10 calls today starting with two minutes after the moment I laid my head down after checking my gear. I’m on my fourth different crew of the day and I admit I am getting cranky. The goal is to reach a zen-like state where you can do each call 100% with full attention and senses focused on the patient and the evolving scene. I can't always do that.
No spectacular calls, just the drudgery of EMS -- falls, motor vehicles, refusals, anxiety, vomiting, chest pain, COPD, fevers.
There’s nothing like having a great partner, someone who knows your every thought and movement. When you work with so many different people, you have to become your own best partner and that means preparation, knowing your equipment cold, laying out what you need -- making certain the 02 is always full, there is a nebulizer in the house bag, a Johnny on the stretcher, enough electrodes in the monitor to do a 12 lead, a towel on the pillow so you can drape a patient's head before carrying them out into the cold, your IV tray is fully stocked -- all little things that make the call run smoothly in spite of itself.
Preparation. If you want to stand tall, you want to set an example of how a paramedic should be, you have to be prepared. Always.
The great fighter Joe Frazier had a saying:
"You can map out a fight plan or a life plan, but when the action starts, it may not go the way you planned, and you’re down to your reflexes – which means your training. That’s where your roadwork shows. If you’ve cheated on that in the dark of morning – well, you’re getting found out now, under the bright lights."
You need to do the road work. No "opps I forgot to check that" or "I never studied that, I didn't think I'd encounter it." It's hard being prepared. I'm not always, but I want to be. I want to learn from my mistakes. I want to be continually better. When you are and a call goes well, it's a good feeling. You can stand tall.
***
I am still recovering from a case of bronchitis that laid me out for two days last week. I was a pathetic coughing feverish wraith of a man, subsisting on cold meds and ginger ale, and memories of once being able to stand on two feet. Now I am like a man returned to earth for a second chance, trying to make the best of it, a long way off from the days of feeling ten feet tall and bulletproof. I want to humbly go through my day being the best I can, and if I can't be great, at least I will have done my best. I am not close to this, but I want to be.
***
One of our patients today was a powerful captain on industry struck down in recent years by CVAs, broken hips, coronary artery disease, pneumonia, and the onset of dementia. He was surrounded by personal staffers who tried to tell us how to move him and repeatedly told us to be careful. One woman -- the personal secretary -- was very meddlesome and patronizing. In the ambulance on the way to the hospital, the man grabbed my wrist with his still powerful grip and looked me in the eyes and muttered something I couldn’t understand. His breath was foul from his GI vomiting earlier, his tongue black and stained. “Sir?” I said. He muttered again and nodded. I still don’t know what he was trying to tell me, but it felt like he was trying to share some important lesson he had only recently learned, maybe to give me a warning.
Another call was for a man who slipped out of bed and needed help getting back in. He had COPD and skin fungus, and was short of breath from the exertion of us picking him back up. He didn’t want to go to the hospital. His companion, who was also his power of attorney, signed the refusal. My partner and I remarked afterwards how many male couples there were in town, older men, who had spend most of their lives together and were helping each other even though they probably never imagined themselves or their lovers in such poor health, just like everyone else. The family in whatever form is what it is about – people standing by each other.
Overtime shifts are still hard to come by. I’m looking at four days off ahead. Instead of lying in bed, I hope to be productive. Cleaning the house, working out, writing, spending some time with my girlfriend, playing with her kids, and maybe later even seeing a movie. The Oscar nominations just came out and every year I try to watch the best picture nominees. The one I most want to see is Clint Eastwood’s Japanese Letters from Iwo Jima. He made Flags of our Fathers in English about the men who raised the flag above the sandy rocky island, and then made another movie from the Japanese point of view, about the men left on the island to fight the Americans, men who knew they would die – that there was no escape.
I think I am also going to go and buy a CD. I’m thinking about Neil Young’s new album, including the angry anthem “Looking for a Leader.” At the end of the night I will have a beer and crank the stereo, and let loose some air guitar.
"Looking for a leader to bring our country home..."
I admire people who try to do the best they can, who are not buffons at their jobs, who don't coast through life, people who are out doing their roadwork.
"Walking among our people, there's someone who's straight and strong...to lead us from desolation and a broken world gone wrong..."
Neil Young. Still Rocking.
"Looking for a leader with the great spirit on his side..."
