Every three years, EMTs and paramedics in New York state need to renew their certifications. This involves attending a refresher course and then taking a written and a practical exam. Refresher set up has changed several times over the years, but in it’s best incarnation it involved three weeks at the Bureau of Training. During that time we would review for the state exam, practice skills, and go over new policies that may have changed since the last refresher. It was also a great time to meet coworkers from other parts of the service and share stories.
One refresher year, I was reunited with a friend I had gone through paramedic school with. At that time he was working in the Office of Medical Affairs [OMA]. Among other things, the people who work in OMA review random pre-hospital care reports. They generate statistics and monitor the quality of care patients are getting.
The call report has also gone through many changes over the years. Although now they are completely digital, for my entire career in the streets they were paper. They changed tiny spaces for the narrative into larger spaces, sections were added for billing purposes, the refusal area has seen it’s language changed, and other sections have been moved and changed over time. Even the report itself has gone from being an ACR [Ambulance Call Report] to being a PCR [Pre-Hospital Care Report] to now having that little ‘e’ in front of PCR [ePCR] to emphasize our jump to digital.
At the time I was taking refresher with my colleague from OMA, call reports started being scanned into a computer, as opposed to being stuffed into an envelope and mailed to OMA. I was under the assumption that they spent less time reading them now and more time analyzing the statistics generated by the computer, which were based on the filled in boxes.
Despite thinking that I had no audience, I still took great pride in writing my call reports. I tended to go beyond the dull narratives and a one-size-fits-all approach to writing them by adding details that would help me remember a specific call if I were ever questioned about it, either in an OMA review or in court. My favorite, and the favorite part of everyone who worked on my unit, was the “Chief Complaint”, which in those days, was a long, wide box on the top of the paper. It’s purpose was to explain why the ambulance had been called. I regarded it as the title of everything else that followed.
From the very first day we learned how to fill out the form, it had been reiterated to us over and over again that we are instructed to use the patient’s exact words. Most people ignored this directive, given the prevalence of foul language and extraneous sentences people tended to use when telling the story behind their phone call to 911. The majority of EMTs and paramedics made an effort to summarize the words that patients actually used, to gear it more toward what was actually going on, but not us. While others were editing those exact words to something more concise (“I have diarrhea”), my partners and I would delight in waiting for the patient to utter just the right sentence that described things the way he felt them (“My ass is like a fountain.”)
You have to take your joy where you can find it. If our service wanted exact words, then damn it, that’s what we were going to give them.
As I was sitting next to my friend in refresher, his department-issued cell phone rang while we were on a short break. Not long into the call, I heard my friend say, “…Oh yeah, she’s sitting next to me right now. Sure I’ll put her on.”
I reluctantly took the phone thinking, of course, that I was in trouble. No one from OMA just wants to say hello.
“Hello, is Nancy on 37V?” I said yes. “Hello, this is Dr. Andrews, in charge of OMA.” I knew Dr. Andrews as one of our doctors who took our telemetry phone calls and did some of our CME [Continuing Medical Education] classes. I didn’t know he had become the MD in charge of OMA. Despite the friendly tone in his voice,I was leery. It couldn’t be good if they knew your unit.
“I just wanted to let you know how much we enjoy reading your pre-hospital care reports over here.”
“You do?” I asked cautiously. I still wasn’t sure if this was a trap of some kind.
His voice remained friendly, “Oh yes! Not just yours but everyone on your unit. Reading these forms gets pretty tedious because they’re usually boring which is why we look forward to the ones from your unit. “
“Really?” I answered. “We were kind of under the impression that no one really reads them. It’s nice to know someone appreciates them as much as we enjoy writing them.”
“Oh you have no idea!” gushed Dr. Andrews. “We love them. We have a board where we write down the latest chief complaints from your unit. We put a star next to the ones where we recommend reading the comments as well.”
“No way!” I was flattered.
“Oh yes,” he told me. “It’s the 37V board. No one uses the chief complaint section the way you guys do. My personal favorite is ‘They sent two hot ones straight to my juice, yo!’ ” He was talking about the chief complaint for a man who had been shot twice in the testicles. It was a personal favorite of mine, as well. That one probably had one of those stars next to it.
He ran through a list of a few others they had enjoyed and told me to let my partners know that their pre-hospital care reports were appreciated as well. He said to keep up the good work and I thanked him again. As I handed the phone back to my friend I still couldn’t shake the thought that I had been set up in some way. But our PCRs did make for a fun read. He hadn’t been the first person to tell us.
Over the years we had written many of our best chief complaints down, to share with our coworkers and friends, and also for ourselves, to make us smile when there seemed to be little to smile about. My list includes:
“God wants me to suffer.”
“People tell me I smell bad so I want to make sure it’s not a disease before I take a shower I don’t need.”
“They beat me like a pinata.”
“I didn’t think I needed to read the directions that came with my new saw.”
“My foot is a new shade of green.”
“Cheap vodka makes me drive like an asshole.”
“I broke my arm on this shampoo bottle.”
“I’m just a loser. Take me to the hospital.”
“I am the great Mephistopheles of legend and lore. I inhabit this body now. Take me to your governing elders.”
“The aliens gave me an implant and I want it removed.”
“I’m just in it for the lawsuit.”
“You can’t brainwash someone who doesn’t understand and yet here I am.”
“He planted it in my rear end so hard, now my neck is crooked.” (this call concerned a car accident where the the driver of the front car claimed whiplash.)
“I just found out about ass cancer and I don’t want it.”
“When you’re a playa, penicillin is just part of the regimen.”
“A demon told me to stab myself but all I had was a pen.”
“My girl tried to give me a salmon named Ella with her warm-ass soup”
“My brother is in the hospital having a heart attack so I must be having one too because we’re twins.”
“I used to love eggs but now I don’t anymore.”
“My new girlfriend’s mother told me she didn’t like the way I looked. Do you think I look sick too? I don’t really feel sick.”
“I’m pretty sure I have a sexually transmitted disease. I deserve to have a sexually transmitted disease.”
“My goldfish gave me gonorrhea.”
“My asthma boy had a seizure.”
“There ain’t no kind of juice that ain’t coming out of that man’s leg.”
“WebMD says I have cancer.”
“That bish put a curse on me and I need it removed.”
“I went on a bender I don’t remember and now it hurts when I pee.”
“The hairs growing out of my mole are turning gray, like my beard.”
“My love juice is looking kinda green these days.”
“I got mascara in my eye.”
“My ex is a demon and I’m scarred by her love.”
“I made my boyfriend break my nose so I could get free plastic surgery.”
“My scalp is peeling off! I got these white scalp flakes on my shoulders!”
“I’m running out of reasons to go. You just write down anything you want.”
“Prostate cancer runs in my family.” (this was from a young woman who was very concerned over information discovered at a family BBQ)
“I can’t reach my toenails to cut them and they keep getting caught up in my socks.”
“I made a pact with tequila and now it’s coming to collect.”
“The peoples in the commercials for eczema medications looks so happy and I want to be like them. Tell them I have eczema.”
“This might look like a mosquito bite but it was from the government.”
“No one can touch me, I’m made of fruit.”
“My skin is dry but when I drink a lot of water all I do is pee, it completely bypasses my skin.”
“I know now that I can’t trust my dealer’s idea of a ‘good time’. “
“The roaches have it in for me. I see them watching. And plotting.”
“My face looked very puffy in this picture my mom took.”
“Take me to any hospital with a microwave that I can use on this food someone gave me that was cold.”
“I spilled orange juice on this paper cut and it must be seriously infected because it hurt like hell.”
“The bread machine sliced off my finger and it got lost in the dough.”
“The evil voice in my head learned how to play the drums.”
“It all started with a bad banana.”
“I got beat with a Slim Jim. The snack not the car opener.”
“There’s a bug in my ear and he talks too much.”
“I think I’ve got a disease.” (this guy would not elaborate as to what disease or why he thought he had one).
“I broke my tooth eating pudding.”
“I’m really into that hot nurse at Bellevue. I’m just going to get her attention.”
“The drugs they prescribed make me pee a lot.” (he’d been prescribed a diuretic, which tends to do that).
“I think I’m smelling too many things. This needs to be stopped.”
“I want the doctors to stop me from sweating.”
“The things I do in the bathroom ain’t right.”
“On my planet, eating paper doesn’t make your stomach hurt.”
“He been falling since the sugar ate his toes.”
“I wanna vomit so bad I could cry.”
“Every time I take tequila I wake up and everything is spinning.”
“I got a itch that makes me less of a man.”
“My cred got busted.”
“My eyes need to switch places. It’s gotta be done by Monday.”
“I don’t think crack is good for my heart.”
“He can’t stop wheazaling.”
“The gremlin I met when I was on mushrooms said I was going to die if I didn’t go to Methodist hospital and see someone called Dr. Joseph.” (strangely enough a Dr. Joseph was on duty that night)
“I need a bed and a woman.”
“There’s a smelly, yellow glue coming out of a hole in his head.”
“I was shot in the leg six years ago and today its thumping like a drum.”
“Someone needs to change my diaper.” (60 year old man)
“My hand smells. The left one.”
“I can’t reach this itch in the middle of my back.”
“I need a shrink to tell me why I attract crazy women.”
“I went to heaven in my dream but I know I’m going to the other place.”
“I gassed my face with roach spray trying to kill a mosquito.”
“The man on TV says I might have carbon monoxide in my home.”
“Women just don’t find me attractive.”
“My husband smells like pee, he must have sugar.”
“My big toenail is the same shade of yellow as my teeth.”
“I need a clean bathroom.”
“None of the doctors believe me when I tell them I’m pregnant.”
“My heart used to go ‘rum tum tum’, now it goes ‘boom boom boom'”
“I thought I could fly.”
“This tumor has it’s own zip code.” (this was for a large pimple, not an actual tumor)
“I want a doctor to prescribe me those new blue pills that will make me a hit with the ladies again.”
“I think I ate my tooth.”
“I beat the s**t out of someone, now my hand hurts.”
“Ny Quil made me have some scary dreams.”
“He beat me with my own [prosthetic] leg.”
“The old lady I tried to rob sprayed oven cleaner in my eyes.”
“God told me to cut off my hand because I didn’t need it anymore. But now I think it was probably the devil.”
“The pencil got stuck when I used it to stab the bug that lives in my ear.”
“This mole needs to come off. It’s the reason I can’t have babies.”
“God is the landlord who shut off the spigot.” (he had problems urinating)
“When they say not to put a fork in an electric outlet, they’re right.”
“That whiskey didn’t smell right but I drank it anyway.”
“My psychiatric drugs are making me crazy.”
“There’s a party going on in my ass.”
“My boy baby daddy stabbed my girl baby daddy in the ear with a skewer.”
“I don’t know man, I’ve been tired for like 30 years.”
“My stomach hurts when I eat a lot.”
“My driving instructor was right. I don’t know what I’m doing.”
“I took the Tylenol like they said but nothing happened and it’s been almost a half an hour.”
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