What Difference Does EMS Make? Choose Your Own Ending

John didn’t need his alarm clock this morning. In fact, he was wide awake just a few minutes before it went off. He turned it off so as to not wake up his wife and got up quietly to start the day. Today was going to be great. It was huge. Months of work at the office were finally going to be recognized today in the biggest project meeting he’d had in a year. Today’s meeting would launch his career faster than almost anything he’d done before. He was excited. He was ready.

John showered, shaved, and got dressed up in his new suit that he’d bought the day before. He wanted to look his best for this meeting. Everything was counting on it. His wife Joanne had coffee and a quick breakfast ready for him when he came down the stairs. He sipped on his coffee for a bit as he ate his breakfast. It was really sweet of her to do that, He thought and he told her so with an extra hug and kiss as he left for his commute. He wanted to be to work early today to make sure that he was there to answer any pre-meeting questions. This was the day.

Traffic was light on the interstate that morning and John was moving at a good clip. It was strange, he thought, for traffic to be this kind to him on a Monday morning but he figured it was a good omen. His phone buzzed with an e-mail and he glanced at it. It wasn’t anything that couldn’t wait until he was in the office, he thought. Then a great song came on the radio. John reached down to turn up the volume so he could get pumped up for the drive…

He never saw the cars stopped just in front of him.

Mary took care of herself pretty well for a type one diabetic. Her doctor had told her that. She stuck to her diet, maintained her sugar levels meticulously, and took her insulin on a sliding scale that seemed to be working perfectly. Her blood sugar readings were always right where her doctor said they should be. Mary was proud of that. She worked out and tried to get out walking or jogging the trail at the park at least 3 or 4 times a week. She felt good, looked good, and thought that she was doing all she could to take charge of her health.

It was a beautiful Saturday morning and Mary thought that she should take her dog Patches out for a walk around the pond. Patches was a 1 year old Golden Retriever and loved jumping in the lake to fetch sticks. Mary had taken her morning dose of insulin, popped a multivitamin tablet from her new bottle that she’d bought the day before, and ate a quick bit of breakfast before she put Patches on his leash and started walking to the park. It was about five blocks away and patches knew the route well. Everything was great, until the nausea hit… Mary tried to fight it but knew that she was going to throw up when she started salivating and breathing heavily. She ended up throwing up in some bushes next to the sidewalk. She thought that she was lucky. Nobody saw her hurl up her breakfast and she immediately felt better. It must have just been the new vitamins that made her stomach upset, she thought as she continued walking to the park. She figured that she just wouldn’t take them again.

Mary never felt sick. She just thought that she should take a nap. The rock over there looked like a good place. Why was she so sleepy? Never mind… Just lay down and nap. Nap good.

Luckily, another jogger happened by to find Mary unresponsive.

Work had been scarce lately and Steve was happy to get his truck back on the road. He drove a live-bottom trailer hauling asphalt for a big local paving company and they hadn’t had many big projects come their way lately. Driveway work was steady, but rarely did the company need Steve to drive a big truck out to a site for a driveway job. Steve made his best money and hours when the company had highway work and today was the first day of a big job they’d just gotten. He’d been in line with the other trucks waiting his turn to dump his load into the paver for hours and even though he was happy to be working, he had to pee. Minutes turned into hours and finally it was his turn to drop his blacktop and head back for a new load. He couldn’t wait to be done. He really had to pee by this time and he knew exactly where his next opportunity would be. He backed his trailer up to the paver and raised the bed. Then through his rear-view mirror he saw the people scramble and jump off of the paver. He felt his truck lurch forward as the paver machine was pushed into it from the impact of a car travelling too fast in the construction zone. When he jumped out of his truck after looking to make sure there was nobody coming at him, he saw his friend Luke laying on the ground. Luke was bleeding, bad. The car and the paver were a tangled mess of metal and there was someone screaming at an unmoving figure in the passenger seat of the car.

Steve no longer had to pee…


Note to blog readers:     I can’t quite decide on what I should do from this point on. I can take two paths, one is a rallying call to community members asking them to put themselves in the place of the people in the above cases and get out there and support their local EMS. The other, is a rallying call to us EMS people… I’ve written it both ways. You can see what you like best.


Option #1

Every day, Paramedics and EMTs put on their uniforms, fire up their ambulances, and get ready to face the onslaught of whatever mayhem the streets produce for them during their shift. They do a job that is unpredictable, complicated, and vital to the community. These three stories could happen to you or someone you love tomorrow and each of them will require the response of a highly trained, expert Emergency Medical Services (EMS) provider. There are times when your local ambulance service makes the difference between life and death but there are far more times when they make a big difference in a person’s continuing quality of life. By interceding in the first few moments of a medical emergency with highly trained experts, EMS makes a difference for us all. Communities that support their local Emergency Medical Services have better services and community members that are more educated about what makes quality EMS are better suited to support their local services.

You may not think about the people who respond to your call when you dial 911, but all we do is think about you. Get informed, get involved, and support your local Emergency Medical Services.

We’re there for you. We need you to return the favor.


Option #2

As you come in to work today, lace up your boots, or turn on your pager, think about the patients in the above cases. They’re people just like anyone you see in your day to day life. They and others like them didn’t intend to be placed in the situations they’re facing and to them; theirs is one of the most intense situations of their life. Their very life and the continuing quality of their lives could rest in your hands today. They are depending on you. Their families are depending on you. Your knowledge, skill, and preparation to perform your best are paramount to these people. Their care rests on you. You owe them your best and there is no excuse they’ll accept for poor performance.

EMS providers transcend their self when they lace up their boots and sign on for duty. Society needs us. Our patients need us. We need us. We will never know the impact we’ll have on the lives of our patients, their families, and their communities… but it’s huge. We as EMS providers play a pivotal role in our communities. They’ll never acknowledge it en masse… but that doesn’t diminish its importance. Recognition for our skills isn’t necessary for our skills to be vital. EMS people do their jobs because they’re important. We do our jobs because our guts tell us that what we’re doing is right… and even when we stumble and find ways to improve ourselves and our care, it doesn’t diminish the importance of what we’ve done. We have acted, and we continue to act in the best interest of humanity.

Today you can make a choice. You can make the choice to seek out and become the best EMS provider you can be or you can choose not to. I suggest that you make the right choice but no one will ever be able to force you. Your care is an art and a science. Your performance is based upon hard science and soft intuition. There can never be a book that will tell you exactly what is right for every situation… you simply have to learn it and learn how to make the right decisions to fit the situations you find yourself in.

My advice to all EMS providers is to take the high road. Err on the side of what you truly feel is best for your patient. Do your best. Study hard and learn from those you consider the best among us. As an EMS provider, you bear the burden of an overloaded system that pays poorly and garners little respect. I feel it too. I say that it doesn’t diminish the importance of what we do and it isn’t the individual patient’s fault. They deserve our best no matter what the system is doing to us. It’s our responsibility and our calling. It has been said that the definition of a “Professional” is one who can perform their duty adequately in conditions that would cause the amateur to turn back. I’d say that we’re living in those conditions today, but we still have to perform. Do your best and know your stuff. Lives depend on your commitment.

It is our job to promote ourselves. It is our job to elevate EMS. It is our job to speak out and optimize the system. The fault for its failings lies within our profession and it is our job to change it. All of us, individually and collectively have the responsibility.

Will you answer?


So I got a little philosophical in this one. Which ending do you like better?

  • Turn away from the choir, Brother, this needs to go out to the masses!

    • Agreed! This is one for the public and the would-be EMS advocates.

  • Absolutely awsesome!!!!

  • Anonymous

    I often wonder how anybody could do this job, considering the enormous impact we have on a person’s present and future, and all of the people who know or depend on that person, and not take it seriously.

    Thanks for taking it seriously!

  • Very well said! I think this really is a two pronged approach. Not only do we need to be rallying the community behind us, but we need to be doing something WORTH rallying the community behind us. At the end of the day, if we are providing patient care we’re proud of, we will influence our communities without realizing it. It starts with us and moves outward. NOTE: Everyone seems to be fired up about improving EMS since HM posted the manifesto on Chronicles of EMS. I posted this article on my blog not two minutes before reading yours: http://510medic.com/2010/09/07/why-ems-2-0/

  • Anonymous

    Amazing post and it couldn’t have come at a better time for me. Definitely one of those “why even bother” days but you’re right, the patient deserves the best. Leave the other stuff at the door.


    Great work Sir.

  • Anonymous

    As far as which ending I like better, I like them both! I think it depends on you intended audience. If it is primarily for your blog, I assume most of your readers are already in EMS- and the second ending would be more applicable to them. If it is meant for the general public (such as a non-ems magazine/ other distributed paper) then the 1st ending would be better suited to your general audience.
    But great article either way. Really makes me think about the back stories we don’t often get on our “cool” trauma or medical patients. Everyone has a story, a past, a family, and it is important to remember that on every call we take.

  • “We’re there for you. We need you to return the favor.”

    But…. how?? Other than letting my kids fall all over themselves to demonstrate their reverence for your hero-like status in their eyes, I am at a loss. Bake cookies? Probably not, but that’s what I do well!

  • Excellent. I’m going to have to go with both versions.

    Ending number 2 spoke to me though. It will be printed and left sitting out at the station upon my return home.

  • Brentdriscoll

    Nice stories, but if you are working in prehospital care for the thanks or to transcend to another plane in the universe, you are mistaken.
    Do what you should not what you have to in this profession. Leave the temporal anomalies and chance calculations to Stephen Hawking.

    • Ckemtp

      I think that my point was to teach people to derive their own satisfaction from their works in spite of the fact that there will be little to no thanks coming their way. However, I am an amature quantum physicist and I read Steven Hawking when I get the chance and the inclination. Facinating stuff, that.

      Your statement to “Do what you should, not what you have to” is poignant. Although I’d add a “just” a “to get by” and a “right” in there.. to say “Do what is RIGHT, not JUST what you have to (to get by)”

      And that’s the point of what I wrote. “Do what is right, not just what you have to do to get by, regardless of the thanks we may or may never recieve. Your works do make a difference and it’s your personal responsibility to be your best”.

      Although trancendental meditation would be good too. Y’know.. whatever works.

  • Chris V

    Awesome!! Needs to be put out to the general public without a doubt! Not only does it give our viewpoint as what we do etc but it gives them the viewpoint of they can make a stand, they can make a difference. Join our ranks or assist till we get there. Do more then rubberneck. VERY NICE JOB!

  • chei

    I like the second ending. It spoke to me. I am a volunteer medic with two services in my area riding every weekend and most holidays. I also am constantly learning what I can and attend paramedic classes in the evening. Sometimes I get caught up in the talk around the station. You know, how hard it is for the paramedics to ride with a basic. They have to run most of the calls and do the reports. I also have been told that running a basic truck was a diservice to the community because they expect a higher level of care and we are just basics. Oh, and that volunteers should ride third because the skills are not up to par because they do not ride enough. I understand where these arguments are coming from. And I appreciate being able to discuss these ideas without taking it personally. I enjoy the debate and think that it is important. But it sure is nice to read something that is uplifting. See, some of us are not just underappreciated by the public, but also by our peers.
    Thanks, I really needed that today.

  • MedicWebber

    So……….. I was wondering how comfortable you would be with me reading this to the EMT class I lecture at in North Haven. This is awesome. I wouldn’t know how you would go about it, but it would be a good article to have printed up in common magazines for the public.

  • wow !!! i haven’t read you post before i posted mine yesterday (ok yours as a lot more righting experience ) but really is great it should be publish on wide media or something . i agree with MedicWebber it should be out there on a flyers or something

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