Joanna Sokol, a former EMT and paramedic in San Francisco, grapples with the complexities of compassion in her new memoir, “A Real Emergency,” published by Strange Light, a Penguin Random House trademark.
After 15 years in emergency medical services, Sokol reflects on the blurred lines between respect for individual autonomy and the urgency of medical intervention in her patients’ lives.
The questions she raises are profound: Is it compassionate to compel someone to adopt a healthier lifestyle, even against their will? Or is true compassion respecting someone’s autonomy, even if it leads to their demise?
Sokol challenges readers to confront these difficult moral dilemmas, sharing her experiences with a diverse population of patients that often defies stereotypes associated with emergency care.
In her memoir, she recounts a day in which a patient described San Francisco as “scary Narnia,” amidst an environment marked by drug use, confusion, and despair, prompting Sokol to respond with understanding and a nod to the surreal nature of her job.
Discussing her experiences during a casual interview in the Panhandle, where she teaches EMS classes today, Sokol acknowledges the unglamorous reality of being the go-to person in emergencies.
The conversations she had with patients, the emotional turmoil they were experiencing, and the stories they shared all contributed to her understanding of compassion, which is anything but clear-cut.
In a moment of levity, she recalls a memorable, albeit inappropriate, insult from a patient that sticks with her. “You baby-Jesus-looking motherfucker,” remains a humorous touchstone when faced with the absurdities of life.
But the job is not merely about memorable quotes; it is about navigating the intensity of human emotions, where frustration can manifest in anger directed at medics. Sokol explains that a significant part of her role involved dealing with people who were not traditionally relatable — those facing chronic illness, mental health issues, or homelessness.
She emphasizes the importance of not taking outbursts personally, recognizing that the anger directed at her often stemmed from a much larger systemic issue impacting her patients.
Sokol believes that camaraderie among her colleagues provided a crucial coping mechanism, yet she points out the limits of resilience when faced with repeated trauma.
The physical and emotional toll on medics is considerable, leading Sokol to advocate for more vacation time to ensure they can perform better and recover from the emotional demands of the job.
As she navigates the critical intersection between physical and behavioral health in her narrative, Sokol sheds light on how deeply intertwined these aspects are with social and economic conditions.
Access to healthcare is often obstructed for those living in unstable housing situations, which directly impacts health outcomes. Sokol illustrates this connection with the example of a patient who missed appointments due to lack of reliable transport, resulting in an emergency situation that could have been avoided.
While addressing the ongoing struggles of unhoused individuals in San Francisco, Sokol acknowledges the frustrations residents face when confronted with visible homelessness and its associated challenges.
She describes a particular case of a woman who suffered significantly outside for too long, demonstrating how the debate over compassion often hinges on difficult questions. Should medical professionals have forced her into treatment earlier?
Sokol’s experiences compel her to continually reassess what compassion even means in these contexts.
The challenges of balancing individual autonomy against the moral imperative to intervene weigh heavily on her mind, leading her to deeper doubts instead of clear answers after years of service.
In discussing the decision-making process for forcing someone into care, Sokol points out the legal and moral constraints surrounding patient autonomy. As long as someone is coherent, they retain the right to make choices, even those that may lead to their demise.
She also reflects on how her experiences have shaped her perceptions of the broader community, admitting a journey of fluctuating comfort levels with individuals facing addiction and homelessness.
Initially, she felt at ease and wished others could see these individuals simply as people, but repeated exposure to trauma led to feelings of paranoia about her safety.
Sokol acknowledges the difficulty of maintaining compassion amidst the harsh realities of her job. Her perspective evolved into a protective awareness that remained at the forefront of her interactions.
Reflecting on the act of writing, Sokol expresses newfound appreciation for the process of articulating her experiences. The regimen of writing allowed her the space to rediscover joy in storytelling and reconnect with the love that initially drove her to become a medic.
Ultimately, “A Real Emergency” serves as a lens into the multifaceted struggles surrounding compassion, autonomy, and societal responsibility. Through her unique insights and candid storytelling, Sokol brings to light the complicated nature of emergency medical care in an often unforgiving city.
In closing, her memoir invites readers to confront their assumptions about compassion and what it means to truly care for others in a society fraught with disparity and urgent human needs.
image source from：https://missionlocal.org/2025/06/real-emergency-joanna-sokol-qa-secrets-san-francisco-emt/
