In 1974, at the age of seventeen-and-a-half, I became the youngest registered emergency medical technician in Arizona. I started as a dispatcher at Kord's Ambulance, which had the distinction of being owned by a relative of Linda Ronstadt. Soon, however, I was gravitating to the Kord's operation in Scottsdale, where my Coronado High friend Marc Terrill was working. There, under the leadership of the legendary Chuck West, the company had established the first advanced life support unit in the Southwest. It was a sea change from the throw-and-go days of ambulance drivers. This ambulance was equipped with IVs, EKG, telemetry, defibrillator, intubation gear, drugs — all the things seen on a modern rescue rig. An RN accompanied the two EMTs, who were trained as true paramedics in a program at the old Scottsdale Memorial Hospital under Dr. Bert McDowell.
From riding along and attending classes on my days off, I wrangled a transfer to Scottsdale in the fall. I was one of "Chuck's boys" (there were two female medics, too, a major breakthrough). The ambulance itself was revolutionary: Life-saving treatments could be begun at the scene. My early time was very difficult. The old guard was dominated by former combat medics who had served in Vietnam: Men who had performed surgery after rappelling into hot landing zones and no doubt they were PTSD'd to the moon. Unlike today, they had no use for the young person in their midst. They were tough, demanding, unmindful of, and quite contemptuous of, what is now called "my self-esteem." So I had to earn it. I learned more from them in a short period of time than I ever have in my life. From not even being sure of hearing a blood pressure while the siren was wailing, I learned to start IVs, intubate, triage, do CPR right, everything. I finally merited their respect. It remains one of the most thrilling accomplishments of my life, and makes me feel sad for young people today who are tossed into over-their-head jobs because they are cheap and never given proper seasoning or mentoring, whether rough or gentle.
They taught me a useful phrase and behavior from 'Nam that has served me well: Run frosty.
In a few months, I became partners with John Jordan, who was only a little older, and the hazing stopped. We worked well together, and I was rich in such partnerships, including with Jim Whiteside, David Huish, Russ Covert, Tom Payne and Sharon Anderson. Scottsdale was a dream posting compared with "the city." We were rock stars in the media (Phoenix Fire was just ramping up its paramedic program). The public loved us. Police and fire deferred to our expertise on medical scenes. The calls were often to the homes of the rich and sometimes famous. I could flash my badge and walk onto any scene. The money was exceptional for someone my age. We were also the first responders to the Salt River rez. On one call, a 300-pound violent patient fought with me all the way to Phoenix Indian Medical Center. At one point he had me on the floor with the side door open as we cruised along Indian School Road by the canal. "Need any help?" Jordan asked. "Nope," I said as I gained the upper hand. The patient became strikingly calm when we backed into the PIMC emergency entrance where four redwood-sized Indian cops were waiting.
Phoenix had five ambulance companies handing all the emergency and non-emergency calls: Associated and Kords, the two most elite, Phoenix AAA, Universal, owned by Lincoln Ragsdale, and Aid Ambulance (the old Mesa Ambulance) in the East Valley. We tended to work 24 hours on, then have a day off, with every other weekend off. I was working my way through ASU, too, so many was the time when I went 24, 48, even 70 or more hours without sleep. I grew up fast and saw much more than someone that age should have seen. But I was also proud of my skills and — given the washout rate from this high-stress job — soon I was a veteran. We had saved many lives that only a few years before would have been lost, although not nearly as many as depicted on television. Most people my age felt invulnerable. I did not. I had seen too much death, the too many ways bodies could be sabotaged from within or torn apart from outside by guns, knives, hatchets, baseball bats and high-speed blunt trauma. I knew the feel of dried blood and cold, dead skin.
These good days couldn't last. West left Kord's to establish a paramedic program in northern Nevada and a few of us went with him. I stayed a few months that included rescues on Lake Tahoe, then came back home. Now "Chuck's boys" were persona non grata at Kord's (whose internal politics were always murky and could result in sudden firings). So I signed on at Phoenix AAA. This was the former Phoenix Ambulance Co., one of the first outfits to be a freestanding operation outside of funeral home-provided ambulances (at one time, Phoenix Police ran ambulances, too). Unlike Kord's, there was less emphasis on patient care, more on collecting ambulance bills and cutting costs. The owner was an unpleasant man who would mutter, "you gotta screw them before they screw you," regarding his employees. He usually avoided us, with Bill Hayden, an irascible old-school ambulance driver, as general manager. Bill liked me because I could drink him under the table.
Here the environment was much more intense. We were based downtown, responding to the most challenging and dangerous calls. Phoenix seemed like a very menacing place, and I was shot at and stabbed at multiple times. I still have a scar from one time a knife connected. The last of the Deuce was still operating and the old barrios and projects were still standing. (I was off duty the night Ernesto Miranda bought it). My command of Spanglish reached its height. Dead bodies discovered in old downtown hotels in high summer washed out many a rookie. We would fly code three up 7th Street, our northbound avenue of choice in the largely freeway-less city, and always play a tune on the siren for the pretty flower girls on the corners.
I was one call rotation away the day Arizona Republic reporter Don Bolles was bombed — we caught an auto accident with injuries (a 962) at 16th Street and Southern; my friend got the Bolles call. A good night allowed you an hour's sleep. One hellish July shift, when the asphalt was hot enough to produce second-degree burns on exposed skin, Covert and I ran 24 calls in 24 hours, a record that stood for many years. Soon, at age 19, I found myself A-Shift supervisor. The outgoing/fired shift boss told me, "always look out for your people," an axiom I have followed, not always to my advancement.
The crews at Phoenix were almost universally (and Universally, for by that time we were operating Ragsdale's ambulances) great people and fine medics. Although I was still one of the younger people, I was the most highly trained and among the most experienced. We were not choir boys and girls, except in the Wambaugh sense. Off-duty pot smoking was heavy. We had no Christian love for the homeless or the poor, for whom we were the primary care givers. Some of them lived in hovels with dirt floors, within sight of the downtown skyscrapers. The entire central core was shabby and in dramatic decline (although full of great bars and buildings with promise, now lost). We saw everyone at his worst. Away from the earshot of civilians, our language was filled with profanity, the more creatively used the better, as well as shocking (to my ears now) ethnic slurs, including from EMTs who were minorities themselves. On-duty sex in outlying stations between male and female partners was not unknown. The wild and gross stories could fill many blog posts, but the ability to tell an entertaining tale about a real call in the squad room was highly valued.
What I can say is that we gave fine, professional care amid very difficult circumstances. So paltry were the supplies in the ambulances that many of us brought our own lavishly equipped jump bags on duty. Unlike many, I kept up my Kord's habit of attending hospital in-service classes and pulling shifts in the ER, anything to keep learning. I became an instructor-trainer for the Red Cross and Heart Association. Under the old rules, I should have "moved up" to driver. But I preferred to be in the back with the patient.
There were two kinds of EMTs: Trauma medics and lizard medics (lizard being the slang for an elderly patient). I was emphatically a trauma medic. The bloodier and more dangerous, the better. All I want for Christmas is a Greyhound bus wreck...or a 747 going to a hemophilia convention crashing into a glass factory. I don't say that as a boast, for the lizard medics probably gave much more loving care. We tried to save lives — or just have a drunk vomit on us as the cops and firefighters laughed — and then moved to the next call. With trauma, you didn't have time to meditate on mortality or the fragility of this human shell. No time to weep for the maimed and dying. You were always thinking: What can I do next to help this person.
Like any endeavor that puts young people together under intense pressure, we were very tribal. We spoke our own language, a combination of radio codes, medical terms, inner-city slang, sexual innuendo etc. Anything was liable to be absorbed into our lingo: The slogan for a Walter Matthau movie was turned into, "The laughing paramedic is never amused." We had tribal customs. Code Seven — mealtime — was precious, and Phoenix was abundant in wonderful mid-century coffee shops, now almost all gone, as well as pretty waitresses to flirt with. We also ate at the Mexican dives in the barrio, where the home boys would protect the unit while we chowed down. In the era before cell phones, the dispatcher would have every restaurant's phone number. You dreaded hearing the phone ring, the waitress holding the receiver out and calling, "Kord's!" or "Triple A!"
Your valued personal items included bandage scissors, boot shears, hemostats and pen light, all in a holster. Uniform boots that resisted violent patients' kicks. The uniform came with a badge and company and REMT patches — if on Code Seven we saw a "high risk factor" person walk in, we would make an elaborate move to slink down in the booth and cover our patches, the better to be concealed if he or she coded out (it was a joke). One's wardrobe was fairly easy: Two or three uniforms rotated through the dry cleaners, and backup scrubs if you got too bloody, or wet on a drowning call. In addition to our jump kits, Covert and I equipped A-Shift Medic 79 with an ice chest stocked with sterile water for burn victims, and a briefcase full of Physicians Desk Reference, Merck Manual, metal patient chart clipboard, etc. And a riot baton tucked behind one of the seats. Happiness was the night-time, when the bosses and the sun were gone, we could run "silent three" without the siren and the emergency lights played mesmerizing reflections off the buildings. Late at night, we would blow off steam with stupendous water-balloon fights. Everybody had a nickname. (At Kord's, mine was Lizardman, after my imitation of disc jockey Wolfman Jack only spinning out calls; afterward, it became B.A., for bad attitude).
Phoenix Fire was following the lead of Seattle in establishing a "medic one" program and took over dispatching and responding to emergency medical calls. This caused much conflict and difficulty. Many firefighters didn't particularly want to be EMTs, and the culture and skillsets were poles apart (one doesn't "fight" a heart attack). There were outright fights over who was in charge of a scene, particularly when some arrogant fire captain would greet us upon arrival with "getchurgurney" — translation: bring the stretcher — without even telling us the nature of the call. Watching PFD paramedics and firefighters "learn" on live patients was particularly maddening, especially for one like me who had to earn my way with the old combat medics and been given first-class training at the SMH emergency department. It was a fraught time. We cherished our grievences. That said, many engine companies and PFD medics were a pleasure to work with. Once, an unnamed fire crew and Covert and I (in Medic 79) had a "steal off." The goal was to grab as much of the others equipment at various ERs. The loser would buy the winner dinner. (We won when I snagged a PFD Hare Traction Splint, a very expensive item).
Decades later I would laugh about this with by-then Chief Alan Brunacini. At the time, we felt disrespected and degraded from our employers on down. Phoenix Fire got all the good press. We got plenty of contempt from nurses and firefighters who viewed us as little more than taxi drivers (although the cops still liked us). Indeed, for a brief period, Jordan left and drive a real taxi driver until a customer tried to kill him and he came back to the relative safety of the ambulance. We fantasized about the companies we would build if only we were in charge, the well-equipped ambulances, etc. How the private-sector could handle this better. How the company would actually make more money by investing in the best equipment, people and training. This would not be the last time in my careers when this dialogue would go on. Southwest Ambulance went on to actually do this, but I was gone from Phoenix by that time. Being stationed downtown was a burnout track and I finally quit. This was a relief to the owner, who always suspected that I was scheming with the Teamsters to unionize the ambulance crews (I wasn't, but good idea).
My last year was spent working for Aid in Mesa, Tempe, Chandler and Apache Junction. The pace was somewhat slower than downtown — anything would be — but many of the calls were harrowing, especially when we were alone in the middle of nowhere. More than once I had a physician say, "I couldn't do what you guys do." Here the owner was also a jerk, reveling in having on-duty EMTs wash his car. But the East Valley wasn't even the East Valley then. Most of our geographic territory was citrus groves, farms, ranches and desert. Lake and mountain rescues were common. We had great freedom when we weren't stationed at the mother ship in downtown Mesa. Our black humor remained and saved us. Tom Payne and I put ambulance lyrics to folk songs and performed as "Gilbert and Southern, coming to you dead from the glamorous autopsy room of the Maricopa County Port-Mortem Lab." (Gilbert and Southern being an intersection). Another time, we realized illegal immigrants had broken into the run-down motel that served as the Apache Junction station. They often had to sleep in the citrus groves. Our response was characteristic: We found a band uniform for a Hispanic EMT, and he stood in front of an ambulance we parked in front of their room one night. We lit up, hit the siren and spotlights, and he announced on the P.A. in Spanish, "This is Col. Nava of the Federales. Come out with your hands up." They scurried out the back door. The jokes, as always, are best not shared with a general audience of civilians.
My mother was terrified that I was so addicted to the rush, and the relatively good pay, that I wouldn't finish college. But I did. I finally moved on, left Phoenix for what I assumed would be good, and took a teaching job at a small college in Oklahoma. The coda was helping the county there set up its first EMS operation. The state accepted my Arizona credentials, so I also worked a couple of night shifts a week to keep my skills up and passed along the knowledge I had learned what seemed so long ago from the combat medics. And there was the rush.
It took months of hard work to clean up my language and stop thinking in radio codes. I still call people "sir" and "ma'am," still in that authoritative cop voice. It required more years before I could really talk about some of the things I had seen, before I even cared to see where a siren was heading. Years to unharden my heart. Perspective was long in coming, too. It is stunning to think that babies I delivered are now in their thirties, much older than I was then. In the late 1980s, well into my journalism career, I wrote a novel about the experience, Response Times. It never found a publisher.
Read more about old Phoenix in the Phoenix 101 archive.