You know, I am not feeling EMS today. I think the discouragement is strongly related to the dread of the working weekend. Either that, or I’m in a rut. Or maybe both. I know that I’ve done a lot of good, but I can’t seem to keep those memories in my head today. The vast majority of the time, we never even find out if our efforts were sufficient enough to make a difference in the long run. Is the job getting to me? I know it happens to everyone, but the perky aren’t meant to be so dismal.
I can’t seem to shake the downers of the job. People are awful to one another. In just a few years on the job, I’ve seen more neglect and abuse than I ever thought I’d encounter in my life. I started this job with rose colored glasses affixed firmly to my face, and I honestly believed people were inherently good almost all the time. That is so clearly not the case. You only have to hold the hand of a 7 year old that is now blind, wheelchair bound, unable to speak, mentally stunted, and has daily seizures as the result of being shaken as a baby once to know there is unspeakable evil in this world. The moment you find yourself thinking that the son of a bitch responsible was even crueler for not killing the child is when you know you have seen enough versions of this child to make your own heart hard. You pick up an elderly woman off of the floor with a hip injury who is covered in her own urine and feces, as she has been lying there for two days as her son literally stepped over her conscious body just one time, and you know neglect is not a passive form of abuse. I know abuse and neglect so well, I bet I could pick out the night shift DSS guy’s voice out of an audio line-up. I know it almost never does any good, but I still call. I can never stop trying to end that kind of malevolence.
Then there’s the violence. I do not understand why people are so horrible to one another. I still give every abused woman the speech that she doesn’t have to live that way, and I mean it every time. I tell them that when he says he will kill you, he probably will one day and there is no reason to give him that opportunity. I give them the address and phone number for the women’s shelter. I know it’s futile, but I still do it. It’s far rarer, but I’ve given the same speech to an abused member of a same sex couple and an abused man in a heterosexual couple. Nothing is sacred and no one is safe, it seems. Just today, a friend told me that she had a pregnant patient with horrible oil burns on her head and upper body; apparently, a member of her family intentionally threw cooking oil on her. I’ve seen similar scenarios, too. Weapons come in all shapes and sizes, and so do victims and assailants. There are stabbings, shootings, assaults, poisonings, and all forms of viciousness. Regardless of what they said first, there is no excuse for intentionally hitting four people with your car in a parking lot. I used to find it infuriating, but nowadays I think it’s fucking depressing.
I also find the apparent constant threat and fear of litigation abhorrent, but it permeates my career. My coworkers seem to constantly speak of the CYA method of emergency treatment, and paramedics can’t initiate refusals because of it. Yesterday, an airline kept a child from boarding an aircraft to go home because she vomited. She is a scared child, in a strange country where they speak a strange language and have greasy food she can’t digest easily. She doesn’t feel well and did vomit, so there is obviously a risk in travelling under such circumstances. That stated, shouldn’t it be her mother who makes that decision? A disembodied voice on a telephone decides their destination fate based solely on the possibility of a lawsuit, however remote. No vital signs, no therapy, no evaluation, no context, no compassion, and no humanity, all for no lawsuit.
If I park my ambulance at a scene of a motor vehicle accident, and I see minor damage and people screaming obscenities at one another, my heart will sink. When I actually watch you scream at someone and hear you threaten to sue them, I have a difficult time believe your neck and back pain hurts nearly as much as your wallet does. My medical opinion is that you are a gold-digging asshole. I always try to calm people down and tell them we can replace cars, but not people. I tell them accidents happen every day, and one should be grateful cars take the majority of the force so our bodies do not. In shocking news, that doesn’t do any good.
I took a lady off a city bus once because she felt she was injured when the bus stopped…not was involved in an accident, but stopped. She said the bus stopped so abruptly, that the force thrust her forward and underneath the seat in front of her. One look at the space to which she was referring compared to her girth ruled that event as unlikely. The only possibility was that she would have had to have the supernatural ability to turn into another state of matter to extract herself, or we would have been spending that moment using pneumatic tools. Apparently, her entire body was injured. I suppose the pain in her entire body was from the cellular trauma of turning from a liquid back to a solid before I got there. I suspected she might have been attempting insurance fraud when she said, “I’m gonna get what’s mine from the city! Oooh, I can’t wait to go shopping!” Don’t worry, I reported all of it, even though I know it’s for nothing.
The generalized 911 abuse is enough to bring one’s spirit down on its own. On the way to a 911 call at the front of the hospital from which I had just left, I was informed by dispatch that a man was having extreme difficulty breathing. When I got there, he was sitting on a bench smoking a cigarette. I distinctly remembered seeing him get kicked out of that hospital 10 minutes before because he screamed obscenities at all the staff in the middle of the hallway because he was displeased with the lack of strong pain medications they gave him. I asked him if he thought it was appropriate to call 911 from a bus stop and telling the call taker he couldn’t breathe while he was smoking. He said, “I lied to them to get you here faster because I don’t want to wait for the bus.” I told him we would be happy to take care of him today, but we wouldn’t be leaving until we made a police report citing 911 abuse. I made the report, but we all know that won’t do any good either.
When the people who know they don’t need emergency services aren’t pissing me off, other medical facilities “turfing” their patients are. You are medical professionals, right? Right? RIGHT? You can’t be that dumb or that mean. You can’t think that the police are going to file a report against a man with dementia that shoved you when you told him he was stuck there for as long as you say he is. He has dementia and you are a horrible person. You can’t tell me that you “don’t feel like dealing with him today,” and expect me to take him to a hospital without contacting your supervisor. You should probably switch your career to a field without people or animals in it.
The one thing that has ground me down completely is the personal attacks. I have been called a bitch, a slut, a cunt, a whore, a dumbass, an idiot, a fine piece of ass, and my personal favorite, a hussy. I have been punched, kicked, kneed, head butted, nearly bitten, spat on, vomited on, shat on, and bled on. Look, man, you called me. Don’t call me names. Don’t assault or batter me. Don’t accuse me of trying to murder you. You snorted both heroin and cocaine today, and now you appear to be an extra on The Walking Dead. This is not my fault, nor is it the fault of my partner or the fire crew, all of whom you are trying to bite and kick and punch for no reason.
I will never instigate a fight with a patient, but some people are so full of hate and anger that I have to restrain them for their own safety. I spent 10 minutes trying to calm down a woman whose family called 911 after she got into a fight with her mother and was anxious. She was screaming obscenities, fighting, spitting, and name calling. Her whole family was an anthropological adventure, but she took the cake.
I told her my name and that I’m here to help, but I need her to work with me to try to calm down. She said, “Bitch, don’t be coming up in my house like you’re somebody.” I told her I am somebody here to help, but she was going to have to calm down so I could understand what happened that I can fix. Apparently, I said something completely wrong, because she became much, much more volatile and violent, and her mother called me a murderer.
I ended up giving her Versed to calm her down, which may be my absolute favorite medication to use. As we loaded her into the ambulance, I remember thinking that she was so much prettier when she was asleep, which is an odd thing to think. She was pretty much out the whole way to the hospital, but her respiratory rate started to drop a bit, so I gave her a light sternal rub. I knew then that she had far more hate inside of her than any one person should ever have to be exposed to; her first statement out of unconsciousness was, “Fuuuuuuck you.”
Along those lines, something I absolutely cannot stand is the accusation of ineptitude by people who have no idea what I do. If you don’t know what I do, please do not tell me how to do my job. I am not your local drug store; it is not ridiculous that I don’t have basic over the counter drugs. Some lady’s “recommendation” that I carry Neosporin does not matter to me at all. Personally, I recommend that you reserve your ambulance use for emergencies, but that clearly doesn’t matter to you, either. A bystander recently gave me a completely unsolicited “recommendation” that a person involved in a minor accident go to the hospital because her husband recently “almost died from a-fib.” Do what? What the hell are you talking about, lady? Strangely, I get asked from time to time by adults with full mental facilities, “are you a real paramedic?” Nah, man. I just wear this outfit because it encompasses my gang colors. And that is how I pimp my ride.
It is hard not to get particularly frustrated with all this while I know I’m missing out on things I’d rather not. My high school reunion came and went while I was on shift. That’s not a terribly big deal, but I kind of wanted to see who got fat. Plus, I was kind of a late bloomer and I would have liked to flaunt that the last decade has been kind to me. It’s silly, but true. It’s always a bummer when I miss out on social events. Tonight, friends of mine from college are getting together, but I’m at work. I want to do things like take night classes, but my schedule is not exactly conducive to functioning within the non-EMS world. I can live with missed social opportunities and hobbies, but the worst is missing family gatherings: holidays, graduations, birthday parties, high school sports, welcome home parties, and reunions. I don’t see how people with kids deal with this. I am very close to my family and lucky that they understand my work demands. This year, they had a mini-Christmas for me two days beforehand, and my mom and aunt chased my ambulance around the city to bring my partner and me Christmas dinner. I know how lucky I am, but it still sucks not to be there.
It’s not that I was born with a silver spoon and expect the world to cater to me. I never had a sheltered upbringing or was coddled. My dad is a drug addict with the kind of mind that shows genius and insanity are closely related. My mom is a single mom who held at least two jobs for as long as I can remember so that we could have luxuries like food. I was awkward, odd, and socially stunted. I kept myself surrounded by books constantly; they were such excellent vacations from reality. I had a weird childhood that turned me into who I am. I believed I could move mountains, make changes, and save the world. I am a girl who read comic books growing up and idolized superheroes, and now I have a job in which I literally save lives.
I guess I didn’t expect the toll it would take on me. I never expected I would constantly see under-education, malevolence, cruelty, ignorance, and rudeness. That was never in my plan.
You know what? I need a save. I’m way overdue.
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