Written by Kate Dernocoeur, Originally published by Jems, 1986.
There's a notion that needs dispelling, because it's disabling for some people, and primarily untrue. That is the idea that "we save lives." Its a seductive, thrilling concept, guaranteed to help raise our collective self-esteem (if only superficially).
It's time to deflate the myth. We have focused for too long on the idea that we save lives and have therefore developed inaccurate perceptions of EMS. It is time to recognize that what we actually do, most of the time, is simply help people with problems which they are unable to handle alone.
This is in no way meant to belittle the importance and value of the efforts we each make, whether EMS is a vocation or an avocation. Our work is important. Anyone who has run one emergency medical call knows the gratification that comes with knowing we can help.
The point, though, is that we have unfairly enticed a lot of people into pre-hospital care with the lure that, given the right circumstances, they could become real heroes. They imagine that EMS is constantly rewarding and stimulating, where each action will make the difference between life or death.
Indeed, such circumstances are to be found, occasionally. Once in a while, a person in ventricular fibrillation converts on the first shock, sits up, and talks with you on the way to the hospital. A call like that yields an inestimable sense of accomplishment. It is also exceedingly rare.
What sorts of calls do we more often see? Many times, we see the calls which, while perceived as an emergency by the caller, do not require undue effort on our part — the isolated fracture; the stable chest pain; the psych emergencies; the seizures which aren't, in fact, pre-cardiac arrest seizures, but non-compliant epileptics; and the non-injury auto accidents.
In fact, we seldom save lives. We provide a service to our communities which, far more often, consists of encountering people in crisis who need a few of our hands-on skills. Even more, they need us to make them feel less frightened and more reassured about a sudden alteration of their plans. A child with a broken collarbone is no big deal in the spectrum where "we save lives" is the bottom line. But if you discard that notion, knowing that your presence made a scary event more manageable should generate a different and lasting sense of accomplishment. It's less dramatic, to be sure. It won't make the papers. But it's just as important, in its own way, as saving a life, and such small, unflashy events are far more common.
So seldom do we encounter a situation that requires lifesaving measures that, for this reason alone, the phrase should be practically eliminated from our vocabulary. It only serves to build unrealistic expectations about how we'll spend our time out there and undoubtedly stimulates many people to invest a lot of time and energy in EMS because of a misconception.
What we much more commonly do is spend time preparing for or awaiting calls. First, there's the training — hours of it. Sitting in classes is not what people thinking of getting into EMS envision.
Then, it is natural to be curious whether the information we’ve learned actually works. Thus, the waiting weighs heavily on us — and that's what we do most in EMS. At first, we wait for any call. Later, when we have a few under our belt we await "good" calls, those which enrich us by their complexity or, even more rarely, drama.
“But," ask some, “if we aren't tantalized by the idea that the next call might be "the big one," how can we find the staying power to stick with EMS?' This is a critical point. Some people need big-time calls to justify staying involved.
In the meantime, while they await that big call, they satisfy a need to feel important with their flashing lights and sirens, pagers and radios, and official- looking uniforms. These are the same people who view a little old lady lonely for some company as a worthless call. A minor laceration that caused panic in a person who faints at the sight of blood is a situation worthy of contempt. These are the people who are in it to save lives.
Another reason to eliminate the myth is that it really isn't uncommon to subtly seduce ourselves (to varying degrees) with the thought, 'We save lives!" We begin to believe it, especially when we’ve been fortunate enough to really do it once or twice. Yet what happens with that ultimate cardiac arrest? The percentage of saves in even the best EMS systems is well below 50 percent. We “lose" far more often that we "win." We end up consoling ourselves that we did our best.
Yet, if even a whisper of the myth lives in your soul, an incongruent message seats itself, and nibbles, then eventually gnaws at your enthusiasm. Many people have left EMS because over time they have realized that "we save lives" is a lie. They feel cheated, all because of an inappropriate — if honestly intended — message we have sent ourselves and those who yearn to join our ranks.
It's time to be more realistic. EMS is a community service where we are able to help people with the problems that they have. If we avoid making quality statements about those problems, we can learn to take each call with a more appropriate sense of mission — not just those that test the sophistication of our abilities.
We help other people with problems they don't know how to handle. It is a valuable, worthy, important task. It in no way diminishes the drama of “putting out" in those rare times when we encounter lives in the balance. Rather, this subtle shift in how we view ourselves provides a more honest appraisal of what we actually do.
Minimizing — or eliminating — the "we save lives" myth will serve to make each call seem important in its own way. It will serve to draw people into EMS who understand that our assistance seldom is of a lifesaving nature. It's a much healthier approach to a stressful pursuit. We owe it to ourselves to introduce an attitude other than the one that has prevailed so long.