I am one of my own favorite comedians.  Perhaps you have seen me on the Johnny Carson show?  No, perhaps not then.  Sometimes I really crack myself up. I am easily entertained.  I don’t perform publicly, other than in small bit roles for my partner and patient while on the job.  My latest gag has to do with the power stretcher.  Once we get the patient on the stretcher and all wrapped up in blankets and strapped in, I stand at the head and dramatically levitate the patient by slowly raising my hands like a master prestidigitator, as my partner presses the up button, then just as we hit the top, I spread my hands out, like a conductor finishing a movement.  The dialysis nurses love it!  I take it that their days are generally lacking in comic diversion.

While taking a patient out to the ambulance, I realized for all the benefits of the power stretcher, we still have to load and unload it, so I wondered if perhaps the next generation power stretcher would be more robotic where we would not have to lay our hands on it to load and unload.  We can stand like foremen in a high tech warehouse and move the stretcher in and out simply by turning a knob on a remote control device,  It gets even better the more I think about it. 

 You know how soldiers living in the suburbs drive to work at their base in Las Vegas or Omaha or some Middle American city, take their desk in front of computer screens and go to war, launching missile strikes, flying predator drones, etc?  Picture EMS in a few years.  Instead of getting in our ambulances and going out on calls, risking life and limb while driving lights and sirens, and walking up three flights of wobbly stairs as cockroaches scatter at out feet, dealing with blood, vomit, decay, and unexpected violence, what if…?

 The paramedics of the future practice by remote control.  We use keyboards and joysticks.  A mechanical arm restrains the patient, while we identify the vein with a little red laser dot and fire the catheter in.  Using a stylus we tap the computer screen, checking a box for the drug we are going to give and the amount.  Zofran 4 mg SIVP over 2 minutes.  If the patient looks like they are about to vomit, no problem.  No need to quickly jump out of the way.  So they might splat on the camera, our camera will have automatic windshield wipers so our vision will only be briefly impaired.

 But I know this sounds too mechanical.  Where is the human touch, the caring?  Why we have paramedic drones.  Robots, and with time they will look less like department store mannequins and more like us.  Eventually, they will be so real people won’t even know they are not being treated by robots.  Their caregivers will look like us, complete with bad haircuts, sweating pores, occasional foul mouths, and sore backs.

And we may not be the only robots.  The nurses and doctors could be robots too.  And why not the patients?  I mean why be sick and in pain when your robot self could suffer for you.

Of course with the economy and the need to impose efficiencies, there will be mass mergers, and soon the EMS world will be all managed in one place by just a few super EMS — let’s call them — gamers.

And what fun they will have!  Since they control not only the EMTs, but the patients and the other medical staff, they can devise elaborate scenarios to mess with us.  “Hey,” one gamer says to the other.  “Let’s F— with Medic G today. ”  “Sounds like fun!”

 The ancient Greeks believed this was how their universe operated.  They were just pawns at the mercy of the gods who sat up on Mount Olympus and played with them while they drank wine and ate meat dripping with fat.  One could only hope to win favor with the gods and protection — to be given gifts of strength and speed and not be sacrificed on a whim.  Maybe today, this is how it is for us too. 

 The gods that oversee us  start hitting all the buttons – fourth floor carry downs, frequent flier with same complaint, long triage lines,  incomprehensible dispatching, irritable nurses,  traffic, spitting patients, pagers going off, sirens, swearing, screaming, conflict, insanity.   All day long they ramp up the stress until at 4:58 the medic’s head starts spinning.  The gamers try to ease the tension back, but it has gone too far.  The head starts smoking, fire comes out of the nostrils and then the head completly blows off and fireworks shoot out of the medic’s open neck and then the screen goes blank.

Meanwhile the next day you come to work.  “Anyone see G?”   “No, he didn’t come in to work today.”  And like so many others in the past, another one of us is gone with no trace, only rumor.  “Yeah, G.  I was at the Institute for the Insane yesterday and I swear I saw him walking the floor in just an untied Johnny, shuffling along with his bare butt hanging out the back of his gown and a vacant look in his eyes. ”





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