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LIFE SUPPORT | By Mike Rubin, BS, NREMT-P LAST MAY MY good friend Cliff became a grandfather for the second time. He describes the experience as "joy without the fear" new parents feel. As an old parent, I'm intrigued. As an old paramedic, I don't think I'll ever be as comfortable with grandchildren as Cliff. The stakes still seem pretty high to me when I'm taking care of someone else's child. I bring this up because, as Christmas approaches, I think of kids—not snow or reindeer or maxed- out credit cards. Children, especially little ones, take to Christmas like tadpoles to water. My daughter's uncompromised delight at the holidays always made me smile. Her health and happi- ness were the best gifts I ever got. I fgured Christmas was my reward for 364 other days of problem-solving and sacrifce that are part of every parent's job description. Working over Christmas was a consequence of choosing EMS over more family-friendly occupations. I'd approach holiday duty like other shifts, hoping not to screw up, then add a holiday wish for no pediatric patients. Tragedies involving children were hard enough to process without linkage to annual events. I didn't need any help remembering my worst kid calls. In 1993, just months after joining EMS, I treated a 12-year-old pedes- trian struck. I had to bag him all the way to the hospital because he was paralyzed from the neck down. My daughter was only a year younger; perhaps that's why my clinical detach - ment was overwhelmed by paternal concern. I visited him in the hospital every day until a senior coworker told me I'd have too many patients to care that much about each one. I thought to myself, Fine, only the kids then. Two years later I was nearing the end of medic school when I was assigned to a peds foor during hospital rotations. There was this little guy who had suffered a stroke before his frst birthday. He was 2 years old with not much more than a sucking refex to indicate responsive- ness. One day he stopped breathing during a CT scan, then brady-ed down just as we'd been taught children would. The nurse standing with me was less prepared than I was to actually use some of the PALS I'd just studied. Then there was the 15-year-old girl in 2003 who couldn't think of a reason to live past November. She climbed through a bedroom window onto the roof of her house and hanged herself from a backyard tree. A small stuffed bear dangled from a branch next to hers—an obvious plea for help found too late to make a difference. That was Helen's last call. My scariest kid case actually ended well. I was transporting a sick 1-year- old with his parents. The mother, who'd been holding the child during transport (the custom in those days), handed me her son at the hospital so she could safely exit our ambulance. When she had trouble with the big step in back, I stupidly sat the baby on the rear-facing captain's chair so I could assist mom. As I walked from the front of the cabin to the double doors in back, my fdgety patient fell from his seat with an audible thud. The child wasn't hurt, but his screams so terrorized and angered his parents, they laid into me as if I were Darth Vader channeling Hannibal Lecter. I started to imagine round after round of discipline beginning with my agency and ending at Sing Sing. I was lucky the only consequence of my carelessness was a well-deserved apology to the parents. My wife and I still celebrate Christmas, but in my opinion it's a holiday for children. Innocent and uninhibited, young ones don't suspect bad intent of strangers bearing gifts. K ids know joy grown-ups can't remember. I think most adults are suspicious of good fortune; we can't help second-guessing ourselves even when life is good. It's as if we cash in our cheerfulness chips to pay for passage from youth. As I drive around town, I see a familiar Christmas landscape: city streets sprouting evergreen canopies as suburban homeowners compete for most colorful use of kilowatts. I have many good memories of colleagues, family and friends, but my Dicken- sian regard for Christmas Past still centers on Tiny Tim's plight. Merry Christmas to sons and daughters ever y where. Mer r y Christmas to parents and grandpar- ents who care. Mike Rubin, BS, NREMT-P, is a paramedic in Nashville, TN, and a member of EMS World Magazine's editorial advisory board. Contact him at mgr22@prodigy.net. Goodness and Light Christmas is for the kids—we get the worry "Then there was the 15-year-old girl who couldn't think of a reason to live past November." 98 DECEMBER 2014 | EMSWORLD.com