I was talking to a doctor friend about the movie Asphalt City. He mentioned the scene where the old crackhead lady was relentlessly berating the young paramedic who just sat there saying nothing, looking all burnt to hell already, not two months into the job. We talked about burnout. Burnout comes in waves, I said. When you are new and getting beat to shit every night, it can come on hard. Once you learn to deal with it, it ebbs, but every so often it comes back with vengeance. I’ve seen a number of medics over the years just snap. One told a frequent patient whose MO was dramatically faking seizures in public places to walk the hell away from the ambulance. Another gave a frequent patient ( a cutter) fifty cents and told him to take the f-ing bus. He also told him if he truly wanted to commit suicide, he should slash his wrists vertically instead of horizontally. Shocking stuff but In both cases there was a precipitant of the medic being involved with a recent traumatic call, a child struck by a car with head injury and broken legs and a mother with cancer found in an intractable seizure by her twin daughters, calls that no doubt weighed heavy on the medics involved. Some medics explode, others burn out silently. Me, I’ve been pretty stable over the years. I’ve learned to disassociate. Like the medic in Asphalt City, if someone is berating me, I don’t take the bait. I just sit there looking down at the floor, letting the time pass by until they lose interest in harassing me. I go on a call with a frequent flyer, I just do the call. It doesn’t help getting worked up about it. Part of the job. Deal with it.
I was talking to a medic from another company the other day and I think he is nearing his end. Five or so years in. He won’t last much longer, I‘d bet.
“’I don’t feel good,’” this medic told me, talking about a patient he had that day. “That’s all this dude said. ‘I don’t feel good.’ He must have said it 125 times during the course of the call. We show up at his apartment and he is laying on the floor thrashing about, moaning ‘I don’t feel good.’ The fire department told me they pick him up every other day for the same complaint. ABD pain. He has no diagnosis. He just moans over and over ‘I don’t feel good.’ His vitals are fine, his ab is soft. We had to carry him down three flights of stairs. All the time, he’s thrashing about. He almost threw us off balance a couple times. Thirty-year-old grown ass man, acting like that in front of his wife and kids. You know what I wanted to do? I wanted to slap him. I wanted to slap him and say, ‘Shut the fuck up.’ Did I? No, of course not. I gave him fentanyl for the pain he said he was having and Zofran for the nausea. By the time we got to the hospital, he was chilled out, almost sleeping. Then, it took us 40 minutes to get a bed. Forty minutes and the meds wear off, and he starts thrashing around on the stretcher again, moaning, ‘I don’t feel good.’. Over and over. I had to lower the stretcher to the ground so he wouldn’t topple out. ‘I don’t feel good.’ It was fingers nails on a chalk board times 100 for me. A pulsing alarm., A barking dog tat wouldn’t stop. It was the worst toothache you’ve had in your life. ‘I heard you,’ I said. ‘I know you don’t feel well, but please stop thrashing around. We are doing the best we can.’ ‘I’m sorry,” he said, catching my tone, ‘but I don’t feel good. I don’t feel good.’ On and on. I tell you, I wanted to slap him. ‘SHUT. THE. FUCK. UP.’”
“I know what you’re talking about and I know who you are talking about,” I said. “I’ve never taken him in but I’ve seen him, heard him in the ED when others have transported him. He’s just like you say. I don’t feel good.”
“I know I was having a bad day,” the medic continued, “but I couldn’t take it, I was at a breaking point. Course, I didn’t break. I just stood there next to him, and everybody was walking by looking at me like I wasn’t doing anything for this poor soul. Everyone except the medical staff who deal with him every other day. They just rolled their eyes. Him again. And we waited and waited for a bed and on and on, he went. I even felt bad for him at the same time I wanted to slap him. What kind of miserable life he must have that every two days he has to throw a fit like that? Some people have told me he has no diagnosis. Others say he has GERD and eats too much fried food. Others say he smokes too much weed and has that hyperemesis syndrome. If he does, I missed it. He told me he didn’t do drugs in between saying I don’t feel good. I tell you calls like that make me want to quit more than any bad trauma or fucked up call. Calls like this I think about calling my brother and taking him up on his offer to work full time for his furniture business doing deliveries. Couches and pianos they don’t whine.”
I don’t like whining either — it is a life sucker– particularly when it comes from from people in EMS. I would rather work with a brand new EMT with a cheery disposition than a seasoned EMT, who does nothing but bitch. But at the same time I know sometimes people need to vent. This was a good medic and a good guy. I asked him if he needed help, and he said he was all set. He’d be over it soon enough.
I’m not so sure.