Searching for Serenity

I seek a state of grace. I want to do every call the way it should be done. I’m not talking about the medical aspect, although I try to do everything right. It is in my case or maybe in anyone’s case, not possible. I do the best I can. What I am talking about it the attitude aspect. I want to have the right attitude – toward the patients, toward the job, toward the work, toward the profession.

I think sometimes to do that I need to retire from the discussion – from the talk about the patients, the talk about other medics and EMTs, other ambulance companies, hospitals, nursing homes. Did you hear? These jokers…Can you believe? And they call themselves. This f-ing guy? Blah, blah, blah…

I have always admired the older quiet medics, who come to work, do their job, sit quietly while they write their reports, never engage in the chit chat of the moment, just go back out and do the job, provide good care, are nice to everyone, and then go home.

EMS, by a strange set of events happened to become my profession, my work, and a large focus of my life. I like that when the day is over, my work is largely over. I don’t have reports due or projects. But I am on committees, I do write about it, and for better or worse, it is a big part of who I am (And I work so many hours). I get caught up in it and everything it sometimes entails.

I get fired up too easily when I think about all the things that aren’t perfect about EMS or the people in it. I’m not even going to list one for fear of raising my blood pressure or going down a path I don’t want to. And while I admire people who tackle problems and fix them, who want to be a part of the solution, sometimes I just want to cleanse myself of all of it. I don’t want to judge, I don’t want to have a bad opinion. I just want to go through my day quietly, trying to be a good man by my own standards, and not judging anyone or saying a word, until I can achieve that state.

Now I’m not going to stop going to meetings or unfortunately, gossiping in the EMS room or at crew change or even writing in this blog. It is just a small wish that I could just be good at all the small things. Maybe what I do need is a vow of silence for awhile. A vow that I will not speak ill of anyone or anything just to hear the sound of my own voice. I want serenity.

***

I had a stressful day on Saturday, including two “medical alerts” – an unresponsive with a difficult carry down and a bad COPDer from a nursing home — and then a cardiac arrest at the end of the shift. The cardiac arrest was also at a nursing home. It came in as an unconscious. On the way we were updated that universal precautions were in effect for the patient. A nurse’s aide, fully gowned, met us in the hallway and started putting gowns and face masks on us. I asked why? What was the condition? but all she would say was the nurse would tell us. So she put long yellow gowns on us, and face masks and still wouldn’t even tell me what the patient condition was. Then she pointed to the room and we walked in, and wouldn’t you know, they were doing CPR on a naked man laying on the floor with a full colostomy bag that looked like it was about to burst. Three minutes we had been standing in the hall, getting the gowns on and trying to get a story. I guess they had gowned us because he had respiratory MRSA. It was my partner’s first code. We got the patient from asystole into a PEA and had to transport, but they called him dead at the hospital. All told, counting scene and transport, we did CPR for 45 minutes to no avail. When we arrived at the hospital, my partner didn’t know how to turn the siren off, plus the parking lot was filled up, so we were parked on an angle with the siren going full tilt, until I could finally get her to hit the right switch. We jumped out still wearing our yellow gowns and masks and the initial people who had come over to help suddenly disappeared. Once we got inside, the hospital sort of chuckled at our torn infection suits. Some places take respiratory MRSA more serious than others. If everyone else is wearing a gown, and they are dressing me in one, I let them put it on me. If they didn’t have gowns, I probably wouldn’t have thought to put on one. Can’t hurt, I guess. Particularly if I am the one who has to intubate.

It took a long time to cleanup and restock. I punched out late, drove home, slept for a few hours, and then got up at five and headed back to work.

It was a much better day. After checking my gear, I got to sleep for a couple hours, and then did a couple routine calls. I had a hearty lunch – thick clam chowder with fresh nine grain bread — watched some football, and then decided since it was such a nice day, I would ride my bike around the industrial circle for awhile. I just got the bike back from the shop the day before and hadn’t ridden for a week. For the last year I have been doing my triathlon training and really enjoy the solitude of biking. I put my radio in my pocket and just pedal around the .7 mile loop. Being a Sunday I can do a figure 8 and go down another road and around the town garage since there is no traffic there on Sunday. It makes a more pleasant mile long course. I had just done four easy miles and was thinking, this is great – what a day, what a life – I feel great — today I am going to go for a record. I’m going to do 16 miles, when the tone went off.

I recognized the address. Georgia again. Our most frequent flyer and subject of my last post.

We drove to her apartment complex non-priority. The complaint – same as always – pain. Now as I wrote in my previous post, I was feeling a little guilty that I had not picked up on her fractured shoulder head that last time, so despite the fact that I could still be riding my bike through the leaves on this maybe last pleasant Sunday of autumn, I resolved that I would be nice to her – extra nice.

How are you Georgia? I asked as I went into her apartment. How’s the shoulder?

It hurt that’s why I called.

How come your arm isn’t in a sling?

I got tired of wearing it. Get my cane and my coat.

Did the hospital give you pain medicine?

Yes, but my arthritis patch is done and I don’t have any refills, so they are going to have to give me a new patch.

Back to Hospital A?

No, I ain’t going there. Take me to Hospital B.

But Hospital A is the hospital we always take you too – they are the ones who have been treating you?

I don’t like the way they treat me. Take me to Hospital B.

Reminding myself that I am going to try to be nice to everyone regardless, I don’t argue, even though my girlfriend is working at Hospital A, which is also the closest hospital. Hospital B is on the far side of the other town.

Whatever you want, Georgia, I say.

I help her onto the stretcher and fluff her pillow and am pleasant to her all the way in.

At the hospital, they put her in the hallway. I wish her well.

When we get back to the base, I slide my radio into my pocket, get back on my bike and ride my slow loop, feeling the breeze in my face, the clear air in my lungs, taking in all the color — the red, yellow and orange — before the sun sets behind the trees.

6 Comments

  • Anonymous says:

    You did it! You have to be proud of that,as I feel proud of you just reading it.You were great,even to the ungrateful,and that’s what it’s all about! I love reading these posts,seeing you evolve,and keeping me believing that I,too,can keep evolving.Thanks,Peter!

  • Anonymous says:

    I find that the people who are most unhappy with work are the ones who gossip the most.That’s not to say I take some moral authority against gossip. I love to hear it. But I try not to spread it. I work in a large EMS organization with a lot of colorful people. The gossip machine never sleeps.There’s things you can change. Often, these are items within your immediate locus of control:Work habits.Attitude.Personal habits that impact work (drug or alcohol use, sleep patterns).Desire.Then there’s the things you can’t change.Systemic deficencies.Protocols.Mindset and attitudes of others.Habits of coworkers.So it takes a conscious effort to prevent the unchangeable factors from impacting the ones I can change.I really enjoyed Viktor Frankls book, “Man’s Search for Meaning.” It’s pretty fundamental in how I’ve approached things — when I can remember to stop and think of it.Frankl was in this environment he had no control of: a concentration camp. Everything he had in the world was taken from him. His life’s work was destroyed. His identity replaced. His health damaged. His family murdered.But here’s a guy who said, in so many words, “This f-ing blows. These people have screwed me, and everyone important to me over. They’ve robbed me of my identity, and my life, and tried to turn me into something I’m not. But what they can’t do is tell me how to think and feel about it. I can’t control what happens around me, but I can control how I let it affect me and how I think about it.”So Frankl found ways to see the beauty in the world, even though that world was 99.9% horror. Instead of dwelling on the 99.9%, he made an effort every single day to find, and relish, that .1%. He also found motivation to keep going everyday. Keeping little notes, recreating his publications on scraps of paper, all knowing that one day, he’d take these scraps of paper and turn them into a tome of something special.So, what I try to do is take a really shitty situation, like someone being a dick to me, be it patient or nurse, and say to myself, “This attitude is that person’s. Not mine. I am not going to let this dick decide my feelings, and let some jerk control how I think.”About 40% of the time, I remember to do that. The other 60% of the time, I get pissed and crabby, and sometimes yell at people. But I still count it as an improvement. The day will come when I do that 50% of the time, then 80% of the time, and so on, until one day, I will be able to just glide over the potholes and canyons of the world without letting awful people pull me down.

  • Stacey says:

    “A vow that I will not speak ill of anyone or anything just to hear the sound of my own voice”I am really glad you posted this. It seems like you and I are in the same place attitude wise. Last year you could not force me to talk crap about people. Unfortunately I let my self get sucked into the gossip machine at work. You can really feel yourself becoming bitter when you allow yourself to talk about people. I have made a conscious decision to try not to let myself get sucked into bashing people. So far I have been doing pretty good and although I have to bite my tongue quit a bit I feel a lot better at the end of the day.

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  • NYC EMS says:

    Stopped by to say Happy Thanksgiving! Im a new reader….WOW!

  • FireResQGuru says:

    It’s hard, to say the least, to remain upbeat in our line of work. We see so many bad things that we often have little control over. We try and pick up the pieces of other peoples shatterd lives. It sometimes is difficult not to get get caught up in the gossip and not make comments. Sometimes, it really does help to vent it out. If you dont, and you keep it all inside, you will drive yourself nuts. Just remember that talking about what we do can be theraputic, but the wrong type of talk or gossip can be harmful. I enjoy reading about your calls. It’s true, no matter what EMS service you work for, the calls are all very much the same. We have very similar patients, the frequent flyers. The ones you can address by name when you arrive, the ones you don’t have to ask for history & meds because you know them by heart and just transported them 2 days ago. It goes with the territory, I guess. Keep it up!

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