The End of an Era

As of 1/31/2006, I am officially no longer an EMT.
In practice, I have not been an EMT since 2003 but on paper, I was a New York State licensed EMT until 2 weeks ago.
Huh.
Part of me is sad about it. That was a career path, I thought I had chosen to follow. But then things changed. And it simply didn't fit into my lifestyle anymore. Also, I didn't love it in America the way that I loved it in Israel. It was so different here. It was no longer about the patient first and foremost. It was about making sure you cover your tush and don't get sued. Here, EMT's are at the bottom of the chain. There is no respect for them (at least in the hospital setting).
In Israel, it was a different story. That's where I got my start as an EMT. Well, a First Responder and then a step up. Kind of a non-driving EMT. When I took my course in Israel and started volunteering in Ashdod, it was like I found my path. I loved it. Every aspect of it. The good calls, the bad calls, the adrenaline. Making a difference. Helping the people of Israel. At a time when the Intifada was at it's worst and every day we wondered where the next bomb would go off, I felt like I stepped in to try and help. It wasn't easy but it was amazing. It changed my life.
To give a little background, I went back to Israel for an Overseas program with Ben Gurion University in August of 2001. I went a little early and volunteered with the Israeli Army in a program called Sar-El for a short time. I wanted to be in Israel to help. I was so helpless in America and just being back in Israel at such a time felt good. Volunteering in the army felt great. No, we didn't do anything major but we sort of took the place of a reserve soldier so they could do other things. We did a lot of grunt work. And I loved it. Someone has to do it.....
Then I started the University program and got into the university lifestyle. We had fun. Tuesday nights were salsa night in the bomb shelter turned disco. Random nights we would drive out into the desert (we had no room for anyone else in the car one night that we went so we stuffed 2 people in the trunk.....) and have bonfires. Touring, classes, having fun.
Then came time for winter break. Things in the country were going downhill and I felt like I was in Israel but I wasn't doing anything to HELP Israel. A lot of my friends were going back to the States for our 2 1/2 month break but I didn't have the money nor the desire for it. I started researching different programs and thought about going back to Sar-El. I even hooked some friends up with the program. But then I found out about the Magen David Adom Overseas Volunteer program. Wow. Intensive training for a week as a First Responder and then be sent somewhere in the country to ride on ambulances for 2 months. It sounded perfect. But could I really do it? I had never seen any blood or guts in my life and never broken any of my own bones. Would I be able to keep my cool? Would I freak out?
But I wanted to do it SO badly. I met with Yochai who was in charge of the program and we discussed it. He said as part of the training, we would be helped out with that aspect and learn how to deal with what we would see. Physically and emotionally. He encouraged me to go for it.
So, I did.
I was sent to Ashdod with 4 other volunteers and we had an amazing time. Truly life-changing.
As for my best and worst cases?
Well, the best were always the pregnant ladies we would transport to the hospitals that always waited just a little bit too long. One of them was REALLY close and the medic in the back with me said that if we didn't make it to the hospital in 2 minutes, we would be delivering the baby right here. I leaned over to the driver and whispered for him to slow down. I REALLY wanted to deliver a baby. But, we made it. Lucky lady.
Worst cases? Well, there are a few of those. But 2 stand out in my head. The first was one of my first few calls. We had to accompany the police to a house and tell some parents that their daughter had been found dead. She had OD'd on drugs. Whew. That was a rough one. Just standing there and trying to keep my composure while watching the police deliver the news. It was rough. Watching the mother crumple down when they told her. Knowing her life had just changed forever. That was a tough one.
The other was more of a physically challenging case. And I believe it is the worst thing I have ever seen in my life. The next few paragraphs may be graphic so beware. Proceed with caution.
We got the call just after my team and I were munching on delicious pizza bourekas. The call is a man shot in the head. I throw my boureka back in the bag and gobble down some TUMS. We don't know any more information than that. It's the driver, an Israeli volunteer and me. The Israeli volunteer is sitting up front and does her lipstick as we are racing through the streets. Thoughts are flashing through my head. What will it look like? Will I faint? Will I throw up? Will we be able to save him? Was it a suicide? A murder? Through the mouth? Through the ear? I told the driver that this is my first case seeing blood and guts. My other cases had been more along the lines of either already dead people or breathing issues. For the most part. But no REAL blood, guts, and gore. The driver's advice to us was whatever we do, don't faint. We can throw up as much as we want, but don't faint. Oh boy.
We get to the apartment and there are police cars outside. We go upstairs in the elevator and a nosy neighbor is asking what's going on. But we don't say anything. Don't faint. Don't faint. I was feeling a little light-headed. The elevator gets to the right floor and I see the doorway opened a crack. Woaaaah.....
But as soon as we enter the apartment and I take a glance around the apartment, I feel my mind completely switch gears. It's not about me anymore. It is about the patient. Let's do what we can and try to save him. I take it all in. A man on the porch, looking upset. Policemen. A pillow on the floor. A black gun lying in a pool of blood. In some ways it looked like a movie scene. The way it was set up. But in the movies, you just have bright red blood. You don't have bits of brain matter and various shades of blood and other goop.
There was an old man, lying on the floor. And he was gasping for breath. He was still alive. But barely. My memory is a little hazy at this point. I was getting supplies from the bag and giving them to the medic and the other volunteer. The medic was doing stuff to the man and getting the Automatic External Defibrilater (sp?) ready and the girl was holding what was left of his head and was bagging him - helping him breathe. I remember at one point, she said she felt his brain coming out into her hands and was going to throw up. I was going to take over but she recovered.
He took some final gasps for air but didn't make it. We had to call another crew that had a doctor and get permission to stop working on him. There was just nothing left to do.
A police photographer was there snapping pictures. We cleaned up our mess and waited for the other crew to arrive so the doctor could officially declare him dead.
We got some of the story while we were waiting. The man had cancer and some other medical issues and was basically slowly dying. His son (the man on the porch) had come to take him to another appointment and when he came into the apartment, found him dead on the floor.
So that was that.
I won't ever forget that call.
During my time as a New York EMT, I did not have anything quite as dramatic as that. The two cases that stick out most in my head are one, when I did my required day at the ER, I had a chance to do CPR compressions on a man. It was tough. He didn't make it and wasn't going to make it by the time they let us try the compressions but it was good experiance. It's a lot harder doing it on an older, overweight man than it is on Annie, the CPR dummy.
The other case was a woman from a nursing home who we pretty much saved her life. She was having really bad breathing issues and kept puking everywhere but she wasn't getting any oxygen. So we had to bag her and I rode to the hospital while crouched over the stretcher bagging her, forcing her to breathe - amidst puke. That was a really intense call. And my partner and I had a fight afterwards.
Well, that's that. My most memorable moments as an EMT. And the end of an era.