Without Substance


Without Substance

By Mike Rubin Aug 05, 2013

I’m happy to say I don’t get many calls at home from Alan, my boss—not that I have anything against him. He’s a good guy, and we share a lot of interests outside EMS. It’s just that I’ve adopted a no-news-is-good-news outlook that’s just as relevant to my work as it is to my colonoscopies.

If I do hear from Alan right before my shift, I almost always know why he’s calling: I’m the lucky winner of an all-expenses-paid trip to a Music City lavatory in a Music City laboratory for a drug test. Yee-haw.

I support random drug testing in EMS. I see nothing wrong with requiring us to mentate at least as well as the people we treat. Our system of healthcare is scary enough without asking our patients to accommodate dopey medics.

For most of us in EMS, drug tests are as inevitable as recertification. We’re not the only ones; some municipalities require all civil servants to be substance-free—at least at the time of hire—and hold members of essential services to even stricter standards. I’m OK with my lifestyle choices being limited by well-intentioned concern for the greater good. The ACLU can sit this one out.

Perhaps the best-known targets of random drug testing are professional athletes, whose specimen regimens are meant to ensure that competitive advantages are congenital, not chemical. I suppose that’s important on some level, but I’ve never felt the outrage of fellow sports fans when some outfielder or midfielder, forward or defender, halfback or fullback gets nabbed by the substance police. I’m more concerned about diminished performance behind steering wheels than enhanced performance on playing fields.

I do believe some professions should be scrutinized more closely. Let’s start at the top. Yes, I mean the very top: the president of the United States. You think he should have a free pass? Not as long as he has the ability to give the dinosaurs a second chance. A hungover paramedic can do some damage, but imagine a return-to-the-planet-of-the-apes scenario triggered by a president on PCPs who pushes the wrong button. I’m not sure, but I think a two-thirds majority in the Senate is needed to Tase the chief executive. Don’t bet on bipartisan support for that; pre-emptive pee testing would be a lot easier.

Another occupation that cries out for mental-status monitoring is veterinary medicine. I was having a conversation with my cat about this just the other day. Timmy said it was bad enough getting “fixed” when nothing was broken; he shouldn’t have had to worry about unsteady hands radicalizing the procedure.

Most people I know seem to deal with drug testing as minor inconveniences—until they get busted. Two ways of ruining your reputation are 1) shopping for shoes while wearing an ankle monitor and 2) failing a drug test.

As a cog in my company’s well-care machinery, I’ve heard my share of excuses from people who test positive for recreational chemicals:

  • “I ate poppy seeds.”
  • “I drank coffee.”
  • “I drank poppy-flavored coffee.”

Please. Save us both the trouble and simply resign in disgrace. Unless you can produce a prescription showing you’re under the care of a physician who attended Woodstock, I’m not even listening. Well, maybe a little bit. I admit I’m concerned about mistakes being made whenever I’m tested. I watch Law & Order. I’ve seen how one unscrupulous lab technician can ruin the lives of hundreds of innocent citizens right before burdening our justice system with appeals of every guilty verdict since Cain killed Abel. Res ipsa loquitur, ’k?

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What if I’m unlucky enough to draw a righteously indignant lab tech with sloppy work habits and sociopathic tendencies? It could happen. Would I still be able to argue my urine is clean—relative to other urine, I mean? Do I offer another sample? Submit to a lie detector? I’ve heard you can’t trust those machines. How am I supposed to convince someone I’m not lying about not lying?

These are issues that occupy my mind far more often than eight out of 10 dentists recommend. I think I need a prescription for something that looks like aspirin, works like Valium, tastes like Ex-Lax, but is chemically similar to, say, oregano.

It would be very important not to mix those 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 mgr22@prodigy.net.

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