Bad Behavior

Years ago I worked for a United States Senator.  One of my early jobs for him was driving him around the state to campaign functions and speeches.  Every now and then someone would give him a hard time about all the rotten people in Washington.  He had a great answer.  He said we were a representative democracy, and that it shouldn’t surprise anyone that Washington had crooks and womanizers and deviants, likely in the same proportion as all walks of life and the general population.

He had a point.

Unfortunately, the same is true of EMS.  While we have many selfless individuals, we have our share of wayward souls, likely in the same proportion of any other profession.

Regularly it seems we see news stories like this one:

N.M. Paramedic Accused of Charging $11,000 on Dead Man’s Debit Card

I wonder when I read these stories what drove these EMS criminals to their actions.  Was this paramedic completely evil?  Did he lack positive role models? Was he mentally ill?  Or was there something more complex and desperate going on?

Here’s another news story I saw recently that did not involve EMS.  

Woman who stole ring from corpse arrested

That’s pretty creepy.  But let me raise this question.  How many EMTs have encountered dead bodies, often old people who live alone, and the EMTs have slipped the diamond off the corpse’s finger and into their own pocket?  Think it hasn’t happened?  There is a long standing story in our area of an EMT who did just this and gave the ring to his fiance.  He was caught fortunately, and fired, and likely prosecuted.  I don’t know the details, but it was a story that has stuck with me for a long time.  

The third story I want to mention is this one about doctors talking inappropriately about patients in their operating rooms while they are unconscious.

In graphic detail, medical journal describes ‘heavy overtones’ of sexual assault in operating room

I suspect that operating room personnel talking trash about patients is not an event isolated to these two cases. They are often in a room together for hours with a patient who can’t hear them.   I can barely recall any episodes of EMS trashing an unresponsive patient in their presence– likely because in most cases we are too busy working on the patients, and family members may be present, but I am sure it happens.  EMS saves most of its trash talk for the EMS room where patients’s grossness or other poor qualities are often revisited.  Some say this is just a means of letting off steam.  A recent one I heard involved a crew badmouthing a patient they had just had to carry down three flights of stairs because he was too sick to stand.  They questioned his manhood — he was a generally healthy muscled man in his thirties with a gold chain around his neck who had been throwing up for a couple hours.  His vitals were perfect – 126/82. Heart rate of 64, room air SAT of 100%, yet they called him a pussy in the privacy of the EMS room because he had put them at risk of injury, and they made great fun of his manhood.  They knew it was their job to carry him if he could not stand on his own, but they had both been out on comp for injuries suffered carrying people, and one of them was running a fever himself, working because he couldn’t afford the time off.  If patients put hidden cameras or recorders in EMS rooms, paramedics and EMTs would be even poorer than they are today.  Is this trash talk of patients right?  Some would say it is necessary to decompress, others would say it still isn’t right, and the problem is it has been allowed to flourish as part of the culture of EMS.  Rather than being frowned upon to talk in such manner, it is often who can tell the best stories of the grossest, stinkiest, biggest pansy patient.  It becomes a sort of badge or honor to be able to top everyone else’s story.  That is not a good thing.

In my years I have seen EMS become much more professional that it used to be, and while it still has strides to go, the change has been for the better.  Things that were once tolerated are no longer tolerated as much anymore.  

When I first started as an EMT working for a small service in Massachusetts, one of the EMTs I worked with once asked me how my patient’s titties were.  He was driving and I was in back with our patient who was unconscious – drunk.  I could not answer how her titties were because she was still fully clothed.  I had not fully exposed the patient as he had instructed me to check for injuries.  It didn’t seem right.  There was no indication of trauma. She was just drunk.  My partner was an moody troubled man.  Every time we went by his ex-wife’s apartment, he’d hit the air horn and announce she was a bitch.  I rarely followed his lead.

About twenty years ago a certain EMT I knew was in paramedic school.  He went to class one day with some Polaroids he‘d taken of a drunk he’d beaten up the night before.  He boasted to others of how he’d taught the drunk the lesson.  He got kicked out of paramedic school and lost his job for it.  The sad thing was that he went to class that night he did sense that what he had done was wrong.  What he knew of EMS told him he would receive way-to-gos for his photos, not the end of his career.  Not long after that incident, a TV camera crews caught an EMT of a nearby city punching a patient in the back of the ambulance.  Few I worked with were shocked by it.  I responded once for an unruly patient giving another crew a hard time.  Another paramedic also responded.  The medic proceeded to choke the patient to submission while I yelled at him to take it easy.  He was upset with my reaction toward him.  Where did you ever think that was acceptable, I wanted to say.  Another EMT at the time lost his job for trying to smother a patient with a pillow who had spit on him.  He did this in the triage line of a hospital in full view of many people.  How did he not know what he was doing was wrong?

I haven’t seen anything like that for a long time largely I believe because it not only isn’t tolerated, it is no longer cool to be a tough, take no shit EMT.  It is much cooler to not be rattled then to put someone else down, physically or verbally.  That is progress.*

To change things, cultures have to be raised up.  That can happen with no tolerance policies and with role models — people who set a standard of behavior they expect others to live up to.

I drew on some of these incidents I mentioned in creating my recent novel, Diamond in the Rough.  Lately, I have chosen to concentrate on writing EMS fiction over non-fiction true stories because I believe it enables a better examination of the way things really are.  There are not just heroes among us.  We are representative of the general population.  But despite the many flawed members of our profession, I still believe in the fundamental decency in all that with guidance can be brought out.

It is not my intention to make EMS look bad by describing these incidents or by creating character who steals from his patients.  My intention is to show how people can rise above the mire based on what is in their hearts, and with the guidance of others they work with.

I took the story of the EMT who stole the ring off the dead woman and tried to write a story where the challenge was to make him sympathetic, to show how he came to do what he did, and to chronicle a journey toward redemption.  

Here are two excerpts from the book that reference the true versions.  Tim, the narrator (and soon-to-be-thief) is a new EMT, who is paired with his friend Fred, who is a poor influence.

***

I knew pretty early on that I was going to have some problems with Fred as a partner.  What I liked best about the job – aside from firing up the lights and sirens and parting the traffic like Moses himself – was when I would come into a house and find a sick person there in need of help, and see them look up at me like they were seeing an angel.  I felt needed.  I was there to help — no matter who they were or what had happened to them.   There was an instant connection between me and the patient that had nothing to do with anything either of us may have done in our lives.  It didn’t matter who we were, where we were from, or how we felt about anything.  We were bonded by the simple need for help and by the basic human desire to aid another in distress.  Then Fred would go and make some rude comment like, “Did you call your Doctor?”

       Now I know a frustrating part of the job was that too many people used us as a taxi ride to the ER whenever they had a sniffle instead of making an appointment and taking a cab to their private doctor if they had one, which many didn’t.  But why embarrass a sick old grandmother in front of her family, particularly one who feels awful and is vomiting up her breakfast.   Fred seemed to get off on an EMT power trip like he had some kind of authority over these people.  I did not like watching as he made an old woman walk or wouldn’t let her go to the bathroom if she needed too.  “You called 911.  Let’s go.  We came here lights and sirens.  You have an emergency, you’re going now.  You’re not the only sick person in town.  There’s  people getting shot, having strokes, heart attacks, cars wrecking, even babies not breathing.  They call for an ambulance.  Sorry, Charlie.  They’re all busy.  We go now or we don’t go at all.  Make up your mind.  Capice?  Now let’s go.  Chop chop.”  I guess I was more in the “Why make it harder on someone than it is?” camp than in the “Bust them because you can” modus of operation.  Still I kept my mouth shut because I was the newbie.  Kept it zipped.

       “483, Pig’s Eye pub, on a one for the unconscious.”

       “Someone had too much beer,” Fred said, “Let’s hope it’s a frauline.”

       Fred got his wish.  We were led to the ladies room where we found a young woman passed out in a stall.  I recognized the red hair and the lime green dress.  It was the girl I’d driven home in my cab that night. She’d puked a fair amount, and her freckled face was pale, cool and wet.  She moaned as we picked her up.  She couldn’t have weighed more than ninety pounds.  If she was a dancer, even I could have lifted her above my head by myself and twirled her around like a ballerina though I suppose in her present state she wouldn’t have appreciated it.  I caught Fred taking a glance up her dress as we moved her to the stretcher.  He raised an eyebrow at me.

       We wheeled her through the crowded bar with all the people drinking with the music blaring, and not one person coming up and claiming to be her friend.

       “Mind if I tech this one?” Fred asked, as I lifted the stretcher wheels up and he pushed the stretcher into the back.  We were supposed to alternate and it was my turn to be up.

       I jumped in.  “It’s my tech,” I said.

       “Your tech?  What kind of gratitude is that?  After all I’ve done for you,” he said, and then added, “Check her out good.  She ain’t wearing panties.”

       I ignored him.

       “Like they say in EMT class,” he said.  “You’ve got to expose.  Check for injuries.  Be a good EMT now.”  And he shut the back door leaving me alone with her.

       She was out cold, her head on the pillow, moaning softly.  She didn’t resist as I took her arm and wrapped the blood pressure cuff around it.

       “I’ll take a few spins around the block,” Fred called.  “I’ll try not to get to the hospital too soon.”

       Her vital signs were all fine – she was just drunk.  I moved her into what they call the Sims’ position on her side in case she vomited.  She didn’t even seem to know I was moving her.  I sat there on the bench looking at the poor girl.  I tried to imagine myself as her boyfriend, watching her sleep at night, wishing I could curl next to her, her back into my chest, as I kissed her behind the ear and told her things would be all right, told her that she’d feel better in the morning.  Of course I would have made her drink water and take Tylenol before helping her into bed.

       I had to dig through her purse to get her ID.  I wrote down her name.  Sarah, along with her address.  I admit I did look through her pocket book some.  Technically I was looking for any prescription meds she might be on or any other medical clues that might help with the diagnosis. She had twenty dollars and two credit cards, an ID from Glastonbury High School, a library card, her license, a fake ID that said she was twenty-one, a small pack of Big Red gum, several things of lipstick and other makeup type stuff.  There were two crumbed napkins with guy’s names and phone numbers on them.  I found another napkin in there and wrote down my own name and number.  I crumbled up the other napkins and tossed them in the trash bin.  I was shocked by what I had done, but at the same time impressed with my quick thinking.  Maybe she’d actually call me.  It’d be nice just to hear her voice on my answering machine.  For a moment I fingered her little vial of perfume.  I opened it up and smelled it.  I thought about taking it, and keeping it by my bedside.  But then I thought that would be the sort of the thing a pervert might do, so I put it back, feeling guilty for having invaded her privacy.  I even considered taking the napkin back out of her purse, but I didn’t.

       “How’s her titties?” Fred called back.

       “Real nice,” I said.  “First rate.”

       I wasn’t of course, looking at her titties.  I hadn’t exposed them.  I wouldn’t have minded seeing them, but not that way.

       After the call Fred asked me for all the details of what she looked like.

       I gave him a line of bull, which caused him to cackle, and slap me on the shoulder.  “You owe me good,” he said.

       I admit to being depressed about it.  If she had hooked up with me, she’d never be passed out alone in some public lavatory.  If she ever called me and we actually went out, we’d spend the evening in style.  A nice dinner, wine, maybe I’d pay for the violin guys to come around and play for her.  We could have a flaming desert, and go for a nice walk afterwards.  She wouldn’t even have to let me kiss her.  She’d say, “You’re different from the other guys I’ve known.” And she’d ask to see me again.  I could close my eyes and hear her say that just like it was real.

       “I knew she’d have nice titties,” Fred said, still cackling.  “I should have come in back and gotten a look.”

       At least he was in a decent mood.  At times he was subject to fits of rage.  If he thought someone was messing with him he got right in their face, and so I avoided upsetting him if I could.  I didn’t like confrontation and he’d gotten big enough in the gym that any battle between him and me wouldn’t have been pretty.  They even suspended him for a week for throwing a fellow employee up against the wall when he thought the guy had called him an ass when the poor guy in fact hadn’t even been talking about Fred.  He would have gotten fired, except he was a good employee in the sense that he showed up to work and put his butt in the seat for twelve or more hours a day most days of the week.

        I enjoyed working with other people in his absence.  EMTs like Faith Creer, Jerry Sneed and Eddie Bozigalup made me feel much better about the work, made me believe you could actually see it as a profession.  They didn’t bitch, they didn’t complain; they treated people with respect.  I wanted to be more like them.

***

857 was sent to the corner of Main and Hudson for an unresponsive/possible ETOH.  Tom and I were bored so we headed in that direction to back them up in case they needed a medic.  They were on the other side of the ambulance when we pulled up.  Tom’s cell phone rang then and since it was one of the girls he was after, he took the call, and told me to come get him only if the other crew needed him. I got out and went around the ambulance just in time to see Fred pop the man in the nose with his fist.  His partner pulled him off before he could hit him again, and I rushed to block the man’s friend from jumping on Fred.

       “That ain’t right!  That ain’t right!” the man protested.

       “You saw him.  He came at me,” Fred said.

       I could tell by his partner’s eyes that Fred was not blameless.

       “Calling you a dickhead, ain’t no reason for you to punch a defenseless man.”

       I looked at the man on the ground.  His nose was spattered wide open.  He reeked of alcohol.

       “Shut the fuck up or I’ll take care of you, too,” Fred said.

       “Get in the front,” I said.  “Right now!  Get up there!”

       I couldn’t believe Fred.  I’d seen his temper, but not like this.

       I think maybe he realized what he’d done because he let me bully him away from the other man who was calling for the police now.

       “Jim will stick by me,” Fred said.  “Jim will tell him.”

       I worked with Jim to get the man up and on the stretcher.  A police car was already coming down the street at a slow crawl, and the other drunk was flagging him down.

       We had the man in the back and had staunched the bleeding from his nose.  The cop wanted to know what the story was.

       “He popped him right in the face, hit a defenseless man,” the other drunk said to the officer, who held up his hand, and said, “Just back off.”

       “ETOH,” I said. “He was a little combative, and fell on his face.  He’s okay, just a bloody nose.  They’re taking him to Hartford, you want to catch them there.”  I stepped out and tried not to be too obvious about standing between the cop and his view of the patient, as I closed the back door.  “I was just helping them out.”

       The cop looked like he knew something was up, but he didn’t look like he wanted to follow it up.

       “I’m making a complaint,” the drunk said.  “I am making a complaint.”

       “You can call this number,” I said, and gave him the supervisor’s phone.  “That’s our supervisor.  He’ll investigate.”

       “Investigate my ass.  I want the police and the state investigating.  This is cold blooded wrong.”

       The cop ended up getting a statement from me, then went up to the hospital to interview Fred and his partner.

       “What the fuck was that all about?”  Tom asked when I got back in the rig, finally hanging up his phone call.

“You don’t want to know,” I said.  “Fred popped a drunk and his buddy told the cop.”

       “Did he pop him good?”

       “Broke his nose.”

       “Did he deserve it?”

       “Probably not, but…”

       “Well, he’s a drunk, his story will be no good, but someone has to talk to Fred.  He’s giving us a bad name.  He’s wound too tight these days.”

       The supervisor came down to the hospital and suspended Fred on the spot.  He talked to me and to Jim, Fred’s partner, and I told him I hadn’t seen anything, but said the man was drunk and combative and probably did slip.

       When the supervisor told Fred he could go home, Fred cursed him up a load and gave him the finger as he walked away.  I thought for certain he’d be fired, but he wasn’t.

       The next day, while Tom and I sat in our ambulance on a street corner, Fred showed up in his private car and tried to get Tom to get the union to appeal his suspension.  “Appeal?  You’re lucky you haven’t lost your cert, you crazy psycho.  You need to just chill the fuck out,” he said.

       “Com’on, he was just a fucking drunk!”

       “Com’on, you’re a fucking EMT!  You’re not supposed to hit people, drunk or not.”

       “You’re the union President, you’re supposed to represent me.”

        “Listen for all the crap I have pulled, I don’t come close to representing you.  You want your union dues back?  I’ll take a collection.  People will be happy to donate to get you gone from our brotherhood.  Here’s five dollars.  That’s my donation.  Now get lost!”  And he rolled up the automatic window.

       Fred just stood there like he had been slapped, then head down, he walked back to his car.  He sat in there with his head on the wheel.  It looked like his body was shaking.

***

To read more of — Diamond in the Rough — Order Today.

Diamond in the Rough

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  • The physical combativeness toward patients I used to witness may have lessened somewhat due to the changing response patterns.  Years ago, we often responded alone to most calls.  No police, no fire.  Now, there are many more people on scene, and we are also now told to stage for EDP patients until police can arrive to ensure the scene is safe.  There is less chance for physical confrontation, as well as more eyeballs watching behavior.

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