By Patricia Poist
Sunday News (Lancaster, Pennsylvania)
Copyright 2007 Lancaster Newspapers, Inc.
LANCASTER, Pa. — The 60-something woman stood on the porch of her brick row home in the city’s west end, clasping and unclasping her hands.
She was agitated, distraught and seemingly disoriented.
“Can you tell me what’s wrong with you?” asked paramedic supervisor Joe Carr of the Lancaster Emergency Medical Services Association (LEMSA). It was a question he and other emergency workers on the scene kept asking her.
“Everything,” cried the woman, who insisted they take her to the hospital.
“I’m sorry,” she said, “I just can’t help myself.”
Spend some time with paramedics and emergency medical technicians (EMTs) and you truly appreciate what they face on a daily basis. Shootings. Drug overdoses. Job-site injuries. Heart attacks. All manner of human misery.
“We can’t help you unless you tell me what is wrong with you,” Carr beseeched her.
The woman is what ambulance crews call “a frequent flyer.” For the past few years, she has been calling 911 repeatedly, sometimes several times a day. Paramedics and EMTs often take her to one of the local hospitals, where doctors examine her and then release her after they find nothing physically wrong.
In one instance, the woman called and said she was sick and required an ambulance. When crews arrived at her home, she told them she needed a cigarette.
This particular late Friday afternoon, two city police officers arrived to warn her about her constant calling and explained how she is tying up emergency-service workers who need to be free to respond to life-threatening incidents.
After conferring with Carr, the police determined it best that the ambulance crew take her to Lancaster Regional Medical Center, where they signed papers to commit her for psychiatric observation for three days.
Obviously, the woman has fallen through the cracks of a broken mental health care system, and the only people to catch her are those not in the best position to help her.
“There are never two days exactly the same,” sighed Carr, 41, who, over the course of more than 20 years (beginning as a teenage volunteer), has tended to thousands of people in all states of distress.
Starting today, through Saturday, the nation, as well as the county, will celebrate Emergency Medical Services Week, drawing attention to people like Carr and their roles in being the first to respond to those needing immediate life-saving care.
Or, in the case of the city woman mentioned above, those who can’t seem to help themselves.
The week’s theme is “Extraordinary People, Extraordinary Service,” and “exemplifies the excellent services provided every day, under any circumstances by the 750,000 EMS providers who serve their communities,” according to the American College of Emergency Physicians’ Web site, www. acep.org, which established EMS Week 34 years ago.
Locally, hospitals will hold picnics and other events for emergency workers. Tuesday, Mayor Rick Gray will proclaim EMS Week for the city; Wednesday, Lancaster County Commissioners will do the same for the county. Also on Wednesday, LEMSA will display some of its trucks and equipment at Lancaster Square.
LEMSA is the largest ambulance service of the county’s 22 companies, serving a population of 135,000. It also has the most sophisticated fleet of trucks and equipment, including a mass-casualty trailer, purchased post-9/11, and a John Deere Gator, which responders can use to navigate rough terrain, such as wooded areas.
Last, year LEMSA responded to about 26,000 calls, which included non-emergency transports such as taking the infirm to and from hospitals and/or nursing homes.
C. Robert May, LEMSA’s executive director, said the struggles are many for ambulance companies. Most operate on tight budgets. They rely on grants and contributions to augment their income from reimbursements from insurance companies, which frequently aren’t enough to cover costs. Often, many patients, such as the woman admitted for psychiatric care, don’t have insurance and the company has to absorb the costs they incur.
Another obstacle for ambulance companies is high-employee turnover. Though there are some volunteers, most are paid. The hours are lousy and the wages are poor, however, for both emergency medical technicians (who start at around $11 an hour) and the more-trained paramedics (who start at around $13 an hour). Many have part-time jobs, in addition to their emergency-care careers, to make ends meet.
And these are people who regularly see the kinds of horrors most people can’t begin to fathom.
Consider Steve Wireback, a 53-year-old emergency medical technician for 23 years. He said he will be haunted forever by the sight of the tiny hand of a little girl - the only part of her lifeless body sticking out beneath a coat someone used to cover her - at the West Nickel Mines Amish school house in Bart Township. That was last October when gunman Charles Roberts IV shot to death five girls and injured five others before killing himself.
“The size of her hand was the size of the inside of the palm of my hand,’' he said, quietly, holding his hand up.
Then there was another little Amish girl, who begged him “to please take the pain away’’ as he tried to tend to her wounds.
He still trembles and gets tears in his eyes as he talks about that awful day when he and partner Ian Solodky, a paramedic, were among the first responders to arrive on the scene of the schoolhouse.
“That was hell; I almost turned my badge in,” said Wireback. Like many emergency personnel who responded to the girls that day, Wireback said he sought psychological help to come to terms with the trauma.
“Everyone in this business has PTSD (post-traumatic stress disorder), to some extent,’' said Carr.
Recently, Carr, accompanied by a reporter, visited his crew, including Wireback, at their small station based at Lancaster General Hospital. This is where, between calls, they catch up on paperwork, eat, rest, read or watch TV.
It was obvious they are a close-knit group of people who love to bust on one another.
They were candid about some of the things they have dealt with, often using gallows humor to deflect from the harsh realities, such as the motorcyclist whose body was shredded on the roadway or the man who blew his head off by sticking a gun in his mouth.
They said they are constantly angered about those who cause emergencies - drunks, for example, and those who speed and drive recklessly.
They are even more furious at people who abuse children.
Paramedic Vickie Horan, an exuberant 46-year-old, said she intended to get her master’s degree in psychology, but decided to do some clinical work with emergency medicine. At the time, she wanted to get over her squeamishness. She ended up falling in love with emergency medicine and became a paramedic seven years ago.
She said first responders gradually get used to seeing the tragic side of humanity and they eventually become hardened to death. “It’s like they went to sleep,’' agreed fellow paramedic Diane Ray, 34. Ray admitted she once succumbed to her emotions, however, when she saw the bodies of children killed in a car accident on Route 272, near the Buck, about 10 years ago.
“We all go to our max,’' said Ray, who first became an EMT in 1994 before recently extending her training to become a paramedic.
All the paramedics and EMTs interviewed said they will never get used to seeing children hurt or dead.
Wireback recalled the anguish he felt as he tended to a 6-month-old baby, after the infant’s caretaker slammed his head onto a hardwood floor; later, the baby died.
“It just tears you apart,’' he said.
Still, despite all the madness and sadness, they get to enjoy vast rewards, such as being able to revive someone from the brink of death. It is even more exhilarating when those folks are restored to full health.