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This month we introduce a new column by Michael Morse, author of  Rescuing Providence and Responding. 

For the fortunate in EMS, the vehicles are safe, the compartments are well stocked, morale is high, training is consistent and productive, and learning new techniques while perfecting the old is a priority. 

For many, things are more challenging. Vehicles break down, supplies are scarce, system abuse is rampant, training is nonexistent, and morale left the building the day Emergency! went off the air. 

Finding satisfaction in difficult systems can be easier than it appears, if you know where to find it. After years of frustration, disillusionment and relentlessly questioning why my profession never failed to disappoint, I finally understood that the answers I’d been seeking were there every time a patient entered my ambulance. Having the opportunity to treat the sick and injured and touch the lives of those who need us was, is and always will be enough to overcome even the most challenging situations. I hope this column leads you to a more satisfying career in EMS.

A new guy was working with me, fresh out of the academy and already pulling an overtime shift on Rescue 4, the busiest of the Providence Fire Department’s six ambulances. The people assigned to the division are a different bunch; relentless calls and lack of support from the department takes its toll on a crew of passionate people, potentially reducing them to shells of their former selves. Yet somehow many stay with it, some for their entire careers, and find satisfaction in the seemingly bottomless pit of need from an increasingly needy public. 

Sadly some of our best people leave the division disillusioned and bitter, and choose to spend their entire careers in the fire service anywhere other than the Rescue Division. It can be a dirty, thankless job, and for many it is. It’s also a vital, challenging, gratifying and honorable job. Perception is the key. 

“Rescue 4, respond to 1035 Broad Street for an intoxicated male.” 

The overhead door opened, then closed behind us as we left the rest of the crew in the station and headed for Broad Street. More than half our calls will be alcohol-related tonight, as they are most nights for Rescue 4, part of the fun of being quartered downtown, where many homeless alcoholics converge. Between the homeless and the college kids living away from home for the first time, the fun never ends. Those experimenting with drinking mix with those whose entire experience relies on it, and the result is often the same: Rescue 4 bringing them to the ER for detox.

“Rescue 4 on scene.”

“Roger, Rescue 4, at 1927 hours.”

“Arthur” stood at one of the two remaining public pay phones in the city and hailed us as if we were a taxi cab and he needed a ride to his next meeting.
“I don’t know how you deal with all these drunks,” said my new partner. “The police should lock them up.”

“It’s a medical call, not a criminal act,” I replied automatically. Impaired consciousness is most definitely a medical condition and is treated as such when I am in charge. My partner had been tainted by the incessant firehouse chatter and had preconceived ideas concerning the patients we would encounter during our shift. It was up to me to clarify things.

“Come on, Arthur, let’s go,” I said, and helped him into the truck.

“All set?” said the new guy, ready to roll.

“I need a set of vitals and a glucose test,” I said. He looked at me like I was crazy.

“For a drunk?” he asked, well within earshot of Arthur.

One of the hardest things to overcome while working in the inner city is the urge to judge a person and treat him or her based on what you see. We see the drunken man, the filthy clothes, the plastic shopping bag with the bottle inside, and immediately switch to autopilot and get rid of him as quickly as we can. There is a person in that shell—why not make the effort to bring him out and perhaps save a life in a way you had never envisioned?

We treated him with kindness, and though that kindness was unrequited, it mattered. It mattered to me, and by doing so I managed to not chip away at my own humanity. If the time comes that a person becomes less than human, and just a means to an end, it is time to stop working with the public. 

We brought Arthur to the ER, and the people at triage gave him a blanket and a sandwich and a warm place to sit. There was no drama, no trauma, no excitement; just one opportunity to show a new guy that success in EMS involves much more than dragging drunks to the emergency department.

We had a long shift ahead of us, and a lot of people to treat.

And teach. 

Michael Morse, EMT-C, is a rescue captain with the Providence Fire Department. 

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