20 Years

On June 22nd, 1993, I made a decision in my life that would ultimately shape it.  I needed to complete six hours of community service for high school as a requirement for one of my classes.   I had three choices locally- the nursing home, the library, or the volunteer ambulance corps.   I spent enough time at the library to know how boring that would be and I had done volunteer work at the nursing home and hated it.  I figured the ambulance corps sounded fun.

Little did I know how much that little decision about a six hour community service requirement would determine my path.  Here's a picture of me around the time I joined GOVAC and GOVAC 4 & 5 circa 1994:

Doing EMS work taught me several life lessons.  The most important, to me, was the sense of family.  This is something that stuck with me my entire career- we take care of our people- PERIOD.   The next was compassion- genuine caring and concern for people- recognizing we were seeing people at their worst and making the best of it.   One of my partners told me very early on- "don't care who you piss of as long as you are doing the right thing".  That sense of integrity in the face of criticism is perhaps one of my strongest traits.  Another important lesson- never take anything too seriously...while I joke around quite a lot- I will never quite follow this 100%.   I am serious about patients and honor, and unwilling to compromise on either.

I have guardian angels- Mark, Carlos, Bill, and Ben- whose lives were cut short by tragic circumstances.   I have had saviors too- people who came to my aid when I couldn't help myself.   I realized the people in my professional life all made an impact on me.   I have had the honor of working with some of the most talented and intelligent EMS providers, and training some of those who didn't bloom as expected.

I look back on my career, though it continues, and smile, cry, laugh, and shake my head at all the experiences that have made it up.  From babies being born to the dying breath of the terminally ill, I have seen a range of illnesses and injuries, people and personalities.  We never stop recalling the best and worst moments and never stop with the "war stories" because they can be an invaluable tool.

When I am asked "where were you..." for 9/11, Sandy, Katrina, Irene, the blizzards, plane wrecks, train wrecks...I know precisely how to answer.


My career has had tragedies and triumphs, medals and grievances, saves and losses, accidents, injuries, mayhem and calm- but it has certainly never been dull.   I have worked as an EMT, a mental health worker, a dispatcher, an instructor, and a leader- but have never forgotten my purpose- getting help to those who need it.  I think I've had a good career so far- how about you?

EMS Week

EMS Week for 2012 is Sunday May 20- Saturday May 26th.  This is an opportunity for all of us to celebrate what we do.  Whether it's agent get-togethers, open houses, or other events, CELEBRATE!  We are a unique and noble profession, and frankly should be out there showing off!

Happy EMS Week All!

The Importance of Dignity

A fellow provider's social media post reminds me of a former regular patient of mine.  They described bringing a patient they had taken before to hospice.  I'd like to tell the story of a retired USMC major general, who became one of those people that changed my life.

At the time, I worked for Hunter Ambulance, doing non-emergent transports primarily.  I was assigned to a call for  doctor's appointment at the local veteran's nursing home and it was there that I met "the general".  He was in a wheel chair, perfect high and tight haircut, with two flags on the handles of his wheelchair.  The nurse told me, "good luck getting him to go, he keeps refusing."

I approached him with a little apprehension, he seemed pissed off and disinterested in being transported for his MRI.  This is how the conversation went:

Me: Hello sir, how are you today.
Him: Oh great, another damn ambulance.  Are you as stupid as the last idiots they sent?
Me: I certainly hope not.
Him (with a slight grin): Well you're more clever.  Let me ask you this (pointing to the US Flag).  What flag is that?
Me (confused): The...American flag.
Him: Oh thank God the last dumb !@#$ that tried to take me out of here thought it was Puerto Rican.
I chuckled
Him: Now, for the real test.  (Pointing to the Marine general flag).  What's that one?
Me:  Well, if it's yours, it means you're a 2-star general.  I actually can't remember the difference between the Marine and Army version, though.
Him (beaming smile): Hot damn, young lady, you win the prize.  The dumb !@#$ I mentioned thought it was from Texas. It is a Marine flag, my dear, and now I will go with you.

We start wheeling him down the hallway.  The nurse looks at us baffled.  My partner had been getting paperwork and missed the exchanged.  As we walk, the conversation continued.

Him: You know what sucks?
Me: A lot of stuff.
Him (laughing): I like you.... What sucks is that three months ago I was commanding thousands of Marines, and now I can't even control my own pee.  Strokes are more evil than the damn Iraqi's.
Me: Wow!
Him: Don't ever have a stroke.
Me: I will try not to.
Him: Good.

As the trip progressed, he told me of the passing of his wife, his two sons who were Marine officers, and his daughter who was a NYPD Cop.  He was genuinely proud of his life and his family.  He told me of his military career, the places he'd been over time, and the best thing, he said, was "my Marines".  The thing that made me enjoy this call so much was his candor.  We delivered him to his MRI, and he requested us for the return trip.

That day, he was diagnosed with pancreatic cancer, which had metastasized to several other organs.  He resolved that, "If I can win wars overseas, hell if I don't wage war on this crap". We took him to almost all of his radiation appointments, with him requesting me and my partner.  He refused other crews twice, and waited for us to arrive.  One day I called out sick and my partner showed up with another person.  The general had my partner call me so he would have someone to talk to.  Over the months that followed, I saw him three days a week.  Every day, he had a huge smile when I walked in.  He met us at the elevators most days.

One morning, we were having breakfast and were sent code 3 to the veteran's home. The call came in as a cardiac arrest.  It was his room, and when we arrived, the nurse met us at the door.  There he was, clutching hands folded on his belly, having died overnight.  He had clearly straightened up his room, in perfect order.

I walked from the room crying, never realizing how much he had affected me.  He taught me the meaning of dignity, even in illness and the importance of maintaining one's pride at any cost.  When I went to his services, I was stopped by one of his sons, and he said "You must be the ambulance driver he talked about.  He thought you were a breath of fresh air."  It made me happy to know I changed him too.

RIP Major General!

Case Study #1

You respond to a street corner for a teenager in respiratory distress.  You find a 16 year old male sitting on the base of a light post having obvious trouble breathing.  He is 6'2" and 105 lbs, a "beanstalk" by his own description.  You exam findings are as follows:

• Alert and Oriented to person, place time and events
• Airway is patent and self-maintaining
• Breathing is 26/bpm with intercostal retraction and tripoding.  
• Lung sounds are clear, slightly diminished on the left
• Pulses strong, regular at a rate of 108 bpm.  He is slightly pale, but otherwise unremarkable.

His history is as follows:

• S: Shortness of breath
• A: Penicillin
• M: None
• P: A "lung problem" when he was 10.  He doesn't recall what was wrong, but it's not asthma
• L: Ham and cheese sandwich about three hours ago with a coke.
• E: He was horsing around with friends, shouted at one of them, felt a pop in his chest then became short of breath.
• P: Came on as described, relieved partly with rest
• Q: "It's just hard to breathe"
• R: Slight pain at the site of the pop, but no radiation.
• S: 2/10 for the pain, 8/10 for the trouble breathing
• T: "About five minutes before they called" (Total time 15 min)
• I: "I sat down and it was a little easier to breathe"

He is placed on the stretcher, and assumes the tripod position, even after being started on 100% Oxygen. His skin becomes slightly more pink on the ride to the ER.

What is your impression of this patient?