The Real Deal: A Philly EMT Speaks Anonymously

He talks about Made in America, the Pope and whether you should just take UberX to the hospital.

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With up to two million people expected for the pope’s visit, all of the city’s emergency responders will be on high alert. That includes the many Emergency Medical Technicians (EMTs), who often provide life-saving medical assistance like CPR and wound care and can also deliver your baby should you not be able to make it to the hospital. Here, a veteran EMT — he worked last weekend’s Made In America Festival and will be on the scene for the papal festivities — tells us all about it.

How was Made In America?

Two days of complete ridiculousness.

Good ridiculousness or bad?

Bad. Three-quarters of the people I dealt with were under 18 and severely intoxicated. Some were unconscious. Some were vomiting. Some were combative. And every intoxicated minor we dealt with went to the hospital.

Mostly booze, or a lot of drugs as well?

Lots of alcohol and a cloud of pot in the air. It wasn’t just that you could smell it, you could literally see the cloud of pot.

But nobody cares about pot anymore.

Right, but when you mix pot with alcohol and molly and ecstasy, the results can be bad. You can tell just by looking at people.

Anything more serious than underage intoxication?

Somebody was hanging off a light post and fell about 15 feet. But mostly the unresponsive alcohol poisoning issues. A lot of them. I would never allow my children to go there. You have girls as young as 15 drunk and dressed like hookers.

But how was the music?

I have no idea. I had earplugs in.

You mentioned the drugs at Made in America. How frequently are you encountering drugs in your job?

Constantly. Everything from people being passed out or walking around like zombies. People are mixing K2, a synthetic cannabis, with PCP. The people taking the straight K2 just walk around like zombies. Then they throw in the PCP or formaldehyde, they get aggressive and you have to restrain them. I am talking about up to eight people to restrain one person.

We all know that there are good cops and there are bad cops, and I assume the same goes for EMTs. Your life might depend on the luck of a draw.

The quality varies based on the individual’s education level, experience and laziness, of course.

Right, but I’m also imagining some total loons, like Nicolas Cage in Bringing Out the Dead.

That’s what the job does to you. You do it long enough and you are banging your head against the wall, seeing the ghosts, and you become that person who will see a dead body and say, Oh well. Part of it is a defense mechanism and then the other part is basically PTSD.

You’ll be working the pope visit. As an EMT who has worked countless city functions, what’s your read on this?

To start off with, they’re not telling us anything. Things will probably go the same as Made in America except a larger area with more responsibility and a different kind of people. They’ll be older and there will be sick people, the people coming to get healed, versus the people who came here to get high and drunk.

So you know as much as the rest of us?

It’s all being kind of held close, for security reasons. We don’t really need to know details until the moment that it happens. That’s how you’re trained.

I have faith in the [emergency workers] and I have trepidation about the system. We’ll do what’s necessary to get the job done. The question is, will the system do what is necessary to sustain us? Everybody working at Made in America worked their assess off and got the job done, but the job was more than the resources we had available. They had to keep calling in medic units from 911, which is taking resources away from the city, the public, from you, to pick up the slack.

What are some of the more serious situations you’ve had to deal with?

Seriousness is a matter of perspective, and it’s a kind of loaded question. Is dealing with a child in respiratory distress more serious than an adult trapped in a car with a head injury and unconscious? It’s a matter of perspective, and I’ve dealt with all of those things. Or what about a gang banger with a gunshot wound who could die? Is that more serious than the father of three standing on the edge of a window sill and ready to jump?

You tell me. I would think there’s a natural tendency to help the father of three.

My official interview answer would be, I take it one at a time. I don’t add any more seriousness to this run than the one before it. They’re all the same.

OK but this is an anonymous interview, so can’t you be a little more candid?

If I treat anybody differently for any reason in this day and age, you’re going to have all sorts of problems. Why did you give an IV to the little kid but not one to this other guy. You don’t want to leave yourself open to interpretation. When you have a fire department that looks at its members as guilty before innocent, you want to limit your liability.

But really, the gang banger gets the same care. Not the same compassion, but the same care. We all have a soft spot for little kids and go the extra mile. Even when we pull up and it’s obvious that a baby or a kid is dead, we’re still going to work it and take it to the hospital.

What percentage of your patients die in front of you?

Less than 10 percent.

Is that still hard for you, to see someone die?

Like we said about the Nicolas Cage movie, you desensitize yourself to it. Death and dying are a fact of life. You do what you can do and as long as you don’t see yourself as making a mistake, it’s out of your control. It’s when you second guess yourself that you get those ghosts that haunt you.

So that’s death. What about birth? You’ve delivered some babies?

Many. It’s gross and nasty.

At an event like Made in America or the pope, how difficult is it for you to actually get sick or dying people to the hospital?

It’s getting people to the first aid tent that is the problem, because you have to get through the crowds. Once they are at the first aid tent, there’s a dedicated avenue to get them to an ambulance and then there’s somebody to tell the ambulance which hospital to go to. Certain conditions can only go to certain hospitals, trauma patients only go to specific trauma centers.

What’s the hardest part of your job?

There are three very hard parts of my job. It’s hard to get something to eat, because you’re so busy that you just don’t have time. It’s hard to do a simple thing like go to the bathroom, because, again, you just don’t have the time. You’re always running. And on a completely different level, it’s hard to tell someone that their loved one has passed away.

What can the city do better as far as your role is concerned?

Educate the public.

How so?

When we grew up, we learned that when there’s a problem, what do you do? You call 911. We never were taught what that emergency is. You get a cut on your finger, do you think that’s an emergency you need to call 911 for and go to the hospital for. In the grand scheme, is it an emergency? No. But you’ll sit in emergency for two hours and accrue an $800 bill for the unnecessary ambulance ride. And something that’s been bothering you for two years, you do not need to call 911 for that either.

What percentage of the calls that you respond to don’t need your response?

I’ll just base it off of my calls today. Just doing the math, give me a second … 75 percent of the calls do not need, warrant or deserve an ambulance. And in general, that number would be true for any day.

Wow, that’s a huge problem.

Almost on a daily basis, the city runs out of ambulances. But if the city refuses to take someone to a hospital, I guess people would sue and the city is afraid of being sued.

Here’s how it works. You call 911 and say you have an emergency, you’ll get the closest available medic unit, which might be around the corner or it might be all the way down in South Philly. And depending on why you called, they will send a first-responder unit, like a fire truck. They might bandage your wounds and chat with you until an ambulance gets there. But it’s all in order of who called. If you’re the fourth person to call, you’ll be the fourth person to get an ambulance.

What? I thought that 911 had a priority system based on severity.

That’s for the police. EMS is first-come, first-served. And like I said, the medic units run out constantly. I can leave my fire house at 7:30 in the morning and not make it back until 9 at night. That’s as many as 20 runs throughout the day, 24 at the most.

Should I just take UberX to the hospital, assuming I don’t have a bullet in the side of my head?

Well, yeah, or call somebody. Hey, Joe, can you give me a ride to the hospital? Call Joe. Call a taxi. Call UberX. Whatever. Not everybody needs to go in an ambulance.

OK, so let’s say someone has a real emergency, what can the public do to help you do your job?

Make sure we can see your address clearly. That’s the biggest thing, believe it or not. Half the time we can’t see where we’re supposed to go, because people don’t have addresses on their houses anymore or they are really small and not lit up. It takes us extra time to figure out where we’re going.

And take care of yourself, see your doctor. Take your medicine like you’re supposed to. Just be smart about living.

Follow @VictorFiorillo on Twitter.

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