You Can’t Treat Stupid – A Critical Look at Critical Patients

In my twenty year career in air medical, I saw a lot of really interesting, gory, repulsive,horrendous trauma, and was exposed to all manner of human shortcomings and foibles. Still, after all the death and disease I witnessed, after flying 3,200 medical patients, I maintained a substantial reserve of compassion for most of my patients. Most of them were just people like everyone else who found themselves facing a serious medical dilemma, tragic accident, or unfortunate injury that battered their lives and their dreams in some way.

Then there were the others; there were a number, not a big number, but substantial, who elicited not sympathy and compassion, but nothing short of scorn. My crew and I even had a rather crude, albeit silent, comment for these people: You can’t treat stupid.

And it’s true. Certain patients came to us in the air medical business having placed themselves in such a precarious and ridiculous position that if others heard of it, their possible disdain for Mister Darwin’s theory would instantly change to profound belief. Here’s a list of some of the things I witnessed, names and locations changed to protect whatever shred of dignity these individuals may have left, and to shield me from any possible lawsuit or HIPAA violation.

1 Seat belt conservers: I call them this, because these individuals prefer to leave their seat belts carefully stowed in the idle position, conserving them, out of harm’s way, behind their owner the driver who sees no need for donning the belt. I never had any respect or compassion for these knuckleheads when we carved them out of their ruined shell of a car after the wreck, their faces planted into the window glass, chests molded against the mangled steering wheel, while the seat belt hung, conserved, in pristine condition, the buckle gleaming in its rack. I’ve heard those folks complain about the mandatory use of the seat belt: it’s an intrusion on their personal space and liberty, they say; it’s a nuisance; it wrinkles my dress; the belt will interfere with Sober living near you my reach if I’m attacked in my vehicle, so I’m not wearing it; it’s another example of big government intruding in our lives.

Well. Speaking of intrusions on personal liberty, how do they feel when their $100,000 ICU bill ‘intrudes’ on the collective cost of all our health insurance? Why should the rest of us bother to care, when they didn’t want to be bothered snapping the belt in place, or wished the government would just mind its own business, while the same government likely doles out our cash from a public fund to help with their re-hab after release from the hospital? Those who refuse to buckle up should have their license to drive suspended, or sign a statement of personal financial responsibility.

2 Smokers: Okay, I’ll take heat for this one, but someone has to say it. Smoking is stupid. If people stopped smoking tomorrow, the amount spent on health care for emphysema, bronchial diseases, heart trouble, pulmonary and all other related illnesses, including those from second-hand smoke would fall immediately. In twenty years I flew 3,200 medical patients. If smoking were not an issue, that number would likely be cut in half. Anecdotal? Perhaps, but cigarettes, in my non-professional opinion, cause most of the non-trauma, non-genetic health related issues in this country. The bottom line is this: Cigarettes should be taxed out of existence.

3 Drunk driving: Okay, we’ve all been there. Every one of us has been out with friends, had a few too many, and decided we were okay to drive home because those phone poles are placed in twos on purpose to make them easier to find at night. We’ve all been there.

This is no excuse. In my flying job, I saw the up close and personal of the national epidemic of drunken driving when those phone poles assaulted the front of a car, or worse, the car assaulted another one driven by someone sober. Why is it the drunks always survive? There’s no way to prove this, but I’m willing to bet that any EMT or Paramedic who’s been on the team more than a year never drives drunk under any circumstances.

This is not for the faint of heart, so be forewarned. Trauma, lung disease, vehicle accidents, all the preventable maladies we face in modern society are gruesome when treated, in the field or otherwise. There is blood; there’s gore; there are intrusive procedures that make the innocent bystander look away, wondering how any human body can possibly withstand them; there are seeming indignities performed that a conscious person would never allow, the pain of which they couldn’t tolerate.

I saw bodies twisted and torn beyond recognition. There were skin colors, rashes and lesions that appeared to be straight out of a Hollywood make-up kit. I saw a man smoking a cigarette through his trachial tube, after losing one lung and part of his jaw to cancer from–you guessed it–smoking. I saw a man who was too drunk to stand long enough to identify his dead twelve-year-old son whom he’d just killed while driving drunk.

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