.
So I was working with CAM for acouple of years, and it really
took me that long to get used tothem.
I'm a little slow.
Sorry, Southeast Coast AmbulanceService.
SPEAKER_03 (04:23):
Thank you.
I'm I'm I'm not I don't know.
SPEAKER_01 (04:25):
No, no, no, I should have said that.
So yeah, that was the ambulanceservice I moved to in Kent, so
the Southeast Coast, they coverKent, sorry, Sussex in England.
And yeah, I left there inDecember 2025.
So I've just left and joined mynew role as a disability
assessor.
SPEAKER_03 (04:42):
Well, a few things that you said I want to make
sure I address.
They're still retired.
I have my younger guys andyounger women here who are
retired.
They're retired.
That doesn't mean they'reretired from life, they're just
retired from their job.
SPEAKER_01 (04:55):
Just yeah, just from that job.
SPEAKER_03 (04:56):
Sometimes a job will retire you, you know.
SPEAKER_01 (04:59):
So I think these type of jobs do sort of earlier
than others, don't they?
SPEAKER_03 (05:05):
I that's my experience.
So that's why, like, while yousaid, Oh, you know, but I'm
still working, yeah.
Well, you're still retired,because you know you know, so
one of the men like you youtalked about being a paramedic
down in you said London and alittle bit in the southeast of
England, and how different it isfrom one space to another.
I know around here I feel likeurban areas, such as Boston, New
(05:29):
York City, stuff like that, areway different than you know,
I'll pick on Poughkeepsie in uhNew York, or shout out to where
are my office in Holliston,Massachusetts.
There there's a huge difference,even though one's suburban and
the other one's urban, andthere's definitely different
types of presentation, eventhough there are some things
(05:49):
that are similar.
Is that what is what what wouldyou say is that like, you know,
what is it to be a paramedic andthe differences between the two
areas?
SPEAKER_01 (05:58):
So I think I don't think we necessarily have that
urban and sort of countrysiderural differences.
Like I think in America you havevast differences in locations,
don't you?
You have big spaces wherethere's not a lot going on,
very, very small towns.
I think in England you don'thave that as much.
(06:20):
I think you know, within half anhour's drive, you're at another
big town.
So you don't really have thatdivide between urban and rural.
So the jobs in themselves don'tnecessarily change much from
area to area.
I found in London a lot of myjobs were mental health that I
went to, a lot of poor mentalhealth within London.
(06:41):
I don't know if that's becauseit's a more built-up urban
population with more sort ofsocial housing and benefit
systems, more people livingthere.
I found that a lot, whether thatwas just my area.
Moving out of London, bigger,faster roads.
So there was more sort of traumaon roads around Kent because
you've got the motorways.
(07:02):
In London, nothing's going morethan 20 miles an hour.
You might get sort ofpedestrians being hit, but
they're not going to be hitfast.
You don't get a lot of trauma inthat sense.
So that was a bit of a differentjob further out in a more rural
location.
Um, it's more how the trusts,because I don't know how it
works in America.
I think you have you haveprivate ambulances services,
don't you?
SPEAKER_03 (07:22):
Sort of depending on the area, some of them are
private and some of them areintegrated within the fire
service.
SPEAKER_01 (07:28):
Yes, yeah.
So they work at the firedepartments.
Yeah, in England you havetrusts.
So the ambulance services arenot linked to hospitals, but
you'll have have ambulancetrusts.
So each area of the UK will havean ambulance trust.
I don't actually know how manythey are, but so London is its
own trust, and then South EastCoast Ambulance Service is the
trust I moved to.
So they cover three counties inKent.
(07:51):
So each region will have atrust, and they just work very
differently.
And I guess it's just the needsof the population they have.
In London, a lot of people havea lot more call volumes, so they
have different sort of policies,different time limits on jobs.
We have time limits for jobs,how long we should be spending
(08:12):
on scene, sort of targets.
And although you know, youcannot you can you need to spend
with someone what you need tospend with them, so they're not
sort of you have to leave oncethe target is here, like just
leave them there.
But they do have the target bag.
Yeah, yeah.
They don't have sort of target.
I know you we'll come backlater.
(08:32):
Call again.
SPEAKER_03 (08:34):
Get sick again, we can come back.
SPEAKER_01 (08:36):
Yeah, it's not quite that bad.
But they're not as strict withthem in London, I think, because
they know the pressure you'reunder.
In CAM, where I moved to inKent, they're a bit more strict
with their targets, and I thinkthat's because you're not you
haven't got as high a callvolume.
So you know, you should be ableto to get more done in a day and
to have more headspace to focuson on your job a bit better,
(08:57):
really.
Another thing that's differentis just the layout of the trust
itself.
So, for example, in SoutheastCoast Ambulance Service, I think
because of the journey tohospital times are longer, not
gonna be as long as in Americaand your rural areas, but in
regards to London, you know, wemight have a 30-minute drive to
(09:19):
hospital.
That's quite a long time for us.
It's a long journey to hospital,and so to avoid unnecessary
journey to hospitals and wastingthat time, there's a lot more
community services.
So I could refer to a lot morepeople and get a lot more help
in the community than I could inLondon.
They didn't really have thatthere's too many people, there's
not enough services to thepeople there, and they're like
(09:40):
five minutes from hospital, sothey would just go to hospital,
but then that would mean thatyou're queuing in London
hospitals because there's nobeds for your patients for up to
12 hours a shift.
So um, when I was in London,most of my shifts were spent
queuing at hospitals in um thesoutheast, we didn't have any of
that.
So just the way the needs of thepopulation are, the way the
(10:02):
hospital everything's just sodifferent, and I just wasn't
wasn't expecting it when Imoved.
There's good things and badthings about both, I would say.
SPEAKER_03 (10:11):
I I think uh yeah.
So yeah, let's just for ourAmerican buddies, which is
mostly what listens here, justfor the record, knowing what
social medicine can do, livingin Canada and most of like for
my first 24 years of my life,knowing a little bit about
England and how it is, it's goodto have access to hospitals to
(10:32):
everyone.
However, if you're willing towait.
And people hear like, oh, Iwaited six hours, eight hours.
I'm like, you know how many likeEnglish, Canadians, or
Australians would be like,that's nothing.
SPEAKER_01 (10:46):
I and I always say, you know, if you need to wait
that long, then you probablydon't need to be in hospital.
That's what I know.
And you know, when people wouldcomplain at me about the wait
times, I'd say, you know, you'dbe you'd if you if I were you,
I'd be more concerned if you'rebeing seen in the first 30
minutes.
So, you know, it's a good thing.
You're not particularly unwell.
(11:06):
It's frustrating, but you know,you need to look at it the other
side.
The reason you're waiting thatlong is because other people
need to be seen quicker thanyou.
So yeah, but the wait times arethey they're insane here.
There's there's too many people,there's not enough hospitals,
not enough infrastructure, it itgets worse and worse every year.
But it's been like it for years.
It's I think it's in the newsmore in recent years, probably
(11:28):
since COVID, let's be honest.
But uh it's been like it foryears.
People have said how you knowbusy the system is for years and
years and years.
I don't think there's anythingmassively different other than
people are I think people arebecoming unhealthier as well.
SPEAKER_03 (11:43):
I mean, the aging of the population plays a factor
too.
I don't want to go into too muchdemographics, but you know, you
know, like Western cultures nowwe're getting elderly type of
population.
I mean, the baby boomers are allturning 65 this year, like Yeah.
SPEAKER_01 (11:57):
You know, people are living longer, a lot more mental
health as well.
A lot more mental health, whichwas one of the biggest problems,
I think.
Yeah, and there's not enoughservices in the UK.
Our mental health services uhI'm not I wouldn't say they're
bad, but there's not enough forthe demand.
So the only place really is totake people to hospital, which
isn't I know you're not sayingit's bad, but I'm saying that's
(12:18):
bad.
So I'm saying it yeah, yeah.
It's not it's not as it shouldbe.
It should be better.
Mental health services are notgood.
SPEAKER_03 (12:25):
Maybe it's a better question to ask this.
Maybe you can uh help me withthis.
Is it that we don't have enoughservices for mental health, or
is because mental health hasbecome more of something we can
talk about, then the servicesaren't there?
SPEAKER_01 (12:38):
I think people are talking about it more, people
are self-diagnosing a lot.
I think social media is iscausing a lot of people to think
they have a mental healthproblem.
I don't think people understandwhat a mental health problem is.
You can have struggles in lifeand not have a mental health
problem.
You know, you you can have dayswhere you're feeling low, you
you can be anxious and not havea mental health problem that
(13:00):
needs diagnosis and treatment.
And I think there's a bit of ablur there for especially young
people with social media.
But I also think that, well,from what I noticed on the
ambulances, the problem is a lotof people don't engage with
mental health services.
So they might be there, but butthey don't engage with them.
And so there's there's only somuch those services can do, and
(13:20):
then that's put out as I'm notgetting any help.
But I I would have uh patientssay to me, you know, I'm not
nobody's helped me with thismental health problem, but I'd
see that they've missed threeappointments, and I you know, I
say, but you you're not engagingwith them, there's only so much
they can do if you're notturning up to your appointments.
So I think that's a big part ofit is people not engaging, but
then there are people thatreally haven't had the help that
(13:42):
they should have had and havesort of fallen through nets.
So I think it sort of goes bothways.
I don't think the services areperfect, but I don't think
people understand how theservices can help them either.
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And I agree with you, Emma.
I I think that that's thebiggest problem, too, is that
you gotta find the right fit.
And I think that one of thethings that I've seen around
(15:08):
here, not only in my area, butwhen I work for a bigger company
where we did telehealth.
If you're in Idaho, I'm justpicking on the US for a second,
and there's like three providerswithin a 20-mile radius.
Well, if you don't like thosethree providers, you're kind of
up shit's creak without apaddle.
And I find that, you know, theother part too that people don't
(15:30):
understand about therapy is thatwhile we are all trained the
same, I'm not everyone's cup oftea.
I mean, I'm a nice guy, but thatdoesn't mean you like me.
Yeah, I hope you do like me,Emma, but if you don't, it's
okay.
I'm not your therapist.
SPEAKER_01 (15:44):
I don't need one of those anymore.
SPEAKER_03 (15:46):
But the point is is her session after this, people.
I don't have a bow in England,so we're good.
I'm kidding.
I'm kidding, everyone.
I'm kidding.
But no, I think that that's theother part too, is that finding
the right fit, and that's theother thing too, is that if the
therapists that you have accessto are not your cup of tea,
you're a woman who is it.
SPEAKER_01 (16:07):
That's your help sort of gone.
Yeah, there's no like, oh, letme find you another one.
It doesn't work that way.
So no, I agree with that.
And and you're not going toengage if you're not sort of on
the same page as your therapist.
SPEAKER_03 (16:20):
And why would you engage if you don't have trust?
I mean, that's the other part.
SPEAKER_02 (16:23):
Yeah, understand.
SPEAKER_03 (16:24):
You know, so I think it it's a conversation I had
recently with another client.
She has couples counseling, andshe was saying to me that you
know, they were wondering ifwe've been working together for
too long.
I'm like, well, that could beit.
I don't know.
Are you comfortable with me?
Are you feeling like you'reholding off or you feel like
you're trying to please me inany way, shape, or form or
whatever?
(16:44):
And she said no.
And then I said, then that'sprobably a good match.
We're still good.
If we start changing our stylein order to adapt to the front
person in front of us, that'swhen therapy is no longer
working.
SPEAKER_02 (16:55):
Yeah.
SPEAKER_03 (16:56):
I I think but you need to have that match because
if you don't have that match,I've met a lot of people who are
really needed the help, but Idefinitely wasn't their cup of
tea.
And that there's nothing wrongwith that.
I gave them other referrals, butwe face the same problem in in
the United States that we do inCanada and England.
And frankly, what I hear most ofEurope is that you have a
limited number of people.
SPEAKER_01 (17:17):
Yeah, exactly.
And too many people needing theservices these days.
But yeah, it's it's difficult.
It's difficult.
Where where I live in Ashford,the hospitals on a motorway with
multiple bridges, and there'sthere's a lot of suicides in
Ashford.
It's really common on the on thebridges of the motorways.
So there's sort of signs allover the bridges from
(17:39):
Samaritans, and you know, so wehave they they do put things in
place very quickly.
So once there was a there Ireally only started recently the
suicides, those signs only wentup recently.
I think once we had a few in arow, they're quite good at
getting emergency help.
I would say that's quite good inthe UK, that emergency crisis
help.
But then it's once that crisisis over, there's just sort of no
(18:03):
more help.
It'll it'll just go round incircles.
SPEAKER_03 (18:07):
Well, you know, that I can go on and on about that
too, because it yeah, you get alot of like emergency help, but
to because you need emergencyhelp, something led you there,
so you gotta address that stuffso that you don't repeat it.
Yeah, you don't have that.
You're gonna do it again.
SPEAKER_01 (18:22):
Waiting lists, you know, there's waiting lists for
everything.
I mean, when I had my therapy,which we will get to, I had my
therapy through the ambulanceservice.
So that, you know, I was luckyand I was in a job where I had
access to that.
But before I went through theAmbulance Service, I went
through just the NHS, theNational Health Service, for
anyone that doesn't know.
And they have talking therapies.
(18:43):
And the waiting list, it waslike eight weeks long, which I
mean it might not sound massive,but if someone's someone can
deteriorate massively in thateight weeks if they're having,
you know, a real mental healthcrisis.
SPEAKER_03 (18:55):
You know, as much as I do, you in paramedic stuff,
right?
If you got an acute situation,you can't just say, you know
what, we're gonna slap aband-aid.
You gotta kind of like do theharder work, but then it's still
afterwards there's rehab,there's this, there's that.
You know, that access.
SPEAKER_01 (19:12):
Yeah, like I didn't have any emergency symptoms,
obviously.
They do triage for someone thatneeds immediate help, but you
know, I I think I would have gotquite a lot worse quite quickly
if I didn't get like therapywhen I did, to be honest.
SPEAKER_03 (19:26):
So I hope that people heard that.
People who are paramedicssometimes need therapy.
SPEAKER_02 (19:32):
Just say sometimes I need therapy.
One of the things you mentioned.
SPEAKER_03 (19:36):
I I just heard you mention suicides in your uh that
that have become repetitive.
I I used being a a a suicideprevention person from the past,
I'm no longer doing that.
I know a whole lot about that,but let's let's move from the
suicide in a sense that maybethat's not the sub what you're
gonna answer here.
But you you know, everyone hasthat one trauma that kind of
(19:58):
triggers them, you know.
Oh my god, I really needtreatment because I just saw a
dead cat on the side of theroad.
And and I say that because it'sless triggering for people.
I try not to trigger my c my myaudience right away.
I wait till they meet me.
But sorry, everyone.
Well, let's talk about yourparamedic stuff.
What was the trigger for you?
(20:18):
What was that event that kind oftriggered you?
SPEAKER_01 (20:21):
Yeah, so I think with trauma, there's two types
of triggers.
You've got like long-term,frequent triggers, like multiple
traumas, and then you've gotlike one traumatic event.
And I think I, you know, I haveno trauma from my childhood.
I had a very good upbringing.
I've I've had a very easy lifein terms of mental health.
I've never really suffered withany mental health problems, I've
(20:44):
never had anything happen in mylife that would cause any sort
of trauma.
So I went into this job with avery untraumatized person.
And then I think so.
I had one event that set off mytrauma last year.
I think in the ambulanceservice, anyway, just everything
you go to builds up a sort oftrauma.
(21:04):
And I found during COVID, so Istarted as a technician in 2019.
So I started just as COVID wascoming into play.
So my whole career was COVID.
And during COVID, so during2020, I was not quite qualified,
but I was out on my own sort oftraining, and I was meant to be
(21:26):
with another clinician, but Iwas actually put with a fireman
because they needed extra trucksout.
So I wasn't even qualified, andI was put with someone with no
medical knowledge at all, so Ihad to learn very quickly.
And so I think little thingslike that affected me throughout
the years, but these aren'tthings that I noticed at the
time, and I think small thingslike watching people say goodbye
(21:47):
to family members or going toelderly people who are lonely
and you're having to leave themalone, those things affected me
the most in this job over time.
But I had one event which was Ican't do that.
Away too much about it.
But basically, I went to a ladywho had hung herself whilst at
home with her ch her youngchildren.
(22:07):
And so her young children hadfound her in the morning.
And I think the reason ittraumatised me so much was
because I didn't know what I wasgoing to.
And I don't know if this willmake sense to a lot of people
who've worked on the front line,but you normally you get the job
dropped down, don't you, on yourinternal ambulance computer and
you see it's a hanging or yousee it's someone that's been hit
by a car or or someone you knowthat's given birth, and you sort
(22:31):
of you build up a bit a bit ofan idea of what you're going to
and you prepare yourself.
And so this one it came down asit came down as someone who had
been found dead, but it didn'thave any more details.
So I think when we got there andfound a young person, relatively
young person who had hungherself and there was five or
(22:51):
six kids on scene, I think itwas just quite a shock.
And I got upset on scene.
And I I never I don't cry onscenes, and I got upset while I
was on the radio asking for moreresources and sort of police,
and I started crying, and that'swhat brought on the sort of
(23:13):
PTSD, me crying on scene, whichjust sounds crazy, doesn't it?
SPEAKER_03 (23:17):
Well, let me do this.
You want to stick around foranother half hour?
Because I want to address whatyou just said, but we'll go
through the other half hour ifyou don't mind.
SPEAKER_02 (23:24):
Yeah, yeah.
SPEAKER_03 (23:25):
All right, so guys, just join us for the next part
of the episode.
I don't mean to interrupt agreat story, but I I want to get
back to that.
So please join us for the nextepisode.
SPEAKER_00 (23:36):
Please like, subscribe, and follow this
podcast on your favoriteplatform.
A glowing review is alwayshelpful.
And as a reminder, this podcastis for informational,
educational, and entertainmentpurposes only.
If you're struggling with amental health or substance abuse
issue, please reach out to aprofessional counselor for
consultation.
If you are in a mental healthcrisis, call 988 for assistance.
(24:00):
This number is available in theUnited States and Canada.
Welcome to Resilience Development in Action
with Steve Bisson.
This is the podcast dedicated tofirst responder mental health,
helping police, fire, EMS,dispatchers, and paramedics
create better growthenvironments for themselves and
their teams.
Let's get started.
SPEAKER_03 (00:29):
Well, hi everyone, and welcome to episode 248.
If you haven't listened toepisode 247, it was with Kimmy
Sadler.
She was a former supervisoryspecial agent in the U.S.
State Department.
And she is on her way walkingaround Europe in order to
support the first responders outthere.
So having said that, I havesomeone we met through online,
(00:49):
and I was like, oh, this isgreat.
I want to meet her.
And we kind of connected fairlyquickly, and she's finally on
here.
When I hear England, I've had afew people from England, I and I
think that it's important for usto have a first responders
perspective from England becausesometimes it is the same yet
different.
And for the record, I did lookat this beforehand, and I'm not
(01:11):
this is just because somethingsomeone else triggered me
because oh, it's different inEngland, it's easier.
And I'm like, well, the suiciderates of first responders in
England are pretty much the sameas the one in the United States.
So it's different, but the same.
That's how I perceive it.
But Emma Irwin, welcome toResilience Development in
(01:32):
Action.
SPEAKER_01 (01:32):
Thank you.
Thank you for having me.
SPEAKER_03 (01:34):
It's always good to have someone like talk about
what they've done when theyretired, because one of the
things that I talk about all thetime is that get ready for your
retirement because it's a lossof role, and a lot of people
forget to get ready for thatretirement.
But I don't think we're going tojump down that right away.
I feel like I read a little bitof your bio.
Obviously, we met throughonline.
So I want to learn more aboutyou.
(01:54):
So tell me a little more aboutyourself.
SPEAKER_01 (01:57):
Tell you about myself.
Well, I'm 33 years old.
So I've retired in the sensethat I've given up that position
on the front line, butunfortunately, I can't afford to
tie from working at this age.
I still need to work.
So I moved into like I'm stillworking as a paramedic, but in
an office role.
So very much not frontline.
I'm now assessing disabilitiesfor benefit systems.
(02:18):
So that's what I'm doing as aclinician.
But I was born in south east ofEngland in Kent in a little town
called Seven Oaks.
And then we moved to thesoutheast of London.
So I grew up around around Kentand London.
SPEAKER_03 (02:33):
Okay.
SPEAKER_01 (02:34):
And I went to university and did a degree in
criminology.
And I wanted to be a policeofficer initially.
That was so I always wanted tobe in the emergency services,
and my dad was an inspector inthe Metropolitan Police in
London.
Most of my family come from somesort of emergency service.
My mum's a dentist, so she'smedical.
So yeah, I think I was destinedfor some sort of frontline role.
(02:57):
My brother's a firefighter, sowe've got it all going on.
But yeah, I did a degree incriminology, and then I don't
know, I just stepped away fromthat.
And a position came up in theLondon Ambulance Service for
like an apprenticeship role.
So I joined as a technician andI was trained up as a technician
(03:18):
and then through the ambulanceservice, they sort of funded a
degree to become a paramedic andtake that extra step join there.
So while I was doing that, Imoved down to Ashford in Kent.
I've got two dogs.
SPEAKER_03 (03:30):
Okay.
What's your name?
Kevin and Phoebe, we better I'mI'm gonna I'm gonna make sure we
get some pictures so I can putthat on.
SPEAKER_01 (03:39):
Of course.
Don't mess with Kevin.
Kevin's a golden retriever.
SPEAKER_03 (03:42):
Okay, yeah.
Well I'm always a Labrador.
SPEAKER_01 (03:45):
He's oh, he's terrifying.
Yeah, absolutely terrifying.
He's a nightmare.
You might hear him in thebackground at some point
demanding attention.
But yeah, now I live, I'm about20 minutes from the sea, which
is nice.
I really like living down here.
And yeah, I moved to SoutheastCoast Ambulance Service from
London Ambulance Service.
So it's it's amazing howdifferent ambulance services
(04:06):
are, even in well, one localarea of of England, even totally
different to work for.
So I was working with CAM for acouple of years, and it really
took me that long to get used tothem.
I'm a little slow.
Sorry, Southeast Coast AmbulanceService.
SPEAKER_03 (04:23):
Thank you.
I'm I'm I'm not I don't know.
SPEAKER_01 (04:25):
No, no, no, I should have said that.
So yeah, that was the ambulanceservice I moved to in Kent, so
the Southeast Coast, they coverKent, sorry, Sussex in England.
And yeah, I left there inDecember 2025.
So I've just left and joined mynew role as a disability
assessor.
SPEAKER_03 (04:42):
Well, a few things that you said I want to make
sure I address.
They're still retired.
I have my younger guys andyounger women here who are
retired.
They're retired.
That doesn't mean they'reretired from life, they're just
retired from their job.
SPEAKER_01 (04:55):
Just yeah, just from that job.
SPEAKER_03 (04:56):
Sometimes a job will retire you, you know.
SPEAKER_01 (04:59):
So I think these type of jobs do sort of earlier
than others, don't they?
SPEAKER_03 (05:05):
I that's my experience.
So that's why, like, while yousaid, Oh, you know, but I'm
still working, yeah.
Well, you're still retired,because you know you know, so
one of the men like you youtalked about being a paramedic
down in you said London and alittle bit in the southeast of
England, and how different it isfrom one space to another.
I know around here I feel likeurban areas, such as Boston, New
(05:29):
York City, stuff like that, areway different than you know,
I'll pick on Poughkeepsie in uhNew York, or shout out to where
are my office in Holliston,Massachusetts.
There there's a huge difference,even though one's suburban and
the other one's urban, andthere's definitely different
types of presentation, eventhough there are some things
(05:49):
that are similar.
Is that what is what what wouldyou say is that like, you know,
what is it to be a paramedic andthe differences between the two
areas?
SPEAKER_01 (05:58):
So I think I don't think we necessarily have that
urban and sort of countrysiderural differences.
Like I think in America you havevast differences in locations,
don't you?
You have big spaces wherethere's not a lot going on,
very, very small towns.
I think in England you don'thave that as much.
(06:20):
I think you know, within half anhour's drive, you're at another
big town.
So you don't really have thatdivide between urban and rural.
So the jobs in themselves don'tnecessarily change much from
area to area.
I found in London a lot of myjobs were mental health that I
went to, a lot of poor mentalhealth within London.
(06:41):
I don't know if that's becauseit's a more built-up urban
population with more sort ofsocial housing and benefit
systems, more people livingthere.
I found that a lot, whether thatwas just my area.
Moving out of London, bigger,faster roads.
So there was more sort of traumaon roads around Kent because
you've got the motorways.
(07:02):
In London, nothing's going morethan 20 miles an hour.
You might get sort ofpedestrians being hit, but
they're not going to be hitfast.
You don't get a lot of trauma inthat sense.
So that was a bit of a differentjob further out in a more rural
location.
Um, it's more how the trusts,because I don't know how it
works in America.
I think you have you haveprivate ambulances services,
don't you?
SPEAKER_03 (07:22):
Sort of depending on the area, some of them are
private and some of them areintegrated within the fire
service.
SPEAKER_01 (07:28):
Yes, yeah.
So they work at the firedepartments.
Yeah, in England you havetrusts.
So the ambulance services arenot linked to hospitals, but
you'll have have ambulancetrusts.
So each area of the UK will havean ambulance trust.
I don't actually know how manythey are, but so London is its
own trust, and then South EastCoast Ambulance Service is the
trust I moved to.
So they cover three counties inKent.
(07:51):
So each region will have atrust, and they just work very
differently.
And I guess it's just the needsof the population they have.
In London, a lot of people havea lot more call volumes, so they
have different sort of policies,different time limits on jobs.
We have time limits for jobs,how long we should be spending
(08:12):
on scene, sort of targets.
And although you know, youcannot you can you need to spend
with someone what you need tospend with them, so they're not
sort of you have to leave oncethe target is here, like just
leave them there.
But they do have the target bag.
Yeah, yeah.
They don't have sort of target.
I know you we'll come backlater.
(08:32):
Call again.
SPEAKER_03 (08:34):
Get sick again, we can come back.
SPEAKER_01 (08:36):
Yeah, it's not quite that bad.
But they're not as strict withthem in London, I think, because
they know the pressure you'reunder.
In CAM, where I moved to inKent, they're a bit more strict
with their targets, and I thinkthat's because you're not you
haven't got as high a callvolume.
So you know, you should be ableto to get more done in a day and
to have more headspace to focuson on your job a bit better,
(08:57):
really.
Another thing that's differentis just the layout of the trust
itself.
So, for example, in SoutheastCoast Ambulance Service, I think
because of the journey tohospital times are longer, not
gonna be as long as in Americaand your rural areas, but in
regards to London, you know, wemight have a 30-minute drive to
(09:19):
hospital.
That's quite a long time for us.
It's a long journey to hospital,and so to avoid unnecessary
journey to hospitals and wastingthat time, there's a lot more
community services.
So I could refer to a lot morepeople and get a lot more help
in the community than I could inLondon.
They didn't really have thatthere's too many people, there's
not enough services to thepeople there, and they're like
(09:40):
five minutes from hospital, sothey would just go to hospital,
but then that would mean thatyou're queuing in London
hospitals because there's nobeds for your patients for up to
12 hours a shift.
So um, when I was in London,most of my shifts were spent
queuing at hospitals in um thesoutheast, we didn't have any of
that.
So just the way the needs of thepopulation are, the way the
(10:02):
hospital everything's just sodifferent, and I just wasn't
wasn't expecting it when Imoved.
There's good things and badthings about both, I would say.
SPEAKER_03 (10:11):
I I think uh yeah.
So yeah, let's just for ourAmerican buddies, which is
mostly what listens here, justfor the record, knowing what
social medicine can do, livingin Canada and most of like for
my first 24 years of my life,knowing a little bit about
England and how it is, it's goodto have access to hospitals to
(10:32):
everyone.
However, if you're willing towait.
And people hear like, oh, Iwaited six hours, eight hours.
I'm like, you know how many likeEnglish, Canadians, or
Australians would be like,that's nothing.
SPEAKER_01 (10:46):
I and I always say, you know, if you need to wait
that long, then you probablydon't need to be in hospital.
That's what I know.
And you know, when people wouldcomplain at me about the wait
times, I'd say, you know, you'dbe you'd if you if I were you,
I'd be more concerned if you'rebeing seen in the first 30
minutes.
So, you know, it's a good thing.
You're not particularly unwell.
(11:06):
It's frustrating, but you know,you need to look at it the other
side.
The reason you're waiting thatlong is because other people
need to be seen quicker thanyou.
So yeah, but the wait times arethey they're insane here.
There's there's too many people,there's not enough hospitals,
not enough infrastructure, it itgets worse and worse every year.
But it's been like it for years.
It's I think it's in the newsmore in recent years, probably
(11:28):
since COVID, let's be honest.
But uh it's been like it foryears.
People have said how you knowbusy the system is for years and
years and years.
I don't think there's anythingmassively different other than
people are I think people arebecoming unhealthier as well.
SPEAKER_03 (11:43):
I mean, the aging of the population plays a factor
too.
I don't want to go into too muchdemographics, but you know, you
know, like Western cultures nowwe're getting elderly type of
population.
I mean, the baby boomers are allturning 65 this year, like Yeah.
SPEAKER_01 (11:57):
You know, people are living longer, a lot more mental
health as well.
A lot more mental health, whichwas one of the biggest problems,
I think.
Yeah, and there's not enoughservices in the UK.
Our mental health services uhI'm not I wouldn't say they're
bad, but there's not enough forthe demand.
So the only place really is totake people to hospital, which
isn't I know you're not sayingit's bad, but I'm saying that's
(12:18):
bad.
So I'm saying it yeah, yeah.
It's not it's not as it shouldbe.
It should be better.
Mental health services are notgood.
SPEAKER_03 (12:25):
Maybe it's a better question to ask this.
Maybe you can uh help me withthis.
Is it that we don't have enoughservices for mental health, or
is because mental health hasbecome more of something we can
talk about, then the servicesaren't there?
SPEAKER_01 (12:38):
I think people are talking about it more, people
are self-diagnosing a lot.
I think social media is iscausing a lot of people to think
they have a mental healthproblem.
I don't think people understandwhat a mental health problem is.
You can have struggles in lifeand not have a mental health
problem.
You know, you you can have dayswhere you're feeling low, you
you can be anxious and not havea mental health problem that
(13:00):
needs diagnosis and treatment.
And I think there's a bit of ablur there for especially young
people with social media.
But I also think that, well,from what I noticed on the
ambulances, the problem is a lotof people don't engage with
mental health services.
So they might be there, but butthey don't engage with them.
And so there's there's only somuch those services can do, and
(13:20):
then that's put out as I'm notgetting any help.
But I I would have uh patientssay to me, you know, I'm not
nobody's helped me with thismental health problem, but I'd
see that they've missed threeappointments, and I you know, I
say, but you you're not engagingwith them, there's only so much
they can do if you're notturning up to your appointments.
So I think that's a big part ofit is people not engaging, but
then there are people thatreally haven't had the help that
(13:42):
they should have had and havesort of fallen through nets.
So I think it sort of goes bothways.
I don't think the services areperfect, but I don't think
people understand how theservices can help them either.
SPEAKER_03 (13:59):
Just a quick break, guys.
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(14:21):
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Now, right back to the episode.
And I agree with you, Emma.
I I think that that's thebiggest problem, too, is that
you gotta find the right fit.
And I think that one of thethings that I've seen around
(15:08):
here, not only in my area, butwhen I work for a bigger company
where we did telehealth.
If you're in Idaho, I'm justpicking on the US for a second,
and there's like three providerswithin a 20-mile radius.
Well, if you don't like thosethree providers, you're kind of
up shit's creak without apaddle.
And I find that, you know, theother part too that people don't
(15:30):
understand about therapy is thatwhile we are all trained the
same, I'm not everyone's cup oftea.
I mean, I'm a nice guy, but thatdoesn't mean you like me.
Yeah, I hope you do like me,Emma, but if you don't, it's
okay.
I'm not your therapist.
SPEAKER_01 (15:44):
I don't need one of those anymore.
SPEAKER_03 (15:46):
But the point is is her session after this, people.
I don't have a bow in England,so we're good.
I'm kidding.
I'm kidding, everyone.
I'm kidding.
But no, I think that that's theother part too, is that finding
the right fit, and that's theother thing too, is that if the
therapists that you have accessto are not your cup of tea,
you're a woman who is it.
SPEAKER_01 (16:07):
That's your help sort of gone.
Yeah, there's no like, oh, letme find you another one.
It doesn't work that way.
So no, I agree with that.
And and you're not going toengage if you're not sort of on
the same page as your therapist.
SPEAKER_03 (16:20):
And why would you engage if you don't have trust?
I mean, that's the other part.
SPEAKER_02 (16:23):
Yeah, understand.
SPEAKER_03 (16:24):
You know, so I think it it's a conversation I had
recently with another client.
She has couples counseling, andshe was saying to me that you
know, they were wondering ifwe've been working together for
too long.
I'm like, well, that could beit.
I don't know.
Are you comfortable with me?
Are you feeling like you'reholding off or you feel like
you're trying to please me inany way, shape, or form or
whatever?
(16:44):
And she said no.
And then I said, then that'sprobably a good match.
We're still good.
If we start changing our stylein order to adapt to the front
person in front of us, that'swhen therapy is no longer
working.
SPEAKER_02 (16:55):
Yeah.
SPEAKER_03 (16:56):
I I think but you need to have that match because
if you don't have that match,I've met a lot of people who are
really needed the help, but Idefinitely wasn't their cup of
tea.
And that there's nothing wrongwith that.
I gave them other referrals, butwe face the same problem in in
the United States that we do inCanada and England.
And frankly, what I hear most ofEurope is that you have a
limited number of people.
SPEAKER_01 (17:17):
Yeah, exactly.
And too many people needing theservices these days.
But yeah, it's it's difficult.
It's difficult.
Where where I live in Ashford,the hospitals on a motorway with
multiple bridges, and there'sthere's a lot of suicides in
Ashford.
It's really common on the on thebridges of the motorways.
So there's sort of signs allover the bridges from
(17:39):
Samaritans, and you know, so wehave they they do put things in
place very quickly.
So once there was a there Ireally only started recently the
suicides, those signs only wentup recently.
I think once we had a few in arow, they're quite good at
getting emergency help.
I would say that's quite good inthe UK, that emergency crisis
help.
But then it's once that crisisis over, there's just sort of no
(18:03):
more help.
It'll it'll just go round incircles.
SPEAKER_03 (18:07):
Well, you know, that I can go on and on about that
too, because it yeah, you get alot of like emergency help, but
to because you need emergencyhelp, something led you there,
so you gotta address that stuffso that you don't repeat it.
Yeah, you don't have that.
You're gonna do it again.
SPEAKER_01 (18:22):
Waiting lists, you know, there's waiting lists for
everything.
I mean, when I had my therapy,which we will get to, I had my
therapy through the ambulanceservice.
So that, you know, I was luckyand I was in a job where I had
access to that.
But before I went through theAmbulance Service, I went
through just the NHS, theNational Health Service, for
anyone that doesn't know.
And they have talking therapies.
(18:43):
And the waiting list, it waslike eight weeks long, which I
mean it might not sound massive,but if someone's someone can
deteriorate massively in thateight weeks if they're having,
you know, a real mental healthcrisis.
SPEAKER_03 (18:55):
You know, as much as I do, you in paramedic stuff,
right?
If you got an acute situation,you can't just say, you know
what, we're gonna slap aband-aid.
You gotta kind of like do theharder work, but then it's still
afterwards there's rehab,there's this, there's that.
You know, that access.
SPEAKER_01 (19:12):
Yeah, like I didn't have any emergency symptoms,
obviously.
They do triage for someone thatneeds immediate help, but you
know, I I think I would have gotquite a lot worse quite quickly
if I didn't get like therapywhen I did, to be honest.
SPEAKER_03 (19:26):
So I hope that people heard that.
People who are paramedicssometimes need therapy.
SPEAKER_02 (19:32):
Just say sometimes I need therapy.
One of the things you mentioned.
SPEAKER_03 (19:36):
I I just heard you mention suicides in your uh that
that have become repetitive.
I I used being a a a suicideprevention person from the past,
I'm no longer doing that.
I know a whole lot about that,but let's let's move from the
suicide in a sense that maybethat's not the sub what you're
gonna answer here.
But you you know, everyone hasthat one trauma that kind of
(19:58):
triggers them, you know.
Oh my god, I really needtreatment because I just saw a
dead cat on the side of theroad.
And and I say that because it'sless triggering for people.
I try not to trigger my c my myaudience right away.
I wait till they meet me.
But sorry, everyone.
Well, let's talk about yourparamedic stuff.
What was the trigger for you?
(20:18):
What was that event that kind oftriggered you?
SPEAKER_01 (20:21):
Yeah, so I think with trauma, there's two types
of triggers.
You've got like long-term,frequent triggers, like multiple
traumas, and then you've gotlike one traumatic event.
And I think I, you know, I haveno trauma from my childhood.
I had a very good upbringing.
I've I've had a very easy lifein terms of mental health.
I've never really suffered withany mental health problems, I've
(20:44):
never had anything happen in mylife that would cause any sort
of trauma.
So I went into this job with avery untraumatized person.
And then I think so.
I had one event that set off mytrauma last year.
I think in the ambulanceservice, anyway, just everything
you go to builds up a sort oftrauma.
(21:04):
And I found during COVID, so Istarted as a technician in 2019.
So I started just as COVID wascoming into play.
So my whole career was COVID.
And during COVID, so during2020, I was not quite qualified,
but I was out on my own sort oftraining, and I was meant to be
(21:26):
with another clinician, but Iwas actually put with a fireman
because they needed extra trucksout.
So I wasn't even qualified, andI was put with someone with no
medical knowledge at all, so Ihad to learn very quickly.
And so I think little thingslike that affected me throughout
the years, but these aren'tthings that I noticed at the
time, and I think small thingslike watching people say goodbye
(21:47):
to family members or going toelderly people who are lonely
and you're having to leave themalone, those things affected me
the most in this job over time.
But I had one event which was Ican't do that.
Away too much about it.
But basically, I went to a ladywho had hung herself whilst at
home with her ch her youngchildren.
(22:07):
And so her young children hadfound her in the morning.
And I think the reason ittraumatised me so much was
because I didn't know what I wasgoing to.
And I don't know if this willmake sense to a lot of people
who've worked on the front line,but you normally you get the job
dropped down, don't you, on yourinternal ambulance computer and
you see it's a hanging or yousee it's someone that's been hit
by a car or or someone you knowthat's given birth, and you sort
(22:31):
of you build up a bit a bit ofan idea of what you're going to
and you prepare yourself.
And so this one it came down asit came down as someone who had
been found dead, but it didn'thave any more details.
So I think when we got there andfound a young person, relatively
young person who had hungherself and there was five or
(22:51):
six kids on scene, I think itwas just quite a shock.
And I got upset on scene.
And I I never I don't cry onscenes, and I got upset while I
was on the radio asking for moreresources and sort of police,
and I started crying, and that'swhat brought on the sort of
(23:13):
PTSD, me crying on scene, whichjust sounds crazy, doesn't it?
SPEAKER_03 (23:17):
Well, let me do this.
You want to stick around foranother half hour?
Because I want to address whatyou just said, but we'll go
through the other half hour ifyou don't mind.
SPEAKER_02 (23:24):
Yeah, yeah.
SPEAKER_03 (23:25):
All right, so guys, just join us for the next part
of the episode.
I don't mean to interrupt agreat story, but I I want to get
back to that.
So please join us for the nextepisode.
SPEAKER_00 (23:36):
Please like, subscribe, and follow this
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A glowing review is alwayshelpful.
And as a reminder, this podcastis for informational,
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