One of Us

I don’t usually recommend movies to people who don’t ask, but when I do I mention Freaks, Tod Browning’s 1932 thriller about circus performers who, as the title suggests, are anatomically challenged. The cast didn’t win any awards, possibly because they weren’t acting; all of their deformities were real.

Freaks is a disturbing film. Some who’ve seen it wish they hadn’t. Why? Because unembellished renditions of real life can be more frightening than the most grisly fiction. Since most of us in EMS don’t go too many days without being reminded of that, I don’t think any of you will need therapy solely because of this film.

I admit I was stunned, initially, by the freaks’ physical defects. Then I felt relief via the same underrated coping mechanism many of us in EMS can summon at will: I’m glad it’s not me. Finally I lapsed into medic mode and started wondering how I’d handle a call for, say, a 40-year-old with only a head and a torso. I don’t remember studying that.

My vote for Freaks’ most distressing scene is a raucous dinner-table gathering of the sideshow gang, who greet “normal” newcomer Cleopatra with an eerie chant:

“One of us, gooble gobble, we accept her, we accept her.”

That reminded me of my first paramedic state exam—not the exam itself, the gathering afterward, waiting for on-site scoring. As I sat in a cramped classroom with 21 fellow medic wannabes, Eric, one of our instructors, addressed each of us individually as “paramedic” followed by our surnames as he gave us our temporary cards. It was a good feeling—like being admitted into a privileged secret society.

Since then I confess I’ve felt like a freak more than once while working in the field. I think much of the public is fascinated by us without really wanting to have anything to do with us. That was particularly evident at Opryland, where guests would often pause when passing my office and say things to each other like, “Oh, look, there’s one of those EMT people.” If I hadn’t been so determined to keep my job a little longer, I might have begged for a banana.

Even in traditional EMS environments, I get the feeling many on-scene observers see us as curiosities. At calls with high body-substance quotients, I can almost hear bystanders reflect, “Wow, he’s actually willing to do that job.” Imagine how much more curious we’d seem if they knew what we were paid.

Some of us are urged by well-meaning citizens to demystify EMS by describing “the worst thing” we’ve seen. I asked as much of folks in the essential services before I became “one of us.” Twenty-one years of patient care made it harder, not easier, for me to answer that question—not because there aren’t plenty of choices; it’s just too much work to explain. Besides, those who ask seem more interested in titillation than education. I always pass.

I’m pretty sure none of my friends outside EMS understand my job—I mean really understand it, beyond what they think they’ve learned watching TV. How could they know? Hollywood’s renditions of our industry are mostly exaggerations that reinforce idealized notions of emergency medical responders: intrepid risk-takers who somehow manage to produce acceptable outcomes while ignoring rules and subverting authority. Those of us in the business know 1) we are rarely intrepid, and 2) SOPs, while occasionally inconvenient and far from dramatic, are almost always allies, not adversaries.

If I were inclined to educate the public in “uncut” EMS, I’d tell them:

• “Good calls” don’t necessarily involve patients who live.

• I still can’t believe how many sick people do whatever we say.

• You wouldn’t want to know some of the places my stethoscope has been.

• If you call us between 3–6 a.m., odds are at least one sleep-deprived, cognitively impaired member of the medical profession will be making decisions about your health.

• Some of us read and write at a level below high school. (Don’t even ask about math.)

• Going to a hospital to get checked out is on a list of things I am least likely to do.

It would be easier on me if some EMT-turned-producer would make a truly realistic film about EMS. If any of you are movie moguls with aversions to profitable ventures, I’d like to announce I am willing to play a brave paramedic who risks career remorse by gallantly offering transport options to middle-aged victims of dyspepsia. Or you could ask De Niro.

Gooble, gobble.               

Mike Rubin, BS, NREMT-P, is a paramedic in Nashville, TN, and a member of EMS World’s editorial advisory board. Contact him at mgr22@prodigy.net.