Tuesday, July 6

Classism All Around

My chief and assistant chief keep subtly suggesting I work to get more faculty members involved in our ambulance corps. Their thinking is that professors have time (particularly in the summer when they most need help), are smart, hardworking and responsible. With 200+ faculty, a good chunk of our corps could be made up of faculty members, right?

Well, there are problems. First of all, temporary faculty and assistant professors are very unlikely to give their time to any pursuits besides scholarship, teaching and service. Why? Being tenure track is like playing baseball in the minors trying to play well enough to get the call up to the show. You are either about to make the jump or your baseball career is over. It is a scary feeling to think you could end up in your mid-30’s and looking for a new career after 4 years of college, 4-8 years of graduate school, 0-4 years of post-doc or temporary work, and 6 years of working at an institution. Searching for a new job at a different institution would be one thing, but a new career altogether? Ouch. The opportunity costs that go into preparing for an academic career are HUGE and one must ensure that a tenure decision is made based on a best effort. So, let’s limit this discussion to full-time, tenured faculty.

Of the tenured faculty, some are old enough that they are going to think they are too old too learn new tricks. Many are so burdened with other volunteer or administrative duties that they can legitimately say they don’t have time. Others just won’t find EMS interesting. Others are book smart but couldn’t coordinate their hands to put a regulator on an O2 tank to save their lives, or be emotionally stable enough to calmly triage patients at a car accident as patients and bystanders are screaming.

Still, two (“B” and I are the only two)? Certainly more than 2 out of 200 will have the time, inclination and physical and mental talents needed? There is one last issue, one that I think few would admit to but that would make their working in volunteer EMS a serious issue. Academics like freedom. Freedom of time, freedom to make their own decisions, etc. Of course everyone values these things, but we can tell from behavior what people really value in a relative sense. Take freedom of time, for instance. Even when I am working 60 hour weeks, I have a LOT of control over what I do when. Sure, a lawyer at a NYC big-time firm might value this type of freedom, but the fact that they chose a path of 80+ billable hour weeks, scheduled by someone else, tells us they value other things over freedom of schedule. We know how much academics value intellectual and temporal freedom over other things (like money) based on their chosen career path (if they were willing to trade freedom for money they would have been in business, law or medicine which all pay considerably more). So, here we have people who as a group (obviously I’m making gross generalizations) like freedom to act when and how they want.. You can imagine that a lot of these people might find it hard to take orders. The average academic has no real boss and takes orders from themselves. Obviously, in EMS there are situations where someone else tells you what to do and there isn’t much time to have a cup of tea and chat about alternatives (or, more likely in academia, form a committee to draft alternatives that will be voted upon).

But it isn’t just the issue of taking orders, as I fear something uglier. Classism. Despite a lot of rhetoric to the contrary, I get the feeling many of my colleagues consider themselves “special” in some way that is hard for me to put my finger on, but very much based on their idea that they have chosen a more noble path, like their value system is superior than others. My gut feel is that many would have an especially hard time taking orders from people with considerably less formal education. In volunteer EMS experience and success in the field are the currency that builds a command structure. Our chief is in his early 30’s, has a high school education and is a landscaper. By his own estimation his skills as an EMT basic are ok. Why is a basic EMT with admitted “OK” skills the chief of an advanced life support (ALS) agency? The guy knows what he is doing on scene. He knows how to judge resources and when and how to ask for more. He can triage, talk to the fire and police, and direct medical personnel while staying calm and collected. He can talk a psych patient out of her house when moments before the police were going to get her out using pepper spray and cuffs, convince someone having a heart attack who hates needles to let the medic start a line, etc., etc., etc. His education has come from being in the corps for a LONG time, paying attention and learning from past experience, and using his obvious intelligence to his best advantage. His being a landscaper with a high school education is irrelevant. Period.

Volunteer EMS is a type of “melting pot” were people with very different educational and socio-economic backgrounds work together as a team. Things are fairly egalitarian until the crap hits the fan, at which point people TELL others what to do. If they are good, they tell you clearly, and the task is something they know you can do, but even when they “ask”, they are telling you (i.e., “can you bag the patient?” is not really a question when there are two of you on a full code and the person “asking” is starting compressions). I take orders from people who are twenty years my junior, are students in my classes or people working jobs earning 20% of the salary I do, and in many cases have at least a decade’s less formal education. I don’t have a problem with this. I know in this arena they know more than I do and have something to teach me. I also know that in the end, it isn’t about ME, but about the patient. I am embarrassed to say that I think for many of my colleagues this would be difficult if not impossible. I hope I am wrong and being too cynical, but my past experience with some of my peers suggests a smugness and self-importance that would seriously complicate their ability to take direction from, for example, a 25-year old car wash attendant.

What I find most disturbing about this is that my chief and assistant chief seem to have classist attitudes as well. In talking to “B” and I about bringing in faculty, they use phrases like “we want to bring {insert agency name} up to the next level” or “we want to bring in people who will be reliable”, etc. You’d think if the high school educated landscaper could be chief they would figure out that we shouldn’t be selecting people for our corps based on anything other than whether they can do the job. In EMS, that is a complicated job description and, in my opinion, including or excluding people based on occupation or education level is a mistake. Assumptions often are.