Pick one

“Unit whatever to radio.”

“Whatever, go ahead.”

“Yeah, we need a second unit out here for an additional patient at this MVC.”

“Do you need that other unit emergency or non-emergency?”

“That depends. Where are they coming from?”

Wrong answer.

Distance has virtually no bearing on how an ambulance should respond. I don’t care about response times, and I don’t care about the company meeting their response time goals. Your patient can either a) wait just a little while to go to the hospital, because they aren’t dying right now, or, b) needs to go to the hospital five minutes ago, and you can’t take them.

Pick one. 90 percent of our emergent responses are bullshit anyways.

Listen and learn

Newguy is out today. He and his wife are finding out the gender of their new baby, so he is going to the appointment. Well, Mrs. Newguy says they aren’t going to find out, but Newguy says he is going to cheat and sneak a peek at the ultrasound. He even has a plan and everything for how he is going to do it.

Nobody tell Mrs. Newguy, okay?

I’m working with a kid today. I did the math, and he was in diapers when I started in EMS. And he already has a bad attitude.

There is a difference between burned out and a bad attitude.

We get a call for a lady who is sick. It turns out the lady is visiting her daughter from Oregon, and has been confused, febrile, and weak for the past few days, and it is getting worse.

Daughter hands me an insurance card and says she needs to go to the hospital about 45 minutes away. While she is saying this, Babyface pipes in.

“Well, we could take her to Local Hospital, and they can just transfer her if needed, but they will probably just let her go if she just has a fever.”

Daughter looks excited, then goes on to explain that the sick lady is allergic to Tylenol and Penicillin, and has a diagnosis of primary biliary cirrhosis. No other medical problems though, which is good for a grandmother in her late seventies.

Finally we see the patient. She’s confused, sure enough. She’s pale, and the jaundice is pretty apparent in her sclera. (What is the plural of sclera? Is there one?) So, she’s sick, and probably needs to spend a day or two in the hospital for some IV antibiotics.

“Okay, we’ll take her to Westside Hospital. We are going to go bring our stretcher in here, and we’ll be out of the way.”

Babyface is absolutely apoplectic. “Why can’t we just take her to Local Hospital? It’s across the street. Westside is forty-five minutes away.”

I get stern with him. “I know where we are, and I know where the hospitals are, and we are going to take her to Westside Hospital.”

Later, at Westside, he decides to assert his position once again.

“Man, we should have just taken her to Local. This doesn’t make any sense.”

“What is primary biliary cirrohsis?”

“She’s probably an alcoholic, and she drank too much, and now her liver is shutting down.”

“Wrong. What is the first thing that comes to your mind when you hear that a person is confused, weak, and febrile?”


“Fair enough. Does the diagnosis of primary biliary cirrhosis change that? You still thinking sepsis? What about her jaundice?”

“I don’t care about her cirrhosis, she just has a fever.”

“No, her ammonia levels are high, and she needs lactulose. She is very confused, and only responds to verbal stimuli, which suggests hepatic encephalopathy, and she needs an ICU. Taking her to Local Hospital would have been a bad decision, and a waste of time.”

He was still mad at me for the rest of the shift.

I don’t chase patients

A call for a person “out of their mind.” PD is already there.

“He’s crazy.”

“No joke. The dispatcher told us that. Why does he need to go to the hospital?”

“His mom wants him evaluated.”


“He’s crazy.”

I’m getting nowhere with this guy, so Newguy and I walk into the house and find the alleged patient and his mommy. The patient is in his mid-thirties, so I don’t know why he calls her “mommy” but who am I to judge?

“Ma’am, why does your son need to go to the hospital?”

“Because he’s crazy.”

I don’t even bother asking again. I just turn to the dude on the couch.

“You ready to go?”

“I guess.”

Cut to 10 minutes later, going down the road. The dude on the couch, who is now the dude on the stretcher, hasn’t said a word. He won’t answer my questions, or talk to me at all, so I’m just sitting in my chair catching up on paperwork.

The ambulance comes to a stop at a red light. Newguy is listening to a Handel on the Law podcast, and I’m kinda trying to pay attention to that.

‘Click click click.’

Before I look up, dude on the stretcher is now dude jumping out the back door. He takes off like an NFL running back with an open field in front of him.

I mean, he is gone.

“Med four radio.”

“Med four.”

“Show us ten-eight. Our patient left the ambulance and ran. Maybe PD might want to look for him.”

“Which direction did he go, med four?”

“I think north.”

“You think?”

“Yeah, I don’t chase people.”

The dynamic duo is back

Slimm and I are going to be partners again.

We had to pull a lot of strings, call in some favors, make some offers, and do some shift trading, but we made it happen. A well-executed plan is quite something to be a part of.

I’ve enjoyed working with Newguy for the past few months, but I need to be back with my partner.

I wasn’t going to last much longer without Slimm.

We are already planning on hugging it out before our first shift back together.

I’m very happy.

Sometimes we pick up chicks

Somebody got tased by the long arm of the local law. Which means, of course, that an ambulance has to ‘check him out.’

Which means, of course, that we turn on the lights and sirens because someone requested our service.

Policy, you know.

Also, because an ambulance is going, the fire truck is going as well. In case, you know, the person is actually on fire. We generally can’t trust police officers to determine whether or not a person is on fire, so we might as well cover all our bases.

The dispatcher hasn’t finished reading the call to us before I stop paying attention and go back to my book. I’m reading The Pillars of the Earth again. I’m at the part where Aliena is about to marry Alfred.

“What are we going to?” asks the student third rider from the back seat.

“The cops tased some guy. Probably bullshit.”

Like all the other calls.

Sure enough, there’s a guy sitting in the back of a cruiser with taser barbs sticking out of his back. He is obviously not an upstanding member of society, and probably didn’t finish high school, judging by his lack of a vocabulary. He’s being such an asshole that I wish we could tase him again just to shut him up.

He’s even being a dick to me as I take the barbs out of his back.

Newguy goes to apply some band-aids to the puncture wounds on the patient’s back.

“Man, I don’t want no damn band-aid!”

“Tough. I don’t want you bleeding on Officer Nicely’s car.”

“Man, this is some bullshit! All this over a dirty ass hoe!”

We glance over to the alleged dirty woman when this rude man with holes in his back informs us of the reason for the argument, which resulted in the assault charges he now faces.

“Man, that bitch gave me HERPES!”

Newguy doesn’t miss a beat.

“So you’re saying she’s single now?”

Hurry up and wait

“You guys want to do a SWAT standby?”

“Uh, is the Pope Catholic?”

“Okay, head over to PD headquarters. Briefing starts in fifteen.”

Forty-five minutes later, no briefing. That’s fine. Newguy and I are flicking a paper football across a desk. He’s winning.

Finally the briefing starts. Some guy got mad at another guy for talking to the first guy’s girlfriend, so he punched him, then the first guy stabbed the second guy with a screwdriver and killed him. Now there is a murder warrant, and these nice fellows are going to persuade first guy to come spend some time with them in their Iron Bar Motel.

All over a girl.

Three hours after clocking in, we leave PD headquarters. My stomach rumbles, reminding me that lunch time is fast approaching. I’m always hungry though.

PD makes us stage at the entrance to the neighborhood, not too far from the suspect’s home, but not visible. Except to the dozens of cars entering and leaving. We are hanging out with some fire guys and PD officers. At least the weather is nice.

“We are looking to go in about an hour.”


Now I’m really hungry, but we can’t leave. I make an executive decision and find a phone number after a quick Google search.

“Hey, what do you like on your pizza?”

“Black olives and tomatoes.”

“On it.”

The pizza shop guy takes my order, and seems confused when I tell him I am at the entrance to a neighborhood. “I’m one of the two guys in white shirts, by the ambulance. You can’t miss it.”

The pizza was delicious.

And after thirty minutes of strongly-worded warnings from police, a door being kicked in, and swift SWAT action, the call is over.

The perp wasn’t home.

Best five-hour call ever.


No comprende’

A call for a “person choking” at the nursing home, in the “Memory Care Unit.”

Caring for something that isn’t there any more.

On the way in, we walk through the obligatory keyed-entry door, and Newguy points out a sign just inside the unit.

“New Memories Made Here!”

Kinda ironic.

A crowd of people is gathered around an old feller in a wheelchair at a dining table. Sure enough, he’s choking. As in, not breathing. He’s blue, but looking around. Close to death.

Newguy springs into action like some sort of caped superhero, sans cape, and performs a few abdominal thrusts. Our patient becomes unresponsive, and we move him to the floor, when I swoop in like the superhero’s sidekick with my trusty laryngoscope.

“What the hell is that? Bro, hand me the forceps real quick.”

There’s something in the airway, sho’ nuff. And I’m about to get that junk out.

The forceps go in, grab the food bolus, and I withdraw it slowly. As the food comes into his mouth, the patient starts to gag, cough, and miraculously, his skin changes color. This guy might be a chameleon.

I look at Newguy. “Just who is the sidekick NOW?”

Somebody examines the food bolus, and quickly deduces that it is roughly two-thirds of a lightly chewed Nutter Butter bar.

“Who gave him the cookie?”

“I did.”

“His arm band says ‘Nectar-thick liquids only’.”

“Oh. I didn’t know. I don’t read English.”

Jimmy Swaggart

A 70-year old female at the assisted-living facility who might be having a stroke. 20 minutes before my end-of shift. Great.

Our local fire-putter-outers are on scene, and they seem to be pretty convinced that she is not, in fact, having a stroke. I know these guys pretty well, so I’m not concerned when I see them standing around, chatting.

“Ma’am, what’s going on today?”

She yells at me. “I told these guys that I’m having a stroke!”

The mustachioed smoke jumper chimes in. “Why don’t you just tell this incredibly handsome, exceedingly nice, overly qualified, life-saving paramedic what happened this morning?” (Those may not have been his exact words.)

“Well, I woke up this morning with a headache, and I never have headaches. NEVER! So I got on the Google, and I looked up stroke symptoms, and I had FIVE OUT OF THE FOUR! And-”

“What time was that? I interrupt.

“Oh, some time this morning, right after I woke up. And I have a low-grade fever, and my temperature is always low, on account of the praying I do to the Lord.”

I sneak a peak at Mustachioed Man and he winks at me. In my right ear, I hear the home administrator whisper to the “nurse” that is standing next to her.

“Who the hell let her get on the computer?”

Good question.

I turn back to the somewhat agitated patient who, after further assessment by Newguy, is certainly not having a serious cerebral event. Hell, her vital signs are better than mine. Plus, we are something like 15 hours into the alleged event.

“So which hospital are we going to this evening?” That usually moves things along right nicely.

“I want to go to North Bumblefuck Medical Center!”

There she is with the yelling again. A quick calculation and a glance at my watch leads me to believe that I’m going to get at least 2 hours of overtime out of this one call. Sweet.

We get loaded up, finally, after several trips for her feather neck pillow, and another one for her cellphone, and another trip for her Bible.

On the way to NBMFC, I hear her making a phone call. She is asking someone to pray for her. It sounds kinda like she is leaving a voice mail. Maybe there is a phone chain or something, I don’t know. She hangs up and cranes her neck to look at me, sitting in my confessional seat.

“That was Jimmy Swaggart. I watch his program EVERY WEEK! He is going to ask his flock to pray for me, Lord bless him.”


“Are you Pentecostal?”

“No ma’am, I’m not.”

“I need someone to LAY HANDS ON ME! Are you a spiritual person?

“No ma’am.”

“Well you should be. I’m going to call Pastor Swaggart back and ask him to pray for you.”


I wonder if she knows about the prostitutes?

Are all FTOs ignored?

A few days ago, I had a new-hire employee riding along with me, for her evaluation rides. My company seems to think that 3 rides with a Field Training Officer is enough to prepare new EMTs for the field, and this was her third ride. So, ostensibly, it was also her last. Her two previous rides were with a different FTO, on the other shift

In the morning, I got an email from Topper, the other FTO that she rode with the previous day. His email was purely objective, and simply stated that the employee drove only for a short while, but was proficient with radios, the MDT, the computer, and checking the truck off.

Essentially, she was going to spend the day with me, driving, and she would occasionally ride in the back with me to the hospital. I like to have a game plan with new employees. We don’t get a lot of time with them, so I try to focus on the things they need the most.

When she introduced herself to me, I noticed something was ‘off’ about her personality. I couldn’t tell exactly what it was, but she was pleasant, and that’s always a good start. She needed some prompting to check the truck off, and to log into the MDT, which I thought was strange, remembering she was with Topper just the previous day, and she did all of this stuff.

Then the day just spiraled downhill.

Her driving was terrible. Not in the rough sense, but in the sense that she was scared to drive. She consistently drove 10 miles an hour under the speed limit. On every road. She was driving on the interstate, complaining that the tractor trailer in front of her was going 45 miles per hour. For several miles. Yet she never tried passing, even though there was virtually no traffic on the interstate. She stopped completely at a green light while we were traveling to an emergency, because “I thought that car was going to turn in front of us.”

She wasn’t interested in patient care, at all. While at an accident scene, with two patients quite some distance apart, I looked for her. I needed some extra hands, and she was standing at the back door of the ambulance, looking around, with her hands in her pockets. After loading a patient from the scene into the ambulance, she had to be told that Newguy needed vital signs taken, and then had to be told to take them when she failed to act.

Typing all this out makes me feel like I am lamenting my position as an FTO. I really don’t want that to be the case. But what we had here was a person who obviously was not Local Ambulance Company material, and maybe was not cut out for EMS at all.

Newguy and I tried talking with her several times throughout the day, but she was either not interested or couldn’t comprehend what we were saying. Neither Newguy nor I are rude, but this girl simply didn’t get it.

So I wrote as much in my evaluation of her. I have never had to give a negative evaluation on an employee since I have been an FTO at this company, and I suppose my naivete’ got the best of me. In my review, I explained what I explained here, and in further depth. I suggested the new employee receive some more FTO-monitored third rides, and perhaps not be hired full-time.

I guess I expected the Training department to call me or email me and want to discuss my concerns. I think most of my readers will know that I wasn’t contacted at all. Of course not. My review was essentially ignored, and the employee was scheduled to ride on her own the next day.

Which lead me to ask the questions: if FTOs aren’t listened to, what is the point of having us out there? Is it like this at every service? Is the joke really on me, because I expected more out of my management team?

Is this just another straw on the camel’s back, causing more burn out, or do I feel slighted because I’m burned out?

Rule #1

Unless your life is in imminent danger, never, ever, run on a scene.

Running back to your truck because you need some equipment? You look unprepared, and should have either brought the equipment with you, or take the patient to the ambulance.

Running with the stretcher towards the ambulance? You look like you don’t have the situation under control.

Basically, you look silly.

Sixteen years, and I have never been faced with a situation that made me want to run while on a scene.