Paramedic Students

 I remember when I was an EMT student doing my hospital observation time and watching the paramedics come into the hospital with their patients.  How confident they seemed.  I marveled at the ease with which they moved through this strange new world.  I held them in awe as I did the paramedics I later rode with during my paramedic ride time.  They knew the secrets I wanted to know, they had succeeded in the world to which I aspired.  I wanted to see what they had seen, to be able to able to handle what they could handle, to stand ten feet tall in the midst of the shit, to have my own swager.  They were mythic characters to me, and I wanted to be worthy of them.

I write this now after rereading Lights and Sirens, Kevin Grange’s new memoir about going through UCLA’s paramedic school and doing his ride time on the streets of Los Angeles.  It has been so long that I was in EMT class, and then several years later paramedic school that I have forgotten the stress, and forgotten the perspective of the new man trying to be worthy.

Grange’s book, which should be essential reading not just for those new to the field and those going through the unique experience of paramedic school, but for people like me and those I have worked with for years to help us remember not only what it was like to be new, but to recognize the ability we have to shape and help those who will soon to be riding alongside us, and for some, riding the streets after we have done our time and faded away.

Some of the people I rode with were real dickheads.  I remember one guy gave me one try at an IV, and when I missed, condemned me to observing for the rest of the shift.  I watched him do IVs and then jam the needles in the bench seat.  I remember he chased a “seizure” patient right off a scene, yelling at him to never fucking call an ambulance again.  “You again?” were his first words to the guy.  Another young woman kept syncopizing, and when I insisted we do a 12-lead ECG, he told me not to speak if I couldn’t recognize bullshit for what it was.  Halfway though the shift, a supervisor came out and told him a hospital had complained about his attitude, to which he swore at the supervisor, who told him to just play nice.  I hadn’t yet understood that sometimes ambulance services needed paramedics in their ambulances more than they needed good ones.  I hadn’t yet heard the term “meat in the seat.”   At the end of the shift, he wrote a short (two words) negative comment on my evaluation sheet.  Rather than turn it in, I threw it away and lost credit for those 12 hours.

Other paramedics I rode with were great.  They coached me through intubations, explained the difference between asthma wheezes and cardiac wheezes, and showed me the value of holding a patient’s hand, and attending to loneliness with the same commitment as I should attend someone with a gunshot wound.  To this day, they shaped the way i view this job, and I am forever grateful to them.

More than twenty years later, I know now that paramedics aren’t special.  We are just people like anyone else.  We have good ones and bad ones, gifted ones and others who just never stop working hard to be better.  No matter what profession or line of work you enter, there are people who will be dickheads, others who will be kind, and others who will be a mixture of both.  Angels and psychopaths can be found on the paramedic streets.  There are more of the former than the later, but neither is an oddity.

I have had a lot of new partners lately.  Between my two jobs -- as a paramedic and a hospital coordinator, I work 70 hours a week, and it leaves me perpetually worn out when I add on top of that being a father to three girls and trying to keep in shape at the pool.  I like nothing more than to come into work and see my regular partner Jerry, so I can go through a day not having to worry about anything.  But two months ago when we had a precepting paramedic with us, we were short cars so they pulled Jerry to work with a new guy in another ambulance who didn’t have a partner and they let my preceptee and I work alone together.  Jerry and the new guy were doing a carry down and the new guy didn’t know what he was doing and Jerry, in compensating for his partner’s mishandle, ended up with an arm injury that has kept him on light duty.

I have found myself being very grumpy to some of the new folk.  I don’t say much, and don’t like being asked if I have any hobbies or what my plans are for after work if I have already answered the first fifty attempts at conversation with monosyllables.  I feel bad sometimes that I am not always gregarious.  Jerry gives my new partners for the day a talk about what to do to get along with me.  Don’t worry if he doesn’t talk to you,” he says.  “Only worry if he says ‘What are you doing?’” That is as close to a swear as I will come to.

I clearly have forgotten what it was like to not know the streets or where I was going, or not know how to get a stretcher in and out of a room, or how unimportant it is to ask someone who is having trouble breathing when they last ate as a lead-off to your questioning.

Once many years ago someone said to me when I was riding:  “Don’t bother to tell me your name because I have seen so many people come and go, I don’t have the energy anymore, you are just today’s rider. There will be someone else here tomorrow.“  I swore I would never be that guy.

Jerry told me some people are afraid to work with me.  I did not understand this.  I tell them you are just a regular guy, he says, but you intimidate them.  Do I really?  Have I become like the old bear in the zoo who the zookeeper has to give special treatment to, and who no longer has to perform for the visitors? I hope not.

I will say, while I may not always be overly sociable to my new partner for the day, who after all signed up to work with me and is getting paid, whenever I have a paramedic student, I do always go out of my way to be hospitable and show them the way.  Even if I am beat and tired to the bone.  I will never write “Clueless Fuck” on any one's evaluation.

All of this is an extended way of saying reading Grange’s book helped me remember what it was like to be new at this work that become my life, and the next time a student rides with me, I won’t forget that I should be a guide and a role model, and that being a good role model to an aspiring medic student is as important a part of the work as giving the patient the proper care.  I should probably also try to extend this to all new partners, even if they are only riding with me for a day.

Check out Grange’s book and remember what it was like in the beginning.