The Midlife Medic: Mirror, Mirror on the Wall

I am not my brother’s keeper, I am his mirror. My words and actions reflect upon everyone who shares my patch and profession. What should we do when we do not like the way we look?

On June 9, broadcasting live on Periscope, an EMS crew in Newark, NJ, delayed a response while waiting for food. (I know the face, I know the uniform–this is the place I left just eight months ago.) I watched the death throes of a provider’s career in that brief clip and saw the display of sarcasm and lack of concern for the call to which they were being dispatched.

I am surprised by neither of those things. To claim you have never screamed at fate (aka dispatch) for sending you on a call when you are about to eat is to throw some pretty big rocks from inside a glass ambulance. What is concerning is that in addition to delaying the response, both he and his partner were OK with broadcasting live—violating multiple policies and creating significant privacy concerns.

His face is all over the EMS and local news outlets. He looks hard and angry. He orders his food and, while waiting at the drive-through, gets a call. You cannot hear the initial dispatch, but the crew does not respond immediately. When viewers ask why he’s not responding, he says he does not want to forego his food for what he says will be a “taxi ride.” When he does go en route, they get diverted to a higher-priority call. He is operating his vehicle with lights and sirens, eyes on the road, responding to the assignment, yet his words negate that he is doing his job. Anything he does now no longer matters in the court of public opinion. After watching that unvarnished glimpse, would you trust him to be a provider fully invested in quality care?

My heart breaks a little because I know what those few minutes of video will do to the rest of the organization, what an awful reflection it is on the patch and the profession. Many departments have scars, made when a reputation suffers damage from an incident where the actions of one person resonate throughout a community.

I am also angry. Let’s not forget there is a second person in that truck. Not three feet away, someone is letting him do that. You cannot see the second person, although the news report mentions them commenting to one another. Why would they not stop it, knowing it violates department policies and puts them both at risk? Perhaps the person is new or not comfortable enough to speak up. That would be upsetting, to think a new provider would be subjected to this demonstration of bad behavior–because that is how it propagates within a department. That’s how a culture of deviance develops as the norm.

The second possibility is even more upsetting, and that is that whoever is in the other seat did not care. Apathy is dangerous, leading to errors that can kill both careers and people. By not speaking up, they are part of that negative reflection. Their reward for implied consent is that they too face damage to their career.

I need to be very clear here: I do not defend or excuse the response delay depicted in this video. Agencies need to look at this event with a wide lens: How do staff members get to the point where this behavior is acceptable? What can be done about it, and what measures can we take to ensure it doesn’t happen in the future?

Inner-city EMS is not for heroes seeking glory. Poverty, no primary care, beat-up equipment, distant management and sitting on street corners in cramped quarters takes a toll. The daily reality is low-acuity calls in a high-volume system, period. Some shifts you are going to go hungry, possibly for nothing more than a series of non-acute “taxi rides” to the ED for patients with no other way to get there.

What if he delayed a call by the same amount of time for another reason? What if there was a medical or policy reason for a delay? Where I work now there are dispatches where certain protective equipment is required–the expectation is that you will don it before arriving at the patient, which causes a brief, but necessary, delay. What constitutes an “unreasonable” delay?

Thanks to the magic of social media, we know he delayed his response for mozzarella sticks. That unfortunate vignette raises questions: Is this a common practice? How many other times has this happened? What kind of care is the community receiving if this is acceptable?

What you do, what you say and how you present yourself at work every day matters. Your bad day could shatter the good reputations of hundreds of providers. The worst part about incidents like these is that after they are discovered, the offenders are removed, leaving the rest of the department to shoulder the repercussions and public response: Comments, jokes, outright anger and a basic loss of community trust .

I am 4,000 miles away, and I heard, “Hey isn’t that where you came from?”

Mirror, mirror…how do you like the way you look?

Tracey Loscar, NRP, FP-C, is a battalion chief for Matanuska-Susitna (Mat-Su) Borough EMS in Wasilla, Alaska. Her adventures started on the East Coast, where she spent the last 27 years serving as a paramedic, educator and supervisor in Newark, NJ. She is also a member of the EMS World editorial advisory board. Contact her at taloscar@gmail.com or www.taloscar.com.