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When I suddenly realized I was transitioning from a paramedic into a doctor

Aaron Hochman-Zimmerman is a native New Yorker who chose to spend his summer in South Africa working as a paramedic. He is currently a 4nd year MSIH medical student in Beer Sheva. Here he shares with us a story of his experience.

By: Aaron Hochman-Zimmerman

I was able to watch South Africa hold New Zealand to 20 hard-fought and scoreless minutes until paramedic Brett turned up with his student, Jess. I was the third member of the crew, a former EMT and current medical student. Rather than an ambulance, we were assigned a “response car” and were expected to be on-scene first, treat the patient and wait for Cape Town municipal ambulances to transport.

New Zealand’s heavily favored All-Blacks were in town and I was about to start a night shift with Community Medics, Western Cape Ambulance Services. In New York, they tell EMTs to cover their medical insignia before and after shifts to avoid being harried for free medical advice. It’s a habit I carried with me to Cape Town, South Africa.

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First Call-out

Before even reporting for duty we were sent to do a “declaration” – something new in the local paramedics’ scope of practice. To relieve the workload of the coroner’s office, paramedics could now make a declaration of death. We didn’t determine a time or cause, but it was an unfortunate scene, and likely several days had already passed.

Once the police paperwork was done, we set out feeling that medically-speaking, it could only get better.

Then a more conventional Cape Town call came over: a stabbing. We arrived at the scene to find a good-humoured patient who complained more about the cold than his injuries – as we cut off his shirt and pants to search for more stab wounds, patching as we went.

At the public hospital, we pitched in with the medical team to help deal with a hypothermic patient brought in by passersby concerned enough for a homeless man to interrupt their night. In the hospital, I was suddenly surprised to discover I was thinking more like a doctor than an EMT. Doctors need a definitive plan. EMTs need to maintain the situation until they arrive at a hospital.

Then, it was coffee time. We met the other medics at their gas station meeting spot to trade stories in the cool spring air. Crews would dash off when their radios crackled calls for help.

When our turn came, it was a call that felt very similar to my home ground – Soroka Hospital internal medicine, in Beersheba, Israel. Loaded with gear, we stepped carefully down a narrow, jumbled corridor. In a small room we found an elderly lady in bed, straining to sit comfortably. Arms wrapped around her stomach and her pulse weak, her blood pressure was so low, the monitor struggled to register a number. She did not speak English and seemingly had no veins whatsoever. An emotional son translated her Afrikaans, but even a second, seasoned paramedic crew was unable to place an IV. We felt helpless, but as paramedics, there was only so much we were equipped to do. Eventually, an ambulance arrived to transport her to the hospital.

That was our last call, but my experience that night made me acutely aware of the change of my perspective. It is gradual and ongoing but to experience the two halves of my medical persona – EMT evolving into a doctor – made me very conscious of my progress, even after just one year of medical school behind me.

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