First Responders Never Run (in a red and white striped bikini)

“Isn’t that true?” asked Tim.

“What?”

“Isn’t it true that first responders never run?” He asked as he walked into the kitchen.

I hadn’t ever really thought about it.  I didn’t seem to recall that particular phrase being echoed in any of my BLS, ACLS, ATLS, PALS or other first responder classes.  Would have thought first responders would want to get to where they needed to go quickly.  But you did see FD and Police, etc. more scurrying with hoses and whatnot rather than sprinting, to the scene of an accident.  It makes sense that you wouldn’t want to get your adrenaline flowing too much, or arrive too quickly in some disaster area, or scare anyone into a panic.  I had never really thought about it.  And Tim tends to correctly remember weird slogans like “First responders never run” or medical phrases like “systemic lupus erythematosus” that he randomly throws about in conversations. So I said, “I guess probably not.”

This after-dinner conversation from several weeks ago was replaying itself in my head as I was running to the Atlantis Cove Snackbar in response to a “Is there a doctor in the house?”.  Let me explain.

So, here I was, lounging on a Caribbean beach in what I call a stretcher (others call lounge chair), all relaxed in my white and red striped bikini, big navy blue straw hat, big Jackie-O sunglasses, Ipad in hand reading Agatha Christie, Jacob nestled between my bosom and left arm, drinking an appropriately named “Bahama Mama” drink.  It’s a beautiful day at the Atlantis resort.  I’m loving life and someone in my book was just murdered.  Does it get any better than this?

Tim, who had been running around with Ben appears from behind my palapa and, looking very concerned, exclaims that something happened at the snackbar, someone passed out, it looks bad, people are calling for a doctor and that I should go.

“THIS IS IT” I thought.  This is the moment I’ve been training for.  4 years of medical school.  4 years of Emergency Medicine residency.  I went into this field because I wanted to be that guy on the plane who, when someone yells, “is there a doctor on this plane?” confidently arrives and saves the day.  Many of my residency friends had experiences of intubating people on the side of the road or aboard a deck of a gay cruise.  Now it was my turn, my chance to shine, my inner test.

An Emergency Medicine doctor  is THE doctor you want to have next to you when you collapse a lung, have a heart attack, break a femur.  That is what we train for, that Golden Hour of opportunity when a potential disaster can be averted with our intervention.  If you pass out at the snack bar at Atlantis, you want an Emergency Doctor at your side.

So I confidently shot up from my stretcher, handed Jacob to Tim, and started running.  Boobs and flab flapping, ass jiggling. Not a pretty sight I realize instantly and I slow down the pace.  I recall that “First responders never run” conversation.  Whether it’s true or not, I’m not sure.  One thing is for sure.  Fat first responders in a bikini should not run.  It’s just not professional.

Should I be going over some ABC’s in my head?  What if it’s cardiac? Do they have defibrillators.  That should be easy.  Head trauma? Pressure.  Tension pneumothorax?  That could be fixed by jamming a  straw through the left chest into the lungs,  like I saw on a movie once where a young female doctor is killed but haunts her ex boyfriend and actually guides him through this life saving procedure at a restaurant in the final denouement of the movie. Shouldn’t be a problem.

At the snack stand, there is a huddled group around a body on the floor and everyone else is staring (while still maintaining their place in line).  On the ground lays an 11 year old girl.  She is smiling and looking around, clearly excited by all the attention.  Not a sign of a dire situation, but still.  You should never just assume everything is OK.

“Someone called for a doctor” I say.  Strictly because that was true.  Later I would go over in my head the other potentially more eloquent introductions, such as “I’m Dr. R and I’m an emergency physician.  Is there anything I can help with.”   It seemed like something Dr. Goldfrank or someone older, more experienced would say as they WALKED, not RAN, over to the site of an emergency.  But this got the point across and I squatted next to the girl.

She was surrounded by a nurse, another doctor, and her mother’s boyfriend.  So I was the second doctor to arrive, which created a territorial quagmire.  Awkward.  How do I tactfully express, that clearly, after my 4 years of Emergency Training, I must be the more qualified expert? So often it’s dermatologist, opthamologists, radiologists who arrive on the scene.  They are usually scared as they try to recall the last time they had a life-threatening situation in their hands, sometime during internship.

The other physician was an OB-Gyn.  Part-midwife, part-surgeon, OB-Gyn’s are definitely comfortable with life and death, but this one seemed happy as a clam to leave the situation to me.  I implemented my greatest pediatric screening skills and assessed in less than a second that there is nothing wrong with my patient, she is and will be fine.  If this was the ED, I’d check her urine for pregnancy and send her home with her parents.  Here, by the snack bar, I wasn’t sure what else to do.  I struggled to stay professional and  linger around long enough to seem thorough and answer questions (“Yes, it may have been the antibiotics and not eating all day.”)  I then gave my name and told the family  where to find me if they needed any further assistance (under that palapa over that way).

Walking back to my stretcher on the beach, I was still shaking and nervous.  Now that I’m not working, this interaction constituted a significant portion of my medical exposure for the year, so I needed some time to regroup.  And old man peered out from his stretcher and asked if everyone is alright.  ”Yes, nothing to see,” I said in my most fireman voice.

I felt proud.  I was a doctor and I helped, or at least could have helped, someone in need.  All that training was really paying off.  Or at least could have paid off if it had been needed.  I had some skills beyond changing diapers.  Awesome.

“So do you think you are as good as an EMT in this kind of situation” asked Tim as soon as I sat down.  ”I mean, they are trained for this kind of thing.  By the time you get the patients, they are all packaged up.  I was thinking that in this kind of situation, my wife the EMT would be more useful than my wife the ER doctor…”

Eh what?