So during the past reading week, as part of my Humanities-in-medicine elective in trauma systems/emergency, I had the chance to look at pre-hospital care. Basically I spent the week doing ambulance ride-alongs with paramedics. Aside from the ungodly hours that we started day shifts (5:30am), it was such a great experience. I had the chance to see the EHS system from the inside….from checking out the communications centre, to riding with the supervisors, to going out on shifts with the paramedics themselves. By the end of my shifts I think I’d made a pretty comfortable place for myself in the captains chair in the back of the ambulance and made good friends with that bottle of manorapid on the bench next to me (note: this is what happens when you’re learning about microbiology and pathology—you start seeing ‘bugs’ everywhere; another shining example of ignorance is bliss).

Anyways, I’ll try put up a post after I’m done all my shifts ( I still have few more to go), giving you an idea of the kinds of things I got to experience while riding along. But for now, I just wanted to highlight something that struck me while I was working with the paramedics.

Its so easy for us to forget that behind every 60 yr. old male with CHF and significant peripheral edema behind curtain 2,

or every 7 yr old female with a purulent wound and a pair of incredibly anxious parents in exam room 5,

or every 87 yr old female with shortness of breath experiencing bronchospasms lying on that stretcher over there against the wall in the corridor—-there’s a person.

And I know many of us tag the line that we treat people, whole people and not just patients with symptoms we can fix. Sure, but the reality of medical care is that its just too easy to forget that in our every day hurly-burly lives as medical professionals (and trust me, we’ll be there soon enough), we start seeing people as objects of our fixation. But when you have the opportunity to see that individual in their element, their home, you begin to see things about that very individual differently. You see things you wouldn’t normally see—and you can begin to understand people in a more meaningful way.

Now, I’m not saying that if we don’t all make house calls—we’re not going to be complete physicians. But what I’m saying is, sometimes we need to take a moment and think about that individual in a way that they didn’t teach us in our 12-step history and physical exam. What I’m saying is that seeing that same person in a different context, can give you a very different picture, or impression (rightly or wrongly) of a person. And that was something that completely struck me when I rode-along with the paramedics.

Every time I entered the emergency department I saw the patients that lined the corridor of the emergency department as just people lying in stretchers who needed to be seen. Some had IVs, some had oxygen masks, some had 12-lead EKG monitors hooked up to them. Some were tied down, some had bloodied bandages, some were nearly asleep. But that’s all that I could see them as. I didn’t see them as mothers, or brothers or car salesmen or teachers.

But the patients with similar conditions or illnesses that we happened to bring in, I saw in a completely different light. I saw them as grandfathers and sisters, i saw them as ‘shirley-with-the-professional-athlete-son, I saw them as Mr. Dyson the vice-president of Globus International, I saw them as recent immigrants trying to settle and give their kids the life they never had. I saw them as people.

I don’t know what it was that I saw in them as different, or particularly why I saw them differently. But something about coming into their homes, seeing a Royal Air Force picture on wall and the bottles of glenfiddich single malt on the table, res-assuring worried partners and stepping over grandkids, hearing the sounds of an old oscar album playing in the background, smelling English rose potpourri mixed with cigarettes; you can’t help but see people differently.

And that’s the muddied point of what I’m trying to say. Making that connection with people, can open up a window of insight that you could never imagine. It doesn’t have to mean sitting down for tea with every tom, dick and harry that walks through the ER or your office. But taking just a moment, or two, can give you a perspective that you never even considered. And it reminds us, truly, that in the practice of medicine, there is rarely anything that will tell you more about a condition or illness—than understanding where your patient comes from.