Vermont Author I.M. Aiken can’t stop writing about Vermont and Vermonters. The Little Ambulance War of Winchester County (Flare Books, 2024) stars enigmatic EMT/Paramedic Alex Flynn and explores the psychological toll of responding to 911 calls. In Stolen Mountain (forthcoming 2025, Flare Books), Alex’s mentee Brighid Doran takes over the narrative, turning sleuth to fight crooked ski lodge developers, while continuing to respond to rescue calls. In the ongoing Trowbridge Dispatch series of short stories that focus on the characters’ emotional journeys, set in the fictional town of Trowbridge, Vermont, members of the rescue team take turns narrating their experiences, with results that veer from the tragic (“The Joker”; Flare Books, 2025) to the absurd (“The Curious”; Flare Books, 2025) to the hilarious (“First Corn”; Flare Books, 2025).
Since her main characters are EMS personnel, Aiken’s novels focus on our present health care crisis. The fictional rescue team follows the tiny dramas of emergency calls. While the plights of those in need of medical care are exposed, the focus is on the struggles of these unsung heroes who brave poor conditions, outdated equipment, and bureaucracy to answer their community’s calls for help, in the process putting their own physical and mental health at risk.
Many emergency service providers, in Vermont and across the US, work on a volunteer basis or are severely undercompensated, especially those that serve rural areas, as noted in a recent video from Vox. Others face disjointed, fractured workplace cultures. This lack of compensation and lack of supportive culture only adds to the trauma, as rescue workers must sometimes leave paid work to serve their communities, only to be demoralized on the job, which makes it all the more difficult to perform their service and maintain their own physical and mental health.
Thanks to the efforts of U.S. Senator Bernie Sanders, and others, these issues are front and center today. For instance, the Emergency Service Provider (ESP) Wellness Commission, a 25-person commission, was established in May 2021 “support/aid to all of Vermont’s emergency service providers.” In their 2024 report, the Commission prioritizes ESP wellness conferences and mental health and well-being training; increases awareness of and participation in peer support groups; and has expanded the Worker’s Compensation PTSD presumption laws to include all emergency support personnel sectors.
While much still needs to be done, and we still need to draw national attention to the crisis in rural health care that we have experienced for years and may continue to experience for the foreseeable future, we can be grateful for the tireless efforts of volunteer EMS and politicians who are working to draw attention to the problem.
We asked Aiken for some background about her work with a couple of candid questions:
Q: Most of your characters take on the role of rescuer. What can you tell us about the theme of rescue in your book?
A: My novels explore my own life. I spent a lot of it as an EMT, firefighter, medic, and crisis manager. I hopped on an inner city ambulance at 20, flew to Baghdad for a year when I was 40, and, after crossing 50, I recognized the impact my decisions had made on me. I have faced sleep troubles, social issues, anxiety, a zealous startle response, and other symptoms that I carry through my days and nights. Laying down at night, I feel underappreciated as I tend to remember the hostilities and trauma of my daily work. In The Little Ambulance War of Winchester County, I asked, “What happens if you are not the hero of your own story?” You spend your life in public service. You’ve saved lives and made a few terrible situations slightly less terrible. You/me/rescuer steps into the spaces most run from. It changes us, sharpens us, tunes us for trouble. It then becomes difficult to turn that off—ever. To this day, I carry a tourniquet, medical gloves, and a trauma dressing everywhere I go. I think I’d like to put that down now. I can’t figure out how to let go.
If rescuers and public servants feel heard, seen, or represented in my books, then I’ve done my job. I am asking readers to understand the sacrifices that we, rescuers, choose to make, the actions we completed, and how this costs us as we age.
Q: The image of a fireman frozen on a ladder in your short story “The Fireman’s Statue” (Flare Books, 2025) is stunning. Where did this image come from? What do you hope readers come away with from this story?
A: I was there. In this story, a volunteer firefighter climbed a ladder just after midnight on a freezing New Year’s Eve. He anchored himself outside the second story, holding a hose that he used to dowse the upstairs’ rooms. He froze in place and never yielded his duty. I respected him that night while recognizing that this fellow was hated by many and loved by few. Our communities depend on these people and many of us fail to recognize the dedication of people like him.
Recently, one of the kids we raised is still working on ambulances as a medic and volunteers on a rural fire company. Every day, our public service agencies struggle to keep volunteers. The agencies also struggle with unhealthy human dynamics: members hating on each other, meanness, jealousy, pettiness. In a way, the work culture around emergency services destroys these same teams that communities ask to respond to 911 calls.
Let’s Talk About This
Help by getting involved. Help by asking how your community is solving these problems. Buy a book by I.M Aiken and help start a conversation in your community around rural healthcare and emergency medicine. All of Aiken’s works are available via the links above, or by visiting your favorite independent Vermont bookstore. All works by I.M. Aiken, including Little Ambulance War, are also available as audio books read by the author, a treat not to be missed. (The audio for Stolen Mountain will be available for preorder soon, so do keep your eyes peeled and your ears pricked up for it).
