Not My Emergency

I have been working for the past few months on a genuine ambulance, as opposed to being the ALS chase car.  I had not realized how much nonsense I'd been shielded from over the last eight years.  So many silly calls that I was canceled on before I even got there.  But now all of those calls are mine.  The good and the bad and everything in between.  So, I must thank all of those BLS crews for keeping my standards high, prolonging my faith in humanity, and staving off my own insanity.

The general public would really not believe what people call 911 for.  Growing up, my career goals were fed by Rescue 911 and ER. Fed by the genuine, 'I'm stuck in a laundry chute', or 'I am inches from death' type emergencies.
I still remember learning how to call 911 in kindergarten (or somewhere around there) and from then until I became an EMT, I believed that, like me, people only called 911 in an actual (universally agreed upon) emergency.  When I started really riding ambulances, I was shocked by two things.  The first was what people considered an emergency.  As it turns out, their definitions and mine were completely different.  They still are.  The second thing was that people would pretend to be sick or unconscious.  Why?  I would ask feebly, my naivete protecting me from drug and attention seekers.

Over the years, and stop me if I've said this before, I developed the understanding that people are different.  Some can cope with a crisis, some can't.  Some can make a sensible decision, some can't.  Some people enter adulthood with strength and poise and character and some don't.  I began to meet people and say to myself: "They believe this is an emergency.  I don't, but that's okay.  They still need my help."  Damn, that is sensible.  That is most assuredly, something they should teach in EMT class.  It's not an empathetic view as such, it's just practical.  After coming to this conclusion, I no longer got annoyed.  I just did the job and believe me, that is easier than dwelling on things outside of my control.  Too many times I've watched my colleagues attempt to 'educate' these people, wriggle out of doing work, or get mad about these types of things.  I quickly learned that it's just not worth it.  Just get the job done, life is so much easier.

I am writing this in the past tense, but that is misleading.  I still look at the job this way.  But, I can already feel my theory eroding.  I am still in a fairly rural, fairly slow area, but now I am seeing every call through.  There is no hope of cancellation.  It is a challenge of language to see if I can get people to make doctors appointments, get into their own car, or stay home instead without getting into trouble.  These three options seem manipulative, but some of these calls are...seriously dumb.  This is all while trying to convey that I genuinely care about their suffering, but I also geninely believe that going to the emergency room via ambulance is inappropriate.

Honesty is tricky in medicine.  Meeting patients and patients families expectations is difficult, especially when they believe an emergency has occurred and I don't.  You don't want me to think it's an emergency because that means something is seriously wrong.  I will take a calm, collected, precise, and deadpan medical practitioner over a jumpy, nervous, indecisive one any day.  That, and people with the flu don't want to be told that there's nothing anyone can do for them.  They don't want to know that they're exposing more susceptible populations by going to the hospital.  They don't want to hear that they will be suffering for a week no matter what.  And usually, I have to take them anyway.