By Kimberly J. Soenen for Boreal Community Media - September 19, 2023

Last spring, I learned of a book called Trauma Sponges: Dispatches from the Scarred Heart of Emergency Response by Jeremy Norton (University of Minnesota Press, October 10, 2023).  My own life’s work has been centered on Health Humanities and healthcare industry accountability so I immediately reached out to Norton to see if he’d permit me to read the early manuscript of his book and talk with him about the urgent need for change across the health, healthcare, and Public Health & Safety models. 

Chicago has the largest Fire Department in the Midwest and is the oldest, but the Minneapolis Fire Department (MFD) also has an extremely high volume of calls. In 2007, the MFD went on about 35,000 911 calls with 434 firefighters, and by 2022, that number increased to 55,000 with the same number of staff.

Norton has been a firefighter and EMT with the MFD since 2000. He was promoted to Captain in 2007 and heads Station 17 in South Minneapolis. He was promoted to Battalion / District Chief in 2015 and then deliberately opted to demote himself and return to Captain rank in 2017 so he could continue “riding the rig,” which enabled him to return to working in the streets and triaging people in his community directly, rather than working only in an administrative capacity.

On May 25, 2020, Norton and his crew at Station 17 responded to a call just six blocks away. A man was being suffocated by a police officer. His name was George Floyd. Norton’s crew tried to resuscitate him at the scene. 

Captain Jeremy Norton in South Minneapolis, Spring 2023 | Photo credit: Carly Danek

I began my conversation with the why.

KS: Let’s get right to it: Why do you do what you do?

JN: I was new to Minneapolis and between jobs and careers. I got to know someone who had just joined the MFD. She was 23, had purchased a house, had a steady paycheck and health insurance. I had none of that. 

I'd been teaching junior high and high school literature but was looking for graduate programs and other ways to make a living. Initially, the Fire Department appealed because of its schedule, benefits, the opportunities afforded, and a different way to engage the world and be of use.

KS: How do you manage witnessing trauma day to day?

JN: I think we First Responders went so long ignoring and denying the ill effects of Emergency Response; we were slow to realize how poorly many of us managed it. 

So, when we started out being told, “Everyone on this job will have a drinking problem, a divorce or three, a bad back, and black lung…” I appreciated the gallows humor but wanted to see what was actually true. I genuinely believe many of us suffer moral injuries but also, we suffer because of a failure to understand what the job actually is. We should train rookies better so they know what to expect. 

KS: There have been more than 199 Rural Hospital closures since January 2005. More than 217 hospitals have closed their labor and delivery departments since 2011. Since February 2 alone this year, 42 hospitals have closed, or plan to close, their Emergency Departments. These closures have run parallel to record-breaking profiteering by the Commercial Health Insurance industry. Because the system dishonors patients and staff, First Responders have become the Primary Care safety net for many. How do you and your crew manage the stress the U.S. model imposes and how do you manage your own mental health?

JN: One of the primary motivations when I began writing this book, as I was a rookie, was to explain to people what it was we actually do. Meaning, I kept trying to explain to friends and family what my work entailed, and they kept saying, “But you're a firefighter, right?” The longer I did my job, the more I saw the sociology of Emergency Response, meaning, the ways that race, class, sexuality, and gender shape our healthcare system at this level. 

The majority of our calls can be people who dial 911 for all of their healthcare needs. We see the endpoints of generations of poverty, poor education, illness, dysfunction, despair, thwarted financial options, and imagination. In short, a loss of hope.

KS: Approximately 33 of 416 Fire Fighters are women in the MFD. There is only one Battalion Chief of 18 and only six of 100 of the Captains are female. How does that gender imbalance impact the culture of the MFD and interactions on calls?

JN: The MFD is largely a white, male, conservative workforce. When workers engage poor people or people of color, things are far messier, and more complicated than either my liberal friends' pieties or my conservative friends' reductive declarations. That's a short answer to a very complicated question. 

KS: How do you navigate those judgments or assumptions while on calls?

JN: I argue in the book for radical compassion, meaning, to push beyond the surface assumptions, and to appreciate the messy humanity in folks. I also recognize that, much as the walls people erect (Us vs Them divisiveness) are counterproductive, there are also risks to being open-hearted. This is not work for the earnest or the soft-hearted, despite all the memes championing softness. We have to be careful not to oversimplify the dichotomy. I am willing to embrace compassion while I recognize that a whole lot of people are going to die badly and there's not a damn thing I can do about it. I will look them in the eyes, give them respect, see them as they are. They will die and I will keep living; I will go home to my family, and I will return tomorrow to my crew, so we can do it all over again. At least that’s what I tell myself every day.

KS: When you witness return patients, how do you cope when you don’t see outcomes improving?

JN: Many of the people we see lack the health literacy to understand the unhealthy path that they're on, whether due to doctors' reticence or a breakdown in communication in the system. Healthcare in the U.S. is unaffordable even while “insured” and insurance has erected barriers to avoid having to pay for medical care. 

Because of this model, we see the unhoused, the unwell, the sick, the scared, the hurting, the drunk, the drugged, and the despairing. 

Firefighters, EMTs, medics, or the police are the responders. But we cannot force the hospital, the medical system, or the commercial health insurance companies, to change how they operate. We are pawns in this ecosystem merely holding the line. 

KS: In May of this year, the State of Minnesota House passed a bill to help slow the rise in retirements among Minnesota First Responders due to Post-Traumatic Stress Disorder. (PTSD.) Is it effective?

JN: First Responders must lawyer up to get the system to follow through on its promises and obligations. So, no, this is not reducing Moral Harm or improving access to Mental Healthcare. Too many barriers are in the way to access the care when it is needed. When people are falling apart, they can’t wait six months for lawyers to make the case.

KS: What keeps you going as a father, EMT, husband, citizen?

JN: My spirituality. 

I marvel at this world and its wonder and madness, its flawed and broken humanity, its beauty and cruelty. I find most organized religions fatally flawed with their human components. 

I hope to live so I do right by others, be of use, and find meaning. If there's Judgment, I hope to pass muster. I hope to be surprised. But, I've seen such variations on death & dying that I feel we are here and then we're gone, but for memories and photographs. 

This doesn't change how I want to treat people.

KS: Who inspires you as a writer?

JN: When I first read James Baldwin in my early 20’s, my understanding of the world —and of powerful writing—evolved. My debt to him is profound. I do believe books can start a revolutionary change. 

Words can save our lives.

KS: Up for a few questions that have nothing to do with Fire Fighting?

JN: I’m ready for it.

KS: Birchbark canoe or fiberglass kayak?

JN: Kayak, but I'm generally landbound.

KS: Favorite Minnesota writer? 

JN: Sinclair Lewis and Louise Erdrich 

KS: UnitedHealthcare or Universal Healthcare?

JN: Universal. 

Pre-order Trauma Sponges today at Drury Lane Books: https://drurylanebooks.indielite.org/book/9781517914189

Drury Lane will also be hosting an Author Talk with Jeremy Norton on Saturday, October 21, 2023 from 6:00pm - 7:30pm. You can learn more about the event here: https://www.boreal.org/events/259551/author-talk-with-jeremy-norton-at-drury-lane-books

 About the author