He makes a nervous, sideways glance at me & I meet his eyes full on. I attempt a smile and try to make small-talk with him to ease his nerves. He lets out the breath he has been holding in, quite possibly from the very moment we got dispatched, and quickly answers me with only one-word responses.
I know I am a medic and have a few more years of experience under my belt but at the same time, it has been almost 5 years since I last donned an EMS uniform. I want to tell him I am nearly as nervous as him. However, for the sake of moral support, I refrain from sharing this piece of information with him.
Instead, I sit quietly, playing scenarios through my head of what could have been the cause of our patient's seizure and mentally review various treatment patterns based upon such. While mulling over the predicament of our patient, I also begin to ponder what I must have looked like racing to calls when I started out 8 years ago. I must have had the same nervous twitches and tight-set jaw that my partner has now.
My thoughts cease when the truck screeches to a halt and our crew piles out, grabbing our arsenal of gear. I silently applaud my partner for walking, not running, into the house. (One of the first principles of emergency response is to never run but always walk with purpose. And, in my humble opinion, I believe it applies to all areas of life.) In spite of the fact that my partner is packing most of the gear, including the cardiac monitor that he somehow snatched from me seconds ago (I steal it back because if I walk into the call empty-handed I feel dumb.), he makes it into the house a full 10 paces ahead of me.
As we enter the home, we step directly into the living room of a small well-kept home where family is nervously pacing around a healthy-looking gentleman who is sitting on the couch like nothing has happened. The temperature of the room on this hot summer day, causes my brain to hone in on the most likely cause of his seizure. My partner situates himself on one knee directly in front of the patient. I plop down the cardiac monitor and assume a fall back position so as to not make my partner any more nervous than he already is. His hands are shaking and I silently cheer him on. I know he knows his stuff...after all, I taught him some of it. However, his voice wavers and his assessment falters. I want to jump in and fire some burning questions at our patient. (Also, my cardiac monitor is still in the chair looking rather lonely at the moment.) But then I think back on all those calls as a newbie medic and how I hated it when my preceptor jumped in at the slightest falter on my part. "Getting things done is not always what is most important. There is value in allowing others to learn, even if the task is not accomplished as quickly, efficiently or effectively," as R.D. Clyde once said. So, with a great deal of effort on my part, I resist the urge to break in on my partner's assessment. Our patient is not critical and, if my partner misses something important, I can pick up the loose ends later.
Eventually, the assessment is complete and our patient makes it very obvious that he does not want to go to the hospital. My partner fumbles through explaining the cons of refusing medical care & explains concisely that, if things deteriorate after we leave, we will glady come back and help. Our patient remains firm in his resolve and the rest of us quietly begin packing up gear as my partner has him sign a refusal form. We file out the door and silently pile back into the truck.
As we rumble back to the station, there are several minutes of tense silence. Our shift commander finally speaks up and asks my partner how he thought the call went. Now it is my turn to hold my breath and brace for the barrage that is about to come.
"I think it went o.k." my partner replies.
It is glaringly obvious to all that this is not the correct answer and our shift commander proceeds to unload a lengthy list of faults that were found on the call. For the most part, he does so tactfully. My partner takes the feedback in stride but I know on the inside he is screaming, just as I would be if I were in his shoes at that very moment. He subsequently avoids all eye contact and, the moment after the truck is securely parked back at the station, he bails out and disappears into the office while the rest of us drift off to finish up whatever it was we were working on before the call came in.
Change is the end result of all true learning. No one wants to be "in the hot seat" but the inevitable reality is that we learn through doing and then through feedback on the outcome of our actions. When something has gone well, that feedback motivates us to repeat our actions on the next call. However, when things derail, as they often do, the feedback is harder to swallow. If we don't learn from our mistakes, we are doomed to repeat them. And, when lives are involved, a mistake is the last thing you want to repeat.
Learning is a continual process. Albert Einstein once said "Intellectual growth should commence at birth and cease only at death." Therefore, the moment we decide not to grow and learn from the lessons of life, we have thrown in the towel on life and forfeited an untold number of beautiful opportunities to improve ourselves and the world around us.
I know it was a brutal and intimidating day for my partner. The real truth of the matter is that is was for me too. To watch a newbie medic awkwardly fumble through calls is like a parent watching their child take their first wobbly steps. They are bound to fall down and no one likes to see that. Eventually, though, something clicks and everything runs smoothly. And when that moment comes, it is a proud day for everyone.
Really, though, I think we should never loose the eagerness of a newbie, that desire to learn and perform and subsequently succeed...although it is helpful if the urge to vomit every time a call comes in goes away.
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