Frequent Flyer: Loneliness is an Emergency, When It`s Yours

"EMS Reruns" is an advice column designed to address dilemmas you may have experienced in EMS that you did not know how to handle. But it offers you a luxury you don't have on scene: plenty of time to think. If you think of an example like the one that follows, send it to us. If we choose to publish your dilemma, we'll pay you $50. We don't know everything, but we do know a lot of smart people. If we need to, we'll contact just the right experts and share their advice with you. Send ideas c/o emseditor@aol.com.

It's Saturday morning, and your town's football team is home to those scary Cornhuskers at 10 a.m. You wish you could be at the stadium, and you hope you don't get a call until after the game. You're planning to watch the action with the crew at Station 2, and you're picking up a few groceries on the way.

The weather is perfect for foot-ball--about 30º, with four inches of new snow on the ground from last night. There's not a cloud in sight, and everywhere you look the fresh snow is simply dazzling in the sun. There are Husker fans all over town. They travel like lemmings, and you wish this wasn't a home game--especially since you couldn't afford tickets. But you're soon reaching for a pen and groaning as you jot down the location of a residence over on 39th for a lady with "heart pain."

You recognize that address, because you've been there a dozen times. The house is a 100-year-old, three-story brick place, with a wide wooden porch in the front and steep, narrow stairways inside. Priscilla Kulleck lives there alone. She's almost as old as the house, and, as usual, she's in bed on the third floor. What's not usual for her is, the sun is up. She normally calls about 3 a.m. Her complaints are vague and variable, she's never really sick, and she's always fussy.

As you trudge up the stairs, you hear a call go down for a fight three blocks away, and a distant medic unit responds with PD. Sure enough, Priscilla appears stable enough to complain about your wet boots.

How do you deal with people who don't really seem to need or appreciate your help?

Not easy, is it? But there are some calls that can force you to reveal yourself either as a professional or an amateur, and this is one of them. You can view this call as a waste of your system's resources (without knowing what the PD will find at the scene of that alleged fight). You can even see it as a more personal intrusion on your plans for the day (which you agreed to spend on duty). Or, you can mentally insulate this call from your personal plans and from other responses to this address, consider this woman's unpleasantness a potential finding and listen to what she has to say.

There are times when it really is your job to lecture the public. Some people's use of public health systems is plainly abusive and warrants police attention. But there are other times when it's much more important to see, hear and feel what they're trying to tell you. This woman is asking for help. Her circumstances place her in at least three risk categories that should get the attention of a professional like you: her advanced age, her obvious unhappiness and the fact that she lives alone.

The other crews at your station see Priscilla just as often as you do. What could possibly justify 30 or more calls a year from someone who never seems to be diagnosed or treated for a significant medical problem, and who always seems to return home no worse for the wear?

Good question! But somewhere deep in Priscilla's life, there is a mystery that a lot of smart people in your system are failing to solve, over and over again. Somebody needs to ask some new questions, like what's really bothering her? When did she call EMS the very first time, and what made her do that?

This time, in the presence of just the right caregiver and in the privacy of an ambulance, Priscilla finally breaks down and admits she has been having "a real hard time" since her husband died about three years ago. Her root issue is that she's lonely.

If loneliness isn't a bogus reason for accessing an EMS system, what is?

Anyone who has ever been truly alone-- absolutely without anyone who cares whether they live or die--knows what an emergency that can be. If you've never had that experience, take a moment to count your blessings. When somebody is so lonely that the only person they can call is a 9-1-1 dispatcher, that's an emergency by any definition. They're not abusing the system. They're pathetic, and they're the kind of folks we're here for.