Q: How did you get into EMS?
TB: My first career was in the theater and entertainment industry. I graduated from high school in 1991 and then went to Emerson College where I received a BFA in Lighting Design. I worked in that field and I still dabble in it a bit. I worked for a company that sent me to conventions throughout the U.S., and then I moved to California for about six months. I also went to Italy for a few months to work on a cruise ship build, and a Las Vegas project. That career had me traveling around a lot. I loved doing the hands-on work. I love live theater and live entertainment, and did special events and concerts, and eventually settled down with a staging and rigging company.
After a while I went from warehouse to onsite to office sales. I was driving a desk more than hands-on stuff, which I missed. I'm not a revenue generating person. All of my years in live entertainment was problem solving. In live theater, you fix it and you move on—you fix it while under pressure. In that industry, you earn the respect from performance and so they hire you again and you build up a reputation.
When I got bored driving a desk, I asked myself, "What can I do now?" I wasn't quite ready to get out of the entertainment industry because it was all I'd known for so many years. Around 2005 or so, I was in my early 30s trying to figure it all out in my life. My mother had been a nurse for over 45 years. Growing up, my parents were separated. My mom worked night shift and we were babysat by nurses. I was always surrounded by medical people, and every other person my age watched the TV show Emergency. My other favorite show was Quincy MD. Back in junior high school, parents always ask you, "What do you want to be?" I had loved Quincy MD and I thought, "Maybe I could go be a medical examiner." My mom kind of turned me away from that a bit when she asked me, "Do you know how much extra school you're gonna need for that?" So I opted not to.
I loved my theatrical career, and I have lifelong friendships from that, it's great. But when it came time to figure it out my next career, I did some research. I had latched on to the medical profession. I took all of those aptitude tests and everything always came back with me working in a field that had something to do with helping people, taking care of people, being there for other people. I took that plus my exposure to my mom's nursing skills, and I decided to pursue EMT and get a job, thinking that if I liked it, I'd get my paramedic. If I liked paramedic, I thought I'd then maybe pursue a physician's assistant. I thought at the time I could afford the school, and 11-1/2 years later, I'm still a paramedic and haven't gone to PA school. But I love what I do. It was a step-by-step process, to see if I liked it each step. But honestly I haven't looked back.
About seven years ago, I was in school, so I could have applied for PA school, but I met my wife and we got married. She's a teacher, and she occasionally asks me if I'll go back to school. I told her, "I'm gonna be 44, do you want to take care of the two kids while I dedicate three years to school?" I'm extremely happy with what I do, and every day is a little different. I'm a lifer when it comes to private EMS in the EMS world. I don't have aspirations to be a firefighter, and there aren't many fire departments who want to hire someone my age. If I could do something else, I'd love it. If I started as a younger person, I may have been a firefighter. I get to spend a lot of time with my family, my kids love it because my youngest didn't have to do daycare because I took care of him. My wife was off when I had to work, so it was great. I haven't looked back for the most part, I absolutely love it.
Q: Where did you get your EMS training and what were your first jobs in ems?
TB: EMT and paramedic both at Northeastern University. I was an EMT for Armstrong, stationed out of Brighton, at the Bravo base. When I got my paramedic I started working for North Shore Ambulance in Salem, MA, and was there for a little over two years when the company got sold and closed. From there I went to Action Ambulance out of the Wakefield base, and later I moved up to their Ipswich base, and was stationed there for almost four years.
Being a person in their early 30s finding a second career, I swallowed my pride and moved back home. It was my mom, my stepfather and me. While I was in paramedic school for the first half I didn't work, as they supported me. After I graduated from paramedic school, about six months later, my stepfather passed away from cancer. While I was in paramedic school he was getting radiation treatments. I was still living at home commuting up to Salem and Peabody for North Shore Ambulance. Initially I was banking some money so I could move out, but I was also aware of my stepfather's condition, and wanted to stay close to home and support my mom as she dealt with the aftermath. I grew up in Framingham and moved to Waltham and it wasn't a bad commute up to Salem, Ipswich was a bit further, but only did that trip twice a week so it wasn't bad. I left Action for Brewster in August of 2012.
My current partner was there just a little longer than I have, and we've both seen a lot of changes over those years. I started out P6 out of Boston and P4 out of Brockton. The commute from Brockton to Ipswich wasn't working out. I felt it was a good time for me to start looking to go elsewhere. So I got a job at Brewster, one shift was in Boston, one was in Brockton. We were doing all of the retail stuff. Both trucks we were doing vent calls, routine discharges, dialysis pickups, drop-offs, and returns. We joked, "We're the anything for a buck truck." Five years ago, they didn't have all of the IFT trucks they have now. Even through we were the only truck in Brockton, we were doing backup for Middleboro and trips in Boston. For 24 hours we were doing any and all trips that were needed. It took them a bit to get more IFT trucks up to ease the burden of the trucks I was on, but now they are where they are now.
Q: How were the ambulance companies that you worked for different from one another?
TB: The ambulance business has changed a lot since I started. Something as simple as the equipment, from the Emergency episodes with defibrillation paddles, we used them in paramedic schools, but now it's all transitioned to the stick-on tabs. Just with that little bit of technology it has come so far in the last decade. The vent technology in the last decade is so much more advanced, and how it's all directed around patient care and outcomes.
As far as the educational standpoint, I think companies have noticed more and more that they need to provide more access to education as opposed to, "Here, sit down in this refresher class, yes it was the same stuff we went over two years ago. Try to stay awake, pay your money and you're good for another two years." Now, I've seen Massachusetts get with the national standards, where they were standalone for a long time. I have been nationally certified and now they're more integrated with MA at the state level standards-wise.
Even something like ambulance technology. There's more and more studies about the injuries in ambulances just from driving and accidents. We have five-point harnesses that allow us to stay buckled and still while working on the patient. They used to be only lap belts.
As far as the different companies I've worked for, they've all been a little different. Armstrong was a family business. When I started working for North Shore, it transitioned from a family business and was bought as an investment to be sold off, so it was a bit of a rough go there for a while. Brewster is a family-oriented business and Action was also, to a certain extent, but less so, more of a business than a family business. You see the differences between companies generating revenue and how much revenue is coming back to the employees and the business type of thing.
I've been with Brewster nearly six years, and they've never let me down and never have disappointed me. They try their very best to treat all employees like family. And, with the massive new pay scale for everybody, I don't think there has been a disappointment for anyone except maybe the people who don't work for Brewster. In that sense, they are trying to set a standard. EMS in general is still an infantile industry, and it goes so much deeper than just making a buck. The Brewsters try really hard to be a company that is a for-profit company second, and a business that provides quality patient care first, and that's very hard to do in the private ambulance industry.
You look at AMR nation wide and their entire northeastern operations crumbled over the years. For the little guys, you don't see longevity in them. Companies like Armstrong, that go back into the early 1900s, and even though Brewster Ambulance took a break, they're back with gusto. That only comes from making money second. You need to give it back to the employees and company because they are the ones doing the work for you. I don't see myself looking anywhere else. I was thrilled when they got the Brockton contract, because I was wearing thin on the IFT stuff, but when I started they only had Middleboro. As far as the south shore and this area, everywhere I go if I'm stopping for coffee, I'm still wearing my uniform, I've yet to come across people who haven't seen a Brewster vehicle or say something positive about the company and it's fantastic to work for a company like that.
Q: What is a typical day working as a paramedic in Brockton?
TB: Brockton is busy. Brockton does roughly 20,000 calls a year. I work on the north side of Brockton. Medic 3 and 4 are the busiest, 3 being the busiest. We see a wide range of everything, including severe medical calls, traumas such as car accidents, shootings and stabbings to a lesser degree. Plus you've got all of the overdoses these days. There's a very large homeless population, and we see a lot for one reason or another call 911. Every city's got their regulars as well. It's busy.
Before we got the Brockton contract, one of the things that excited me was getting the 911 contract not only from a 911 standpoint, but from an educational standpoint as well. To be able to have a city like Brockton to train paramedic students, because you have a hospital on either side of the city, both have functioning cath labs, both provide emergency services, Good Samaritan is a level three trauma center, so there's enough of a little bit of everything in the city. Every day is different.
I just got off of a 12 hour shift where the day crew said it was non-stop all day. We did one call in the overnight and that was it. Some days are busy some are not. I work out of the North Montello base. I work with a great group of EMTs and medics. They have my back and are on the calls with me. The fire department in Brockton is great and we like working with them and have spent the last two and a half years building a relationship with them.
Overall we've got a great relationship with the fire department and they enjoy having us in the city. I work a 60-hour week now, but when I was working just two days a week, that was enough. We get a little bit of everything. Nobody ever hopes for the big bad one, but when it comes, you're trained to do it and I couldn't do it without the people I work with.
Q: When you're asked to share a memorable call, what do you share?
TB: Because of human nature, people want to know the goriest call. That's what people always ask. I turn around and I say this quite often to people, "Do me a favor and everyone else in EMS a favor, don't ask us what our goriest call is because it makes us relive it. We don't want to relive it. So instead, ask me, 'what's the best day I ever had,' or 'the best call I ever had.'"
For me, the call that will always stick out in my mind was up in Peabody when I was working 911 in Peabody for North Shore Ambulance. I was in my first year as a medic, and this particular day I was the senior medic. The guy I worked with was a brand new paramedic. We got sent to the high school for an unknown medical or an unresponsive person. When we pulled up outside, there was a police officer running outside to tell us that they were performing CPR. We grabbed everything, head inside, and took the stairs to the second floor. It was one of the the students. He was about 15 and in full cardiac arrest. One of the teachers was performing CPR on him. We went blindly into what we were trained to do, and took over, managed CPR, got him intubated and got him in the ambulance. We worked on this child for 90 minutes. Would not leave his side in the ER, me and my partner, two other medics met us in the hospital. We worked him with a nurse and doctor and finally got pulses back.
After that I went home. I didn't want to be there the rest of the day. We later attended a critical incident stress debriefing with the fire department and the teachers. It was a closed door open forum type of environment to get it out so we could all move on. If you asked me who was in the room, I couldn't tell you. I paid attention to the patient and we did what we were supposed to do. I found out about a week after he was sitting up playing video games with no neurological deficit, and was perfectly fine. I will never forget that. Other than we got pulses back, I had no idea how that kid was going to be after that. I went home, I slept the rest of the day. It's a day I'll never forget. That's what the job is all about. It was probably one of the best and worst days I have ever had because nobody wants to work on a kid. But it all came together. We did our job and that kid lived.
Q: What would be your advice for new people coming into an EMS career?
TB: I would ask them, "How are you with the sight of blood?" I'm just joking. I do get paramedic students a lot and I ask them, "Why do you want to be a paramedic?" Some people say because it's a stepping stone to a firefighter. Some people don't want to work on an ambulance, but it helps the fire department career track. Other people felt less than satisfied working as an EMT and felt they could do more. I came from that tree branch knowing I could do and provide more. I tell everybody, "When you have the opportunity to learn, learn. When you have the opportunity to ask questions, ask questions. Anybody that you work with who has worked longer than you, they are a great resource to ask questions of. You're there to learn, be it hands on from a book or from someone else. "