Rescue 471

by Peter Canning

  When I started in EMS I worked for a small mom-and-pop commercial ambulance service in Springfield, Massachusetts. Eastern Ambulance’s home base was a far cry from the fire station that had housed the Emergency paramedics on TV. In the garage was a dusty Fleetwood ambulance that hadn’t seen the road for decades and three other junked rigs, whose parts had been cannibalized to keep the rest of the fleet running. Off the garage was a dimly lit rec room with a pool table that cost you two quarters to use, moth-eaten couches, paperback books from the fifties, a Coke machine with an out-of-order sign on it, and a windowless sleeping room with squeaky wire cots. The place looked more like the set from Taxi.

  The pay was terrible. I started at $5.50 an hour and worked up to $6.00 after three months. The highest pay rate was $8.00 an hour. Many people hadn’t had a raise in three or four years. The equipment was poor, too. The in-house suction on the ambulance was unreliable and our wooden backboards were splintering. I don’t know how many times car 7 would cut out on us when we were en route with full lights and sirens. We’d kick it into neutral, turn the ignition again, and continue on our way. The shocks were bad. Sometimes the brakes or steering got so bad in one of the rigs, we would refuse to drive it. A shift didn’t seem to go by without one of the rigs going down to Robbie’s garage for repairs. Originally we had two backup rigs, then one, then none. Sometimes we’d work a crew short. Our owner made vague promises about new ambulances, but they never materialized. Neither did the raises. In many respects the ambulance company was a disgrace to EMS.

  But the employees were loyal. It was a family-run business and that atmosphere helped. If you needed time off, you got it. If your phone rang at six-thirty Sunday morning and Lynn Delaney, the dispatcher, asked you in her sweet Southern voice if you could possibly fill in for the next twenty-four hours, you said yes because you knew they’d help you out when you needed time off. Some techs had been there nine and ten years, working seventy-two or more hours a week. You got attached to the people. They helped you—taught you to be a good EMT. Doing calls together—whether a bad MVA or watching the progression of a regular cancer chemotherapy patient—bound you together. Steve, M. J., Christine, Abdullah, David, Kevin, Brian, Sherry, Linda, Bob—these and others were my teachers.

  In time, I learned how to drive like a chauffeur, taking care to ease the bumps and go smooth on the turns. In the back I learned how to take a blood pressure and pulse despite the rough road and sirens, and how to write the run report without scrawling all over the page. And I learned how to treat people decently from watching the EMTs around me. Abdullah, the manager, stressed patient care and we took pride in that even when we couldn’t take pride in our equipment. It was the people and their attitudes that made the place.

  We lost one of our 911 contracts to another company, who offered defibrillation and paramedic intercepts. The company owner was ill and his wife was doing her best just to keep the place running, much less put money back into it in such hard times. With the bad Northeastern economy, with many people without insurance, and with Medicare and Medicaid paying only a portion of the bill when they paid at all, the till was running dry. Fifty percent of the accounts were uncollected. Soon we went down to three crews, then two after five at night.

  Then we heard the company was calling it quits. I worked my last shift on a rainy Sunday, with Steve Czyprena. Driving around one of the towns we covered, he pointed out the intersections where he had worked MVAs and the houses he’d taken people out of. “People know me in this town,” he said. “They don’t know my name, but they recognize me. I felt a part of things here.”

  Eastern was a big family. People feuded with each other, bitched about equipment and living conditions, and griped about the pay, but they stuck together. Closing down was hard. Some of the younger ones got hired right away by the competition. Most of the older techs needed more time to think about their alternatives. You don’t go into this field for money and there’s no real future in it. Ten years in one place, then you’re out of a job. No more climbing into the same old rig, spending seventy-two hours a week with the same partner, responding to calls for help at all hours of the day and night, all for eight bucks an hour. It’s a hard business. It gets in your blood and won’t let go.

  Today most of those people are still in EMS and working in various locations for the same big company that I work for. It is a different feeling. There are some pros to it—the equipment is top of the line, the cars well maintained. But it is a business, which is the bottom line with commercial EMS. It exists to make profit. Our union negotiates a contract that fails to keep up with the cost of living, and significantly lowers pay for all future employees. Our negotiators tell us it is the best they can do. The company, operating on orders from corporate headquarters, says they can’t and won’t offer more. We vote the contract down by a huge majority. What will it lead to? A better contract? Impasse? A strike? Large-scale firings? A busted union? All of us working for even less? Or the division closed down and all of us going to work for the competition, losing all seniority, making less money?

  I read where an ambulance executive of another corporation allegedly said in a meeting that if a paramedic owns a house, he is making too much money. I picture a corporate meeting where they go over company finance reports and earnings projections. Cut cars, cut personnel, give us that big dividend. I try to picture an alternative, where the executive says to the paramedic, “You’ve worked hard, you’re stressed out after that dead baby call, take six months off, and here’s a five grand bonus so you and the wife can go to Hawaii.” It’s not long till that company goes bankrupt. I know capitalism has its rules. The lines on the charts need to go up, not down. I understand that. Maybe we should be thankful we have jobs. There are paramedic classes churning out new medics more than happy to take our places. Meat in the seat.

  It is too easy to blame the corporate bosses. They are filling a need. Towns and cities are trying to cut costs. Most pay big bucks for police and fire. It doesn’t leave much for the new kid on the block, EMS. Why pay salaries and pensions for paramedics when a commercial company will provide the service for next to nothing, or, in the case of Hartford (or other big cities with a sufficient call volume to support the business), for free? What do taxpayers care if after twenty years of working side-by-side on dangerous calls, the police officer and firefighter get generous pensions when the paramedic gets nothing? Spit. Shown the door with broken back and spirit. The smart ones, those who started young enough, leave to work for fire or police departments. Shawn Kinkade gets hired by East Hartford Fire. Mike Lambert goes to Manchester Fire. Tom Harper gets a job as a construction foreman. Shirley Lessard goes back to running a hair salon. Kelly Tierney becomes an insurance adjuster. Others leave the field for “real jobs”—selling, nursing, truck driving.

  I admit to being discouraged. I don’t like to think of myself as replaceable, although we all are. I don’t like having to work four days a week, and being in a different car with a different set of gear every night, and I am not crazy about the corporate logo on the back of my jacket. I bitch along with everyone else, and all the bitching does is wear me down.

  The truth is I love what I do. So do my coworkers. We all could do something else and make more money, but we don’t. We love our jobs. The years start to go by, opportunities for some slip past, but many stay because for all the bullshit, this is still the best job on earth because we get to do what we love. Answer calls. And on the call, the ambulance service, the logo, the pension or lack of it, the pay make no difference. It’s just my partner and me and the patient. And we do what we are good at. Help people.

  One night after the new schedules have begun, I see Missy Young washing the windows of her ambulance outside Saint Francis.

  “With the way these cars have been getting beat to hell lately, your car is looking like the prize of the fleet,” I say. My car, like others, is trashed. Not having regular cars, some of the pride has gone out of it. The cars are no
t getting washed, checked, and stocked like they used to.

  “I don’t care that I have to clean a new one every night,” she says. “This is my home for the next twelve hours, and I want my patients to feel comfortable here, like they were in my own home.”

  I look at my ambulance, the dirt caked on the sides. Winter weather is hard on it. If I wash it now, I probably will have to wash it again in a couple hours, so why bother, I say to myself. But Missy is right, of course, though it takes me a couple days to come around to it. I get tired of looking at the dirt, tired of listening to the complaining, others’ and my own. This is my car. My work. My patient. My professional care. I pull the car I am assigned into the garage bay and park it by the hose. I turn the water on and start hosing it down. I dip the broom into a bucket of soapy water, then start scrubbing the sides, scrubbing hard. I wash the ambulance. I wash it till it gleams.

  Ups and Downs

  I’m sitting at the office talking to Rick Domina, who I think is one of the best medics in the company. We’re talking about burnout. It is true that some people stay on the job too long, become jaded, incapable of feeling, and stop caring altogether. But he says that for him—and for many medics that he has known—the longer he works at this job, the more temperate his feelings. When you start, the highs are really high, and the lows are very low. Everyone goes through periods of burnout. Sometimes it seems you’ll never get out, but if you make it through the bad ones, you get better. At least for him, that’s proved true. The bumps are less abrupt, and the emotional line straightens, but it isn’t flat. It has little regular blips. Like life.

  I hope that is how it works out for me.

  Last Day Together

  I will miss Arthur. We fought, but we had good times and came to an understanding. He went a little easier on the air horn; I gave him a little more time to wash his hands and use the bathroom between calls.

  I tell him I finally figured a way to get rid of him—conspire with a large national corporation to take over our company and change the shifts.

  He laughs. “You’re going to miss me,” he says.

  “I won’t miss you,” I say. “I won’t miss you at all.”

  Arthur is paired with Rick Ortyl. I joke that I have traded him for a Snickers bar, but I only get a minisized bar. I point this out to Arthur. “Depreciation,” I say. “I got you from Shawn for a regular-sized bar.”

  “It’s ’cause you wore me down,” he says.

  On our last day together, they send us out to Windsor for a woman going into the hospital for cellulitis. “Let us know if you need a lift assist when you get there,” the dispatcher says.

  Arthur and I have never called for a lift assist in our two years of working together. But when we enter the woman’s apartment, we understand what the dispatcher was talking about. She is nearly five hundred pounds. Fortunately, she is able to stand herself with the help of her motorized pivot chair, and we have our one-man stretcher that means if we can get her on it, then lift the stretcher part up while keeping the wheels on the ground, we ought to be able to slide the stretcher into the ambulance. “We can do this,” I say.

  She stands and we get her to lie down on the stretcher, then roll her outside in the down position. We bend our knees. I pull the trip, and we drive up with our legs. Upright. We slide the top of the stretcher in the ambulance, then I lift up, keeping my back straight, and Arthur brings the wheels up, and we’re in. Done. Good work.

  When Rebecca sees us wheeling our patient into Hartford Hospital, she asks if we lifted her ourselves. She says when she was sent for the same patient, she had to call for the fire department, who carried the woman out in a Stokes basket. “We did her ourselves,” I say. “Just solid lifting technique and brute animal strength.”

  “With a couple ibuprofen thrown in,” Arthur says.

  “You guys are too much,” she says.

  “The last of a dying breed,” I say.

  * * *

  We respond on a priority one for an unconscious person. The man is cold, clammy, and has poor respirations. He is a diabetic. Arthur assists his respirations with an ambu-bag while I get the IV. His blood sugar is 0. I give him an amp of D50 and he wakes up. His breathing is back to normal.

  “Did you eat today?” I ask.

  He shakes his head.

  He doesn’t want to go to the hospital so we sit there with him while his wife makes him some pasta and sets it in front of him and he starts to eat. We have her make an appointment with his doctor for the next day and promise to see that he eats and checks his sugar regularly. They both thank us.

  “I never get tired of seeing dextrose work,” Arthur says. “It makes me feel like we’re making a difference.”

  “I hear you,” I say.

  We’re sent to a nursing home for a man just diagnosed with tuberculosis. We have to wear personal protective gear, OSHA-approved HEPA masks that make us look like characters from some science fiction movie. We breathe in and out like Darth Vader and the mask sucks in and out. We stand over the man who is looking at us like we are crazy. “We have come to take you from this sector,” I say, in a fake computer-modulated voice. “Watches synchronized. Time is of the essence.”

  The man laughs.

  “Resistance is futile,” Arthur says. “Surrender to the dark side.”

  The man is laughing hysterically as we wheel him into the elevator, keeping our dialogue running.

  A maintenance man steps in, sees our masks, then steps out quickly.

  “We’ll have to come back and kill him,” I say.

  Arthur pushes the button for the ground floor. “Escape hatch deployed.”

  In the afternoon, we are sent to pick up a woman with Alzheimer’s at another nursing home. She has fallen and broken her hip. “This could be our last nursing-home tour together,” I say, “Except when I visit you in a few years.”

  “Let’s get them stirred up.”

  We do the routine up and down the halls with excellent response, lots of smiles and hellos. Coming back with the patient, just as we hit the exit, a short old man looks up and says, “Who you got there?”

  “We’re coming back for you,” Arthur says.

  “Fuck you, you are, fuck you in spades,” he says.

  “Well, isn’t that nice.”

  “Up your kiester for Easter.”

  “What a pleasure meeting you, sir,” Arthur says.

  “Not for me,” he says, “not for me at all.”

  “Losing your touch,” I say.

  Arthur shakes his head. “You gotta love these places.”

  At the end of the day, we finish up our paperwork, then meet at the time clock. “Well, Pedro,” he says, “it’s been fun.”

  “I swear I won’t miss you,” I say.

  He offers his hand and a broad smile. We shake warmly.

  “Have a good weekend,” he says.

  “You, too, old man,” I say. “My friend.”

  I’m driving home up I-91 when a car comes up fast behind me, flashes me. I look to the side and see Arthur pull into the next lane. He smiles, gives me a salute, then roars on ahead.

  Life

  It’s night. A full moon is visible at the end of Albany Avenue, lit up all yellow and orange. Like outer space sitting on the city’s shoulder. It’s one of those moments that make me stop and appreciate what I am doing. Life here on Earth.

  * * *

  The call is for a baby who choked but is now breathing. On the third floor of a tenement we find a father holding the child, a baby of just seven days, in a pink blanket. It is the middle of the night. He says she vomited up her milk and had trouble breathing. The baby is on AZT, an anti-AIDS medication. The baby is so tiny, I do not want to say everything is okay. I am not a father, although I share this new father’s fear and concern. I listen to the baby’s lungs, which are clear. I listen to her tiny heartbeat. I look into her eyes, which are barely open. “What hospital?” I say.

  “Saint Francis.”
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br />   I hold the baby in her blanket as the father gets in the ambulance, then I pass her up to my partner, who secures her on the stretcher in case we have a wreck, even though at this hour my headlights are the only ones on the night city streets.

  Later I stand outside in the darkness and look in through the window of the ER waiting room. I see the father, rocking the baby slowly, whispering words I can’t hear, sitting alone in a row of seats.

  The Job

  Hartford has launched a project to knock down all of the estimated eight hundred abandoned buildings in the city limits. They’ve closed down two of the worst public housing complexes and are working on fixing up the third. Hartford, for all its problems, is a good city, one that I care about. There are good people here. I think about Mrs. Mays, her family, and the neighborhood deacon. She passed away in a convalescent home a few months after we took her to the hospital. As Arthur said when he read of her death, she is now undoubtedly dressed in her Sunday best, listening to harp music and walking in the garden with her Lord.

  I get called for a woman with a sprained ankle and find it is the snake girl, who is now seven months pregnant. I ask her about the bunny in the cage; she says the snake got out and ate him. Does she still want a monkey? I ask.

  She nods. “I know a place in Philly they will sell me one, but I want to have the baby first, and let him get grown a little before I bring a monkey in the house.”

  I am responding to a woman not feeling well, and when I notice her husband, a legless man in a wheelchair, I say, “Hey didn’t you used to live over on Hudson Street?”

  “Yeah, yeah,” he says.

  “You’re Joe, right?”

  “Yeah, yeah, that’s me.”

  “How’s the heart?”

  “The old ticker’s beating strong,” he says.

  He is concerned about his wife, who has been growing weak lately. We put her on the stretcher and he wheels up beside her, puts his arms around her, gives her a big kiss that causes her to blush. “These boys’ll take good care of you, honey. Ain’t that right, boys?”