White Coat, Black Art

Meet the paramedic with a side hustle as the town mortician

In his hybrid working world, Matthew Sias has found himself acting as paramedic and mortician on the same day with the same person.

'I don't have that fear of death or dead bodies that even some of the people in EMS have'

Matthew Sias, paramedic, assistant coroner and mortician, beside a hearse from the Cook Family Funeral Home on Bainbridge Island, Wash. (Submitted by Matthew Sias)
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Matthew Sias's job description is part Quincy M.E., part Six Feet Under, part Northern Exposure.

Sias is a paramedic with the Sedro-Woolley, Wash., fire department. It's a logging community with a population of about 10,000, located halfway between Seattle and the Canadian border.

But that's not his only job: He's also a part-time deputy coroner and a former funeral assistant. 

The career crossovers have given him more than enough stories to fill his new book, Silent Siren: Memoirs of a Life-Saving Mortician.  

And as he told Dr. Brian Goldman, host of White Coat, Black Art, his many roles have taught him a lot about accepting the inevitable end we all meet. 

"I don't have that fear of death or dead bodies that even some of the people in EMS have. [Death] is always in medicine considered a failure, but for me it's the logical conclusion to life. Sometimes it happens when you're 50 and sometimes it happens when you're 80-years-old. I'm just more comfortable with it."
Front cover of Silent Siren, Memoirs of a Lifesaving Mortician by Matthew Franklin Sias, published 2019 Vulpine Press (Submitted by Matthew Sias)

Hybrid working world

He gave Dr. Goldman a tour of his current work spaces: the local ambulance dispatch station and the funeral parlour. 

Sias says that in his hybrid working world, he's found himself acting as paramedic and mortician on the same day with the same person. 

He was at a gravesite delivering flowers when he got a call from his funeral director who was inside a church at a funeral reception.

"He said this woman at the reception does not look very good and if you could come and check her out that would be great. So I drove back and by the time I got back she was in full cardiac arrest," said Sias.

"I went into paramedic mode wearing my suit and my name tag on that said funeral assistant, and I'm administering epinephrine to this woman." 

The woman passed away despite Sias's efforts to save her. After the moment of death, Sias says he "switched out of paramedic mode and went back into funeral mode. I had to intake this woman at the funeral home."

Double duty

Surprising to lay people, the idea of working as both an emergency responder and a mortician isn't a new one. Sias said that in the 1970s, there were funeral homes that ran ambulance service on the side. 

"That was back in the days before there needed to be so many licences and so much equipment on the ambulances," he said. 

"It was a double duty. So the reality is that the roots of EMS [emergency medical services] is in the funeral business."

The leap to add coroner to his job description came almost as easy. Sias says that a lot of EMS personnel moonlight in coroner's offices. 

"You've been out there in the field. You have enough medical knowledge. You know what most of the medications do. You've interacted with family and police. You know how to lift a body, living or dead." 

But Sias is careful to keep the roles separate. He tries hard to avoid any perceived conflict of interest. 
Matthew Sias, wearing his paramedic uniform, displays some of the tools in the embalming room of a mortuary in Mount Vernon, Wash. (Brian Goldman/CBC)

"It's not like I'm going to be dropping my [funeral home] business card on scene of failed resuscitation. I will work just as hard as we can on somebody but eventually you know everybody's gonna die and there needs to be those people that take care of them and their families when they die."

Sias's multifaceted career began to take shape when he was just 16-years-old. He joined the Explorers, the Boy Scouts program that gives teens on-the-job experience. Sias was posted to the local fire department. To his surprise, he was quickly allowed to go hands-on with real on-the-job calls.

"I was doing CPR. I was using the bag valve mask. I was putting patients on oxygen. I was carrying the stretcher. It was basically all the EMT skills.The only thing I really couldn't do is I couldn't go into a burning building and I couldn't drive the trucks which was probably good because I was a really rather poor driver in those days."

It was during those years as a teenage volunteer with the EMS team, that Sias went on a call to the home of an elderly man with heart failure. As the paramedics fought to save the man's life, Sias noticed the man's wife off to the side of the scene in obvious emotional distress. He put his arm around her.

 "She just needed that reassurance that everything was going to be okay, even if it wasn't. And ultimately it wasn't OK. But I think she needed that sort of human contact." 

I like to be out in the middle of an uncontrolled situation and to bring some order into chaos.- Matthew Sias

That moment led to a realization that has guided Sias through his career. 

"You're there to give people reassurance. I've always enjoyed that and that's why I've had these vocations where I've been a volunteer firefighter, a deputy coroner, medic and funeral director. I like to be out in the middle of an uncontrolled situation and to bring some order into chaos."

Like most paramedics, Sias gets tremendous satisfaction from the patients he has helped save.  In his book, Sias wrote about a time when he worked to resuscitate a man who had collapsed during an early morning jog. A dozen first responders defibrillated the man's heart, inserted a breathing tube, and gave him medications to stabilize his heart rhythm. Then, they transported him to a hospital in Seattle. 

Paramedics like Sias seldom find out what happens to the patients they attempt to save. One day, Sias went with a friend to a packed waterfront bar to share a meal. In walked the man he'd saved along with his wife. 

"Here in this bar was the same man, once drained of colour and staring vacantly at the ceiling of the medic unit, now vertical, happy, and full of life," said Sias.

"How refreshing it was to see the concrete results of my efforts in the eyes of someone who was given a second chance at life. I am reminded of why I do what I do."