Flight Paramedic, Air Evac Lifeteam
Becoming a flight paramedic
I’m a paramedic for Air Evac LifeTeam. We serve about a 75 mile radius from the base I work at and that backs up different counties like Washington County and Crawford County. We basically provide health access to these areas that don’t have bigger facilities, like cardiac health centers or respiratory issue centers. We get people to hospitals that can provide services quicker by air versus ground. Just to give you a bit of insight, the ambulance can do everything that we can, but the obvious difference is we fly 1,500 feet above the ground and we’re going 130 mph versus 70 or 80 mph. Our job is to get patients who are having either a heart attack, a stroke, or respiratory failure to one of the bigger hospitals that have all the services available.
Take Washington County Memorial Hospital. They do what they can with the limitations they have, but they don’t have the capability to do what Mercy Hospital St. Louis does. The nearest big hospital from here is about an hour drive away. Flying, it’s about 20 minutes. You’ve got St. Mary’s, Mercy South, Mercy St. Louis, and Missouri Baptist. And then you have your trauma centers, which are Barnes-Jewish Hospital and Saint Louis University Hospital. They say time is muscle with certain things. And if you don’t have the capabilities in these smaller communities, you’re looking at a life or death situation. Sometimes getting into a surgical center 15 minutes faster or receiving blood that may not be available here can save a patient’s life.
I’ve been doing this job for about 20 years. I always had a passion in high school to help people and to work in the medical field. I wanted to be a physical therapist actually. But I met some individuals who pointed me in the direction of the prehospital side of medicine. I went on a couple of ambulance rides and fell in love with it. So this is what I’ve been doing ever since.
Misconceptions about EMS
You look at fire departments, EMS departments, flight services, and a lot of communities think that we just sit around and get paid to do nothing. And there are days that that happens. But that’s not what we do. We’re there for when you call because, who knows when an emergency is going to happen? So it would be nice for people to know we’re always on call and when we’re not doing patient care, we’re constantly training to make sure we know what we need to do when we have to do it. If your grandpa or mom or has some type of medical emergency, and we’re called, we’re the first ones there. And if we don’t know what we’re doing, then we’re not going to do those loved ones any bit of good.
Burnout and concern about working in healthcare during COVID
Burnout has been a huge issue lately. We’ve seen a lot of turnover and it has to do with this pandemic, because you’ve got a lot of individuals who are scared to bring COVID back to their family. We’ve all seen our loved ones or someone we’re close to go from perfectly healthy to getting what looked like a cold to being on their deathbed. That’s a scary thing.
Both my wife and I are paramedics, so it’s something that goes through my head every day
when I go on a job or a call, "Am I going to bring this disease back to my kids?" We’re safe with what we do, but there’s always the chance that something’s going to happen
Describing public health
There are two big things that come to mind for me, and the first is education. Education goes a long way, whether it be with COVID or a recent heart attack or a stroke. Knowing what to expect is important not only for patients, but also for the people who are taking care of them. It should be our job as clinicians to educate the public on what to do, preventative medicine, and ongoing care. Because if we saw as much media about how to prevent COVID as we do about what’s going on in politics right now, I think we’d have a completely different situation. I mean, how often do you hear that you should wash your hands? It may be common knowledge, but those are things we need to push on the public to remind them, "Hey, these are some of the things we can do to prevent what’s going on: wearing a mask, washing hands, having proper hygiene."
The other aspect of this that’s close to me is mental health — and it’s sad that it’s still not addressed enough, because we don’t always know what we’re looking for. We hear we’ve got a psych patient or some guy wants to commit suicide. Well, how do we help these individuals get the help they need? Going through school, we never learned that. We just heard, "Here’s how you handle this patient. Do what you need to do." But we need to know what resources are available, whether it be a suicide hotline or a Pathways clinic or just general counseling.
I’ve dealt with mental illness for the last 20 years — specifically depression and anxiety. Unfortunately, I’ve stared down the barrel of a gun a couple of times. The last attempt that I almost pulled the trigger on, I finally reached out to one of the local pastors here. If it weren’t for him, I guarantee I wouldn’t be standing here. He forced me to be more transparent with the things I was going through. I had him, my wife, and my kids to talk to. I started seeing a counselor, and I’ve learned how to cope with different things and go from there. But for whatever reason, divine intervention or whatever the case, I’ve dealt with my personal struggles and found ways I can cope to try to help myself. And I’ve turned that into ‘how can I help other people going through some of the same things I’ve gone through?’
Reaching out to address teen suicide
There’s been a flood of teen suicides in both this county and small surrounding counties. You have to wonder to yourself, "What is so bad that a 12- or 13-year-old kid decides to take their own life?" I’ve got two daughters in that age range, and as a parent, I see them go through phases and wonder if I’ve missed anything that could have allowed them to not travel down that path. I’ve unfortunately had to work on some teenagers who had a bullet in their brain. And you wonder, knowing that they’re more than likely going to die, are they still able to hear and feel this caring touch? Do they know we’re doing everything we can to help them?
I talked to my pastor and said, "There’s been this flood of suicides or attempted suicides. We as a community need to do something about it." So together we’re starting something we’re calling Project Safe House. We’re going to start meeting every Wednesday, just to share some of the things we’re going through and experiences we’ve had personally. Because knowing that you’re not alone in that situation and that there are resources and people willing to help you overcome whatever demon you’re facing is a huge help. It was something that helped me then, and it helps me in my job now. I do see a lot of patients who feel like they’re at the end of their life and don’t know where to turn. And all it takes is, "Hey, there’s a place you can call. There’s a place you can go." And if that’s known to the public, I think we — not only as clinicians, but also as a community — can do a huge benefit to everyone we’re around and make our area stronger and healthier.
A lot of schools in this area have the hotline numbers up. They’ve got the flyers out already. I think we’re going to follow a different path and make this program at the church more of a support group where people can share stories about what they’re trying to overcome, or have overcome, and talk about how everyone is on different paths. Things like how they’ve either created a relationship with God, with family, or whatever it is they needed at that time. If you’re in that situation where you feel like you’re all alone and don’t know where to turn, just knowing others have gone through something similar is so reassuring."
Mental health, stigma, and local resources
The hospital is the first place you can always turn to. Unfortunately, the hospital here doesn’t have a behavioral health center, but they do have someone who can evaluate you and give you resources to get help or send you to a different facility that can give those services. The school has a program for teens and school-aged kids. There are places like Pathways, a medical group focused on behavioral health that gives people someone to talk to, and if there’s anything else they need more on the medical side, they’ve got doctors on staff who can prescribe. Then the EMA, which is the Emergency Actions Committee at the old Parkview Hospital in Farmington, created a program for the homeless shelter. A lot of the unhoused population with mental illness can receive services there as well.
In terms of talking about mental health, there’s a group of providers who see some of these patients dealing with psychiatric issues and they’re dismissed like, "Oh, that’s just crazy Bob over there." Without ever being in their shoes or having an opportunity to talk to them, you’ll never know what an individual is actually going through.
In general, some tend to chalk these folks off as lost causes. And that’s so sad because talking to someone who’s experiencing homelessness and has mental illness, you get a whole different insight of what they’ve been through and what they’re going through. Still, as a community, whether it be Washington County, St. Francis County, or Crawford County, there are some powerful things going on to provide supports.
Rural challenges to navigating the healthcare system
I grew up in St. Louis in the Fenton-High Ridge area. So the things I saw here were completely Greek when I decided to come down this way. Before, we had every big hospital within 20 minutes of us. And down here, you’ve got Farmington County and Washington County, and the next closest place is St. Louis. You kind of have to pick where you go depending on what specialists are available. My son is hearing impaired. There’s no audiologist down here. There’s no pediatric surgical centers down here.
The closest pediatric specialty center is in St. Louis at Children’s Center or Cardinal Glennon. There are pediatricians down here, like Parkland has a pediatrician on staff, but that’s not always necessarily what you need. If you need a specialist, you’re driving. We make an hour and 15-minute drive to Cardinal Glennon every other week. So that’s definitely an issue we have to overcome as a community, but something that’s probably never going to go away.
Services aren’t available in smaller communities because there just isn’t enough to go around. At one time we had ER docs who were allergists or podiatrists. They really didn’t understand emergency medicine, but that was what health facilities had. And at least there was a doctor there to provide some type of services. Then they’d ship people to St. Claire Hospital in Fenton, or Barnes-Jewish or Missouri Baptist in St. Louis, where they could get continuation of care. That said, you compare ER docs from these big trauma centers versus what you see down here and it’s night and day. And those healthcare professionals are dealing with issues we’re seeing every hour of every day. So you kind of have to go where the population is going to get the most benefit. That’s another problem with healthcare — big medical centers are put where they’re going to get the biggest bang for their buck. Unfortunately, rural populations are not going to get that — and that’s a shame because you’re dealing with people’s lives.
Most difficult day on the job
One of the hardest days of my job, I had a young mom who wrecked her car. Her little boy, probably six or seven, was in the back seat. He looked pretty banged up and was luckily okay, but she died in the car accident. And the only thing he said to me on the way to the hospital was, "Where are my ears?" This was just after I found out my son was hearing impaired, and it finally clicked. I was like, son of a gun, he’s deaf. He lost his implant and the only thing he could hear were men’s voices. Every person is different, but he could hear lower waveforms better than higher ones.
We went to Cardinal Glennon and all we saw were female nurses and doctors. There aren’t a whole lot of men there. So this boy was completely lost. I sat with him and relayed everything I could to him. Anything that was going on, I said, "Hey, here’s what the nurses are gonna do." I mean, it sucked because a complete stranger was sitting there holding his hand and all he wanted was his mom. And he had no idea what was going on because he was just in this nasty car wreck.
I ended up sticking around with him for about four hours until someone from his family could come. Seeing the look on his face when he realized Mommy wasn’t coming back was devastating. And just seeing him and then thinking of my son, because my little boy is a mama’s boy through and through — it killed me. What a tough day seeing that kid go through all the emotions and being scared because he couldn’t hear anything.
Most rewarding day at work
I think the most rewarding day of my job was New Year’s Day a couple of years ago when we had a guy who held a gun to his head. This was right after I went through one of my own battles. Everything he said were some of the same things I had said, like, "I got no one to turn to. There’s nothing left for me to live for." I sat with him for 45 minutes before we drove to the hospital. I said, "You’re not alone. Everything that you’re telling me, I promise you, I just went through." It took some convincing for him to understand I wasn’t kidding. And I said to him, "Here’s what I felt. I promise you, you probably
feel the same thing or have felt that before," and I gained his trust.
We ended up going to Phelps County Hospital in Rolla and had a good 30 minute talk with him about what services were available, what he could expect, and how he can get better. I gave him my number and said, "I want you to call me when this is all said and done and you feel like you’re in a place to talk." He called me about six months later and told me, "I’m doing okay. I’m holding a job. I’m getting my kids back."
Knowing I saved a life, not necessarily in the way people think paramedics save lives, was a cool feeling. Knowing he wasn’t afraid to open up to me, and then seeing what he transformed his life into, was probably one of the biggest pat on the backs I’ve ever received in this field.