Monday, March 16, 2009

Truths (II)

EMS is not what they teach you in classes, in books, in school.

Or, rather, that is merely the surface of EMS, the way a history textbook's account of politics is merely the surface of the sweaty, ugly truth of marches and protests and speeches and backroom deals.

EMS is a journey, much like grief, with defined and common stages, and yet a differing experience for everyone.

EMS is opening a bar at 7am, rather than closing at at 2:30am, but getting just as drunk, stumbling tired into the daylight, cussing because now you'll sleep the entire day and get nothing done and you only have so many days off.

EMS is becoming comfortable with things than would have horrified you a few years ago, and finding wholly new things to horrify you.

EMS is an arranged marriage to a stranger who you will spend 48 hours a week with, locked in a box, in stressful situations, talking and eating and sleeping and laughing and fighting and working it out and fighting again and learning more about them and yourself than you ever wanted to know.

EMS is standing in the house of a stranger, telling his wife he's dead, and putting your hand on her shoulder or hugging her or making her a cup of tea, like you've been friends for years, because there's no one there but him, and he's three flat lines on a LifePak screen.

EMS is rolling into a trauma center with a critical shooting victim, more holes than you can count, walking right up to the senior attending trauma surgeon, and telling him, not asking but telling him that he needs to put this patient directly in an operating room, do not pass go, do not stop in the emergency department, and here's exactly why, do it now, sir.

EMS is pushing PLAY on the CD when the tones go off, cranking the rock up until it drowns out the siren, and cranking the radio up so you can hear Ops over the rock.

EMS is realizing that as much as you are there to help and care for your patients, you must help and care for yourself and your partner and everyone else in blue first, and learning that sometimes your "primary survey" will be their hands against the side of your bus as you search them for weapons.

EMS is walking into rooms or onto streets or into buses or onto planes with people who are dead, dying, bleeding, puking, crapping, coughing, and in many cases are just fine, and holding the same calm expression on your face.

And that's only the beginning.

Tuesday, March 03, 2009


We're all in National Registry refresher class. A fellow medic is giving a pretty solid lecture on cardiac physiology, with plenty of audience participation.

This may or may not be a good idea.

* * * *

Instructor: "So, what causes cardiomyopathy in young, healthy adults?"

Medic In The Next-To-Back Row: "Cocaine!"

Instructor: "Yes, indeed, that's one cause ... What about our elderly population? What causes cardiomyopathy in old people?"


Yours Truly, In The Very Last Row: "... Cocaine!"