It is no secret that the majority of what we do in EMS is deal with the mundane. Routine chest pain, the ubiquitous "cold and flu" symptoms, benign shortness of breath calls and a mixed bag of minor trauma: these things fill up our days often from start to finish. Though these calls are far from the flashy stories of life and death, the reality is we ambulance drivers are much more experienced at dealing with the quasi sick than with we are with the deathly ill.
Those complicated calls - the ones where we are forced to make tough decisions or recognize an elusive pathology - those are diamonds in the rough. They happen so infrequently that news of them spread far and wide, across our service and beyond as tales of so-and-so's call permeates distance and time. If someone gets a good call, even in this city, you can bet that most will have heard about it by day's end. It seems sometimes that truly challenging calls are so rare, that when they do occur we find ourselves so surprised and unpracticed that we might be glad to get through it all without making an idiotic mistake. My last entry on this blog might serve as case in point.
And yet those calls are the reason why so many of us decided to do this job. I hope I have convinced my readers by this time that I have a genuine interest in medicine and that I do my best to learn from each and every patient, but I must admit that I too do what I can to seek out those elusive diamonds in the rough. I want to be challenged. I want the excitement and pressure of the unfamiliar. I want to be able to say that I've been there before. I want to respond to the side of a patient for whom a special skill or talent might mean the difference between better and worse. Who doesn't, right?
...But the mundane. Oh, the mundane. It is almost suffocating in it's volume. Paralyzing in it's persistence. My days are absolutely filled with it, and I find myself sometimes in the backs of ambulances, plugging away at the routine ALS as if my job could be performed by a machine. We get dispatched to calls like a short order cook during lunch rush. Chronic back pain. Hand swelling. Car crash and everyone is out walking around. We trudge through it for twelve hour shifts, heads high only for the hope that one of these might turn out to surprise, to challenge or intrigue. There are a lot of disappointments.
I would like to know how those who have been doing this job for a long time are able to withstand the mundane. Do they no longer live for the exciting calls? Are they content to relax in the routine, or have they a way to find interest in the subtleties that I may perhaps miss in my eagerness for something new?
Am I missing something?