I got involved in EMS because my mom moved to Florida. Needing a job to support my sudden non-rent-free lifestyle, I answered an ad in the newspaper (how employment was often procured pre-internet). It offered free training with the promise of future employment in a desperate bid to get a huge influx of naive do-gooders to join the ranks of the city’s ambulance service, which at that time was run by NYC’s Health and Hospitals Corporation. I quickly took the bait. Having been a fan of the “Emergency” television series back when TVs only had 5 channels, I welcomed this opportunity to be like Johnny and Roy, intrepid pioneers in a new medical field. I looked forward to an exciting job “saving people” until I could get my life together and do something else.

I passed my 3rd grade level reading and math entrance exam, took a physical and joined the training academy shortly thereafter. Our education started with CPR. When I received my coveted provider card it was with the mindset that my newfound skills were the catalyst towards changing dismal outcomes for the better. To say I was excited was an understatement.

After my EMT graduation I was off to “the city”. (For those of us who live in the outer boroughs, that means Manhattan). For the benefit of us newbies they held a “roll call”, where the lieutenant addresses everyone at the shift and gives out the unit assignments. On the following days things went back to normal and we just showed up, got our keys and left. But on day one the lieutenant apologized to me saying he had no choice but to put me with the only person available. The EMT I was supposed to have been paired up with had called in sick and this man with the vacuous eyes and ill-fitting uniform was the only one they could put me with. “Any problems,” the lieutenant told me, “you call me up right away. Keep your eye on this guy. And don’t be afraid to snitch. I’m expecting a phone call.” Great.

I discovered I had been paired up with “a skell”. This is someone who is lazy and takes unnecessary shortcuts. (There was also a term “skell” for the patients which had a slightly different definition). The naive, idealistic me was nervous and scared. I had no idea what to expect from a terrible partner. This wasn’t what had been sold to me at the EMS Academy. I expected equally enthusiastic coworkers. We were ‘saving lives’. How could you not be 100% into this? Instead I wondered if I would I be fired on my first day. Why would they do this to me? But also, how bad could it be?

Our first call was assigned, a cardiac arrest. I was going to use my CPR card! I was going to ‘save a life’! Right out of the box. It was exactly how my new position had been described to me. I was going to a high priority call to help someone in need.

My partner, however, hadn’t had his coffee yet.

Prior to firing up the lights and sirens he stopped at a local deli and in the most nonchalant tone ever asked me if I wanted a cup of coffee. I was astounded. “No!” I said. “We have a job! We are going to an arrest! Seconds count! We need to go! Now!”

“Well I’m getting a cup of coffee.” he stated. After was seemed like hours he emerged, cup in hand, and off we went, finally. “I like to drive holding my cup,” he said, “that way no one thinks we’re using the siren to get coffee. I can show them I already have it.” He laughed and took a sip, with enough practiced skill that it didn’t spill despite the bumps and swerves of our emergency response.

My initial consternation with my partners lackadaisical attitude was cut short when we arrived at our destination and my idealism took an even bigger hit. Our call had taken us to Chinatown and into a rundown building where our patient was on the fourth floor of a walk-up. It was a dingy and depressing looking apartment with bunkbeds and cots in every room. There was nothing on the walls and the windows were covered with sheets duct-taped to the frame. The centerpiece of the kitchen was a dirty bathtub, which I would come to find out later was not uncommon for many apartments on the lower East side. The paramedics were already there, having not made a pitstop en route for caffeinated beverages. They were working on an older woman who was laying on the floor of this relatively small apartment inhabited by at least 20 other people. A young boy stood nearby with a look of panic and sadness and it caused me to become slightly unfocused. My partner directed me over to the BVM where I would be providing artificial ventilations. His cavalier attitude had been completely transformed as he spoke to me both professionally and with patience. He seemed empathetic towards the emotional reactions I was, apparently, doing a poor job of hiding. The little boy was crying. For me this was just one of many cardiac arrests to come, for him this was his whole life. Everything he had and the direction of his life were all on the line here. To make matters worse things did not seem to be improving for this woman. Cardiac arrest is a very, very difficult thing to reverse.

The paramedics who were administering the drugs and watching to monitor were also kind and seemed to have a great deal of respect for my partners skills and experience as they bantered back and forth. The whole scene in my memory seems very surreal looking back. So much was going on and yet it seemed to be moving in slow motion. There many people standing around, watching, making my first foray into real CPR a bit unnerving. Also, as this was my first cardiac arrest, my first call altogether, I was unfamiliar with how casually emergency medical providers do their jobs while holding mundane conversations in the midst of someone else’s tragedy. It was something that I would soon take part in myself. No one was dismissing the seriousness of situation or being unsympathetic towards the family, (or as it turned out, living companions who barely knew each other). It was just normal to make conversation at work. It was just that our workplace was someone’s home and our job involved a dying woman.

As I squeezed the BVM to push air into this woman’s lungs I couldn’t help but be fixated on the young boy watching intently with hope and tears. He didn’t speak English. No one in the apartment did. A translator was found in the building somewhere and even her ability was limited. After putting a few snipets of information together it was discovered that the woman was the only relative the young boy had in this country and it was questionable if there were any family left in China. No one else in the apartment knew the woman. It was a mutually beneficial living situation for everyone there to share space and meals but people came and went frequently and most of the residents barely spent more than a few hours at time at the apartment, usually just coming to sleep in between different employment situations. My thoughts were with child and wondering what would become of him should the woman not survive, a circumstance that grew more likely with each passing minute and eventually actualized. Would any of the others there take him under their wing? Would he get sent back to China? Did he want to go back to China? I would never find out but I think about it often, actually. We were both thrown into an unpleasant reality that day, made to realize that everything can change and not always for the better.