After EMS: House Medic

Editor’s Note: This article is the second in a series from Mike Rubin. In this series, he’ll reflect on his career and share practical retirement advice for emergency medical personnel.

As I write this, The Lovely Helen is not at her best. She’s sick and injured, neither of which is unusual for a fellow retiree with moderate immunity and bad balance. I’ll spare you the details because they don’t matter as much as how I’m trying to help her and why I’m failing.

Although I’m retired from EMS, I play the home version of paramedic whenever I think Helen needs my kind of help, even if she doesn’t want that kind, or any kind. I wish I could be more tactful, like an ageless, off-duty Johnny Gage, but I lack his charm. It’s easier for me just to tell my wife how to get well. Good thing I never had to earn a living being charming or tactful.

It’s different caring for a spouse than a random patient:

1. I show up in a bathrobe and baseball cap instead of a neatly pressed, form-fitting uniform with an Advanced Housewives Life Support patch.
2. The only equipment I carry is a stethoscope and a thermometer. The stethoscope is mostly for show.
3. No amount of small talk makes the leftover medic in me seem interesting or sociable. I even tried, “So, what’s for dinner?”
4. The only treatment I can offer legally is something below basic life support (BLS), better suited for least-favorite siblings and house pets.
5. If anything feels awkward, we can’t just assume we’ll never meet again.

This is all pretty far from ideal for Helen and me. I still remember most of what I learned during 30 years in the field, but without even a Jack Daniels First-Aid card in my wallet, I can’t do much more for her than tell her how sick or hurt I think she is. She already knows that. Since I can’t fix it without going to jail for impersonating Marcus Welby, I feel compelled to recommend urgent or emergent care from someone legitimate, just in case.

I know Helen finds that annoying. Like me and many other seniors, she prizes her independence and wants to make her own decisions. She isn’t a big fan of the medical-industrial complex after more surgeries than I can count.

Whether I actually know what’s best for her isn’t as important as how I tell her. If I said, “Wow, that looks infected, you need to get it lanced,” the chances of us promptly seeking definitive care would be lower than me working another Brooklyn night shift.

It would be so much better for me to start with, “What do you want to do?” even if I suspected something serious. With Helen in charge of next steps instead of me, we’d both find it easier to work toward her recovery. That sounds so obvious, it barely qualifies as help.

Let me tell you about an ophthalmologist I saw many years ago for my glaucoma. I’d started new eye drops that were causing unpleasant side effects, and told my doctor I think we should try something different. His response? “Don’t think.”

I can’t imagine saying that to a patient, although I now realize some customs and habits of prehospital care may seem uncompromising when I cling to them at home. I mean, I wouldn’t tell Helen not to think unless I had a running start, but I can still be tenacious about resolving family health issues.

Shortly after I began my first medic job, my father had a heart attack. Then my mother had a stroke. With more medical training than other Boston-based Rubins, I became the default intermediary between doctors and parents. Some of that got contentious because I didn’t balance my intensity and book learning with common sense. I had to become more of an advocate, less of a technician. Now, after two years of retirement, I suppose I need to lighten up even more. Here’s some advice I’m giving myself:

• Don’t broadcast what you think you know. Better to be sneaky-helpful.
• Let doctors do the diagnostic heavy lifting. Keep listening for zebras if you must.
• Be less obnoxious. Don’t tell people what to do, especially the ones who can’t escape you.
• Seek healthcare providers who partner with patients to achieve mutually beneficial outcomes.

Ever wonder why there are no TV shows about ex-medics? Because we stop being interesting as soon as we leave the field. Thank goodness for our spouses. Most of them accept us for what we’ve become: nostalgic, heavier, old. The least they deserve are sincere efforts by their significant others to be more accommodating and less clinical.

I keep hearing retirement should be fun. I am dubious. Please help me seek fun by taking a poll that has nothing to do with EMS. You can add your answer to the comments, email me, or leave a message at Station 51. Now that would be fun.

Mike’s Exit Poll #1: Who is the best Bond villain?

Mike Rubin is a retired paramedic and the author of Life Support, a collection of EMS stories. Contact Mike at mgr22@prodigy.net.