Many years ago, I was a taxi cab driver. Us cabbies used to talk about cab towns. What was a good cab town and what was a bad cab town? A good cab town was always hopping. People used cabs instead of cars. There were no traffic jams. The rides were of conversation distance. You wanted at least a $7 dollar fare. You hated the take me three blocks calls. In a good cab town, cops couldn’t be bothered to hassle cabbies. And in a good town, people knew how to tip proper. At least ten percent of the fare and lots of keep the change, buddys. You could make a living in a good cab town without having to hustle all the time, and if you did hustle all the time, which is what we did, you could make a fine living. A bad cab town, on the other hand, had short rides, dime tips, parking lot traffic, cops who like to bust on cabbies and a safe and functional bus system.
Having worked in more than a few towns in EMS, I can tell you there are good EMS towns and bad EMS towns. A good EMS town has single floor homes, not too many nursing homes, a populace educated enough not to call 911 for a genital wart, and enough highways, industrial buildings and driveways that need shoveling to ensure that when EMS is called, the people likely really do need a paramedic. A bad EMS town has three and four floor walkups, apartment buildings with broken elevators, nursing homes as a their cottage industry, a populace without cars and a dsyfunctional transportation system. A bad EMS town isn’t necessarily a poor city. Sometimes architecture alone can be a drawback. Some of these nice two story homes in upper class towns are such that the patient is always bedbound up on the second floor and there is little room to maneuver at the top of the stairs, and the staircases are narrow and steep, and there is artwork on the stairwell walls, and antiques on the landings. In bad EMS towns, they don’t like bad weather boots on their carpets. I will take a town of humble single story homes any day over most anything.
It is hard to find a town with all the elements of a good EMS town. And of course, it varies with what you like to respond to. Don’t like trauma? You don’t want an interstate or windy back roads in your town, nor do you want hip hop clubs and crack houses. Don’t like sick old vomiting people? You don’t want an elderly population. If you like crazy people, the city is for you. If you don’t like crazy people, I have news for you, crazy people are in every town! Tired of taking people two blocks to the hospital for a finger lac? Find a town without a hospital in it.
Me, I like variety, which I get now. I respond in several different towns during the day depending where system status management has me posted. Variety is good, but I also like decent calls. By decent I mean if someone is going to call 911; I like them to really need us. I like to have my skills and knowledge challenged. Although sometimes, I am content to not have to do more than be a taxi driver again. I don’t get tips anymore, but my paycheck has always been good at the bank.