For those that knew him I am my father’s son. Same wild professor eyebrows and prematurely graying hair. The music gene seemed to skip me for the most part but the tendency to be a creature of habit did not. My dad preferred some routine when it came to meals. For me I have pretty much opened the door on what I’ll try but do have some standbys.

My father was a very quiet spoken person and I inherited that, even shy early on. I discovered once I got into the EMT world that being reserved did not serve either the patients or myself well. One needs to be aggressive enough to put hands on anyone. I always volunteered to go first during classroom skill sessions. I learn from my mistakes and have no problem leading the way. Fools rush in and all. When you work in a slower system and not that many critical procedures come your way, you better be the first to jump in. If you don’t your skill sets will suffer and ultimately so will some patient down the road.

This call occurred in my first six months as an EMT working on an ambulance. A transfer of a patient from a Portland-area VA hospital back to the coast. It was December 23rd. You’ll discover if you stay in EMS for any length of time that the holiday seasons can be tough on folks. Depression, suicides and assaults all can go up, making it a stressful time to work as well. Inter-facility transfers are not usually exciting calls and this would be about a 3-4 hour round trip. We headed off to Portland from the coast to pick up the patient.

The patient was a late 60s male, about 70 KG and diagnosed with terminal cancer. He was being brought back to the coast to be closer to his family when he died. Transfer orders showed he was on MS for pain, a restricted diet and was DNR. The patient was pleasant to converse with and had no complaints other than the hospital food.

Something I discovered over my career is that sometimes you don’t have policies and procedures that cover every situation. What I have found works for me is to be a patient advocate and be able to articulate your decisions when questioned. The patient was talking about how he and his son used to go to McDonald’s on the weekend. Always the same order. Hamburger, fries and a chocolate shake. We were about to leave the metro area for the wilds of the coast range so I poked my head up front and asked my partner to head through the drive-in at the McDonald’s I knew was coming up.

I wasn’t technically violating a department policy (we didn’t have one) although I was going against the written orders regarding diet. The patient had lobbied for it. Even saying “what’s the worst it can do to me?” I ordered 2 hamburgers, fries and chocolate shakes. My partner didn’t want anything and probably assumed he would get in less trouble if he didn’t participate with us in back. We ate our meals and continued talking the rest of the way to the coast. I hid the evidence when we got to the hospital and didn’t mention it to the receiving staff either. I felt good though as the patient was so happy to finally have something to eat that he wanted.

He died the next day, Christmas eve. At least he had been back to the coast long enough for his family to say goodbye. For me it had been even more. A chance to have one of our favorite meals again. Just me and the man with the mad professor eyebrows and white hair.

Lessons to Learn: Start volunteering to go first in every training evolution. You’ll benefit from being assertive and in charge. Follow your policies and procedures but don’t forget to temper your assertiveness and treat the person when the situation calls for it. It could mean a great deal years later.