day

   Working as a paramedic is, I think, alot of fun. It is not, however, like it is on TV. Life as a paramedic is about taking care of people as much as it is about saving lives. People call all the time for help getting off the floor. This isn't by any means what we think of when we think of ambulances rushing to the aid of the stricken, but these people need help, and we're there to help. Between ten and fifty percent of the calls an ambulance runs, depending on the community, are non-emergency transfers. These involve picking up a patient at a nursing home or doctors office and taking them to the hospital to unclog a feeding tube, or something along those lines. Not very glamorous, but quite nessicary.
     If you're going into emergency medicine just because you want to run into burning buildings and save helpless babies, you're going to become quite frustrated and you probably won't last very long. If, on the other hand, you like helping people with what they need, you'll do fine. Very bad things do happen with some regularity, but that's not our bread and butter. I'd say on average, in the five or so places I've worked we'd run a really gut wrenching, life and death, traumatic injury every few months or so. There are definite ups and downs in this trend. I had one thirty-day period during which I ran on six trauma fatality accidents. The next twelve months I had exactly none. You learn very quickly that while serious trauma calls are challenging and. in a way, exhilirating that they are also tragic. Your "trauma high" comes at the expense of the life of some twenty year old kid. Career medics and EMTs have little patience for "trauma junkies". These are people, and what happens to them is bad. That said there is nothing, and I mean nothing, more exillirating than finding someone who's near death, or perhaps a bit past death and using what you know to pull them back from the brink. I've talked to people who had died in front of me, heard their thanks, seen the grateful faces of their family members. It's a kick.

    Everyday life for a medic involves driving to work, meeting your partner, catching up on the days events while you check off your ambulance, making sure it's full of gas, has enough oxygen, that the drugs aren't expired, calibrating your glucose meter, making sure the cardiac monitor works and a dozen other piddly little things that if left undone could make your day go horribly wrong.
      That done, it's off to breakfast. A lot of people in the ambulance business put on some weight when they start, because it seems like we're always eating. You don't know when you're going to get a chance to eat again, so even if you're just the slightest bit hungry, you eat. You might run for four or eight or even twenty-four hours in a row. You never know. Many ambulance services work on a 24/48 schedule. You work for 24 hours straight, then you get two days off. This is pretty good if your ambulance's area isn't that busy. If, however, you're in a zone that runs 20 calls a shift, this can be quite grueling.
         After breakfast, assuming you get to finish it, you may hang out for a bit, but usually the nursing homes are changing shifts, and they invariably find a patient in need of your attention. There are also scheduled visits to MRI scanners, doctors' offices and the like. These are normally low stress, but need to be done. Somewhere in there you'll get an emergency response.
        10 am shows a peak in cardiac arrest calls. Frequently the patient's family goes to check on someone who hasn't gotten up yet to find that they've expired during the night. Most trucks have about one arrest a month on average. Cardiac arrest calls are pretty exciting to new medics, but they shortly become less so. The diagnosis is quite easy, their heart stopped, and the prognosis, sadly, is also pretty predictable. The success rate for unwitnessed out of hospital cardiac arrest is around 3 percent. This isn't a misprint, three in a hundred. Where we really save lives is by properly managing people who are having chest pain or trouble breathing to keep them out of cardiac arrest. This opportunity actually comes up quite a bit, and represents the greatest challenge to the paramedic and is our greatest area of success. You might run as much as one or two critical chest pain or difficulty breathing patient on an average day. These people frequently need help and lots of it, and this is the kind of help we can really provide.
         Sometime late in the morning you might go for a visit with your local "frequent flier". There is a group of people scattered throughout the world who feel compelled to call for an ambulance daily, or nearly so, for months or years at a time. These people normally have some illness that makes them genuinely sick from time to time but mosly they're lonely, or hungry or just a little wacky.
     Frequent Fliers are great liability magnets. After you've been to the same guy for the same thing forty or fifty times your assessments tend to get a little lax. Around the fiftieth time they call they actually get sick, and a less than astute paramedic might miss the fact that they actually are having genuine chest pain this time. The medic arrives at the hospital with a patient complaining of chest pain for the fiftieth time this week with no IV, heart monitor or oxygen in place and the doctor on discovering thet the patient is actually having a heart attack, usually goes hunting for the medic. This paramedic shortly finds himself working at a tire store.
        Those who consume large quantities of alcohol regularly are also excellent producers of tire salespersons. An alcoholic wakes with the thought that he doesn't feel well and adds this unpleasantness to the disdain he feels for the world in general and whoever happens to be standing in front of him in particular. When the medic arrives the alcoholic in question usually unleashes a vituperative that that would bestill a Bangkok brothel, breathing his ethanol laden breath in the medic's face as he goes. Many medics, while having their lineage called into question in front of a half a dozen mall patrons might become a bit angry at this point. You may at this point suggest to the client in question that he go jump in a lake. This normally encites the client to further abuses. The cops are called and the client in question dies quietly in a jail cell of the heart attack that was making him feel ill in the first place. Thus would ensue the aformentioned career in the automotive accessories trade.
       Alternatively the alcoholic in question may just have decided he'd like to abuse some public servants on waking in the early afternoon. Your arrival at the hospital with this foul person will encur the wrath of the emergency department staff for weeks to come. This is the burden of the modern medic. In some cases no matter what you do, someone's going to be mad at you.
       Near noon you make an attempt to grab some lunch, and then just after you've paid for your tasty smelling meal and just before it's ready, you get another call. This time for a kid. Kids are your worst nightmare. You hardly ever see really sick ones, so when you do you don't have any recent experience starting IVs on their tiny little veins, which you can't do anyway because they're screaming at the top of their lungs while their parents are screaming at you. It's an absolute nightmare. Luckily most of the time it's something minor, like a scraped elbow and in general the louder they're screaming, the better off you are. Nothing scares the hell out of me more than a kid who sees a big funny looking stranger with a stethoscope around his neck come at him or her and doesn't scream. This means they're too sick to care, which is really, really sick.
        The afternoon brings a smattering of patients with diffuse abdominal pain, the flu, some pain in a shoulder that's been getting worse over the past few years, and a fender bender or two. Things slow down quite a bit after everybody goes to bed. Night usually brings a few fairly minor altercation calls, although these can happen day or night. Your main job here is usually to stop some fairly minor bleeding (minor to you, bleeding is never minor to the bleedee) and to calm down the combatants. Alcohol is frequently involved here also. You get to bed around one in the morning, and an hour later your frequent flier calls back. Chest pain again, and maybe he's a bit hungry.
     At 4 am you have to take a high risk obstetrical patient from your local hospital to a hospital in another town. You then drag yourself bleary-eyed back to your station and sleep for an hour until, about fifteen minutes before your relief shows up, you get another call. A guy who fell, and needs your help getting up. You go back to the station, wash your ambulance and go home, where you pass out on the first horizontal surface you encounter, not to be heard from again until early evening. Not like they do it on TV, but not a horrible way to make a living if you have the aptitude for it.