Since the mid-80’s the Ambulance Guy has written for a variety of BEMS publications, on a variety of EMS and non-EMS related topics.

But, Since his critically acclaimed “Snow Desk” in 1996, the voice has gone silent.

Theories abound. The Ambulance Guy was in rehab. He was at the Puzzle Palace. He went to the Fire Dept. or worse (gasp) Management. There was even a rumor that he was appearing nightly at the Glass Slipper under the name Vixen.

Through a confidential source the PAX found the Ambulance Guy, who reluctantly agreed to a meeting at a secret location (Doyle’s).

The Ambulance Guy arrived early wearing dark glasses and a large straw hat with flowers. He also insisted on speaking in the voice of Topo Giggio, until I begged him to stop.

Our conversation was as follows:

PAX: So, where you been, man?

TAG: (The Ambulance Guy)

I’m still here. I never left. I did some stuff for Barnicle…. It didn’t work out. Mostly, I wondered if the Ambulance Guy was still relevant. Most people on the job came on since 1995. Were they really interested in what the Jurassic EMT thought? I wasn’t sure.

PAX: What made you change your mind?

TAG; Some people I really respect told me otherwise. Plus, the thought of dusting off my writing chops again was exciting. The Ambulance Guy has a huge ego.

PAX; And refers to himself in the third person.

TAG; He does.

PAX: So, what’s your take on the last five years?

TAG: Wow, let’s start off with the easy ones! What about my favorite color or if I were a tree?

PAX: Sorry.

TAG: Okay, lets start with the positive so I don’t sound like a whiny union malcontent. You know, there’s lots of positive stuff.

PAX: Seriously?

TAG: Oh sure. MDT’S, how did we ever get by before them? Portables and pagers for the masses. We drive trucks every day that other services would kill for. New toys….EPI-pens, albuterol, twelve leads, paralytics. We used to have our awards dinner in the Piano Lounge on a Thursday afternoon, now we’re at the Seaport Hotel.

Look at Support Services! You can get a four by four at four a.m. We used to wash dirty ambu bags in the sink at the BCH. We used to scrub wooden backboards with peroxide to get the blood off just so we could have one. We have spare trucks that run and they’re already stocked! We’re spoiled rotten.

PAX; I guess…

TAG; Look at Training. I know everyone likes to bash those guys, but do you remember going to MIT on Friday night to listen to some retired Jake drone on just to get 2 CEU’s? Now I may not get tumescent on my Thursday Training day, but we’ve really got it easy. How about a college-level A&P course for free? How cool is that?

Details, Special OPS. We used to cover the Puerto Rican Festival with one truck…. In service! Now we descend on the Esplanade on the Fourth like an invading army. Operation Sail took more planning than Desert Storm!

PAX: Okay, Mr. Glass half-full, how about some negatives?

TAG: Well, this Public Health model EMS is a tough transition. We’ve gotten so good at the non-emergency stuff we do that it has become our realm. So, now we’ve taken on all these new duties with pretty much the same staffing we had when we were primarily an Emergency Service.

Now when Billy runs with scissors at school or when someone at the clinic needs a chest x-ray, we not only sends an ambulance but we treat it like a true emergency.

I’m not necessarily against this “new age” EMS. It does have the benefit of making us more secure in our niche as the EMS authority to the city, but it puts a major stress on the system.

It puts the System in an almost constant state of stress. We send all our units to clinic runs and private ambulance calls and men sleeping in ATM’s. We chase our people out of hospitals for toothaches and three-day-old ankle sprains and wonder why, when the “Baby on a Meat-hook” call comes in we have no one to send.

It’s easy to blame this on our brothers and sisters who toil in Operations. Remember that they have their own list of stressors and torments we can’t even begin to understand. They’ve been stripped of their power to make sound decisions and made slaves to the screen, sort of like the Stepford Dispatchers.

My point, and I must have one, is that we can’t do New Age EMS with yesterdays staffing. We’re as lean as we’re going to get. We’ve abolished shift change, code tens and, at times, documentation. The poor bastards in the working trucks routinely get out 1-2 hours late. And you can’t blame the poor slob doing last radio; he’s got a screen full of pending calls and a gun at his head. He just wants to get through the shift without any blood on his hands.

Once again, this isn’t trigonometry here. You don’t need a six-figure consultant or a Kennedy School grad to figure this out. You could get the guy from small appliances at K-Mart or the counter-person from Dee-No’s Subs, sit them down at a console and in two hours they’d say “Hey, you need some more ambulances”

PAX: So, what’s your solution?

TAG; I’m afraid, short-term, there is none. That’s what scares me. I dread that high-profile call that lies just around the corner, when everyone is too busy or just too exhausted to go.

Remember Charlestown? East Boston? “Wrong Way Medics”. Those calls are out there every day like a shark in a wading pool, we’ve just been fortunate. Remember that this is a system that can be brought to its knees by a three-car MVA at noontime in Uphams Corner.

PAX; You’re bringing me down, dude, is there any hope?

TAG; There is. I’m no political insider by any stretch, but we do have a strong advocate at City Hall in Mayor Menino. Without the Mayor, we would not exist today. Mr. Mayor could have taken the easy political road and sacrificed us to the Fire Dept. Instead he listened to the outside consultants and us and took what was, arguably, an unpopular stand.
I think, with some thoughtful dialog with the Mayor and the citizenry we could make a strong case for expansion.

Few people understand what we really do. Many still think we’re part of the Fire Dept. or run out of City Hospital.

I’m certainly no advocating any “Fear City” tactics. But in a city with so many elders and other at-risk populations, the fact remains one is more likely to need the services of EMS than the other older, more established Public Safety agencies.

Can we convince an entire city and it’s leaders of that? I’m not sure. We’ve never tried. We’ve been too busy trying to survive.

PAX: Okay, you’ve convinced me. Let’s say we get the big green light to expand to the next level. Where do we go from here?

TAG; Don’t look at me. I’m just an ambulance driver.

PAX: Let’s say you’re the Boss.

TAG; Can I be the Emperor of EMS?

PAX;If you must.

TAG: Well, first…I’d get rid of this hat. Then I’d hire Topo Giggio as my spokesperson. Then…..

NEXT ISSUE:

The Ambulance Guys Big Plan.