From Paramedic to Publisher: Why I Started Beyond The Chart

Orlando Rivera
Oct 30
3 min read

I didn’t start writing to inspire anyone. I started because I was unraveling.

There’s a moment, if you’ve been in EMS or nursing long enough where the things you’ve seen start to rot in the silence.

You keep showing up. You go to work. You do what’s expected.But the weight never resets. It compounds.

Every “frequent flyer” becomes a trigger. Every “nonverbal dementia” patient starts to look like someone you used to know. Every overdose feels like a warning you wish someone had given.

And yet every chart you write makes it all seem so…

sterile.

Vitals WNL. Alert x3. Tolerated well. Discharged to home.

Meanwhile, you’re still replaying the call three days later because it didn’t sit right and you didn’t know what to do with it, so you did what we all do, you shoved it down and moved on.

Until one day, I didn’t.

I started writing because no one had ever asked me what it was doing to me.

Not once.

Not in medic school.Not in nursing orientation.Not in any trauma debrief.

I didn’t even know I needed to say anything until the words started falling out of me.

They weren’t polished. They weren’t professional.They sure as hell weren’t “publishable.”

But they were mine.

And for the first time, they made me feel less hollow.

Turns out, silence is a slow death.

We treat patients. We transport them. We patch them up.

But no one ever trained us in what to do with the stuff that stains your identity, the helplessness, the missed signs, the rage at systems that don’t listen, and the shame of going home while someone else didn’t.

And still we keep showing up.

Not because it gets easier. But because that’s what we know how to do.

That’s when I realized writing isn’t just release. It’s record.

It’s a record of what really happened. Not what made it into the chart. Not what looks good on the board. But the part you carried with you long after the ambulance was clean and the bed was reassigned.

Writing became survival.And then it became a bridge.

Because the moment I started sharing what I wrote, even a line or two, people started messaging me:

“Same.” “I thought I was the only one.” “This put words to what I couldn’t say.” “This brought something up I didn’t even know I buried.”

That’s how Beyond The Chart was born.

Not to sell books. Not to build a brand.But to make room.

Room for the things we never got to process. Room for the voices that don’t sound like textbook authors. Room for the providers who’ve lived through hell and still show up.

If you’re still carrying it, you’re not alone.

If you’ve got stories stuck inside you, the kind that don’t fit neatly in a run sheet or a discharge note this space was built with you in mind.

I don’t care if you call yourself a writer.

If you’ve held a hand while someone coded, if you’ve cleaned up a scene while your own heart was breaking, if you’ve ever said “I’m fine” when you weren’t, you’re exactly who this was built for.