Cameo of System Abuse

Sunday, August 21 2005

An auspicious start for a duty night. General tones dropped, and the station south of us is dispatched to an overturned vehicle, one occupant ejected. This is muy serious stuff. We follow the call on the computer aided dispatch (CAD) system, and the radios. An engine company is called to clear an LZ for a helicopter to fly out one of the victims. The nearest first-class trauma center is fewer than ten miles away, but that’s ten to fifteen minutes by ground – the victim just doesn’t have that kind of time. Both a medic and a basic unit are on scene, so it’s unlikely that DTs and his merry band will be needed.

But wait! Station tones drop, and off we go! The dispatcher relays the address as we pass through the vehicle bay and into the unit. The station doors roll up as DTs locates the address in the map book. Further details arrive as the driver rolls the unit onto the apron, hitting the lights.

“Turn left,” says DTs, “Then take the first right.”

“What’ve we got?” asks his partner.

“Adult female. Sore throat.”

“You’re shitting me,” his partner says. “We’re going lights and sirens, people are panicking to pull over, we’re gonna blow some red lights and make people stop on green – if they’re paying attention – for that?”

“Let’s pray we get there in time,” says our steely-eyed Hero.

“Yeah,” says the driver, “With the chopper busy, it’s all on us. Straighten your shoulders, DTs – they have become stooped with the Weight of Terrible Responsibility. I’ll grab the Lifepak when we get there.”

Could it have been “something”? Sure, if the sore throat was the result of Drano gargling. By all means, we make the bambulance go with blinkies and woo-woos, just in case. But one acquires a feel for these things, and it was what you might have guessed – what we in EMS refer to as System Abuse.

Now, kid calls are never system abuse, even if it’s simply a scraped knee that First Time Mom doesn’t know how to dress. I love it when kid calls are for “nothing”. It beats hell out of when it’s a kid call for “something”. And we carry little plastic fireman hats we give ’em, which is always fun. But we’re talking about adults here.

Case in point, from the transport gig. We’re dispatched to Hospital X to take a patient home. Our patient is quite large. Each of her legs was bigger, and weighed more, than me. Best estimate from the hospital is 520 pounds, and it ain’t glandular. We load the patient into the ambulance and two ambulances (one for her, the other with personnel to help lift at the destination) are heading to her home.

“How far are we from Hospital Y?” she asks. “I should probably go to Hospital Y. My other doctor is in Hospital Y. Can you take me there?”

“No ma’am,” says the attending. “We’re taking you home.”

I’m having chest pain,” says the patient. “It’s radiating all through my right arm.” Ping! “radiating” pain is a possible symptom of a cardiac problem. But who says “radiating”? She knew the buzzword – but got the wrong arm. We pull over anyway and the medic from the other ambulance climbs aboard. As he climbs in, the driver from the ambulance comes over and tells me this patient was taken to Hospital Z just two days ago. Hmmm.

“I hear you have some chest pain?” the medic asks skeptically.

She senses he’s not buying it. “No, it’s my kidneys, they really hurt.”

“Kidneys,” says the medic.

She stares a second, then quickly says, “No, it’s my hernia. I have a hernia. I should really go to Hospital Y.”

“Ma’am,” says the medic, “Your doctor said you were well. His orders are to take you home.” He gets back into the first unit, and to the home we continue.

“I have to pee,” says the patient. The attending says there’s no way he can lift her to place a bedpan, she’ll have to hold it. No, the patient lets go with about two liters of urine onto the cot while maintaining a smirking eye contact with the attending. This is payback for not taking her to Hospital Y. When that doesn’t seem to faze him in the least, she lets go again five minutes later with another liter or so. Strong yellow urine is dripping down the cot onto the ambulance floor. She seems to be working on a bowel movement.

We arrive at her home, and DTs enters to see how many steps, and if we need to move furniture to facilitate the cot coming in, and so forth. The couch onto which the patient will be placed has half an upside-down pizza on it. DTs asks the husband to please clear the couch, then moves it to a better position. For a moment it seems I’ve knocked over a cup of coffee onto the floor, but it’s just a wave of disturbed roaches fleeing the vicinity of the couch.

Six of us manage to get the patient inside and settled on the couch. The children are happy because mom is home again. One of them brings a third of a cake in a plastic container from the kitchen and holds it up in both hands, an offering to us the nice ambulance guys for bringing his mom home. We politely decline, but it’s such a sweet gesture. Everything he’s been taught says food makes grownups happy, so it’s the most loving gesture he knew, and we respect that. Mom meanwhile is already complaining to hubby about the kids, the house, where’s food? We leave.

I hear she dialed 911 that evening and was taken to Hospital Z again. Food on time and someone to wipe you when you crap yourself, no kids pestering you while you try to watch your “stories” on TV. If you can’t afford Cancun, call EMS and let Medicare buy you a little vacation.

‘Cuz that’s what The System is for, ain’t it?


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