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Difficulty Breathing
Heat, fuel, and oxygen. These comprised the fire triangle. Lose one—no more fire. I kept these firefighting 101 basics in my head as I arrived at Phoenix Fire Department Station 45. For the next 24 hours, I would be on call as an emergency medical technician trainee. Taking on a shift that becomes a true waiting game—no second of peace guaranteed, no idea what each dispatch held, and no understanding of which emergency would be my last —created a feeling of anxiousness. I attempted to prep myself, bringing food, water, and an open mentality to learn. However, I quickly realized this wouldn’t be a steady breath, close-read learning about fires and medicine. Exertion, engulfment, and struggle became the most important lessons of all. In the moments when it becomes hardest to breathe, a peak understanding of how struggles indicate progress is developed. It’s not just about fighting fire but accepting it.
“These guys are scary,” I remember whispering to another colleague. It was like I was reading a television script. Six colossal guys with a defined muscular brawn and stride of an ox rolled out from the station gate, grinning at all the possible ways they were going to gruel us youngster hotshots. That is where the script ends. With no greeting nor warning, the firemen ordered us to do 30 consecutive push-ups on the searing, cracked Arizona pavement. Those who could not were all sent home disgracefully. It always fascinates me how time—so standard in its units—progresses differently in our minds. Every single push-up felt longer, harder, and unbearable as I tried to reach thirty of them. I grunted in pain, feeling the skin of my palms bake in the asphalt heat.
“27…28…I can’t anymore.”
“What are you? A wimp? Get your ass up and finish, or you're out.”
A rage had taken hold of me like feeding wood to a fire. The blood pumping through my veins echoed through the abyss of my thoughts. At that moment, the pain was no longer physical.
“I do this, or I remain the same useless piece of garbage everyone thinks I am. 29…”
The consistency of my failures clouded my head. I embraced the heat of the flame.
“30.”
I collapsed onto the floor. Tears in my eyes. Blood on my hands. I fought to breathe against invisible hands grasped around my throat.
“Going through the fires of the furnace, eh?” laughed the Captain.
“No, sir.”
It was a professional response given with the best at-ease countenance I could muster, but the nonchalant gesture was nowhere near the signals my body was sending. I had lit up like a Christmas tree of warning lights on a car’s gauge cluster. It was no furnace—rather the ninth circle of hell.
As I followed the firefighters into the station, I muttered under my now stabilizing breath,
“I don’t think I have ever been able to do that—to go even further beyond.”
Pride, pain, perplexity, and profoundness of thought pranced along each of my neurons, jumping from synapse to synapse. In the face of struggle, I had burned a ceiling to my confinement—achieving a power beyond what I had been capable of. I felt different—a better different.
“Listen here, rookies.”
The fire apparatus engineer interceded,
“You three go wash the rescue. You two come with me inside to the dispatch comms.”
“Yes, sir.”
We followed the engineer into a plain, beige-colored server room with a popcorn ceiling. Software lined the walls head-to-toe. The dim lights buzzed with the sound of the fans, keeping the computers at operational temperature.
“Pay attention here.”
The engineer directed us to a small digital screen—an old one—that dispatch was relaying calls to based on location proximity and availability of each fire station. It was breathtaking how every little detail followed a set structural pathway as soon as a call came through.
Seconds later, the screen flashed.
“Dispatch. MVC Difficulty Breathing!”
The lights went from dim to blinding, as if the gates of heaven had opened. Everyone started scramming toward the truck, putting on their gear. We hopped into the engine, sirens blazing, heading to the location. The captain barked at us to put on safety vests. I hastily put one on, panting at the sudden urgency. The flame began to draw fuel.
“An MVC is a motor vehicle collision. Grab the gray bin with the oxygen supplies as soon as we arrive.”
We reached a gridlock, swarming with traffic, all keen to view the misfortune of others. The metal of the cars wrangled between one another, each bleeding oil and coolant. The captain slammed on the brakes.
“Move. Move. Move.”
Adrenaline surged as we filed out of the firetruck, grabbed the medical supplies, and began to assess the scene's safety.
“Triage Cap!”
“Three patients. There are apparent fractures and bleeds on both drivers. Passenger is not moving any air.”
“Split. ABCs.”
We ran to the woman passed out in the passenger seat. Hearing her gasps for air, we quickly began to attach the nonrebreathing mask to the oxygen tank.
“A—airway. Ten liters a minute… correct psi… correct tank.”
I could barely breathe. The lady’s skin had lost its color, turning white like a ghost. Her lips and fingers—a deep shade of blue. Her eyes—wide and desperate. It was fear—fear of struggle. The lady took shallow, rapid breaths—watching the flame vacuum her oxygen.
“Fifteen liters a minute!”
The tension, ever-present at the moment, began dissipating as she breathed easier.
“Get a pulse oximeter on her.”
“95% and climbing, sir.”
“Good.”
“Breathe in through your nose and out through your mouth like you are blowing through a straw, ma’am.”
I did the same myself.
“This is scary.”
The rescue crew transported everyone involved in the accident to the hospital no more than ten minutes after our assessments. However, the images stayed in my head.
“Breathe Ray. Breathe.”
I began to disassociate myself as we returned to the fire station. Everything seemed far away—almost unreal. Everything felt like a copy of a copy of a copy.
“Gear disinfected?”
“Check.”
“Supplies level?”
“Check.”
“Fuel gauge?”
“Just under three-quarters of a tank.”
I gazed at the firehouse crest strewn along the walls and doors of the station. At its center, a flame with trails of smoke unfurled toward the sky. The flame meant more—more than just fighting fires or living in a fire station. We didn’t just wear the flame, but we went through it. Burning corresponded to progress. Like diamonds, the only way to find the best versions of ourselves was to embrace the excruciating heat and let it morph us into an improved being. A fireman’s favorite meal: steak—endures a purifying flame before reaching its tender perfection. The flame no longer carried the sole purpose of destruction. As fire needed oxygen to burn, struggle required difficult times—difficulty breathing.
“Walk it off. You’ll be alright,” the firefighters would tell me.
Back home, my parents told me, “It’s nothing; you’ll get used to it.”
The same message echoed from everyone. I never entirely agreed. Difficulties do not exist to become accustomed to, but rather as necessary to improve. The struggle and the flame are one. Just as undergoing struggles is not meant to keep one down, the flame does not act in isolated destruction. Fire cauterizes the wounds. It burns the detriments and then some—illustrating a necessary pain to find improvement. A favorite quote of mine is, “The sicker the man, the bitter his medicine.” Struggle does not just become normal or a daily chore. Struggle leaves scars, figuratively and literally, in moving toward growth. I struggled, the lady struggled, and as a team, we struggled. We accepted our flames.
I keep the motto that whenever I do something without difficulty breathing, I’m not pushing through the obstacles and limitations hard enough.
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Working around a year now in emergency medicine, it becomes ingrained in who you are as a person, the struggles that you endure.