The Ramblings of a Quixotic Dad, Firefighter, EMT, and God-knows-what-else…

Archive for April, 2012

A Note on the Fire-based EMS Debate

I am, first and foremost, a firefighter. That is the career I have chosen.

But I am also an EMT with advanced training, working on finishing my EMT-Paramedic.

My department required me to have a Basic certification to be eligible for hire. But that is all.

No one forced me to advance my medical certifications. I have done that of my own accord and mostly at my own expense.

That being said, I could care less whether fire runs EMS or EMS is a third agency. That’s above my paygrade and beyond my scope. The people I work with in EMS are fine, dedicated people. I am proud to work alongside them, regardless of whose name is painted on the outside of the ambulance.

But what irritates me is when people say that Fire-EMS is just the Fire Department trying to justify their existence by trying to do someone else’s job.

That’s like saying that the 343 firefighters who sacrificed everything on 9-11 were only justified because FDNY also runs medicals.

I know it’s more complicated than that (I think FDNY took over EMS in 2005, but that’s not the point), but yet it is also that simple.

“I can think of no more stirring symbol of man’s humanity to man than a fire engine.”

Kurt Vonnegut was a firefighter. He is also a fire survivor rescued by firemen. At a tribute for our fallen brothers and sisters, he recited the names of all of the firefighters who were killed from the station he was saved by.

Firefighters are not heroes by default, and fire calls are down. I will give you that.

But go home. Look around. Look at the things and the people you love.

Now imagine that all burning to the ground.

I have worked in a burn center. I have seen what flame can do and I have felt its heat kiss my flesh.

George Orwell is attributed (perhaps incorrectly) with saying “People sleep peaceably in their beds at night only because rough men stand ready to do violence on their behalf.”

Maybe we can sleep peacefully because someone stands ready to rush into harms way, regardless of their career (Fire, EMS, law enforcement, military, etc) and who needs their help.

They hear the call, and they answer.

That, to me, is justification.


To wonder, “Do I dare?” and, “Do I dare?”

When she put the poster in her office (which had, until the day before, been a small closet), I couldn’t help but stare. For National Poetry Month in 2009, the American Academy of Poets put out a beautiful image of these two lines written into the condensation of a piece of glass.

“Do I dare /Disturb the universe?”

T.S. Eliot’s The Love Song of J. Alfred Prufrock is a complicated poem, one whose analysis is way beyond my scope. But I love it.

“Do I dare /Disturb the universe?”

I love that thought. It haunts me.

Mainly, it’s because I find myself asking myself that question all the time. Oftentimes, first responders (regardless of what field – EMS, Fire, Law Enforcement, etc) find themselves in futile situations. Anyone who has ever worked a cardiac arrest at a nursing home will understand what I mean.

“Do I dare /Disturb the universe? / In a minute there is time / For decisions and revisions which a minute will reverse.”

If only it were that simple. But still, I wonder.

Do I dare?

Do you?


Writing for the Dead

It was a saying he seemed to like, though he couldn’t resist modifying it.

“Write.” – “For whom?” – “Write for the dead, for those in the past whom you love.” – “Will they read me?” – “Yes, for they come back as posterity.”

I’m not a Kirkegaard expert, so there won’t be any brilliant literary analysis or some  moment of existential clarity. If you want that, you’d have to talk my wife, Dr. KindofAFireWife. She’s the English expert. I just love the quote.

It makes me think of Bringing Out the Dead  by Joe Connelly. In his book (and in the film adaptation), a burned out paramedic in New York reflects on his role as a provider. He has stopped seeing himself as anything beyond an intruder on the end of the people he is sent to help. Indeed, as he performs CPR on an elderly man surrounded by his family, the medic decides that his purpose is now solely to bear witness to the lives of those he responds to.

It’s a great book that shows the dark side of EMS through powerful satire. And let’s be honest: there is a dark side to this job. There has to be. We witness terrible things in dark places. We often share in the worst moments of the lives of those we help. Anyone who says otherwise is either ignorant or lying.

Maybe that’s the real reason I’m typing this. Maybe I want someone to know I was here. Maybe I want to let out the darkness so that it doesn’t follow me wherever I go. Maybe this is my 911 call.

Maybe I just want someone to bear witness to me.

Kirkegaard wasn’t satisfied with the saying the way it was.

“Write.” – “For whom?” – “Write for the dead, for those in the past whom you love.” – “Will they read me?” – “No!”

That’s a bit more damning.

Hell, maybe I’m a little damned, too.


Verisimilitude of Gratitude

His hat said “Vietnam Veteran,” and it was covered in service pins. He walked up to the four of us standing in the checkout line, where we were waiting to buy the next day’s lunch for the station.

“Thank you guys for your service.”

It took us a few seconds to pick our jaws up off of the floor and respond.

“No sir, thank you.”

I never know how to react when people thank me for being a firefighter. My wife always laughs when it happens around her, because she says I become a bumbling, awkward fool. While we were getting coffee at a bookstore one day I was thanked by the barista for “all I do.”  I awkwardly mumbled something about it being no big deal, and my wife laughed and told me it was.

I can’t help it. I don’t think what I do is that special.

Don’t get me wrong. I love what I do. But I’m definitely no hero. I’m not worthy of anyone’s praise or gratitude.

That old man has probably, literally, bled for this country and for everyone here in it. He’s probably watched friends die thousands of miles from home at a time when many in his own home town couldn’t care less.

There is an honor and nobility to that.

I haven’t done anything like that. I didn’t get into this job to be some hero figure. I don’t want anyone’s praise. I don’t need thanks. It’s just a job. I get paid to go to work.

I’m a selfish person. Sure, I wanted to help people. I always have. But it’s not the only thing that keeps me going.

I got into this job because I’m an adrenaline addict. I got into this job for the heat that makes you feel as if you have the world’s worst sunburn underneath your bunker coat. I got into this job for the scream of sirens and the rush it brings. I got into this for the 8,000 things you have to do while you’re running hot to the hospital with 3 minutes to do it in.

I got into this because I can’t sit behind a desk.

I don’t deserve any thanks for that.

But thank you for telling me all the same.


My gut tells me…….I have no idea.

I’m not trying to brag. In all honesty, I’m a pretty modest guy. But I have good instincts.

At least, I have good instincts in the back of a box. They haven’t really let me down yet. Granted, I don’t have the kind of experience many medics and providers have. But I have enough, combined with my gut, to generally carry me through the day.

The guys I work with know this. I work at a multicompany station. That is, we have a truck company and an engine company. 10 people. Out of these, 90% of our medical calls are handled by myself and FireMedicBA. He has about 3 times the experience I have, but trusts me enough to ask my opinion and evaluation.

Typically, that’s not a problem.

A few weeks ago, while roved out to another station, we were dispatched to a report of a patient suffering from an altered level of consciousness at an assisted living facility. We arrived to find a man in his mid-80s laying on the floor. The nursing staff had found him this way. His blood pressure was well over 200/100, and the medic on the engine I was with (who is a relatively new medic), tried to do a full assessment. I told him we needed to load him up and leave. The arriving ambulance crew agreed. Long story short, our patient ended up being admitted for a massive stroke.

I’ve learned to trust my gut.

Today, I hung around a few extra hours to work for a friend of mine on the next shift.

About an hour in, we catch a run to a local sorority house for a report of an unconscious female in the doorway.

In a college town, this can typically be stereotyped as an inebriated sorority sister. That’s typically what it is when we get there.

Today, though, it was different.

We arrive with the local EMS service to find a young female seated in a chair. She’s pale, diaphoretic, and barely responsive.

She didn’t look drunk. She didn’t look high. But she had the empty, glazed stair of someone very sick.

When we left, one of the firefighters with me asked me what was wrong with her.

I honestly didn’t know.

I figure it was one too many diet pills and one too few waters. But that’s just a guess. What I do know is that she was sick.

And my gut let me down, because I didn’t really have an answer for him.


Random Thoughts on a Monday

Holy hell. I haven’t been on here in close to two weeks. A lot has been going on, though. Kindofafirewife just defended her dissertation, and is now Dr. Kindofafirewife. Hell yeah!

I’ve also been doing a lot of time on the ambulance. I had one day where I started multiple large bore IVs on multiple patients, which was a first for me. I’ve usually only gotten to do one or two. To top it off, they were medicals.

More to come.

 

Oh yeah. An officer at my station tried to pass off vegetable stew to me as gumbo. I’m Cajun. Gumbo does not include cabbage, squash, zucchini, or ranch style beans. But it does make for a hell of a vegetable stew.