The year was 2014. The place, a well-respected Medical College in Kolkata. I remember the slight ache in my legs as I climbed the old staircase leading to the CTVS department – Cardiac Thoracic and Vascular Surgery. My heart thumped almost as loudly as my footsteps. It was my first day in the cardiac anaesthesia unit for my post-graduation. Everything felt huge, intimidating, frightening.
We weren’t allowed to do anything that first day. Just arrive early – by 8:30 AM sharp – observe, absorb, understand the rhythm of the cardiac suite. I made it on time, pushing open the heavy OT doors to find a scene of quiet industry. Young men, barely older than me, were already there. Not chatting, not idling, but toiling. They moved with purpose, arranging complex instruments, checking dials on towering machines, preparing silently for the life-and-death dramas about to unfold.
By 9:30 AM, the atmosphere shifted. The "big shots" arrived. Seniors from anaesthesia, senior nursing staff, and finally, the surgeons. And then it happened. A senior surgeon, barely through the door, unleashed a torrent. Not directed at a problem, not about a mistake, but just… blatant abuse. He raged at these young men who had been meticulously preparing his operating theatre. Their boss was summoned, only to receive the same verbal thrashing – harsh, loud, humiliating. It seemed utterly without reason, a storm erupting in a clear sky.
My stomach churned. I watched these youngsters, heads bowed, taking it. These very same young men were the perfusionists. Their hands would soon command the heart-lung machine, the perfusion machine. Think about that. While the surgeon cut open a living heart, while we anaesthetists held the patient in the twilight of GA, it was these young men, silently focused, who would literally keep the patient’s blood flowing, their oxygen circulating. They held life itself in their steady hands.
They were the gods behind the curtain.
Unseen. Unthanked. Holding the fragile thread of existence while the spotlight shone elsewhere. And yet, the abuse wasn’t an aberration. It became the grim soundtrack of the day. Curses, slangs, harsh words – flung at them like stones, seemingly just to break the monotony, to vent the fatigue that creeps in during long, tense hours in the OT.
Later, when the surgery was done, the patient safely shifted to the ITU, and the rest of us began to think of home and rest, I saw them gather their things.
"Where are they going?" I asked quietly.
"Back to the ITU," someone murmured. "To monitor the patient through the night."
Through the night? After that grueling day? My heart clenched. I asked their in-charge, "When do they rest?" He just shrugged, a look of weary resignation on his face. He didn't know. There was no time.
The CTVS technicians. The perfusionists. The invisible ones doing the thankless, vital work.
My rotations took me to the Critical Care Unit later. The CCU technicians there? Their treatment was perhaps slightly better than what I’d witnessed in cardiac surgery – a little less overt shouting, maybe. But their reality? Living conditions cramped, respect for their crucial profession non-existent. Everyone else on the night shift had some corner to rest their head. Except the technicians. Always moving, always monitoring, always indispensable, yet perpetually overlooked.
Underpaid. Overworked. Unseen.
Even after I finished my post-graduation and stepped into practice, the scene in private nursing homes wasn't much different. Too often, OT technicians were treated like mere servants, their expertise ignored, their humanity forgotten.
Today, July 8th, is International Paramedics Day. I write this not just as a doctor, but as a witness. I write it with a knot of shame and deep admiration in my throat. I write it for those young men on that Kolkata morning in 2014, bearing the brunt of undeserved fury while preparing to be gods behind the curtain. I write it for every paramedic, every technician, every silent guardian holding the line.
We see the surgeon’s skill. We see the anaesthetist’s vigilance. But how often do we truly see them?
They are lifesavers.
It’s time we treated them as such.
Paramedics, perfusionists, critical care technicians, and OT assistants are vital to any healthcare system. Often unseen and rarely appreciated, they keep hearts beating, lungs ventilating, and trauma patients alive under the most harrowing conditions. But behind the gloved hands lies a grim truth: they are overworked, underpaid, and routinely disrespected.
📌 Global Evidence of a Crisis
🔹 Burnout & Toxic Culture — Ambulance Victoria, Australia
A 2025 parliamentary inquiry exposed a culture of bullying and burnout at Ambulance Victoria. Delays in dispatch led to preventable deaths, including an elderly man who bled to death after waiting hours for help while paramedics were stuck outside the hospital (“ramped”). Over 10% of staff reported they were planning to quit due to stress, toxic culture, and lack of support.
Source: Herald Sun
🔹 NHS Crisis — United Kingdom
A 2022 study revealed more than half of NHS paramedics suffered from burnout, with many experiencing symptoms of emotional detachment and stress. They described working in conditions akin to a war zone—back-to-back emergencies, missed breaks, and no time for mental recovery.
Source: The Guardian
🔹 Physical Assaults on Paramedics — Australia
In Northern Territory, two violent assaults on ambulance crews in one weekend exposed the growing danger faced by paramedics. Crews were threatened, trapped, and emotionally shaken.
Source: Courier Mail
🔹 Legal & Ethical Consequences — USA
Several paramedics have faced criminal charges in recent years:
Elijah McClain (Colorado): Paramedics administered excessive ketamine, leading to fatal complications.
Earl Moore Jr. (Illinois): Paramedics were charged with murder after mishandling a mental health call, resulting in positional asphyxia.
These tragic incidents show how paramedics are thrust into ethically complex, high-risk situations—often without adequate training or systemic support.
Sources: AP News, Wikipedia
🌍 A Global Pattern: Undervalued, Overloaded, and Overlooked
🧠 Mental Health Emergency
A UNISON UK survey found:
91% of ambulance workers experience stress.
38% took sick leave due to psychological burnout.
Many considered quitting altogether.
Source: UNISON
🔥 Canadian Paramedics During COVID-19
Paramedics reported cognitive overload, moral fatigue, and challenges with PPE access. Many felt they were being sacrificed to keep the system running, developing long-term psychological trauma.
Source: International Journal of Paramedicine
📉 Alberta: Burnout Leads to Staffing Collapse
An alarming number of paramedics in Alberta shifted to part-time or early retirement due to unbearable workloads. Rising vacancies and call volumes only worsened the cycle.
Source: Calgary Herald
⚠️ Why This Matters???
These are not just support staff. Paramedics are first responders, crisis managers, and lifelines for patients in transit and in trauma. Yet, they are routinely denied basic workplace rights, mental health support, fair pay, and dignity.
Invisible in gratitude but always first in crisis, their neglect leads to systemic breakdowns, burnout, and avoidable fatalities.
✅ What Needs to Change
1. Public Respect & Professional Recognition
Paramedics deserve acknowledgement on par with physicians and nurses. Their technical expertise and emotional resilience are vital.
2. Mental Health Support
Structured debriefing, trauma counseling, and PTSD care must be mandatory—not optional.
3. Safe Scheduling & Staffing
Enforce mandatory breaks, limit excessive overtime, and ensure backup staffing to reduce exhaustion-related errors.
4. Zero-Tolerance to Abuse
Bullying in medical culture—whether verbal, emotional, or physical—must be addressed at every level.
5. Policy-Level Reform
Governments must legislate for better working conditions, safer environments, and increased funding for pre-hospital care systems.
🎗️ On International Paramedics Day
Let this be more than a ceremonial date. Let it become a rallying cry to:
- Elevate the status of paramedics worldwide,
- Demand institutional reform, and
- Express collective gratitude not just with words—but through action.
Behind every stable patient and successful surgery lies the unwavering focus, skill, and sacrifice of a paramedic. It’s time the world saw them.
📚 Further Reading & References
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Herald Sun. Bullying, burnout crisis at Ambulance Victoria costing lives [Internet]. Melbourne: Herald Sun; 2025 [cited 2025 Jul 10]. Available from: https://www.heraldsun.com.au/news/victoria/inquiry-hears-concerns-over-ambulance-victorias-workplace-culture/news-story/654279149410daa47aded0360999c366
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The Guardian. More than half of NHS paramedics suffering from burnout, study finds [Internet]. London: The Guardian; 2022 Feb 6 [cited 2025 Jul 10]. Available from: https://www.theguardian.com/society/2022/feb/06/more-than-half-of-nhs-paramedics-suffering-from-burnout-study-finds
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UNISON. UNISON survey reveals scale of secret stress among ambulance workers [Internet]. London: UNISON; 2015 Apr 24 [cited 2025 Jul 10]. Available from: https://www.unison.org.uk/news/article/2015/04/unison-survey-reveals-scale-of-secret-stress-among-ambulance-workers
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International Journal of Paramedicine. Challenges and changes with COVID-19: Canadian paramedics' experiences [Internet]. 2022 [cited 2025 Jul 10]. Available from: https://www.internationaljpp.com/content/features/challenges-and-changes-with-covid-19-canadian-paramedics-experiences
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Courier Mail. Paramedics assaulted in two separate incidents over the weekend [Internet]. Brisbane: Courier Mail; 2024 [cited 2025 Jul 10]. Available from: https://www.couriermail.com.au/news/paramedics-assaulted-in-two-separate-incidents-over-the-weekend/news-story/201f9d0d63052ec4e565f0c12603c134
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AP News. Paramedics overdosed Elijah McClain with a sedative he didn’t need, prosecutor says [Internet]. New York: AP News; 2023 [cited 2025 Jul 10]. Available from: https://apnews.com/article/afc07d1d1bf6b20888c0e3511463b9c5
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Wikipedia. Killing of Earl Moore Jr. [Internet]. 2023 [cited 2025 Jul 10]. Available from: https://en.wikipedia.org/wiki/Killing_of_Earl_Moore_Jr.
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Calgary Herald. Alberta paramedics facing burnout and staffing shortages [Internet]. Calgary: Calgary Herald; 2023 [cited 2025 Jul 10]. Available from: https://calgaryherald.com/news/local-news/alberta-paramedics-shortages-burnout
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