An ambulance ride to town and back


The patient gave us a scare
We did as much as we dare
A long ways we did ride
While it was raining outside
And I spotted a young dead black bear.

Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, traveled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I went back to traveling and adventures in temporary positions. Assignments in Alaska, rural Iowa, suburban Pennsylvania and western Nebraska have followed. I finished my most recent assignment in Clarinda on May 18. Right now I’m in northern British Columbia, getting a first-hand look at the Canadian system. Any identifiable patient information has been included with permission.

I ride in the back of the ambulance with the patient, a nurse, and an EMT.
I can’t talk about the patient or the patient’s problem, except to say its seriousness demanded the presence of a doctor and a nurse on the ambulance.
Sending both of us put a significant crimp on the healthcare manpower of the town, as well as leaving the municipality without ambulance coverage.
I have ridden in ambulances before, but during the last century. Common IV pumps remained a dream then, and I adjusted the IV drip rate using my wrist watch. Ambulances ran a lower profile at the time, and I couldn’t stand up while we rode; nor did I have a seat belt.
I got little precious sleep in the wind-up to this transfer, and we left in the rain while the beginnings of daylight brought color to the world.
Between the bumps in the road, the need for speed, and my position sitting sideways, after 40 minutes I begin to fear meditation failure ending in vomit, and I request a basin. The nurse, a woman of immense and invaluable experience, knows exactly where to reach for it.
I see nothing of the beautiful landscape as we proceed. Mostly I keep my eyes closed and my breathing deep and slow while I imagine worst-case scenarios, and how I would proceed if they happened.
Three times the nurse asks for permission to medicate the patient, and I consent. We keep our eyes on the instrument that measures blood oxygenation, blood pressure, pulse, and breathing rate.
A few miles out of the city the road acquires more lanes and divides, and the traffic picks up. The change in siren pattern tells me when we blast through intersections.
Ten minutes from the University hospital I look at the patient and the word “deterioration” springs to mind. But when we wheel into the brightly-lit, well-staffed, fully-equipped Emergency Room I know that we’ve done our job.
Just before we depart, one of the EMTs gets a call to transport a patient from the city back to their outlying hospital. In the time it takes to ready the next patient, we decide to go to breakfast, and the choice is easy: Tim Horton’s.
“Timmy’s,” as the Canadians call it, with higher quality than McDonald’s, not quite as fancy as Perkins, has outlets across Canada. I’d think they’d want to invade the US.
We drive a few blocks in traffic denser than anything I’ve seen for weeks. We park in a position of dubious legality, knowing ambulances never get parking tickets. The four of us stand in line, a little too polite to walk up to order. But at the end we walk out with our food, past a rapidly growing line. I carry a cookie and a yogurt parfait, hoping the way back will go smoother.
We pick up the new patient, the transport does not justify lights and sirens. I get to ride in the front.
On the way back I learn about the pulp industry, how ambulance services get billed, how EMT shifts get arranged, and some of the history of the town. I comment that although I see signs cautioning wildlife corridor I don’t see dead animals on the side of the road.
The EMT explains that Animal Control removes the carcasses quickly, so that local predators don’t hang out on the pavement and cause more problems.
And, just like that, we pass a road-kill bear.

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