Cleveland EMS union battle puts mental health in spotlight
Cleveland EMS providers are protesting the city's repeated legal challenges to a contract that would provide paid leave and treatment for PTSD
Cleveland.com posted the following editorial "Cleveland EMS workers suffer trauma, too — so why won’t city help its helpers?" after the city renewed its challenge to an arbitrator's ruling that it must include mental health protections in a new EMS contract. For more background, see our coverage of the ongoing protests and legal battle.
The Plain Dealer, Cleveland
CLEVELAND — When the call came in, paramedic Chuck Cali and his partner hoped it was a mistake, or some feeble attempt to get the fire department there faster: “Neighbors report there’s a man on fire walking down the street.”
Then they turned a corner.
He was just standing there, not waving his hands or yelling. All his hair had been burned away. So had his clothes. Naked and still smoldering, everything that had made him recognizable was gone. Everything but his wide eyes.
“Am I going to die?”
As he spoke, part of his lip broke and flaked off.
The 23-year-old had suffered more burns than the decorated Cleveland paramedic had seen on some cadavers, and yet here he was, talking to them.
He wouldn’t tell them who had tied him up and set him on fire. If he told, they’d promised to do the same to everyone in his family.
“Please call my Dad.”
“Not now,” Chuck answered. “We need to get you to the hospital.”
A doctor took one look at him and declared him dead. “He’s still talking, sir,” Chuck replied. Three nurses left the room, crying.
Chuck followed them, fighting the tears building in his eyes. Then it was on to the next call.
There was no time to decompress, to make sure their heads were clear enough to treat the next critical patient.
In Cleveland, an EMS ambulance crew is expected to be back on the road 12 minutes after arriving at the ER.
Nobody said the job was easy — the bullet proof vests Cleveland paramedics wear to protect their bodies are proof of that. But what about their brains?
In its latest contract proposal, the EMS union drew up a set of mental health initiatives for its paramedics, dispatchers and EMTs, including one that would allow them to qualify for treatment and paid time off for PTSD — post-traumatic-stress disorder.
The city is refusing to provide that crucial protection, even after an arbitrator and a Cuyahoga County Common Pleas Judge agreed it was the right thing to do. The city dug in Friday and filed its notice of appeal.
The mayor’s office isn’t commenting, citing “pending litigation” but it doesn’t have to. Cleveland’s own people — from the dispatcher on the phone with a man who ended the call by shooting himself in the head, to paramedics like Chuck in the field — are crying out for help. And the city doesn’t want to hear it.
Unions are always battling employers for better wages and working conditions. But this is no ordinary contract dispute. There are lives on the line: those of EMS workers and ours.
“The mental stability of the personal and professional lives of EMS providers is necessary to commendably serve their communities,” concluded the National EMS Management Association.
“It is time to provide care to the care givers so they can effectively respond when the next caller dials 911. . .”
A divisional notice, issued by EMS Commissioner Nicole Carlton in 2019, allows medics who go on an especially bad call at least 60 minutes to reflect and reach out for help if they feel they need it. But the union wants more formal and lasting policies in place. Divisional notices can be revised or erased at the whim of a commander.
Union reps also want a doctor, one hired by the city, to decide who needs help and how much, not a boss concerned with staffing levels or how many trucks are on the streets. That’s also a way, they say, to guard against fraudulent claims. And the city’s policy only goes so far.
After a crew responded to two horrific car crashes this summer, they were having a hard time coping. Union president Paul Melhuish asked the brass to give them an extra day off before going on a long weekend shift. That request was denied. “It was a horrible mess,” he says.
First responders in Cleveland and across the country are coming to realize that if they don’t deal with the awful things they see on the job, they risk bringing those traumas home. Living by the old school, “suck-it-up-and-take-it” philosophy is toxic, making even the toughest vets more vulnerable to depression, substance abuse and suicide.
The numbers are impossible to ignore. Nationwide, more cops died by their own hand in 2019 than were killed in the line of duty; 37 percent of EMS workers surveyed in a national poll said they had thought about taking their own lives, a rate ten times greater than the general population.
In 2016, a Cleveland EMS crew answered a call for one of their own. He’d been struggling for a long time but no one knew how mightily. Their friend had hanged himself.
The city’s response? Sure, the job is hard, but they knew what they were getting into when they became paramedics. “Nebulous” claims of mental suffering, argued an attorney for the city, could be a way to abuse leave and get undeserved paid time off.
Cleveland EMS is busy and understaffed. Though budgeted for 333 people, the union reports there are currently 260 on the rolls. It’s hard to keep good people, says union reps, if you don’t treat them well.
Last month, Chuck Cali quit to take a gig at a suburban unit where his chief understands that memories of bad calls don’t go away if you just don’t talk about them.
Chuck still remembers everything about that day in 2008 — the bloody footprints on the sidewalk, the miraculous voice asking, “Call my Dad.” Burning man is one of the hundreds of people who live in his head.
The pay cut was worth it. He was bringing his “bad days” home to wife Sabrina, daughter Henley, almost 5, and Charlie, soon to be 3. He was tired of shambling down to the basement to hide so the kids wouldn’t see him cry.
During his 13 years with Cleveland EMS, Chuck earned his sergeant stripes and trained plebes how to be paramedics. He traveled with Joe Biden’s motorcade when the VP came to town and won a distinguished service medal for saving the life of an East Cleveland firefighter, shot in his own home during a robbery. He’s been deployed to Puerto Rico to help after Hurricane Maria and Paradise, California to aid refugees of wildfires. And he teaches paramedics from all over the US how to deal with everything from anthrax to dirty bombs.
He wanted to keep working in his hometown. But he couldn’t stay. “When we try and go to administration with concerns, we are spit on by them,” he explained. “It’s almost impossible to go home healthy after that. I couldn’t do it. I wasn’t strong enough, and bless those who are. The City of Cleveland broke me, and I had to leave to try and fix me.”
I wish he was still here, too. The 37-year-old has the laugh of a stand-up comic — wild and loud and infectious. It’s people like Chuck you want in the back of the ambulance with you, on one of the worst days of your life.
How many more will go, taking their passion and experience with them, while the city wastes years and tax dollars in a fight . . . to do what exactly? Keep helpers stressed out and broken?
On Wednesday and Thursday, EMS union members, families and friends invite us to join them at the corner of Cleveland’s East 16th Street and Davenport Ave. where they’ll gather for a march to City Hall. The parades of solidarity will begin each day at 11 a.m.
Let’s be sure to answer this call.
©2020 The Plain Dealer, Cleveland