X-ray Chapter 6, part 2

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Nonradiating chest pain, it turned out, respirophasic, exerted by moving and tender to the touch. Strong pulse, lungs clear, mentating well. Ian completed a CYA EKG, which showed a normal sinus rhythm in all three leads. History was remarkable for helping a friend move a sofa yesterday, "you know, one of those sofas with the foldout bed. Do you think that's important?"

"Probably," Ian said. "We can take you to the hospital, if you'd like. I think you're sore from moving that sofa," Ian said. "I'll take you to the hospital if you want, though -- otherwise, if we can clear you with the doctor on the phone, you can stay."

"I don't know," said the patient. "I think I'd rather go to the hospital -- I mean, you guys are just the ambulance drivers, right?"

In cleared his throat in attempt to master himself. "We're paramedics," he said evenly.

"Yeah," said the patient. "You're the ambulance drivers."

A veil began to fall across Ian's vision. He turned his attention to shutting down the EKG monitor to give himself a moment to regain his civility, then, "we have hundreds -- thousands of hours of medical education," he said calmly. Five of them -- five hours -- relate to driving the ambulance." He felt Marcus's eye upon and he avoided looking in his partner's direction, busying himself with the stair chair to make this less obvious. When he could no longer reasonably continue with this he said to the patient, "if you'll slide over to this chair we'll carry you down to the ambulance." He gave the stair chair instructions ("don't reach out") and tipped the chair back. Thankfully, there was an elevator in the building, and only one step to the stoop. Soon they were in the ambulance, dropping the patient off at the hospital, and back in service. Ian was thoroughly dissatisfied with himself; his outburst was unjustified, unjustifiable, and he waited for a lecture for Marcus.

He was disappointed in this, at least at first. Marcus was already in the cab when Ian joined him. He said nothing, but dropped the ambulance into gear. A few minutes later he spoke, but only to asking how Ian liked his coffee before double parking the ambulance and briefly stepping into a deli.

"Back when I started in EMS," he said after he handed Ian his coffee and they had been sitting quietly for a while, watching the world through their rain-flecked windshield, "we had a portable, oxygen powered resuscitator, a bag of trauma supplies, and that was it, really. We carried a first-aid cart from the Red Cross, and we drove fast. Nobody ever imagined defib could be done in the field, because we weren't doctors. No imagined we could give drugs, or start IVs. We had an old pickup -- I think it was a Dodge, or maybe it was a Chevy. Probably a Dodge. But we put a red light on the roof and a sirenlight the front fender, and if the patient needed to be transported, we phoned the mortician -- he had the only car that could carry a person lying down -- and he'd take the patient to the hospital." He fell silent, looking back over a quarter-century. "It wasn't that we didn't think we could use the drugs or defibrillator," he explained, "but the docs didn't, and that was that."
Ian nodded to show that he understood.

"Ian, people don't know we do because we do more every day. They all remember 20 years ago, and don't think that anything has changed. They rarely get the chance to what see we do. And when they do," he added, the thought suddenly striking him, "when they do, they're usually more worried about their illness than what we're doing. Or with their family member's illness.

"Ian, every EMT is a paramedic, and every paramedic is an ambulance driver. You know who you are, you know you can do, and that's what's important."

After they sat quietly for a moment or two, Marcus turned to the computer and put them back in service. Immediately the computer beeped and their radios crackled: unconscious patient. Ian put them en route, Marcus dropped the transmission into drive, and away they went.

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