The EMTs: The Island’s Emergency Medical Service Providers

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Left to rt: Mike Salvatore, Paramedic; Eric Hunter, Paramedic; Trulayna Rose, Paramedic; Capt John Gonsalves, Firefighter/EMT — Photo by Lynn Christoffers

It’s one of those things we’ve almost grown to take for granted: You can call 911 at any time of the day or night with a medical emergency, and in next to no time (even though it can seem like an eternity) an EMT or paramedic is at your door. Here on the Island we are fortunate to have a superb team of EMS professionals who work closely with the hospital and our local fire and police departments.

Each of these people has had extensive training in emergency medical procedures, as well as in handling patients in trauma. But at the end of the day, they’re only human, and working in such a stressful environment can be very demanding.

We sat down with five Island EMS professionals to talk about their work, how they got into it, what they get out of it, and what it takes out of them.

Jim Osmundsen, Tri-Town Ambulance; lives in West Tisbury;

EMT and President of Martha’s Vineyard Association of EMTs

On becoming an EMT

I took my EMT course in 2007. I guess it was something I always wanted to do, but didn’t have the time, as I had a corporate job which required travel. I didn’t really have a career pathway: My career happened; I just fell into one thing after another. If I had a different opportunity, I probably would have gone to medical school; for me, the EMT training was the next best thing.

The EMT shift and 911

When someone calls 911, the call goes to the Com Center at the airport, and the call will be dispatched to the EMS according to the location of the problem. If I’m on call for that shift and the call is for Tri-Town, I will be called. The Com Center will give the address and description: “Respond en route to scene … trouble breathing.” The general rule is if you are responding to a call and are not at the station, you go to the station in the town nearest the scene to pick up an ambulance (unless your partner is already with the ambulance). You’ve got to be able to manage the truck, find the scene, the patient, communicate on the radio, and work in the back with the patient following your protocols.

Biggest challenges

Weather always plays havoc: When we have icy or snowy conditions, it increases our response time and creates potential hazards for patients and crew. Last year we had a heavy snow when we had an early-morning call for a suspected gas leak. The ambulance got stuck at one point. No one was injured, but what a mess up those back roads in Chilmark.

Six degrees of separation

One thing I tell students on the Island — you’re often going to know your patient. Like the six degrees of separation. It may be a cousin of a friend, your girlfriend’s mother, or your neighbor who you care about … and you need to perform as a professional.

Frequent flyers and friends

The other thing that happens is that you are going to have frequent flyers: people who call the ambulance on a regular basis. About six years ago, we were responding to calls from a person regularly. I watched her progress through her illness. The last time I took her to the hospital, I didn’t think she would make it, and I was right. To see a patient over time, dying … I saw her die in pieces. That was tough.

Brazilian EMTs

I had a heavy science background and a leg up on the vocabulary. But it’s such a challenge when English is a second language. We need more Brazilian-speaking EMTs on the Island. For most Brazilians, English is their second language, and they have to study twice as hard to get through all the testing because the exams are in English.

Hadley Antik, Edgartown Fire Department; lives in Vineyard Haven; Paramedic/EMT

Early training and skills

I took the EMT course here on the Island when I was in high school. After high school I moved to the Amherst area, living next to a golf course. One snowy day a woman came knocking at our door in distress: She had taken her adopted children from Ethiopia sledding, and they hit a gigantic post; the young girl had a broken leg. Neither child spoke English. The little boy bonded with me. I couldn’t leave this kid who was scared to death — the kid trusted me. I had never met these people before, but I ended up going to the hospital, helping out in the back of the ambulance, drawing on my EMT training from high school. One of the paramedics in the back with me said, “Do you do this for a living? If not, you should.”

EMS lessons at Edgartown School

I work over at the Edgartown School for community outreach. A couple of us go over once a week: We hang out in the cafeteria when they are eating, or in physical education class. We feel that by the children getting to know our faces, in the event that their family had an emergency, they would feel a little more secure seeing us walk through the door.

The other big thing that we are pushing right now is that kids know a parent or guardian’s phone number and their physical address. A lot of grandparents are living with their families these days, and the occurrence of strokes and heart attacks is prevalent. Little Johnny may have to deal with a grandparent’s stroke, and he needs to know to call 911 and give his street address.

Trauma and counseling

I started working in this field when I was 20 — 18 years ago. I think anybody who can sit in this chair and say, “No … I haven’t had nightmares” — I think they are full of beans. There’s always counseling offered should one need it. If we are bothered by an incident in the field, there is a counseling team off Cape Cod that comes over just for that, scheduling a closed-door session. It allows us to say that this is bothering me — I keep seeing that kid’s face, or that mom screaming in pain since she lost her loved one.

Turning it off

When I first started this job, I wore my pager all the time. Now that I’m into this for 18 years, I have the ability to truly put myself on off-duty. It’s important.

Future on the Island

For right now, EMS service works for me. I’m not done yet. I like to take inventory and make sure I know when I’m done — right now I’m not. I like helping people, and I feel like I’m good at what I do. It’s definitely rewarding. It’s a good experience, and it’s a way to help your community in a changing world, that’s for sure.

Trulayna Rose Oak Bluffs Fire Department; lives in Oak Bluffs; Paramedic/Firefighter

Hospital transports

In Oak Bluffs it’s a little different from other towns, because we transport patients off-Island to other hospitals from our hospital. We have four ambulances, so our crew is a little bigger. I’m a shift commander now, so I don’t do transports as often, but for 10 years prior, that’s all I did. In the winter we have more hospital transports than 911 calls.

911 and Com Center

When a call is made to 911 from a cell or home phone, it goes to the Com Center at the airport — they take all the calls. Police calls, fire calls, EMS, animal control center … they call us once they’ve determined the dispatch and if it’s for our area; they give us the address and the problem. Working at the Com Center can be stressful; the worst part is when you hang up, you never know how that patient made out.

A family of firefighters

As a child, I always played the doctor when my friends fell off their bikes. I wanted to be a doctor. My mom was a nurse, my dad was on the fire department, my brothers are both firefighters, it’s always been a part of my life. That’s how fire departments are formed: generation after generation.

File of Life

As firefighters and paramedics, we are here to help, and we try to educate as best we can. When we respond to a call, if the person doesn’t have a File of Life I give them one from our ambulance. It’s very important for people — particularly those who live alone, or the elderly — to have a current File of Life posted on the refrigerator or in a visible place in the house. The File lists all important information for the medical staff: Name, date of birth, phone number and address, medical history including current medications, and any allergies. A good portion of our calls are from the elderly, especially in the wintertime: Lots of seniors gets sick with pneumonia and flu. Often they live alone, so the File is extremely helpful.

Days off?

Quite often on my days off I actually work in the other towns. Yes, it’s something, I do work a lot. I mostly work in Edgartown on my days off. I also fill in here and there for Tisbury and Tri-Town. I’ve always had this huge work ethic and had two or three jobs — work, work, work! But sometimes I do get exhausted. If I have a day off, I’ll hang out with my godchildren or my nieces and nephews. For me, relaxation is being around them. I don’t get to see them that often.

Biggest challenge

I would have to say, my biggest challenge is change, only because I’ve been here so long and have experienced the family atmosphere. People come and go. It’s kind of like watching your family leave you.

Max Moreis Tisbury Ambulance Service; lives in Oak Bluffs; Paramedic

Youngest paramedic

I am a full-time paramedic for the town of Tisbury. I’m active with the other three town services as well. At age 22, I am the youngest and newest paramedic on the Island.

Family

I was born and raised here on the Vineyard, and took the EMT basic course while in high school. I went to college in New York for two years and graduated with an associate’s degree, and I did my paramedic program in Cambridge. I found EMS work interesting. I had an uncle and an aunt who were EMTs and paramedics, several firefighters in the family, and an uncle in the police department. It seemed a good fit; I‘ve always liked helping people.

Culinary arts and stress

I initially went to school for culinary arts. Ever since I was 6 years old, I thought I would be a chef. But even though I love to cook and eat, I found the kitchen job to be incredibly stressful — more stress than what I’m doing now.

The Disney experience

As a paramedic, every time I have a patient in the back of the ambulance I try to give them that Disney experience. Most of our patients call 911 on the worst day of their life.

If the EMT or paramedic doesn’t try to lift the patient’s spirits and make the patient feel better, they aren’t doing done their job.

City calls/Vineyard calls

I did all my time for clinicals and internships in Boston. These people were very experienced, phenomenal providers, but with that experience comes a certain mentality: that I’m here to do 100 percent the best medicine, but not here to hold your hand.

On the Vineyard that’s not the case. The Island is surrounded by people who want to help in every way possible. We’ve learned this from instruction from our Ambulance Coordinator Tracy Jones, who is the most compassionate EMS provider. I’ll be lucky to have half of that compassion for my patients going forward.

Teaching kids

I have a couple of things I’d like to implement for EMS, both in Tisbury and Island-wide. There’s been a movement to train kids as young as 12 years old to learn hands-only CPR, and basic first aid for life-threatening injuries. I would love to start implementing much more community-based training of this sort, starting by working with the Tisbury Middle School.

Seniors and the community

Also, I’d like to work with senior centers, getting seniors more familiar with their medications and Files of Life so there is less confusion should an emergency arise. We might have one paramedic on duty for a day going around to people’s houses to point out a few safety things. Throw rugs cause thousands of broken hips a year, and we encourage households to put down a nonslip mat in the shower; doing this could take 20 minutes, and save them thousands of hours in ICU.

Ben Retmier  Tri-Town Ambulance: West Tisbury, Chilmark, Aquinnah; lives in West Tisbury; Ambulance Chief and Paramedic

Three towns

Tri-Town Ambulance serves West Tisbury, Chilmark, and Aquinnah. Each town pays a third of the total budget, and all get the services.

Becoming a paramedic

I was in EMT basic school in 2007 with Jim [Osmundsen]; we started together. While there, I discovered, “I really like this … this is what I want to do.” At the time, Martina Mastromonaco was our Tri-Town coordinator. I steadily wore her down asking to learn more, and she decided to send me to paramedic school in 2009.

Three levels

There are three levels of EMS: EMT, advanced EMT, and paramedic. Jim went the instructor route. I went the paramedic route. Paramedics do everything that the EMT does; in addition, we provide IV access, we can administer 50 medications, interpret cardiac rhythms, we can do advanced airways — all of what we do is pre-hospital. We bring the ER to your door. We do a lot to stabilize, to get you ready, then transport you to the hospital. There is always a paramedic on duty in all towns.

Community outreach

On the Island, we live in a small community where we know each other. People will come up to me and say, Thank you, thank you for taking care of my mother or my brother; EMS is very rewarding in that sense. I love the feeling when I know that I’m making a difference.

Trauma and burnout

It is often a grim experience for us. There have been times when it’s been difficult. I’ve been doing EMS work for almost 10 years now. Yes, it’s Martha’s Vineyard, but you still see bad things. The summer before last, there was the fatal moped accident on South Road, and it was tough. I went home that night, and for whatever reason, my girlfriend and I started talking, and I just cried for about two hours.

Coaching youth hockey

I started coaching youth hockey as a kind of way to separate my life between work and other activities. I was getting close to that burnout stage, I could feel it. Lots of my friends are in EMS. My girlfriend is not in EMS, but also is in a public service role. It’s great that I have the youth hockey to help take my mind off of things.

Biggest challenge

As chief, the hardest part of the job for me is the political side: maintaining the coordination with the towns, keeping good political relationships, and managing the personnel.

As a paramedic, for me the hardest thing is maintaining my knowledge. I want to be the best when I’m in the field, staying up-to-date with current knowledge and staying on the cutting edge of emergency medical services.

The future

I am 31 years old. I can see me staying in EMS until I can’t do it any more. I love it because I never know what I’m going to do the next day — I love coming in not knowing what’s going to happen that day. I’m in it for the long haul.