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Administrative Amnesia: New disease hits EMS

Most of the symptoms go unnoticed in the early stages of the disease

ATLANTA — It started innocuously enough at an EMS staff meeting at Mercy Ambulance in Collier County, Ga.

"Our operations supervisor was explaining to us how administration calculates Unit Hour Utilization," said EMT Jonathan Davis, "and he just froze up there with a dry erase marker in his hand, staring at the board like a duck in thunder. We thought he was just kidding around, but he'd totally forgotten how."

But soon, operations supervisor Gavin McDonald's memory lapses intensified.

"I couldn't calculate a dopamine dose, something I'd done hundreds of times before" he said. "Little things, like remembering which hand I hold a laryngoscope in, what those little humps before a QRS complex are called… all of that went away within six months of me putting on a white shirt."

Not isolated
Supervisor McDonald's symptoms aren't isolated, according to the CDC.

"In the past ten years, we've noted a marked upswing in cognitive impairment and memory loss in EMS providers, almost exclusively limited to administrative personnel," noted CDC epidemiologist Neils Voerheek. "First, they start losing short-term memory: little details, like where they left their office keys, passwords, narcotics box combinations, that sort of thing. It seems to worsen as they progress up the promotional ladder, but we're not sure if that's a causative factor or mere coincidence."

Most of the symptoms go unnoticed in the early stages of the disease or are attributed to the sleep deprivation common among EMS crews.

"A student intern spotted it first," said Voerheek. "She was updating our databases when she noted that symptoms were most prevalent among non-field personnel who work regular office hours. We crunched the numbers, and that's when we realized this was far more ominous than simple sleep deprivation. We had an honest-to-God epidemic on our hands."

As the disease progresses, memory lapses become more frequent, followed by periods of disorientation and impaired cognitive ability. The terminal stages of the disease leave the victim unable to do little more than play Angry Birds on their iPhones and compose poorly worded, disjointed memoranda rife with grammatical errors and misspelled words.

"It's gotten really bad here," reported field supervisor Cody Amherst of StatCare Ambulance in Grand Rapids, Mich. "Our ops manager sent out a memo last week requiring all crews to use unleaded gasoline only, no 'leaded' gas. Problem is, leaded gasoline hasn't been available for years, and all of our rigs are diesel anyway."

"I had only been a supervisor a week," Amherst said. "Last Tuesday was my first supervisor's meeting. I brought up the memo, and my ops manager didn't even respond. He was all engrossed with something on his laptop, oblivious to what was going on in the meeting. I peeked at his screen, and he was playing Solitaire, trying over and over to play an eight of hearts on a nine of diamonds.

"No one else noticed he was acting strangely, either. I tell you, I was afraid to drink the coffee or eat the donuts after that."

Thousands of cases
So far, CDC has identified over 14,000 potential cases, spread out all over the United States.

"It's hard to pin down an index case, when it's this widespread," Voerheek explained. "We still haven't isolated a causative factor. It may be bacterial, it may be viral, it may be fungal, it might be caused by prions. It might not even be pathogenic at all. I mean, this could simply be atrophy from lack of use, for all we know.

"The only disease we've seen like it is the new airborne mutation of Alzheimer's that affects nursing home nurses, but the only time those two groups are likely to be in contact is during EMS Week, when the supervisors are out passing out pens. Frankly, we're stumped."

CDC officials caution that they are far from identifying the cause of the disease, much less finding a cure. Meanwhile, men like McDonald continue to struggle with its effects.

"Last week, we were short-staffed, and Gavin filled a paramedic slot on my rig," reported Davis. "We had a bad CHF patient, and I laid out the Nitro and CPAP for him like I do for my regular partner before we went en route to the ED. When we got there, I found Gavin flipping through the protocol book like he'd never seen it before, asking me what had happened to the protocol for rotating tourniquets. It was pretty sad."

Whatever this mysterious malady is, it has EMS crews worried.

"We have an opening for a relief operations supervisor," said one La. paramedic who asked not to be identified, "but I'm afraid to apply for it. I mean, what if I catch this thing at some supervisor's meeting and wind up needing a drool bib and Velcro shoes?

"Senior management requires a college degree, and good luck on getting one if I catch whatever it is that's going around at those meetings. The only place left for me would be dispatch."

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