JEMS.com Editor s Note: Read Dr. Bryan Bledsoe s take on how far EMS has come in 30 years in his Thursday column.
NEW YORK -- At first, Bill Amaniera thought it might be his imagination. "I noticed the same woman in a few different stores looking at me like she was going to say something," he recalled recently. "I finally asked her, 'Do I know you?' Then she asked if I was an EMT. Well, then I figured she was a patient."
With a smile, the woman pointed to her 18-year-old daughter standing next to her. "You delivered my daughter."
"That's one of the things I love about this job, it's spontaneous. You never know what will happen."
After decades in public service as an emergency medical technician, Amaniera is now the interim director for EMT's and paramedics at Richmond University Medical Center's (RUMC) ambulance department. And, like other veteran prehospital professionals, he has witnessed first-hand the long road from the 'grab and run' days to the advanced levels of care now available.
In the early 1970s, many of Staten Island's more seriously injured victims would have to be treated outside the borough in order to provide the best level of in-hospital emergency care.
"There's been a marked improvement in comparison to how it was (in the '70s). Any major trauma would have to be transported by Medivac (helicopter) off Staten Island," said Amaniera. "Then, during the '80s, there was this odd-even system."
He went on to describe a system that allowed the former St. Vincent's Medical Center and Staten Island University Hospital (SIUH) to share the designation of trauma center by having one hospital receive seriously injured patients on even-numbered days while the other ER would receive such patients on odd-numbered days. Even though neither hospital had full trauma center status, at least most seriously injured patients could receive life-saving treatment without leaving the Island.
"Both hospitals are now fully functioning trauma centers," Amaniera pointed out. "We have a burn center at SIUH now, as well."
Does Staten Island need trauma centers? Apparently so. A booming population and congested roadways still spell trouble for drivers. "There are too many drunk driving incidents here," Amaniera said.
"D.A. Dan Donovan has really stepped up. I've seen what he's done. There are more check points than in the '70s and '80s. Unfortunately, I guess there's not enough.
"I've given talks to adolescents on the seriousness of getting behind the wheel after having a few drinks," said Amaniera. "I do that because of what I've seen."
Many rescue workers and prehospital medical care providers suffer from job burnout. How does Amaniera see himself in this respect?
"I was on site during 9-11. I lost a lot of friends that day. It was a different time before then. Afterwards, it was a wake-up call. It kind of rejuvenated my outlook on it -- the whole perspective of the system. There's camaraderie within the EMS community."
Even his feelings toward certain types of calls has changed, such as ones that previously may have been more annoying due to their non-emergent nature.
"You still get the toothaches and other calls, but for some people -- they just don't understand. I explain to my people (EMTs and paramedics) that no matter what, you've got to try to help these people along -- get them educated. We can do things in the hospital like refer them to social services so they can be helped."
In a field where clashes and burnout can sometimes distract the professionals from the task at hand, Amaniera, a veteran of 30-plus years on the job, remains optimistic.
"Everybody is on the same team and at the end of the day, that's the way it has to be. I get to the scene, I try to get everybody involved -- give them a sense of responsibility," said Amaniera. "You forget about personalities. The bottom line is about giving the best care for the patient."Gail Larkin's column on Emergency care appears Monday in the Health section. Questions and comments can be addressed to her in care of the Advance.