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L. Neil Smith's
Number 755, January 26, 2014

The whole of American domestic history has
consisted, pretty much, of one long, constant
battle between those two points of view,
freedom versus Puritanism...

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Policification of Fire Departments and EMS
by Joe Collins

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Attribute to L. Neil Smith's The Libertarian Enterprise

My opinions are my own and do not reflect the views of my employers, past, present and future.

They are also my opinions and observations, nothing more.

I have been involved in EMS and fire for almost fifteen years as a volunteer EMT, paramedic and as a volunteer fire fighter. I worked for almost eight years in the downtown area of a metropolitan area that has been declining economically and socially for the last twenty years.

I probably have another five years in this business before I find some other way to make a living. Currently, it's a calling for me, not just a job. I like being able to occasionally help the sick, injured, frightened and dying despite the hours, working conditions, crummy pay and lack of respect by everyone who deals with us. I have two college degrees and could make a decent living with a little work, but I still get up in the morning with the expectation that I may be able to make a difference despite that chance that I could die in a flaming ambulance wreck caused by a cell phone using moron, get killed on a call by a wacked out nut job or be crippled for life lugging some 400 pound medical train wreck down stairs, all for the princely sum of $32K or so a year.

Not many people know that the average career expectancy of a paramedic is only five-years. Understand that it takes typically two years of school to become a paramedic, and at least three more years of experience depending on the call volume to get decent at the job. Shootings, stabbings, suicides, cardiac arrests, difficulty breathings, overdoses, endless transfers, all should add to your skills and abilities.

Many paramedics and EMT's leave the field because of many of the reasons discussed previously, others go onto other careers including law enforcement. And many young kids joining the field think it is all glory and saving lives like what they see in TV shows and movies whereas the reality is dealing the worst things that you can imagine, endless "frequent flyers," washing blood and vomit off your uniform and doing the "granny shuffle" taking people to and from to nursing homes and the hospital.

We also receive almost no respect from anyone who deals with us—I've been insulted by hospital CEO's all the way down to CNA's, patient's, families and anyone else you can think of and much more.

Now, with that background, understand that from your first day in EMS class it is pounded into your head, "Scene safety, scene safety." You were not to enter a scene without making sure that the scene is "safe." Now, safe is a relative thing—we all have to consider the potential danger on every scene no matter what it looks and sounds like. As an example, I was once attacked while at an extended care facility that costs over $6K a month to live at.

If there is a shooting, suicidal person or potential for violence, we are to wait until police go in first and let them clear the scene for you. Never mind it might take them a while to arrive on scene and the patient may bleed out on the front lawn while the cops do their thing. On the other hand, when a scene becomes unsafe—which happens all of the time, and you needed help, they always seem to be ten-minutes away.

The joke in EMS class was that the police were the "blue canaries." Like the canaries carried into a coal mine to check for the quality of air, the idea was that if you rolled up on a crash say involving the potential for hazardous materials, and you saw a police officer laying on the ground clutching their throat and twitching, put the ambulance in reverse and get the hell out of there.

It is also pounded into our heads both in the fire service and EMS that on a scene, my first priority is my safety, then that of my partner and fellow first responders, followed by the patient and public at large.

As a paramedic, body armor has always been on the list of equipment that could be bought with your uniform allowance. There are several paramedics in a service that I know that have bought soft body armor and carry all sorts of knives and "compliance" weapons. They would carry guns if they were allowed to do so. However, they work in a rural system beset by meth cooker types and general dirt bags. I worked there for a while and at several scenes I wish that I had access to air strikes and artillery on call.

The concern is that we, firefighters, medics and cops all wear uniforms and many in the public can't much tell the difference between of us. I feel there is a deep distrust of anyone in authority that is growing in this country.

Many of us first responders—police, fire and EMS do a horrid job in nasty places and don't get respect from anyone. We deal in the worst that humans can do with each other all of the time—I've spent too much time washing brains off my boots over the years and have the nightmares and PTSD to prove it.

As for medics working for private services, we get paid horribly for our trouble—I am the highest level of pre-hospital care and am proud of the title "ditch doctor" or "alley doctor" pulling off feats of medicine that scare even ER doctors. Yet the starting wage for many of us $12 an hour. I had to work for almost five years with lots of overtime to break the $40K a year barrier that the local police departments start their new employees at.

There have been more than a few situations in the past that I wish I would have worn body armor—either as a volunteer firefighter or as a medic. I am assaulted while working as a medic at least 2-3 times a year. It's considered part of the job and happens to almost all of us. As much as I want to stomp some of these drunk, drugged out morons, there isn't much I can do if I want to keep my job—I used to love to brawl in the back of the rig, now I just sedate the heck out of them and let them wake up on a ventilator in the ICU.

My physical skills to defend myself are based on years and years of martial arts training and experience, not the stupid classes taught by some employers unsuited for dealing with a violent patient in the back of an ambulance.

As someone who follows the militarization of the police, I'm not sure as to what the future holds after many of us older, more mature medics who believe that the that every contact with the public needs a SWAT team response is a wrong thing retire or find greener fields. For me as a paramedic, an intoxicated, overdosed or psychiatric patient is a medical problem not non-compliance with the police situation.

The attitude of police has changed over the last fifteen years that I've been doing EMS. There was a case around here where a guy had a seizure, wrecked his car, was unresponsive and uncooperative as seizure patients often are, so got tazered for his trouble. He continued to have seizures all the way to the hospital and after he was released he was charged and convicted of variations of resisting arrest. The attending paramedic offered to testify but that was quashed by the employer for unspecified reasons. Thankfully, the patient wasn't convicted but had to pay for lawyers, take time off from work and will have that arrest on his record for the rest of his life.

I don't have a gun, and can often talk the most violent patients into cooperating. Yet, when the police show up, they almost always escalate the situation to the point it makes the patient very much harder for me to deal with. Then they get to go back to their squad car and I have to deal with a very pissed off patient until we arrive at the hospital.

There are police officers who arrive on scene and are helpful, taking your gear back to the ambulance for you, helping haul patients and keeping the family out of our way when needed. Some of them have driven the ambulance for me while my partner and I were in the back of the ambulance fighting for the life of a very sick or injured patient. But the good ones are greatly overshadowed by the jack-booted thug type of officer who is typically young and expects everyone to instantly comply with their every command no matter what is going on.

I think the attitude of the officer arriving on scene to help is based on how the department is run. If the department is staffed with young, ex-military people with all the military toys, and they are allowed by command to do what they need to get the job done, my life as a paramedic suddenly becomes a great deal more difficult. It was so bad where I worked that I took a significant pay cut to work for another company rather than deal with the jackbooted thugs in police uniforms in any way.

There are probably a lot of factors involved in the attitude of the responding police—in one town where I worked, the officers, while being young, were mostly not ex-military, had lived in the town for years or just moved there and were active members in other aspects of the community. They cared about the people they serve and it showed in the way they dealt with everyone.

In other, larger, better equipped—read lots of surplus military toys and similar training, higher call volume systems, everyone is seen as a dirt bag criminal, even EMS and FD. Rather than living in and being part of the community, they live in suburbs and quickly drive out of town at the end of their shift.

Now, this isn't a bash the police type of opinion piece. I am happy to count as friends many officers who believe in actually helping people, contributing to their community and not considering everyone that they deal with as a violent criminal.

The original theme of this article was the militarization of the fire and EMS service. I think that the better term should be "policifying" of those services. It is perfect as many of these services already are paramilitary in nature with command staff, uniforms, policies and procedures for dealing with various situations.

Several firefighters that I know have gone through the LE academy so now they can carry guns while on duty and are technically sworn LEO's. Some of that is involving being a fire investigator with powers of arrest. But with that police badge, they seem to immediately become a super cop. It seems to be the new thing, firefighters and EMS running to get police training and certifications. And access to all sorts of new toys along with the "kick ass and take names" kind of attitude.

There are also a couple of local FD's involved in "tactical medicine." In theory, they would stay outside the danger zone during a SWAT raid to provide care, but some are sworn officers so they can enter with the team, carry weapons and all of that fun stuff. My sources tell me that there has not been yet one call out for their services despite it being in place for half-a-dozen years.

As far as military surplus materials being distributed to fire departments, there is a lot of stuff like trucks that lend themselves to being utilized by other than police services—civilian equipment isn't often built to the rugged standards required by the things a fire department has to do. An average piece of new fire apparatus ranges from $200K up to and over $1M and in these lean times, many departments actively seek military surplus equipment because they can't afford the capabilities offered by such things. However, I can't imagine a circumstance where an APC or MRAP would be appropriate for anything that a fire department would ever do.

A lot of problems going on now I feel are that the public thinks that fire, medics and police are all the same anymore. All branches of first responders seem to be working towards the same goal, being able to carry a gun and police badge so you can force people to do your bidding no matter the circumstances.

In conclusion, there probably are wanna-be police officers in EMS or on fire departments. But, no one is prepared for the repercussions when the lines between all of us are blurred to the point where no one can tell the difference. I hope I don't have to work in the future where if you show up at someone's house to help them and are wearing a uniform, any uniform, you are automatically considered a threat and are there to find an excuse to beat them up and or throw them in jail.

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