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Strong Work

I’m not much of a singer, but I do it anyway—mostly in the car, and only when the closest amateur music critic is at least a bus length ahead or behind.

Then there was the regrettable moment at the breakfast table when I was absentmindedly humming “We’re All Alone” in much the same way Rita Coolidge once sang it, except I was chewing and she was on key. According to The Lovely Helen, my performance was disturbing enough to make her wonder whether my mother had taken too much cough syrup while she was carrying me.

Well, we can’t all be The King, or even Prince. Knowing our limitations is an important part of good citizenship. Often the best we can do is play to our strengths while encouraging others to do the same.

I can carry a tune, but I sing in the key of Frog even when my mouth isn’t full. When I helped produce a CD of EMS-themed songs last year, there was no doubt my value—if any—to the project would be administrative: budgeting, scheduling, packaging, marketing and sales—not very exciting, but as essential to the music business as documentation is to EMS.

Working on that CD reminded me it’s OK not to be good at everything. EMS allows for that. I’ve never seen a policy, protocol, algorithm or curriculum that assumed practitioners apply impeccable reason in the realm of all things possible. Much of our prehospital guidance is in the form of easy-to-process bullet points intended to buffer crew members’ fallible memory. And when written rules aren’t flexible enough, there’s always medical control—an often-undervalued reservoir of good advice.

Knowing how and when to get help is just as important as the advice itself. Unless you and your partner routinely share ideas with Solomon-like propriety, there will be calls when one of you doesn’t make the best use of the other. Can the two of you talk about that? Competition, insecurity and ego sometimes make it hard to offset weaknesses with pooled strengths.

Early in my career, I rode with a medic who insisted on doing all of our airway management. Sometimes he’d apologize by explaining he considered intubation “a manhood thing.” Lucky for me I had plenty of FTOs who didn’t feel that way.

During primary training, when habits are works in progress, it’s important to understand the connection between strengths and preferences. Strengths usually become preferences (and vice versa), but overindulging the latter can hinder development of the former. Forcing ourselves to engage in less-comfortable tasks can expand our capabilities. We just have to guard against thinking of our patients as manikins. Unwavering determination to succeed is admirable when running a marathon; not so much when puncturing a patient.

There were times in the field I said, or perhaps only thought, “Just one more try” when a coworker nearby might have been more successful. All of us need practice, but we have to recognize when someone else’s talent is a better match for the emergency of the moment. There’s more at stake than bragging rights; most important is a favorable outcome.

Sometimes EMS mixes its message to caregivers by simultaneously lauding individualism and teamwork, as if decisiveness were a trait partners should employ separately yet concurrently. I don’t know about you, but I’ve rarely seen that work. Someone needs to recognize when weaknesses compound rather than offset. Even with two alpha medics, at least one had better be willing to take direction.

In the field I never felt I had a monopoly on insight. I learned, as a new medic, to value contributions from every crew member regardless of certification. I still believe authority is something you titrate when, despite your best intentions, teamwork isn’t yielding a critical next step. Reviewing those moments as a group decreases the chances they’ll be repeated.

The most capable people I know are also the ones who most readily admit their faults. They seem to see their talents as gifts, rather than as rewards or rights. I think they try to leverage strengths like the rest of us, but they have better timing; they can spot opportunities for collaboration from a distance and feel energized—not threatened—by the prospect of mutual success. They know being strong means sharing strengths while acknowledging weaknesses.

I’m no singer; then again, Elvis was no EMT.

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

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