Emergency Medicine’s Original Sin
Lindsey Kaczmarek gets called an ambulance driver more often than she gets called a paramedic. “That’s absolutely not what I do,” she told me. What she does do is show up when someone needs medical help, figure out what’s wrong with them, and do whatever she can to help them survive the trip to the hospital—in her case, the Mayo Clinic in Rochester, Minnesota. The primary symptom for one in three 911 medical calls is simply “pain,” but during any given shift, Kaczmarek might attend to a heart attack, a stroke, a car crash, a labor and delivery gone wrong, a mental-health crisis, a shooting, or an elderly patient suffering from a severe urinary tract infection. “If they’re not breathing, I will breathe for them,” she said. “If their heart’s not beating, I will be the heartbeat for them.”
The job of providing emergency medical services, or EMS, often resembles medical detective work, with limited clues, no specialists to consult, and very little, if any, of the sophisticated equipment available to doctors and nurses. But even though emergency medics—a catchall term used throughout this story for paramedics, emergency medical technicians, and emergency medical responders—handle tens of millions of calls in the United States each year and make life-altering decisions for their patients every day, they remain all but excluded from institutional medicine. “You’re basically like a glorified taxi,” says Sarayna McGuire, a Mayo Clinic emergency physician who has studied pre-hospital health care.
