Life of a Rural EMT

As an Emergency Medical Technician, I spend most of my time in rural areas. You would be surprised to know that many people from these areas suffer from the same illnesses as people from urban areas. Diseases caused by cigarette smoking are just one typical example. Unfortunately, even in rural areas, we are not short of people with lung cancer, heart diseases, and strokes caused by smoking. What’s more, the American cancer society (ACS) is constantly warning people that tobacco smoking is hazardous for their health, but I guess the message of the tobacco industry is stronger than the one of the ACS.

Some might think that having a fresh village air will counter the negative effects of smoking. Maybe they believe that tobacco is natural, so it can’t harm them, or maybe they believe they are healthy enough not to suffer from tobacco-related illnesses. Who knows, to each their own. It’s an individual decision, however, people who don’t smoke may also suffer from the negative effects of secondhand smoke, but that’s another topic. Even people who live in rural areas and can enjoy the privilege of open wide space smoke indoors. That’s why I would recommend either opening the windows frequently in order to get some fresh air or finding a suitable cigarette smoke air purifier that will protect you and others from secondhand smoke.

A funny story, once I was talking about smoking with a patient of mine who had a stroke. He was a middle-aged man, with dry skin and a pale tone. After he told me that he had been smoking his whole life, I started educating him about the negative effects of smoking. He was obviously bored when he interrupted me and said – “Look. This is the only vice that brings me joy. I don’t gamble, I don’t drink, I don’t do other stuff either, but smoking is something that has kept me company for my whole life. If that doesn’t kill me, something else will. Now do you have a cigarette or not?” I just stood there shocked by his demand and the simplicity of his answer. My thought instantly went to some of my friends in the navy. I remembered how some of my pals dealt with the uncertainties that tomorrow brings. I am here now, I said to myself. Safe and alive.

Hey y’all, I’m “Doc” Marc. For a while I was a corpsman in the Navy, where I got my FMF (Fleet Marine Force) pin and served as a “Devil Doc” for some of the bravest Marines I have ever known. It was a real honor and probably the highlight of my life. When I left the military and came back home, I wanted to use all the training and experience I had gained to make things better in my own hometown. I signed on as an Emergency Medical Technician and that was a great decision too! Join my blog and hear my adventures then and now. I love the accolades for my work and never mind the frequent hassles and obstacles involved. It can be a high stress job, but only if you let it.

Life on the road as an EMT can be daunting as you encounter situations in all kinds of weather and environments. You can’t be afraid of soiling your clothes. I may come home less pristine than when I left. I might have been involved in helping to extract someone from a muddy roadside bank after the car has barely escaped collision. Or, the day might have been filled with a visit to a musty cellar where a would-be carpenter cut his arm. Then I am engulfed in enough blood to soak my uniform. Then there was the time I stood in the rain for precious minutes waiting for the firemen to bring me the patient. It all adds up to the need for a heavy load of laundry.

Given this regular occurrence in my life, it might not come as a surprise to you to learn that I have a state-of-the-art tankless water heater from Tanklss Center that guarantees me a few loads in the washing machine followed by a very hot shower. I have had my share of cold showers at the gym or the fire station so I don’t expect a similar one at home. I regularly maintain my appliance so I suffer no more. It doesn’t take much to get a tankless unit in perfect condition compared to the old-style metal versions. Plus, they don’t take that much energy. Lots of hot showers can add up to a big gas bill if you have a faulty system. The day I changed to the new style was a happy day indeed.

When people find out that I am an EMT, they always ask for my weirdest stories. I don’t know why. Sure weird things happen almost every day. But don’t weird things happen at your job too? Everybody has an idiotic coworker that does things like stick metal in the microwave or calls IT because the company firewall is preventing him from looking at porn. You’re probably aren’t bound by HIPPA privacy laws, either.

I’ve got some FMF stories that would make you puke. There’s the idiotic stuff that you would expect from guys who get really bored and don’t have any of the usual outlets, and then the other stuff, the terrible things that happen to people in combat. I am not going to tell you that stuff because those aren’t my stories. They’ll tell you themselves for the price of a beer.

I don’t get a lot of those people sticking things in their butts or getting their hands stuck in things calls. People tend to get themselves to the ER themselves if they can in those situations, rather than invite a huge audience to their house. But we do often get called for people stuck in things. We have absolutely had to bring in bolt cutters to free people from their headboards. There have been loads of others stuck in spaces they really should not have fit (my buddy calls these calls Winnies, after the bear), and all kinds of weird scenarios. People should definitely think twice before enacting some of their more interesting fantasies, that is for sure.

One of my more memorable calls happened last year. This genius decided he was going to jump off his roof onto a trampoline, and then leap from there into a pool. If he had made it, it would have been pretty epic. However, he did not. He didn’t even make it onto the trampoline. He was drunk and so were his idiot friends. We were trying to stabilize his legs (the tibia was sticking out of one, and both his ankles were at really unnatural angles) but his friends were all filming him and laughing. They started calling him “air ball” and that made the guy cry. So, the multiple fractures, all kinds of bruises and abrasions, and who knows what kind of internal damage, yet his friends calling him stupid nickname is what made the guy cry. Between the idiocy of the whole stunt and the taunting of his friends, that call really stands out in my head.

Besides the drunk people and the car accidents, there’s always a lot of people maiming themselves with power tools and lawn equipment. Never a dull moment around here, I tell you.

One of the things I like best about my job is that there is no typical day. Sure, the downtime can get boring, but the calls themselves are always interesting. There are some days where being an EMT is the greatest job in the world. The days when you get to rush an expectant mother to the hospital and she has her baby on the way there, or when you give someone the right medicine at the right time to stabilize them so they’ll live to see another day – those days are the best days. We all want shifts like that every time; people go home at the end of the day having made a difference, and if we’re lucky nobody died.

I don’t do well with boredom, which is probably why I chose this line of work in the first place. We work out of a fairly rural area, so some shifts can be painfully slow. But we are close enough to Knoxville that we’ll sometimes pitch in if something big happens.

The start of my shift is probably a lot like your day. We inspect the rig and do a stock check to make sure that we are good to go. Then we wait for calls. On the one hand, it is great when we don’t get any calls, because that means people aren’t getting hurt or requiring emergency help. However, it can be boring. Once that first call comes in, though, my job is probably different than yours. There are always some nerves because you never really know what you will be walking into. Once you’re there and assessing the scene, though, training takes over and things are just second nature.

If there’s bad weather around here, we know we’ll be heading out on at least one vehicle accident call. It’s just always going to happen. The same thing goes for certain holidays – people are always maiming themselves while cutting Thanksgiving turkeys, falling while putting up Christmas decorations, blowing themselves up on the 4th of July, drinking and driving on New Years (or Saint Patrick’s Day. Or Memorial Day. Or the 4th of July. Or Labor Day. Or pretty much most other days around here). Once you’ve done a few holiday shifts, you kind of know what to expect.

It doesn’t matter what I think about the person we’re helping, or even the situation that prompted the emergency call. It doesn’t matter if you are a junkie who OD’s while driving a car or the pedestrian that the junkie ran over, I (and my EMT brothers and sisters) treat both of them. It is not my place to judge anybody. Many of the people I meet on the job are at their most vulnerable, and judgment is the last thing they need. I’m just there to help in whatever way my training has taught me. It is my job to help stabilize a patient and transport them to a hospital close by. That’s it, and that’s plenty.

Sometimes being an EMT is frustrating. We take people to the hospital who, had they made a few different choices, would be OK. I’m not just talking about choosing not to take drugs or drink and drive, although I wish I could go back in time and beat different decisions out of those people. But there are people out there that don’t take basic care of themselves. Sure, maybe we all put off going to the doctor or dentist for longer than we should. That’s both a normal part of being an adult and having a busy schedule. But if something is actually wrong and you ignore it, well, you’re just asking for trouble.

When I was in the Navy, it was an oddly ideal situation. We got to treat people in the way that they needed to be treated, without having to worry about insurance approvals and all of that. As long as people got treated at a military treatment facility, we could do what was needed to get them healthy again. It’s a pretty good system if you get the right people to work it.

But for the rest of you, I know that medicines and doctor visits and tests and specialists and all of that can really add up. No doubt it is expensive and unfortunately not everyone can afford all that they need. But there are grants and supplemental insurances and payment plans. You should at least try to do all you can to get the care you need, whether it is difficult or not.

Look at it this way: if you need a certain medication to make sure that your blood pressure stays low enough for you not to die, you should try as hard as you can to get that medication and continue taking it on a regular basis. That’s expensive and I get it. But the heart attack you have when you don’t take the medication will make things worse. If the heart attack does not kill you, you’re faced with a whole host of other problems. Aside from the health concerns after having the heart attack, you’ll have more financial difficulties. The ambulance ride, the specialists, the possible surgery. All of that stuff is way more expensive in the hospital. Comparatively, monthly maintenance medications don’t seem so expensive now do they?

I know, I know, it’s all wishful thinking. It is stupid that people who need treatment can’t always get treatment when they need it, or they have to get prior medical approval, or it costs thousands of dollars. The people around here have a tough time in a lot of ways, and that can make it difficult. In general, it isn’t a healthy area, jobs don’t pay enough, and healthcare is stupidly expensive. I get that there isn’t much I can do about that, either.

Just please. Do what you can to take care of yourself. I would much rather meet you at a bar over a few beers than while you are face down in your kitchen when you keel over from that heart attack.

The average person spends more time in their car than they want. If you commute long distances, you spend a lot of time in your car. Those of you with kids who are in different activities also spend a lot of time in your car shuttling kids around. Why am I reminding you of that depressing fact?

It is because the more time you spend in your car, the more likely you will have some kind of incident while in it. I know this because I essentially work out of a vehicle. It might be as small as a skinned knee or as big as a crash but stuff happens on the road so you need to be prepared. To make things harder, you need to be covered on two fronts: mechanical and personal.

For your car, you need jumper cables or a portable starter battery (which you then have to remember to keep charged). A phone charger is good to keep in your car in case your battery is dead during an emergency. The camera on it will also help if you are in a wreck so you can take pictures of your car and the other person’s. Also a flashlight and flares or triangle reflectors to keep you safe if you have to make repairs or wait for a tow in the dark or bad weather. Speaking of repairs, a toolkit with a jack, tire iron, a tire inflator and patch kit, and a spare will make things easier for you. You also need fluids – motor oil, coolant, washer fluid, and water. If you live where there is snow, you’ll need an ice scraper. Kitty litter can help you gain traction if you are stuck in mud or snowy slush. I also keep a seatbelt cutter/window breaker in the car. Those things will help you handle most situations.

Now for things to keep in the car for you: a pen and paper in case you get into a wreck and need to take someone’s information, some non-perishable snacks like granola or energy bars to eat if you get trapped in your car and need to wait for help, a blanket to stay warm if you get stuck and need to stay warm, and a basic first aid kit.

If this sounds too complicated, there are pre-assembled kits you can buy online. Whether you buy it all together or you assemble it yourself, keep everything together somehow. A box, a backpack, whatever works for you. Here is the most important part: please leave it in your car so you’ll have it if you ever need it.

Regular maintenance can stop many vehicle problems before they start, so stay current with all that. And even if you obey every safety law and are careful when driving in bad weather, sometimes you cannot avoid an accident. So it’s better to just be prepared.

When I was out in the field with Marines, they all had to know at least some first aid just in case I got myself blown up or something, despite the fact that they treated me like a bunch of nerds with a first edition comic. Everybody needs to know the basics. It doesn’t matter how old somebody is, there are things you can teach kids to help them take better care of themselves or even others. You just have to know your target audience.

I bet there are books or videos you can show them if you want. However, you don’t really need to bother with all that. It isn’t hard to talk to kids. You don’t need to dumb things down but you do have to explain stuff to kids in a way they can understand. You can’t actually see germs, and getting an infection is something that happens in the future. They can both be hard concepts to figure out as a little kid. But you can tell them that not keeping a cut clean could make them sick. Most kids have been sick, so that is a concept they understand, so that is something they can work with.

Another thing you need to remember is that kids often learn by watching, so give them the chance to see what first aid looks like. Let them see you taking basic care of yourself if you yourself get hurt so they can see the things that you need to do.

Even small kids can learn how to put antibiotic ointment or cortisone cream on themselves and how to open packages of adhesive bandages. You can teach them how to recognize certain things, like what a seizure or broken bone looks like. Or what having an asthma attack or allergic reaction might feel or look like if that is something that is a concern at your house.

Once you think they can handle it, you can tell them where the first aid kit is, what’s in it, and how to use the items in it. If anybody in your house has a medical condition, teach them what the signs and symptoms are, what problems look like, and what to do about them. You can also give them more responsibility for their own care. If anyone has severe allergies, you will need to teach them how to use an epi pen. If your kid uses a rescue inhaler, they need to know how and when to use it.

If you don’t think your kid is ready for all of that, it is fine. There are still a couple of things you can do. Making a list of helpful numbers and an emergency plan and posting it where your kid can see it is an excellent idea. But the most important thing you can teach a kid is what we consider an emergency, and how to call 911. They need to know their address and phone number to help the dispatcher if they are at home when they need to call.