Let's Digress

Entitlement and EMS

*Disclaimer: This is mainly geared for EMS people, not so much non-EMS people.*

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This picture popped up on my Facebook timeline the other day. A friend of a friend liked a comment on a post that another person shared that did the one thing with the stuff after the other thing happened, but before the last one or something. Really, I don’t know for sure how it got there.

Long story short, this was on my newsfeed and it bothered me a little. It bothered me a lot, actually.

It didn’t irk me because of the blood and the graphic nature of the picture; the general population sees more than that on any given episode of Criminal Minds. It bothered me because of the caption attached to it.

“Normal people could never understand what we do daily.”

The initial problem I see with this is threefold.

  • “What we do daily” implies that mass gore and fatalities are a daily occurrence.
  • “Normal people” implies that we EMS people are not regular people, i.e., that we are better than “normal” people, in this context anyway.
  • Thinking that we EMS people are better than non-EMS people fosters a mindset of entitlement and arrogance, and our mindset always has behavior that follows suit.

Let me get this out of the way first: Yes, we do have runs like the one in that picture. Yes, we sometimes get all gross and bloody and messy and smelly and covered in the bodily fluids of other people. Yes, we sometimes have those runs where everything goes to hell in a handbasket. Yes, we sometimes have people die in front of us in traumatic and dramatic ways.

However, the key word is sometimes. Sometimes it happens. Most of the time it doesn’t, but occasionally it does. In fact, those are some of the most rare runs we go on.

So, to say that gore and death and having bodily fluids all over the place is “what we do daily,” well, that’s just an inaccurate and massive exaggeration geared at inflating our ego.

To be more accurate, it should say, “what we may possibly do each shift, but most likely not.”

Generally speaking, our runs are for abdominal pain, chest pain, breathing difficulty, narcotic enthusiasts (drug seekers), transfers from nursing homes, people who have been ill for days and/or just want a ride, overly concerned new moms, etc.

Very rare are the runs where someone has a knife literally protruding from their head or a chainsaw suck in their thigh.

Moving on, saying that “normal people could never understand” implies that we EMS people are not normal. In this context, it’s implying that EMS people are better than non-ems people. Especially since the EMS people who normally say phrases like that wholeheartedly believe that EMS is a “higher calling” vocation and that to be in any profession is beneath the ultra-high moral level of EMS.

It’s easy to identify this particular flavor of cot jockey; they believe they are “special” (arrogant) and have excessive levels of confidence in skills they don’t yet completely have under control. And because they’re so highly skilled and special, they don’t believe they need to play by the rules like everyone else.

In reality, we EMS people are not better than the non-EMS people. Sure, some people are better than others, but that’s usually in the moral/ethical context, which is not the one being used currently. [For blogs about moral/ethical betterness, click here!]

“But Adam, EMS is a higher calling! We save lives and make a difference! So we are better than other people!”

False. EMS is a noble profession, but not any higher of a “calling” than being an electrical engineer or a lineman or a preschool teacher or a pastor or a farmer. Those jobs all make a difference and “save lives” too. To suggest that EMS is anything different is simply an attempt to feed our own ego and make us feel higher on the figurative totem pole.

What happens when we start to think that we EMS people are better than the non-EMS people? We become entitled and arrogant.

What do entitlement and arrogance look like? Here are some definitions:

Arrogance: Having or revealing an exaggerated sense of one’s own importance or abilities. Basically, when we think we are more important than we actually are and/or being excessively confident in skills that we do not have.

Entitlement: The belief that one is inherently deserving of privileges or special treatment. Essentially, it’s an inflated sense of self, which believes that things are owed to them because they are special and above others.

Arrogance and entitlement go hand-in-hand. [For more on entitlement, how to overcome it, and how to deal with people who are entitled, I recommend this book: Entitlement]

Does that caption seem to take on more meaning now? “Normal people could never understand what we do daily.” It’s arrogant, entitled, and utterly inaccurate.

Calm down, Adam, it’s just a picture on Facebook…I’m sure they didn’t intend for it to be taken that way.”

Fair point. But if that wasn’t the intention, what else could it possibly have been meant to convey?

In his book, The Entitlement Cure, Dr. John Townsend says, “Entitlement tells you to be your own boss… Entitlement teaches you to say, ‘You’re not the boss of me!’ It implies that you can be and do anything you want, demand of the others around you anything you want, and that it’s lame to depend on anyone. After all, it’s your life, so you need to follow whatever path you choose.”

Dr. Townsend goes on to say, “People with an attitude of entitlement project the responsibility of their choices on the outside… The fault lies with other people, circumstances, or events. They blame others for every problem… Blame is a first cousin to entitlement.”

Blame also involves a lack of ownership, but that’s a different blog for a different time.

Entitlement and arrogance are insidious cancers already, but they carry exponentially higher risks in EMS.

The risks are higher for EMS because entitlement and arrogance both encourage us to play god in our lives. It’s one thing for our behavior to only affect our life (just kidding, our behavior always touches more people than just us), but with EMS, our actions have a direct and immediate impact on those around us. Specifically, it impacts our patients.

Let me elaborate: Classic heroin overdose runs. Some EMS people suggest, rather resentfully, that we should just stop giving Narcan to heroin overdoses.

When people overdose on heroin, or any opioid, their breathing becomes depressed, then it stops completely, and they quickly spiral towards death and the great beyond. EMS typically administers Narcan, an opioid antidote, which reverses the drug and restores breathing and takes away the high and blah blah blah. Essentially, it saves their life in every sense of the overused phrase.

However, some EMS people don’t think we should continue to give it. They say, “They did it to themselves, they deserve to die from it. It’s not my job to fix it.” Or if they’re really clever, they’ll say, “If we continue to give Narcan and save them, then we’re just enabling the cycle of drug addiction because they’ll just overdose again. Especially since they can get it at assorted CVS stores over the counter.”

That is classic entitlement and arrogance. That is the mindset of playing god, especially in the first example. By definition, it is our job as EMS professionals to do whatever we can to fix what is causing the death, something about a “duty to act,” if I remember correctly.

Entitled people want to be judged by their intentions, not their actions, and even with that, they want to be graded on a curve. With the second example, their intentions sound quite honorable. Not wanting to participate in furthering the cycle of dysfunction and abuse is a very good thing, just not in the context of someone dying, especially when it’s easily reversible and when we have a legal obligation to act.

Milder, but no less dangerous, situations would be pushing for SOR’s (refusal paperwork) when it’s not appropriate because we don’t want to deal with the extra time and paperwork of treatments and transporting.

Yes, those are both a tad on the radical side, and hopefully none of us EMS people have played a role in anything of the sort. But like I said, entitlement and arrogance are both insidious cancers. They sneak up quietly and quickly and before we know it, everything is infected and we’re drastically behind the eight ball.

It all starts with thinking we’re more valuable than we are, having an inflated view of our position, feeling wronged when we weren’t, not accepting ownership of our behavior, blaming others for our failures, and refusing to accept reality for what it is.

Resist entitlement and arrogance regardless of how it reveals itself, and help those who struggle with it, just remember that the arrogant and entitled are usually the last ones to find out.

Our words and actions always carry consequences bigger than ourselves.

 

For more on arrogance, entitlement, integrity, and overall betterness, check out these books!

 

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