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Day One

A recent social media post asked the question, “Tell us a story from your first day in EMS.” That becomes difficult if you struggle to define what “first” means. The path to this profession veered so sharply off the rails of where I thought my life was going that there is this sequence of “firsts” in my memory, all with distinct impacts and no doubt influencing who I became.

January 11, 1988 - my first night working as an EMT in Newark. It’s cold and damp, I think. I am too nervous to really care much about anything other than not screwing up. There’s no formal orientation, just show up for the shift and check in with the tour chief. I sign my name on the attendance sheet and eventually am pointed out to my partner and the ambulance that will be my home for the next 12 hours. It’s exciting, nerve-wracking and I literally have no idea what I am supposed to be doing.

My partner is polite, pleasant even, but he remains pretty quiet except to answer my questions. He never says it out loud, but I can tell he’s not thrilled to be stuck with the new girl. I am an anomaly in every sense of the world. This is the inner city in the ’80s and here I come, the white chick from the ‘burbs going to do all the things. A 45-minute drive had taken me from middle-class colonials to an urban landscape that was completely unfamiliar. I did not speak the language or understand the dynamics. Settling into the passenger seat, I spend a lot of time looking around and listening, trying to interpret the input into something I can make sense of. There are three distinct memories from that long winter night.

The very first call we were dispatched to was a seizure. It had not been that long ago that I had seen my very first grand mal seizure ever and I was still mildly traumatized from it. While transporting a patient to the hospital with my volunteer agency, I was alone in the back with a man whose eyes suddenly rolled back in his head. Contracting sharply, his back arched and his eyes fixed on a point that I could not follow. As he shook and bucked against the straps I called out to the driver for help, ducking bloody spittle and convinced that this was some sort of zombie scenario. She looked in the mirror and talked me through it, eventually, it stopped on its own and we got to the hospital safely. Now I was being sent to another one.

My partner navigated smoothly to the call, telling me what he wanted me to bring into the call. I barely heard him, playing out all the possible scenarios in my mind. What if he gets violent? What if he’s really sick and I don’t know what to do? What if he’s too big and I can’t manage to move him? What causes seizures? Are the paramedics coming? Ok, take a breath and just follow his lead. We pulled up outside the house, I remember looking at the doorway and …

Nothing. I remember nothing else about that call. It turned out to be non-emergent and a routine transport. See, seizure disorders were super common in the inner city, for a wide variety of reasons. So while “Dawn of the Dead” had been playing through my head, my partner did not see it as anything more than a garden variety of medical call. There was nothing unique or dramatic about my first call in Newark.

My second memory from that night was going to my first cardiac arrest in the city. Even with my limited experience, I’d done enough CPR calls to get through the basics at least. My first call working with a paramedic crew as well. Old furniture pushed aside, on the first floor of a dilapidated house. Someone moved a lamp to the floor and I recall the harsh light of the bare light bulb and the way it lit the scene up from the low angle. Controlled chaos, no assist devices or hands-free here, push hard, push fast and get out of the way when they tell you to. I didn’t know where half the equipment was, or what they were expecting, I was rattled but kept at it. We must have gotten pulses back because I know when we put him in the ambulance compressions weren’t going but the paramedics were moving fast - adjusting wires, hanging bags, barking orders. I stood there, feeling as useless as I must have looked because finally one of the medics looks at me with exasperation and says, “Can you at least find the hospital?”

I couldn’t, not really, just had a general idea of the direction but I nodded mutely. No GPS or smartphone people, and looking at a map wasn’t an option at the moment, but I still nodded. They told me to go drive.

Drive an ambulance I’d never been in before tonight, lights and sirens, in the dark, on my first shift, with a critical patient, to a hospital I’d never been to. There’s an excerpt from a quote by Carrie Fisher that goes, “Stay afraid, but do it anyway.” I was definitely afraid, but I put it in drive and went. The medic at the head of the stretcher kept an eye upfront and shouted directions as we went. My heart pounded at every intersection, I was so afraid to make a wrong turn. I may have sobbed quietly when I finally saw that beautiful blue “H” sign and the lights of the ER entrance. My performance on that call was terrible and I took a beating but it gave me another glimpse of what I wanted to be. High-performing, confident, part of a team unafraid to take on the worst calls. Someday.

My final memory of that first shift means the most to me for many reasons. It’s well past midnight and we get sent for a stabbing, somewhere deep in a railroad yard. This is a large facility and parts of it are difficult to access. We make our way along the tracks, easing through the aisles of unused rail cars. The dark silhouettes of trains loom over us as we creep past, the empty windows glaring balefully down at us. It’s hard to navigate, the paramedic unit assigned to us is coming in from another direction. We find her first.

She’s laying in the middle of some exposed tracks. Oddly, I can remember seeing her knees first, her exposed legs moving listlessly as our headlights fell on her. A police officer is there, waving us in. A prostitute he says, cut up by whoever brought her out there. I jump out of the vehicle, adrenaline surging, and head right toward her. My partner calls out to me, asking where my gloves are. I’d forgotten them in my haste but was already a dozen strides from the vehicle and halfway to where she lay writhing on the ground. “I’ll be OK,” I say. Can’t he see she’s hurt? He can, but he insists - ordering me back to the truck to put on gloves and get the right equipment. As I came back out he looked at me, smiled, and said, “I just saved your life.” Then he headed for the woman bleeding to death on the tracks.

In all likelihood he did, you know - save my life. This was Newark in the late ’80s, HIV was rampant, especially in the drug population and the prostitutes. They didn’t know they had it and we couldn’t tell, yet. Nobody then realized just how that insidious disease would eventually turn people into skeletal husks who could do little more than babble and hope for an end. I would spend the next decades transporting people just like her to the hospital, safely. If he hadn’t stopped me, right then and there, who knows what the outcome might have been - because she had been stabbed, a lot. There was blood on the ground all around and all over her. She was slashed on her arms, her legs, and stabbed in her torso. The paramedic unit was stuck on the far side of the yard, it did not look like they would be able to get to us before we’d be able to leave. It was just us. We load her into the ambulance and head out.

Pink. She had this pink fuzzy sweater on and the bubblegum color distracted me. It seemed so out of place with the whole scene. Blood was caked where he had stabbed her, especially on her left side. Her dark skin was ashen and wet, she kept trying to talk to me under the oxygen mask but her words were breathless and almost unintelligible. “Can’t … breathe.”

My partner was navigating us out of the rail yard and trying hard to intercept with a medic unit. He did not have time to tell me what my job was. I should know what to do, shouldn’t I? But I didn’t, not really. So I managed what I could, my brain flailing for what little I could remember. Put her on oxygen, stop the obvious bleeding, oh wait, take her blood pressure. 60 systolic. Shit. That’s bad. What else? Lung sounds. Wait, can’t hear anything with the siren on. Is she breathing? Course she is, she’s talking. Sort of. She’s really pale. What’s that? Hold your hand? I can do that. I’m sorry, I want to do more. I'm sorry.

How did I get here? I’m a 19-year-old chubby white girl from the suburbs, how I am suddenly responsible for this random life in this place that is so foreign from everything I know? How did I go from chem lab at Rutgers to patching up stabbing victims in the middle of the night? I could be the last person she speaks to and I can’t even understand a damn thing she’s trying to say. She’s crying. She’s dying. I’m failing. I force a smile and keep encouraging her to breathe, squeezing her hand and checking a pulse that’s barely there, but essentially all I’m doing is the stare of life at this point.

Fortunately, my partner’s driving was faster than her blood loss and we got her to the hospital in time. The trauma team swarmed over her, moving me aside. They immediately cut off that fuzzy pink sweater to expose her wounds. I hadn’t done that, I’d never had to take a step like that before. It had occurred to me, but I hesitated and ended up not doing it. If I had, I would have seen the large sucking chest wound on her left side. The only positive was the cold temps had caused the blood on the sweater to congeal enough to seal the wound, slowing the progression. In my indecision, I had missed the life threat.

Defeated, I went outside to clean up. My partner is tired, I’m sure I haven’t helped. Still, he takes the time to, kindly but firmly, go over how to safely approach a scene. About not rushing, always wearing gloves, bringing the right equipment so you’re prepared, never losing sight of your partner, and just reminding me how skipping any of these steps could easily get me hurt or even killed. This is so not what I am used to. Pretty sure the end of that shift was the first time I went and cried in the car.

I don’t know what happened to the prostitute in the pink fuzzy sweater, but holding her bloody hand that cold January night was part of the crucible that forged my career. Three decades later and she still gasps at me from time to time, reminding me to move past mistakes and not hesitate when there is more I can do. She answered my own question for me. How did I get there? I got there because that's where I wanted to be.

On the other hand, I do know what happened to my partner that night. Antonio Gary went on to become a well-respected EMT in the department, eventually becoming a supervisor before leaving to continue his career in the fire service. There he continues to inspire and lead, and in 2016 he became the first African-American Fire Chief in Irvington, New Jersey, where he serves to this day. I am forever grateful for having the opportunity to learn from people like him.

Thanks for saving my life that day Chief Gary, hope I did alright by you.

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