Have protected me from the bitter cold while treating the homeless,

Have stood and witnessed the joy of a mother at her newborn baby,

Have felt the tears of a daughter at the loss of her mother,

Have waded through victim’s blood to save another,

Have searched in the woods for a lost hiker,

Have kept my feet planted on top of buildings while treating an injury,

Have been soaked in the rain more times than I can remember,

Have protected me from glass and debris at MVCs,

and needles on the floor of a crack house,

Have been run over by students pushing stretchers and nurses pushing beds,

Have stood many hours at standbys,

Have walked through the smoldering ruins of a family’s house,

Have been suspended over 300 feet in the air,

Have straddled a young man while I did CPR and tried to save him,

Have kept me steady while I told a wife her husband had passed,

Have seen crime scenes and an unsolved murder,

Have fallen through the detritus covering a bedroom into a running fan while

treating and old woman,

Have sat on the floor during a few precious moments rest,

Have carried a child from the home where he was beaten,

Have seen the best homes and the worst hovels,

Have been spat, bled, and vomited on,

Have stood at your door whenever you called.

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...a frequent flyer when the ER Doc says:
“She’s Back!!! She was just here!”

My partner and I were having a moderately busy Sunday.  We were stationed out in one of the suburbs. Churches had just let out, and the sun was shining. It was cool, but not cold.  We had just returned from lunch when the pager went off.

“Medic 119, need you enroute to Local Restauraunt, 1234 Highway, Code 3. Unresponsive.”

My partner and I jumped in the truck, received the remainder of the dispatch and headed out.  The restauraunt was only a mile or two up the road.

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The streets are our purview and scope of practice.  Butting in where you aren’t wanted or needed only hinders patient care and makes an already stressful situation worse.  So unless you are a trauma surgeon and have all the necessary equipment to manage a patient on scene, LEAVE ME THE HELL ALONE!  I have the equipment, know-how, and I see far more of these things than you ever do!  I know when to grab and run and when to properly manage C-spine before extricating the patient from a four by four square.  I have very short on-scene times (twelve minutes from arrival to departure, including actually finding the patient), and I will manage my patient properly, regardless of how much you push.

If you want to help, let me know you are there and available if I need assistance, then back the hell out and let me do my job!  If I have to move you out of my way to manage and transport my patient properly, you are wrong!  Getting a case of the ass about it will only make things worse, especially in Alabama where you have ZERO control over me or my truck unless you have a Medical Cotrol Physician ID Number and are willing to ride in to the hospital with me as primary provider.

That being said, I really hate running calls at churches on Sunday Mornings!

Long before I was involved in EMS as a full-time job, I was volunteering at the local Rescue Squad.  At the time, EMT Basics and Intermediates were rarely hired at the ambulance service.  So I figured the best way to get my feet wet was to respond as a member of the Rescue Squad, not to mention the adrenaline rush of cutting someone out of a car and doing heavy rescue.

In our system, we have an Urban Responder Program.  It’s a volunteer organization that is part of the Ambulance service.  The volunteers are provided with BLS Kits, AEDs, and a responder car.  They respond to calls within the city to provide assistance or first response along with the ambulance.  The local Rescue Squad I was a member of also participated in the program with both rescue vehicles and the “administrative” cars. 

One night, while working as a member of this crew, we were called out to assist with a possible full arrest in the parking lot of a grocery store.  We arrived directly behind the ambulance and responder.  The patient was a lady in her late twenties.  She was lying supine on the ground where her husband had laid her.  It was dark, and there weren�t any streetlights nearby.  The ambulance crew approached and started their assessments.  I had been designated as the responder on the rescue truck.  I was green and quite nervous as I stood by in my turnout pants ready to assist.

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It was one of those nights when the ambulance never stops moving.  Call after call and it was already into the wee hours of the morning.  My partner and I had barely had time to eat, shoving it into our faces on the way to yet another call.

“Medic X, Need you Code 3 to 1234 Middle-o-the-Night Dr.  Possible Respiratory Arrest.”

My partner flips on the lights and siren while I shove the remainder or my hamburger in my mouth.  The unit accelerates as I copy down the information, overhead cabin light flickering.

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I was working a regular 24 hour shift with an Intermediate level EMT in one of the busier stations in town. It was early on a Sunday Morning when the call came out.

“Medic X, need you Code 3 to City Church. Possible Full arrest.”

We hopped into our truck and started Code 3 towards the call.

The patient had collapsed while walking down the halls during Sunday Morning Service. Church calls are always difficult call because the place is crowded with well meaning bystanders. Everyone wants to help, even if that means just holding hands and praying. The problem is, more times than not they are a hinderance. They stand crowding in to get a look, blocking your way and not leaving you enough space to breathe, let alone do your work. You can’t be rude or pushy, and people just seem more “politically correct” in church. This particular case was made even worse by the attendance of 1) A Nurse from somewhere I’d never heard of, and 2) An “ER” Doctor from somewhere in Tennessee.
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Before I continue, I must remind my readers that no matter how much education and experience Paramedics have, we are generally looked upon as bufoons and rednecks by every other medical profession. We are the only ones working in an uncontrolled environment and we are generally alone, so our histories may not be as thorough, and our bandages not as neat as in the controlled environment of the ER where there are six people to do every task. Not to mention the time limits known as “The Golden Hour” and “The Platinum Ten.”

So we pull into the Church lot and are immediately bombarded by several people directing us to the door. Hands waving, people trying to act like traffic cops, and some just runnning to and fro. All pointing in different directions. We manage to find the right door and pull up.

At that moment a woman (the Nurse) comes running to the truck and pulls my partner’s door open. She says “I am a nurse! Are you guys ALS certified and know what to do!?” We looked at each other, now knowing what we were in for, and jumped out of the vehicle.

The nurse still stood there staring at my partner, not moving. He looked at her and uttered one of the greatest lines I have ever heard: “We are everything, ma’am! We can do it all!” and pushed her aside.

We entered the church and found our patient surrounded by people. We pushed our way in and my partner set up the monitor while I searched for a pulse. About that time the second major obstacle approached.

“Why aren’t you shocking him?” He stated.

“Because we have to check his heart first.” I replied.

He looked at me and got on his knees and said “I am an ER doctor in Tennessee and he’s in arrest.”

I could well see he was in arrest by this point, but I couldn’t shock him yet because the stupid doctor was too busy talking to me, not to mention that no one would clear the patient. The “nurse” leaned over and started to give a compression. My partner was still clearing people and I looked her in the eyes and said, “Can’t you hear? I said CLEAR!” at which point she jumped back and I shocked him three times. That was the last I saw of her.

After I completed the shocks, my partner attempted the IV and I turned to find the good doctor rifiling through my bag, taking my laryngoscope and attempting to intubate. I was getting rather angry with all the distractions and obstacles at this point. I looked at him and I said “EXCUSE ME!!!”

He got up looked at me straight in the face and said “He’s anterior and I can’t get it. Just use your BVM” Like he even had the right to try. I looked at him and said “Do you have an MCP ID Number? Are you certified and licensed in Alabama?” He replied no to both questions. “Well then under Alabama State law I cannot take orders from you, so please back up and let me do my job.”

I snatched the scope and intubated the patient first try with no difficulty. The CO2 detector agreed with me. I began giving my drugs down the tube while my partner tried to keep people clear so we could get the spine board in to transport. The IV had been unsuccessful because bystanders wouldn’t stop jostling us around and my parttner blew the vein. Out of all those well meaning bystanders, not one would help keep the area clear.

(So far we are less than 5 minutes into the call)

After the first round of drugs (via the ET Tube) and CPR (Thanks to the Fire Department responders, not the “nurse") we got a pulse back in our patient. We secured him to the backboard and got the hell out of there so we could actually work on him.

We moved him to the truck and actually managed to get him loaded before the doctor hopped in the back of truck. He looked at me and asked “Can I do anything?” Looking icredulous I repsonded that we had it under control and asked him to leave the truck. “Can he not listen? Or is he just that dense” I thought. After all, we already had a full patient compartment with myself, the Fire Responder, and the patient. The doctor slammed the doors and then proceeded to berate my partner because he wasn’t driving yet!

The rest of the call went like clockwork. The patient lost his pulse and regained it several times. We managed to get the IV and gave several rounds of drugs and shocks enroute, and the ER staff worked on him for over an hour. In the end he did not recover.

“Medic X, I need you enroute for an unknown medical.”

Yet we hop in our truck and head off to the call, arriving within minutes.

A large, worried mother runs from her house screaming “My Baby! My Baby! He don’t stop cryin’!” So we grab our jumpkit and head for the house.  The mother, out of breath, tries to explain the situation.  Eventually we gather that the baby has been sick recently and she took him to the doctor.  He was given tylenol and the mother was told to make sure he drank plenty of fluids.  She was worried because he had been unable to “void” and had not stopped crying.

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This episode happened to me about a year ago.  It spread throughout the company grapevine and now it seems I am infamous for it.  Although some people don’t know exactly who it was, they all know what happened.  I can deal with most aspects of this job, but one.  The utter lack of respect given to us by other people in the medical profession.  Even CNAs and aides seem to garner more respect than Paramedics.

We had an out of town transfer to a rehabilitation hospital near Atlanta.  The patient was a seventeen year old boy who had been in a car wreck.  He had a few complications during his recovery, so they were transferring him to the rehab hospital.  The transfer went without a hitch and we soon had him settled into his bed at the hospital.

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The following story still ranks as the most tragic call I have ever run.  One of the worst things involved in being a Paramedic, the traumatic death of a child, took place. If that might bother you, please read no further. This incident occurred during my last days as a Paramedic student.

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