Who’s Responsible?

Twenty-three years ago, after being an EMS provider for one whole day, I relaxed with an appropriately potent beverage and thought about head lice.

My second patient ever, a 30-something-year-old male without an address, had been infested with the little arthropods, or so I was told by a senior colleague who would have known such things. My job was to perform something resembling palliative care without offering my own scalp as a reservoir of basic lice support. I would have opted out if I could have.

I think I realized midway to the hospital that whatever I’d learned about commitment during 18 years in the corporate world hadn’t prepared me for this latest development in my middle-aged life:

I was suddenly responsible for the welfare of strangers, no matter what.

I don’t recall any allowances for inconvenience, fatigue, distractors or indifference. Even employee illness was frowned upon, as if calling in sick were less honorable than working while contagious. If you felt like crap after exposure to another horde of microbes gone viral, too bad; try not to cough on the patients.

My bosses expected my “A game” every day. Merely showing up was not, as Woody Allen claimed, 80% of success; you had better be prepared for the exceptionally challenging and dangerously unusual. Staying alert was optional for customers only.

My partners and I knew we were in a buyer’s market; there were plenty of EMTs and medics who wanted to work. Those who wouldn’t be held accountable for their actions might as well have mulched their cards and joined a bowling league.

Or become baseball players.

Last April, an immensely talented major-leaguer named Josh Hamilton, who has an extensive history of substance abuse, was traded by the Los Angeles Angels to the Texas Rangers after he suffered a highly publicized relapse.

The deal with Texas required the Angels to pay about 75% of the $80 million owed Hamilton—a hefty amount just to make a player go away. When asked about the financial arrangements between his current and former teams, the 34-year-old outfielder was less than contrite.

“He knew what he was getting,” Hamilton said of Angels’ owner and ex-employer Arte Moreno. “He knew what the risks were.”

Hamilton presumably meant the risks of trusting Hamilton. I sense a new hiring paradigm in there somewhere.

Prospective employer: We think you’re a good fit for our company.

Prospective employee: I think so too, provided I don’t duplicate the sort of behavior that got me fired from my last job.

Prospective employer: Well, yes, there is that risk of you building another meth lab in your cubicle, but we think you’re past that.

Prospective employee: Let’s hope so.

I don’t know any healthcare companies likely to embrace such nonsense, so I guess those of us in EMS are still stuck taking responsibility for the following:

Our attitude—Some days the job sucks. Embrace the suck by showing patients and partners you’re much too good-natured to let working for a living disturb you.

Our education—Know what you need to know, but don’t stop there; part of being in a people business is conversing with your customers. That’s hard to do if your knowledge and interests are limited to rescue. If the last book you read had at least one picture of a sucking chest wound, you might want to try an author who doesn’t have an EMT number.

Our words—In my opinion, the most noteworthy legacy of modern technology is the ability to screw up at the speed of light. Take my smartphone. Please. If I’m not careful every time I type, I can insult more people per second than Andrew Dice Clay and Don Rickles combined. The difference is that they get paid to be offensive and I might never get paid again if I’m offensive.

Our appearance—Wear what you like…at home. Answer a call in something with gravy stains or a demeaning message, and you’ll find yourself a little less respected than the rest of our profession.

Our preparedness—There aren’t many people out there whose only job is to help others. Be vigilant and proactive; emergencies rarely resolve themselves.

Maybe you can’t hit a curveball or catch anything smaller than a beach ball, but show responsibility, and you’re welcome on my team.

At 1/1,000th the cost of Josh Hamilton, you’re a bargain!

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