ER on Wheels

They are startled awake in the earliest morning hours and within minutes are racing toward a car crash site or heart attack victim.

This is the life of a paramedic.

“We literally bring the emergency room to the patient,” says Tom Gallegos, 32, a paramedic with Gold Coast Ambulance in Oxnard.

Gallegos and co-worker Dana Paris, 36, have been at the job for eight years. They have been called to wipe runny noses or to hold the hand of someone frightened by a bad dream. And they have fought furiously to hold onto a life slipping away.

On a recent Saturday morning, Paris stood in the hallway of the ambulance station thinking about her job. It was 7 a.m., the end of her 24-hour shift. She held a toothbrush in one hand and rubbed the sleep from her eye with the other.

“It can be hard,” Paris says, leaning against a wall. “But mostly, you feel like you are making a difference, that you are out there helping people. So losing a little sleep now and then doesn’t seem so bad.”

7 a.m. Monday

Gallegos and partner Traci Malone report to the station on A Street. They are one of several ambulance teams that will cover the cities of Oxnard and Port Hueneme on this day.

On the bottom floor of the station is a day room with a few couches, a big-screen TV, a VCR, a folding table and chairs, a phone and a refrigerator. The top and bottom floors have a number of small bedrooms.

Down the hall is dispatch.

Gallegos and Malone check in with supervisors, then settle down on a couch in front of the TV and wait.

10:30 a.m. Monday

By midmorning, Gallegos and Malone have answered three calls. They picked up a man who died during the night and took two people complaining of shortness of breath to the hospital.

Now back in their rig, ambulance No. 614, the scanner comes alive. A female ward of the California Youth Authority has stabbed herself.

Gallegos is behind the wheel. Lights flash and sirens blare; the race is on.

The first hour of a serious medical emergency, referred to by doctors as “the golden hour,” is critical for survival. Gallegos knows this and gives himself about four minutes to get to a scene.

Cars are slow to respond to the sirens, so Gallegos blasts an earsplitting horn. At a red light, several cars are stopped in front of him. He cuts a sharp left and drives over a median, putting the ambulance into the path of an oncoming car. Both screech to a halt before Gallegos guns the gas pedal and clears the intersection.

At the Youth Authority, the paramedics find a girl on the floor with a 2-inch gash in her stomach.

Gallegos examines the wound and tries talking to the girl. He begins with the four questions asked of every patient to determine the level of alertness. Fully alert means you know where you are, what day it is, your age, and your name.

“How old are you?” he asks.

The girl is conscious, but only blinks in response.

Malone gives it a try. She strokes the girl’s long, dark hair.

“You need to talk to us, OK? When is your birthday?”

“July,” the girl whispers. She is 20.

Gallegos is worried about the seriousness of the stomach wound.

“A lot of major organs around there,” he says, while attaching heart monitor pads to the patient’s chest. “We need to get going.”

Inside the ambulance, Gallegos starts an IV, while trying to get information from the patient that will be critical for doctors.

He learns the cut was made by a 10-inch kitchen knife and the girl has two stab wounds. She is not on any drugs, and it’s not her first attempt at taking her life.

As he talks, Gallegos works, giving her oxygen and reaching for needles, medication, gauze. He braces himself as the ambulance speeds over bumps and around curves.

Gallegos calls ahead to the hospital and relays the facts he has learned. Her abdomen is soft, the wound is dressed and the ambulance is five minutes away, he says.

They drop off the girl, fill out paper work and scramble back into the ambulance to restock and prepare for the next call.

11:45 a.m. Monday

In this line of work, time to eat is a luxury. Most paramedics keep a stash of granola bars or fruit to carry them through frantic days. But with the scanner quiet, Gallegos and Malone decide to grab lunch.

“Where should we go?” Gallegos asks.

“Somewhere fast,” Malone says.

She is the less-experienced of the two, having worked only a year as a paramedic.

In line ordering tacos, Malone talks about her job. Like all paramedics, she began as an emergency medical technician--responsible for rendering basic first aid but not licensed to administer drugs or start an IV.

“I wanted to do something with my life that was meaningful,” Malone says. “And this was something I became passionate about.”

After five years as an EMT, Malone went back to school and became a certified paramedic. There is pride in her voice as she talks about her job, but she has made plenty of sacrifices.

Emergencies occur around-the-clock every day, so paramedics work nights, weekends, Thanksgiving and Christmas.

“This is a young person’s profession,” says Gallegos, who is not married and has no children. Despite his love of the job, he is thinking of returning to school to become a medical assistant. It may not offer the same adrenaline rush, but the hours are more stable.

Back in the truck with tacos in hand, the radio crackles with another call, and ambulance 614 screeches onto the roadway.

“That’s why we get this stuff to go,” Gallegos says.

12:15 p.m. Monday

The call is for a man with an “altered level of consciousness.”

“That could be anything,” Gallegos says. “You can hear one thing on the radio, but you never know what you’re going to find inside.”

At the apartment, the pair find a frail, 72-year-old man in bed. He is staring at the ceiling and humming loudly. His daughter says she found her father sitting in a chair drooling. When his eyes rolled back into his head, she called 911.

Gallegos grabs the man’s hand and tells him to squeeze, but he doesn’t. He is Samoan, and though he speaks fluent English, he is now responding only to his native language.

“Squeeze his hand,” his daughter tells her father, and he does.

The paramedics suspect the man may have suffered a stroke. They scoop him into the ambulance and rush to the hospital.

En route, Gallegos struggles to insert an IV, but the man pulls away, smacking at the tubes protruding from his arm.

“No, no, don’t do that,” Gallegos says, in a patient but firm voice. “I know it hurts a little, but we have to, OK?”

The man calms down as the ambulance pulls into the hospital.

Later, on the way back to the ambulance, Malone learns that the stabbing victim from the morning is in surgery. The knife wound was deep.

“She nicked her liver,” Malone says. “Really, really sad.”

1:20 p.m. Monday

Back at the station, the two turn their attention to their now cold tacos. Other paramedics crowd the TV room, some watching a History Channel program, others reading the paper. A 21-year-old EMT has her head buried in a thick training manual, preparing for a test that will allow her to use the defibrillator--a device that emits shocks to jump-start the heart.

Paramedics and EMTs endure regular rounds of tests and continuing education classes to ensure that their medical skills stay sharp. And once a month, they have map drills.

“You have to know your way around,” Malone says. “You have to know how to get in fast and then find your way back out again.”

Malone is still eating lunch when a Code 3--a top priority emergency--is announced over the station’s loudspeaker. A man with chest pains. They are off.

3:55 p.m. Monday

An hour after dropping off the heart-attack victim, Malone and Gallegos are sent to see about a disoriented woman.

An elderly woman, struggling to slip on a housecoat over her clothes, greets the paramedics at the door.

“What’s the matter?” asks Malone.

“If I knew that I wouldn’t need to go to the hospital to find out, would I?” she snaps.

“What she means,” says Gallegos in the kind of soothing voice usually reserved for children, “is where are you hurting?”

“I’m dying,” she says, groaning. “I feel like I’m dying.”

“Do you hurt anywhere in particular?” Gallegos asks.

“Does it matter?” she responds in an irritated tone.

“Actually, it does,” Gallegos says. “That’s how we know how to help you.”

The paramedics decide to take her to the hospital, but she is reluctant to go. She has a wheelchair-bound and senile husband inside the house. A neighbor promises to look after him.

On the ride to the hospital, Gallegos learns the woman is 90 years old, but she can’t say where she hurts. She can’t remember her birthday or when she had her last meal. And she doesn’t know who called paramedics.

“Well, how do you feel now?” Gallegos asks.

“Very comfortable,” the woman replies, then adds, “I think you are a very beautiful man.”

Gallegos laughs.

“I can’t argue with that.”

*

It’s been a typically busy day for Gallegos and Malone, but the night is just beginning. Some evenings are quiet and paramedics spend their time around the television. They often share stories about their daily runs, all the while joking and teasing like family members.

On a recent Friday night, Paris had co-workers laughing to the point of tears retelling stories about the more risque calls she has answered.

There was the time, for instance, she treated a feverish woman, whose family had slipped slices of bread into the woman’s undergarments. Relatives thought the bread would “soak up” any evil spirit causing the illness.

“Just when you think you’ve seen it all, . . . “ Paris begins.

”. . . out drops a sandwich,” Gallegos finishes, prompting more laughter.

By 11 p.m., the paramedics head for bed, but just as lunch and dinner are never a guarantee, neither is sleep. Even on a quiet night.

“I just don’t let myself go into a deep sleep,” Gallegos says. “I can’t. You’re always expecting that call.”

On this night, Paris and Gallegos, who are partners, room next door to each other. They sleep in shorts and T-shirts, their paramedic jumpsuits and boots on the floor within arm’s reach. Lights go out. Soon, the sound of soft snoring echoes through the hall.

1:15 a.m. Saturday

Overhead lights flick on, illuminating the rooms with a bright intensity. “Code 3,” announces the dispatcher on a loudspeaker.

Within a few seconds, the paramedics are running down the hall and jumping into their ambulance. Paris blinks hard to wake herself up and listen to the radio call. Gallegos is behind the wheel.

A minivan has collided into a parked semitruck loaded down with new cars.

In minutes, Paris and Gallegos are at the crash site and talking to a 17-year-old girl still strapped into the van’s passenger seat. She has a few cuts and complains of neck pain. She is shaking, and Paris tries to calm her.

“I don’t want you to move, OK?” Paris says. “We’re going to take you to the hospital.”

Firefighters on the other side of the van work to tear apart collapsed metal and extract the girl’s 20-year-old boyfriend from behind the wheel.

He is out in minutes. Gallegos and Paris strap both victims onto gurneys, load them into the rig and head for the hospital.

The entire call is over in less than an hour, and then it’s back to the station. They rest until their 6:30 a.m. wake-up call, when it’s time to dress, brush their teeth, clean the ambulance and hand it all over to the next crew.

The dispatch room is usually still about now. But soon, it starts all over again. More calls about chest pains, traffic accidents and suicide attempts. But no call is routine.

“It’s always something different, something interesting every day,” Gallegos says. “That’s one of the rewards of this job. The good always outweighs the bad.”

About This Series

“On the Job” is an occasional series about working people in Ventura County and how their lives have been shaped, challenged and enriched by what they do.