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Up-and-coming playwright Rosamund Small turned to the gritty real world of emergency services for play material after feeling like ‘everything I was writing was really fake.’

You can already hear the sirens in the distance: Rosamund Small is set to be the next big thing in Toronto theatre this spring.

It's not every day that a playwright's first professional play extends its run before it even opens – but that's what has happened with the 23-year-old's new one-woman show about the emergencies faced by Toronto paramedics.

Vitals, which is being produced by site-specific theatre company Outside the March in collaboration with Theatre Passe Muraille, will allow 30 audience members a night to respond to a 911 call along with an emergency medical services (EMS) worker named Anna (played by Katherine Cullen).

After picking up tickets and headsets at a mobile box office, patrons will be dispatched to a real home in Toronto's west-end Roncesvalles neighbourhood for this immersive production directed by Mitchell Cushman, the house-on-fire creative force behind recent indie hits Terminus and Mr. Marmalade.

But Cushman points to Small as the real story this time around. "I think that Rosamund is someone who feels bored in the theatre a lot of the time and her writing really showcases that," he says. "It has a visceral quality to it, and that's something I really identify with."

How did a University of Toronto undergraduate in sexual diversity studies and theatre studies come to make her professional playwriting debut with a show about paramedics? At Theatre Passe Muraille, on a recent spring day that actually, finally felt like spring, the black-haired young woman spoke about the rut that she felt she was in as a writer a few years back – you know, when she was about 20.

"I felt like everything I was writing was really fake," recalls Small, who has been cranking out a new play every year since she was in Grade 9 at the Rosedale Heights School of the Arts. Her fear of a lack of authenticity in her writing led Small – the daughter of retired Toronto Star court reporter Peter Small – to embark on a documentary play about the Occupy Toronto encampment, for which she interviewed 125 protesters and transcribed their actual words to create the script.

Performing Occupy Toronto, as the eventual production at Helen Gardiner Phelan Playhouse was called, was massive the way plays can only be when you're not paying the actors – with 100 characters played by 50 actors between 16 and 21. It made waves beyond the U of T campus, however – and Small eventually remounted it for one night only in St. James Park in downtown Toronto for former protesters.

Vitals has a single character rather than 100, and is a fictional script rather than based on interviews. But it continues Small's interest in telling true stories from the city she's grown up in.

It is inspired by conversations that Small has had with a first responder named Kaleigh O'Brien, who has been responding to car accidents and suicides around Toronto for a decade. The two met through mutual friends and Small was immediately struck by the no-holds-barred way O'Brien spoke about bringing people to the hospital – or back to life – on a daily basis. "She used the term 'died' as a temporary term," says Small. "Everything she told me was gory, but beautiful."

Talking to O'Brien, a matter-of-fact 39-year-old mother of two, you can see why Small was inspired by the dramatic potential in her line of work. She is full of TMI tales about her routine – which, on a typical 12-hour shift, involves responding to overdoses all night long and then cardiac arrests in the morning. (Heart attacks, you see, most frequently occur when a person has his or her first bowel movement of the day, she informs a squeamish interviewer.)

O'Brien has acted as a consultant on Vitals – and likes that the staging will truly immerse audiences in her world. "They'll get to experience what it's like to walk into a stranger's house when you have no idea what's lying behind that door," she says. "That's a big part of my job."

For director Cushman, Vitals is an exciting opportunity to create a site-specific production from the ground up for the first time. Over the past few years, he's taken existing scripts and staged them in unexpected places in Toronto – an East End church for Sarah Ruhl's Passion Play, or a Queen West classroom for Noah Haidle's Mr. Marmalade.

"This time, the script and the production concept have been able to grow symbiotically and inform one another," says Cushman, who first met Small through the youth-oriented Paprika Festival, when he was working there and the playwright was a participant.

In addition to the dramatic emergencies related in flashbacks in Vitals – the asthma attacks, fires, car crashes and shootings – Small's play also delves into the emotional effects being a paramedic has on her fictional Toronto EMS worker, Anna.

Asked about how her job has changed her, O'Brien confesses that she believes all paramedics suffer from post-traumatic stress to a degree. For instance, she sometimes sees body parts and organs out of the corner of her eye when she's off-duty with her children. But she shrugs this off as no big deal: "It sounds creepier than it is."

And O'Brien says – unlike what you might see of the job on TV and in movies – there are wonderful parts to being a paramedic as well. "I see the resilience of life, every day," she notes. "I get to deliver babies. And I see how supportive strangers can be to people who are having a really bad day."

Small is proud to expose O'Brien's world to people for whom paramedics are mostly just sirens in the distance – until they turn up on their doorstep one day. "Other people in emergency jobs feel more visible to me," she says. "But the stakes are so high – they restart people's hearts."

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