The Myth of Saving Lives

“I couldn’t do what you do.”

I get variations of that quote from most of the people I meet, from John Q. Public to doctors and nurses. Invariably they wax poetic about the drama and romance of Saving Lives and being on the front lines of medical care…

Never mind that the job is rarely dramatic and almost never romantic.

Now, after professing admiration for your altruistic bent and your Life Spent Thwarting the Reaper, many of them will lean in with a feral gleam in their eye and ask in a conspiratorial whisper, “Sooooo…what’s the grossest thing you’ve ever seen?”

Sigh…

There is a little rubbernecking adrenaline junkie in all of us.

Folks, I’m going to let you in on a little industry secret, one that will surely offend many of my colleagues and shock the rest of you. It runs contrary to the image we try to cultivate, both in our own eyes and with the public.

We don’t save lives.

Oh sure, that’s why most of us get into this business – dreams of heroism, snatching people from the Jaws of Death at least twice a shift. Public adulation and all that, you see. But the reality is that the chances we get to actually Be The Difference Between Life and Death comes but rarely in a career. Ask any experienced EMT how many times they can count where they have actually saved a life, and the numbers will be damned few. Folks, cardiac arrests make up about 1% or fewer of the run volume in the average EMS system. And of those 1 in 100 cardiac arrests we work, the very best EMS systems in the country fail to resuscitate them 75% of the time.

Anyone that tells you he has saved many lives is either lying, or still deluded with rookie ideas about his own importance in the patient’s outcome.

A good friend described it this way:

EMS is the Special Teams of health care. In the Great Game of Saving Lives, our job is to field punts and kickoffs and advance the ball as far as possible, so that the offense is in a better position to score. Not that our job isn’t important – no team can consistently win if they don’t have good field position.

Occasionally if we’re very good or very lucky, we run one in for a touchdown all by ourselves. It’s exciting, and rewarding. But it ain’t the norm. Not at all.

The norm is dialysis transfers…old folks with bedsores…hemorrhoids at 3am…scared little kids with minor illnesses…rude people with acute Samsonite Syndrome…minor accidents with lots of whining people with advanced Allstate-itis…the scared old woman who lives alone and calls 911 just because she’s lonely…and obnoxious drunks with no visible means of support who insist that they pay YOUR salary…

And I gotta confess…I love it all. Aside from my professed world-weariness and cynicism, this is what I was born to do. So if you want a real Day In The Life of An Ambulance Driver, here is what we REALLY do…

We make far less money than our health care brethren with similar education. And the sad fact is, a whole lot of us do not even deserve the pittance we’re making.

We bitch and moan about low pay, yet we steadfastly oppose any attempt to advance our profession through higher educational standards.

We make a Big Deal of the whole lifesaving myth, smugly convinced of our own inflated sense of worth, yet we ignore the actions of the untrained bystander who probably made the greater difference.

We eat our own young.

We attract the wrong kind of people to our profession. I’ve often wondered what would make a better EMT- teaching an adrenaline junkie some compassion, or teaching a compassionate person how to handle themselves in a crisis? For my money, it’s Option Two.

At our best, we ease someone’s pain and suffering a little bit, and perhaps intervene in a critical event at a crucial time.

At our worst, we’re condescending, arrogant and rude, especially to people we deem Not Worthy of Emergency Care.

For 75% of those people, we are an entry point into the health care system of the world’s greatest nation, yet we fail to recognize the importance of that simply because the patient’s condition doesn’t fit OUR definition of an emergency.

Sigh…

People ask me what makes a good EMT…and here it is:

If you can be the island of calm when the feces strike the thermal agitator, and keep your wits about you when everyone else is losing theirs…and then turn right around on the very next call and do nothing more than gently hold a frightened old lady’s hand on the way to the hospital and perhaps coax a smile from her…and realize that BOTH are equally important skills…then THAT is what makes a good EMT. Even if they never saved a single life.

Until next time…