Small Talk


Small Talk

By Thom Dick Jan 04, 2012

The man on your cot is in his early seventies, maybe, or late sixties. He has a long history of multiple sclerosis. He’s been suffering from an increased frequency of painful muscular spasms, mostly in his lower extremities, and tonight he was unable to get out of bed in time to empty his bladder. That fact is clearly embarrassing to him, and he seems emotionally depressed. His facility of choice is 30 miles away; and considering his many years of experience with the staff there, the transport seems sensible.

The man’s name is Hans Telemann. He’s comfortable for the time being, so you’ve tried to engage him in conversation. He’s polite, and judging from his bearing and his vocabulary, you’re guessing he’s much better educated than you are. You can’t seem to get him past his medical history—and maybe the snowy conditions outside. So you avert your gaze toward the rear windows of the ambulance, staring at the weather swirling in your wake. It ought to be easier, sometimes...

Q. What do you say to people? I mean, they don’t all want to make small talk, do they?

A. You’re so right. It’s not like they’re just cargo, and those long silences can be worse than forced conversations. Of course, a big part of it is talent. Some of us seem to be able to talk to any old body, any old time. Having a repertoire helps; you know, a handful of simple prompts you can rely on. Like, are you from around here, do you have family in town, or what are you planning for the summer. And education’s a valuable tool, because it increases your versatility in any conversation. I think it makes you a better listener as well.

Q. I don’t disagree with you, but what do you mean about education increasing your versatility?

A. Well, take this gentleman’s name. Telemann, does that ring a bell? Georg Phillip Telemann was a German Baroque composer, a contemporary of Bach and Handel who mastered at least a dozen musical instruments. He pioneered musical constructs like counterpoint and fugue. And he probably composed as much music in his lifetime as anybody in history, despite his family’s insistence that he study law instead. The gentleman in this story spells his name Telemann, with a double “n.” Maybe that’s just a coincidence, but even if so, it’s worth a casual comment about his musically famous name. It may go nowhere, but it could lead to a very interesting conversation.

You have a powerful advantage over medics who left the field, say, 10 years ago. If you own a smart phone, you carry in your pocket the key to what would have been a great library even then. So, you have constant access to facts. All you need to turn facts into knowledge is a little curiosity and conscious thought. Think about what EMTs do every day, on every call. An EMT’s most basic job is to notice stuff and then wonder about it. And, there in that compartment of yours, you have access to the minds of, what? A thousand people a year whom have nothing better to do than share their experience with you. All they want in return is a listener’s ear. That, and maybe a little kindness.

See, you may not have a degree from Cambridge or Dartmouth (or perhaps you do), but plenty of people with fine educations have never had access to the perspective, understanding and collective wisdom that you do as a result of your work. Being a street medic can be a rich, lifelong experience.

Q. Hmmm, I have to say I never thought about my work in quite that way. But how can you interact with people like the one in this example? If somebody doesn’t want to talk, you can’t force them to engage you.

A. I agree. Ambulance transports are simply not meant or expected to be social events. Most folks we meet there are having the worst days of their lives. Don’t force them to converse when they don’t feel like it, but do invite their comments. A good strategy for interacting with non-talkers is to switch gears and make like a flight attendant. Announce a few turns, maybe, and provide them with a couple of ETAs. Tell them what to expect when you get them indoors. Then introduce them to the receiving medical staff, and wish them well before you leave.

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Let them all remember you as a professional.

Thom Dick has been involved in EMS for 40 years, 23 of them as a full-time EMT and paramedic in San Diego County. He is the quality care coordinator for Platte Valley Ambulance Service, a community-owned, hospital-based 9-1-1 provider in Brighton, CO. Thom is also a member of the EMS World editorial advisory board. E-mail

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