Seeing Is Believing

It’s not always busy where I work. Let me rephrase that: I’m rarely busy, at least not in the conventional paramedic sense of busy-ness.

If you were to count the number of employees, performers and guests intersecting at Opryland, most days you wouldn’t have enough to justify both Johnny and Roy standing by. A perpetual shortage of sick people at our entertainment complex leaves me with discretionary time many of you don’t have. I could run serial 12-leads on myself, or sort syringes by lot number, or help my non-medical coworkers dispense customer service imaginatively and emphatically, with therapeutic doses of southern hospitality. I routinely choose the latter, which is how I became Minister of Elevator Operations on the General Jackson, Opryland’s 300-foot showboat.

In December, while I was transporting guests two decks down from the boarding area, one of them commented that I must have the best job in the world. I hear this a lot—something about being paid to work on a boat on a lazy river on a nice day. It’s easier to just nod and grin than to describe the healthcare issues I face whenever the spit hits the fantail. On this day I said, “Well, the real challenge is staying prepared,” or something equally pithy. The passenger replied, “You mean in case it breaks?”

The elevator. He meant the elevator. You see, we don’t wear EMS patches at Opryland. Except for the scissors sticking out of my pants pocket, there were no visual cues to contradict his assumption that elevators are my life. (Do they use trauma shears to fix those things?) The doors opened before I had a chance to explain.

Afterward I had mixed feelings about the encounter. I don’t mind helping wherever I’m needed, and I appreciated the humor of the moment, but I’m proud of my real job, too. I would have liked to persuade my captive audience that downtime in the essential services isn’t time off—it’s time between emergencies, and making use of that time while maintaining readiness is a skill in itself.

Preconceived notions were my chief constraint; even if I’d been outfitted in state-of-the-art buff stuff, my passengers’ opinions of me—and probably of EMS—would have depended more on delivering them to the right floors than on anything I could have preached about prehospital care.

Part of the problem is that EMS’s backstory—training, anticipation and a willingness to engage—isn’t nearly as interesting as the exaggerated images of lifesaving choreographed for prime-time TV. And people experiencing real emergencies are too preoccupied with survival to appreciate the subtleties of our work. Other than the most stirring street-side resuscitations, I think our best opportunities to enhance public perception of EMS come between calls, when impressionable bystanders are relaxed and more receptive.

I’ve written about downtime before, but only from an in-house perspective. Not all of our downtime is staged at headquarters, though. Consider the public’s perception of these very visible, on-duty pastimes:

Eating—Unless you and your partner routinely order in, someone has to venture outside to gather consumables for the coming shift. No problem, but not everyone watching will sympathize if the need to feed becomes an extended sit-down meal accompanied by animated shop talk.

Sleeping—You know you’re getting acclimated to EMS when sleep is mediated more by opportunity than by need. However, if the moment strikes while you’re riding shotgun on the way back from the hospital, in full view of pedestrians at each red light, don’t be surprised if you’re the subject of a sarcastic YouTube video entitled “EMS Hard at Work” or “Patient? What Patient?”

Shopping—Some of my employers allowed us to run personal errands between calls. Window-gazing at the local mega-mall was a stress-reliever—for us, not for our fellow shoppers. Our mere presence at a public facility prompts two questions from onlookers: Is there an emergency? and Shouldn’t you be responding to one?

Smoking—Yes, it’s unfair you can’t smoke when it doesn’t bother someone else. Yes, it will always bother someone else.

I’m adding EMT (elevator management technician) to my personal list of downtime imperatives. Barring free fall or premature rupture of membranes, I doubt I’ll have a chance to prove my true worth between floors. I’ll just try to be the best vertical transport medic east of Station 51.

Going up.

Mike Rubin, BS, NREMT-P, is a paramedic in Nashville, TN, and a member of EMS World’s editorial advisory board. Contact him at