Dante and Virgil in Hell

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In the old days, we would have quarters to retreat to and many distractions from one-on-one interaction. Whether it be chores, fire inspections, drills and training, or just TV – at least one wasn’t forced to interact with their partner all day.  Times have changed and employers are getting more calls out of their medics through that great invention of System Status Management.  Consequently, we spend our entire shift locked in a cage and chained at the hip to our partners.  Depending on the situation, this can be a good thing, or a bad thing.

Assuming you draw a good partner, a friendship usually unfolds and going to work can  be quite pleasant.  However, given the opposite situation, this doesn’t always work out so well.  How does one deal with endless minutes, hours, and shifts with the partner from Hell?  Dismiss the fact that we all have bad days, and overlooking some minor personality defects – which we all possess, what do we do with people who are just plain hard to be around?

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We can’t keep doing things the way we’ve always done them, or we’ll keep getting the same results over and over again.  That’s called insanity.  We have to keep moving forward.

I ran my first EMS call in the early 70s.  I’ve been involved in this profession since I was a teenage, snot-nosed, kid.  Those early days of EMS were incredible.  CPR, Hurst Tools, Advanced Life Support, and even the 9-1-1 system brought radical life-saving to the prehospital setting.  But now I have to ask, what have you done for me lately?

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Study of a small girl with a prize Scottish terrier dog, c. 1935 / by Sam HoodThree times in my career, I’ve treated small children who were accidentally backed over by the family car. These kids are so small, so mobile, and very quick – in a heartbeat they are where they shouldn’t be.   It’s made me very cautious when backing my car around my kids. Usually, I just bring them into the car with me – that way I know where they are.

The first kid I saw that had been backed over was in a retail parking lot. His mom had run into the store really quick and the kids took the opportunity to get into mischief. First the three-year-old boy got out of the car, then, coincidentally, his older sister took the car out of gear. Upon our arrival, we found the boy lying in the parking lot, crying. As I bent down to assess him, he began projectile vomiting – which is a terrible sign for someone with a head injury.

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The real you by =Sha-X-doW on deviantART

There used to be a downtown “hotel” that was notorious to street paramedics.  Located on N 2nd Street, between Main and Oak, across from the Salvation Army.  We knew the address well, and unfortunately, we were often there at least once per shift.  Paramedics in large cities probably have numerous places like the Home Hotel, but in our city, during the 70s and 80s, few places rivaled the desperation one would find on the second floor of this transient venue.

As a young, naive EMT (not quite a paramedic), I had much to learn.  My first call to the Home Hotel was an eye opener.

The call came in just before shift change, about 7:00am. My partner and I were in a bleary-eyed stupor from a night of sleeplessness, brought on by the constant needs of a city that never sleeps.  She gave me no warning of what I was about to encounter – not to surprise me, but because it was so normal – at least to the medics who worked downtown.

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Update: Check out this interesting discussion at EMS1.com

When I first began my medical career, I would get nervous around exposed patients.  I was young, full of testosterone, and very curious about the opposite gender.  It made me all hot and bothered, but other care providers would tell me that it wasn’t an issue for them.  “We’re all professionals,” they’d say. “It’s really not an issue.”  So, why was I so bothered?  Was I not a “professional?”

Maybe I was just a loser?  Maybe I was a pervert?  Maybe I was just weird?

I remember taking a 21-year-old unconscious female to the local trauma center.  She was attractive, and just a year or two younger than me.  As I gave my report to the receiving staff, they stripped this young woman down to her underwear.  I got distracted by the polka-dots. But when I looked up, one of the nurses was glaring at me.  Oops, the patient wasn’t the only one exposed.

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Don´t shoot me in the face.I think one of my biggest frustrations is when people fail to see the bigger picture.  When a system plays out, just the way it is designed to operate, why do we blame the people who are merely actors in the process?  Why do we shoot the messengers?

For example, there are 30-40 million people in this country without health insurance.  Many of those people are good, respectable individuals who find themselves in a difficult, and possibly temporary, situation.  Others have been raised within a culture of poverty – social, spiritual, cultural, and financial poverty – they don’t know any other way.  It isn’t their fault they are in the situations they find themselves, and they don’t know any other way out.  Why do we blame these victimized people for the using the only system they know?

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Photo by: Michael Ferrari - http://www.flickr.com/people/bunshee/

Photo by: Michael Ferrari - http://www.flickr.com/people/bunshee/

Time stood still as I stood motionless in the stranger’s apartment.  It was beautifully furnished.  There was a baby grand piano across the room with a silver tea set carefully placed on an expensive table-cloth.  Exquisite furniture, expensive carpets, and decoration only found in the most expensive homes.  Yet, here on the floor, lay an elderly woman in her night-clothes.  She looked very peaceful.

I was a young, eager, and very inexperienced EMT. Not yet a paramedic, that would come several years into the future.  Now, on this quiet Sunday morning in, I stood in a luxury, retirement, high-rise building in the 16th floor suite of a very unconscious, peaceful elderly woman.  My senses sought desperately to keep up with the scene unfolding around me, but my body remained motionless.

My partner on the ambulance that day was one of the first paramedics in the country, yet he was only a few years older than me.  His certification number was three – as in the third in the nation.  Bob carried himself with the nonchalance of the streetwise, the coolness of the experienced, and the cynicism of someone who has seen the darkest of the human soul.  I wasn’t his regular partner, in fact, I normally worked transporting people in wheelchairs.  This was just a fill-in shift – to prepare me for my future as a street medic.

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