By Michael Morse
At the beginning of my shift, I often give myself a little inspirational speech.
"I will take this job more seriously."
"I will listen to my patients’ complaints."
"I will stop eating everything in sight."
"I will try to learn something new."
"I will not drink a gallon of coffee."
"I will be more professional."
The list changes from shift to shift, but I always start my day with the best intentions. Sometimes my resolve lasts for hours. Sometimes it is gone in minutes. All too often, I don't even get out the door with my new attitude.
“Rescue 1, respond to 160 Broad Street, at the women’s shelter for a report of back pain.”
"Rescue 1, responding.”
“Back pain can be debilitating,” the new me says to my partner as we roll through the city, quite proud of my new, noncynical take on this call. Experience reminds me that 99 out of 100 calls for back pain turn out to be nonemergent calls for a ride to the hospital via a narcotic justifying advanced life support vehicle and a certified EMT person to present further validation to the jury at the ER, but this very well could be the one that isn’t.
“It can also be somebody looking for some pain meds,” he replies.
Here, the old me would reply with some silly comment like, “They should put a Vicodin lick at the entrance door to the ER; that way, 90 percent of the patients would get what they want and go home,” but it’s a new day and a new attitude, and I keep my thoughts to myself, knowing that the person next to me is working overtime and his optimism faded some 20 hours ago.
We arrive on scene and find two women–one the patient, the other the patient advocate. The Old Me wonders just what a patient advocate is and how in the world can the taxpayers afford something like this, but the New Me assumes that a patient advocate is a wonderful idea, the wave of the future, a great way for non-English-speaking people to better assimilate into the health care system. The patient speaks no English, and my Sesame Street Spanish is not enough to convey the emergency information to the ER, so thank goodness for the patient advocate!
New Me: "What is the problem?"
Patient (through Advocate): "I have severe back pain."
New Me: "How long have you had this severe back pain?"
Patient: "Many years."
New Me: "And how did this severe back pain begin?"
Patient: "My breasts are too large; I need a breast reduction."
Less New Me: "Your breasts are too large?"
Patient: "The weight of my breasts causes severe back pain."
Even Less New Me: "And how is this even remotely an emergency?"
Patient: "I have back pain."
Old Me: "Get in the truck."
On the official State of Rhode Island and Providence Plantations Emergency Medical Services form there is a spot for "Past Medical Conditions." The New Me would have written "Back Pain" on the form. The Old Me is waiting for the phone call from the EMS chief to explain why "Large Breasts" occupies the space relegated for "Past Medical Conditions."
1840 hours: The Old Me has returned; the New Me is back in the attic, waiting for tomorrow.