Thursday, January 27, 2011

Am I trustworthy, or not?

All paramedics go through it. You medics know what I mean. I once went through a period in my career in which I was called a nickname: "Doctor Death." In a 24 week span, I worked 29 codes. In only one of those codes did I get pulses back, and that patient died two days after I took them to the hospital. The oldest of those dead patients was 102 years old, and the youngest was 6 months old. Also in that 24 week period, I had trauma alert patients, STEMI patients, and all sorts of odd events. One of the Doctors at the hospital asked me in jest if I ever got tired of my patients dying all the time, and I responded with a joke about how my laryngoscope was a deadly weapon.

You need a sense of humor in this profession, or you will soon burn out and leave, as so many who wear their hearts on their sleeves do. You wear that sense of humor, as odd as it becomes, like a suit of armor. That is the protection that you need if you are to survive the sights of hundreds of dead bodies. Trust me, that number is well into the hundreds. There was an incident several years ago where I triaged bodies, and personally decided that 31 people were dead in less time than it took me to write this post.

In essence, triage is a lot like playing god. You decide who will live, and who will die. The decisions that you make on every call will affect people for the rest of their lives. I have welcomed newborn babies into the world, and I have held the hands of people as they left this world. Every one of these decisions were made with relatively little oversight, and a whole lot of latitude as to how I come to that decision. It is a position of trust that I do not take lightly.

With all of that trust, the background check that I had to endure was not nearly as thorough as the one that was done when I got a concealed weapons permit. Ask yourself why people who feel that I am trustworthy enough to give potentially lethal medications and make life or death decisions as a paramedic feel that I am not trustworthy enough to carry my defensive weapon to class when I am attending college.

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