“They’re in so much pain, and nobody knows.” That’s the most shocking thing television news and documentary producer Bryony Gilbey discovered researching what would become “Honorable But Broken: EMS in Crisis” — her powerful new independent documentary looking at the state of EMS workers today.
“We’ve got 24-hour news stations — we’ve got so many news sources — and no one was giving the whole picture. I think that’s what shocked me the most,” Gilbey says. Long hours, unsustainable wages, stress, burnout, lack of support, Honorable But Broken: EMS in Crisis puts an unflinching spotlight on the often-catastrophic challenges American EMS workers face — and have met for a very long time — in major metropolitan areas and small rural communities alike.
Gilbey’s journey to awareness and activism about the plight of EMS workers began in her home — her daughter fell in love with EMS in high school, broke volunteer records, became an EMT before graduating, and later trained as a paramedic during the pandemic.
“Her dedication is unparalleled,” Gilbey says. “But she was just dealing with these horrible, horrible situations, and not just the disease — but so much violence, trauma, and suicides. I just listened to one particular call she was on, and I was just like, wait — how much are you making for this?”
Gilbey started to talk to neighbors in her New York neighborhood who were also EMS workers and confirmed yes, “It’s a terrible economic model — we’ve tried so hard to change things, but nobody listens.” That’s when she decided maybe “getting to the bottom of it all —and figuring out a way to publicize it in a way that gets outside the EMS community” might be her calling. “I certainly don’t feel like I have all the answers,” Gilbey says. “I just feel like we as a nation need to have a conversation about it. This is not going away and will affect everybody at some point.”
Astonishingly, fewer than half of the U.S. states today require the establishment of local EMS departments. According to the U.S. Bureau of Labor Statistics, the median pay for EMTs and paramedics in 2022 was just $18.95 an hour.
Gilbey has two other children who also decided, despite the severe challenges, to dedicate themselves to EMS careers.
Honorable But Broken: EMS in Crisis deftly examines how EMS came to operate in this country, tracing its rickety roots to an ad hoc reaction to increasing motor vehicle accidents on the nation’s highways. “There are people who know what needs to be done,” Gilbey says. “You can figure out the sequence of how things need to be fixed. But I mean, at a very basic level, the entire reimbursement structure needs to be recreated.” Struggling to make ends meet is challenging enough for EMTs and paramedics called upon daily to retrieve lives from the jaws of death — but the stress and trauma of always being those lifesavers has driven many to tragic ends.
Gilbey’s documentary features the heartbreaking story of John Mondello — a 23-year-old rookie EMT from New York State who took his own life after just three months on the job in 2020.
Mondello was part of the Tactical Response Group tasked with handling the highest emergency call volumes in New York City during the pandemic. Before he died, Mondello reportedly told colleagues how difficult it was carrying all the Covid deaths he encountered on the job.
According to the Centers for Disease Control and Prevention [CDC], EMS workers are 1.39 times more likely to die by suicide than the rest of the public.
Gilbey calls New York City, “Obviously one of the worst cases of the budget, and the pay, and the number of calls that they’re dealing with. It’s kind of a good example to throw at people as an extreme.” “It’s so short-sighted — that’s what I don’t understand,” Gilbey says. “You want to see some sort of logic in the world — and it doesn’t make sense on any level. It doesn’t make sense to the people, and it doesn’t make sense for the healthcare system. It just blows my mind.”
Members of Congress were treated to a special screening of Honorable But Broken: EMS in Crisis earlier this fall, which was well received. It’s also been screened for local commissioners and New York State Legislature members at the Westchester Dept of Emergency Services. “[Fixing EMS] probably will require, at least at the outset, spending more money,” Gilbey says. “But in the long term, I think it could actually save us a ton of money. I mean, just to look at the economics of it. My only goal is to bring some attention to this issue.”