Safe Spaces

The girl looked about 12, but her father said she had just turned 16. He had returned home from work unexpectedly, and found her vomiting into the kitchen sink.

We had been dispatched for a “Sick child- vomiting, possibly flu.”

The empty 100 count bottles of Tylenol and the almost empty bottle of blackberry brandy told a different story.

“How many pills did you take, honey?” I asked her quietly as my partner gently helped her onto the stretcher. He placed a plastic emesis basin on her lap. She turned her head away, not answering. Her freckled baby face was streaked with tears and melted mascara. Strings of chalky- looking vomit clung to her hair, and had begun to dry on her shirt. Pulling her arms across her chest, she looked down. Tears and snot slowly dribbled down her cheeks and slipped off her chin. The room was cold, and her pale, almost translucent skin felt even colder. There was no way of knowing how many 325 mg pills had been in the bottles. Or how much of the fifth of booze she got down. She looked to weigh about 85 pounds.

“Let’s get a blanket on her and get going. I’ll get vitals in the truck if she’ll let me. Ask dispatch to get a medic started our way for an accidental poisoning” I quietly said to my partner.

No need for everyone in town with a scanner to hear about an overdose, or possible suicide attempt at that address. The poor kid has enough problems.

The medic had given me attitude since he got on board. He clearly felt I was wasting his time. I told him what little I knew. Our young patient became increasingly agitated when he attempted to start an IV and place her on his cardiac monitor. He didn’t bother to introduce himself, or ask her name. He simply shrugged, moved to the captain’s chair and said nothing until we were backing in to the ambulance bay at the hospital. And then he leaned over and got up close to her face.

“This is a really stupid way to try and kill yourself. Next time, get it right. Find some better drugs, or drive into a bridge embankment at 100 miles an hour. Blowing out your liver with acetaminophen is a nasty way to die. It could take days. Or you might just live and end up with brain damage and a transplant.”

I can still hear the echo of those words from a call from that happened 10 years ago.

Because it should never have happened that way.

Because despite the care and compassion my partner and I provided, I knew that little girl would never forget the words of a paramedic who in that moment failed his patient, his profession, and any litmus test that might determine what embodies a decent human being.

These kinds of interactions have been some of the most disturbing things that I have experienced in the back of an ambulance. And far from being isolated incidents, they seem to be proliferating. What chills me to the core is this: in our increasingly angry, “Mean is the New Cool” society, I could post this story in a variety of EMS forums and a significant number of commenters would come to the defense of the medic. And probably provoke a frenzied, rabid posting of memes and EMS platitudes disparaging a patient who today would no doubt be deemed “one of those special snowflakes.”

You know, the ones that just can’t cope, and need blankies and coloring books. Boo-hoo. The ones that create burn out and compassion fatigue, like those other skels- drunks, addicts, the homeless and the lonely frequent flyers. The ones who are undeserving of the time and effort that Highly-Skilled, Infinitely Well-Educated, Super-Excellent Health Care Professionals could be spending on *real*, deserving patients.

The patients the “HSIWESEHCP” crowd talk about incessantly, that need incredibly complex assessments and treatments.

The ones that make up less than 10 percent of all 911 calls.

The EMS community needs to be unified and vigilant about excising those individuals who display a lack of empathy, compassion or respect for any victim they have been tasked to care for. As healthcare professionals and trusted members of society, the responsibility to provide kind, appropriate and non- judgmental care cannot be compromised.

As I watched the inaugural ceremonies take place in Washington, there is no doubt that our nation remains bitterly divided. Promises of change and feelings of triumph give some Americans hope for a better future. But for thousands of others, it is clear they share a collective trauma. Fear, anxiety and despair have displaced any sense of normalcy in their daily lives. Violent protests have erupted in some areas as emotions run high and sometimes out of control. Non- violent protests are somehow seen as undermining the new-found hopefulness of others.

For everyone, there is increasing uncertainty about what the future will hold.

Nobody is “getting over it” anytime soon.

What is certain is this:

“Reassurance” is more than a check box on a patient care report.

All EMS providers need to understand and appreciate more than ever how important a commitment to providing reassurance is not only to the public, but also to their peers. Many are struggling to manage the responsibility, and physical and mental demands of this work while they find themselves emotionally exhausted by the polarized atmosphere and inescapable and hateful rhetoric that has somehow become the new normal.

There should never be a doubt that the EMS workplace, and the back of an ambulance, are safe spaces.

“The World is indeed full of peril, and in it there are many dark places. But still there is much that is fair.And though in all lands, love is now mingled with grief, it still grows, perhaps the greater.”  ~ J.R.R. Tolkien, The Fellowship of the Ring


* A Safe Space is a place where anyone can relax and be able to fully express concerns, without fear of being made to feel uncomfortable, unwelcome, or unsafe because of biological sex, race/ethnicity, sexual orientation, gender identity or expression, cultural background, religious affiliation, age, or physical or mental ability.