Emergency medical services in America
This comes from an article in Current Affairs, which to be upfront is an openly leftist publication. I thought it was an interesting anecdote, especially with the news from a few weeks ago about the woman in Boston begging for people not to call an ambulance for her because she wouldn't be able to afford it (which is also mentioned in the article).
I was in a New York City diner two nights ago and something disturbing happened. It was about 2am, and a woman was sitting alone in the next booth. She was disheveled and possibly homeless, and looked unwell. She had been eating a plate of food, but then sprawled herself along the seat and fell asleep. Someone in the restaurant must have called 911, because an ambulance showed up. They parked directly in front of the entrance and left the flashing lights on, and through the large windows the lights filled the restaurant and were overwhelmingly dazzling. The two paramedics approached the woman and told her to sit up. She mumbled a refusal. They insisted. As she finally sat up, bleary, they told her she would need to leave with them and that she should pay her bill. She replied that she had no money. The paramedics became upset, one of them asking her why she would order food if she couldn’t pay for it, and telling her she’d need to pay before they left. While the paramedics stood issuing her instructions as she muttered and fumbled, a young man at the front of the restaurant quietly approached a server and paid her bill. He then told the paramedics he had paid for her. They looked vaguely annoyed, and told her she should be grateful that a stranger just paid for her. The woman did not seem to comprehend, and just made a noise. Then the paramedics took her out to the ambulance. In the hour or so I stayed in the restaurant, the ambulance didn’t leave, and kept its lights on.
Here’s why I was disturbed: the paramedics did not act like health professionals. They acted like cops. At first, I thought they were cops. Their uniform was similar, and the dazzling flashing lights were like police lights, and had the same bewildering effect. They were more concerned with whether the woman had paid her debts than whether she was okay. They had very clear contempt for her, treating her as a nuisance who was bothering restaurant patrons and needed to be removed. She wasn’t actually bothering anyone, of course; I was sitting in the next booth and had barely noticed her, and there were plenty of spare booths in the diner. But the paramedics were aggressive and unsympathetic in the way that many cops are. Incidents like the one I saw must happen constantly all across the country: homeless people and drug addicts (I don’t know whether the woman was intoxicated or on drugs, though it seemed somewhat likely) not being cared for with compassion, but being “policed” even by those who are supposed to be selflessly devoted to the improvement of health. The flashing lights were totally unnecessary, and made the whole diner feel like a police raid. And, of course, how typical of America that the issue of whether you can pay the bill is more important than whether you will live or die.
What do you think of this? If you've had an experience with emergency medical services, how did it compare?
I used to be an EMT as a part of my credentials I was building up before I applied to medical school.
One thing I noticed, when training to become an EMT is that there were a lot of firefighters and cops who were getting EMT training. When I finally got to the point where I was applying for a job in an ambulance, I noticed that all the jobs were going to ex-cops, ex-firefighters, etc. There was very much a "club" of individuals for which these jobs were available.
This club fostered a certain environment that you also see among cops, firefighters, etc. A "good boys club" if you will. From the limited experience I had with this environment (ride alongs, etc.) it seemed as in if some of the behavior they participated in was very similar to what you see in cop movies - very "bro" behavior in the locker rooms, very protective of each other, and a heightened sense of "importance" or whatever you want to call it.
Now obviously not everyone is like this, but I think it's a combination of the realities of the job itself causing people who stick around to have to develop behaviors that protect their mental health with a very limited pool of jobs with a lot more qualified individuals than available jobs (it's very easy to become an EMT) leading to some nepotism which just promoted the same behaviors through lack of diversity.
I personally think this anecdote is not the appropriate way to treat the poor woman, but it's almost as if the system self-selects out the people who would see this as bad. They do this because if someone were to report their fellow EMT/paramedic this would cause disruption among the unit - so they just don't hire anyone they think might act in that fashion, in a way to protect the people that are already in the system.
I didn't realize EMS was allowed to treat a person like that. Even if a police officer injures a person while apprehending them, they are typically brought to the hospital and have an officer standing by the entrance to the room and handcuff them to the bed when possible. Why would these paramedics do an even worse job than most police officers?
Typically when an ambulance doesn't leave right away, it means the person is dead or requires life support which the ambulance is not equipped with. But considering she was definitely alive when she was put in the ambulance, I have to wonder why they didn't leave.
Someone has to either agree to being brought back in an ambulance or be unable to make that decision themselves. The only way a paramedic or EMT could claim that someone was not be able to make that decision themselves is if they are not alert and oriented (AOx4 - alert and oriented to self, location, time, and what just happened). While this detail is left out of the anecdotal story, she was clearly awake, responding, and not in any imminent danger. These paramedics were likely acting in a criminally negligent manner.
Unfortunately, I'm fairly certain the woman neither knows that this is the case nor has any avenue to pursue suing the ambulance provider's company.