EMS.O.S.

For years I’ve been trying to justify my appreciation of the Three Stooges—mostly to The Lovely Helen, who claims the Stooges are proof the alleged 5% difference between human and chimpanzee DNA is more like 4% in men. To my wife I say wake up and go to sleep.

“Getting” the Stooges is a Mars/Venus thing. On behalf of my fellow Martians who happen to be in the patient-processing business, I’ve figured out how to make Moe, Larry and Curly almost as relevant to EMS as Johnny and Roy. But first some background:

I’ve noticed discussions on EMS websites about the use of code words to request help in the field urgently and secretly. I can relate. I used to annoy my partners at Opryland with hypothetical scenarios about sedate guests suddenly going postal. What if a presenting lunatic insists I treat him for an allergic reaction to, say, gunpowder, then refuses the SWAT team AMA? Am I supposed to look for an opportunity to disarm him with my penlight? “Sir, I just need to check your pupils for a few minutes—slowly, very slowly, while you’re getting sleepy, so sleepy…” I don’t think so.

A better solution would be a stealthy signal, known only by my agency, its members, their spouses and Facebook friends, meaning help me right now or I will haunt you for the rest of your life. Just put it in the back of the employee handbook under a heading that only EMS people would look at—something like Photo of Human Eyeball Clawed by Rabid Chipmunk.

Look no further than the Three Stooges for a precedent. They had to deal with imminent badness in their 1950 short Studio Stoops.

Moe and Larry are in a room, hiding from gangsters. As Larry leaves he tells Moe, “When I come back, I’ll give you the password.”

“Brilliant. What’ll it be?” asks Moe.

“Open the door.”

That still cracks me up, but the idea of prearranged words or phrases in EMS to limit danger is worth considering. I don’t remember being in a situation where I needed that, but I came close, twice, when patients who told me they were ex-cons objected rather vigorously to being examined in a small room with a closed door. OK, so maybe I shouldn’t have referred to my LIFEPAK 10 as “Old Sparky,” but hey, live and learn.

If we’re going to do this, we need to decide on the type of signal we’ll use. Consider these possibilities:

• 10-codes—Almost every department has them or used to. The best thing about 10-codes is they’ll sound plausible to psychopaths.
• The problem is consistency; there is none among agencies. I’ve worked in systems where 10-1, 10-3, 10-13 and 10-24 each meant help in the name of all that is holy, but 10-13 also might be the code for ordering a pepperoni pizza in some places.
• Words—I’m thinking they should be part of routine transmissions—something like “Medic Rubin to Base, show me back in service PUH-LEECE.” Or “Hospital X, I’m inbound with a morderiske galning.” That’s Danish for homicidal maniac. Studies show very few sociopaths speak Danish.
• Phrases—One approach would be to involve a significant other, as in, “Hey, honey, just called to say how much I enjoyed watching Real Housewives with you.” Helen would know right away I was in trouble or suffering from a berry aneurysm. Either way she’d call 9-1-1. An alternative would be to keep it strictly business: “Base, just wondering when that shipment of bretylium will be in.” Heh heh, got you there, Mr. Bad Guy…unless you happen to be one of my deranged ex-partners.
• Protocols—You could disguise your crisis code as a medical control option. Medical control would figure out something’s wrong if you asked for, say, a chamomile infusion or a porridge challenge. I bet they’d send help after they yanked your card.
• Nonverbal signals—How about keying S.O.S. through our radios? Oh, so Morse code isn’t part of your curriculum? Fine, then just keep pressing PTT to the beat of “Stayin’ Alive.”

Cell phones might work if we could operate them like spies do in the movies—by feel, from a pocket. The idea would be to discreetly send a canned text message, something like “I’m being kidnapped by a patient who’s fondling my stethoscope.” Not sure about that one; Helen might think it’s just another overly dramatic excuse for being late.

Nyuk, nyuk, nyuk.

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