Paramedics’ Pace Ruled by Affairs of the Heart : Aid: Leisure World cardiac cases help make Laguna Hills rescue station one of the busiest in the country.

When the alarm rang a little after 10 p.m., Bill (Doc) Lockhart gulped a forkful of pie and left the rest on his plate as he trotted to the red van. Sirens blaring and lights flashing, he sped to the next emergency.

With two years under his belt, Lockhart, 34, is one of the senior paramedics at Orange County Fire Station 22 in Laguna Hills. Most paramedics who arrive rapidly suffer burnout and request a transfer.

That is because the station--which serves the gated retirement haven of Leisure World and the burgeoning communities of Mission Viejo, Aliso Viejo and Lake Forest--has the busiest paramedics in the county. Last year they answered 4,108 calls, more than any of the county’s other 56 medic units. Nationally, the station’s paramedics ranked 13th, trailing only units in large cities such as New York, Chicago and Los Angeles.

The station is unique because it fields an enormous volume of calls but does not serve a high-crime, low-income area. Its forte is geriatric medicine, especially cardiac cases. “These are guys who can read EKGs from across a room,” an admirer said.

Lockhart, who had reported for duty at 8 a.m., would make 17 emergency runs before his shift ended the next morning, when he would begin a second 24-hour shift to fill in for a friend. Then on Friday he was scheduled to work yet another 24 hours for Lifeflight, a private helicopter emergency medical service.

A bachelor who became a paramedic in 1978, Lockhart relishes his fast-paced life, even if he gets little sleep the days he works and even though his colleagues jest that two years ago his rising forehead sported a full head of sandy hair. “I still love it,” he said. “You just adapt and keep smiling and keep going.”

Lockhart’s zeal inspires such others as Matt Holke, 30, who graduated as a paramedic seven months ago and recently asked to be stationed in Laguna Hills. “This is the place to get experience,” Holke said.

Holke and Lockhart worked as a team on a recent Wednesday at Station 22. Although they were the only paramedics among 13 firefighters at the station that day, the others could be depended on to lend a hand.

But emergency medicine, Lockhart said, is “where the action is” at the station, because 80% of the calls are of a medical nature.

One of their first calls that day was from a board-and-care home in Laguna Hills. Soon Lockhart and Holke, assisted by three firefighters, were huddled over a 92-year-old woman stretched on the floor of the living room. She was incoherent and barely breathing. They gave her oxygen, monitored her vital signs and listened to the concerns of the workers at the home, who said the woman’s health seemed to have been deteriorating for a month.

The woman was lifted onto a stretcher and transported by a private ambulance to Saddleback Memorial Medical Center. Holke climbed in beside her and advised hospital personnel about her condition via a mobile telephone.

By midmorning, the Saddleback emergency room was filling with patients that the men recognized. One elderly woman waved at Lockhart from her steel bed, and he hurried over to say hello to Virginia, one of his regular patients who has become a friend.

Virginia quizzed Lockhart about how she wound up on the floor of her Leisure World kitchen. “You got dizzy and fell against your kitchen cabinet,” Lockhart said, adding that watchful neighbors had summoned help. Before Lockhart left her side, Virginia, a Louisiana native, promised him a Cajun recipe--if he would please stay in touch.

Lockhart said he has learned how loneliness can ravage the elderly, who frequently call 911 in the middle of the night as much for companionship as for medical attention. “Sometimes all we do is go out and hold hands,” he said.

That afternoon a paramedic trainee joined Lockhart and Holke on their rounds. Field experience is part of the intensive six-month training of a paramedic. Lockhart said that trainees are eager to learn the medical side of the job but that he tells them about the important human side too.

The van screamed out of Station 22 on the outskirts of Leisure World to a call in Mission Viejo, but some of the older motorists seemed oblivious to it and did not pull to the side. One hulking car hugged the fast lane at a snail’s pace.

“A lot of people drive around here thinking right of way is determined by seniority, so we don’t try to stress them and just go with the flow,” Lockhart said, smiling, as the van melded in with traffic.

The call was for a woman with stomach pain. After a quick check, they accompanied her to the hospital. Then it was back to the station.

After a quick lunch of pasta salad, another bell sent the paramedics to Beverly Manor, a convalescent home, where an 82-year-old woman was in full cardiac arrest. After drugs were administered, she seemed to be coming around. Then her pulse vanished. Only a flicker of life was reflected on a heart monitoring tape that the paramedics handed to emergency-room workers at Saddleback hospital.

Before the paramedics had time to restock their van with hospital supplies, she had died.

Lockhart, who has had up to nine patients die in a week, said he has come to realize that for some elderly people who are bedridden, death is not to be dreaded.

He fondly remembered the case of a terminally ill cancer patient he found wearing a band on his wrist that told the paramedics that the unconscious man had no interest in being resuscitated. Lockhart said the medics advised family members what to expect as death approached while they held the dying man’s hands and stroked his hair.

“At the end of it, everyone hugged each other. It was perfect,” Lockhart said.

Harder to accept, Lockhart said, are the deaths of children. He recounted his first harrowing experience as a new paramedic in 1978, when he wrapped wet sheets around a toddler who had been severely burned in a garage fire. Later he would be haunted by the smell of burning flesh and how the boy looked at him “with a nonverbal scream of terror.”

Lockhart had been certain that the child, Vinnie, had died. But years later a nurse at UCI Medical Center burn unit told him that the boy had survived. Last year Lockhart got to meet Vinnie, then 13, at a picnic for former burn unit patients.

“To see he was well was so satisfying,” Lockhart said. “I’ll never forget it as long as I live. The tears were flowing from my eyes, and he looked at me like what’s the big deal?”

Such moments of professional gratification, paramedics say, make the long hours worthwhile. Paramedics also receive a $430 monthly bonus over the usual pay of a firefighter. It works out only to about $2 extra an hour. “We don’t do any of this for the money,” Holke said.

Lockhart has obtained advanced training as a physician’s assistant. But he said he has no interest in becoming a doctor, even for greater financial rewards. “I’m a pickup truck kind of guy. I could never decide what color Mercedes to get anyway,” he joked.

One of the firefighters who appeared that afternoon to assist the paramedics was Capt. Jack McFadden, a department veteran who recalled that life at Station 22 was much calmer when the facility opened in 1964--before the first homes were sold at Leisure World.

“For the first nine months, we got only six calls,” he said. “We would sit on the fence and watch sheep.”

At that time, he added, firefighters prepared for medical emergencies by bringing along oxygen and a small first-aid kit--without the cooler-size medicine box, heart monitoring gear, electric paddles and intravenous solutions that Lockhart and Holke now carry. Back then, he said, “paramedics weren’t even a gleam in anyone’s eye.”

The county’s first true paramedic unit was placed at Station 22 in August, 1973. Soon that unit had more business than it could handle.

While paramedic duty at Station 22 is hectic, it was even more demanding before another unit was placed in East Irvine in 1987 to cover part of Station 22’s original territory, which stretched south from the Costa Mesa Freeway to San Clemente.

Gordon Levine, who was a Station 22 paramedic back then, recalled that at about 4 a.m. during one particularly strenuous shift, he and his partner asked to be pulled off the job. “Neither of us could drive anymore,” he said.

Paramedics admit that as the early morning hours wear on, their energy is sapped.

Lockhart has become adept at taking catnaps when his partner is driving back to the station from a call. The hardest thing to adjust to is going to bed at the station, only to be interrupted. After nightfall, old people lying down to sleep frequently suffer congestive heart failure, and heart attacks are most prevalent in the early morning.

With the marathon hours they put in, paramedics often go home exhausted, and that can be taxing on family life. Levine said he transferred to a firefighting unit without paramedics in 1985 after struggling during his first year of marriage to spend time with his bride. “We didn’t have a lot of time together because I would go home and start sleeping,” he recalled.

To ease the stress of their hectic work shifts, paramedics take solace in the camaraderie of other firefighters, hospital emergency room physicians, nurses and ambulance workers with whom they swap banter. Inside humor, sometimes of the gallows variety, is a universal method that paramedics use to reduce tension. Other ways of coping with stress are more personal. Holke likes to work out at a gym, while Lockhart winds down by tending to a vegetable garden behind Station 22.

As evening arrives, the paramedic calls at Station 22 get tougher. At 6 p.m. the crew headed down the wrong side of El Toro Road to beat the commuter traffic to Freedom Village, another hotel-like retirement home. There Lockhart encountered teary-eyed Mary Card of Arcadia. Two days before, the paramedics had come for her 84-year-old mother, who had died of a heart attack. Now her father, a victim of prostate cancer, seemed to be failing.

On the way to the hospital, drugs started to clear the man’s lungs and his blood pressure grew stronger. “He is doing better, but unfortunately he has a terminal condition,” Lockhart said.

About 8 p.m., just after a late dinner of enchiladas and rice, the alarm sounded once more. “I guess we have a swinger,” said Lockhart, referring to a report of an attempted suicide. In a comfortable two-story home in neighborhood of manicured lawns, a 6-year-old boy had called his grandparents when his mother had slashed one of her wrists. The terrified parents summoned paramedics.

Lockhart said the patient, who abuses alcohol and drugs, actually had barely scratched herself. But she would be taken to the hospital and probably admitted to a mental health facility for her protection.

Lockhart said he did not believe that the young mother really wanted to die. “It was a cry for help,” he said.

Throughout the day, Lockhart and Holke spoke with sympathy of the plight of their patients and their patients’ families. They said they felt the frustration of those they called the “frequent fliers,” patients they see repeatedly.

That night they immediately recognized a Latino man who had suffered an epileptic seizure in the parking lot of a Laguna Hills apartment complex. Family members standing nearby said they already owed $14,000 in emergency medical bills and begged the paramedics not to take him once more to the hospital, because his ailment can’t be cured.

Speaking in Spanish to the family, Lockhart allowed the father of the epileptic man to sign a “waiver” so his son would not have to take another ambulance ride.

Lockhart said his work has taught him to be grateful. “Our lives are good,” he said “We have nothing to complain about.”