Blood on My Shirt: Memoirs of a Bc Paramedic

By Michael C. Burzek

Emergency response is an unpredictable and ever-changing experienceboredom one moment and chaos the next. The efforts of the paramedic are singular in purposethat is, to save lives. But not everyone is cut out for a career in emergency medicine; the demands can be overwhelming.

In his memoir, Blood on My Shirt, former British Columbia paramedic Michael Burzek provides a fascinating glimpse into the life of emergency medicine that encompasses car accidents, bar fights, freak accidents, and heart attacks. While sharing the perils that accompany paramedic duties, Burzek also dispels the myths that surround emergency medicine. As he narrates his personal story of how he was led to become a paramedic, Burzek also details the conflicting emotions that regularly surround EMTs such as fear and frustration, anxiety and anger, laughter and love, and the ever present question, Why couldnt we save the victim?

For anyone who has wondered what it is like to ride in the front seat of an ambulance with its sirens blaring while on a mission to save a life, the stories in Blood on My Shirt provide an honest, eye-opening snapshot of day in the life of an EMT.

• Language: English
• Publisher: Trafford Publishing
• Release date: Mar 21, 2011
• ISBN: 9781426956829

Michael C. Burzek

Mike Burzek worked as a paramedic for the BC Ambulance Service for nine years, has taught both elementary and high school students, and is currently employed with the BC Oil and Gas Commission. Married with five children, he presently resides near Dawson Creek, British Columbia.

Book preview

Table of Contents

Acknowledgments

To:

Introduction

The Early Years

Getting Started

City Bound

Humor in Uniform

The ‘Repeat Offenders’

Almost There!

Above and Beyond

As Kids See It

Killer Bee

Little Angel

The Young and the Reckless

Stop Her!

Is that Thing Loaded?

An Unforgettable Christmas

Wasn’t that a Party!

Mr. Lepage

Airborne 911

When Duty Calls

A Happy Ending

End Notes

Acknowledgments

Rebecca Malchow: editing

Motion Media: cover design

To:

My wife, Teresa, who really understands me most

My five special children who try to understand me

My parents and grandparents who never gave up

The dedicated men and women who serve

on the front lines of emergency medicine

"All actual heroes are essential men, and

all men possible heroes"

- Elizabeth Barrett Browning

Introduction

Over the years, paramedic services have evolved simultaneously with the increase and improvements of human mobility. Even as far back as the American Civil War, the medical profession recognized the importance of removing wounded soldiers from the battle field; some waited several days for medical aid and suffered horribly with little or no pain relief whatsoever. The lucky ones bled to death quickly; others died several days later from their infected wounds. Mobile services were rudimentary and extremely slow, practically ineffective; nothing was fast, and sometimes the ride alone in the horse drawn carriages or overcrowded trains had horrible consequences.

These challenges frustrated the physicians and nurses who daily witnessed untold human suffering and mortality. Global conflicts further underscored the need for rapid transportation of the critically wounded from the battle field to a medical facility. Military leaders recognized this as well; wars were won by the common soldiers. If mortality rates could be decreased, and injury recovery time improved, more men would be available for service; it was purely strategic. Slowly, first aid units were trained, organized, and deployed; it proved to be very successful.

Off the battle field, medical personnel took notice. If a mobile emergency service was effective in war, surely similar methods could work anywhere. Physicians had given up the notion of house calls as an effective and efficient way of delivering their services; the sterile medical clinic or office was preferred; patients would have to go to them; the concept was deemed far more practical and economical. The ‘Golden Hour’ became the focus; emergency surgeries and other critical interventions were the keys to patient survival and recovery. Yet, how were the critically injured or ill going to get to a hospital or clinic? The problem was readily solved; first aid vehicles were utilized to fill this newly created niche. As roads and transportation systems improved, the more these specialized automobiles were needed and used.

After World War II, first aid services rapidly evolved into a pre-hospital care system - and big business. Automobiles previously used for transporting the deceased were outfitted with sirens and gurneys; motor vehicle laws were passed to grant the strange newly modified hearses right of way on the roads; and so the ambulance was born. There was finally a way to safely and quickly transport the sick and injured to the hospital. Unfortunately, the concept was misguided, and nearly failed completely.

As demand for services increased, so did the opportunity for profit. Fees varied between communities and jurisdictions; some were exorbitant; it was quickly developing into a service for the rich. Competition became fierce as independent businesses vied for a share of the lucrative market. Funeral homes had a leg up on other competitors; understandably, they were very interested in this new line of work. If patients died, the business was quick to offer its mortuary services to the hospital and the victims’ families; if a patient lived, they would charge fees for transporting the ill or injured; either way, the funeral home profited substantially.

Other problems surfaced as well. The availability and reliability of the independent ambulance services was inconsistent. Patient care was secondary; the decision for treating and transporting patients centered on corporate greed. It was not uncommon for two or three ambulances to receive word of an accident, which created chaos; each unit raced to the scene for first dibs on innocent victims who were unaware they would be snatched up and rushed to the hospital, even if under protest. Other tactics were even more deplorable; drivers would convince uninjured bystanders or family members to go along for the ride to the hospital, then charge handsomely for ‘services’ rendered. Hence, the term body snatchers was coined.

These practices did not go unnoticed; there was public outcry over the methods and costs; unfairly, the drivers bore the brunt of it. For the most part, ambulance drivers had little knowledge of life saving procedures or medical processes; the primary objective of the business was to transport as many patients as possible in order to maximize profit. There was little difference between an ambulance driver and the typical ‘cabbie’. A critical element was missing, and for years, very little training was provided to these individuals on the front line. It would take more than a generation to change the way ambulance services conducted business and earn the public’s trust.

Towards the end of the Vietnam War, motor vehicle accidents were on the rise; in fact, over fifty thousand Americans were dying annually; millions more were getting injured. The statistics per capita in Canada were not much better. Demand for ambulance services increased sharply; public expectations gradually shifted. Protocols and procedures were updated as medical practitioners came to understand head and spinal injuries better. More training and equipment was urgently needed; response personnel started to work in pairs; and the Cadillac hearse style ambulances were scrapped in favour of the larger cube-style van. The use of aircraft for rapid transport, especially helicopters, also increased dramatically. Emergency medicine had come of age in North America.

The status of emergency medical response service in British Columbia was no different in the early seventies. However, a new concept was taking shape in the minds of several political leaders who wished to put an end to the constant squabbling between municipalities, and the lack of coordination during emergencies; officials reasoned that jurisdictional boundaries should not interfere with patient care. They also envisioned a much more equitable emergency health service where residents in rural communities would be afforded the same level of service as city folk. And after some stiff resistance from various stakeholders, a Commission was established in 1974 to coordinate and manage a provincial ambulance service. Critics scoffed at the idea; independent operators were outraged, and some municipalities refused to go along with the plan. But soon the Emergency Health Services Commission (EHSC) commenced operations throughout the province.

It was not an easy task; everything would have to be standardized; uniforms, ambulance vehicles, protocols, procedures, and training. Administration was to be centered in Victoria; regions were mapped out, stations were acquired, and additional personnel were hired. Phone and dispatch systems needed upgrading. It nearly failed before it got off the ground as a new government was swept into power, but somehow it managed to survive. Understandably, there were a lot of growing pains, but emergency health care was no longer controlled by big business and corporate philosophy; it was bank rolled by the tax payers. Patient care would be the first priority; only time would tell if that notion would hold true.

The role of the paramedic is on the front line of an integral component of modern health care. But it is completely reactive. Who can predict natural disasters, myriad accidents, pandemics, or sudden illnesses? Even when these types of events are anticipated, the severity is never fully known until later; it is purely speculative and hypothetical. Emergency response is an unpredictable and ever changing paradigm; boredom one moment; chaos the next. The whole system is quite complex; thus, the nature of work presents multiple challenges including the administration of services, personnel, supervision, planning, and financial resources; every component needs to be carefully assessed and continuously monitored. However, what matters most on the front line is patient care; and so the efforts of the paramedic are singular in purpose; that is, saving lives. Not everyone is cut out for a career in emergency medicine; the demands can be overwhelming.

The work experiences as a paramedic were a real eye opener; like many others, I had preconceived notions about expectations for and capabilities of emergency health care professionals. There is the dramatized Hollywood version of emergency response which warps public perception and idolizes first responders; and then there is cold reality. Paramedics do not and cannot possibly save every life; cardio pulmonary resuscitation does not bring the ‘dead’ back very often; in fact, the success rate is quite dismal. Victims do not bleed and die the way they are portrayed in the movies. And the daily tasks of the paramedic include mundane chores like mopping floors or scrubbing ambulances; many days and calls are quite ordinary; a boring routine.

There is also a frustrating level of bureaucracy which gets in the way of performance and patient care; paramedics would much rather deal with blood and bandages.

The nature and scope of work is not the only misconception. An unrealistic personal image of the ‘ideal’ paramedic also exists. Very few possess the physical features portrayed in movies by tall muscular actors. Quite the opposite is true; there is a broad mix of physical characteristics. And as a whole, response personnel in the BC Ambulance Service would probably be classified as unfit and unhealthy. There is too little focus on employee health and wellness within the organization, which partly explains why injury severity and frequency rates have been intolerably high. Sedentary lifestyles, little exercise, poor eating habits, and obesity also contribute to the problem.

For many years, employee safety did not top the list of priorities within the ‘Service’. Many tragic accidents, including several fatal ones, exposed a dangerous lack of hazard awareness education and safety training for emergency health care workers. Paramedics routinely face the very real threats of dangerous road conditions, inclement weather, patient violence, toxic atmospheres, fatigue, and varying degrees of stress. Yet, during my years of service, supervisors paid little attention to the safety concerns of employees; and senior management allocated few resources to address safety issues, focusing more on public image and response times. Accountability for employee safety rested squarely on the shoulders of the front line workers. The tragic deaths of two paramedics in 2006 and the subsequent inquest highlighted the need to improve employee health and safety. The long list of injured and disabled employees also showed the need for change. Unfortunately, it would be a slow process.

Aside from the tertiary issues and routine frustration with station politics and government bureaucracy, emergency medicine is a rewarding occupation. So much is learned in the daily interaction with patients and other health care workers; it is a great mechanism for studying human behaviour; how individuals differ; how they react and respond in the worst possible circumstances. I witnessed the toughest looking men cry unashamedly at the loss of a loved one; and I saw the ugliest injuries and most gruesome scenes one can imagine. I experienced the roller coaster ride of emotions; the highs and lows; and the sudden rushes of adrenaline, which left me shaking and utterly exhausted. But the most gratifying reward is the memories; a few lives saved; a little comfort provided in moments of crises; some laughter; and enough lessons learned to offer some advice: life is short; so enjoy the ride.

The Early Years

Most readers would consider my upbringing as relatively normal by today’s standards; I was born into a Canadian society which embraced social justice, love, and world peace. By 1970, man had already landed on and returned from the moon, a feat considered impossible thirty years before it actually happened. Pierre Elliot Trudeau was introducing sweeping reforms in Canada; the Vietnam War was coming to an end. There were the hippies, heavy rock music, the bamboo curtains, dope, incense, roach clips, and big hair - everywhere. Bell bottom corduroy pants and platform shoes were trendy. The clothing styles, the bizarre colours, and the abstract art said it all. I really was a flower child of the 1970’s; part of the age group classified some years later as Generation X.

Mom was an army brat and met Dad in Germany. My maternal grandfather was posted over there with the Canadian military as part of the NATO peacekeeping contingent. I was the second child; an older brother Richard died of a lung infection in a German hospital before he was a year old. Mom yearned for home and a fresh start, and so they decided to make the move to Canada. Vancouver, British Columbia was the final destination. There was an abundance of jobs, albeit low paying ones. Very soon after their arrival to Canada, I was born. Life for the two of them was not easy; Dad struggled to learn English, and the language barriers limited his employment prospects. Mom battled with depression after losing a child and facing a great deal of uncertainty for the future. Predictably, their marriage became unstable; after two short years of a tumultuous relationship, they split the sheets. After they divorced Mother was forced to work a lot, and so daycare was the norm for me throughout much of my childhood.

Several times I caused her great anxiety. Setting things on fire, consuming large quantities of chocolate laxatives, dancing on the roof alone with my favourite cat, ‘breaking and entering’ into a house to play with some newly discovered toys, were just a few of the events that only added to the burden of care- poor Mother. What could she do with such a child? The daycare providers did not help much either, especially when I came home speaking Punjabi and reeking of curry. But even a change didn’t help; another sitter failed to notice her own child and I were ‘missing in action’ one morning; four hours later Mom received a phone call from the police. It was not a good day.

Mom wrongly assumed a school class room environment would be good for me; she was dreaming. It really did open the doors of opportunity, whether that included manipulation or extortion of class mates, pranks directed at the teacher, chasing the girls, or all of the above. I was a capitalist, but the term ring leader more aptly describes my personality and character; trouble discovered me quickly. But it was always worth the risk even though I sometimes got caught. My first kindergarten report card read like a repeat offender’s criminal record; and I was labeled as rude, intolerant, and mischievous. I did not agree with my teacher’s assessment. What did she know?

The misdeeds and unacceptable behavior can mostly be attributed to sheer boredom; my attitude towards learning could be blamed on an aunt who taught me all the basics of reading, writing and arithmetic far too early. She inadvertently crammed too much into my little brain which caused extended thickening of the skull. At least that’s what my psychologist told Mom. The doctor also prescribed discipline, physical activity…and supervision. But my aunt was really cool! Some of the best times of my life were at hers and my uncle’s where I spent many weekends and summer days. The camping, fishing, crafts, hockey games and other myriad activities taught me a lot of life skills. My appetite for adventure and mischief was somewhat satiated; at least until I got home.

Grandfather was also to blame; I inherited a lot of personality traits and energy from him. When he was not overseas fulfilling military duties, he was often given the unenviable task of overseeing a mischievous grandson. I’ll never forget the first trip to the barber at the military base. Mother insisted her boy’s long blonde hair was becoming; Grandpa insisted I looked like a girl. Tempers flared; voices became louder as a shouting match ensued and gloves came off. Grandpa’s face was getting redder by the second; Mom started crying; I hid in the kitchen with Grandma. In the end, Grandpa won the battle; he usually did; and I ended up getting scalped. Mom was waiting for us at the door when we returned from the base; Grandpa grinned with pride as if he were returning to a military camp with a POW. She was not impressed and couldn’t speak civilly to him for several weeks.

Discipline was Grandpa’s favourite past time; he had me pegged and always knew when and how to exact the worst possible punishment. The military regime carried over to the home; breakfast at four o’clock in the morning; fifty push-ups at five, and the two cords of firewood had to be split and stacked by six. How could I question his authority? He was the sergeant, I was the private; orders were orders. He was not an easy man to keep up to, either; work was another well-greased tool, and he wouldn’t let up until I was visibly exhausted. Of course this was all planned; I usually slept like a baby every night, having little time or energy to cause trouble.

Unquestionably, my grandparents were two of the most influential people in the early years of my life. Personality wise, Grandma was completely opposite to Grandpa; she was a mediator; a graceful lady of the highest order; a quiet disciplinarian. They made a great team; her focus was education and etiquette; grandpa’s priorities included responsibility and retribution. My focus was staying alive while under their care; I got away with very little. But I really admired them; they had a stable marriage; seldom did the couple ‘discuss’ weighty matters in my presence. Never did I hear Grandpa raise his voice with Grandma. Their love for each other was obvious; it meant a lot to me. As the only child of a single parent, I did not see the day to day interaction of a husband and wife. Their examples taught me the importance of family values, one of the things that really stuck with me.

missing image file

Although I was a rather adventurous youngster, there was a soft spot for those who needed help no matter what the circumstances were. It mattered not how people got there. I didn’t care; every human was equal in my view. And I could relate; Mom made several trips to the local emergency hospital ward on account of my injuries; once for a nasty fall from a tree; another time a fingertip was sliced off while playing in a sand pile with some playmates. Before the finger completely healed I rode a bicycle into the neighbour’s parked car. Naturally, I was able to sympathize with the sick and wounded; this compassionate nature would surface many times throughout my childhood.

At the age of four years, I was walking back to the day care centre one day with our group after a morning swim at the pool. With no warning, the sound of squealing tires got my