Some day, your life may be in the hands of Matt Sproul and Nathan Miller and the other squad members in their big maroon-and-white ambulance.
Paramedic Nathan Miller sets the siren to wail and runs a pair of red lights. The traffic parts as the eight-ton ambulance barrels down Canandaigua's North Main to North Street, where an elderly patient had just taken a spill.
"In the summer, we get a lot of elderly patients because of the heat," says Kathleen Holevinski, a volunteer emergency medical technician bouncing along in the back of the Canandaigua Emergency Squad ambulance.
Lt. Matt Sproul sits shotgun. He looks stoic. His gaze sweeps over the traffic like a radar beam, ready to warn the driver of hazard.
The rig can get up to 120 mph or more, he says. But here on city streets they go only as fast as the traffic will allow — it's called due regard. The last thing you want is for a rescue crew to cause an accident on the way to an accident, he says.
The dispatcher says the patient is conscious but cannot or will not talk. She's clammy-skinned and trembling.
Holevinski grabs the supply bag and hops out the back of the rig. Sproul and Miller unload the gurney and the wheelchair with tank treads that lets them get immobile patients down stairs.
All three head back out of the house a few minutes later. Miller wheels the patient out to the gurney. She can't talk, "and she should be able to, so there's something wrong," says Sproul.
He tourniquets her arm, finds a vein and sinks a needle. An IV bag drip-feeds a sodium chloride cocktail as Sproul tests the patient's blood sugar and monitors her heart rate. The patient is a diabetic. Sure enough, her blood sugar is far too low.
"I'm going to give her some dextrose, and she should start talking to us," says Sproul.
As the sugar dissolves in her bloodstream, the patient starts to find her words — enough of them to let Sproul know she doesn't understand where she is or why. Sproul speaks slowly, runs tests, even chats a bit as reality filters haltingly through to the woman on the gurney.
"Give me some squeeze like you're mad," says Sproul, giving her his hand to see if she can show the strength she should be getting back.
At Thompson Hospital, the back doors of the rig swing open and the outside heat hits hard. It's too hot, says the patient. No one disagrees. As Sproul helps lift out the gurney, sweat pours down his face. Droplets roll off Miller's fingertips as he swings his badge by the remote lock and the hospital doors slide apart.
Inside, the patient immediately starts to shiver and complain of the cold. Sproul leans close, lifts a blanket up to her chin.
"You can tell how people want to be talked to," says Sproul in an aside. "With some patients, you have to be direct. With others, you're like a member of the family. You never want to talk down to a patient. If you don't treat them with a hundred percent respect, they shut down. It's like a door closes."
Sproul waxes philosophical on occasion — a mood balanced by the cool, smiling pragmatism of Holevinski, who just happens to be his sister-in-law.
"We're like a close family," she says. "We support each other. Half my family is in the medical field. I met my husband in a course at the hospital. No other people really interest me. I like what I do here."
The squad has had a busy couple of weeks. Car crashes, respiratory distress, cardiac arrests. But the storm seems to have settled, at least for the afternoon. No calls have come in for a couple hours. That means catching up on paperwork.
"It's eight hours of sheer boredom, then 10 minutes of sheer terror," says Paramedic Don Scicchitano.
Crew members squirm in their chairs, eager to be anywhere but in front of a computer screen, typing.
What about the other extreme? How bad — how weird — does it get?
"Well, there was the woman who sneezed and her eye fell out," says a nonchalant Scicchitano.
All chairs swivel to face him.
It happened in Utica — a dirty, gray, unforgiving glob of a city. Scicchitano was serving with a crew out that way. They were stanching and patching a stab victim when out runs this huge woman screaming: "I sneezed and my eye fell out! I sneezed and my eye fell out!"
When the medics finally calmed her down, they figured out that she had sneezed while she had her nose pinched shut.
"But she had a deviated septum that had cracked so all the air blew up into her ocular cavity and puffed out her eye," said Scicchitano. "She thought it fell out."
He looks pensive.
"That was in '88," he says.
Sproul holds up a little brown teddy bear. They have plastic trash bags full of them in the back, he says. The Rotary Club donates the bears for the ambulance crews to hand out to any little kids who end up as patients.
"You give a kid one of those," says Sproul. "They don't know what all the lights are, the equipment, the stethoscopes. But they know what that is — that's happy time."
Three more hours pass without a call. A pair of medics take out a rig to get ice cream.
"You never know what your next call is going to be: an accident, a bee sting, someone who stopped breathing — so we wait," says Sproul. "We wait until somebody needs us... You hope everyone is OK, but you prepare for the worst."
Sproul grabs a glass from a cupboard in the squad's kitchen. As he turns on the tap, the third call in a row comes through. An elderly woman was laid out after she got hit with a swinging door at Quail Summit, an assisted-care community. Still thirsty, Sproul heads out to the rig.
The patient lies on the floor of the lobby hallway. She can't get up. The pain is a 10 on a scale of 10, she tells Paramedic Donna Bailey. When they try to turn her onto her side to get the back board underneath, she howls in pain: "I can't do this! I can't!" But it's already done.
Other residents mill about, pushing their walkers past the front desk to see what's going on.
"Bye-bye, girls," says the patient as Sproul and Bailey carry her up onto the gurney and out to the rig. "Say a prayer for me."
The patient is 91, lucid and chatty. She had a heart attack and two strokes in the past couple years but she was doing fine until the kitchen door swung open and floored her, she says. No one doubts her when she tells them the pain is the worst she has ever known.
"And I'm no sissy," she adds.
They drop her off at the hospital, but before Sproul can locate the drinking fountain, the next call comes in. Another elderly patient, unconscious.
"We're not just taking care of the patient," says Sproul in another aside. "We're taking care of the friends and family. That's why you don't just go in and start pushing people around."
The patient is awake but confused. She just had knee surgery the other day, and the medics think she may have had a reaction to the Vicodin. Her pain is a 10 out of 10, she says. But she doesn't know why.
"I just don't know how it got so bad," she says. "I don't know how it got so bad."
Her friend stands beside her. She had come by earlier and couldn't wake her, got scared and called the paramedics.
"It's OK," says the friend. "You don't have to remember, today. You can remember, tomorrow."
Another call intercepts Sproul's search for a glass of water at the hospital. It's a possible overdose. When they arrive, they find the patient slumped and unresponsive in the passenger seat of a parked car. Her husband or boyfriend says that she took too many painkillers — her back just hurt that bad, he says.
Sproul fingers an orange pill bottle with a variety of multicolored tabs: SOMA, methadone, Valium. No judgement follows. Only treatment.
"People always say, well, they took them accidentally or they took them on purpose," says Sproul. "But that doesn't matter to us. It doesn't change our treatment.
"We don't ask why. We don't treat why it happens. We treat what happens."
Philip Anselmo can be reached at (585) 394-0770, Ext. 322, or at firstname.lastname@example.org.