Huddled Masses. Healthcare. Honor. EMS.

A conversation that I had with another healthcare provider has me pondering a lot of things. Until now, I’d been pondering these things in a solitary way but I think that I’m going to put these ponderable thoughts up on the blog.

This post gets a little more political than my usual stuff. I don’t post politics up here unless the politics specifically relate to EMS (unless they’d get me in a lot of trouble, for example the best EMS delivery model).

But today, I’m making an exception. I think that some of the things that I’m pondering have to be put out there and I think that if I don’t throw this out to the blogosphere I’m gonna go nuts.

I work in a community that has a large Hispanic population. A good portion of them are probably undocumented immigrants from Mexico. Yes, I said “undocumented” and that can mean Illegal immigrants if you so choose to say that. It’s a fact that small towns in the Midwest have been growing by leaps and bounds with undocumented immigrants looking to find work wherever they can. Some of them have legal members of their family that they live with, some don’t.

There’s a huge debate going on in this country over illegal immigration. It’s bigger than me, it’s bigger than this blog, and it’s bigger than EMS. I’m not going to get into my personal opinion on the topic as much as I would if we were discussing this in a bar over a couple of beers, or a country cafe over coffee if you’re a morning person. I can say this: I’m all for border security. I’m all for people following the law and I believe that illegal immigration is a drain on our resources. Those points are barely arguable. Another thing I believe in are the words to a song that I used to sing when I was with a rather patriotic small-town childrens’ choir. The song went something like this: “Give me your tired, your poor, your huddled masses yearning to breathe fee. The wretched refuse of your teeming shore. Send these, the homeless, tempest-tost to me. I lift my lamp beside the golden door!” There’s a lady that stands in the harbor that has these words inscribed upon her, and they mean something.

I look upon this debate and I see both sides fervently trying to destroy any point-of-view other than their own. The lefties want them here because their hearts bleed for them. The righties think that the lefties want them because they can mold them into a new communist workers’ party. Both of them may be right. I am more of the opinion that America is an experiment. We’re a melting pot of people that have come together over the last two-hundred and some odd years to be stronger in our diversity. I believe that any cultural group entering our melting pot should come here and embrace the American ideals. “Melt” into the pot if you will. This has made us strong over the centuries and has built the country that I love, the one I will stand up for. Europe didn’t do that, they isolated their ethnicities into countries and fought amonst each other for a thousand years. We melted and homogenized into a strong nation full of rugged individuals championing their best ideals. I say that the most successful immigrant groups in the storied history of this nation celebrated their old cultures while melting in to our diverse one.

As far as today’s debate goes, I wonder if that would be the whole rub. Are the new illegal immigrants celebrating their own culture while melting into ours? Or our they placing their old culture on top of the American culture and creating discord within a proud nation? I think that we have always accepted the “Tired and poor huddled massess yearning to breathe free” because of our American Dream. People here have equal opportunity, a guarantee of the equal chance for humans to strive to reach their potential. Everyone has the chance to try and succeed to their own definition of success. “Life, Liberty, and the Pursuit of Happiness” is a guarantee of the chance to pursue. It is not, however, a guarantee of results. Our experiment is that everyone who has the chance will strive to give it their best shot, and that the people who succeed will pull others up alongside them.

I can’t say what’s right here. I don’t know. I don’t want to offend, but here I am, a paramedic. My job is to help everyone and anyone who needs me. I will do so. I have always done so. I took an oath and I honor my convictions. The hypocratic oath means something to me. Healthcare providers are honor-bound to help everyone as much as they can. I always will.

The conversation that we had was short, but he got his point across. I had brought up that while we have a large hispanic population in our coverage area, we rarely have calls involving those hispanic members of our population. I think that this is a bad thing because obviously these people fall ill and get injured at a rate comparable or even moreso than the other demographic groups in our area. I don’t know why they’re not calling but I can figure that it might be alleviated for the good of our community as a whole if we reach out to this population and let them know how, and when, to access the emergency healthcare system. I don’t believe in race and to me “hispanic” is a cultural label and is not even close to whatever “racial” means, but this is a cultural group that should be calling us and doesn’t. It’s deliniated over cultural lines and therefore is handy to address that way.

The other guy thought that it was stupid, pointless, and maybe even wrong to do this. It was because of the “illegal” thing. As strongly as I feel on that issue, and I do have strong feelings, as a healthcare provider my job is to help everyone. Every human deserves the best care that we can give them, every time. I don’t judge people. He shouldn’t either.

Neither should you.

Thoughts?

  • http://sixlettervariable.blogspot.com/ Christopher

    We don't get to pick our patients: illegal, legal, visiting, permanent, whatever. Besides, we treat people rather than citizens of this country or that country. If I'm ever required to check somebody's ID prior to transport, I'll be taking John or Jane Doe each and every ride.

    I'm of the mindset that our country is where it is today because you're not an American by birth, so much as you're an American because you want to be.

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  • http://roguemedic.blogspot.com/ Rogue Medic

    Treating patients differently, just because I assume I know something about their legal history, is just plain wrong. If we are to behave professionally, we need to ignore distinctions that are not relevant to patient care.

    How can you have free markets with closed borders? Closed borders is not the same as unsecured borders. They are just borders with arbitrary limitations on immigration.

  • mickmayers

    Sorry, man, you've got no disagreement from me either. I didn't sign on to be the Border Patrol, I signed on to ease pain and suffering and to make somebody's day a little better than it was when I got there. Whether or not they've got the green card is irrelevant to me. I have even learned Espanol in order to communicate better.

    Should they become legal? I think we need to look hard at our own ancestry and like the case of the Irish Catholic immigrants, how badly they were treated by the Know Nothings and the KKK in the early years, and remember that no one different ever had an easy time integrating into what is supposed to be a homogenous society.

    I think if we were to grant amnesty to whomever is here so far we would get these immigrants paying taxes to compensate for their use of “the system” and it would allow the hypocrites to stop saying its a problem (but continuing to enjoy the fruits of their labor). Once we have a period of amnesty, we can then secure the borders toward “undocumented visitors” and start over with a better system, but the current method isn't working.

    Great post. Glad to see I'm not alone. And no, I'm not a liberal. But I'm certainly not a conservative either. I'm what you call, “willing to look at the facts and make a decision based on the merits of the argument”. Too bad we don't have a party that represents that.

  • Scott Cook

    Excellent post. While we should do outreach programs, the fear among those we reach out to is they will be deported back. As well, from what I am told by some hispanic immigrants, seeking medical care is not a part of their culture unless and until it is absolutely necessary.

    I also understand that the Phoenix FD has (or used to have when Bruno was there) an excellent outreach program to hispanic communities. You may consider giving them a ring.

  • http://www.theemtspot.com/ Steve Whitehead

    I worked for years in Bakersfield California where we had a large Hispanic population in the surrounding rural areas around town. Working in this community left me with a tremendous respect for the immigrant Hispanic community and I haven't forgotten those experiences. The true experience with these migrant, mostly agriculture workers, is so far removed from the illegal-immigrant stereotype of the political arguments.

    My image of this community looks like this: Hard-working, stoic in their medical care, quiet (until Friday night or May 5th) and deeply wanting something better for themselves and their children. Often, they are willing to defy two governments in the hope of finding something better (like education and freedom) for their children.

    And one day it occurred to me that many of our most cherished American values are embodied in our immigrant populations. The same values that brought my ancestors to our shores and caused them to stand in defiance of their government are still alive. You can find them in our legal and illegal Hispanic workforce.

  • http://www.firedaily.com Fire Daily

    Well said, Chris. The true professional EMS workers will perform professional EMS, regardless of any personal feelings and uninformed assumptions of our patient. If you want to be paid to be a judge, then become a judge.

  • http://www.firedaily.com Fire Daily

    Well said, Chris. The true professional EMS workers will perform professional EMS, regardless of any personal feelings and uninformed assumptions of our patient. If you want to be paid to be a judge, then become a judge.

  • http://www.thediversityprojekt.org/ Kathrin

    As a pro-migrant advocate AND public health advocate I am really excited to see words like “migrant” and “undocumented” used in this discussion here.

    For many undocumented migrants legal status is something that is unattainable under our current immigration legislation, yet we still proclaim the US to be a land of opportunity. We rarely ever consider the contest in which this is presented…the US is the land of opportunity for those who are “desirable” within a certain socio-political and economic context.

    Anyway…..the point of my comment is to say THANK YOU for having CIR discussion.

  • CBEMT

    Theres a lady that stands in the harbor that has these words inscribed upon her, and they mean something.

    They meant something when the huddled masses were willing to become citizens, learn English, earn a legal living, pay taxes and not disproportionately use public services that the rest of us (who were raised by the immigrants who did it right) have to pay out the nose for.

    It was was a different world when that lady took up her post in the harbor, and it's certainly a different world now.

  • kathrinoutloud

    @CBEMT – I think one of the major differences between then and now that often gets overlooked is that in the era you reference there were no immigration laws. Since the 1950s immigration laws have grown exponentially, creating far more restrictions than there ever were. The people you reference were able to come to America and build a life for themselves and their children because there were very few laws barring them to do so. We have created so many road blocks in the last few decades, many of which are predetermined my socio-economic status and race.

    A large portion of undocumented workers pay taxes and want to earn a legal living, but our laws bar them from doing so. Many of them want to learn English but their socio-economic status and working 2-4 jobs bars them from doing so. Many of them DO learn to speak English, especially the younger generations. There are lawful US citizens who don't speak English. If you immigrate after a certain age you are able to waive the language requirement. I know many first generation Italians (in Philadelphia) who can barely pull a sentence together in English. Most undocumented migrants, if given the opportunity, would become citizens. Most of them are law abiding members of our community.

    Just some thoughts…..

  • http://roguemedic.blogspot.com/ Rogue Medic

    CBEMT,

    Are immigrants unwilling to learn English?

    If we wish to have a successful free market economy (in spite of the recent trend), we need the risk takers of the world. Those willing to leave everything behind to move to a new country, to pursue opportunity, are what we need. Innovation does not come from those comfortable with their existence.

    Without immigrants, a lot of immigrants, a lot more than the politicians want, a lot more than the I'm in, now lock the gates people want , we will lose our place as a world leader. Restrictive immigration laws are anti-American.

    If I have to choose between a nation of immigrants and a nation of laws, I choose the one that has led us to growth, progress, and prosperity. That is the nation of immigrants.

  • kathrinoutloud

    Hope I didn't help contribute to the post being derailed, but I think that this discussion can and should be had in many professions, not just the emergency med community. How do and should public servants who are committed to serving the public be held accountable (or in this case hold themselves and each other accountable) to doing the right thing? Does it go beyond doing the right thing when on some level it comes down to doing their job? Can one pick and choose? (somewhat rhetorical)

    And…an important question to be raised is, how do you know that someone is undocumented? Profiling? That leads us into extremely murky water, no? Assuming that all Latinos are undocumented would be quite bold and grossly inaccurate. Jurisdictional, only ICE officers have the authority to ask for such documents. Not even municipal and state police have the authority to require an individual to provide documentation of his or her legal status in this country.

    One thing that breaks my heart in this discussion and many others like it, is the fact that there are many individuals among us who feel dis-empowered to reach out for help because they have been told that due to the pervasiveness and plethora of xenophobic messaging in our society. I think that is the fundamental crime against humanity.

    I will go out on a limb to say that most public emergency servants – firefighters, paramedics, police officers, etc. – go above and beyond their call day after day in doing the next right thing. I think it supersedes any job description or political ideology.

  • CBEMT

    Theres a lady that stands in the harbor that has these words inscribed upon her, and they mean something.

    They meant something when the huddled masses were willing to become citizens, learn English, earn a legal living, pay taxes and not disproportionately use public services that the rest of us (who were raised by the immigrants who did it right) have to pay out the nose for.

    It was was a different world when that lady took up her post in the harbor, and it's certainly a different world now.

  • kathrinoutloud

    @CBEMT – I think one of the major differences between then and now that often gets overlooked is that in the era you reference there were no immigration laws. Since the 1950s immigration laws have grown exponentially, creating far more restrictions than there ever were. The people you reference were able to come to America and build a life for themselves and their children because there were very few laws barring them to do so. We have created so many road blocks in the last few decades, many of which are predetermined my socio-economic status and race.

    A large portion of undocumented workers pay taxes and want to earn a legal living, but our laws bar them from doing so. Many of them want to learn English but their socio-economic status and working 2-4 jobs bars them from doing so. Many of them DO learn to speak English, especially the younger generations. There are lawful US citizens who don't speak English. If you immigrate after a certain age you are able to waive the language requirement. I know many first generation Italians (in Philadelphia) who can barely pull a sentence together in English. Most undocumented migrants, if given the opportunity, would become citizens. Most of them are law abiding members of our community.

    Just some thoughts…..

  • http://roguemedic.blogspot.com/ Rogue Medic

    CBEMT,

    Are immigrants unwilling to learn English?

    If we wish to have a successful free market economy (in spite of the recent trend), we need the risk takers of the world. Those willing to leave everything behind to move to a new country, to pursue opportunity, are what we need. Innovation does not come from those comfortable with their existence.

    Without immigrants, a lot of immigrants, a lot more than the politicians want, a lot more than the I'm in, now lock the gates people want , we will lose our place as a world leader. Restrictive immigration laws are anti-American.

    If I have to choose between a nation of immigrants and a nation of laws, I choose the one that has led us to growth, progress, and prosperity. That is the nation of immigrants.

  • kathrinoutloud

    Hope I didn't help contribute to the post being derailed, but I think that this discussion can and should be had in many professions, not just the emergency med community. How do and should public servants who are committed to serving the public be held accountable (or in this case hold themselves and each other accountable) to doing the right thing? Does it go beyond doing the right thing when on some level it comes down to doing their job? Can one pick and choose? (somewhat rhetorical)

    And…an important question to be raised is, how do you know that someone is undocumented? Profiling? That leads us into extremely murky water, no? Assuming that all Latinos are undocumented would be quite bold and grossly inaccurate. Jurisdictional, only ICE officers have the authority to ask for such documents. Not even municipal and state police have the authority to require an individual to provide documentation of his or her legal status in this country.

    One thing that breaks my heart in this discussion and many others like it, is the fact that there are many individuals among us who feel dis-empowered to reach out for help because they have been told that due to the pervasiveness and plethora of xenophobic messaging in our society. I think that is the fundamental crime against humanity.

    I will go out on a limb to say that most public emergency servants – firefighters, paramedics, police officers, etc. – go above and beyond their call day after day in doing the next right thing. I think it supersedes any job description or political ideology.

  • Ambulance_Driver

    Dude, do we share a brain? I just wrote a semi-rant on my blog about immigrants, and found your blog post via the related posts widget. Hell, you wrote pretty much everything I said, and using much the same words.

    And you did it first, dammit! ;)

    Good job.

  • Ambulance_Driver

    Dude, do we share a brain? I just wrote a semi-rant on my blog about immigrants, and found your blog post via the related posts widget. Hell, you wrote pretty much everything I said, and using much the same words.

    And you did it first, dammit! ;)

    Good job.

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I am a paramedic trying to advance the idea that the Emergency Medical Services can be made into the profession that we all want it, need it, and know it deserves to be.
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  • Comments
    DiverMedic
    Welcome to the Club
    Very well done, Chris.
    2014-09-17 22:15:00
    DiverMedic
    My Blogroll
    One of these days you'll figure out where my blog is... :)
    2014-09-17 22:11:00
    emtterri123
    Six Tricks You Can Use Today to Improve Your EMS Narrative Report
    The first and best way to get people reading you to think that you are an idiot is to pepper your writing with spelling and grammatical errors. It makes you look dumb. - Me thinks this should have been restructured as it does not flow and caused me to reread it several times. lol :)
    2014-09-17 08:27:00
    Алексей Рукин
    So You Think You Can EKG?
    78% accuracy... and I'm not even a medical student, only a blog reader...
    2014-07-12 18:12:00
    Another One Bites the Dust (Part 2) | Medic15
    The Five Second Rule – Six Ways you can Reduce Pauses in Compressions and Save More Lives with CPR
    […] 5,7,9 http://www.lifeunderthelights.com/2014/03/24/the-five-second-rule-six-ways-you-can-reduce-pauses-in-… […]
    2014-07-09 18:39:31

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