A Song to the Unsung

     Welcome to Life Support, a new column that you'll find here each month. My goal is to stir emotions and provoke opinions about issues and practices that we encounter every day. I hope you'll let me know if I'm hitting that mark. Enjoy!

     January 14 is Thanksgiving in southern India. Well, sort of. It's more of an agricultural festival, known as Pongal. Instead of turkey, a traditional rice dish is served to celebrate a successful harvest. I mention this only because I missed an ideal opportunity in November to thank the unsung heroes of EMS and other essential services who have helped keep my patients and me safe during another year of frequently challenging, occasionally life-threatening interventions. So, in honor of Pongal:

     I like dispatchers so much, I married one. She is absolutely committed to the safety of the police, fire and EMS personnel she directs. I know that because she won't even speak to me if she has anyone on the road.

     Most dispatchers I know take pride in matching resources to emergent needs. They work in dynamic, unforgiving environments where a missed transmission or wrong address can jeopardize lives. Dispatchers have been my lifeline whenever my reach has exceeded my grasp.

     As a new medic, I viewed medical control as just another regulatory agency that existed to enforce policy and punish offenders. I overlooked the resources it offered…until the first time I needed help with an ambiguous presenting problem. What a relief to discover there were no black marks appended to my name just for seeking a second opinion. Years later, when I was invited to supervise medical control for a large suburban EMS system, I vowed to offer that same level of service to new providers.

     Like dispatchers, medical control personnel are constrained by not being on scene. They need superior communication skills and the talent to visualize evolving scenarios. I know I haven't always delivered the sort of presentations that make their jobs easier, but I'm grateful for their ability to bridge the gap between MDs and EMT-Ps.

     The thing I appreciate most about the police is that almost every time I've needed them, they've known that before I did.

     Sometimes I forget I'm not a big person, and the only weapon I carry is a radio that keeps getting smaller. I could tell you stories about highly effective tactics used by men in blue to subdue scary people who wanted to make me a patient. Instead, let me just marvel at what their training and courage can accomplish in difficult situations.

     Of course, police officers aren't just about protection. Some of the best first responders I've worked with have been cops. Answering "aided" calls is a natural extension of the services they provide. They frequently arrive first, they're experts at scene size-up, they can enforce some degree of order amid chaos, and they're extra hands for care and equipment. I've often thought a police officer with a paramedic card is an ideal combination of skills for the streets.

     The rivalry between fire and EMS personnel is understandable, given our comparable mission profiles, job stresses and budget constraints. The debate about whether to combine these services will linger long after I retire. I'd rather focus on how much help I've gotten from firefighters at medical scenes.

     I can't remember a firefighter ever telling me something couldn't be done. During my most challenging MCIs, whenever I've asked FD for assistance, manpower and equipment have materialized almost instantaneously. I can also remember being spared indignity, and perhaps even disability, by thoughtful firefighters who loaned me protective gear when vehicle windows and posts were disintegrating around me and my patient.

     I spent only one of my 17 years in EMS working for a fire department. What impressed me most about that organization was respect for the chain of command, conscientiousness about training, regard for tradition, and recognition that family and friendship are essential ingredients in managing any stressful occupation. Those of us in EMS-only agencies might absorb a lesson or two from those traits.

     We haven't always agreed on priorities, but to paraphrase author William Safire, "Collective opinion, when crystallized, can make history."

     I've appreciated the opportunity to hear and be heard, to disagree in an atmosphere of mutual respect and to debate without allowing egos to trump issues. Thanks to you, I'm a better medic and a better manager. I won't stop trying to give you a return on your investment in me.

     I can't imagine not being part of EMS. Sure, I gripe sometimes about long hours and low pay, and I dislike the daily lumbar-limbering that allows me to remain vertical, but I've had one heck of a good time. At the end of the shift, when the catecholamine-fueled intensity of in-your-face illness and injury subsides, and I ponder the latest round of risk-taking, I'm grateful to colleagues who caught my mistakes, solved critical problems and were partners in patient care.

     Mike Rubin, BS, NREMT-P, is an EMS educator and consultant based in Nashville, TN, and a member of EMS Magazine's editorial advisory board. Contact him at mgr22@prodigy.net.