W is for Women in EMS

The sight of a female paramedic raises nary an eyebrow these days, but 25 years ago, when I first got into EMS, the obstacles were as rampant as they were ridiculous. I would like to systematically address the arguments against women in EMS that I have heard over the years.

First there are the charges that are simply untenable. We are too emotional and we can’t handle the blood and guts. Emotion is a trait that is absolutely necessary in this line of work. Being unable to control one’s emotions is a liability but it is baseless to claim that women as a gender can’t and men can. I have comforted a male co-worker as he sobbed after we had to pry the stiff body of a baby boy who had died of SIDS from his hysterical father’s hands, and I sent a room full of male police officers puking over a motel railing when I accidentally “popped” a guy who had been dead for a week in July. (I’ll leave the specifics of that one to your imagination). Some people want to do this work and some don’t. If you have an aptitude for it, education and training gets you through the sad and icky parts.

Women aren’t strong enough to do the job. It is an anatomical fact that women, overall have less body strength than men. The important thing is to have physical standards. At our agency we have the MPAT, (Medic Physical Agilities Test). It is the same for men and women and is designed to replicate the physical demands of the job. Do the men get through it faster? Some do. My time is near the top of the females and about in the middle of the males and I am 53 years old and weigh 135lbs. The important thing is to stay healthy, maintain a good weight, and exercise! And, use your head as much as your muscles when encountering heavy lifting. No one can lift a 400lb patient by themselves…ask for back-up!

Women aren’t good at math and science… (Huh?) Do I really need to address that one?

Women shouldn’t work so closely with men, they might have sex. (This was always spoken in whisper). News flash folks…men and women in all professions have affairs, fall in love, get married, get divorced, have sex with their boss, have sex with their employees… It’s a matter of professionalism or the lack thereof. I have slept in a station bunk room with half a dozen men who snore, fart and their feet stink. Trust me; I would be much more inclined to tete-a-tete with a well groomed executive in a suit, if I were inclined to do such a thing, which I am not. Most women in EMS have had to work way too hard for respect in this industry to jeopardize it for a fling with a fireman. Does it happen? Oh sure, but no more so than in any other work situation.

On the same note…The station wives will be jealous. HMMM…they probably would be jealous of their husbands’ secretaries if they worked in an office or the female teachers if they worked in a school. To systematically deny women an opportunity based on the fact that a lot of people have bad marriages is just plain stupid. Nuff said!

Now here is my favorite. Men are naturally protective of women and will put their lives on the line to save them in dangerous situations. Let me set the scene. A male and female crew responds to a general illness call. They are the first to arrive and there was nothing in the 911 call to indicate a need for police response. Our crew finds an elderly woman crying and complaining of feeling bad. Unfortunately, she doesn’t feel well because her grandson has been beating on his girlfriend for several hours and she is nearly unconscious. The situation quickly deteriorates, a gun is produced and the female medic gets shot. Our male hero then has to put his life on the line to try and drag his partner to safety. Uhhh…if the injured partner were a man wouldn’t he do the same thing. I mean, wouldn’t anyone try to save their partner regardless of their gender. I have never really understood this argument. Oh, and by the way. If the roles were reversed and the female had to drag the male to safety, don’t worry, being able to drag a 190lb body dummy is part of our training. Piece of cake, especially in a high adrenaline situation.

Last but not least…women will upset The Brotherhood. Take the no girls allowed sign off the tree house boys. We don’t want to ruin your party; we just want the same opportunities afforded to you. You can get together after work and bond and complain about women all you want, but to deny over half the population a chance a something meaningful to them based on what I have discussed here is illegal and just plain wrong. Good thing it doesn’t happen anymore…or does it? These arguments sound similar to ones being played out in the news these days about women in combat. Hang in there ladies…one day the military will chuckle and wonder why it was ever such an issue.

X is for X-Ray

Modern medicine is a wondrous thing. Many of the advances in treatments and cures are a result of the advanced imaging available to doctors and diagnosticians. X-rays, CAT scans, MRIs, Pet Scans, sonograms...the list goes on. These miracles of modern technology have given the medical community a window to the body never thought possible even in the recent past. Determining the ailment is half the battle. Proper diagnosis leads to proper treatment and medical imaging is a huge part of this process.

As a Paramedic, I am a medical professional, but I don't have access to these instruments in the field. I cannot hook a patient to a scanner in their home and see the culprits of their infirmities. I have to rely on good, old fashioned patient assessment. What are they telling me? What are their symptoms, what does their skin look like, or their eyes or their nail beds? What is their medical history? What is their family's medical history? What happened to them?

I think the Titans of medicine could learn a few things from us lowly Paramedics. Too often, a doctor will read a CAT scan or an MRI and see nothing amiss and dismiss the patient's complaint. These machines are not infallible and patients are suffering because their doctors are treating the machines not the patients. I have been a victim of this as has members of my family. My Father's cancer went undiagnosed until it was too late because the initial scan was negative and his back pain was dismissed as "arthritis".

I am not suggesting that we do away with advanced imaging. They are invaluable tools, but I challenge the medical community to "get back to basics" when addressing a patient's complaint. Look, touch, smell, talk and most importantly, listen to all of your patients. In case you were wondering, the letters in the attached picture stand for…Onset, Provokes, Quality, Radiation, Severity and Time. A simple formula that has stood the test of time.

Y is for Yawn

Most people know that the acronym EMS stands for Emergency Medical Services. What isnt widely known is that it also stands for...Earn Money Sleeping! Yes, we are the slackers who go to work in fancy stations, watch TV all day then get a good night's sleep before we go home fresh and well rested, all on the taxpayer's dime. Yeah...right!

Well, I wouldn't be honest if I didn't admit that occasionally in my 25 year career I have had that happen. But those times have been few and far between. I have worked several different shifts over the years. The first fourteen or so were 24 hours on 48 off. Sounds really good, especially if the shift is slow and you really do have a lot of down time, but I work in a busy urban system and the reality is the call load usually outruns the resource. There are no built in breaks or meal times. If the call comes in, you run it, regardless of what you may be doing. The mantra I usually recite at the end of an exhausting shift is, "They don't pay me enough to do this".

About a decade ago, my agency got rid of 24 hour shifts. The system was just too busy and exhaustion was becoming a liability so we started working 12 and 14 hour shifts. We no longer languish in the fancy stations. Instead, we roam around, guided by a computer program that distributes the ambulances throughout the response area as needed. We find ourselves on street corners and in parking lots. I have warmed and rewarmed food in convenience store microwaves, and utilized public facilities that would have had my mother running for Lysol. Hand sanitizer has become my constant companion. Sometimes we are lucky enough to be posted near a fire station and can "borrow" their kitchen or bathroom, but we are forever the red-headed step children of emergency services.

And we are busy. More often than not, the calls are relentless. As soon as we clear the hospital from a run, the pager is going off again. I have been so tired that I have cried and so hungry that I would have vomited if I had anything on my stomach. I have cussed and thrown temper tantrums, blaming dispatchers, the public, and God himself for making my life miserable, but I always run the call. Just when I think I am ready to throw in the towel, ready to chuck it all and go work in a bank, I will give a man a few more years with the wife that he adores, keep a child from succumbing to an asthma attack or help bring a new life into this world, and in spite of my exhaustion, I find myself saying, "I can't believe they pay me to do this."

Z is for Zygomaticotemporal

Zygomaticotemporal...pertaining to the zygomatic and temporal bones of the face. I named this piece thus, not because I plan to discuss anatomy, but simply because I know what that word means. I know what a lot of medical terms mean because I went to college and studied Anatomy and Physiology, Pharmacology, Cardiology...the list goes on. No, I am not a doctor. I'm not even a nurse. I am a Paramedic and there are lingering misperceptions about just what we do and do not know, what we can and can not do. I aim to clear that up.

If you know the history of EMS it isn't hard to see why the level of education and skill required for this profession isn't common knowlege. This is a relatively new service industry. I am 53 and in my lifetime, ambulance services have gone from being run by funeral homes to the sophisticated agencies they are today. As late as the early 1960's, if someone had an emergency, they would call the operator and she in turn would contact the local mortuary who would send an ambulance (basically a hearse with a white coat of paint) staffed by a couple of dudes with absolutely no medical training. Talk about your conflict of interest. What is more lucrative, a ride to a hospital, or a funeral...HMMM?

In the mid-60's things began to change. Congress enacted a law requiring a single number that would connect citizens directly to whatever emergency services were available, and on February 16, 1968, in Haleyville, Alabama, the first 911 call was placed. By the early 1970's, the Emergency Medical Technician course had been established and in less than 50 years, the industry has grown into a vital link in the chain of patient care. I have a degree in Emergency Medical Science. I took the same science and medical classes as the RN students. The course load did differ in some ways. When the nurses were taking bottle washing and butt wiping, I was taking car cutting and butt whipping, but that's a whole other blog topic.

Unfortunately, respect and especially compensation have not kept up with the growth in the industry. I have been asked if we have oxygen, been called a "stretcher bearer" by a nurse, and have been ordered to "just take me to the hospital where I can get some help". I was transporting a homeless man once who looked a me and stated, "You're a loser 'cause you're nothing but an ambulance driver"...a HOMELESS MAN!

In spite of these short comings, I love my profession. I have worked in EMS for over a quarter of a century, all on the front lines and I wouldn't trade my life with anyone. I am looking forward to sharing some of my experiences, from Z to A with folks and can't wait to read about the lives of others. There is one question that I am sure everyone reading this wants to ask. I have been asked it hundreds of times in my career, so I'll go ahead and answer it...Yes, I drive the truck!