It never fails….I’m sitting at a table, socializing with people I just met. Eventually somebody is going to drop the “what do you do” question. I used to be quick on the draw when it came to waving the “life saver” flag – be it in a feeble and unsuccessful attempt to pick up on women, or to simply impress somebody – but that quickly changed. After I got over myself, I actually started dreading that question because I know where the conversation is going to go. People want to know what I have seen and how I deal with the “horrible” things that they think we come across every day. Of course, their definition of horrible is much different than mine.
Movies and TV have given society the impression that we see a bunch of really nasty, mangled and bloody patients, then just drive them to the hospital. What they don’t see on TV is a paramedic talking to a grieving father after his 8-month-old child choked on a water balloon and is showing no signs of life. They don’t glamorize the mother of a little girl that was found beat up and left for dead in a trash pile, only to find out that her own husband was the one that tried to kill their daughter. When someone inquires about the “worst” thing I have ever seen, they usually aren’t expecting one of those answers. For the sake of not ruining casual conversation, I typically just tell some humorous story and keep those painful memories to myself.
When I started in EMS, death didn’t bother me like I thought it would. My first full-arrest was a rush. I was applying newly learned skills and doing something exciting. Most of my friends from high school were still smoking pot, partying, and enjoying life under the shade of the parental umbrella. Not me. I was pumping on chests, driving fast, and looking freaking awesome while I did it. I didn’t quite grasp the seriousness of the work I was doing. While I’m glad I started out when I did, I often wonder if I was mature enough to handle the job I signed up for. Fortunately for me, it wasn’t until sometime later that I truly experienced my first case where I got hit with the ole’ reality sledgehammer.
I’ll never forget the day I transported an elderly lady in full-arrest from a nursing home who was pronounced dead shortly after arrival at the ER. For me, this just another old person that died. I couldn’t even begin to count the amount of calls like this that I had run during my career. It was business as usual until I walked into the room of the now deceased patient to find a little girl crying by her side saying “I’ll miss you, Grandma”. It wasn’t the emotion from the family that bothered me, it was the guilt of not feeling anything. I wondered how I could have watched so many people die and never lost a night of sleep? Was I even human anymore? What was wrong with me?
I took a big look back on my career and couldn’t help but think about the all the times I ran a critical call, and went about my day like nothing happened. Hell, I even joked about some of these calls. The deeper I dug, the worse I felt. This was the start of many years of feeling guilt and questioning myself as a person.
For the longest time, I have felt that EMS has changed me as a person. I often question my morals, and at one point, I even questioned my faith. The things that bother me aren’t death or crippling injuries….it’s misuse of ambulance services, the entitlement mentality that many of our patients have, and the on-going joke called Medicaid reimbursement.
I often wonder if I’m so calloused as a person that something like the death of somebody’s loved one just doesn’t touch me. It’s not that I don’t care, I just don’t have any emotion invested in it. I know that as an EMS provider, I can’t be emotionally tied up in all my patients or their tragedies. If I was, I would be mess. We all would.
Now having said all that, I must clarify that I’m far from bullet-proof. I can go about my business of providing on-the-spot taxi services for those who refuse to care for themselves, pumping on grandma’s chest and doing my part to combat natural selection. That is, until I run into one of “those” calls that jump right out of nowhere and hit you right in the face. Like a young man in his early 20′s that was tragically killed in an unfortunate accident at work. Life is fine and dandy until I have to notify his father and inform him that his only son just died during a freak accident at a low-risk job.
So how do I handle that? I finish my PCR, help my partner finish cleaning the ambulance, and try to go about my day as I always do. I’ll eventually reach a quiet moment where the emotion from the event hits home. I think to myself that it could have easily been me or any one of my friends or family members. I put myself in the shoes of the grieving father and imagine how I would feel if I received that phone call. Then I take a look at myself and maybe even crack a little smile, because all the emotion I’m experiencing means that I’m still human. I remind myself of the reasons I do this job, then head out to start the cycle all over again.
Most of the readers of this blog are probably familiar with this weeks “Celebrity Medic”. If you’re not, go check him out of Facebook and read his blog. When he isn’t busy crushing the souls of the sinners of the highway, you might be able to find him chatting it up on the Crossover Show, or bragging about making people cry on Facebook. Although being a motorcycle cop sounds pretty freaking cool, I can’t help but wonder if one day MC will hang up his helmet and boots. What if he decided to leave the Dark Side and take up a career in pre-hospital emergency medicine? That would leave us no other choice but to ask ourselves the big question of the week:
What kind of Paramedic would Motorcop be?
First and foremost, guys like MC need a saying or a slogan. “Soul Crusher” just doesn’t seem fitting for a paramedic…..”Disease Crusher” however, does. Perhaps a patch featuring a picture of him stomping out disease and punching bacteria in the face would be appropriate.
I couldn’t imagine that MC would be happy working on an ambulance as it’s too big and too slow. I could see him working in a first-responder vehicle or perhaps even one of the lucky few that get to work EMS on a motorcycle. I couldn’t see him working 24 hour shifts, instead he would probably seek the traditional law enforcement schedule of 8-10 hours.
Instead of following a set of protocols, MC would set rules or guidelines for the body systems of patients to operate under. Any deviation from the rules would result in citations or fines. He would most likely specialize in motor vehicle collisions and his trauma care would mostly consist of investigating the mechanism of injury. Patients receiving transcutaneous pacing or electrical cardioversion would not receive sedation. Instead, they would be told “If you got shocked, you deserved it”.
Transitioning from a law enforcement job to EMS would require some specialized equipment. Here is a list of essential equipment for MC’s medic bike:
- Baton: Used a long-bone splint.
- Bullet Proof Vest: Used as a make-shift KED.
- Taser: Used as an Automatic External Defibrillator.
- Breathalyzer: Modified to detect CO2 for use in confirming ET tube placement.
- Handcuffs: Made larger for use as a tourniquet.
- Radar Gun: Used as a portable x-ray device.
- Gun: Still used to shoot bad guys…….
Overall, I think MC would be a perfect candidate for a job in EMS. Response times wouldn’t be an issue and scene safety would be assumed. While obtaining blood samples would require a search warrant, pt’s would otherwise not have the ability to refuse treatment. Patient rights would be replaced with Miranda Rights, and patient care reports would be replaced by citations. While the transition would be tough, I think he would fit right in with the rest of us gurney-pushers.
Have an idea for next week’s “Celebrity Medic”? Send me an e-mail at firstname.lastname@example.org
A fellow nurse blogger and I were sitting together watching baseball at our local family watering hole (Go Rangers) a couple nights ago when she got the idea to write an article comparing the game of Baseball to the day-to-day operations in the Emergency Department. Once the ideas started rolling in, we pulled out the laptops (yes, we are THOSE bloggers) and signaled our bartender to keep the brews coming. And when I say brews, I mean brews. None of that light crap. If I can see through the glass, it aint’ dark enough…..
As I am attempting to unwind from the day by having a beer and watching the Texas Rangers kick some Chicago White Sox ass, it occurred to me that ED is much like baseball…..Please, allow me to elaborate……
If you haven’t read the article, go check it out and come on back when you’re done.
Seeing how well her article played out, I decided to
shamelessly steal expand on the idea and write a comparison of EMS and the game of Baseball.
Batter: (Paramedic) Whether on a street corner or housed in a station, this is the guy that sits in a rotation just waiting for his turn at the plate. The better he and his teammates are, the more times he goes up to bat. The paramedic may enjoy his share of the action, but ultimately just wants to head straight for home.
Pitcher: (Dispatch) The Clash of Titans often occurs between a paramedic crew and a dispatcher. When the dispatcher throws junk calls their way, they try their best to stand back and avoid them, keeping themselves available for the next pitch. That is until that crazy trauma call gets thrown right in the wheelhouse for them to take a swing to get a nice big piece of the ball and send them home with a sense of accomplishment and satisfaction.
Catcher: (Lead Dispatcher) While the dispatcher and medic crew are typically in the center of the spotlight, the lead dispatcher is sitting behind everyone, calling the pitches and directing all the players on the field.
1st, 2nd and 3rd Basemen: (Patients) The patients are always there, waiting, eager to tag you at the most inopportune time. A good and fast paramedic will run right through them all on his way home.
Shortstop: (Frequent Flyer) This person isn’t your average patient. They play the game and they play it well. They are the ones that will jump up out of nowhere and jack your world up before you even knew what hit you. They are known for jumping in the middle of the game at the worst time and stopping you in your tracks on your way to a good run. This person is the vacuum of the field, nothing gets by them and they will suck you dry.
Outfielder: (Firefighters) These are the guys that are usually standing around at a distance unless the paramedic is working. Just when you think you have hit a home run, they are there to jump up and steal the glory.
Manager: (Field Supervisor) This supervisor is the one watching over everything. They get to decide who to put in the game and who to take out. A good team can make the games and their career successful, while a poor team can make for some miserable work days. A good manager will stand back and watch while his team plays the game, making minimal changes when necessary.
Bat Boy: (Supply Tech) This is the guy that the players tend to dump on and is often unappreciated. A good supply tech works fast to clear out equipment and re-supply the team. They often go unnoticed until the one time they slip up and a used ball gets left on the field.
Base Coach: (Base Physician) When the Medics are rounding the bases, this is the person they look to for the go-ahead when they want to run the extra mile.
Umpire: (Law Enforcement) Nuff said.
Fans: (Bystanders) These are the friends, family members, and Monday morning quarter backs that stand around and watch you work. They all believe that they know your job better than you do and are the first to complain when things don’t go their way.