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What Might Have Been


It was August of 1985. I had just completed my graduate degree and my paramedic program and was off to my first, full-time teaching job at a small college in northeastern Ohio in the middle of nowhere. I left the interstate and traveled for about an hour and a half through rolling hills, tiny hamlets and farmland. As I drove into town from the south with my Adventure in Moving trailer in tow, I saw the fire station on the left and pulled around back. The academic stuff was all well and good, but EMS was still fresh and exciting, and I couldn t wait to sew on my brand new paramedic patch and get out there and do it. I pushed the doorbell and, as chance would have it, the chief greeted me on the other side of the door.

I got the lowdown from him on local EMS. The fire department didn't provide it, but the hospital in town did. There was a hospital in town? A town this small? Yup, there was. Then there were two medium-sized cities, both about 11 miles away, that had ambulance services, but the chief didn't know much about them. I filed the information away and got busy moving into my apartment and settling into my new job and new town.

A couple of weeks later, I set out on a Sunday to check out some of the local EMS services. My first stop was the small hospital in town. It had an emergency department (ED), with about four or five beds, that was staffed by a couple of nurses and either the local family docs or pro-tem residents from Cleveland. They staffed one paramedic ambulance 24/7 using paid EMS and cross-trained ED staff. They paid minimum wage, and they did about a call a day. Not exactly the kind of paramedicine I was looking for. I did end up working there for a very brief stint, but that's a tale for another day.

So I got on my 1978 Honda 750 and headed up to Lorain, Ohio, a sagging, rust-belt city on the shores of Lake Erie whose heyday was around 1950 when the skies glowed red from the fires of the steel furnaces, the lungs of the immigrants who worked them filled with the acrid smoke belched from the plants, and people had good jobs and decent houses and big cars with yards of chrome and fins. My first look at the city was on the far west side -- the good side of the tracks -- and it wasn't so bad.

Lorain had two hospitals: St. Joe's downtown and Lorain Community Hospital (LCH) on the west side. St. Joe's served the poor folk while LCH served the better-off, and it looked it -- new, modern, and low-slung. So I puttered up to the emergency entrance and there it was, in all its glory, a young man's EMS fantasy writ large, the Paramedic Promised Land. First I beheld the helicopter, sitting on its haunches, shiny and beautiful on the most high-tech, yellow-striped, marking-lighted, wind-socked helipad I had ever seen. Emblazoned on its side was "The Golden Eagle" and it had -- oh, yes it did -- a decal of an eagle coming in for the kill, wings spread and talons extended, ready to snatch its prey, I mean patient, from the jaws of death, I guess.

The next glory my eyes beheld was the emergency bay. The three huge doors were open, and there, glinting in the August sunlight, sat the most beautiful, matching Type Three ambulances ever created by Horton, Braun or whoever. And along one wall of the bay -- and here I almost fell off my bike and I get teary eyed to this day -- in perfect order like 18th century British soldiers on a parade ground, sat about 10 matching scuba tanks, and above them hung state-of-the-art full scuba gear. My body was nearly vibrating at this time. I had to stop and calm myself down before I could bring myself to enter this sanctuary, this Holy of Holies of all I desired.

I finally got a hold of myself enough to enter the inner sanctum, and it was more marvelous than I could've imagined. I approached the entrance shadowed by a marquee with huge red letters on an illuminated white background: "Trauma Center." As I stepped through the swooshing automatic doors that parted before me like the Red Sea before Moses, I beheld to my right and left two exam rooms, each festooned with every doodad and gizmo a trauma junkie could desire, including bags of hanging fluids and -- wait for it -- X-ray machines actually attached to the ceilings. As I walked through the sparkling ED in a daze, I beheld them for the first time -- were they superheroes or only mere mortals? The flight crew was wearing striking cranberry-colored jumpsuits with silver piping, shining insignia and leather name badges.

I inquired at the desk if there were someone I might speak to about, um, if I might be so bold, er, employment. She wrote down the name of the director for me to call. I chatted briefly with one of the flight-suited demigods. He told me such tales of daring-do as landing on highways, dropping scuba medics from the helicopter and rescuing babies from certain death. I climbed back in the old Honda and headed home; glancing back wistfully and I turned the corner as that Shangri-La of a young man's EMS fantasies faded from sight.

I called, got an application, sent it in, and then nothing. For weeks. So I called and left messages. Lots of them. Alas! Nothing. So I realized my dream was not meant to be. What I later learned was that the dream was, in fact, a mirage, a chimera, a pipe dream brought into being by enthusiasm unmatched by good planning, the brainchild of an overenthusiastic trauma doc hired by the hospital to put it on the map.

Apparently this community hospital had envisioned itself becoming THE trauma center of the western suburbs of Cleveland. They were operating on the "Field of Dreams" theory of, "if you build it, they will come." But, "they" didn't come. The hospital had built the field, but it didn't have the players. Despite the big red-and-white sign, it was still a community hospital, and it was competing against one of the most venerable and highly respected trauma systems in the country, Cleveland Metro. What I failed to realize on my visit to LCH was that I could behold the shiny helicopter, the dazzling ambulances lined up in their bay, and the strutting flight crews in their cranberry-colored jumpsuits, because they didn't go anywhere very often. So much for my dreams of dropping from a helicopter, trauma bag in hand and scuba tank on back, to save innocent submerged trauma victims from a watery grave. Oh, and with Channel 6 News right there filming, of course.

So, I ended up working for a couple of months for minimum wage averaging one run a day at the local hospital ambulance service until we came to a parting of the ways as a result of my lack of appreciation for their cutting edge Craftsman tool boxes, but that s another story. Eventually, I landed downtown working out of St. Joe's for several years, but that's another story as well. Yet even today, as I sit in the back of the rig chatting with Elsie as I transport her back home from the ED at 3:47 a.m. (after getting her stat G-tube replacement), I think of those scuba tanks and what might have been.


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