The Godfather’s Rules for EMS

Anyone know what day December 25th is, besides Christmas?

This year it happens to be the 25th anniversary of the release of The Godfather Part III, the third installment of a Hollywood epic so compelling, so majestic, so fantastico, the saga requires Roman numerals instead of ordinary digits to distinguish its chapters. Only a pezzonovante would call it The Godfather Part 3.

Given the early-’70s release of the first two parts—1972 and 1974—and the body counts in each, the Godfather franchise may be partly responsible for the development of EMS in this country, and probably in Italy too. I think I even remember an episode of Emergency! when Roy had to remind Johnny of a Godfather-inspired rule, “We don’t discuss business at the dinner table,” but I might be confusing that with a scene from the first Godfather. You have to admit, though, Johnny could be a little pazzo at times.

Most men I know like The Godfather, while most women I know like other things. I love The Godfather. Parts I and II are my favorite movies of all time—not that I have anything against Part III, except maybe the way Sofia Coppola, the Godfather’s daughter in the movie and the director’s daughter in real life, tries to keep up with actors who actually have some training. Hey, if my name were Mike Mantooth, I probably wouldn’t have had to follow the same protocols as the rest of you.

Tom Hanks called The Godfather “the sum of all wisdom” and “the answer to any question” in his 1998 film You’ve Got Mail. I agree and propose we pay our respect to The Godfather by listing the ways that movie’s timeless dialogue applies to everyday EMS. First, though, we need to define two common Godfather terms within the context of patient care:

Family: Your industry, your agency, your partner—basically anything you care about except your real family.

Business: Stuff that happens on the ambulance and stays on the ambulance.

Here we go:

“Leave the gun, take the cannolis.” If you’re into metaphors, that line is really quite brilliant. It reminds us to prioritize—or maybe just to eat more cannolis.

“Make him an offer he can’t refuse.” This is all about compromise. Say you have a patient complaining about the hospital you’re heading to. Ask him if he’d like to go somewhere else—like maybe to a landfill.

“I’m a businessman; blood is a big expense.” This is wrong; blood is actually a profit center. Everyone in EMS knows that. The character who said this, Bruno Tattaglia, wasn’t as smart as he thought he was and probably wouldn’t have passed his hemorrhage-control station.

“I didn’t know until this day it was Barzini all along.” Just pretend Barzini is another word for pneumonia.

“Never tell anyone outside the family what you’re thinking.” Very sound advice whenever circumstances force you to consider extreme, quasitherapeutic procedures even surgeons can’t do.

“Don’t ask me about my business.” Often said dismissively by medics to friends or spouses. Or to plaintiffs’ attorneys.

“Go to the mattresses.” Get some rest between calls.

“Today I settled all the family business.” Either your boss finally paid the past-due rent on that firetrap he calls headquarters, or you and your partner now work for a nationwide ambulette service.

“You broke my heart.” The last thing your patient thinks as you realize her saline flush was actually a dopamine flush.

“My final offer is this: nothing.” How to negotiate with volunteers.

“This is the business we’ve chosen.” What you and your coworkers keep reminding each other when it hurts to lift anything heavier than your arms.

“It’s your favorite song, Michael…Where are you going?” A misunderstanding I have with my family whenever they play “Muskrat Love.”

Merry Christmas and pass the cannolis.

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