The white patch.

"I'm going to wear my old pair of scrubs." said the artistic director of my improv troupe. He was referring to the presentation that we were going to make to the transplant team of the money (that was raised through a special performance) for the patient's Special Needs fund by the improv troupe a little over a month prior. Being an improv troupe, we were thinking of doing something a little different rather than a straightforward, formal presentation of the $1,400 that was raised. We hit on the idea of presenting this donation in an organ transport box, which I was able to obtain from my old place of employment, the organ donor network here in Rochester. We were going to run in to their weekly meeting as if delivering an organ.

What he asked next however, was wholly unexpected.

"Do you still have your old paramedic uniform?"

I had not been asked that question in a long while, and I felt the blood drain from my face at the question.

"Yeah, I do." I knew where he was headed, and while I silently smirked at the thought, as it was rather funny, but it still scared me. "Great." he said. "I think you should wear that."

Every instinct inside of me was screaming "NO!" Somehow, the word "Okay" came out of my mouth. I don't know why it did, but it did. It has been 12 years since I wore that uniform, 12 years since I was part of a profession and a world that I never envisioned leaving, as I did 10 years ago. Why the number discrepancy? Well, for the better part of the last three years as a paramedic, I was in management, and wore a suit more often than a uniform, and didn't touch a patient.

I tried to convince myself that it was really nothing, that I would put in on, wear it for a couple of hours, and then take it off. It wouldn't mean anything. It was simply a costume for this purpose. I was going to be acting, and why should my old uniform be nothing other than any other stage device that I have used in the past.

The answer, of course, was far more complicated.

So, the morning came for me to prepare for the presentation. Going through the morning ritual of showering, brushing my teeth, taking my transplant medications, and all the other mundane tasks carried an air of tension. I then went down into the basement of my house, and found the box where I keep all my memories of my EMS life, and found my shield and collar bars. Shield #6241. Collar bars with my unit, 35V. The black shield holder and securing pin. I remember this being part of my mrning ritual for so many years.

I went upstairs and found the long sleeve uniform, as this had the perforations above the left breast pocket sewn into the fabric where the securing pin would pass through, pinning the shield to the shirt. The shield holder also had the small metal plaque with my name, and then below it, "PARAMEDIC."

The shirt has two patches. The left sleeve at the shoulder had my hospital's blue and white patch. The right had the one that has been earned by only a comparatively few, the one that said 'EMS-PARAMEDIC - CITY OF NEW YORK." White, with an orange border, orange and blue lettering, and the blue star of life in the middle, it was simply known to us that rode the ambulance as 'the white patch." It was coveted by anyone that worked in EMS, in any capacity, in NYC. There were, and still are, far more EMT's than paramedics. We were an elite group, and we knew it.

I attached the collar bars, pinned the badge on, and slipped the shirt on. As I buttoned it, I was first pleasantly surprised to find that it still fit, and like a glove too. I then went and looked in the mirror, and a wave of emotion overcame me.

I cried. I cried, and cried, and cried. It went on for about 10 minutes.

I missed it. I missed it all. The good, the bad, the silly, the insane, the danger, all of it. I missed my friends, my colleagues, the two partners I had that I worked so closely with for so long, that they became second and third spouses in a way. I was in grief. I was in grief for a life that I left behind so long ago, that I was never able to grieve for, and that I was never able to fully accept that I left behind. I think it was just then that I honestly faced that emotion, as I faced myself in the mirror, in that uniform.

I was grieving for myself.

After I stopped, wiped my tears, and pulled myself together, I went to the presentation. I went into character, and along with my artistic director, made everyone laugh. We presented the money, had some nosh, pressed the flesh with the transplant staff, and then left. I got home, took off the uniform, hung it in my closet, but left the shield and collar bars on. I have yet to remove them and put them away.

I went to my therapist earlier this week, and related this story to him. He just let me talk, not offering any advice, but rather smiling and nodding with each major point that I brought across. We're going to discuss it further next time around.

As I unburdened myself of this grief, I began to realize that this was one of the biggest obstacles, if not the biggest, that has stood in my way all this time. While I was not living in the past, it was always close behind, and impeding my progress in life. I think now however, that I can move forward with more confidence.

The white patch will always be with me. It is part of who I am, a source of pride, and always the greatest title I will ever have, that of NYC Paramedic. From now on however, it won't stand in my way.