'I will make a terrific ghost'

5 Questions for EMT, private investigator, and writer Jennifer Murphy

I probably first met Jen Murphy in a dark bar, surrounded by loud and beautiful poets. I don’t remember the moment, but I remember the era—lower east side, lots of vodka soda and nervous energy, our mutual friend, the incomparable Felice Belle, taking the stage and saying something about Prince and heartbreak. Jen was noticeably talented and tall. She had an Irish twinkle in her eye.

Jen still writes, and now she also saves lives. She also writes about saving lives. She wraps words around experiences that most of us only know from television dramas or our own nightmares. Her new book, First Responder, is pathos and comedy playing out with a background of flashing lights and sirens. Reading it, you fall in love with Jen, you fall in love with a city, you fall in love with friendship and its enduring quality (transcending even death).

It’s a special kind of participatory witness, a special kind of catharsis. Meet Jennifer Murphy…

Courtney Martin: Part of what I love about this book is the way you make the “thin place”—as the Celtics call it—of an ambulance come to life. Some of it is mundane—the same diabetic patient, day after day. Some of it is quintessential emergency. But all of it feels like it happens in a more truthful place than the rest of the world. Is that part of what you drew you to this job and to write about it—the no bullshit zone of it all?   

Jennifer Murphy: I didn’t consciously seek out a vocational landscape that collapsed the earthly and eternal, or put more plainly, life and death, as a decision to find a more truthful landscape. But I absolutely agree with your observation that emergencies are a no-bullshit zone. This is one of my favorite aspects of the work.

If someone is having a heart attack and a flock of first responders appear at their door, the masks people wear in the everyday world fall away, what is essential rushes forward, and everyone is reduced to their most basic state of humanity.

No rescuer arrives on scene and asks the patient what political affiliation they hold or what books they’ve read before they attempt to save a life.

It’s about presence, witness, action, togetherness, nowness. And in this way, it’s about reality. There’s no time for us to dance around what’s truly going wrong with ornate language or intellectual pondering. It’s a world of feeling, immediacy, and intimacy, a world of frank discussions about sickness and death, and life-preserving gestures that create connection and work in defense of life.

A sense of belonging to something meaningful emerges as a result of being an EMT, which I love, along with adjacent feelings of esteem in being able to show up for people on what’s often the worst day of their life, self-forgetting by placing other people’s needs above my own, and a direct route to the language of the heart and soul. I love that. And I need it. I suspect we all do. While difficult, being a first responder is an antidote to alienation and despair. I cannot recommend it enough.

You write: “These women. My street wives, sisters, partners. I didn't know how I would get through this life without them. Much has been written, perhaps a bit too much, if you ask me, on the importance of brotherhood. Of sisterhood we hear almost nothing. But time and again, my life has been saved by women.” Say more: how has your life been saved? I imagine you mean both literally, given the nature of your work, and emotionally? 

“I come from a long line of strong women,” as my mother often reminds me. My grandmother, mother, and aunts showed me early on in life that they took full responsibility for watching over me, financially and emotionally, particularly when I was too young and defiant to look after myself. And they took their work seriously.

They told me difficult truths about myself that provided me with a salvational baseline for developing into a woman who could trust other women with her life.

I’ve spent the greater part of my career(s) working in a “man’s world,” from being an investigator to being an EMT. And because those worlds are dominated by men, the narratives derived from the worlds are problematically male. Much of the language of war, rescue, and heroism is woefully masculine. It’s about brotherhood, we hear repeatedly. And yet beside – not behind, beside – every great brother is a phenomenal sister. There are scores of women rescuers in EMS. And yet we rarely, if ever, get to see them in literature, history, or art. When we think of firefighters, we think of men. Soldiers, men. Detectives, doctors, EMTs, paramedics: men. But women are out there doing this difficult and important work, too.

There’s a phenomenal book called Women at Ground Zero by Susan Hagen and Mary Carouba that offers stories of women rescuers from the terrorist attacks, which acknowledges that women also sacrificed their lives that day and worked the cleanup. The stories of these heroic women have been overshadowed by public mourning over the male rescue workers who perished in the disaster. I’ve spoken to women rescuers who worked the cleanup after 9/11, and so many of their stories are about how they were down there digging, too. And not only were they digging, but they were also doing the impossible work of trying to emotionally console the bereft men. Talk about labor. Their stories are powerful, important, and largely lost to society. I didn’t want that to happen with the women rescuers who worked Covid-19.

Some of my favorite first responders on the street are women. My closest partners are young women. I wanted people to see them. And I wanted the book to open with scenes that demonstrate how my non-uniformed women friends, my sisters, have saved my life: medically, financially, and emotionally. Sisterhood is a nourishing and important narrative, and one we desperately need to hear. It’s a crucial narrative, it’s a missing narrative, and it’s long overdue.

The solutions journalist in me was fascinated to learn about how badly designed our emergency medical services are--overrun with what you call “frequent fliers,” folks with alcohol and drug addiction who emergency workers might see multiple times every month. In much of Western Europe, and some more innovative states in the U.S., people are doing it differently. Can you talk a bit about the alternative models you like most? 

EMS in the United States was in crisis long before Covid-19 hit, and now it is in near collapse nationwide. Our system is broken from almost every angle, rural and urban: poor reimbursements from insurance providers for ambulance services that have rising costs; the stunning turnover rate of EMTs and paramedics, in part due to the terrible pay and emotional toll of the work; on-the-job assaults against first responders and injuries; and nearly every state has severe problems with chronic 911 callers – “frequent flyers” who strain the EMS system, which is already strained.

Many chronic 911 callers suffer from alcohol and drug addiction, food insecurity, mental health and mobility issues, reoccurring medical conditions, social isolation, age-related complaints for elderly populations, poverty, and lack of access to alternative services. And then there’s the expense of having medical conditions. America is the only wealthy nation without universal healthcare where a significant portion of the population avoids seeking medical treatment due to the exorbitant costs, and 66% of bankruptcies are tied to medical issues. Until we fix this systemically, all of these healthcare problems will continue to fall on our EMS system until it breaks. We’re almost there now, due to Covid.

Many countries and states have attempted to solve broader systemic issues by offering alternatives to 911 and hospitals. In France, an EMS-like service called SOS Médecins dispatches doctors to visit sick people at home, rather than sending an ambulance. I love this model. We can do it here—why not? Covid has shown us that telemedicine can also work well for patients who are too sick to leave home but may not qualify for the ER. In parts of Texas, pilot programs send EMS opioid response teams to help people connect to medication-assisted treatment, peer recovery, and educational prevention, along with distributing life-saving doses of naloxone. A similar program was tested in Baltimore. These pilot programs prevent repeated overdoses and help people achieve long-term sobriety, and attempt to address the addiction cycle beyond the crisis point. California has also tested and deployed impressive models for “community paramedics,” teams that follow up with patients’ post-hospital discharge and provide alternative destinations like urgent care facilities and sobering centers, which fill gaps in health and safety services. I love these programs.

The future of EMS can be greatly improved by increasing the number of mobile, at-home healthcare alternatives. And these services have to be available 24/7, or people will call 911 rather than wait for the urgent help they need and deserve. I’m also a huge advocate for turning bystanders into rescuers. There is no reason everyday people can’t take a quick class and learn CPR and bleeding control. Creating more helpers who can act before the professional rescuers arrive unburdens the 911 system and saves lives. Do you really want the fate of your loved one to be entirely at the mercy of EMTs who are on an ambulance stuck in traffic?

You survive via what you dub “tragicomedy”—taking in the depth of loss and sadness and also laughing your ass off. Say more about the balance between the two.

First responders live in a world set apart from other people. On a daily basis we’re in the projects, homeless shelters, ERs, prisons, hospice facilities, halfway houses, nursing homes—you name it. We’re in the trenches, and it’s a harrowing and tragic place to operate. Street humor is particularly dark, and I find the humor involved in rescue work salvational. Sometimes the situations we face are so sad and hopeless that the only way to survive without lasting damage to one’s soul is to laugh. A lot goes wrong in the field, and it becomes a sort of tragicomic space. “Sorry I’m trying to help you, but I seem to have lost the keys to the ambulance, so just hang tight while I look all over the place to try and find them.”

Humor is a sacred tool for walking through the unspeakable.

In terms of balance—what’s that? Just kidding. I do indeed survive on tragicomedy. One of the responses I keep getting from people who read the book is that it is “heartbreaking and hilarious,” often all at once. When I hear that, I feel like I’ve done my job as a storyteller. To achieve both registers of emotion in a reader is, to me, the highest achievement. The way to change minds is to move the heart. Move the heart, and you can change the world.

You write: “If you remember nothing else of what I've told you, I beg you to remember this: The dying should get what they want.” It's your funeral, Jennifer Murphy. Who is there, what are they wearing, what music is playing, what food is everyone eating? 

This question took my breath away, because it arrived in my inbox after I returned home from my annual cancer screening. The doctor unexpectedly found things she didn’t like and took two biopsies, so I’m bandaged up and waiting for test results. Waiting for test results is always unpleasant, and one’s possible death moves from the back of the mind to the front.

Over the years I’ve had many frank discussions with Felice, my sister/best-friend, about my funeral. She is in charge of it.

I’d love to have a service funeral, so my servicepeople friends should wear their dress blues—and sabers. Don’t forget the sabers. Someone in a kilt should hit the bagpipes, and my sister-wife-friend Ylfa should sing “The Parting Glass.” I’d like my funeral to be packed with a city of people from all different walks of life, just like my friend Pat’s funeral after 9/11. I want to touch as many people as humanly possible while I’m alive. And when I’m dead, I want to be buried in my uniform.

I’ve always wanted to be buried rather than cremated, because I like the idea of sleeping inside the earth and I do not like to be hot or burned. But recently I lost a close friend, and he was cremated, and I am blessed to possess some of his ashes. I love having some of him with me at home, so now I’m rethinking my end-of-life plans in terms of the body. What I can tell you with absolute certainty is that when I’m on the other side, in that thin and sacred Celtic place, surrounded by my fallen friends, I plan on staying connected to people I love who are among the living.

I will make a terrific ghost.

Yes you will, Jen. Yes you will. A portion of your newsletter subscriptions have been donated to Park Slope Volunteer Ambulance Corps, where Jen serves.