PROVIDENCE, R.I. -- On a recent Saturday night, as many Brown University students prepared to set out for on-campus parties and Thayer Street bars, four radios crackled to life in the basement of the University Health Services building. A student had sustained a sports injury earlier in the day and needed transport to Rhode Island Hospital for care beyond what the University could provide.
Brown's on-duty Emergency Medical Services crew consisting that night of student volunteers Dan Resnick-Ault '09, Cathryn Olsen '09 and Brita Larson '11, along with paid supervisor Brendan McStay sprang into action. After gathering jackets and equipment, the four rushed upstairs and helped the patient into an ambulance idling in the parking lot behind the building.
Unlike Dartmouth or Cornell universities, where student Emergency Medical Technicians call in municipal ambulances for life-threatening emergencies, or Penn, which has no EMS service at all, Brown belongs to the 10 percent of colleges that maintain Advanced Life Support services.
On College Hill, no outside crew will arrive to take over. Whether the problem is a dislocated shoulder or cardiac arrest, patients at Brown are evaluated, treated and transported by the University's own EMS teams, which must meet the same standards as any professional service.
That night, the team divided responsibilities quickly. Resnick-Ault drove and Larson took blood pressure with an old-fashioned nylon cuff, while Olsen quizzed the patient on medical history and made small talk ("Is this your first time in an ambulance?"). McStay, the only paid member of the crew, kept careful watch over the scene.
The patient, a bit dazed, stared at the sterile, well-lit interior of the ambulance from a stretcher bolted to the middle of the floor. Glass-fronted cupboards filled with supplies lined the walls, along which the EMTs sat on cushioned, bench-style seats. An external defibrillator hung from one wall, wires protruding in all directions.
Soon, the team arrived at Rhode Island Hospital.
McStay and Resnick-Ault wheeled the patient in through a set of glass double doors reserved for patients arriving by ambulance. A nurse took over and began entering medical information into a computer console.
When the ambulance pulled away several minutes later, the patient had been transferred to a bed and had joined the queue of others awaiting treatment.
Overall, there was little to distinguish this Saturday from any other Saturday that Brown EMS covers each year.
With 115 volunteers, each of whom works a total of 24 hours per month, the organization is one of Brown's most popular extracurricular activities.
Brown also maintains a paid staff of five, led by EMT Amy Sanderson.
"It started as a volunteer organization and, eventually, it became clear that we needed a paid supervisory staff because an EMS service is a lot of work to run," said Sanderson, who also works as a volunteer EMT for her hometown fire department in Warren.
Many of EMS's volunteers come from its 10-week summer course, which meets on campus four times a week and qualifies its students for Basic EMT certification. Others arrive at Brown already certified.
EMSmaintains a speedy five-minute average response time for its 900 annual calls, McStay said.
The day after a patient is taken to the hospital, a nurse from Health Services will call to see how the stay went, offer advice and schedule a follow-up appointment, McStay said. Before the crew leaves a patient at the hospital, it provides a cab voucher for transport back up College Hill.
"The care's not going to stop when you walk out the door of the hospital," McStay said. "It's going to continue when you get back to Brown."
BACK IN THE OFFICE ...
After the hospital trip, Brown's EMS crew settled into a more typical nighttime routine in the threadbare but homey office that serves as its headquarters in the Health Services building. Its first priority was dinner, which had been procured earlier in the night during a trip to Thayer Street in the ambulance, of course but abandoned once the first call came in.
After the meal, McStay surfed EMT blogs at an aging desktop computer, while the others chatted about their reasons for joining the service.
"I read a book called 'Rescue 471' by a guy who was a paramedic in Hartford," Resnick-Ault said. "It was a little bit romanticized ... but it got me into it."
Resnick-Ault took a night class at Northeastern University during his senior year of high school and took the certification exam soon after he turned 18.
Now, in addition to his work at Brown, Resnick-Ault works up to 20 hours a week in other EMS services: a private company in Rhode Island and Sanderson's volunteer department in Warren.
"After having a few really good medical calls at Brown I decided that I wanted to work somewhere where the population was a little bit more at risk for more health problems," he said.
Among other things, Resnick-Ault said his outside work has taught him the value of humor. "When you have a 27-year-old guy with testicular torsion, you cannot provide adequate care without joking around with him," he added. "It's part of the care because if that's something the patient is uncomfortable with, you have to find a way to make them comfortable."
Olsen said that during freshman year, she was debating whether to attend medical school or go into research after Brown. She enrolled in the EMS summer course to get a taste of real-world medical work.
"It was really one of the best decisions I've made at Brown," she said.
Now, Olsen is planning on attending med school. She's also dating Resnick-Ault, after the two met in an ambulance.
"I sniped a shift from someone so that I could work with her and ask her out," Resnick-Ault said. "We have a lot of fun together."
In addition to several couches and bunk beds, on-call EMTs can take advantage of an aging big-screen television and a sizable video library with titles as diverse as "Indiana Jones," "King Kong vs. Godzilla" and "Sister Act 2: Back in the Habit."
"I bring work sometimes," Larson said. "Generally, though, I assume it won't get done. ... I take the time here as a break in the week to relax."
... AND OUT AGAIN
At 2 a.m., the team's radios buzzed to life once more. An inebriated student was vomiting at an off-campus residence, and one of his friends had called the Department of Public Safety.
Again, the crew set off, followed closely by a DPS officer in another vehicle.
When they arrived, the patient was leaning on a porch railing, semi-conscious. Larson, as the least experienced member of the team, volunteered to question the patient about the location of his Brown ID (eventually found by a friend) and how much alcohol he had consumed ("too much").
The patient was lowered onto a stretcher and carried down the stairs into the ambulance. As they set off toward the hospital, the crew members took turns questioning the patient as he drifted in and out of consciousness.
"Can you open your eyes for me?" Olsen asked, ready to check their dilation. The patient opened his mouth. "No, your eyes. There you go."
"Did you do any drugs tonight?" McStay inquired. "We don't care if you did, we just need to know."
Somehow, their combined efforts resulted in a University mailbox number and an age, which Larson recorded. By the time they'd arrived at the hospital, she'd gotten a good start on the standardized form that the team must fill out for every call.
Upon leaving the ambulance, the patient resumed vomiting, and a man in green scrubs rushed up with a pink plastic bucket. The EMTs shared his information with one nurse, while another gave the patient a breathalyzer test.
As the ambulance pulled into the Health Services parking lot for the last time that night, the team members seemed content with the night's work.
"It's definitely a community," Olsen said of EMS. "We're a family in a lot of ways. We spend a lot of time together and, you know, we're family. We have our little fights, our little drama, but we're close."