I ran into a former co worker who is now a police officer. We were talking about how he likes his relatively new job and he told me that being a paramedic was far more challenging than day to day law enforcement work. That seemed odd to me because as many experienced paramedics will tell you most calls become routine after a few years.

It turns out that the same is true for police work. Exciting moments are few and far between. Which is probably for the best as an exciting call for either police or EMS likely means misery for someone else.

My friend mentioned that he has a application in for transfer to the detective bureau of his department. I thought this a bit odd as he hasn’t been a police officer for too long. When I asked him about this he told me that being a paramedic gave him a distinct advantage in the process. He went on to explain that the people who would be making the decision have determined that being a paramedic is a lot like being a detective.

When you think about this, it makes sense. A paramedic often has a mystery to solve. Some medical problems jump right out at you and are easy to “solve”. Others take more questioning and inquiry. Same for a police detective. Sometimes the whodoneit part solves itself, but often there is extensive interviewing and interrogating to be done. Both paramedics and detectives have to have good people skills in order to build a rapport with the person they are dealing with. Both have to have good verbal skills and be good listeners. Both have to know when a story rings true and when it doesn’t. It’s a well established fact of life that suspects and witnesses will often lie to the police. It’s probably less well known outside of those that are on the inside in medicine that patients will often do the same. Fear, denial, embarrassment, are all factors that induce patients to lie. Interestingly, the same dynamics seem to be at work for the detective.

Like the detective, the paramedic can’t always take things at face value. A bit of suspicion is helpful to a paramedic when a person who is clearly ill tells him that everything is alright. Gaining the patent’s confidence and a bit of questioning will often reveal details that might otherwise be obscured. Not unlike a detective who has a suspect that isn’t revealing the whole truth. Bit by bit, the detective or paramedic must piece together the real story and develop a plan.

I like this analogy, I think it will make a useful teaching tool. As you work your shifts, keep this in mind. Don’t blindly follow the mnemonics you’ve been taught. Investigate your patients, look for the non obvious, be inquisitive. Solve your medical mysteries and perform good medicine. I think you’ll find the result is better patient care and maybe even more fun on the job.

UPDATE: Just so I’m clear, I’m not suggesting you engage in a hunt for Zebras. They are almost never out there. I’m saying that when the diagnosis isn’t obvious, use your detective skills.