In my 20+ years in EMS, I’ve had the fortune of working on all types of settings, urban, rural, remote, sports, industrial and even on a motorcycle, days, nights or mixed shifts; this allowed me to experience the different challenges in every one of them. Even though Mexico City is 100% an urban setting, the traffic during rush hours, anytime between 0600 and 2100 hours, will make your response times as long as any rural settings; in the same way, your transport times to the most appropriate hospital is a 40-minute ride.
Working in a night shift makes the times shorter, both response and transport. However, nights make it more challenging to find the “proper” hospital; let me tell you why: Unless your patient has private insurance that provides you with a fancy private hospital, you and your patient have to deal with the odyssey to find the public hospital that has all the services that your patient needs; you take your MVC patient to the trauma centre, but the guy who operates the machine took a day off. Therefore CT is not working, so you have to take your patient to a faraway hospital that has a CT scan working, but the Neurologist in that hospital is on vacation, so they gladly perform the CT Scan, but you have to go back to the first hospital. Once you are back and neuro checks the CT scan, it is found that the patient needs surgery; however, the operating rooms are contaminated, and you have to take your patient to another hospital where OR times are available, and this odyssey can continue for hours until you finally find a final destination just to find out that there is no bed available, and you are in an offload delay.
When I moved to Saskatchewan, I never imagined I would be working in a rural setting; in fact, I barely imagined that this setting exists. I heard about “tractor accidents” in the literature but it is nothing that comes to your mind when your whole life you’ve been in a big metropolis. And do not get me wrong, Mexico City is not as big in area: it is only 1,400 square kilometres (for you to have an idea, Toronto GTA is 7,200 square kilometres, so its not that big but with about 20 million people living there, it certainly feels bigger than any city in Canada).
Do I have a favourite place to wok? Do I prefer one more than the other? In Mexico, we have a saying “everyone talks about the fair depending on how it went for them”, roughly that means that you will talk of a place depending on the experience that you had in it; in all places I’ve been, I had a wonderful time while working there and enjoyed each one. However, I have to say that I am currently living and working in the best place I could ever ask for, and it will be hard for me to trade it for something else, but sometimes and some days, maybe once a year, I miss the city.