What Scares Me Most About EMS

I used to think the scariest part of EMS was getting started. I was 39 and about to try a new, physically demanding, minimally paid occupation. Sure, I had doubts. Did I really want to swap a spacious, climate-controlled office for a bench in the back of a truck? Could I adjust to partners and supervisors young enough to be my children? Would I look even half as good saving lives as Johnny Gage?

The answers were yes, mostly yes, and not without plastic surgery. Fine, but here I am 30 years later, facing a whole new set of prehospital challenges. I’m not talking about deadly viruses or gratuitous violence. If you’re expecting a rant about paramedics carrying AR-15s, you’ve clicked on the wrong column.

What worries me is ambulances—specifically, what happens the next time I’m on the stretcher inside one.

I’ve been transported before, including twice after working on rigs that collided with large objects. I wouldn’t say I suffered any major injuries, although my wife, Helen, claims I have even more mental deficits than before those wrecks. Such a kidder, that Helen.

Being an MOS counted for a lot among the crews that treated me. They must have figured that as long as I was alert enough to take my own pulse, our brief time together shouldn’t be complicated by “me medic, you patient” posturing.

Now I’m semiretired and living in a district that doesn’t know what I did for a living. If you came to rescue me, you’d find a remarkably unremarkable old guy who seemed too placid to be a hard-charging, card-carrying colleague. I’m sure I’d relate to you and hope you’d feel the same. Even so, I’d have a few concerns.

Nobody Listening to Me

One thing I’ve noticed about aging is that people pay less and less attention to me. You’re probably doing that right now, as you text your friends about this silly article EMS World just posted. I said, you’re probably doing that right now… Never mind.

If I promise not to micromanage my prehospital care, will you at least let me have a say about:

• Invasive procedures, especially anything you’re doing mainly for practice?
• Our destination? Being able to see my doctor without either of us needing a travel agent would be helpful.
• The music? I’m OK with anything that has a discernible melody.
• Topics of conversation? How about you postpone any talk of “releasing the Kraken” until my GCS drops below 8?

Clinical Errors

We all make mistakes, but let’s try staying on the right side of common sense: me by not bothering you when you’re figuring things out, and you by being appropriately aware of:

• Drug doses. Go ahead, use that calculator on your phone the way Apple intended, especially if you think decimal points are like commas.
• My anxiety. Just because you’re making my blood pressure go up faster than bitcoin doesn’t mean I need all the labetalol in your bag.
• My medical history. Do you know how much Tylenol I take per day? Neither do I, but it’s a lot. Give my liver a break and save that IV APAP for someone with less chronic pain.

No Pain Meds

Speaking of pain, I promise to tell you when I’m having lots of it. All you have to do is believe me and try to do something about it. Please don’t let paperwork, protocols, locks, seals, an impatient partner, or the number of minutes left in your shift interfere. Get permission if you must. In return I will freely admit I’m seeking drugs.

No Advocate

I may want someone to accompany me. I mean, besides you and your partner. No offense, but I don’t like being outnumbered when there’s so much at stake. Please don’t put my protector in the front unless she’s more frightened than I am.

An Indifferent Crew

Apathy is hard for me to accept. We won’t get along if I sense any of the following:

• You don’t understand who’s serving whom. It’s not my job to make your job less inconvenient. Even if you wish you’d never left that gig as an extra in a Bye Bye Birdie revival, at least pretend you don’t mind keeping me homeostatic for a few more minutes.
• You’re not up to date on modern medicine. If you’re the kind of responder who takes the same CME every refresher cycle just so you don’t have to learn anything new, I’ll wait for the next bus.
• You’re patronizing me as a senior, a medic, or a senior medic. I’ll know that’s true if you call me “chief,” “ace,” “bud,” or “pops.”

A Fatigued Crew

If you’re on the back end of an experimental 168-hour shift, please tell me, so both of us can lower our expectations. For example, don’t try anything on me you can’t literally do in your sleep. That should rule out everything more invasive than a nasal cannula. And if you start to nod off, I won’t mind switching places with you if I’m not in shock…or if you have an old MAST suit I can borrow.

No Time to Prepare

This one bothers me the most, possibly because of the time I was transported with a kidney stone in my underwear (how it got in my underwear, I’ll never know). I was discharged with a Dilaudid prescription and a pair of paper pants. It wasn’t a good look for me. I saw mothers pull their children closer as I left the ER.

Maybe I should keep an old uniform by the bed. It wouldn’t fit very well, but at least my caregivers would know I used to be one of them. I’d impress them further by refusing their stupid stair chair and racing them to the ambulance, where I’d check my own gag reflex and show them how to finagle an EKG with a pocket watch. Then I’d call in a hospital report on myself and tell war stories about prolapsed organs all the way to the ER. Be there in a few, Rampart.

See, this is what worries Helen.

Mike Rubin is a paramedic in Nashville and a member of EMS World’s editorial advisory board. Contact him at mgr22@prodigy.net.