Earn Money Sleeping

During the year I devoted to getting hired by a fire department, I worked for a private ambulance company. I already had my EMT certification through volunteering, and I had the luxury of a temporary post-divorce lifestyle that could sustain a $10.60 hourly wage. When I finally pulled the trigger, and made the trek down to the local American Medical Response headquarters, I was informed, after acing the preemployment test, that there were no spots in the orientation class for several months. There's a high turnover in the private ambulance business, but an equally high interest in the work.

Prior to my brief career as a professional EMT, my patient contacts were limited by the frequency of my volunteer firefighting shifts, and the relative health of the population we served. Every six days, I would tag in and take my place on the engine or aid car, and hope for disaster. Typically, we'd see one sick person per shift, which works out to be about 5 a month. Pretty hard to become the seasoned seen-it-all EMT I hoped to be at that rate. And I'll profess to a small amount of terror every time I'd walk in the door, confronted with a medical emergency. I'm a quick study with the book learnin', but nothing makes you a better EMT like seeing a lot of patients.

Two months after I applied for the ambulance gig, I got the call to come in for an interview. I detailed my experience and career goals, I asked smart questions about benefits and and the interviewers' experiences, and I shook some hands. I tried to play a little hardball and make them want me, but I'm sure they could smell my eagerness in the panelled meeting room.

Almost every month AMR starts a new-hire class that lasts two weeks. There were about 25 people in my group, ranging from 18 years old to Old Man Schlem, at 40. Some of the training was practical, how to drive the ambulances, how to fill out paperwork, how to protect your self from violent patients. Much of the material, however, consisted of CYA page-by-page reading of policy and procedure. One gal (not being sexist), a Russian imigrant (not being racial) did horribly on driving drills. She was clearly intimidated by the big boxy vans, outfitted as ambulances. We discovered that she had gotten her driver's license two weeks prior to being hired, and had never driven before. She didn't even own a car. She didn't last long.

I precepted for three weeks, working with three different crews, on three different shifts. As an EMT, your work week might assume several shapes. You could be assigned days, either four 9 hours shifts, or three 14 hour shifts, or work at night. With enough seniority, you could elect to simply cherrypick available openings, working around the rest of your life. The first week, I worked with a crew that worked 14 hour shifts during the day. The second week, I worked a "fire car" 5 PM until 7 AM. Moving from a normal diurnal schedule to that nocturnal shift for 3 days, and back again to the real world just about killed me. The two guys precepting me were a little crazy, I think, from the normal weekends and inverted weekday shifts they worked. To make matters worse, they doggedly stayed awake all night, listening to country-western music or reading historical fiction.

It's a tired joke to say that EMS stands for "Earn Money Sleeping", one of the reasons many EMTs are attracted to night shifts. I decided this was not going to work for me. I wanted to be able to see my kids on the weekend, and I had my volunteer firefighting shifts to think about. At the end of my precepting weeks, I lucked into a unique five day 9 hour schedule, with five hours of built-in overtime, with the lovely and charming Greta.

All through the orientation and hiring process I was assured that this was a fun occupation, provided you had a good partner. Greta was the perfect partner for me. She wasn't hard boiled or cynical, she was cheery and flexible. She didn't lord her experience or knowledge over me (like a couple of my preceptors had). We had a lot of fun. Barely twenty years old, slight of build, a freckled redhead, Greta put other EMTs to shame. We carried fat people out of their homes, and back up the stairs when we brought them home again from the hospital. She wasn't a big woman, but she was strong. The kind of strength that comes from knowing what you can do, and recognizing what needs to be done. She was funny, and popular with other EMTs. I basked in her glow and I know my reputation at AMR was enhanced by my association with her.

The time we hit the road in the morning coincided with the opening of Harborview psychiatric court. Harborview Medical Center is the level 1 trauma center for Washington, Alaska, Montana, and Idaho (WAMI), and provides every emergency medical service possible, round the clock. In addition to their in-house psychiatric patient care, they have a King County courtroom for the purposes of commitment and related hearings. Our first call of the day was typically at West Seattle Psych, a mental health facility, tucked into a quiet neighborhood in west Seattle.

I met a lot of psych patients during my stint at AMR, some merely troubled, others profoundly disturbed, crazy. We'd get an aide to key our elevator, sending us up to the appropriate floor, the bigger the floor number, the greater the psychiatric needs of the patient. The patients wore slippers or shuffled around in shoes from which the laces had been removed. Before I became acquainted with the facility, often the only way I could differentiate the staff from the guests was by inspecting their footwear. Most of the time, our patient was cooperative, maybe withdrawn from the medications, other times non-communicative or even openly hostile. Greta and I usually alternated patient care, but I always offered to tend to the higher-risk transports.

"I'm not in the mood for any shit this morning," I'd say, relying on my bulk to imply a world of hurt if things didn't go smoothly. The patient's response to this statement usually determined whether or not they'd be restrained on the stretcher. You can always untie someone who is cooperative, but restraining a combative patient, in the back of an ambulance, is a huge pain in the ass. It means pulling over, the driver coming to the aid of the tech, and maybe an assist from a (hopefully) nearby unit, or rarely, the police.

I came to enjoy working with psych patients. Of course, depression, suicide attempts, and self mutilation aren't funny, but the ones that talk will talk about anything. Want to know if they hear voices? Do they feel like hurting themself? Have they ever received psychiatric care before? Ask. They'll tell you. I learned to recognize patterns of behavior that now might make me suspect psych patient, even though we were dispatched for something entirely else. It's a useful skill, and I try to use it when my patients are behaving strangely.


After Greta left me to work in "the cage", the office which disbursed and collected the kits and radios each shift, I worked with John. John looked like a cool dude, trendy eyeglasses, a little high-tech dumpy maybe, but clear-eyed and well groomed. I quickly learned that John obsessed over Ethipian restaurants, of which their are several on Pill Hill, by Harborview. He'd never had Ethopian cuisine before, but it was his goal in life to have lunch at Kokeb or Meskel when I met him. One day we stopped at McDonald's for a quick and cheap lunch. After he went in the store a third time for a third quarter-pounder, I knew he wasn't roly-poly from days spent at a computer. And when I realized that he was, apparently, incapable of eating with his mouth closed, I knew I couldn't work with him. Listening to him smack and salivate almost made me vomit.

One of the greatest perks of the job was our autonomy, the freedom to use our time, waiting for a call, as we pleased. John, however, lived in terror of losing his $10.60 an hour job, and was absolutely against any, even the slightest, breach of rules. No window shopping, no bookstore browsing, no napping in the grass. I had been spoiled by easy-going Greta, and karma had compensated by delivering John. One morning I showed up and my partner was Jessica, John having accepted another shift, with, presumably, someone less inclined to threaten his employment with enjoyment.