I came into work yesterday morning and as I always do, switched ambulances. We have three rigs here, and each of the four regular medics are assigned their own (two share one). Every six months or so we switch assignments. Right now I have my own ambulance, but it is the oldest one. Very rough riding. As I get grumpier with each passing year, I find myself constantly wanting to say to my many partner, "Slow the F-- down!" Some partners are great drivers, others not too good. The ambulance offers a driving class taught by a police officer. It is all about defensive driving, keeping your eyes on the road. Etc. Sometimes I want to barge into the class and say, keep one eye on the road and one eye in the rear view mirror watching what is going on in the back. Am I standing? Am I about to stick an IV? Remember that Saturday Night Live spoof of the comfortable car ad where the rabbi does a circumcision in the back. Think about that. If you hit a manhole cover, I go airborne. If you slam on the brakes, I hurtle-slide forward. A week ago after one ride, my back was so jarred, I had to go lay down for an hour. I would gladly have payed Igor to strap me to a dungeon rack and turn the wheel to lengthen me back out. I had the ambulance sent down to the town garage to have the shocks checked, the radio repaired (bumps seem to jar the wires) and the stretcher mounts tightened.
My back feeling strong, and recovered after four days off the ambulance (four days at my clinical coordinator job) and with great hopes that the shocks have been repaired, I climbed onto my ambulance with the medic gear and did my weekly checklist.
The oxygen was bone dry. I wasn't upset by this. There is a leak and if the 02 isn't turned off after every call, the tank will eventually run dry. I got out and changed it. I am lucky most of my partners are good about changing the main, so I don't have to do it too often. We have a new machine that is supposed to make changing the main easier. It is a fancy contraption -- some kind of mechanical lift device. I like doing it the old fashioned way -- just muscling it, hauling out the one big green tank, and then lifting up a new one, getting it all switched over and strapped in. So I changed it. I turned the valve. 2000 psi. Good to go.
I get great satisfaction sometimes about the smallest things. I like to do my start of the week ambulance check, making certain all my equipment is in place and working order. The bulbs on my scope blades are bright, my monitor batteries are fresh, my drugs have not expired, and my ambulance IV tray, which I keep on the bench seat, has enough supplies to do 5 IVs (syringes, saline vials, saline locks, Venaguards, 4X 4s, assorted catheters, roll of tape, alcohol wipes, fresh tourniquet, and there is a bottle of ASA, a NTG spray, and a vial of Zofran all handy.
Nothing quite beats changing the main though for a reminder of the physical element of the job. (I prefer it to lugging 400 lb patients down narrow stairs). I like the manual work. Whether it is using brawn to ready the oxygen for the day's emergencies, using dexterity to insert an IV or using your hand to feel a patient's brow, the physical connects us to the world and our patients in an immediate way that roots us in the reality of our work and its stake -- peoples' well-being.
I know my work as a clinical coordinator is also important, but I don't think I could survive my cubicle if I wasn't able to get out three days and do work that seems more real than reading run forms or writing memos.
There is an interesting article in this Sunday's New York Times called The Case for Working with Your Hands. It is adapted from a new book by Mathew Crawford called “Shop Class as Soulcraft: An Inquiry Into the Value of Work.” Crawford is a former office worker, who now makes his living as a motorcycle mechanic. The article may be about a motorcycle mechanic and his philosophy of work, but it could as well be about a paramedic who finds meaning in his work.
Here's how it begins:
The television show “Deadliest Catch” depicts commercial crab fishermen in the Bering Sea. Another, “Dirty Jobs,” shows all kinds of grueling work; one episode featured a guy who inseminates turkeys for a living. The weird fascination of these shows must lie partly in the fact that such confrontations with material reality have become exotically unfamiliar. Many of us do work that feels more surreal than real. Working in an office, you often find it difficult to see any tangible result from your efforts. What exactly have you accomplished at the end of any given day? Where the chain of cause and effect is opaque and responsibility diffuse, the experience of individual agency can be elusive. “Dilbert,” “The Office” and similar portrayals of cubicle life attest to the dark absurdism with which many Americans have come to view their white-collar jobs.
Is there a more “real” alternative (short of inseminating turkeys)?
High-school shop-class programs were widely dismantled in the 1990s as educators prepared students to become “knowledge workers.” The imperative of the last 20 years to round up every warm body and send it to college, then to the cubicle, was tied to a vision of the future in which we somehow take leave of material reality and glide about in a pure information economy. This has not come to pass. To begin with, such work often feels more enervating than gliding. More fundamentally, now as ever, somebody has to actually do things: fix our cars, unclog our toilets, build our houses.
When we praise people who do work that is straightforwardly useful, the praise often betrays an assumption that they had no other options. We idealize them as the salt of the earth and emphasize the sacrifice for others their work may entail. Such sacrifice does indeed occur — the hazards faced by a lineman restoring power during a storm come to mind. But what if such work answers as well to a basic human need of the one who does it? I take this to be the suggestion of Marge Piercy’s poem “To Be of Use,” which concludes with the lines “the pitcher longs for water to carry/and a person for work that is real.”
