At the start of the year, ambulance stations across Estonia receive a new wave of trainees: medical and nursing students, medical technicians and paramedics from the Defense Forces and the Defense League. They begin riding along with ambulance crews, gaining their first real experience interacting with actual patients and performing medical procedures. By the end of their training, what began with a tentative attempt at taking blood pressure typically becomes the confident insertion of an intravenous cannula — thanks to encouraging and supportive guidance.

Stories about the workdays and nights of ambulance crews usually reach the public only when a major incident occurs, something that captures everyone's attention. These reports describe what happens once the crew is already on the scene. But what the everyday reality of ambulance work looks like — what takes place around the kitchen tables at the stations and what they encounter during calls — is known only to the crews themselves and briefly glimpsed by the trainees.

Real people, real problems

There's an old saying in the ambulance world: there are no healthy people, only poorly examined patients. Sometimes the most routine call can suddenly turn serious, while a case that initially seems critical might dissolve into nothing at all.

People's complaints vary, as do their perceptions and pain thresholds. On emergency calls, one sees a cross-section of Estonia: illnesses, family dynamics, self-expression through home décor, interpersonal relationships, the real pressure points of society, despair and giving up.

The stories that linger longest are those where relationships between parents and teenagers have become so strained that the only way forward seems to be involving the police and ambulance — like when a child, in anger, punches through a kitchen counter. Or when a teenage girl is so utterly exhausted that she seriously considers ending her life because she can't bear the thought of going to school the next morning — where bullying, loneliness and the relentless need to prove herself to teachers await.

Loneliness is such a widespread problem across all age groups that it could warrant a dedicated social unit tasked solely with taking relevant vital signs and listening. Loneliness makes people sick, and too often, the only solution people can think of is to call an ambulance. Crew members sit with them, listen and try to understand — sometimes they even look at the pictures on the walls together. Sadly, no medicine yet exists that can permanently heal a soul afflicted by loneliness.

Death

In our society, death is touched on only in passing — and with fear. The process of dying is often pushed into nursing homes and hospitals. Part of an ambulance crew's job includes confirming death.

Dying at home has become a true privilege, a kind of end-of-life lottery win. To pass away in one's own home, surrounded by loved ones, in one's own bed, is a gift that most people are unable to give to a relative. The demands of caregiving can be too overwhelming; caregivers themselves may be unwell or relationships strained.

An old man dies at home, surrounded by clean sheets, photo albums on a stool, a still-warm cup of tea on the table and his wife and children around him. Of course, they're all exhausted — his illness was long and draining — but they wouldn't have wanted it any other way. "How could we stand here knowing that he had to die among strangers?" they say. The foundation for such a passing is laid over decades — through a happy childhood, care for a spouse and a kind outlook on life. It's not something that can be bought from any nursing home.

Headaches and the sniffles

A large share of ambulance calls are related to complaints that should be addressed by family doctors. Fevers and coughs that have lasted for weeks, when vital signs are within normal limits, are not within the ambulance's scope — the crew simply can't do anything. There's no magic remedy in their case that, once injected, will make every symptom disappear. Viruses need to run their course, and that takes time.

Often, the ambulance crew administers paracetamol, brews a fresh cup of tea, fills a glass of water — and that's about all they can do. Of course, every individual's ailment feels significant to them, but when we zoom out and look at the bigger picture, the ambulance is a shared resource meant for serious situations. It's like a fire extinguisher: always there and within reach, but meant to be used for a fire, not to blow out a candle.

Calling an ambulance for a mildly feverish child just because "they wanted one" isn't reasonable — especially from an educational perspective. A child also needs to understand that an ambulance is a serious matter. Help will always come, but calling for it should never become a case of crying wolf.

On the other hand, consider a different example: teenage girls who called an ambulance for a drunk boy their age because they sensed something wasn't right. The boy was, in fact, on the verge of hypothermia. He got warmth, care and a lesson. The girls were praised — and rightly so. This is exactly the kind of principle children starting out in life should remember: don't be afraid to call for help. It won't make the situation worse, but it could save a lot. But when an adult calls an ambulance in hopes of convincing the crew to act as a taxi from a nightclub, that reflects a deeply unrealistic self-image.

Obese children and decaying teeth

The statistics on childhood obesity don't usually stand out in everyday life — especially if you live in a comfortable bubble of athletic children and like-minded friends. But during ambulance calls, a very different picture emerges. Five-year-olds with milk teeth darkened by poor nutrition, candy in their mouths and the body weight of a ten-year-old, fed mostly white bread and sugary drinks, with bowls overflowing with cheap sweets readily available.

These are often homes where there is deep love — but misdirected. They represent a looming public health risk and the future drain on our social insurance funds. Of course, ambulance crews always offer guidance and refer families to appropriate specialists when possible. But the root causes of these problems lie elsewhere. Along with parents, half of society needs to take a hard look at itself — those who advertise such foods, sell them cheap, push them in stores, serve them at birthday parties and label them as "kids' meals" in restaurants.

An ambulance is dispatched when the internal radio receives a call via 112. Depending on the priority, there may be time to calmly tie one's shoelaces — or in the case of a delta-level call, the vehicle must leave the station within a minute, lights flashing and sirens blaring.

From inside the ambulance, you see things that people on the street are often unaware of— namely, how poorly most drivers respond to sirens. Some dart back and forth across the road, trying to get through as if the ambulance will take hours to pass. Others even speed up to cut in front. The rule of thumb should be simple: stay in the lane you're in and stop. For an emergency vehicle, it's easiest to maneuver between stationary, not moving, cars. As a pedestrian, stay still — either on the sidewalk or a median — so the driver can see you clearly. The vehicle will pass in seconds. In that moment, your job is to "freeze."

The mindset among ambulance crews heading to a call is likely closest to that of a unit setting out on a shared (battle) mission. A crew is a team; inside the vehicle there's camaraderie and focus — they are going to help, together. It's the kind of experience that everyone, especially young people, could benefit from witnessing, even just once. It makes the daily life of paramedics more understandable and offers real value for personal growth: to be like an ambulance worker — receptive, attentive, calm under pressure, intelligent and sometimes incredibly brave and humble at once.

Pulling an adult diaper onto a stranger who is already strapped onto a vacuum mattress probably isn't anyone's dream moment — but it can bring a certain peace. The person has been helped, and in a way that preserved their dignity. We don't get to choose how life ends, but if I have the strength to make it easier for someone else, then I need to find that part of myself in that moment.

When a patient sees themselves as a customer, there's a risk they'll complain about everything: if the IV leaves a bruise (which is often unavoidable), if they're asked "too many" questions ("don't you believe me?"), if they aren't admitted to the ER immediately or if the cannula doesn't go in on the first try because the vein is barely there.

Those who are truly sick, who've already endured great suffering, never complain. The tone of the interaction is set the moment the crew leader asks the first question — revealing whether the person expects a service or whether they and the ambulance staff are joining forces to do their best to alleviate suffering.

The nurses, technicians and doctors working in ambulance crews are always helpers. Only someone who sees themselves as a customer would mistake them for customer service reps. Each of us should ask ourselves: would I rather be someone with whom a human relationship is formed or someone who expects the helper to prioritize avoiding hematomas over helping? Because if the main goal becomes sticking to protocol and avoiding complaints — not providing care — then the entire society is in trouble.

In a single 24-hour shift, an ambulance crew will encounter numerous moments the public will never hear about — but that deeply affect someone's life. The difficult cases — where, for various reasons, help couldn't be provided — stay with ambulance staff for a long time, sometimes for life.

Finding balance is a shared responsibility and patients play a role too. Each time, they must weigh whether it's truly necessary to call an ambulance or whether a call to their family doctor would suffice. When the person taking your blood pressure has been working for 20 hours, catching rest in scattered two-hour naps, the last thing you should do is treat them with condescension.

It's a true privilege to sit at an ambulance station's kitchen table, where cases are analyzed, notes are made and people learn from one another. Seeing an ambulance on the street warms the heart. You might wonder: is Meelis or Indrek driving today? Is Kristiina or Andres riding up front? Maybe Robert, Olga or Julie is in the back. You usually can't see them — but just knowing they're out there, and that the kitchen table at the station is never empty or silent, is incredibly reassuring.

We are in good hands.

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