Priorities

I am stubborn. My wife warned me not to try and change that lightbulb on my own. She told me I ought to ask our neighbour from across the street to lend me a hand. I waited for her to go over to one of her friends for tea and muffins and then I decided to give it a go.

“I have fallen and I cannot get up,” I said in slow and determined fashion to the emergency operator who answered the call I placed to 911. I remembered that series of television ads and winced at the realization I had just used the same line to call for help.

“No, I am not having any difficulty breathing. Yes, I hit my head but no, I did not lose consciousness. No, my neck doesn’t hurt. No, no chest pain to speak of. Yes, I do have some terrible pain in my hips. I am 81-years-old. No, I do not take any prescription medications of any kind. No, I am unable to get up on my own. The pain in my hips is quite intense and it gets worse when I try to move.

“Yes, I understand there might be a lengthy delay before the ambulance gets here. I know it’s very cold outside and I understand you must be very busy. I would not have called if I could get up on my own. I fear I have injured my hip otherwise I would not be calling for help.

“Pardon me for asking but I thought we had first responders in our town who might be able to help me before the ambulance crew is available. Oh, I see. They only respond to higher priority calls. Well, I do understand. I will do my best to stay comfortable until the ambulance crew arrives. Yes, I will certainly call you back if anything changes or I feel worse in any way.”

The light of the afternoon faded into the early darkness of a winter evening and the ceramic tile floor quickly lost any of the heat it had retained. I struck up a conversation with the cat but the cat lost interest and walked away. I watched the time on the microwave clock move slowly minute by minute. I fought the urge to pee.

I concentrated on looking at the photographs of our children and grandchildren we had proudly hung on the livingroom wall. I couldn’t remember the phone number at my wife’s friend’s house. I wanted to cry.

I couldn’t believe that I was all alone, had called for help, and no one was on their way yet. I wondered what level of priority my call for help was for that first responder team.

Were they only concerned about life and death? Were they so busy they could not even spare a moment to check on a resident of the community who had confirmed he was in a spot of trouble?

Had they no idea how important it was to provide a physical presence for someone in a time of extraordinary need?

And so, I lay alone on the kitchen floor with a badly bruised hip for more than forty minutes before the ambulance crew and my anxious and bewildered wife arrived simultaneously.
___

Right. The preceding was just me, Hal Newman, trying to imagine what it would be like to be all alone and waiting for emergency medical assistance after having been classified as a priority Two or Three call on a day chockfull of priority One calls.

Calls of every priority should be responded to and not only by an ambulance crew.

Actually, I believe it would be rather interesting to have a first response team specially trained to respond to calls of a lower priority to determine whether or not those patients actually need to be attended to by the much scarcer ambulance-based paramedics.

There should never be a monopoly on saving lives or helping people in an extraordinarily difficult moment of their lives.

The clock begins ticking when someone calls for help. The primary consideration should be who can get there quickest to render aid – not which response organization has a ‘claim’ to the territory.

It’s not about what uniform the responder is wearing. Every EMS organization should take an enormous leap of faith forward, work with all of the stakeholders and establish a model that ensures everyone in the community gets the EMS they deserve.

Be well. Practice big medicine.

Back on my path

“Each of us has a special contribution to make to the human world. Each of us is born with the package of assets, deficits, problems and blessings needed for that work. Each of us struggles to understand what our task is and how the package with which we have been born suits us to our work.” – Rabbi Nachum Braverman

It took me a long time before I realized EMS represented my calling and not just my job. I did everything I could to rebel against that realization. I abandoned my early work as a paramedic to attend a small Disciples of Christ College (Bethany) in West Virginia. It was as far as I could get from my home environment without actually leaving the planet. I left the mainly Jewish neighbourhood I had grown up in to live in a town where I was one of eight Jews. Which brings us to this little bit of free verse.

“If I die in Bethany who’ll say Kaddish over me.”

Kaddish is the Jewish prayer for the dead. Ten Jewish men must come together to pray. Bethany would have required religious mutual aid if any one of us had kicked the bucket.

The late great pastor Hiram Lester once sat me down on the porch of the Alpha Sigma Phi fraternity house and asked me what I needed to do after I graduated from Bethany. It was mid-summer and we were watching the sun turn crimson red as it dipped into the horizon. I paused and answered, “Well, sir, I’d like to be a journalist. Maybe write for a big-city newspaper one day.” Hiram looked at me. “I didn’t ask what you wanted to do. I asked what you needed to do. There’s a serious difference, you know.”

I graduated from Bethany College with a bacclaurate degree in Communications. That’s not to say I negated entirely my need to continue carrying an EMS banner of one sort or the other. The siren song of the Bethany Volunteer Fire and Rescue Department drew me down the hill to the firehouse. The folks of the BVFRD adopted me and taught me an appreciation for the art of caring. They invited me into their homes and made me a part of their lives and shared their backwoods comraderie. When I left Bethany I actually believed I was going to be a big-city journalist.

Before I lit out for parts unknown I stopped by to pay my respects to Hiram. He told me a story about hitchhiking home after the Second World War and catching a ride in a beat-up old pickup truck. The driver asked Hiram penetrating questions about his life and his love and what he intended to do now that the war was over. Hiram said he told the driver he wanted to be a farmer but that he needed to be a pastor. The driver stopped at a crossroads in the middle of nowhere and told Hiram he could do anything he wanted if he gave up on what he thought he needed to do. Hiram told me it was the Devil driving that pickup truck. He says he got out of that old pickup truck and walked out of those crossroads and went home.

Hiram told me I had enough passion at my core to have the courage to listen to the sound of my soul crying out and realize that what I needed to do was be a paramedic.

I have never looked back. An old preacher man from West Virginia taught me the most important lesson in life: be true to yourself—once you realize what you need to do–pursue it with all of your strength. Don’t stop for anything other than food and water.

And so here I am in the Town of Stanstead [Quebec] where the powers-that-are have refused to allow me to play an official role in the first responder program that isn’t, or the fire department that is, or the emergency preparedness plan that needs to be better. In this small town, there is a cost that comes with passion, principles and freedom of speech – and that cost is borne by the community when people with something important to contribute are continually pushed away.

I’ve come to the realization that sometimes you just need to be the unwanted camel outside that pisses into the tent and hopes to bring about needed change through awareness and advocacy.  Any good political strategist will tell you that it’s far better to invite the camel inside so he can relieve himself outside the tent.  However, it’s been eighteen months and I’m fairly certain no invitations to the tent, the ambulance house, or the fire station are forthcoming.

Thanks to the inspiration provided by old and relatively new friends, I’m back on my path… and listening carefully to the siren call of EMS.

Be well. Practice big medicine.
Hal

Newman: Failure to launch first responders sends a message

Stanstead QC–I believe that a strong Emergency Medical Service – including first responders – sends a strong message to all parts of a community. We care enough about each of you to ensure that there will be qualified care providers by your side as quickly as possible each and every time one of you calls 911 for assistance.

So what is a town saying when it continues to delay the launch of its medical first response service? We just can’t see past the paperwork to the potential benefits this program will bring to our community. We’re too busy fundraising for the new arena to realize there will be no one to respond lest a child gets hurt on the new ice surface. We’d like you to bring your business to our town but you need to know that if the ambulance is on a run you’re strictly on your own out there.

There are no good excuses for not having a first responder service in a rural town like Stanstead. Not a single one. We have one ambulance available at a time here. If it’s out on a call the next one might be coming from Magog or Coaticook – 20 minutes away if all is right with the world and a lot longer if it’s midwinter and there’s a storm blowing through the region.

Clearly, the Stanstead Ambulance Service recognizes the need for first response. The Ambulance service was the prime mover for the town’s public access defibrillation program which saw five automatic external defibrillators deployed in publicly-accessible buildings. The AEDs are a solid link in the chain of survival. First Responders are the next essential link in that chain.

The chain can only be as strong as its weakest link. And the potential for lifesaving is not maximized when there are enormous delays between accessing the EMS system and the arrival of ambulance medics.

We moved here last June. During the summer there was talk about establishing a medical first response program in town. It didn’t happen. Last Christmas word went out the town was seriously considering launching a first response program. Applications were taken. The rumoured launch date for first response was May 1st.

I put in my paperwork before the program was even officially announced. I waited to hear if my application for the first response program would be accepted. Eventually I heard I could expect an interview with the new Fire Chief and the EMS Coordinator responsible for the project.

I’m still waiting.

So is rest of the community.

Failure to launch sends an equally powerful message.
Sadly, it’s the wrong one.

Be well. Practice big medicine.