Administration and Leadership, Columns, Special Topics

Working as a Magnet

Issue 10 and Volume 40.

They’re among us—always. They appear to be just like you and me. They have the same amount of training, work the same hours, eat the same fast food, breathe the same air, wear the same uniform, speak the same language and walk the same walk. But in reality, they play the game of EMS with a different deck of cards (9-1-1 calls)—mind you, not as charlatans with a deck purposely stacked in their favor. No, despite mathematical improbability, these cards seem to be dealt unevenly in their direction.

There’s no particular rhyme or reason as to why these cards, no matter how well shuffled, fall into their hands. There are no lucky trinkets, no special underwear they wear, no rituals they practice. It doesn’t matter which shift they’re on: night or day, weekdays or weekends, winter or summer, full moon or no moon, holidays or workdays. It matters not if they’re old guard or newbies, for they are the chosen ones. They are the magnets.

We call them magnets because they’re pre-destined to be dispatched to calls of an undesirable nature (or desirable, depending on your cup of tea) that are much more extreme than the normal, run-of-the-mill 9-1-1 call. A MAGNET (Medic Attracts Gravis Never-Ending Tragedies) is usually expressed as a two-word euphuism to denote a stronger, undesirable negative connotation, but for my editor’s sake, I will leave that s—- out.

Most of us have experienced a time when there was such a continuous string of bad calls that when other medics were assigned to work with us, they instinctively lined their pockets with two dozen 14-gauge angiocaths while inserting copies of their personal advanced directives under their bulletproof vest. For me, those were some of the worst and best of times. Despite the tragedies that had befallen others, my skills as a medic were never sharper and, yes, I thrived on the adrenalin.

To be honest, bad calls for the most part were in reality good calls. Never have I felt more alive than when I was so close to death. I would also feel guilty that others had to suffer for me to reach that level of exhilaration, but I also rationalized that bad things were bound to happen to people, so why shouldn’t I be the one to practice the art of emergency medicine I worked so hard to perfect?

Some EMS providers have been magnets for a long time—sometimes years—while others have only periodic moments of magnetism lasting a week or two. But either way, it’s during those times when great war stories become permanently warehoused synaptically—and continue to be referred to for the rest of one’s life.

Our adrenals, despite the evolutionary process, never really lost their selfish need for relevance in a world that was once filled with peril and no Starbucks. They despise the comforts of a modern age where survival doesn’t depend on one’s ability to fight or flee. And once you become a magnet, the adrenals yearn for more. But even magnets have their moments when their plethora of colorful triaged red can fade to a dull green—a welcome respite from it all as long as it’s temporary. If dejected for too long, the adrenal glands begin to resent their now-deprived hormonal influence, tamed by the return of routine day-to-day transport of stable patients.

This brings me to another type of magnet out there. Opposing in nature, these magnets (My Ambulance Gets Nothing Except Tedious Senselessness) are a reversed polarity to bad (good) calls. They repel any prospect of coming in contact with any patient truly requiring emergency medical care. Also known as KOLs (Kiss Of Life), these guardians bring an aura of peace and harmony wherever they happen to be stationed. Skills become atrophied and the lack of motivation to move forward in learning until the next string of good call comes along can even make it hazardous for others, especially if a crew gets to the point of such frustration that they purposely turn their siren on just as a pedestrian crosses in front of their ambulance grill in the hopes of creating an acute adrenalin-induced cardiac arrhythmia.

I began to write this article two weeks ago out of the pure frustration of being a KOL magnet for the past several months. Ironically, every time I now try to sit down to finish it, I get toned out for a call adrenal in nature. Is there a happy medium between the KOL magnetic and s—- poles, or are we all doomed to be 9-1-1 bipolar? I’ll let you know after I get back from this call.