Medics carrying firearms has been hotly debated by EMS professionals for the last couple of years, but it’s old news to Ed Gilbertson, Program Director of Community Paramedicine for Little Rock’s Metropolitan EMS system (MEMS).
“People I rode with 30 years ago carried guns, but it wasn’t because of the patients or the neighborhood,” says the 53-year-old RN and former paramedic. “It was because of their boss.”
Fear and loathing in Little Rock
Gilbertson is referring to the owner of now-defunct Medic-Vac Ambulance, a man we’ll call Bud. When Gilbertson went to work for Bud as an EMT in 1983, Medic-Vac was the only EMS agency in Arkansas’s capital.
“We served Little Rock and surrounding areas — maybe 200,000 people,” Gilbertson recalls. “This was back in the day when you had a dispatcher sitting at a desk with one radio and one telephone line.”
Gilbertson says Bud had a contentious relationship with city administrators.
“He didn’t care much for rules and regulations. He figured he had some leverage because he ran the only game in town. If he got angry with the city, he’d remove all the ALS items from the trucks and drop to a BLS level. Our medics used to carry their own equipment for those situations.”
Such initiative had to be kept secret from Bud, though.
“He was known to get physical with his employees if they displeased him,” Gilbertson says. “He threw one of our guys through a plate glass window. Everyone hated working for him, but if you wanted to be a paramedic in Little Rock, that’s what you had to do.”
Just before Memorial Day in 1984, Medic-Vac responded to a three-wheeler wreck in a remote part of their district. The teenage victim had life-threatening injuries and was in shock.
“The paramedics on that call — two of the finest, smartest people I worked with — figured the kid wouldn’t make it by ground to a hospital, so they called our dispatcher and asked him to launch the helicopter.
That cost Medic-Vac a transport. Bud was furious.
“He came down to the office that night, beat up the dispatcher and fired the two medics for taking money out of his pocket.”
Time for a change
When the night shift reported, some coworkers wanted to quit. They didn’t want a confrontation with a man many considered psychotic. “Bud could have easily replaced those people, then continued doing business as usual,” says Gilbertson.
He and his partner, a paramedic named Kevin McCoy, decided to intervene.
“We convinced almost everyone to quit at the same time,” says Gilbertson. “We wanted to shut Bud down, then help the city take over and fix this. Meanwhile, we’d work for free to keep EMS up and running.”
Gilbertson and McCoy drafted a petition-like letter of resignation that 21 of 24 workers signed the next day. As of May 25, 1984 at 10:00 a.m., Medic-Vac was down to three employees: the boss, his assistant and the assistant’s brother.
Medic-Vac lasted two more days. By then Little Rock, its hospitals, neighboring EMS squads and even the American Red Cross had loaned people, vehicles and supplies to an interim agency that would become MEMS. McCoy was considered the best candidate to take charge, but family obligations made that impossible. Gilbertson was appointed chief of operations instead — a lot of responsibility for a 22-year-old still in paramedic school.
“So here I was,” Gilbertson says, “this kid with one year of EMS experience in some ragtag service suddenly charged with buying ambulances, sourcing equipment, and developing policy.
“I guess you could say I had a very steep, very quick learning curve.”
From paramedic to problem solver
Gilbertson somehow managed to finish his paramedic training while running MEMS, then stepped away from his management role several months later to return to the field. All along he had a very different career path in mind.
“I wanted to be a nurse anesthetist,” the Chicago native says. “I’d talked with the anesthetists quite a bit when I was practicing intubations during medic rotations. I figured I’d get my BSN, get experience in critical care, then go back to school.”
By 1993, Gilbertson had achieved two thirds of those objectives. He was working as an RN at Little Rock’s old Southwest Hospital when he was asked to serve as assistant director of that facility’s problematic emergency department.
“The director was focused pretty much on her other responsibilities in the ICU, so I had free reign over the ER,” Gilbertson says.
“Thanks to some really good folks working for me, we turned that place around. Then I was hired by another hospital to do the same kind of work in their ER.
“I guess I got pretty good at managing and fixing broken departments.”
From 2000 through 2014, Gilbertson accepted a variety of EMS troubleshooting assignments lasting anywhere from six months to two years. His paramedic certification became a casualty of that lifestyle.
“As much as I loved being a medic, it wasn’t how I was paying the mortgage anymore,” Gilbertson says. “I just didn’t make the effort to get recertified.”
That didn’t stop MEMS from inviting him back last January to run their new community paramedic program. Gilbertson says the challenge isn’t just to teach the medics about public health, but also to educate the public about EMS.
“The system is like a bicycle that’s not put together yet; then you give it to your kid without a wrench or a set of instructions.
“Citizens don’t understand how to use EMS. They figure the easiest thing to do is call 911 and somebody will figure out what they need.”
Opportunity rocks
So whatever happened to Bud, his boss from the bad old days?
“He might still be alive,” Gilbertson says. “I wouldn’t know. I’ve seen him around Little Rock from time to time. I just kind of go the other way.
“As bad as it was, working at Medic-Vac opened doors for me. If you want to grow, personally and professionally, you have to be willing to walk through those doors and see what’s on the other side.”
