How did you get into EMS?
BG: When I was in Norwich University in Northfield, Vermont, I volunteered with Northfield Ambulance Service while I was in school. I enjoyed helping people and being on the ambulance. When I came back home I took an EMT class and got certified as an EMT. I started working with Fallon Ambulance Service in January 2006. There wasn't a ton of opportunities at Fallon for your Basic EMTs to do 911 work, which is what I really enjoyed. I started working in Quincy as a Basic EMT for a little while. When I got certified as a paramedic, I worked Quincy, Braintree and Weymouth. I was with Fallon until 2014, and then I was with AMR out in Framingham for about a year. When Brewster Ambulance took over the Quincy 911 emergency ambulance service contract, Chris DiBona got in touch with me and asked if I wanted to work in Quincy. I love that city, so I said absolutely. It was like coming back home.
What did you like doing at Fallon and AMR?
BG: With Fallon I worked in their Incident Response Group, and did some of the fire standbys, basically a support role for the SWAT guys. That led me toward the tactical part of EMS. Fallon had some of their medics embedded in the SWAT teams and I always loved watching those guys work.
AMR was a gigantic corporate company. You went in and you did your shifts. There wasn't very much as far as extra that you could do. It wasn't really anything like the Incident Response Group that Fallon had or anything like that. At Brewster, this is something that we could investigate. It'd be good to have some people on standby in addition to the rehab we provide for firefighters and the police we work with.
Talk more about developing an EMS-centric Incident Response Group at Brewster Ambulance.
BG: I would love to sit down with police captains and fire chiefs at the municipalities we serve and ask them, for example, "What is your tactical response to an active shooter in office or school and how can EMS provide better tactical support?" Also, to sit down with some of the facilities managers or executives at some of the bigger companies we take care of in those towns and discuss their security plans and how we can help incorporate EMS support and safety as a preventive measure and really just help them plan for these unfortunate emergencies.
I'd love to see our 911 trucks and teams go through some of the local schools to learn the layouts better. As unfortunate and unlikely as it is, there are more and more of these active shooter situations and when it happens, it's complete chaos. If you've never been in any one of these buildings, it would be a good way to start the planing phase of it. Some departments allow their guys to go through the buildings, and that's a place to start to establish that understanding and familiarity of the campuses. I think you have to have the town's police, fire and school departments be on board planning out something like that which incorporates EMS. Everyone has to work together to make sure the entire scene runs smoothly, and EMS plays a critical part in supporting those guys who go in first to deal with these situations and help EMS get to those injured faster.
How would medics support those types of operations?
BG: The old mentality of the medic siting outside and waiting is pretty much going away in today's EMS. Some departments are putting together what they call "rescue task forces" where the medics don't necessarily go straight into the hot zone, but they do go in with the police and start treating victims. The Columbine death toll was so high because it took the medics too long to get to the injured. An EMS task force like this with specialized training would allow medics to start treating the victims much sooner and cut down on the time between injury and when the patient can receive treatment and evacuation.
I think that if we could integrate the training with our municipalities now it would help support those responders during a critical incident. The national average is 45 minutes for responders to get on scene. You can't have a patient waiting that long inside. You take a couple of officers and go in. I know certain towns do the active shooter situations. They should definitely have some of the medics that are on every day included in that to say, "You guys are gonna go in as a rescue task force as soon as the officer clears the room." That's how a scene should run, as far as the tactical portion is being taught right now. I'd like to see us trained like that. I'd like to take this on.
What is different about the process and how it's being taught in EMT school?
BG: Everything they teach you in EMT school is scene safety. An active shooter situation is not a safe scene. But you have patients in there who need to be treated, and need to be treated immediately. What we need to do is enter the scene, but enter under the supervision of the police. They are the ones who are going to protect you, stay with you, and it's a different way of thinking that what we've been taught. A lot of it comes down to how you are trained and what are you trained for. It'd be good to have a team like that that went to the big situations with a higher level of training, and who've trained specifically with the municipalities.
What else have you experienced as a paramedic?
BG: My job title is paramedic, and that's always first. I came over with Quincy when Brewster Ambulance first started. I do my two dedicated shifts. I pick up all of the time, any of the municipalities. I also worked in Brockton when I was at AMR, and I've done Braintree with Fallon and worked in Taunton, too. I've been around and I don't mind doing the transfers. I don't mind helping out. I'll look at the schedule and see if there are openings. The field supervisors send out texts saying they have an open shift and I'll take it if I can or put in for it or call up. It's easy on the ALS side because they are 24-hour shifts. BLS have different time shifts, however.
What to you like about how Brewster Ambulance and how is it different?
BG: When I was with AMR, the owners were in Colorado. I never met the owner, and there was no personal touch in a big company like that. Here you see Mark [Brewster]. You don't see that with a big company—you're a number, you do your shifts and there's nothing else to do. At Brewster, we have a Christmas party and they have the cruise and family picnic in the summer and those are nice touches. These events get all of the employees together and I like how the Brewsters give you a turkey at Thanksgiving. I've never worked for a company that did that. It's touches like that that make working in a family-run company that much better.
What was your earliest impression of Brewster Ambulance?
BG: When I first came over to Brewster, they had the sit-down for Quincy and Brockton and I introduced myself to the Brewsters and said hi. The first day of the contract, they—Mark, George and George Senior—showed up and knew everyone's name. Mark came over and shook my hand and said, "Hey Bill, thanks for helping get this contract started." I liked the fact that I'd only met them once and they took the time to know your name. Every time I've seen them—I saw Mark out in Hingham with his family and he took the time to come over and say hi and he knew exactly who I was and asked how I was doing. You don't see that anywhere where management takes the time to really know their employees. I do like how throughout the time that I've been there that I've noticed that the Brewsters will drop in and see how things are running. George Sr. will come down and he'll just sit and shoot the breeze with you or answer questions. The same goes with Mark. They have no problem taking time out of their day to hang around with their employees. You can talk about anything and I think that's a great way to run a business. Knowing your employees and making sure they are real happy makes your business run good.
I think that the newsletter was a good idea and that they decided to do that. It is humanly impossible to meet with everyone every day. We all have rotating schedules, we aren't there some days, and it's tough to see everyone. It's nice to see the line of communication with management is open and accessible.
What do you think about the company's growth?
BG: I don't think the Brewsters would jump into anything. For example, the recent purchase of EasCare. I don't think they just woke up one day and said, "Hey, let's go buy an ambulance company." Everything they do business-wise is well thought out. Knowing they own a lot of property, they do a lot of other things other than own an ambulance company, and they are a very smart family when it comes to running any business. The growth they had they took on what they could. I don't think the purchase of EasCare is going be a problem.
What else do you feel sets Brewster Ambulance apart from the rest?
BG: I like that they care about their contacts, their patients, and that they go ahead and buy some of the best equipment in the industry. The trucks always look clean. With some of the companies I've worked for in the past, you don't wash your truck from December until March. I like that they like their stuff to be presentable from the truck to the uniform. They take pride in the company, themselves, the name, and I like that about them.
Can you share a story about a call that you've been on?
BG: As far as calls, for me, a lot of calls I don't remember. It's a few calls that stick with me through my time, and I've had one or two with Brewster that have stuck with me. A funny one was when the Wollaston Theater on Beale Street in Quincy in 2016 was being demolished. One of the guys I worked with, Tom, he's been in the city a long time working, and it was kind of a running joke that they were waiting for something to happen and part of it to come down. I happened to be on the north side of Quincy and I heard over the police radio that a big section had collapsed. I immediately thought of him because he'd sit in the parking lot, and see, our joke was that Tom was supervising the job and he was off that day, so I called him and told him that a piece of it had come down and he wasn't doing a good job supervising. That was one of the funnier stories that stood out to me at Brewster.
What are your favorite types of calls?
BG: I like any of the calls that make me think and use my skills as a medic. But as far as calls, any call you go on can be a learning experience. I'm one of the Field Training Officers (FTO) and my partner is an FTO too. I love when you have the students and you can train them. I love any opportunity to teach those who are coming up after us. The medical field as a whole thrives on teaching, and if you don't teach what you know, the industry dies. Any of the calls where I can teach what I've learned, and I see my partner teaching, I honestly enjoy those calls the most.
What are you noticing about EMS students coming into the field?
BG: I notice a lot of them come in some cocky, some nervous. I would prefer someone nervous, as I feel like I can work with that a lot better than someone who is cocky. I have no problem taking a new person and saying, "Listen, this will help you do that." Or, even when I was at Fallon, I had a person who had problems with her medic partner and I said, "Come work with me and I'll teach you what I know," and we're still good friends to this day. She's a great medic now. I feel like I can work with that. The ones that come in and think they know everything, it's tough to work with them. You kind of have to break them of that. I personally like the nervous who want to learn. In our industry if you make a mistake, that's when your patient ends up dying or the outcome is so bad that they are permanently disabled and you can't have that.
What advice would you give to those pursuing a career in EMS?
BG: Honestly, I think that it takes a certain type of person to do the job. I'd say they have to be able to deal with what we deal with and not take that home. As long as your confident and you know what you're doing, you take care of your patient, take those and balance everything together, you wouldn't have a problem doing this job. You can't bury it. As soon as you start carrying that with you and take that home, that's when you become a hazard to yourself and those around you.
What is the best way for EMS professionals to deal with troublesome calls?
BG: Those calls are where we need to sit down and talk to someone about it. It does affect you. A lot of people bottle it up inside them until it's too late. We need to break the "bad-ass" stigma because we're not. We're human. We have to be able to open up and talk to someone about a call that goes bad or has a bad outcome. There is a team that comes out of Boston EMS that's a critical incident stress debrief team that they can bring in if it's needed. I've never sat in on one of them, but I do know people who have. It's a safe place for you to open up and there's no judgment. It's important to have that type of support mechanism to keep EMS workers free of the burdens of work-related stress and PTSD.