“This work is a continuation of my life”

HEART responders are equipped with a diversity of skills and compassion

A HEART Team leaves the Duke Hospital emergency room where they accompanied a person in distress to ease her admittance

We had just driven by a billboard illustrated with flowers that read, “Life is beautiful, life is hard.”

I was riding in a van with Yolanda Dawson, a peer support specialist; Chris McMillan, a medic; and Emma Post, a mental health clinician. Together, they formed one of the HEART response teams dispatched by the Community Safety Department, a co-equal branch to police and fire in Durham, North Carolina.

Emma commented that the billboard gave her an odd feeling, and I was curious to hear more. She hesitated so she could gather her thoughts.

“This work brings up a lot of aspects where [I know] it doesn’t have to be that way, where people’s trauma is connected to the larger system,” Emma reflected.

Yes, life is both beautiful and hard, she explained, but there was something about the billboard’s placement in a gentrified area where there was also a lot of homelessness that shook her. Life was hard, but it didn’t need to be this hard.

“I feel like we talk about it a lot,” she said of her team. Chris, Emma and Yolanda spend about 12 hours a day together, so they slipped into the familiar banter of people who, well, spend about 12 hours a day together.

Their banter floated among their joys and jokes, seeming to level them as they swerved from crisis to crisis in their work. Emma had way too much lettuce delivered from her C.S.A. Lettuce wasn’t a high priority for Chris, who had to manage to eat 250 grams of protein a day to prepare for a weight lifting competition only weeks away. They all reminisced about Yolanda’s grand gesture over the weekend —a party in which, on bended knee, she asked her now-fiancé to marry her, surrounded by family and friends, a goat and a majestic white horse donning a a unicorn’s horn. All these days later, Yolanda was still hoarse from the celebration. She grinned as she recounted the fun; I began to look forward to how Yolanda’s wry, dimpled grin emerged as she told stories.

Because their jobs brought them to the brink of human experiences, they also transitioned into deeper conversations, too, like the one Emma was opening up.

She observed that they so often had to “respond to people who are getting kicked out of places.”

They had recently been dispatched because someone was concerned about a woman sleeping in the park. The woman, it turned out, had been told that she would be evicted for back-rent owed.

“She had preemptively left her apartment to sleep in the park,” Chris told me. “She was just so anxious. She said she left at 4 in the morning.”

So many people in this country are harmed by anxiety over legal, bureaucratic systems that hold power over their lives. Evictions are legal processes that snap people from being housed to homelessness, a rapid clip of disruption.

The HEART team explained to her there was a whole legal process, that she still had time. They helped her move back into her still-unlocked apartment, but were worried about how afraid and vulnerable she seemed. When we drove by a long line for food boxes passed out by a food bank, they discussed grabbing a box for her.

Emma was driving the van and Yolanda sat next to her, navigating and writing reports into a tablet. I sat in the back with Chris, who operated the radio. He reflected on what Emma said about how much they saw larger systemic issues driving the problems they encountered.

Chris commented that might be why some first responders get jaded. They can’t solve the underlying problems; they have to keep moving. There is an eventual helplessness in that.

Chris had plenty of experience with first responders. He’d been a police officer at the time of the murder of George Floyd, and quickly transitioned to become a firefighter and then, a HEART responder. He was seeking the best way for him to make a positive impact on people’s lives.

As a firefighter, he’d been accustomed to being dispatched to crises where they had to move fast — and then move on.

“As firefighters, we get there and within five minutes, we handle the medical thing and then turn around.”

But as a medic with HEART, he had different tools, including more time to teach people how to care for themselves. He recently encountered someone injured by bite, their flesh now swollen, so he took the time to explain what happens with infections, and how to care for them.

It might seem counter-intuitive that time is a tool to be deployed in crisis response, but a rushed response could escalate a crisis in which, in fact, the goal is to deescalate. The average time spent on a call for HEART is 30 minutes; they had in fact just devoted a couple hours to a call because it was needed. A school had called them out for a girl whose behavior had suddenly changed; she had keyed a car, which was totally out of character, and then seemed to not remember that she had done that.

The team listened to her for a long time, and then brought her father in to talk, engaging an interpreter by radio so everyone could speak fluently in either English or Spanish. Finally, they formed a caravan, supporting the girl and father with traveling to, and then navigating, a hospital.

“Building rapport is very important,” Chris explained, “and treating people like human beings.” The rapport, the time — all of this differentiated this mode of first response.

“I don’t think I could get jaded,” Yolanda said.

Jaded. Did that word emerge from the green stone? The succulent plant? I looked it up later; it was an old English word for tired-out work horses. They were called jades, the opposite of that beautiful horse in Yolanda’s betrothal photos. A jade became exhausted by doing the same tasks over and over, body worn down.

Yolanda was communicating something quite nuanced. She wasn’t just doing a task over and over until the body — or spirit — breaks down.

“I am the work. I’m here to share my story and all the stuff I’ve been through.”

That was the power of including peer support specialists on the teams, people who understood what it was like to be on the either side of the crisis.

“This is a continuation of my whole life,” she said. “I’m a part of it. I’ve just got to keep myself healthy, but still it’s just a continuation of my life.”

By being in relation with the work, rather than distant from it, Yolanda found her wellspring.

The HEART teams did a great deal to maintain their health. Their banter was part of it. So was the meditation that all the response teams did at the beginning of their shift.

A few hours earlier, when I first met this team in the lamp-lit first responder room in the basement of Durham city hall, Yolanda had invited to me to join them for their meditation. I fidgeting a bit, sinking into a saggy posture — sort of half sitting, half lying down on the office carpet — until a member of the other response team clicked on the day’s meditation from their phone, an app put together by the Veterans Affairs Administration, “The Mindfulness Coach.” I shimmied a bit more upright. A deep voice guided us to notice how our thoughts dwelled on a sound — first it was music, then traffic, then a bell — and to notice when our thoughts shifted away.

I could see how that meditative practice around attention ran through how this team worked. The team could enter into a hard situation, then move into lighter chatter without disrespecting what they had just faced. It was as though each experience was distinct, had its own contours.

Emma pulled the van into the Durham City Hall’s parking structure. They were going to take their dinner break.

I walked with the team, struck by these three people with whom I had just shared five hours. They weren’t exactly apart from the suffering all around; they were among, and among, and among, like a bell ringing out, the contours of its sound softly distinct from the sounds all around.