Our original EMS Paramedic class consisted, as I recall, of 32 students. We were each street hardened, having served the City of New York as EMTs for an average range of 18-months to 36-months. EMT-1 is the basic level of emergency care for ambulance crews, EMT-4 is the paramedic level. Without doling out too much information, an EMT-1 can offer Basic Life Support a Paramedic is authorized to be “invasive,” i.e., to start IV’s and administer drugs, to deliver oxygen via a laryngoscope tube, etc. A Paramedic in the field had more latitude than an R.N. in an emergency room.
In those days, NYC EMS handled about 1-Million calls per year. No system in the country handled as many calls. I am not boasting. There is a downside to that kind of call volume I will address in another post.
Our class had a wide range of educational experience. A few had some college, a few, associate’s degrees, most had a college degree, others had one or more graduate degrees. The media image of the educational level, the erudition if you will, of Paramedics has traditionally been equated to cops or firefighters. This is a mischaracterization. Paramedics are usually well-educated or certainly have the capacity to absorb a lot of information. After EMS, some of my fellow classmates went on to nursing, PA, hospital administration and even medical school.
The Classroom
Paramedic school is intense. Some schools combine associate’s degrees with coursework (usually for younger students), some are paid courses. Back in my day, EMS paid for our schooling however, it was a condensed course. It was just as much material as longer courses but the material thrown at us plus practical testing was relentless.
Our first medical director was one of those passive-aggressive types paramedics have experienced over the years. It wasn’t our imagination. We always felt he considered us as second class. It was proven to us one day. In paramedic school it is required to do rotations through various departments including the emergency department.
One afternoon, one of our classmates, while doing an emergency room rotation was minding his business when he overheard a conversation between our medical director and a medical resident.
The resident innocently asked who those fellows were who “were wearing green trousers and white uniform shirts.” It was us. Our uniforms were green and white. You have to understand, our instruction was by that point, about 75% complete. Our medical director said (verbatim):
“They’re paramedic students. I don’t know what they do, but we have to put up with them.”
We had spent (by that time) about 700-hours with him as a class, plus individual meetings. The student who overheard went to our chain of command, and not long after, the medical director was fired. He was replaced by another medical director who — to our huge endorsement — had been “one of us,” a paramedic, before completing college and then admission to medical school.
The Arrogant Divide
This is not going to be a post about how wonderful every paramedic has been who ever wore a uniform. We had our share of duds, and they still populate the pre-hospital emergency responder equation. My contention is that most of those duds were/are burned-out and depressed souls who have given up. We had drunks, abusers, racists and more than enough cop-wannabe’s. However, to ignore the unfair judgment, the arrogance and derision many physicians and nurses had toward us, would be flat-out wrong.
The overheard exchange in the room off-of the Emergency Department was not unique. It was an arrogant divide, a chance for a nebbish to pile on a group of paramedic students who were simply trying to do good. Up to that point, I never heard one student belittling our first medical director. I suppose the medical director felt it was his mission to put us in our place, though we had done nothing to offend him.
My classmates would go on to other professions in healthcare or to higher levels as first responders around the country. At least one would go to medical school. At least one, tragically, would die on 9/11. My hope is that medical directors have finally come to understand what paramedics can do in the field. I am dubious.
The arrogance still plagues paramedics and I believe much of it stems from countless, arrogant pieces of judgment. To this day, paramedics are underpaid with lousy benefits and ill-defined career paths. They desperately need allies. Shouldn’t the healthcare providers have helped? Shouldn’t they have said something besides snide comments?
