Latest / Dispatched & Dysfunctional / The Job Was Never Supposed to Be Your Whole Life — Anna Lombardo
Transcript
- Anna Lombardo: Ha ha Chris: It was, and then I got mad I studied fuck it. Anyways Welcome back to this fashion and functional. So I've been looking for for this one for a while, people. ⁓ and full disclosure, I apparently had ⁓ to harass my guest long before she finally agreed to sit down with me and do this. And same thing before whole episode. But anyways, today's guest is Anna Lombardo. ⁓ before titles, credentials, and also the experiences of medic, ⁓ all the polished resume bullshit. Who are you really and what made this conversation worth saying yes to besides me bugging you all the time? Anna Lombardo: I don't know, the the ⁓ the p the constant pressure was definitely a ⁓ that was definitely a key factor. Chris: Hey, gotta be persistent sometimes. Anna Lombardo: ⁓ yes, you should. You should be persistent in anything. ⁓ I don't know why my stupid butt is ⁓ is is worth the effort, but I appreciate it none the same all the same. ⁓ Well, I am Anna. I'm a I've been a NMS for about ten years. I have I have had a pair of my paramedic questions for about nine. I'm still waking up. Took a dad before the not only not only did he have to like fight to get me on here, I was late to this because I fell asleep and did not wake up with my timer. ⁓ so we're starting off great. But ⁓ Chris: It it helped me, so it's all good. I got me a nap where I got to work on shit. Anna Lombardo: We we hate we we all got naps. A good day. but I have ⁓ in those ten years I've worked ⁓ interfacility transfer with basic or ⁓ BLS backup for a primary fire department. I have worked primary nine one one ⁓ during COVID and then ⁓ now I've worked ER, I've been in ER tech with some transfer, some transport capabilities there. Chris: And I think and let's see. Anna Lombardo: ⁓ for higher acuity and then I am now primary nine one one rural with a fire department. So I've I've done just about I'm never gonna say I've done everything because there's always gonna be something to find. Like I I've found the weird corners of the of the career field, but I I have not done error, I've not done any of that, but done just about I've done been around a whole bunch of different ⁓ fields for EMS in these last ten years. ⁓ I'm a mom. ⁓ I was a str for about six months I was an instructor. ⁓ yes. ⁓ that was I loved it, but that in that six months the administrative side was just it it could it could have been a little more it could have gone a little better. ⁓ but it was it was worth it. I enjoyed it a lot. ⁓ I Chris: An instructor too, aren't you? Anna Lombardo: I'm constantly taking students or I was constantly taking students while I was working at the ER and it was always very ⁓ very rewarding. It's probably my favorite part of this field. mom, I'm an aspiring writer. That's that's the best I've got that's one of things I want to come in here and talk about today is how important it is to have a life outside of this field and ⁓ find something a hobby or something fun to do so that when you do eventually have to get out that you still have a sense of identity. You know what I mean? Outside of this. ⁓ Chris: Don't let don't let this job control you. Anna Lombardo: Don't let this job control you. Don't let this job be everything you are and everything you know. ⁓ that's that's the key takeaway I would like to give everyone today. ⁓ So I trying to think. ⁓ I'm still waking up. I need I probably should have grabbed some coffee or something before. Chris: You're good. So on your you know, ⁓ as I do every guest, on your form you put silence has a measurable cost and that trying to keep your burden away from everyone else, you make it harder for yourself in the long run. ⁓ again, that I I feel that, I've been there, I've done that. ⁓ it it took me having a fucking stroke to realize it. But ⁓ so ⁓ when did you realize your silence wasn't protecting your family at all? It was actually costing you your own mental Anna Lombardo: It does. Mm-hmm. Yes. Chris: Health and actually physical health in the end really. Anna Lombardo: Yes. ⁓ so in twenty twenty one we went through the delta epidemic. The area that we are in actually saw the highest. Yeah. Chris was there for me. Chris Chris was there right alongside me for that. ⁓ we went in the area that we were in for about three weeks of the Delta ⁓ run of the pandemic, Delta strain, we saw I wanna say a ten percent reduction in population in our area. We were the highest death toll for a solid three weeks. during that time, if I rem if I'm remembering correctly. and I was working twenty four hours ⁓ in a very rural part of our area, ⁓ to where medicine is not seen as a priority. You know what I mean? Taking care of yourselves. There was a lot of widespread panic. I think this area did not get hit very hard by the initial strain. And the people there once it started hitting once Delta started hitting really hardcore panicked. Panicked. And they and you know completely understandably. it really took a toll on that community and as you know with us as well, I mean we were very, very low, ⁓ we we did not have a whole lot of support in the area that we were in. So what ended up happening a lot of times. ⁓ people would panic. They would call, they would get a positive home test for COVID. So we would start the shift off ⁓ running pretty much like home tests. Hey, you know, I got this positive test, what do I do? That was a lot of it for for the first part of the day. And we just have to say say the same thing over and over again. We do vital checks and stuff like that. Just be like, look, ⁓ you know, as long as you're not significantly short of breath, you're not having ⁓ these symptoms there's not a whole lot the hospital's gonna do for you. Just stay hydrated. ⁓ the zinc vitamin C regimen the C D C's been recommending, like it that's that's pretty much all you can do. And then the second half of the day would be the major calls. Those would be those would be the times when we were pulling people out, ⁓ left, right, and sideways, not just from COVID. There, you know, the the world still continued on behind the COVID, but there was a good bit of COVID in there where, you know, people were people were angry. We were in an area where the the political side of COVID ⁓ really, really was very prevalent in that time and people, you know, who may not have believed that that was real were coming at us angry. You know, when they were they were critical. They were coming at us angry. Like I bet I remember one patient saying to me, I bet you're happy that I'm sick. I bet you're happy that I'm dying and it's like, I'm I'm no. Like no, not at all. Like that's I don't take joy in being right about certain things. You know what I mean? And ⁓ It it was just it was heartbreaking to see that those active stages of death and dying that it really it really put the textbook into reality. ⁓ so we did and then, you know, the rest of the day, I think I think in total we were averaging calls. Our call volume was sitting there like at sixteen to twenty calls in a twenty four hour shift. So we did that for three weeks. Three weeks straight. Chris: Yep. So just just for everyone to know just for everyone to understand on this, the area she's talking about would take a minimum of forty five minutes to get to a hospital. ⁓ so that f twenty runs a shift, I know a lot of people are like, ⁓ that's not a lot. That that was literally running our dicks in the dirt and going home dead. Anna Lombardo: Yes. Yeah. Yeah. PRTs, PRTs, PRTs, but then at the same time still still doing that. So I mean you were sitting there after shift. You just could not catch up. You really couldn't. From the on the emotional side, on the paperwork side, like it was it was just a constant battle to keep ahead of things and even still it was like two, three hours after shift catching up on everything and you know And ⁓ still on a twenty four forty eight, I mean that's the rest of your your initial off day that that's gone. ⁓ especially when you're not sleeping on shift. ⁓ so that being said, so this was I think it was mid July all the way through August. And finally, I think about the second or third week into August, I just I had I hit a breaking point. I hit a massive breaking point. And ⁓ at the time I could not find because everything was so limited in time slots, because everything was still so shut down, I could not find therapy. I could not find psychiatry and I began to have those interesting thoughts. like I'd rather I'd literally rather, you know, commit Kurt Cobain style than go into shift today. You know what I mean? I remember having those thoughts and those those urges and I was just like, Okay, we gotta do something. So I reached out to where my parents live in a different part of the state and we were able to find ⁓ psychiatry and someone who had an open appointment and they were willing to take me. And it was on my Kelly Week. So Kelly Week you have like the first day and then you skip a day in the you so it's it's your Sunday day. ⁓ You skip a day on Wednesday and then you come back on Monday. In addition to everything going on, I wanted to give myself a little bit of time to ⁓ just kind of decompress. So I was gonna have to drive six hours in order to get to the office that I was going to. And I emailed the ⁓ I emailed the supervisor and I emailed the ⁓ operations manager at the time, the overall operations manager, and I was like, Hey, this is what's going on. I was not upfront to how severe it was because I was not sure how seriously this was going to be taken in terms of like, hey, y you know, we're gonna have to report you to the state, like you're gonna have to go through this entire in because I've seen this happen before. You're gonna have to go through an entire inpatient, you know, three days day, and then you have to reapply to each other license. I've seen that happen before. And Chris: So I think I think before you just go keep going ⁓ on that, you know, I I think that's honestly a and I've said this in the past few podcasts, but I think that's honestly one of the killers for our careers is, you know, in in first response, not just paramedics, so you know, police, fire, nurses, anything to deal with, you know, taking care of people really. ⁓ if you admit you have a problem ⁓ of that sort, then you're one Anna Lombardo: Mm-hmm. Chris: You blemish your freaking resume and two, you could possibly lose your license. ⁓ so I think and that's why I started this podcast, but I think that's why a lot of us ⁓ either a like you said, we go s start seeing psychiatrist in silence or we pretty much say fuck the job and leave. You know, and yeah, or worse, and we ⁓ we we've we've had that, you know, that we for people we've known and called friends. ⁓ so you know, and everybody listening can understand that. ⁓ we all wear a uniform, we all have a purpose, and you know, we we want to be the person we left as when we kept before we come home. Anna Lombardo: Worse. You know. Or worse. Yep. Chris: But ⁓ and I'll be the first to admit it too, during COVID I was not myself. I was stressed the fuck out. I didn't get sleep, we were pretty much getting mandatory to overtime a lot. And a system that did not use the overtime or mandatory people. So Anna Lombardo: Yes. That was Yeah. Yeah. Yeah, we I I don't we we were getting mandatory on top of everything else. That was the crazy part. Was like we're still I I don't know if they just did not look at the statistics or like we've talked about before, they just did not care. Or, you know, they you know, I don't know if they were looking at the numbers. I remember it took them like a solid two weeks when this first kick doctor realized that there was a problem. Like that that the call numbers had jumped in. It was it was crazy. But like and and I think people told them, but I don't know exactly how that conversation was. So that's you know, that's I said I'm not I'm not privy to that. ⁓ anyway, so the only thing I don't want to do is complain. This entire time, you know what I mean? Chris: Right. No, no, you're good. And you know, and that that's that's the other thing is as you said earlier, you know, we we we all get into this career, we all get into this field, and a lot of the time we forget who we were before we started this. and that's kind of I hate to say it this way, but that's how the job rewards us in the end. You know, we're not the same person. We're not who we ever were, we're never gonna be the same person we ever. Anna Lombardo: The four. No, yep. And it's it's hard to remember how to be somebody that is not a paramedic. That is not it's hard to learn how to turn it off. ⁓ and that was one of the biggest struggles I had a couple years in was was learning how to turn that off and be just be a person. and it definitely had its toll in the end. ⁓ in tur in terms of that situation. Chris: ⁓ so kinda brings me this Anna Lombardo: Towards the end. ⁓ when it finally came to a head, I had one of my first manic episode in ⁓ September of twenty twenty one. ⁓ I had gone part time, my dog is tearing up the ⁓ screen outside on the window, sorry. ⁓ but in September twenty twenty one I have my first manic episode. ⁓ not not significantly severe. Thankfully I saw I have bipolar two on top of Chris: It's okay. Anna Lombardo: obviously PTSD anxiety depression. and this was the first moment of like, ⁓ something is like really wrong. So but so we ⁓ luckily it was not the kind that you get nine one one called about to you, but it it was ⁓ a s textbook bipolar two manic episode. ⁓ so we I was also freshly pregnant at this time. ⁓ like that that was a terrible way to work. But I had just found out I was pregnant ⁓ with my youngest. I had just gone part time, thankfully, you know, I had just gone part time at the company because it was getting to a point of like we have to do something. Something is something is not right. Chris: Well also also at that time they were getting rid of our twenty fours. So Anna Lombardo: They were getting rid of our twenty fours. I got I got out right before that. ⁓ thankfully, I think it was like the first week of September I worked my last shift. ⁓ and I it w to prove to prove the point here, to prove to nail the point home of the attitude that we face as first responders. ⁓ when I went part time, it was approximately I think a week or two after when I find when I sent Ben email when I sent my ⁓ notification in. I sent my intention in. And ⁓ sorry. I emailed them I was like, hey, I'm going part time for the sake of ⁓ because my family was starting to see the effects. I was short tempered. I was barely functional, barely you know, barely there. Even on my times when I was, you know, recovered from from my twenty fours that there I just was not I was not here. I was not around. I had a two year old daughter. my eldest was was two years old when this was all happening and I had missed so much of her life and it was becoming apparent. You know what I mean? It was it was the the toll on her was was very much becoming obvious and the toll on my husband as well. It it was something else. And he was so he is an advanced D ⁓ T. ⁓ and he was also in this field but he was part time. ⁓ going through school. he was going through school for another career field and but he was still working hard time. So he did absolutely experience that same that same toll. ⁓ he you know, they were they were becoming affected by by what was going on in my head. And I did not want to talk to even though he was a first res a first responder, i it I wanted to keep him away from how it was affecting me because I did not want to put any additional strain on him or any additional burden on him. And at the end of the day it it still it it it was a brick or it was a boulder dropped on him instead of something that could be brushed off his shoulder once we had the time to process it. Chris: And I think that's I think that's honestly what we all do on that too is because, you know, our minds are we don't want to stress our family out, we don't want to burden them with our issues. But at the same time we're trying to hide it, they know something's wrong, which causes them more of a burden, which causes them more issues, which causes us even more issues, more stress, and yeah, it it's a snowball effect in the end on our own part for not communicating with our spouses. ⁓ Anna Lombardo: Yep. And and they're trying their best to be supportive. You know what I mean? They're they're trying their best to be supportive. So they want to give us the you know, they w they don't want us to think that they're stressed about all of this. So they're trying to they have their own cost for their silence, you know what I mean? In turn for them. And it it really just it's not fair to them by any means. So I I knew I had to make a change. On top of this, I started seeing my temper come out of my patients. And that, you know, and just in not being understanding, not being empathetic, and just that that burnout, that ⁓ emotional burnout was sh it was causing me to be less of a provider and less of ⁓ a caretaker than I wanted to be. And it it it j we just need to make a change. So I put in my I put in my two weeks ago part time. ⁓ I picked up the job as an instructor ⁓ during that period as well and went became a a full licensed instructor in that time. And ⁓ I the last shift that I worked before I went part time. It I was relieved by the operations manager that he that person was putting in ⁓ was putting in some hours to try to help out finally. And they ⁓ we were talking about there was a hurricane that just came through Texas at that time at that point. I'm trying to remember which one it was. ⁓ but they had sent one of our only helicopters out to Texas to help with that because we have we have two in our system. We have two available to us in our system. And they had sent one out to Texas to help with that, which is fine, but it was like this is kind of a strange thing to do in if we're looking at the entirety of the grand scheme of what they provide to this community. And I think I made a comment of like if what's almost it was almost selfish 'cause it felt like a PR stunt. I know that's that maybe that seems cold and but it it felt selfish at the time of like why would you pull yourself out of where you're where you're needed the most and He walked by and he put a hand on my shoulder and was like, I'm really glad to hear you say that, Anna And then he walked away. And I think this is just to me I took that as ⁓ I'm selfish for for stepping away from what is killing me, what is hurting my family, what is causing all of these problems. And it just kinda goes to show it showed me the way that these things are handled at this particular company. And hopefully not overall, but we've heard all the stories. We know that their this attitude is not isolated to where we were at the time. ⁓ Chris: Very true. Anna Lombardo: So I I stayed out. until I think I was able to pick up like my brain's beginning to have some physical complications. ⁓ the shifts that I were I was working with this company, we so we're on a posting plan. ⁓ for those who are not familiar, this means that we don't have stations necessarily. So we're we have certain posts around the area that we work. So we'll balance from post to post as needed. And this can change between obviously us getting a call, but other people getting a call, And if there's a particular need in a different area, there are obviously higher volume areas in the area that we work. We have a total of a 200 square mile or ⁓ or 200 mile radius that we are working on, I think it's like 204 or something like that. And it is not ⁓ something that's easy to manage with the amount of trucks that we had. And so we would be constantly moving, we were constantly moving. And if we remember, if we go back to anatomy and physiology real quick, ⁓ when you are pregnant, you have a release of a hormone called relaxin. And it is pretty much just helping the body grow and expand with the baby, with with the fetus and eaters. And when you are stable like that for twelve hours, the call volume that we have, we were not sitting up, we were not having an area to stand up, unless we ran a call and we got to a hospital. or somehow finally made the two of those. We were we were not really able to stand up, so it ended up for me, in my case, ⁓ separating my pelvis and causing damage to my SI joint and something called ⁓ Pew ⁓ the pubic synthesis in itself actually separates. So I'm I'm blanking on what it's called at the moment. It'll hit me in like thirty minutes and I'll come back to it. But ⁓ Chris: So just to hit on this real quick so everyone knows and understands the posting more. ⁓ but the area that we're talking about, the company that we worked for covered roughly fourteen hundred square miles ⁓ between I wanna say twelve to fourteen trucks a day. so, as she was saying, the posting plan did vary widely. Anna Lombardo: ⁓ thank you. Yes. Chris: So if you have two trucks, you have two posts that are main. ⁓ and they are literally at the furthest end of the county to the northmost of the county. ⁓ so yeah, again, if anyone can figure it out, it's a roughly around fourteen hundred square miles. So i i it takes a while. and Anna Lombardo: Yep. It does. Yeah. And I was working night shifts on top of this, so like we had even fewer trucks. I think we were down to like five or six ⁓ after a certain point. So I'm sorry I cut you off. I did not mean to. Mm-hmm. Chris: Yeah, that's you're you're good. So they stagger the trucks is what they do at this company as well. day shift again they have ten, twelve trucks running at a time. Night shift maybe six to eight. ⁓ so and they do that ⁓ from the standpoint of the statistics of calls, ⁓ Anna Lombardo: There is a name for this, but I'm ⁓ system status management. System status management is what it is. Chris: Can't remember. That's it, yeah. Couldn't think of the name. So, ⁓ but ⁓ so before EMS, ⁓ we all are different people, like we said earlier. ⁓ so who were you before EMS, Anna? Anna Lombardo: ⁓ really good question. I've always it's hard to remember after a certain point. I know that yeah, it's hard it's hard to remember to be perfectly honest. Before EMS I I know I went to college and I was in line to be a nurse. I actually ⁓ was getting ready to get my nursing degree. It was the semester before I was supposed to start nursing school and I Chris: There's a reason I asked it. Anna Lombardo: was excessive whole nine yards, but I needed like two or three extra credit hours and went ⁓ and took basic EMT just to k just to have the medical background and that was it. Fell in love with it. But before that, I had always been I was a reader. I had always had an interest in medical studies and I was an avid reader. I read everything I could get my hands on, especially like Chris: Fell in Anna Lombardo: You know, these magical worlds like Harry Potter and I was a big fan of Rick Free Orton, ⁓ so the Percy Jackson series and all of his subsequent series. ⁓ I thought that was always a really cool concept and then Lord of the Rings, ⁓ The Hobbit, I got into The Handmaid's Tale, ⁓ Agatha Christie too, honestly, Agatha Christie and ⁓ her all of her little murder mysteries. Those those are fun to go through if you have not read those. Those are really It was a really good time. I started playing video games in I think twenty tw I was twenty years old. So probably probably about twenty sixteen and fell in love with that, especially like story based and I that stemmed from obviously my love of reading and everything like that. ⁓ Chris: I always played Final Fantasy when was a kid, so it's okay. Anna Lombardo: Final Fantasy, I love yeah. alternate timelines, alternate roles are always fun. ⁓ that that was a big portion of what I enjoyed. ⁓ Sabas Nerd, obviously, and Chris: You know, you forgot to mention something that I I remember you doing quite often. and that you also crochet quite a bit as well, if I'm not Anna Lombardo: I crocheted, yes, I do crochet. I picked that up during COVID. ⁓ I think I tried to learn I tried to learn as a kid for so long. My grandmother tried to teach me and it just we you know, it it never worked out, never had patience for it. But we had plenty of time during COVID. So ⁓ I learned how to crochet during COVID. Chris: I know where it went. Anyway, I th I think I got one of your first hats. ⁓ Anna Lombardo: You did, yeah. Yep. Chris: ⁓ so so what you know, back to back to the families, ⁓ what do the people closest to you notice ⁓ that that that that this job has hardened you for? You know, I know we all say we have a dark sense of humor, which we we do but we have to, and we all become numb and cold due to our jobs. ⁓ for instance, when my father passed I didn't shed a tear. Anna Lombardo: Yeah. Chris: ⁓ it it sucks, but you know, that's part of the job becoming us. So what what do you you think, you know, your husband, your kids, your mom, your dad, what what did they notice about you that has this job's hardened in you? Anna Lombardo: ⁓ I think honestly my patience for complaining has gone down a lot. Like and ⁓ I think during my worst times I just could not empathize with why these things were so hard for kids, which obviously is a huge problem. You know what I mean? ⁓ that was one of the things that that went away first, thankfully. But ⁓ I've been thankfully deconstructed if you want to call it that for so long. ⁓ the family side, like I that that has thankfully gone away. ⁓ my mom saw a lot of Just a l a lot less personality for a while. She said that it was just this was it. This was it. This was all we had to talk about. And ⁓ that was hard to do. I have a hard time with th it everything feels unimportant. You know what I mean? In the grand scheme of things, of like the things that people worry about. I have a lot less patience for I'm ⁓ again something that I'm that I'm obviously working on and have worked on a lot, but ⁓ just could not understand why like you could walk out and get killed tomorrow. Like why why are you worried about these small little things? And obviously I have my own small little things I worry about. But ⁓ for a time it was like that empathy was very hard to find and that understanding was very hard to find. And as such my patience and my temper were very, very much heightened. ⁓ I think that's the biggest part of that, honestly. ⁓ I've tried very hard not to not to be a different person. And and it comes to the point where you kind of wear two different you wear different masks for what you need what you need to do. And I've gotten my my mask pretty well for my family life or my family's life before ⁓ that but also have learned how to not have to have that on all of the and be able to take these things, take these masks off and just be myself and be a person and find other things in this life. So that and that's that's a very difficult thing to do, but it's a very important thing to do is to figure out how to do that. Chris: So if anyone listening hasn't got into EMS or first response yet, ⁓ you will hear a phrase that is commonly said, ⁓ we are chameleons and that's where that part comes in. we do have to wear multiple hats, we do have to help act certain ways with certain patients. ⁓ I regret that ⁓ some of the patients I've treated before that I was cold and Anna Lombardo: Mm-hmm. Chris: you know, ⁓ misjudged on s things I shouldn't have. ⁓ but and it does. A and and that to me, ⁓ you have to learn from it. And that kind of brings me to my next one I got written down here too is, you know, we all have a thought process, we get into this. We all have a this is what a good medic is, this is what a good cop is, this is what a good nurse is. ⁓ Anna Lombardo: Yeah. It happens, though I mean it's Yeah. Chris: So what what do you th or what did you originally believe being a good medic required from you before actually getting into this? You know Anna Lombardo: I I believe that this this had to be everything everything. I mean you had to eat, sleep, read the EMS, you had to be constantly in the textbooks, constantly in the studies. And while that isn't necessarily a bad thing to be informed and educated, again, this cannot be everything that you are. You had to become a soldier in your own right. You had to and this was your cause. This was everything that you were, there was nothing. And it that's not feasible. That's not feasible at all. You had to get every call right, you had to know every diagnosis, you had to know everything, every little thing about the human body. And again, these are not necessarily bad things, but the cost of knowing of of finding this and knowing this is this can't be everything. You know what I mean? Yeah, it's astronomical. Chris: It's astronomical. I and you know, I I I pride myself on this is during the whole debatical we were talking about with our company, I wound up leaving around the same time to go offshore, ⁓ and and wound up learning quite a bit more. and as you said, I y the whole studying is not a bad thing, but you have to make sure Anna Lombardo: Mm-hmm. Chris: you take breaks, you you keep hobbies going. ⁓ you have to have outlets. i and ⁓ just everybody remember that, you know, you can dedicate yourself to this lot of work, but don't dedicate your life to this work. Anna Lombardo: Right. Right. being said I also want to note for the moms here too that could be watching, ⁓ or parents in general, like you also have to find something outside of your kids. Like that can't be everything too. You have to make that time for yourself. And and that's I'm just gonna throw that out there because that's also very important. ⁓ obviously we we Chris you're a parent too, you know like they are you know they are the center of your world. And but balancing the home and the work and the self, you know, the the things that you do for yourself to to keep yourself grounded, to remind yourself of who you are. Like finding that balance is very difficult. And but it is worth every minute that you do it. Chris: And when it comes to that when it comes to that, you know, we We all have apologies that we we have to say in the end and in truth. ⁓ sometimes that's one of the hardest things we do after realizing all this. ⁓ so what was the apology or truth that was hardest for you to say to everybody? Anna Lombardo: Mm. For me Obviously the the initial truth of like something is wrong, something is ⁓ acknowledging that both both with myself and admitting it to people was difficult. But I remember with my daughter with my oldest, because she suffered a lot of the temper and the consequences. ⁓ nothing illegal, but ⁓ she did she did suffer the the lack of, you know, understanding. And I still to this day have to catch myself, but every now and again I'll, you know, s sit down and be like, hey, I'm sorry. You know, if I'm if I react poorly, I make sure to tell her that I'm sorry. And one day, 'cause she's not quite old enough yet to understand, but one day we are going to sit down and have a long conversation about the whole thing. And ⁓ I plan on joining therapy at some point with her. ⁓ both of them really, but sh her in particular, because of what she endured. during all of that. I don't want obviously down the road I don't want that lingering ⁓ resentment. ⁓ my husband every time like he he's got the patience of a saint, do you know him and he I do my best if I know like to be aware of like, hey, this is this was something that happened during an episode. I still will apologize because At the end of the day, even though you have these diagnoses, you are still responsible for what you say and do while you are under that. And you have to take accountability for for what you do while you're in there. And it's up to people, you know, it's up to the people around you if they want to, you know, forgive or understand that, but you have to ⁓ push forward and and acknowledge it. You have to make that first step then. You know. Chris: So speaking of your husband, ⁓ does I just had a question drop pop up ahead to just leave me for up there just okay, sorry. I just popped up ahead and left and then came back. ⁓ so working at you know, he works EMS as well, you work EMS. So making it a dual response ⁓ household, does that seem to complicate things? Does it made things easier or do you just think it kind of helps to normalize? Hello. Anna Lombardo: That's okay. Speaking of which speaking of which, come here. No. Chris: Ha ha ha. Anna Lombardo: They're always saying hi, but that's ⁓ it does so it it does and it doesn't. I think the hardest part for us I feel like he needs to be here for this question, but he he's like, No, I'm gonna send you that out of here. ⁓ me the camera. ⁓ The hardest part that for us that we've talked about before is I think ⁓ having to rely on external sources for the childcare. But ⁓ when we were working opposite ship that Chris: What's that? I don't wanna be on the camera. Leave me alone. Anna Lombardo: That was the hardest part, I think, because we never saw each other. You know, we when we when I got the new job that you and I are both at now, we we follow each other. Yeah. We follow each other. ⁓ when I when I started that job, it was kind of we were worried about it for a minute, but it ended up being a very good thing that we were on the same shift. Chris: When I can't get fire. Anna Lombardo: ⁓ again the hardest part of that is finding is the external sources and putting that burden on our my in-laws. ⁓ that that's a very b heavy burden for them to carry because now they're all like, okay, you know. And they were always were the the caretakers for the kids, but now it's more often and more intensive, especially with ⁓ the shift that I work, it alternates nights and days every every month. So that's difficult for them. They've had to make, you know, a lot of changes and Chris: Yeah, that's Anna Lombardo: ⁓ it it's hard, you know. It's a very hard thing to do. Especially when you haven't had ⁓ young children in God, like eighteen, twenty years. You know, it's has it been that long? I can't do that. ⁓ yeah, ⁓ I changed my years. So sorry. Chris: Mm. So y you know, ⁓ as you said earlier, the family is the biggest part ⁓ of it. And you know, the I I kinda kinda switch gears in a way, but not really switch gears. and I I don't know why I'm reading it the way I'm reading it, that's what I fucking wrote. Anyway, ⁓ so you know, it in our in our ⁓ at that at Anna Lombardo: Yeah. Chris: At both companies here, ⁓ we do run calls ⁓ to where we didn't or do not ⁓ always have P D SO assistants. So do you ever feel that, you know, you may not come home to the kids due to this job? Anna Lombardo: Mm. I've had that thought as well, especially the area that we're in now, has some shortages in P D. ⁓ they're you know, they they're having some hiring issues, so like we don't always have necessarily what we need and the the cops don't, you know, like they say they may need backup and there's just not enough backup. So I do wonder sometimes ⁓ if that could be a thing, but ⁓ whether that's from you know, any sort of crime willingly being committed against or or a psychation or whatever, somebody who can't control what's happening or a complete and utter accident. Because it does happen, you know, rations happen. ⁓ Chris: I I mentioned that machete by a guy who went to cardiac arrest, so hey. Or family that went card. But anyway. Anna Lombardo: Crackets and shuttings. ⁓ I I had almost ADHD to do a story from somebody else. But yeah, ⁓ the ⁓ that that has been a concern before. It has never been forefront, but enough of you know, to where we make plans and have have that sort of thing in place for the kids. ⁓ I can't say that that's been like a constant fear like going into work and stuff like that. But that it is it does sit and it does wear on you after a time. But like for real it it Chris: Right, right, right, no. I get that. Anna Lombardo: Yeah. Chris: So, you know, back to what you were saying earlier too is you y y you went and sought help. ⁓ did you ever think during all this that that that you would not be back to nine one one, you wouldn't be back on the truck or or that your career was over. Anna Lombardo: ⁓ absolutely. One hundred perne percent. So in a number of ways. So when I finally had my daughter, ⁓ I think I stopped working the truck because of the physical issues from my pregnancy in January of twenty two and notified everybody, it was like, Hey, I don't think I can you know, I I'm I'm done, I've got the doctor's note, I've got everything, you know. And I moved into the ER setting. Which was very beneficial in the long run, very beneficial. But that effectively that move right there I didn't think I was gonna be able to come back to nine one one. And both from a mental standpoint and you know, just I don't think there was a company that I'd be willing to work for besides the one that I was at that ⁓ that did nine one one. And there was another there was another episode, while I was working after we got because I worked for kind of a start of transport operation through that ED for a while and there was a incident when we received a contract with the hospital that I took most of my patients to. ⁓ and I didn't really I I thought I was okay 'cause like the we went and did a walkthrough and I was like, okay, we know that that spot is here. We know that that room is here because there's that there's that one call. We know that the room is here, we're okay, we do all that. And then I think it was like two days later it finally hit while I was at work and working overtime. ⁓ but my poor partner that day, God bless you, David, like you he put up with a lot of crap. He put up with a lot of crap through all this because I was still getting adjusted on medications and and learning ⁓ fresh diagnoses, like learning all of that and he put up with a lot of a lot of shit. ⁓ during that period of time. But he but, you know ended up having having an episode that day. Had to go home, you know, the whole nine yards and ⁓ I think it was really more of an anxiety job than anything else I think it was a full blown full blown episode, but we still had to we had to do some recon work after that. ⁓ Chris: So on that note, sorry, I didn't mean interview, but no, you're good. I I So on that note, you know, ⁓ did you ever feel like you failed at do because of that? Or is it just ⁓ Did? Why why do you think that? Anna Lombardo: Sorry. No, you're ⁓ absolutely. Absolutely. Because you should be able to bounce right back into it, right? There's this preconceived notion of like because you do this, you're strong. Because you and that particular day made me wonder, like, am I ever gonna be able to come back to this? Because and that was the final like I have failed. I have failed in this. I have not I have not been able to to fix anything at all. And I had to be reminded that like, hey, this is a process, this is a this is this is not something that you can just take a little break and and be completely fine after you take your little break. But I had been looking for ways back into the field at that point and it that was a huge smack in the face of like, Elia, I don't think you're gonna be able to do this again. And thankfully thankfully that was not the case. Chris: And you know, on that I I have felt that before. ⁓ and just for everyone listening, everyone that may feel this at sooner or later, you're not you're not a failure due to that. no one is a failure for their own mental diseases or illnesses, whatever you want to call ⁓ that's nothing you can control. So i in my opinion and again Anna Lombardo: Mm-hmm. Yeah. Chris: people can argue with me all day long, but I'm gonna die on this hill. In my opinion, you cannot fail at something that is not in your control. That would not be ⁓ so and I've told you before, you're one of the best medics I've ever worked with. So don't d don don't ever think you failed anybody f for for the things that's happened. and and you know we all have to recover. We all have to get through things. and I Anna Lombardo: Right. Absolutely. Don't make me cry Chris. Chris: ⁓ what to the last two years I've realized that my PTSD was getting to be worse than I thought it was. ⁓ my diagnosis, you know, like I said, I thought it was a failure. I even had my old boss call me and tell me like, look, you did everything you could. and that was it, you know. and you know, remember everyone, recovery don't mean Anna Lombardo: Yeah. And it happens quick out of nowhere. It happens fast. Mm-hmm. Chris: that you're learning how to tolerate the same unhealthy stuff before. It's changing your own relationship between your health and your job. ⁓ it's building bridges between your own family and your own well being. it it's creating boundaries that everyone needs to have that we fail to create or even notice that we don't have. You know, on that, ⁓ what what did recovery actually require from you? You know, not the inspirational version, but the daily version of this is how I have to recover, this is how I have to fix this. Anna Lombardo: Turning it off at the end of the day is is and not just compartmentalizing it. ⁓ for me, we so there are different forms of PTSD and provider burnout. ⁓ I've there's a whole list somewhere that I have to look it up again. ⁓ but for me, understanding what's happening in my brain and understanding what's going on, even if I can't be fully aware of it at the time. is very it for me that has been key in knowing my weaknesses and my strengths and when I need to step away and when I need to take some time. ⁓ so it's doesn't always work, but you know, but there are stages of ⁓ provider there are different types of provider burnout, there are different like presentations of provider burnout and I'll I'll find it for you in a little while. But ⁓ Chris: So for PTSD everybody, there's complex PTSD, ⁓ dissociative PSD, T little bit disassociative PTSD, delayed expression PTSD, uncomplicated PTSD, and acute stress disorder. and most of us in this field wind up with the complex or ⁓ dissociative or the delayed expression. ⁓ so Anna Lombardo: Mm-hmm. The light expression for me is a big one. ⁓ it takes me about two to three days or a week to up to a week to actually process that hey this is affecting me. and not just not feel anything about it in between that. So if you can find your for those in the field, if you can find that the way that your PTSD manifests, ⁓ that's going to be a very beneficial thing for you. And Chris: And that's Anna Lombardo: on top of everything, just being open with yourself and willing to do that self reflection on it. ⁓ I think the the layman's term ⁓ out in the community would be shadow work. But ⁓ being you know, looking into what's causing these things and how they affect you and noticing the patterns of how how long it takes, you know, and understanding. I am rambling crazy hang on. Chris: So ⁓ no, you're good, you're good. So on that note, you know, how how did you honestly learn to leave work at work? ⁓ even though like ⁓ you ran it say, God forbid you ran a call, pediatric cardiac arrest, you know, that does sit with us, ⁓ and and it all second guess ourselves. How did you learn to leave that at work and not bring it home? Anna Lombardo: Mm. My my go to and I learned this while I was working ER, ⁓ when that badge comes off, you hang it in your car. And you and that all that energy goes with it. All of that time goes with it. And that and it's a conscious effort to make. ⁓ but as soon as that badge comes off, we're done. We you know, until we have time to process this in a healthy manner and we have the ability to it stays there with that badge. ⁓ it's it's important to learn how to understand your own mind in order to make that work. But for me that was that was a good little ritual to do ⁓ for it. Chris: I gotcha. So did did did any of this I know I know it did, but how did this change the way that you communicate now with ⁓ your husband and your children? Did d did that change a lot or did it just a minuscule amount? Anna Lombardo: It it honestly changed. I am so I feel like I have the capability to be so much more open with Wes ⁓ in terms of what's happening and how it's going and I feel like he knows how to respond to that a lot better. and again, this has been a process to learn this does not change overnight. ⁓ but everything about this is is it's not gonna be quick. ⁓ but as far as the kids go, it's still It's still you still have to be very careful obviously because you don't want to tell them what's going on. You know, you can't you can't tell them what's going on, but you can't explain like, hey, this sometimes they're sick you know, we've explained kind of mental health and how that works a little bit, but like sometimes sick looks a little different, but ⁓ we sometimes we get sick in our head and sometimes we you know, it's it can be difficult. So ⁓ Sometimes when mommy or daddy says that we're sick, it may just look a little bit different. Sorry. Suck your head. Chris: No, you're good. So that kind of brings me to my next one. I just literally wrote down as you were saying that, is is how do you recognize the warning signs earlier now, you know, before the stress or the sicknesses ⁓ present? Anna Lombardo: ⁓ shorter temper is the biggest one for me. ⁓ over nothing or getting wound up over over very little. And you you know me, I'm a dramatic. I'm I'm very dramatic. But if that drama increases or I start or I stop being able to process that, or you were with me the other day when that flat effect started. ⁓ that that is a key indicator for me. ⁓ and it's important to note that You know, this ⁓ and be aware of these things. Chris: So, you know, everyone listening, ⁓ just remember as well as ju you work with these people day in, day out. ⁓ may not realize it as much as you know it, ⁓ but you will notice subtle changes in their behavior, you'll notice subtle ⁓ affirmations, if you will, ⁓ of of how they act, ⁓ they talk, ⁓ or or react to you. Anna Lombardo: Mm-hmm. Chris: and that's you know, that's that's on that one. So make sure we keep an eye out for everybody that that's you know, keep an eye out for your partners. And that kind of brings me to this one here is you said something ⁓ simple on the forum that you said something simple on the forum. ⁓ but that EMS still struggles to understand that we are a team, not competitors. You know, we should all be teachable, accept constructive criticism and respect what others are other providers bring. And that Anna Lombardo: Mm. Chris: kinda falls back to that at the same time is, you know, we're not in direct competition with each other. ⁓ we are a team. You have to make sure you take care of your team. and that that doesn't mean that competence is a competition. ⁓ and I have seen that myself throughout this field, you know, and I I Anna Lombardo: No. Yeah. Chris: I can honestly say I've been guilty of it a time or two. But and you know, why why do you think that is? Why do you think it's so easy for us to turn our composants into competition? Anna Lombardo: ⁓ yeah, we I yes. Sorry, yes, we ⁓ we absolutely all have I think a lot of that is ⁓ If we feel that we are not doing enough, there's a portion of overcompensation there. I think I think that's a part of it. And then there's That's how we were raised. I mean that this is how we came up is like, ⁓ while there's a teammate aspect, especially amongst paramedics, you I I think it's very difficult for us to CRC I'm losing I'm losing my words here. ⁓ I don't want to be very careful about how I word this because ⁓ Yeah. Yes. Chris: You're good. Well this this next one may this one goes into this as well. So I'm gonna help you with your answer. You know, so on on when we do compete on that stuff, it it it kind of makes an experience provider ⁓ that gets a criticism from a supervisor ⁓ very angry or feel like they're being attacked. and that that might help you as well. And and that's kind of this all bridges all in this whole thing that I'm Anna Lombardo: Yeah. Chris: got right here and and that makes, you know, making our own mistakes. It it makes us being teachable into the whole thing. And and you gotta be humble about it all. You can't Anna Lombardo: Mm. Chris: You can't sit there and and degrade everyone else around you because you think that you're better than them. It just you're not. None of us are better than anyone else in this field. We all have our niches. We all have our our specialties. Anna Lombardo: We all have our mistakes that we make and I think our common mistakes are more common than we realize or want to admit because we don't want to talk about our failures within within the community. You know what I mean? Like it's it's hard to even yeah, because he feels so stupid when he makes such a basic mistake, you know, like ⁓ that's terrific. I forgot to grab a damn blood sugar. ⁓ it it it's such a small thing, but it's such an important thing and I think I think 'cause we have that suspicion that we're gonna get torn apart. I th and I see a lot of this especially in the older generation, my you know my generation of medics coming in, ⁓ at the ten year Chris: I was thinking the younger generation is worse, but that's just me. Anna Lombardo: In the beginning. So I think in the beginning when we've gotten all this praise, I think there's a lot of expectation on on you to be a perfect medic. You know what I mean? You get everything right, you do you follow every everything to the T and again I'm just as guilty of this as as anybody else's, even especially especially when I'm like falling back on those old habits when I'm very tired and like masking and just trying to you know, it's I'm very guilty of this as well. But It I the younger generation, like first coming out of school, they have not been humbled. They've not been humbled by a bad call. They have not been ⁓ put they have not been put in their place yet. So again I want to be very specific about how I word this. But I know those are a lot fewer than they used to be. Like they're I've seen so I've not seen as many paragots with this younger generation and I've done obviously I've done a lot of ⁓ preceptor over the last few years and it's very ⁓ it's very nice to see. I think that there is a culture change coming. Thankfully. ⁓ and then and then that's up to us and the older generation to kind of facilitate, but like I think there's a culture change coming of like you you have to be teachable, you have to be ⁓ supportive of your other paramedics. Now I'm not saying if they do something like significantly, you know, y you have to approach it a certain way to where it becomes a teachable moment and you can't just like, you know, smack ⁓ down, you know. Chris: And on that make sure if you are in leadership you don't ⁓ you don't y berate your guys in front of the other guys. ⁓ pull them behind close Anna Lombardo: Mm-hmm. Yes. It needs to be a decided conversation. Chris: it needs to be a private conversation on, you know, this is what's wrong, this is what you did wrong a and and tr teachable. ⁓ and ⁓ let's see, where the hell was I just going? And and that's you know, that's the big thing. ⁓ I'm ⁓ so, you know, that that was pretty much my end of all those ⁓ that I got and and I got I like doing this too now lately I've been doing this a lot. ⁓ I got a few questions write down. ⁓ so I just want the first answer to comes to your mind. Anna Lombardo: Easy tool. Mm-hmm. Chris: You know, just whatever the hell you think of. That's my favorite one to ask too, is what's the biggest lie burnout tells? Anna Lombardo: I'm scared now. I'm sc what What's the biggest lab burnout tells? Ooh. I'm fine. That's the first thing that comes to my head. I'm fine. I'm good. You know? I'm good. Chris: It works. So what's what's one word for healing? Anna Lombardo: One word for healing. I didn't have anything immediately. I'm I'm I promise I'm following the rules here. I just didn't have anything immediately. One word for healing is happiness, honestly. ⁓ healing means so much. Healing means happiness. Chris: Here we go. And that's fine. ⁓ what's one boundary every responder parent needs? Anna Lombardo: I was right to be scared, I think. What's one boundary every responder parent needs? Chris: You know, I think it's Anna Lombardo: Honestly, the ⁓ the more you have to be open without being completely open. Does that make any kind of sense? I think that y you have to be very careful, especially as your kids age, in saying, Hey, you know, I understand I you know, whatever you're going through I'm here but they need to know that you have the background to understand to a degree. Like you've been through you've been through some things as well. And again, I think this comes with as they age and as they grow. Chris: Yes. Anna Lombardo: you have to take it just to their understanding level. You know what I mean? You definitely don't need to trauma dump on them, not by any means. Like, but I think explaining explaining mental disorders as a sickness or in a in some way, shape, or form, definitely helps them understand, especially younger. But the the boundaries in terms of you you have to be able to turn it off. You have to find some kind of way. ⁓ you can put it away, you can compartmentalize it for a little bit just for their sake. But you have to also take it out at some point. You know? And if you can take it out beforehand before you go home, great. ⁓ if if you are like me and it takes you a few days to realize what's happening, ⁓ then then, you know, take it as it comes, but Chris: Good. Anna Lombardo: Do your best to do your best to keep them from it as much as possible while also being able to understand it when you can't. Or be able to explain it when you can't. Does that make sense? I don't know if that makes any kind of sense. You're making me think, Chris. Chris: Yes, it does. So can people honestly can people honestly rebuild? Anna Lombardo: Yeah. You can come back. I spent three and a half years in an ER thinking that I was never gonna be able to come back. ⁓ one of the places that I ended up at, or the place that I ended up at, I kind of was like, Okay, I was drawn out of it because I needed to get out. ⁓ because where I was at that that ER was not doing me any favors in terms of my mental health, in terms of how I saw myself as a provider, in terms of any of it, like it got to a point where w a change needed to be made. And one of the draws to that area, not only was it an area that I love to be in, like my my whole life I've loved the area that we work in now. And it's always been a place of peace for me. But it also was a low volume. ⁓ a low volume until something happens. Which for it's one of those places. And it it you really have to be on your toes for it, but it was still it's still a greater place of peace than any other career field I've been in so far. Chris: So what's the best harmless way to decompress after shift? Anna Lombardo: I think ⁓ being around your crewmates, I think is one of the best ways. ⁓ exercise is another key one. If you can't do that, ⁓ and this is me I mean ⁓ but go for a walk, go for a run, go be outside, be around the world and just kind of remember that, you know feel feel the peace of the day is the best thing I can say. Chris: So so what is one thing EMS needs to stop glorifying? Anna Lombardo: ⁓ Burnout. burnout. Quit glorifying being a complete asshole. If that makes any sense. Stop glorifying that we were fighting patience. Stop glorifying that we had to be a jerk. Stop glorifying and and because that doesn't do anybody any favors and all it does is rile other providers up and especially the younger ones, make them think that that's the correct answer for everything. And it's not. It's not. Chris: There you go. Anna Lombardo: Stop rattling up psych patients, stop, you know stop reaching for ketamine for everything. Treat people as humans. You will find a lot of times with psychiatric patients, if you just show them a human to human connection, that is all it takes. Now sometimes you do I mean, obviously sometimes you do have to bring out the narcotics, bring out the the heavy hitter stuff, but Chris: Treat them as humans. Anna Lombardo: Nine times out of ten, they are not really anything to fear as long as you treat them on a human to human basis. Chris: So what is one thing EMS should never lose? And that was my last question for that one, by the way. Anna Lombardo: Okay. Thank God. ⁓ one thing Image should never lose is a sense of community. I think that is a very big part. I think as but as long as everyone understands that there's more outside of this, as long as that community understands that there's not ⁓ this isn't everything, that I think I think that sense of community is a beautiful thing. It's a beautiful thing. It it brings everybody together in places that we need it they need to be. As long as everyone knows how to handle what's happening inside our heads and can reaffirm for each other that you're not alone. You're not alone in this at all. Chris: Very true. Very true. So you said so you said lit somebody listening may need permission to establish boundaries with the job earlier. directly speaking to the medic sitting in the driveway after shift, staring at the house because they know the family inside is about to s receive whatever's left of them. ⁓ they're numb, they're dull. ⁓ what do they need to understand before s silence costs them more than the job ever has the right to take? Anna Lombardo: They need to know that it is okay to not be okay. It is and it's important to acknowledge that you are not okay. ⁓ because the y the the weight that will come off your shoulders when you acknowledge that you are not okay is I can't describe it. You're gonna cry and you're gonna break down and and you're gonna you're gonna feel Like you failed, but honestly, like you did not fail. Not by any means. And it the when you get this off your chest, when you get this off you out of off your shoulders and you do what needs to be done to fix it, it it is a pride and a lightness that just cannot be cannot be matched. Chris: Very true. So if someone wants to follow your work, read what you'll eventually publish, or reach out to you, ⁓ where should they go? Anna Lombardo: ⁓ if you for some reason want to indulge with my ramblings about stuff that does not make any sense, ⁓ I am on TikTok as Amalusa. ⁓ I will provide its capital A M-L-U-S-A. I I'm here. That that's the most I can offer right now. I ramble about a whole bunch of other crap. ⁓ I don't have anything really in terms of publishing yet, but ⁓ when the time comes I will I will provide more information on that. So Chris: Gotcha. So very last question and I'll be done with what is the what is one thing you want to say that I did not ask? Anna Lombardo: Mm. I love you, Chris. ⁓ I think what you're doing is very important. I think this is this is a very, very important thing to to present to the community. I am very proud of you and as how how far you've come, you're a great medic. I it's watching you grow because I've known ha ha gotcha. ⁓ watching you grow from, you know, because I Chris: Ha ha. Anna Lombardo: as an EMT and watching you grow into a paramedic has been such a privilege and you're doing an amazing job. And just just keep doing what you're doing. And this whole thing is is amazing. It's so Chris: Thank you. ⁓ yeah, I love it. Like I said, this is this is my mental health, ⁓ this is my outlet, and this is what everyone needs to find is something to help decompress, to help fix their own ⁓ compartmentalizations. ⁓ their mental health is the most important thing. and as you said earlier, physical health y is important. ⁓ but ⁓ to me the mental health is top priority. Anna Lombardo: Uh-huh. Yeah. And mental health equals physical health. ⁓ recently somebody I I will have to look up the name of the individual that said this, but on ⁓ the Silent War Within podcast, they they came he came out and was like for it's a firm belief that mental health is physical health, and that is one hundred percent correct. ⁓ if you take care of your mind, you can you can do that. What what'd you say, Chris? I'm sorry, I lost you for a second. Chris: And now we like to be on the show. I will be on their sh I will be on the silent ⁓ war within podcast in August. So Anna Lombardo: Nice. Awesome. Chris: And this episode, by the way, will be public or let me hit stop. So ⁓ let me go ahead and hit stop real quick for ⁓