In our last issue we presented part 1 of “Return of the Ambulance Guy”. The Ambulance Guy has been a contributor to several BEMS publications for more than 15 years. He has been, at times, the voice of humor, reason and, yes, madness.

In part 2 of our interview we met the elusive Ambulance Guy at a secret location {the Pig and Whistle}. In a pitiful attempt at disguise the Ambulance Guy wore Osco Glaucoma glasses and an Omaha orange hunter’s cap. He insisted on speaking in the voice of Elmer Fudd---until I begged him to stop.

PAX: Thanks for coming back, can you summarize the first part for our readers?

The Ambulance Guy: I can’t even summarize the drive over here, are you insane?

PAX: Okay. You portrayed a state of the art EMS system overworked and understaffed, a system that has easily taken on the roll of the “Public Health Ambulance”, has performed in that role admirably but has not been given the funding to staff accordingly.

I agreed to let you be the Emperor of EMS and you promised to unveil your secret plan to save EMS.

TAG: I said all that?

PAX: And more.

TAG: Okay. The secret plan is--------Hire more EMT’s and staff more ambulances! There, can I go back to bed now?

PAX: That’s it?

TAG: I don’t mean to be overly simplistic, but yes, in a nutshell. I feel like the shut-ins that call sports radio “Trade Carl Everett for Barry Bonds”. Easy for me to say, cause I don’t have to get all bogged down in the details. I know next to nothing of budgets, politics and the like. I don’t need to; I’m a concept guy! They don’t pay me to know that stuff; they pay me to be an ambulance driver. I understand that this process is difficult and complicated. I do not envy that whose job it is…But that’s their job.

They have inherited a legacy, a national-class big-city EMS. They are the caretakers of something very special.

BEMS did not become national-class by memorandum or protocol. We become what we are because the people here have a long history of doing one thing well. We take excellent care of people in crisis. Sick, hurt, drunk, drugged, injured-we’ve been doing it better than almost anybody for years!

PAX: Can I get an Amen!

TAG: Sorry, I tend to be rather passionate about this subject. This systems potential is limitless, we have a lot of talent here but we can barely perform our primary role {care and transportation of the sick and injured) because we have always been understaffed.

PAX: So, Emperor, where would you start?

TAG: Lets start in the middle-Amb. Four.

PAX: There was once an Ambulance Four?

TAG: Yes, my son. A-4 was the “working” truck’s “working ambulance”. Busiest truck in the city (When they weren’t chasing purse-snatchers) It was the South End ambulance when the South End was the South End and not “Disney does real estate”. Geographically it was the “next truck into anywhere”. When it went out of service, it left a big hole in the city.

PAX: Sounds great, where do I sign up?

TAG: Easy, cowboy. You need at least two major personality defects to apply for A-4.

PAX: Sorry.

TAG: We’re not stopping there. Get your passport, homey; we’re going to Eastie!

PAX: Eastie?

TAG: You bet. We’ve established that Eastie is “geographically isolated”. That’s fine. (I think every neighborhood is “isolated” when the closest ambulance is twelve bloody minutes away!) Since the Winthrop closed, the only option is to go in town. That means you need ALS on the East Boston side of the tunnel. Let’s put up P-7 ALS/BLS for Eastie. (They’d cover A-7 when busy) KeepA-8 on the Boston side to cover the Seaport District and impact Southie and Downtown.

PAX: Did you say, (gasp!), ALS/BLS?

TAG: Don’t get your paramedic bloomers in a twist, ducky, any new ALS truck posted to an outlying district is going to have to back up the BLS. It’s a brave new world, dude.

PAX: Gasp! Take people to the hospital?

TAG: Relax Sidney, have a cream soda!

PAX: Sob! Stair Chair! Sob!

TAG: Get a grip, man, we’re heading west! If we’re talking geography, let’s put a truck in Rossie Square and a truck out around Spring and Baker.

PAX: Are you done?

TAG: Nope, North Side Float (Dock Square) South Side Float (Franklin Park) Let A-15 and A-12 stay home.

PAX: Okay, how may bodies are we talking?

TAGA: The bean counters tell me 10.5 people per 24-hour truck. (One would have to be Brad) We’re talking a max of 63 people. Factoring in a 20% failure rate we’re talking..Take out your abacus.

PAX: Not in front of the waitress!

TAG: Three recruit classes of 26-27.

PAX: Wow! That’s some serious cha-ching!

TAG: Excellence is expensive. You be the politician. Let’s maintain the current staffing. Which neighborhood do you want to short-change? Who loses their ambulance to cover the busy city core? Brighton? Hyde Park? Charlestown? That is, in effect, what we do when these trucks “cover” other areas. We’re taking someone’s ambulance away. You call that City Councilor and tell him we’re taking “his” ambulance because his neighborhoods not busy enough.

PAX: More trucks. Faster response times. Stay-at-home ambulances. That’s it?

TAG: Do not underestimate the trickle down effect of this plan, said the urologist. This is a young person’s job. It’s nice to have wisdom and age, but an infusion of youth, a recruit class, can be a good thing. As long as we have veterans who are willing to “mentor” young people, we’re okay. You dig?

PAX: I’m still having a little trouble with that whole” trickle down” thing. Where’s the men’s room here?

TAG: We staff up. Less overtime. More bodies available for details and special events. People are beginning to expect us at events. We need to do more, but we can barely cover what’s on our plates now. Did I mention Bikes?

PAX: Bikes?

TAG: Bikes Rule! Bicycle EMS saves lives. Boston is not ambulance friendly, especially downtown. We should have bike teams downtown every day, weather permitting. Castle Island, Esplanade in season, It’s too good a tool for special events alone. Good medicine, good for morale, good for PR.

PAX: Let’s play word association.

TAG: Oh please, let’s not..

PAX: Tell me the first thing that comes to mind.

TAG: Carmen Diaz.

PAX: Carmen Diaz?!

TAG: First thing that came to my mind, great smile.

PAX: Think of something else.

TAG: Trot Nixon.

PAX: Trot Nixon?

TAG: When I try not to think of something I think of baseball, Trot bats leadoff.

PAX: Try to focus. Twelve-hour shifts?

TAG: George Carter said he’d rather not be taken to the hospital by a person who “had driven through two rush hours”. Makes sense to me. Factor in someone who has missed two meals, has already done 18 trips and really has to pee and you can see I’m not painting a very pretty picture. Extended tours are for folks who work a second job in a comfy suburban firehouse.

PAX: Schedule.

TAG: Eight-hour shifts. Three person trucks. Four on two off. On one of those off days every month you go to TQI. Our current schedule we have 104 days off a year. Four and Two gives you 130 days off. Four and two “lite” gives us 118 days off, it’s a perfect compromise. We get rid of the worst feature of the current schedule, the stretch where you work eight out of nine days. It gives us more off time for the old farts like myself, more time for OT and details for the youngsters.

PAX: Retirement Bill.

TAG: We really need this, or we need to find another job for our veterans. As an old sage said to me, “I’m carrying people half my age and twice my weight.”

PAX: Federal Death Benefit.

TAG: Three words, World Trade Center.

PAX: Paramedic Intercept.

TAG: A pox ! A virus brought to us by Private EMS. Two goobers in an ambulance need two guys in a Bronco to tell them how to take care of a sick person! Not here. Grow a pair and do your job, take the sick person to the hospital. That’s why we spent $10,000 training you. That’s why you make the big bucks. Except for some extreme conditions (airway compromise) there’s no place for this in an urban system.

PAX: Spoken like a true grizzled vet.

TAG: Born to be Brown.

PAX: What’s up next time?

TAG: Satellites . The good, the bad, the ugly and the nonexistent.

PAX: I look forward to it. Anything else.

TAG: You gonna finish those homefries?

PAX: Help yourself, take the sausage.

TAG: Word!