My first ambulance field rotation was on Mother's Day, 1971.
I was a high school senior taking the "Emergency Medical Technician/Ambulance" course offered through the adult and vocational training division of the community college.
Mike DeWalt was in the class and let me ride with him at Northern Virginia Doctor's Ambulance. This was a private ambulance service that provided occasional back-up for the Alexandria Fire Department.
A Busy Sunday
The EMT-in-charge was a tall, skinny musician who worked part-time at the ambulance service. A very friendly and helpful guy, he was reading Dale Dubin's Rapid Interpretation of EKG's.
While Virginia had not authorized a paramedic training program, Glenn Luedtke wanted to be prepared.
Some of you know Glenn from his recent work on the NAEMT EMS Safety Course.
Or his tenure as the EMS Director for Sussex County (Delaware) or Cape and Islands (Massachusetts).
There were six nursing home-to-house transports scheduled that morning. Followed by six return trips that evening.
Idealistic high schooler meets complex relationships
With nearly no life experiences, and that teenaged sense of "how things SHOULD be," it seemed to me that many of these patients were going to homes hostile to the visit.
I could not understand why Glenn talked so loud to the patients, or why he insisted on talking with the family before we moved the stretcher into the house.
Now I get it
During the past three years I have been on a geriatric journey with my parents. Including a recent acceleration that requires more action than discussion.
I whined about an interfacility transport experience five months ago (On Airline Travel and Ambulance Transfers) and finding my "Adult Command Voice" (“The Greatest Generation” white-knuckles through another Winter Carnival).
The novelty of being the designated adult/primary caregiver has worn off.
We are in the day-to-day grind of assuring a safe and comfortable environment for a couple who are struggling to maintain as much independence and autonomy as they can while medical conditions continue to change.
The excitement two weeks ago was an intense effort get Mom out of a hospital and into an assisted living facility that evening. Worked with Dad to visit a couple of places and make a decision by early afternoon. Not a lot of choices within our timeframe.
Followed by an evening stand-off with my Dad who wanted to take her home (where there was no assistance in place and physically inappropriate).
We told you …
The language of federally-regulated health care ranks right up with airline travel. Accurate statements made in a neutral tone using industry terms.
They were told on admission that she was on "observational" status and would be discharged in three days. They did not realize it until her last night.
Even with this issue, the federally-regulated part of health care provides much better information than the unregulated parts of health care.
"What I want is …"
… not what we can get you. It sometimes feels like I am explaining to a 9 year old why he cannot drive the car.
This morning I am at work, the final day of EMS testing, looking at the list of things to do this week. Wondering if it is safe to make a business trip and resenting the probable answer.
On this Mother's Day I understand the complex emotions felt by the children when we delivered their Mom's for a visit in 1971. Relationship defined by decades of experience, conflict and compromise.
Mother!
Mike "FossilMedic" Ward
for more details and to order.
Are We Needed or Not?
2 commentsAre We Seeing a Culture Shift, or Just a New Excuse?
Firegeezer had the story the other day of the Milwaukee alderman who thinks the city can do without the fire department. Bill correctly noted that hizzoner apparently has no concept of the importance of response times or the importance of EMS first response. Bill is right and probably a little too polite in his characterization of the idea as "Looney Tunes".
But let's engage in a little counterfactual daydreaming. Many of the fire service blogs I read are up in arms about "victim survivability profiling" and I would go so far as to say that this is the preeminent argument in the fire service right now. But a rose by any other name is just as ineffective so we'll combine with this the generic culture shift that so many are pushing on the rest of us. You know, the risk-averse mentality that argues that firefighter injuries and fatalities can be eliminated altogether if we "just change our culture." At the risk of caricaturing these people I dare say they would forbid interior attack anytime there's smoke too thick to see. I'm curious what the consequences of their vision would look like. Let's say they had their way in Milwaukee and the fire department takes no risk for buildings and anyone in a smoky building is written off as dead.
The alderman would then be right. The fire department and its careful distribution of engines, ladders, and BC's would be an entirely superfluous waste of the taxpayers' resources. If we won't accept risk for property and we assume everyone in heavy smoke is dead, then we really don't need a 1710-compliant box alarm. You don't even really need a box alarm at all. At that point you're talking about confining fire to the building of origin in a defensive mode. Outside the old industrial towns of the northeast you can do that with four or five guys and one pumper; they don't even need to show up for about ten or fifteen minutes! So yes, an engine or two from a contracted suburban department ten miles away would be enough to keep most fires to the building of origin. At that level of care, Milwaukee could be more than satisfactorily covered by contracting distant fire departments.
Of course, it would also mean a lot of civilian fatalities and millions in lost property, not to mention the losses to the invaluable property that is most important to our citizens. I'll say that again more plainly: property is important. No, it is not more important than our lives, but it is important and its preservation is worth some risk. For every saved wedding dress in the attic, family Bible in the bookshelf, and home-business record in the erstwhile den, we prove our value to the citizenry and we fulfill our duty. We protect quality of life as much as we protect life itself. When you decide property is not important enough to risk anything over and civilians in heavy smoke are dead and you implement that in your department, then you make a visionary of the idiot alderman from Milwaukee.
Thank you…..Patrick Mahoney
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