Glimpse of the End


Let me say right from the outset that I love being a paramedic and dread that day that I can no longer do this work. That said I have had two moments in my career where I have glimpsed that day.

These moments are not moments that you would expect. It was not a bloody, gory call or a tragic death of a child or even the more typical getting splattered with poop and vomit.

Approaching Sirens

The first moment was actually many years ago. I had probably been a medic five or six years. We were called for a multi-car motor vehicle involving a semi-truck. I was the first responding ambulance, but two others were within siren range. I stepped out and got the quick run down from a first responder. There were four patients. The sixty-year-old driver of the truck who had a head laceration and no recollection of the crash, although now he was fully alert and oriented, a thirty-year-old hysterical woman in a car that was pinned between the semi-truck and the bridge abutment who had neck, back and leg pain, and two men in their forties in the pickup that had rolled over, one had neck pain and the other had an obvious broken shoulder. The first responder said a fellow firefighter had crawled under the semi truck and been able to access the woman by entering through the hatchback of her car.

As I listened to the sirens of the other ambulances get closer, I thought how when I was first a medic I would have quickly scooted underneath the semi-truck and gotten into the back of the pinned car to assess the patient for myself. But now the thought of stooping down low and maneuvering myself into position just didn’t seem like something I wanted to do. i thought about the choise between crawling on my hands and knees or staying on my feet and scrapping my back on the underside of the truck. Niether choice appealed to me.

To the first medic I said, “Your patient is pinned in the car. You can get to her by going under the truck.” To the second medic, I said, “You have the truck driver.” And I took the two patients from the rolled-over pickup.

My triage wasn’t inappropriate. You might argue that the first medic on the scene should be the last off, therefore I should have stayed with the one who needed the extrication. But that’s really neither here nor there. I took two patients, one who I gave ALS care. Everyone was treated. No one complained. The crew that got the trapped lady was thrilled by the call and got to tell their extrication tale many times over that day.

The point was I stood there and thought I really don’t want to have to go under that truck unless I have to. Maybe it’s because I am six-foot-eight (I was likely six-foot-nine then as this job has knocked me down at least an inch over the years). Or maybe it was because I was on that line between not being nimble enough and not being excited enough to call on my nimble reserves and so I punted to the other crew.

I thought that day – I may not do this job forever.

This Morning

The second occasion was this morning. After checking my gear, I got in the bed in the bunk room and took a little nap. I’ve had my annual bad winter cold, aggravated by the dry cold air of late and have been hacking up a storm, enough to disrupt my sleep at night as the phlegm rolls down my throat and sets off a violent coughing attack. I managed an hour or so of sleep when the tones went off – man with abdominal pain.

We pulled up to the house and I got out. It iwas really cold. The thermometer on my car said 6 degrees as I drove in this morning. I would guess it was still not much more than ten, which is cold for these parts, and colder still because it has been so dam cold every day for the last several weeks that it makes me wonder if it will ever be warm again.

A Small House

I looked to the house and saw a handicapped ramp and then saw a very large man walk out of the front door, and motion to us. It wasn’t the motioning of a frantic man, just a motion to say this is the house that called not the neighbor’s. But the size of the man – I pegged him at 400 pounds — made me think for some reason that an even larger man lay within the house, and on this cold morning, we were going to find a very large patient in a very small house and we would face difficulty.

I have been in the houses on this block many times before and the rooms are small and the halls are narrow and in most cases, you can’t get your stretcher into the bedrooms. And taking this all in, all of a sudden I just knew I did not want to be there. I didn’t want to be there in deep-rooted way. As I walked up the driveway, I thought is this really what I want to be doing with my life? Is this what I will be doing for the rest of my working life?

I was right about the patient being large. The two first responders stood inside the door and said the patient was stable, but he was big. How big? They did not know. They pulled back the covers and saw only enough to confirm the patient was large. They chose not to uncover much more. They had the basic truth of the patient’s size and that was enough for them. They said they were glad we had a three person all-male crew. They were waiting there by the door in case we needed their help, but they were hoping we would not need them.

This Time

The hallway and bedrooms were as narrow as I had guessed. The stretcher clearly would have to stay in the living room, but this time the call itself went fine.

The patient had a Hoyer lift and the family was more than willing enough to operate it for us. They lifted the patient up, wheeled him out of the bedroom, down the hall and into the living room and set him down on the stretcher easy as pie. We then raised the stretcher up by pushing the (+) button at the foot of our power stretcher and not a muscle was strained.

The Thought

Still, it was that thought on this cold morning staring at the house that made me take notice –that thought that inside could be the end of my trail –that something small but telling might happen, and that something will happen someday. And when it does, I will say – that’s it. I’ve had enough. It’s time to do something else. And I will finally walk away.

Hopefully that day is still far off.


  • Mike Ward says:

    So, what is the plan when your body, mind or spirit says “enough”?

    Whatever you do, it will not provide the same intrinsic excitement. If you are lucky maybe a similar level of wonder and adventure.

  • medicscribe says:

    Thanks for the comment Mike.

    I don’t know what the plan will be. I guess I hope I can keep working. My shift to the suburban town and only working my regular 40 hours i think will help me stay at this longer, along with our new power stretcher and the tracks on the stair chair we have.

    Every medic I know who has left the street tells me they miss it.

    I’m sure I will, too.

  • Suzi Bernert says:

    I have hit that wall already – back surgery after 29 years. I was lucky, I have teaching credentials and my service kept me in Education. I miss it still, even after 2 years off the street. One thing I am doing is trying to teach the newbies to take care of their bodies, to ask for help if they need it and not ignore “the small stuff”. You WILL miss it, but maybe through your writing, you can help the next generation of EMS.

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