My first ambulance field rotation was on Mother's Day, 1971.
I was a high school senior taking the "Emergency Medical Technician/Ambulance" course offered through the adult and vocational training division of the community college.
Mike DeWalt was in the class and let me ride with him at Northern Virginia Doctor's Ambulance. This was a private ambulance service that provided occasional back-up for the Alexandria Fire Department.
A Busy Sunday
The EMT-in-charge was a tall, skinny musician who worked part-time at the ambulance service. A very friendly and helpful guy, he was reading Dale Dubin's Rapid Interpretation of EKG's.
While Virginia had not authorized a paramedic training program, Glenn Luedtke wanted to be prepared.
Some of you know Glenn from his work on the NAEMT EMS Safety Course.
Or his tenure as the EMS Director for Sussex County (Delaware) or Cape and Islands (Massachusetts).
There were six nursing home-to-house transports scheduled that morning. Followed by six return trips that evening.
Idealistic high schooler meets complex relationships
With nearly no life experiences, and that teenaged sense of "how things SHOULD be," it seemed to me that many of these patients were going to homes hostile to the visit.
I could not understand why Glenn talked so loud to the patients, or why he insisted on talking with the family before we moved the stretcher into the house.
Now I get it
During the past five years I have been on a geriatric journey with my parents. Including an acceleration in 2011 that requires more action than discussion.
I whined about an interfacility transport experience (On Airline Travel and Ambulance Transfers) and finding my "Adult Command Voice" (“The Greatest Generation” white-knuckles through another Winter Carnival).
The novelty of being the designated adult/primary caregiver has worn off.
We are in the day-to-day grind of assuring a safe and comfortable environment for a couple who are struggling to maintain as much independence and autonomy as they can while medical conditions continue to change.
Just before Mother's Day in 2011 was an intense effort get Mom out of a hospital and into an assisted living facility that evening. Worked with Dad to visit a couple of places and make a decision by early afternoon. Not a lot of choices within our timeframe.
Followed by an evening stand-off with my Dad who wanted to take her home (where there was no assistance in place and physically inappropriate).
We told you …
The language of federally-regulated health care ranks right up with airline travel. Accurate statements made in a neutral tone using industry terms.
They were told on admission that she was on "observational" status and would be discharged in three days. They did not realize it until her last night.
Even with this issue, the federally-regulated part of health care provides much better information than the unregulated parts of health care.
"What I want is …"
… not what we can get you. It sometimes feels like I am explaining to a 9 year old why he cannot drive the car.
When I wrote the original post I was at work at the university. It was the final day of EMS testing and I was looking at the list of things to do that week. Wondering if it is safe to make a business trip and resenting the probable answer.
On Mother's Day 2011 I finally understood the complex emotions felt by the children when we delivered their Mom for a visit in 1971. Relationship defined by decades of experience, conflict and compromise.
Mother!
Mike "FossilMedic" Ward
originally published May 8, 2011
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Shock … followed by purposeful action
Comments OffA brilliant and terrible Tuesday morning
Fourteen months into retirement I am teaching a Fire Officer II class at the Reagan National Airport fire station. The classroom is also their kitchen. The kitchen has a television.
The acting battalion chief steps in, apologizes for the interruption, and turns the television on.
As the news camera focuses on the entry hole, many of the experienced air-crash-rescue guys are speculating on what type of plane hit the tower and the issues facing FDNY.
After a dozen minutes I try to restart the class. Agree to leave the television on with the sound turned down. I get one or two sentences out when we see the second plane hitting the tower.
Class over!
You do not need a Formal Announcement to Mobilize
As FDNY Firefighter James Hanlon (Ladder 1) points out in the opening of the Naudet Brothers documentary 9|11:
When the civilian editors of Fire-Rescue Magazine and Journal of EMS were vetting my article, Attack on the Pentagon: The Initial Fire and EMS Response (April 2002 issue), they struggled with the concept that hundreds of emergency responders initiated action without receiving a formal notification.
The Metropolitan Washington Airports Authority Fire Department never expected a 757 to be used as an assault weapon against the Pentagon. When the second plane struck in New York, the dozen off-duty members attending the Fire Officer class joined the 16 on-duty members preparing for the unknown.
Most of the senior staff and urban search and rescue commanders in my department started purposeful action when they heard of the second plane in New York City. The information came through radio and television, informal digital networks and word-of-mouth.
Rapidly deploying 72 USAR members and 75 tons of equipment
It takes dedicated action by dozens of staff, support and non-USAR firefighters to make a deployment happen.
A point of pride is the ability to assemble the team well within the response deadline for domestic and international response. A deployment represents an administrative five alarm event.
A small role I had while assigned as a company officer at the Fire and Rescue Academy was to respond from home to get the facility unlocked on evenings, weekends and holidays. The Academy, with six classrooms and a large training bay, is the point of staging and assembly for the team.
Far from high tech. The tasks included moving apparatus out of the bay, properly configuring the "quad" – a large space with movable walls to create smaller class spaces, and powering up the facility.
Have to do Something
Ten years ago I also had a part-time job as a civilian Fire Instructor III at the Fire and Rescue Academy.
American Airlines Flight 77 struck the Pentagon shortly after I left the airport.
I was stunned. What could I do? No fire gear in the car, not in uniform, my "retired" fire department ID card did not provide KardKey access to headquarters or communications.
Headed for the Academy. Maybe they are assembling a fire crew with Engine 407. I was at the Academy in 1982 when we loaded up a Suburban with EMS gear and responded in near-blizzard conditions to the Air Florida 90 crash at the 14th Street bridge.
Not this time. All of the on-duty uniformed staff are away, either responding to the Pentagon or the anticipated USAR deployment. None of the remaining staff experienced a USAR deployment.
I looked up in time to see the South Tower collapse on live TV.
Purposeful Action – Setting the Academy for USAR deployment
No more wondering what to do.
Without asking for authorization, started moving academy apparatus out of the high bay building and up the hill. Configured the quad. Tried to set up the communications equipment, but no one had the key to the cabinet.
Before the 11 am official federal mobilization notice, the academy was ready …
… and I was on my way home, satisfied that I did something worthwhile in reaction to the unthinkable.
An Inherent Orientation to Action
Emergency service folks are hard-wired to take action.
To validate the impact of our Citizen CPR program we tried to identify the background of every person who performed CPR prior to the arrival of the department. More than half of the citizen responders were off-duty or former police, fire, ems and health care staff.
The same orientation that motivated Jeff Simpson, a Dumfries-Triangle Rescue Squad volunteer EMT who was near the World Trade Center.
From the National EMS Memorial:
Mike "FossilMedic" Ward
Earlier 9/11 essays:
2011: Remembering 41 EMS responders who died at WTC, including a hero from Prince William County, Virginia
2010: A Terrible and Brilliant Blue Sky Morning
2008: Reprint "The Anger Never Dies"