After posting the story, my old partner that I worked with that day contacted me to remind me of a another part of the event. I’m not sure how I forgot, but my lapsed memory caused an important part of the story to be left out.

I forgot to mention that the captain on the engine company had rang the doorbell of a nearby house to ask if it was OK to use their phone book to find a coupon for a nearby pizza place. He was successful in his mission and saved us a couple bucks. To top it off, the residents of that house felt bad for us sitting outside for so long and actually baked us cookies and brought us some lemonade after our pizza arrived.

Another thing he added to the story, was photographic proof that I didn’t realize existed. At the time, cell-phone cameras weren’t anything like they are today, but you can clearly see our pizza and my hand giving the “thumbs-up” on a well executed plan.

A special thanks goes out to my old partner who’s identity will remain protected.

When working in busy systems, I usually see the downtime as a chance to get caught up on paperwork. Sometimes these standbys can go on for several hours, and on one occasion, it lasted my entire shift. We logged on, immediately got assigned the standby, and had to be relieved at the end of our shift. I accomplished 2 of my “EMS Bucket List” items that night, one of which should have gotten me fired.

So here’s the story:

There I was, minding my own business, logging on for the night shift. This was my first job in EMS, but I had been working at the small service just long enough to get over the nervous feeling that you have when you first start in the field, but not quite long enough to get passed the stupidity.

We were assigned a standby at a nearby “SWAT” standoff and were told that we couldn’t use any radio communication. That worked out well for us, being that we inherited the long-standing dislike for EMS dispatchers that had been handed down over several generations. We arrived at our scene and were directed towards a staging area that was supposed to be a safe distance from the “action”. Just as we put the vehicle in park, I got to thinking about how I should have brought my lunch. I figured it was no big deal as this thing would be over with in a hour or so and we could grab a bite on our way to post.

Fast forward about 4 hours and you would find us sitting in silence staring awkwardly at the fire-engine crew that parked facing us. They were doing the same. We were hesitant to go talk with them because we didn’t know this particular crew at all, plus they didn’t seem very social.

Partner: “Let’s go talk to those guys, I’m bored out of my mind”

Sean: “I don’t know, man. They are just sitting there doing nothing. They don’t look very sociable. Seems kinda weird and awkward to me.”

Partner: “We’re doing the same thing, dude.”

We finally got out and walked over to the engine. The crew hopped out and exchanged a few words with us, but not without a few awkward moments of silence. I looked around and it seemed like nobody was doing anything. I started to wonder if this thing was ever going to end.

Fast forward 2 more hours and you would find us and the fire crew laughing hysterically over some “war-stories”. You would also see us scheming up a plan to get some food. Nothing was within walking distance, so we starting calling people that we knew to see if they could make a food run for everyone. No such luck at 10:30pm. This is when I decided to check off an item on that bucket-list I mentioned earlier.

I had made it my goal that one day, I would order a pizza to the scene of a call. Don’t ask me how I came up with that goal, I just did. This was the perfect moment to execute the plan. What better scene than a SWAT standby? Unfortunately, most pizza places were closed. After about 30 minutes of calling around I finally got a hold of one that was open for another hour. Only, convincing them to deliver to the scene of the SWAT standby was going to be a bit more difficult than I had thought. Here’s what you might have heard had you been watching me order the pizza:

“Yea, I would like to order a pizza……um, well, I don’t really have an address, you see I’m working on an ambulance at a SWAT standby….no this isn’t a joke sir, we have been here for hours and we would like to order a pizza……it’s at the corner of 10th and Henderson, but I would probably come in from the east to avoid getting near the scene…..oh yeah, it’s totally safe, we are blocks away from the incident. I don’t even think bullets travel that far…..”

And it just continued on from there.

Our pizza finally did arrive, and we pulled out the gurney to setup our buffet line. We had pizzas, sodas, bread sticks, and hot wings, all lined up on the gurney. Of course, no good plan like this would be complete without my supervisor pulling up. After being at this standby for nearly 7 hours, he decided to come check on us. He walked up, looked at the gurney with all the food, looked at me, then back at the gurney, then back at me to deliver a silent stare for about a good 20 seconds. Without saying a word, he grabbed 2 pieces of pizza and a coke, got back in his vehicle, and took off without saying a word.

We stood around awkwardly as my partner and I didn’t quite know what to make of it. We finally came to the conclusion that he probably wouldn’t have taken any food if he planned on getting us in trouble, so we continued about our business of swapping stories and killing time.

Shortly after our supervisor’s visit, one of SWAT officers walked up. He looked big and mean enough to turn us into another topping on the pizza. Unfortunately, like previously mentioned, I had yet to graduate from the “being stupid” phase of my EMS career. My partner inquired about the incident and we were informed that a man had barricaded himself inside a travel trailer in his driveway. The officer then informed us that our pizza looked tempting.

This is where the stupid part comes in. 

I must have felt invincible after getting a pass from my supervisor, because I told the officer: “Come on, man. We took up a collection earlier, you should have pitched in. By the way, if that guy is locked inside a trailer, why not just hook it up to a truck and tow his ass to jail?” He moved in just close enough to invade my comfort zone and said: “How about this, Kid? How about I throw your dumb-ass in the trailer with him? Got any more advice for me?”

His booming voice shut us all up instantly. After a moment of awkward silence, I quietly replied: “Would you like pepperoni or combination, sir?”

He turned towards the pizza, grabbed a couple slices, smiled and walked back to the incident.

The Bucket List

The 2 items I checked off that night were ordering a pizza and going an entire shift without transporting anyone. The 2nd one was bound to happen eventually, and has happened several times since. As far as the pizza incident goes, I got lucky. It was stupid, unprofessional, and I should have been fired. That would have been a foolish way to lose my job, especially with how hard it was at the time to find ambulance services that were hiring.

The upside to the story? I got 2 items checked off my list

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With the state jumping in to fix the problem, city officials now have some serious changes to make. Privatizing the EMS system is now on the table as a big possibility. Personally, I think it should have been on the table a long time ago, but that’s neither here nor there at this point. The talking heads at City Hall say it will save money while the union heads say it will cost the city money. So which is it?

There are a lot of details I don’t know about Detroit’s EMS system so I can only speculate based on some assumptions, so if I’m wrong about something, please feel free to correct me.

It’s pretty obvious at this point that Detroit EMS operates at a loss. This isn’t much of a surprise to me given the unemployment rate in Detroit and the fact that 911 simply isn’t a money-making enterprise. It’s very rare to find an EMS system that actually makes money on 911 calls alone. Where the money is usually made is event standbys and inter-facility transfers. Most private ambulance services use both to offset their losses from the 911 calls.

I’m not sure if Detroit EMS runs inter-facility or just 911, but I’m going to assume they only run 911. If I’m correct, then it is going to be virtually impossible for any service – whether it be public or private – to operate without a subsidy. So what can they do? Well 2 viable options exist. They can either pay a private service a fixed subsidy to run the 911 calls, or they can pay them no subsidy and give them exclusive rights to the inter-facility transfers and 911 calls. Personally, I think the second option is better at this point.

They can set performance requirements as a condition of the contract. These might include response times, minimum staffing, complaint resolution, etc. The service that wins the bid is required to operate within their budget and meet the requirements of the contract. I have seen this type of exclusive operating contract work very well in several areas, including a few that I have personally worked in. Where things usually go wrong, is when the city decides to start over-regulating the ambulance service to the point that they can’t afford to operate without a subsidy. At that point your right back to square one.

If the City of Detroit goes through with this decision, then my advice to the city is this:

Pick a good company with a good reputation. There are plenty of them out there. Give that company exclusive rights to all emergency and non-emergency responses within the city limits. Set reasonable requirements and hold them to it. After you do all that, stay the hell out of their way. Don’t start trying to fix something that isn’t broke.

I’m sure plenty people will disagree with me on privatization, but we do know that the public system isn’t working for them. The city has proven itself incapable of keeping a balanced budget, so why not wash their hands of it and allow someone else to manage the EMS operations? I really hope the best for the EMT’s and Paramedics working in Detroit. We’ll see what happens in the next couple months.

And late payments at that….

MT. JULIET, Tenn.–A man hopped into a Wilson County ambulance that was blocking his car and tried to move it while paramedics were loading a patient.

http://www.jems.com/article/news/blocked-tenn-man-tries-move-ambulance

Ambulances get stolen all the time, and yet many of us still think it’s OK to leave them unlocked. If someone truly wants inside your ambulance – or any vehicle for that matter – they will get inside. What locks do, is keep the honest people honest.

Locking your vehicles doesn’t just stop people from joy-riding, it also keeps idiots like the one mentioned above from damaging your equipment. Take for example, my story:

We were on scene of a 2-vehicle collision in the middle of the highway. I had parked my ambulance on the pavement as it had just finished raining and the shoulder was muddy and most likely too unstable to drive a large vehicle on. We were caring for 4 patients, 3 of which were critical.

We had a total of 2 ambulances, and 2 fire engines on scene. All vehicles were parked on the pavement (there’s really no coincidence here). Everything was going fine until a battalion chief rolled up on our scene and decided that the spot where my ambulance sat would be a perfect parking location for his bat-mobile. Never mind the fact that it was intentionally parked in it’s current location for quick and easy access.

So, Mr. Bat Chief (AKA Batman) decides that he is going to hop inside my ambulance and pull it over on the shoulder to make room for the bat-mobile. The ambulance did exactly what I was afraid of, and it slid about 5 feet into the mud and got stuck. So now we had the pleasure of sitting on scene with a critical patient for 35 minutes while we waited for another ambulance to arrive. And I got the pleasure of sitting on the side of the road for the next hour waiting for a tow-truck while I came up a good story to explain to my boss why I hadn’t locked the doors.

Obviously the morons in both stories weren’t trying to steal the ambulances, but I guarantee a locked door would have stopped them in their tracks.