Rewards

It’s Saturday morning. You and your partner, Brad, have just met the owner of a new hip fracture at a SNiF a few blocks from your station. Nothing unusual happened—to you, anyway. You medicated the lady for pain, stabilized her the best you could, transported her locally, introduced her at the ED, covered her up, wished her well and left. The media wasn’t invited, no chiefs showed up, and the x-rays revealed what you expected. She’s headed for routine surgery, when somebody gets around to it. Skiers have real insurance, but she’s on Medicare. So, her number will come up on Monday morning. Maybe.

You’ve handled the sequential details of that call so many times over the years, you could have run it in your sleep. In fact, backing the rig into the bay at quarters, you’re thinking about the list of mundane stuff you have to do as soon as you’re off duty. You’re certainly not thinking about this lady’s predicament. In fact, you barely remember rolling out of your bunk an hour or so earlier.

You end your shift, negotiate a predictable day off, and return to the station for another Sunday. Brad’s there ahead of you, and he’s at the kitchen table, immersed in animated discourse with the offgoing crew about the Titanic. (The Titanic?)

Brad’s story is that when he got off duty, he went by the hospital to visit Ms. Dukeman, the lady with the hip fracture. He says he felt sorry for her, because during the transport she mentioned having no relatives.  He was rewarded for his time.

It turns out Ms. Dukeman was thrilled by his visit, during which she described one of her male ancestors who was a third-class passenger in the last lifeboat (#D) to leave the Titanic. None of the ship’s survivors are still alive. Her uncle was picked up in the water, she said, after being left behind and jumping ship. She said not many people survived that experience, and that any men who lived through the sinking eventually had to answer a lot of questions about why they weren’t dead. Mrs. Dukeman said her uncle eventually lost his legs to frostbite. 

Q. Brad does stuff like that, but he’s young and dumb, and he’s only been in EMS for a few years. You can’t sustain that kind of personal involvement with people for very long. Don’t you agree?

A. You know, I heard that so many times in my early training. “Professional detachment,” it was called. Our teachers said it was necessary for us to distance ourselves from patients and their families or we would burn ourselves out. I think the lesson’s obsolete, conceived in a time when physicians condescended to a hierarchy of vertical caregivers, all looking down upon horizontal, impotent sick people. There was no internet, so the only source of information was education. And information was power.

Doctors were better educated about medicine than anybody. And what’s more, they were known to be educated. Even my mom taught me “The Doctor Knows Best;” and throughout my career I answered to several practitioners who’d have been only too happy to affirm her faith in them. I respect people who know more than I do. But I think if we keep our minds wide-open, we can learn some important lessons from just about anybody, including the very young.

Q. You can’t be suggesting we get involved with patients on our own time.

A. Actually, I am. I think your whole life depends on balance—metabolically, chemically, spiritually, emotionally, physically and professionally. You’re the only one who can assess the dynamic status of your personal balance. And as you know, it is a dynamic. Certainly, it’s different today than it was yesterday.  Sometimes you really need to give it a rest. But once in awhile, you can’t help encountering people who fall through the cracks in any system. When that happens, I think it makes sense to reach out and catch them—even if only to remind them they’ve been noticed and somebody cares. As humans, it’s our nature. As authentic caregivers, it’s our most natural work—and the source of our lives’ truest rewards.

Q. What do you mean, rewards?

A. Describing the nature of caregivers exceeds the scope of a small column article in this publication. But I think part of what makes us choose this calling are the things it unexpectedly reveals to us. And just one of those are the fascinating characters we meet in the stories they tell us themselves, shift after shift and year after year, in environments where no one else would be welcome.

We’re personally invited, and I’ve always loved that distinction.  

A Little Farewell

This installment of EMS Reruns has turned out to be my last column submission. As you read it I’ll be retiring in a few weeks, and you deserve the wisdom of authors who are anything but. You’ll notice it’s about love, and I have indeed loved writing it for you throughout the past 11 years. 

I salute you all. You do the most important work in the world, sharing those beautiful gifts of yours with the poor and the forgotten. I suspect very few people have ever called that to your attention. I hope you learn to love doing it, humbly and quietly, in the most private moments of people’s lives. If I could have the experience of my last 40 years to live all over again, I’d want no honor greater than to work alongside you.