Friday, January 22, 2010

Well Schmoe, ya killed him!

Not words that an EMT student wants to hear. Especially one who has no clue as to the sick, sarcastic and sadistic humor that permeates the fire and ems business.

It was the early '80s. Political correctness was a term that had not been invented. In the county where I grew up, there were no fire service ALS providers. Most fire departments were EMT-1s and were first responders. There were a few fire departments that only provided first-aid level EMS service. A myriad of small private ambulance companies provided ALS.  AMR had never been heard of.

I was 20 years old and finishing up my EMT certificate. I had already completed the classroom course of study and the ER room clinical work. It was now time to get the required ambulance ride-along stuff done. The only option available to us was the Local Ambulance company.

The Local Ambulance Co. was based in my home town. I think that they owned 15 or 20 ambulances and operated three or four stations. Some of the best medics I ever met worked for the Local Ambulance co. Many went on to work for Med Trans and then AMR. Some are still with AMR in management positions. A few work for the K.B.F.P.D.

This tale begins on a Sunday afternoon. We were watching a football game on a ratty old console TV in the common area of a converted house, which served as the crew quarters for the Local Ambulance Co. Two AFC teams were playing to see who the AFC West champion was going to be. Yeller, the medic on the ambulance, had a strong interest in the outcome of the game. I don't remember who the EMT on the ambulance was, but the three of us were engrossed in the game as half-time approached.

Dispatch was located in what was originally a bedroom. If I remember correctly, you could hear the emergency line ring in the rest of the house, but there was no tone or PA system. We were alerted to our call by the voice of the dispatcher yelling from her office. "14, you got one in Dilapidated. Dilapidated FPD is en-route."

Of course I, being new, jumped up and rushed toward the door. Yeller and the EMT remained seated and looked at me with mild amusement. After the play was finished, the EMT got up and headed toward dispatch while Yeller and I headed for the ambulance. The EMT soon joined us in the ambulance and we made the 10 minute drive to Dilapidated.

Dilapidated is an unincorporated area located just outside of my home town. Then, as now, there was little commerce other than retail establishments and restaurants located along a main drag. Dilapidated was served by a small fire district which has since been dissolved. Things haven't improved much in Dilapidated. Although millions have been spent on improving the looks of the main drag, the biggest buildings are still county offices and clinics.

We pulled up in front of a neat home on a large lot. Several cars are parked in the driveway and a squad from the Dilapidated F.P.D. is already on scene. We went inside and found our patient, a male about 50, sitting on the couch. His wife and two young adult sons were in the room, as were two young ladies. The football game was on the TV, beverages and snacks on the coffee and end tables.

Our patient was oriented and alert. He was complaining of minor pain and discomfort to his chest. I don't think he had any medical history and appeared to be in minor distress. Yeller had me switch the patient over to our 02 and get a set of vitals while he hooked up the monitor. After looking at the EKG and deciding that the patient was stable, he cut the guys from Dilapidated Fire loose.

A minute later, he removed a small brown vial from the drug box, removed one tiny pill and gave it to the patient. "Take this and place it under your tongue" he told the patient, "it might make you feel a little weird".
The patient did as he was told, all under the watchful eye of us and his family. I visualize what happened next every time I watch my medic give someone a nitro.

No more than 30 seconds later our patient advised us that he felt weird.

"What do you mean weird?' Yeller asked him.

"Weird, you know weeeeiiiirrrrd" the patient shrieked as he began thrashing wildly about. This thrashing knocked over a lamp and some drinks. It only lasted a few seconds and was followed by a short, milder convulsive period then by apnea and pulselessness. The whole process only took 15 or 20 seconds. Everyone was stunned when it started. Yeller checked ABC's and had me begin CPR, while the EMT ran out to the ambulance to radio dispatch and have the Dilapidated Fire District re-respond. Back then, ambulances did not carry handi-talkies.

The family was in a state of shock. What had started as a family gathering ended up with Pops on the floor being resuscitated by some Schmoe  and an EMT. When they figured out what was going on, their emotional output increased dramatically.

The fire dept. arrived back on scene. By then, Yeller had an esophageal airway established and I used a E and J resuscitator to ventilate the patient. The firefighter from Dilapidated Fire performed compressions. The family sobbed. I don't remember if the patient was in a shockable rythym, but I do remember the looks on the family's faces as we wheeled the patient out to the ambulance. 

A fifteen minute ride to the hospital, followed by the ER staff pushing more meds, yielded no positive result. After a few minutes at the hospital, they called it and it became official. My very first patient was dead.

I pondered what had just occurred as I helped carry supplies nack out to the ambulance. I was just going to ask Yeller what the hell had happened when he looked up at me and clearly stated "Well Schmoe,  ya killed him!"

I was perplexed by what he said. I believed him of course. I just couldn't understand how he LET me kill our patient. I mean if I was really screwing it up that bad, he should have said something or advised me how to do the ventilations better.

This event screwed me up for months before I realized Yeller was just being an asshole and was trying to mess with my head. He succeeded.and succeeded well.

As the winter EMT students are beginning to show up in the stations,  I will remember this event and also remember that the student has likely not yet developed the sick, sarcastic and sadistic humor that most of us have. As such. I will be a kind and gentle captain and will withhold my wit and my tongue.

I know that should they stay in the business, they too will develop this raw, exposed humor and may even embrace it. Perhaps, as much as I have.

Thanks for reading,


  1. Some people don't know just how much damage "a little joke" can do to people. Conversely, instead of constructively critiquing personnel who need remediation, they'll let that go all day. Sad but true. Glad you made it through.

  2. Dear Captain Schmoe,
    Sometimes the only way to get through moments of stark terror or desperation is gallows humor.

    "The world is a comedy to those who think, and a tragedy to those who feel."

    Maybe the humor gives the distance necessary for thinking-or-the laugh cuts the stress. But if you're not quite in the group, or don't get it, ouch.

    So I'm glad you introduce it more gently than it was introduced to you!

    Ann T.
    Booklady as I am, I have to give the reference:

    Quote from Jean de la Bruyere or Horace Walpole, depending on who you ask.

  3. So did you get to see the end of the game or what?

  4. Mick - It all seems kinda funny now..

    Ann - What about those who think and feel?

    Mrs. B - Nah, I think we stopped and got a burrito on the way from the hospital or something.