Of squeamies and maniacs

Posted by nycmedic059 on 4 August, 2007, 4:56 PM

Working with so many different people over just a couple of weeks has given me the chance to fine-tune the authoritative Malek Typology of Contemporary Paramedics, which I'm proud to share here for the first time.

Working with Peter Petrelli has also, rather single-handedly, resulted in the need for a previously unknown type. But more about that later.

First, there's the doc-a-medic. This type is by no means the most common, but nevertheless it's one that everyone has met and worked with. They're the ones who just stay in the trauma (or cardiac) room after delivering a patient, more or less unobtrusively, and are allowed to pass tubes or get lines, do a thoracostomy here or maybe a triple bypass there. I'm joking. But some of them would. They chat to the doctors rather than the nurses, who regard them as valued advisors rather than ambulance drivers who keep getting in the way of people doing the actual job, and are asked frequently when they'll finally go to medical school. Most of them do just that, or they'll end up as supervisors.

Mercy Heights has two of those. Or maybe one and a half. Karen O'Neill qualifies in some ways. She's got the medical knowledge, but she's a medic through and through. She wants neither the doctor's degree nor the desk job that goes with supervisor.

Our resident doc-a-medic is Gerald Macmillan. Like Karen, he's been working as a medic in NYC for almost twenty years, but unlike her, he got into EMS after dropping out of medical school. He says he could take it up again at any time, and in all fairness to him, he very probably could. He certainly has demonstrated a lot of knowledge and ingenuity in the field. And a lot of commitment is needed to last in this job, and in this city, for such a long time. Gerald will forever be remembered for picking up a fifteen-year-old boy who had overdosed on crack, and when he berated him forcefully all through the ride to the hospital, the boy finally said, "Fuck off! You're not my mother!"

Gerald replied, "No, and I know that 'cause I delivered you, you little piece of shit!"

That last remark probably crossed the line to another type of paramedic, and that is the cynic. Many people think the cynic is burnt out, but most of the time, that's not the case. If you're truly burnt out, you don't last. Although it can be argued that many cynics are recovered burnouts.

The true cynic cynicises about everything and everyone. Nobody is safe: from the triage nurse, the paramedic's natural enemy, the ER doctor who makes a decision the paramedic wouldn't have made, the nursing home nurse, even the pretty one, to the hypochondriac patient and, if he's really unlucky, even the patient who is actually in distress, they may all get their share. The only ones who are relatively safe are usually the cynic's partners. Otherwise, I don't know how Karen O'Neill could still put up with Nicholas Greentree.

You have to hand them one thing: Cynics are usually exceptionally witty, so working with them can be a lot of fun (the less witty cynics tend to be categorised as the much more obnoxious subtype assholes). But you're also in constant danger of turning into one yourself, and God have mercy on your soul if you ever find yourself in any real distress and you get picked up by not one but two cynics.

There are two types the cynic doesn't get along well with, and who they love to poke fun at. Those are the squeamie, and the Mother Theresa.

Of course, a particularly evil-minded cynic can have a lot of fun working with a squeamie. This sort of fun is typically one-sided. The cynic (who is almost invariably more experienced than the squeamie) will probably ask his squeamie partner to do those MVA extractions where dustpan and brush would come in a lot handier than a spine board or cervical collar. Almost certainly, he'll have him search for a vein on an HIV or hepatitis patient. Squeamies will spend a lot of time retching, standing around helplessly on scene, do loooong resupply runs to avoid having to go out there again, and you usually end up having to tell them what to do every few minutes.

Like burnt-out medics, squeamies don't last long. Most of them quit at some point. Squeamies with connections are sometimes promoted to supervisor (which is a bad way to go for all concerned, especially for a squeamie's former cynic partner, who may be in for a lot of very ugly payback).

And then there's the Mother Theresa.

A lot of paramedics start out as Mother Theresas, but very few manage to keep it up. Working in the inner city for a few years will do that to you. Most paramedics whom I consider deserving of their patches in any way still have some small but persistent amount of Mother Theresa stashed somewhere deep inside of them, even if it's not always apparent.

Most paramedics fall into more than one of those categories most of the time, to varying degrees. As for me, I consider myself as a surprisingly well-balanced mix of a cynic and Mother Theresa (now isn't that a disturbing image), with some very rare instances of doc-a-medic thrown in, which I reserve for the few times when I encounter a doctor who truly and clearly doesn't know what they're doing.

Peter? When I first met him, I had him booked down as one of the most typical Mother Theresas I'd ever met. I expected him to come around at some point, and after working with him again for a week now, I daresay he has – but in a direction I've never encountered before. What would describe him best right now is maniac.

While Peter has never been comfortable with the idea that there will always be times when the Reaper is quicker than us, now, he's downright refusing it.

We're dispatched to an MVA mid-town, and are the first to arrive on scene. A truck has spun out of control, sliding against a wall and pinning a Ford Mustang in between. The truck driver appears mostly unhurt; there are a lot of other cars involved, but none as badly as the Ford. Peter jumps out of the rig immediately, running for it. The Ford has been squeezed up against the wall, resting on the ground by no more than one of its tyres as far as I can see. The windshield is cracked, so I can't see inside from a few yards away, but there's blood on the cracks.

Seeing Peter is about to climb up on the hood of the Ford, I yell at him to stop it. He acts as if he didn't hear. Cursing, I get out a longboard, collar, bag, and monitor, and follow him.

When I reach him, he's perched precariously on the hood, which slants at a 45 degree angle, and is leaning around to peer into the side window.

"Give me a collar, Hesam, will ya?" Peter says, not looking at me as he extends his hand for it.

I give it to him, adding, "Get off that as soon as you're done, you hear me? That thing isn't safe. It could crash down any second."

"Can't," I hear him reply as he twists himself to reach through the side window. "She's bleeding badly. Can't palpate a pulse. We need to get her out at once."

I realise this is 13 June all over again. "Peter," I say, with as much authority and reason as I can. "Get out of there. The fire department will be here in two minutes."

"Yeah, and it'll take them another fifteen minutes to move the truck and extricate her, by which time she'll be dead," he says flatly. "I can do this. I've got a pretty good hold up here right now, and I don't want to chance losing that."

Looking at him, I can't help but think the "pretty good hold" he's got looks awfully like a bird perched on a rather weirdly angled branch.

"You realise you're gonna kill her, yourself, and quite possibly me if the Ford crashes down on its remaining three tyres."

"Got a seatbelt cutter?" is the logical reply.

I roll my eyes. "Peter, I've never had a seatbelt cutter."

"Damn." I can't see what he's doing, his entire upper half having vanished through the smashed-out side window, but then I hear something ripping.

"OK, I've got her free," he says. I find myself fighting the mental image of him ripping the seatbelt with is bare hands. "Get the board as close to the car as you can, OK? I'm gonna pull her out now."

I wouldn't have thought it possible, but somehow he manages to maintain his hold, and his balance, while vanishing into the interior with an even larger percentage of his upper body. When he emerges, he's holding a rather large woman of around fifty, who is pale and obviously unconscious, as well as weighing around two hundred pounds.

"Peter," I say, quite urgently now. "I can't get the board up there. I can't lift it over my head while you put her on it, and I can't rest it against the hood either. It's not stable."

I can see his mind racing, while he holds on to the half-extricated patient. In addition to being unstable, it's too narrow to wield around a longboard. "All right, change of plan," he says. "I'm gonna carry her down."

The truck's tractor unit towers over the Ford next to Peter, and he braces himself against a dent in the door, tests its stability, and then climbs down, not using his hands as he still has to hold on to the patient. I can barely watch, thinking he's going to slip any second, but he doesn't.

As soon as he's close enough, I reach up and take the woman's legs – both of which appear broken – and together, we ease her down on the board. Her colour doesn't look good, but I agree with Peter that there might still be hope we'll save her.

"Let's get her out," he pants, grasping the handles of the board as soon as he's slid off the Ford, and we nearly collide with two firefighters, who are staring at us – mostly, at Peter – after witnessing the last half minute of his impromptu extrication.

"What they hell do you think you're doing?" one of them asks.

Peter gives them a grin deserving of the term "manic". "Saving a life," he replies, and we don't waste another moment on scene, get the patient into our rig, and are out.

Peter works feverishly in the back while I drive to the nearest hospital. When I open the back doors, I find he's gotten in two IVs, has her on oxygen, and has managed to splint the worst of her fractures. Her blood pressure, from what I see on the monitor, is a bit low and her heart rate a bit high, but as far as we're concerned, we did our jobs well.

Later, Peter gets berated by the shift supervisor for failing to wait until the scene was safe. I get my share of it as well, since I failed to make him see reason.

I can tell Peter doesn't care. He's in a great mood for the rest of the day. When we get permission to head in at seven, Supervisor Vasquez is trying to find someone to take over the shift of Doug Richards, who has reported in sick an hour ago.

Peter says he can take it, and I shake my head as I join him for a coffee and a sandwich in the cafeteria before his second shift starts.

"Vasquez wasn't that mad at you," I tell him. "And anyway, you really want to challenge your good luck?"

He gives me a wolfish grin. "Absolutely."

I shake my head.

Maniac.