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.

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