ride, Sally, ride: mrtsa

This story is first in our new online series Ride, Sally, Ride, where writer Sally Bucey will accompany municipal employees and agencies as they do their important work.

“How are you?” asks Richard Weisner, an emergency medical technician with Medical Rescue Team South Authority (MRTSA), as he checks the vitals of the man, who has just woken up from a very deep slumber. “Not good,” the 89-year-old says with a smile and a chuckle from the comfort of his pale blue recliner. Then, a change of mind, common for dementia patients: “Everything’s good,” he reports—giving a thumbs up. His wife, only slightly younger, wasn’t able to wake him this morning. She called 911 and is palpably worried, rubbing her hands together while talking to Weisner’s partner, paramedic and Mt. Lebanon resident David Terkel. An old photograph of a young couple on their wedding day sits on the table next to her, seemingly watching the drama unfold. When Weisner taps the elderly man on the shoulder, though, he wakes up—albeit with a start—and is responsive, has no pain, and seems in decent health, considering his situation. His wife still decides on a trip to the hospital to make sure everything is okay. The patient, in a cheerful mood and oblivious to what’s really going on around him, agrees. “Why not?” his grinning expression seems to say.

web-exclusive-logo2Loaded into the stair chair (we have two flights of stairs to get down), he exclaims “Wheeee! Oooooh!” as he’s tilted 45 degrees backwards to begin the descent. Later in the day, back at the station, this spurs a new round of jokes about emergencies only happening on the third floor or attic, which contributes to the hundreds of pounds MRTSA employees lift and handle during each eight-hour shift. Even the bag of essential supplies carried into every call weighs 40 pounds.

What’s in that essential bag? A clipboard, machines that monitor pulse and blood sugar, an IV start kit, non-narcotic drugs like naxolone, which will pull people back from opioid overdoses, and dextrose (sugar) for diabetics, “convenience bags” for vomit, a sharps container to house used needles, soft-tissue injury supplies like tourniquets, and a terrifying drill that’s used to deliver medicine and fluids straight to an unconscious patient’s system through the bone marrow, when their veins aren’t reliable. Cardiac arrest is a common reason to bring out the drill, and as Weisner turns it on, my stomach flips at the thought of drilling into someone’s shin bone, a common point of entry. It’s still pretty early into my ride-along, but I’m already sure: I would not be cut out for this job.

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Mt. Lebanon’s fire department and MRTSA responders work together to bring an older person with dementia down his steep driveway and to the ambulance. The fire department is often the first responder in an emergency.

Weisner and Terkel, the team I’m following around today, certainly are, though. Terkel is a veteran paramedic in his 19th year of service with MRTSA, while Weisner started as an EMT in 2004, after 21 years of firefighting in Castle Shannon and Dormont. EMTs aren’t authorized to start IVs or give medications and work side by side with fully trained paramedics. MRTSA employs 15 full-time paramedics, 8 full-time EMTs, and more than 20 part-time staff members. They operate in Baldwin Township, Castle Shannon, Dormont, Green Tree, Mt. Lebanon and Whitehall, and as I’m about to find out, any other community that calls in for backup.

Terkel’s phone blares and the Active911 cell phone app alerts him of another emergency. This one isn’t in the neighborhood; it’s a mutual assistance call from the City of Pittsburgh.

We jump in the truck and head for Mount Washington. It’s MRTSA’s 1,099th call in 2015. The nonprofit averages about 10,000 calls a year. The city of Pittsburgh, on the other hand, is already on number 6,471; it’s not a surprise that they call in for assistance from the outer boroughs from time to time. Weisner drives and Terkel sits shotgun, reading the call information off the monitor as we make our way down West Liberty Avenue. The truck is outfitted with Wi-Fi, enabling the laptop to live-update as needed or receive calls while Terkel or Weisner are out on a call. We follow the GPS and park behind a fire truck—firefighters are always the first responders to a 911 call in the city.

The young male who called in, feeling faint, dizzy and generally sick, is well enough to walk onto the truck, but it’s easy to see that moving around is an effort for him. Three days of fever and sickness has left him weak. As we take off to Children’s Hospital, where he’s requested to go, he answers Weisner’s questions: “What’s your address? How many days? Have you taken any medication? Any dizziness?” Vitals taken, symptoms recorded and contact information out of the way, Weisner asks for the most important part: the man’s signature. Without it, MRTSA doesn’t get paid.

While it seems unnecessary to  call 911 when a patient is just sick, it’s a necessary part of MRTSA’s budget. Without those “nonessential” calls, there wouldn’t be enough operating budget to keep paramedics and EMTs on staff for more serious emergencies, like heart attacks and in especially grim circumstances, shootings and stabbings. Weisner unfortunately knows those circumstances better than anyone would like. “I was on call for the LA Fitness shootings.” I don’t probe him for details, because his face, sepulchral and somber, says it all.

“It’s a stressful job. There are times when you’re never caught up,” Terkel says. As Weisner types a report from our first run, the key taps echo in the background. Each report requires exquisite detail—which part of the body had what injury, and to what degree–and often takes half an hour to complete, even for simple calls. The notes Weisner types on each page are the most important part; they enable him to remember details about the scene and event, because with MRTSA’s 20 to 30 calls a day, it’s easy to lose track. “You relax when you can. If you get downtime, you have to take it,” says Terkel. Paramedics and EMTs might go from one call to the next, not coming back to headquarters until their shift ends, or they might spend several hours waiting for their alarm to go off.

You never know with this job.

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Moving the patient from the stair chair into a stretcher is a multiperson job and one of many times EMTs and paramedics use their lifting skills.

But, unlike police and firefighters, Weisner says it’s not a “cool job.” Elementary students tour the station each year, but are often antsy in the MRTSA offices, too excited to see the police and fire stations slotted for later in the day to really pay attention to the paramedics or EMTs on staff. Most of the magic of MRTSA doesn’t happen in the office, anyway, though—the break room looks nothing like the scene of an emergency, the real bread and butter of their job. They may lack  romantic appeal, but they’re nothing less than heroes to the people they serve and sometimes save, and much more than “ambulance drivers.” Terkel laughs. He received the 2014 Chief’s Award this past December for displaying dedication, resolve and initiative and is part of several special-ops teams, like the South Hills Area Council of Governments Technical Rescue Team and Allegheny County Hazardous Material Medical Team, who are called in separately for specialty rescues. He knows well that MRTSA is more than just a bunch of ambulance drivers.

Thankfully for me, though, even heroes need a break. After each patient is safely shuttled to a hospital, either the closest one or his or her hospital of choice, checked in with hospital staff and successfully moved into a hospital bed, Weisner and Terkel restock their supplies. First up are the stretcher linens, found on a shelf around the corner. Old blankets and sheets are dyed purple to differentiate them from hospital bedding; Weisner grabs a few and remakes the stretcher for the next patient. Next up is the break room. Not just a place to rest up and grab a bit of food or drink, the rooms are stocked with medical supplies for the trucks, like non-narcotics, IV starter kits, cotton masks, and a sea of other plastic-wrapped packages I’m woefully unfamiliar with.

While walking into Children’s Hospital’s break room feels like I’ve just walked into a closet someone forgot existed—an empty cardboard pack of Pepsi sitting on a shelf next to a few remaining Mountain Dews and not a snack in sight—the break room at St. Clair Hospital feels more equipped for humans. I make instant oatmeal around lunchtime and Terkel, suggesting I stir peanut butter in it, shows his additional expertise in packing energy-filled calories into quick foods. Once again, I’m reminded: you never know when you’ll need to jump right back into the truck and run to the next call. This time, though, I finish my peanut butter oatmeal in peace and we head back to the station a few minutes later to write up the report and catch those precious moments of downtime before the next call comes in.

Shortly after we get back to the station after the second call, Terkel’s wife and daughter arrive for a quick visit. “It’s a joy in my day if they stop by,” Terkel bounces his 21-month-old a little bit on his lap. She quickly squiggles off and waddles around the room, while Terkel and his wife discuss Valentine’s Day art projects for their 11-year-old son, Noah, a fifth-grader at Jefferson Elementary School. Weisner also has family at home in Baldwin Township. He describes his 5-year-old son as “very intelligent” and good with computers. Their jobs often take them away from normal family life, though, Terkel confesses. “You miss birthdays, anniversaries… you can’t plan anything. The day you have plans, they’re ruined. But it’s nice because when I’m home, I’m home.” Off-duty paramedics and EMTs aren’t called in for anything less than a catastrophic event. And when they’re on duty, they also can’t leave for anything less than catastrophe.

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Paramedic David Terkel and EMT Richard Weisner

I ask Terkel and Weisner why they chose these jobs; they don’t really have clear answers. Weisner said he enjoyed working with EMTs while he was a firefighter, and decided to switch. “I just liked it.” Terkel, on the other hand, fell into the job. He used to work at a restaurant and a coworker had an EMT textbook. After flipping through it, he decided to try it out. Now a paramedic and long-time MRTSA employee, there are hundreds of patients he’s helped. “It was sheer chance.”

The shift ends quietly—a call comes in but is dispatched to MRTSA’s Green Tree station—and I bundle up and walk out of the station hungry, but not for knowledge. My brain is stuffed with information, novel experiences and a new perspective on what it means to be a paramedic and an EMT. While I may not be able to do much myself in the next medical emergency I encounter, I know that when I call 911, it’ll be paramedics and EMTs like Terkel and Weisner who come running. And I know that without a doubt, I’ll be in good hands.


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