Medic: Please place your hand, the one not holding your inhaler, on the book of Life-Saving Protocols while raising your other hand above your home O2 tank. Do you swear to tell the truth, the whole truth, and nothing but the truth so help your HMO?
Defendant: Huh? What the…
M: You are brought before this ALS crew based on your 9-1-1 testimonial declaration of acute respiratory distress. Is this affirmation correct?
D: Well, yeah. I can’t breathe.
M: We’ll be the judge of that. And please speak up. We can’t hear you over your inspiratory and expiratory wheezes.
D: My wife says my chronic obstructive pulmonary disease is aggravating my cold.
M: Objection! Do you have this material witness to provide a deposition to support your argument and who’s available for cross-examination? Remember, you’re under oath.
D: No. She’s shopping. (cough, wheeze).
M: Objection sustained. Why do you need to be transported by ambulance at this time?
D: I ran out of my prescribed oxygen and …
M: So, you’re admitting to negligence? Do you wish to amend your opening statements or risk being accused of perjury during this interrogation … er, I mean inquest?
D: Wha …? Hey! You’re an idiot.
M: Hostile witness! You, sir, may be charged with contempt of court and are in jeopardy of having your Medicare/Medicaid insurance garnished without the possibility of parole. Validation for transportation to hospital at this time is denied. Oh, and please sign our refusal and customer service satisfaction form on the way out. Have a nice day.
I was raised to believe there are two kinds of people: those who give and those who take. I associate a taker as one whose ambitions and definitions for success are inspired by a compelling drive to obtain power, attention and/or wealth. Maybe it’s an oversimplified interpretation, but I have met very few takers to prove me otherwise. Givers may still share some of the same values as takers, but the significance those values play in their own self-defined meaning for success are minimal. Givers share their wisdom and compassion in the service of others and are often under-compensated and have little recognition.
Welcome to EMS. I believe we all started with the same resolve to provide a service of caring for the health and well-being of our fellow man, without any strings attached. Yes, there are those who began their EMS careers as takers, only there to be in the hero limelight. They like taking control while focusing on building themselves up and tearing others down who don’t meet their judgmental standards. Thankfully they usually don’t survive long. Because only 8% of their time deals with true emergencies, they fade out, often bitter at a career that didn’t allow them to take more.
But what of the givers of EMS who have served their communities with honor and distinction over the span of many years? It’s hard, if not impossible, for the average citizen to comprehend the incredible toll EMS can take from the lives of these givers, both physically and mentally, for wages that are incompatible to what they’ve sacrificed.
Sadly, I have seen many of these longtime givers become takers. Satisfied to provide only their mere presence and no more, they’re now unwilling or unable to give of themselves as in years past. It’s no longer an aberration when “I’m here for the paycheck” becomes their new norm.
I get it though. I can no longer take on the high number of calls I used to brag about. The spirit is willing, but my body requires a smaller call volume. But when EMS providers want to be placed in the far outer regions of their districts (the moon) for the sole idea of avoiding all patient contact while maintaining the status quo of “You call. We haul. That’s all,” or “I’ve paid my dues. Just leave me alone,” they’ve switched sides.
In 1966, the National Academy of Sciences implemented what most experts believe to be the birth of EMS. Now we’re experiencing another groundbreaking development in our profession, known as mobile integrated healthcare (MIH), which will, like it or not, change the landscape of how we provide prehospital care. Many don’t like it and, please, I’m in no way implying the naysayers of MIH belong in the taker category. But, they’re takers if they go out of their way to fight those eager for change, if the first words out of their mouths are, “No way!,” if their minds are closed but their mouths are not. I doubt my words will even be read by these takers—it’s not in their current scope of practice.
To my fellow medics who’ve over the past many years given yourselves unselfishly and have sacrificed so much for our profession, I thank you wholeheartedly for helping make EMS what it is today. But if you feel you paid your dues and are at the point of only taking, it’s time to consider hanging up your stethoscope. There’s no such thing as paying your dues in EMS: You either evolve or die out. Don’t become the medic who’s only remembered for being the burnout of the squad. I hope you do evolve—you’ve given so much. That’s a given not to be taken for granted.