A Day on the Front Lines

I drive up to a building that looks like a schoolyard. The sky is pitch black—it is 5:30 in the morning, and my heart is pounding from the two coffees I forcefully ingested to keep myself awake. I would spend the next twelve hours shadowing people on the front lines of medicine.

The EMS personnel at the station I visited worked 24-72’s, which meant that they would work from 6:00am to 6:00am the next morning and spend the next 72 hours recuperating. I discovered that for many of them, recuperating was taking classes to gain next level certification or going to PA school. Due to short-staffing, there were several times a month where they had to be ready to haul to the station to serve as backup personnel. There is a lot of pressure—each station is run by a paramedic and an EMT. That’s it. There’s no room for delegation or relying on others.

I had just gotten settled into the station (which closely resembled a small apartment with a kitchen, a bathroom and a nice bed to nap in) when our first call came in. Within minutes, we were off to a construction site—a worker was injured on the job and likely had several hip fractures. I watched as the lead paramedic carried the patient straight to the truck on a stretcher. Within minutes, narcotics were being injected and the patient drifted off into a hazy slumber. Not a moment was wasted in ensuring that this patient was free from pain as we pulled out to the nearest trauma center.

And the coolest part was that during this whole chaotic thing, I sat less than two feet from the patient. There’s this strange feeling of camaraderie you feel being close to a patient as they are being cared for. I felt invested in this person—I knew that after he left the ambulance, I would never see him again, but at that moment, I felt like I knew him. We put him on the phone with his wife, and as he talked to her, his weak voice like sandpaper, I was right there with him.  I can’t quite put words to it—but I’ve never felt a patient connection like that before.

After taking him to the hospital, we took a break and got breakfast at a Texas Roadhouse. And of course the second I decide to go to the bathroom, I hear the pager go off, signaling another call and another patient. As I come running from the restroom, I curse my poor timing. At this point, it’s 8:30am—and the lead paramedic has had two monsters and a coffee.

Before lunch, we had a couple of calls. I learned that as a paramedic, you see it all—some days it’s running an old person to the hospital over a broken toe, and other days it’s racing after a patient in cardiac arrest. EMS is equipped to handle everything—IV drips, narcotics, AEDs and other bells and whistles are stocked in the truck. And this stuff isn’t cheap—an ambulance ride can cost a thousand dollars without insurance.

After lunch (considered a rare luxury by EMS personnel), we got a chance to talk. Paramedics deal with a lot of junk—stubborn people, habitual drug users, violent drunk people, gunmen etc. Working in an ambulance isn’t as glamorous as people think, and paramedics aren’t exactly treated like royalty. They told me about a fight they had to break up the other day in which the paramedic was compelled to knock the assailant out cold, all during rush hour at a friendly neighborhood Chick-Fil-A. A lot of patient interactions with paramedics are in times of high stress, and not knowing what is going on is the most demoralizing feeling in the world for a patient.

After learning some trauma basics (ask me about the lethal triad!) and how to use a tourniquet (this is a very important skill, and when done correctly can save a person’s life), we got another call—a “stabbing”. That was all we knew.

When we arrived on the scene, I donned a bulletproof vest and observed policemen clear the area. Sirens flashed all around. I could hear my heart pounding. After a few minutes of uncertainty, we got the story. It turns out a couple had gotten into a fight, and one partner had stabbed the other in the hand with a box cutter. We had no idea what the situation was until we got there, and I spent the whole ride stressing about what could have happened. Thankfully, there were only minor injuries: the victim was rushed to the ER with only a wound in the center of her palm, and victim services promptly took up the case.

Before I knew it, my shift with the EMS team had come to a close. It was 6pm—the team would spend the next 12 hours dealing with the chaos of a Saturday night, and I was back to studying for my next biochem exam. As a person who thrives in chaos, I found a home in emergency medicine that was far removed from the realm of differential diagnoses and week-long blood tests. There’s a good helping of drama and despair, pain and sometimes death. As the EMT told me, you’re never quite the same after seeing a baby die in the arms of her mother or racing to stop a teenager from taking his own life. But it’s knowing that you made a difference in someone’s life that makes it so worthwhile in my eyes—the sighs of relief when the construction worker’s wife heard the words “I’m ok” and other magical moments stand as a testament to the sacrifices you make every day on the job.

Thank you for reading, and feel free to let me know what you think/leave a comment below! (Your email address will be kept confidential)