Emergency Medical Services would be nothing without a well-equipped communications center, and the capabilities of the extraordinarily talented emergency medical dispatchers (EMD’s). The dispatch center that governs my area looks like something that I would expect to see at NASA. The staff is professional, polished, calm, and very well-trained. I do not envy their jobs, however, because I wouldn’t last even one day as an EMD. I know this because I inquired once about a job at the dispatch center (for the day when I am too old to work the streets) and was told they do not like to hire former paramedics because ‘we know too much.’ They were not referring to our knowledge about emergency medical services. They were referring to our knowledge of what is really on the other end of the phone, and thus an inability to take certain people seriously. I couldn’t agree more. I can only imagine how the conversations would go:
Me: Nine, one, one. What is your emergency?
Caller: Um, yeah, I need an ambulance.
Me: <Big, audible sigh because I recognize the voice> Any particular reason…Bob? (Not a real name)
Caller: Man, I’m really sick.
Me: That’s what you said yesterday when you called and I didn’t send an ambulance then, either. Perhaps you should come up with something new
Caller: My, um, back…I think it’s broken.
Me: I thought you said you were sick.
Caller: I think I am sick because my back is broken.
Me: Unless you come up with something better than that, I am hanging up now.
Caller: Okay, well, I think there’s a gas leak or something
Me: <An almost audible eye roll> You mean carbon monoxide?
Caller: Yeah, man, that’s it. I think the furnace is acting up
Me: It’s the middle of July
Caller: Um, well, I think my back is broken
Me: Now we are back to that? Come on, Bob, I know better.
Caller: It really hurts, man. I think I need some medicine.
Me: What kind of medicine?
Caller: Um, you know, something to make the pain stop
Me: You mean like Morphine?
Caller: Yeah, man.
Me: The ambulance service is out of Morphine.
Caller: No way! Maybe a doctor can help me out. I still need a ride to the hospital
Me: Do you own a car?
Caller: Yea man, but I been drinkin’ beer… <snorts and giggles>
Me: It’s nine in the morning.
Caller: We never stopped from last night
Me: Color me surprised.
Caller: Hey man, I need an ambulance.
Me: <another sigh> Don’t you ever give up, Bob?
Caller: I, um, I’m having a seizure.
Me: You are having a seizure right this second?
Caller: Um, yeah, you better send an ambulance. I’m having a seizure and I need some medicine to stop it.
Me: Do you have a sharp object nearby?
Caller: Um, yeah, I got a knife. Why?
Me: Okay, I want you to take that knife and stab yourself in the eye.
Me: If you can stab yourself in the eye and not say ouch, then I will believe you are having a seizure and I will send an ambulance.
Caller: Um, yeah, I think my seizure stopped, man
Me: No kidding…
<Long, uncomfortable pause>
Caller: Um, are you going to send an ambulance?
Me: I have to send the police first.
Caller: Why you gotta send the cops, man?
<The sound of footsteps as there is a mass exodus when hearing the police might be en route>
Me: Because you said you have been drinking and the police will need to make sure the scene is safe for the ambulance crew
Caller: I don’t want no cops here. I just want an ambulance.
Me: Have you been doing drugs today?
Caller: I don’t do drugs, man.
Me: I used to work the streets….man. Last time I was there you were so stoned that Mount Everest would be jealous
Caller: That was you?!
Me: Yes, and by the way, thanks for puking on my new boots.
Caller: Sorry, man.
Me: Do you really want me to send an ambulance?
Caller: Uh, no thanks. I think I am okay now
Me: Glad I could help you out
The pink slip would be waiting as soon as I hung up.
One of the unfortunate aspects of dispatching is that the EMDs can only go by what they are being told. It’s kind of like the ‘garbage in, garbage out’ theory. If the caller says something like, “OH MY GOD! THERE ARE BODIES EVERYWHERE!” then the dispatcher has no choice but to send police, fire, EMS, the National Guard, the Mayor…even though the caller might be snickering while they are talking.
One of the other unfortunate aspects of dispatching is that they have to follow a script. I have seen the scripts that the EMDs use and, like most bureaucratic endeavors, they are written without a shred of common sense. I would venture to say that whoever crafted these masterful ‘talking points’ probably never answered a single 9-1-1 call or worked out of the back of an ambulance.
This is the system we have, however, and this is the system that we live by. I appreciate our EMDs and the incredible challenges they face, and I also appreciate some of the laughs they give us, whether they mean to or not. Here are some examples of dispatches and updates from dispatch:
“The patient is unconscious but breathing.” Isn’t butt breathing urban slang for passing gas?
“The patient is a three month old female having difficulty speaking between breaths.” This is one seriously gifted three month old to already be speaking.
“Patient is conscious, alert, and breathing normally, but actively seizing.” Actively seizing? Is it possible to inactively seize?
“Patient has been in the bar for eight hours and fell off the bar stool. They are unconscious, breathing…….possibly intoxicated.” I never would have guessed.
“Patient is a white male, six foot tall, two hundred pounds, blond hair, green eyes, white pullover shirt with dark trousers, brown belt, dark socks, black loafers…had an argument with his girlfriend…patient is crying and walking north on Elm Street.” The patient sounds like a good looking, well dressed, sensitive guy, but does he have a medical complaint?
“Patient was chased on foot for six blocks by a K-9 unit. Upgrade to code three for a breathing problem.” I have a breathing problem if I run to the refrigerator.
“Patient is unconscious but snoring,” Again, more urban slang.
“Patient is conscious, alert, breathing, no bleeding. Just wants to be checked out.” They sound very lonely and desperate.
“The accident occurred on the west shoulder of the northbound lane just east of the west onramp to the interstate.” I’m not even sure if this is logistically possible. We ended up just looking for the big red fire truck and all the commotion.
An ambulance service is blind without a good dispatch system. Thank goodness I work in a city that has a good one. Thank goodness there is a calm, steady, sometimes inadvertently humorous voice on the other side of the radio when my world is going straight to hell.