Lessons in EMS #1: When to Take "No" for an Answer
by
First in a series
Note: Most of Brice's main "speech" is shamelessly borrowed from a comic strip in Steve Berry's book "I Am NOT an Ambulance Driver! II" If you like the idea of EMS cartoons drawn by a paramedic, get the book; it's hilarious--and a little too true to those of us who DO work EMS.
"Do I even WANT to know how this happened?"
John Gage shook his head at Joe Early's question. "No, Doc, you probably don't. Just, uh, get him cleaned up so we can get outta here, will ya?"
Craig Brice, the "him" in question, dabbed gently at his split lip with a gauze pad. "I WOULD appreciate that, Doctor."
Joe nodded, and turned to give instructions to the nurse. "Carol, would you get some 4x4s and a basin of sterile saline, please? Thanks." As they waited for Carol to procure the necessary supplies, Joe turned back to the paramedic pair. "All right, I'm doing this ,,,,,,,,,,,,,,,,,,,,against my better judgment, but they do say that curiosity killed the cat. What on earth happened?"
Brice inclined his head slightly. "It all began when I arrived at Station 51 to cover the end of DeSoto's shift."
Johnny was quick to explain. "See, Doc, Joanne's out of town visiting her mother, and Jenny's got the flu. Roy got a neighbor to watch the kids during the day, but he couldn't find anyone to cover the night shift, so to speak, so--"
Early intervened. "Okay, so Brice had to cover for Roy, who had to go home because his daughter's sick. I have that. How did Brice end up looking like he lost the prize fight?"
Johnny grinned, but it quickly faded with Brice's glare. "THAT started when we got the call to Moby Dick's."
"Moby Dick's? Isn't that a bar downtown?" the doctor asked.
"Yes," Brice said, "and we were called there for a bar fight...."
*******************
Two hours earlier...
Craig Brice unlocked the equipment compartment of Squad 51, removed the trauma and medication boxes, set them on the ground next to the squad, then closed and locked the compartment. His temporary partner watched, sighing in frustration at the damned accuracy of it all.
My luck to spend the rest of the shift with the human rulebook, Johnny lamented, shaking his head. He picked the trauma box up. "Come on, let's go."
The bouncer led the two paramedics almost immediately to their patient. He was a rather large man--at least 6'4"--in his early thirties, and obviously spent a lot of time working with weights. Johnny immediately decided that this was one man he did NOT want to cross. "Hello, sir, I'm John Gage. I'm a paramedic, and we were called here to help. My, er, partner over there is Craig Brice. What's your name?"
Obviously drunk, the man slurred, "Todd Richardson--and I didn't call you."
"The manager of this bar did," Brice volunteered. "May we help you? You appear to have a rather nasty-looking laceration on your forehead."
"Lasser-WHAT-shun?"
"Laceration," Johnny clarified. "A cut. He means you have a cut on your head."
"Oh. Yeah. That's from where that one asshole hit me with a Corona bottle!" Richardson crossed his arms over his chest. "Help me? You don't look like no damn doctors."
"We're not doctors, sir," Johnny explained. "We're paramedics. We're here to treat you and take you to the hospital where the doctors can look at you."
"I ain't going to no damn hospital!"
Johnny assessed the situation. Their patient was bigger than they were. The bleeding had stopped, and the cut needed cleaning, but probably not stitches. There were no other obvious injuries, except a possible concussion. Richardson was drunk, and--judging by his demeanor--likely to become combative. I have a solution for this problem. "Sir, would you like to sign a form stating that you refused treatment?"
"Gage!" Brice scolded. "The Refusal of Medical Assistance form is designed to be a last resort! That's IF the victim is fully conscious and coherent, and this man is obviously intoxicated."
"Brice," Johnny replied, trying not to roll his eyes, "trust me on this. The guy doesn't want to go to the hospital. Rampart's probably busy enough tonight. He's not going to keel over anytime soon."
"You don't know that!"
"My best guess, then," Johnny countered, "is that he's not going to keel over any time soon. Let's have him sign the RMA, and we can go on with our lives."
"May I talk to him?" Brice asked.
"If you think it'll do any good," Johnny agreed. "Just be careful, huh?"
"Knowing your track record of injuries," Brice responded, "that sort of warning from you is nearly ironic."
Johnny frowned, trying to determine whether or not he had just been insulted, and watched as Brice approached Richardson.
"Sir?"
Richardson turned to glare at Brice. "Yeah?"
"No doubt you were minding your own business during this asinine ritual of skull-cracking. However, with your possible head injury, it is most advisable that you be seen by a medical doctor. Shall we proceed to the hospital now?"
"No way, man!" Richardson insisted.
Ah, I see, Johnny thought. He's trying to confuse the hell out of the guy in the hopes that Richardson will agree. It was a viable strategy, but ill-advised in the particular case. "Brice, I wouldn't--"
Brice ignored Johnny and continued. "Indeed! You're obviously well-versed in English. It would also seem that your IQ matches your pH balance. Furthermore, inhaling your unsavory breath has not only pickled my brain, but also alerted me to the fact that you are unable to make a rational decision in regards to your personal well-being. Therefore, you have no choice but to go with us for treatment."
Johnny opened his mouth to warn Brice, but was an instant too slow as Richardson swung on the paramedic. He landed a right cross to Brice's jaw, knocking him to the floor. Richardson was immediately restrained by security, but Brice was still unlucky enough to bump against a bar table on his way to the floor.
"Then again," Brice sighed, his voice sounding vaguely pained, "who am I to judge your mental status, now that my occipital skull has become one with Moby Dick's bar? Your refusal is accepted."
Johnny bit his lip as he stooped to help Brice up. "Man, he's gone. You can drop the act now."
"It's worked beautifully before," Brice insisted, sitting up and shaking his head.
"It didn't work this time!" Johnny handed Brice a 2x2 gauze pad to dab the blood from his split lip. "I'll get you an ice pack for that jaw, and then get our, um, first patient over there to sign a refusal."
"Good idea."
"Hey, Brice?" Johnny knew he shouldn't, but he couldn't resist.
"Yes, Gage?"
"You don't have any problem with going to the hospital, do you?" Johnny grinned.
"Gage?" Brice asked in reply.
"Yeah?" Johnny waited.
"Shut up."
*******************
Presently...
"So," Johnny finished, "that's how we ended up here now."
Early was biting his lip. "You know, once I retire, I'm going to write a book on some of the stuff I hear in this ER."
Johnny chuckled. "Sure, just cut us in for some of the profits."
"Absolutely." The doctor finished cleaning Brice's lip, and called to order x-rays of the jaw, just as a precaution. Just before he turned to leave the room, Joe paused. "Oh, and Brice?"
"Yes, Doctor?"
"I'm thinking that the frontal section of your skull probably made more of an impact than the occipital, but we'll see what your x-rays show." Not waiting for a reply, Joe winked and left the treatment room.
There was dead silence for a few moments, as Johnny tried to think of something to say, then Brice spoke. It was so soft that Johnny might have missed it if he hadn't been paying attention.
"I can't win. I just can't win."
The End