ARMY 68W, 2008-2016 — From combat medic to rural EMS in West Virginia

Two tours in Afghanistan as a medic with an infantry battalion. Got out in 2016 wanting to do trauma work in a small town. Moved home to West Virginia and tried to figure out how to convert what I knew into a state EMS license. The conversion is harder than people think. The military trains you to do certain procedures (needle decompression, surgical cricothyroidotomy, IO access in the field) that the state scope-of-practice will not let you do outside of a hospital, even though you have done them under fire. Conversely, the state tests you on protocols and pharmacology that you never had to memorize because you were following a battalion surgeon's standing orders. I used VR&E (Chapter 31 Vocational Rehab) to fund an accelerated paramedic bridge program at a community college, then took the NREMT-P. Pass on the second try. Two-year process, end to end, and the VR&E counselor stayed on top of the paperwork while I studied. I now run nights on a county EMS truck. Most of what I see is diabetic emergencies, COPD exacerbations, opioid overdoses, and the occasional motor vehicle collision. I am almost never the highest medical authority on a scene the way I was downrange. I miss the autonomy. I do not miss the cost.