The Front of the Frontline

“Front of the Front Line”:

EMS Honors its Covid-19 Dead

Whatever the “Front of the Frontline is”, that is where the women and men of EMS always stand.

Sometimes people hand you a dead blue baby, and you have to do everything at 10,000 miles an hour. Sometimes you turn up on a huge hysterical crowd where a couple people were shot and are bleeding everywhere. Sometimes you have to deliver a baby in a project stairwell. Sometimes you show up to a tight asthmatic gagging ready to arrest. Or you bring back a junkie, over and over and over again. The same junkie. Or sometimes you show up and someone was just raped in a park. Or you show up and shots are still being fired or a building is still on fire and you have to stand across the street in case someone has been burned alive get carted out and thrown on your stretcher.

You have to rely on your training. For an EMT three-months and for a Paramedic one year.

You had to feel and to care so much to have even shown up for the training. But to keep working you have to learn to un-feel and un-care and learn to forget. 

You had to learn to drive with an efficiency and speed that allows you to get to these terrible moments quickly. You have to carry with your partner 125 pounds of gear up the stairs, or down a subway tunnel, over the river or through the woods. You have to bring the first thirty minutes of the ER out to the streets. 

EMS did this during Hurricane Sandy, we did it on 9.11 and we did this for the very worst five weeks of the Covid 19 Pandemic. We are made “different” by how much we bring, but also for being closest to the danger of an emergency, we always are bold. We leave no one behind. 

It was like a vast invisible wave broke over the city and suddenly everyone who was elderly and everyone who was infirm started going into cardiac arrest.

It was like a natural disaster, except that it wasn’t. There was no clear epicenter or limit to the contagion. There was no sense that the worst was ever over. There was no warm zone. There was nowhere to retreat to except sleep when you could get it.

For most of the Pandemic it was all of us together against an invisible relentless enemy, rapidly spreading out amid fever, cough and death. Unlike all other “front line” services, EMS was running towards unpredictable death, as usual with inadequate equipment, shortages of everything, being compensated as though it were all a summer job. 

I remember very well the worst five weeks of the Pandemic, for there we were with our ambulances, our stretchers, our chairs and our oxygen tanks, arriving at cardiac arrest, after arrest, after arrest. Using the same masks for weeks. Carrying men and women out of their homes in our stair chairs as they desaturated and respiratory arrested right in front of us. In a city that suddenly couldn’t breathe. 

In the very worst period, those five weeks of total chaos; 20% of the FDNY went out sick. Fire Fighters stopped going out on medical calls, then going in much much slower than usual. In that chaos hundreds of EMTs and Paramedics came from around the country, deployed to NYC to manage a daily call volume above 7,000 a day. All services took casualties, everyone was thanked for their service. The pandemic moved to other parts of the country. Some we saved, many we did not. 

Sometimes a civilian friend or a pretty girl at the bar will ask, “What’s the craziest thing you’ve ever seen.” And then, no matter what you say or don’t say, they change the subject. It’s just so dark what we actually have to do. Show up over and over again as people get sick or die. Over the course of the Pandemic a lot of people died one after another.

Recently, as the smoke began to clear the from Covid-19 Pandemic which killed over 22,872 New Yorkers; the Emergency Medical Services counted our own dead. 

So far there have been at least 17 active duty deaths, and 9 amid EMS retirees. Thirteen died from line of duty Covid-19 exposure. Three were from out of town. Several were 9.11 Responders, men and women with over 20 to 30 years in EMS. Several worked at Voluntary Hospitals. Most people in EMS with or without a pension can’t actually afford to ever retire.

Four didn’t die from Covid-19 directly. They died from the bullets of a gun and from drug addiction. Two from overdoses.Two commited suicide off the clock.

John Mondollo was a 23 year old probationary EMT at the FDNY EMS at Bathgate Station 18 with less than 3 months on the job. Matthew Keene was an FDNY EMS Lieutenant, an experienced EMS Officer at Station 17, the Highbridge Outpost. Which is to say one was brand new and one was quite experienced. 

Alexander Raso, a 24 year old FDNY EMT from Station 59 died from a drug overdose in the very beginning of the Pendemic. Brandon Dorsa, a 36 year old FDNY EMT was critically disabled when his ambulance was struck and flipped over in a collision in 2015. He was permanently disabled, developed serious depression and subsequently transferred to Dispatch. His death,  another an alleged suicide was reported on Wednesday 7/15.

The NAEMT published results from a survey indicating that, compared to the general public, EMS professionals had a tenfold higher rate of suicidal thoughts and attempts.

Perhaps the greatest unquantifiable stress associated with the Emergency Medical Services is the feeling that you and your partner have been trained well and tasked to save lives, but over and over again you must watch people die right in front of you. That is in essence a serious part of our job, we must day after day, night after night be there for the worst moments of your lives, realistically speaking, statistically speaking. We are only going to save a certain portion of the lives we are thrust into, called into at the very worst moment to effect. 

The very best EMT or very best Paramedic is only going to be successful some small part of the time, but on varying levels, in varying ways your traumas seep right into us.

The vast majority of people who go into cardiac arrest in a prehospital setting do not come back, and when a combination of early CPR, intravenous epinephrine and defibrillator shocks do bring them back only a tiny percentage of a percentage are neurologically intact, walking out of that hospital to see their families. Over 90%, they just die and they stay dead. They might die in an ER, or spend months or years on life support, but most do die. 

These are very unnerving, intimate moments. We are physically pumping the heart of your dead loved one. We are pushing medications, placing a tube down the airway, we are for about twenty or thirty minutes, with fire men hovering around us, angels of life and death. In the park, trains, six floor carry down tenements, 5 star hotels and housing project towers.

In moments like these, a whole family screaming and crying, your partner advancing a laryngscope blade and ET tube down the trachea of your loved one, who had just been having dinner with you. While you watch the EKG screen flicker out the signals showing what is happening in this person’s heart. You tie off, you insert an IV, you spike a bag of normal saline and begin pushing the appropriate variants of drugs or shocks per signal, the EMTs do CPR, and you try not to get blood, vomit or feces on your uniform. It’s very stressful work trying to bring people back from the dead. It also doesn’t pay the bills consistently in New York City.

So we all have 2, 3 or 4 jobs. We all work 50, 60 or 70 hours a week. A lot of the Medics are in Nursing or PA school too. It is that combination of high stress, chaotic draining interactions, lack of any respect and long long work weeks that does people in. People abandon this field the very minute they can. Most quit this field after only 4 years. 

Some go crazy from it. The rest, it changes us probably for the very worst. The saying goes “Don’t lose your civilian friends”, but you do. And for some, 10 times the national average, they give up. They take their own lives in one way or another. Like Lt. Matthew Keene and EMT John Mondello with guns. Like FDNY Paramedic Lenny Joyner who went alone up a mountain in 2012. Like EMT Alexander Raso who overdosed in March of 2020. Like many that never even made the news.

The parity issue is larger than EMS. It has to do with a wider issue of the public paying for two systems. One that’s mostly white and one that’s diverse, but the diverse system always gets less and inadequate service.

EMS “deserves more” not because it is stressful, or dangerous or how well we did during the Pandemic. We deserve more because of supply and demand. More because we generate profits. More because we do so much every day for New York.

For the sixteen Martyrs we lost, that we know about, for the nine old time EMS members who just passed for all the 13,500 men and women out right now on the trucks as we speak, let’s renew our demand for parity. Let’s be united as a service that is resourceful, resilient and diverse as the city we serve. We do as much or more as any other uniformed civil servant. We’d like to be paid like adults, to live in the city we come from. The city we serve.

Rest in Power:

FDNY Lt. Matthew Keene 

FDNY EMT Brenden Dorsa

FDNY EMT John Mondello

FDNY EMT Idris Bey

FDNY EMT Gregory Hodge 

FDNY EMT Douglas Gertz

FDNY EMT Richard Seaberry

FDNY EMT Alexander Raso

FDNY EMT-D John Redd

FDNY EMT-D Michael Lalima 

FDNY EMT-D Emilio Navedo

Paramedic Marlene Picone/ Maimonedes 

Paramedic Anthony ‘Tony’ Thomas  (HHC/FDNY EMS), NYU Langone

CCEMT-P, RN Brian Saddler/ Northwell

Paramedic Paul Carr/ Ambulnz

EMT Mike Field/ VSFD

EMT Salvatore Mancuso/ BGFD

17 Active Duty EMS Deaths

Retired MOS

FDNY Chief Edward Gabriel ®

FDNY Lt. Trudel Hiller ®

FDNY Lt. David Stone ®

FDNY Lt. Richard Dunn ®

FDNY Paramedic Robert Gibbs ®

FDNY EMT Jim Geraci ®

FDNY EMT Robert Hudson ®

FDNY EMT Robert Hudson ®

EMT Sy Collins ® 

9 Retiree Deaths

Author Bio:

Paramedic Walter S. Adler is a 16 year veteran of the Emergency Medical Services and a Native New Yorker. He served the FDNY EMS for 4 years and has served overseas in Israel, Palestine, Egypt, Haiti, Iraq and Syria. He is currently a 911 Paramedic with Montefiore EMS and BronxCare EMS in the Bronx.

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