editors: laura berman howard brick contributing editors: dan borus Sunday magzn inside: page four-books page five-joseph heller page six-week in review mary long Number 15 Page Three Januar ________FEATUF y 19, 1975 E S Meeting skik TI danger with e chaos of 1 running ambulances The men and women on the Fontana-Taylor ambulance service must have quick and accurate reflexes, even on little or no sleep. Trained professionals, these peo- ple prove that ambulance service is no longer a mat- ter of "Hurry Up, Throw 'Em On A Cot, and Bag-Ass It To The Hospital. By KEVIN PERROTA IUXtNING AN AMBULANCE sere- ice does not at first sight re- semble bronco riding. But John Pontana and John Taylor, who op- erate a local ambulance service, are Lmpelled by some of the same fascinations that lure a man to mount an unbroken horse in a ro- deo - the desire to match what is quick and unpredictable with equal quickness, the desire to master danger with skill. The bronco the two men have to ride is the emergency medical situation in Washtenaw County. From the more than 300,000 stu- dent and non-student residents of the county, calls for help flash to the Fontana - Taylor Ambulance Service with the irregular rhythm of a failing heart and the sudden- ness of a splintering windshield. The service - partly subsidized by the county to insure coverage of rural areas, but privately owned and operated - responds to more than 1,000 calls each month. The company, with more than 30 em- ployees, keeps five emergency med- ical vehicles on the road. There is one post each in Chelsea, Saline, and Ypsilanti, and a post with two units at Ann Arbor. Fontana boasts of the company's fast reflexes. "We consistently get to more than 90 percent of our calls in less than 10 minutes," he claims. That's far ahead of the national average. In Detroit, which is smal- ler geographically than Washte- naw County, and where they have more vehicles, they don't even compute a 10 minute figure be- cause it would probably be so bad." Given the least opportunity, John Fontana will try to clear up any misconceptions you- may have about ambulance work. About six feet tall, with a slightly weathered face and a no-nonsense manner, 33-year-old Fontana dominates his small office. His room is tucked away behind the dispatch area, which is crowded with four phones, radio gear, and a five-foot high tape recorder-clock, which looks like the modern descendant of the grandfather model. "This business is more complex than even your stretch of the ima- gination could think," he says. "Most people see an ambulance driving down the road and think, 'Oh, I could do that. You'd be sur- prised how really complex and fast changing it is." Fontana makes a clear distinc- tion between "traditional" and "professional" ambulance services. "Traditionally, ambulance serv- ice was Hurry Up, Throw 'Em On A Cot, Bag-Ass It To The Hospital," he explains. "Ambulance crews weren't trained, ,so anyone could tell you what they wanted done. There was a failure to be profes- sional. Ninety percent of the am- bulance companies used to be run by funeral homes. Why should they make ambulance service a profession?" FONTANA HIMSELF was attract- ed to ambulance work as a boy when his father served on funeral company ambulances. His dad went on to operate his own funeral home - Fontana Funeral Nome, in Ann Arbor. But John Fontana cherished a desire to operate an ambulance service - a professional ambu- lance service. At age 18, he and John Taylor -who met during registration at EMU--considered setting up their own company. But they didn't have the money. Both entered the serv- ice for eight years - Taylor the Navy, where he worked on nuclear submarines and scuba diving, Fon- tana the Army, where he taught electronics and worked 86 hours per week on the side with an am- bulance company in El Paso, Tex- as. Then three years ago Fontana started the present business. Tay- lor joined him a few months later. "The ambulance industry now is in one hell of a revolution," Fon- tana states. "It's becoming a sepa- rate career field like police and firefighting. Traditionally, it was a business for 18-year-old jet joc- keys who wanted to do something exciting until they figured out what they really wanted to do. Now we have people 30 to 35 years old, people with families, register- ed nurses. Nationally, the industry used to have a 70 percent turnover in personnel every six months. Here we have a 15 percent turn- over every year." Also 33 years old, Taylor stands about six inches shorter than Fon- tana. He looks you directly in the eye when he talks, purses his lips firmly when he's listening, and doesn't smile often. He's as no- nonsense as his partner. Ambu- lance work requires military organ- ization, he says, just as police and firefighting. * * * PONTANA - TAYLOR crewmen and women work a 24 - hour day which begins at 8 am. During those hours there is usually some time to sleep. But ambulance peo- ple don't overestimate the length or value of it. At an ambulance post, everyone sleeps lightly. You're always waiting. You may be having a sandwich in the dining area of the loft above the garage, or you may be sacked out on one of the seven beds lined up between the dining table and the stairs. But inside yourself, you're listening, listening for the horn blasts which come ripping through the large windowless loft, knocking sand- wiches out of crewmen's hands, pulling sleepers upright in their beds, sending workers down the stairs to the ambulances below. "I've gone four or five days with- out sleep," claims Jay Blethen, 30, a wiry man with curly brown hair, a moustache, and a thin, high voice. Five days without any sleep? "I take catnaps. My favorite place is behind the wheel of a car," he jokes. "We're paid for 24 hours, and we usually work 24 hours," Kel Lowe asserts. Kel, 26 years old, is thin, with black hair and moustache. "On our day off, we're mostly rest- ing." Fontana - Taylor crews work ev- ery other day. This is more than firemen, who are on duty 24 hours every three days. "It's very rough on family life," Kel states. "I see my wife every other day for an hour." KEL JOINED Fontana-Taylor last July when he and his wife moved to Ann Arbor so that she could complete a program in sue- Mial. education at the University of Licensed Practical Nurse with 14 years experience in various phases of hospital work, Jay is looked up to by other crewmen as a man who knows what he's doing. A wearying, demanding sched- ule. An endless round of meals at places like Arby's and The Jolly Tiger. Low pay - about $700 per month. Why do it? Ambulance workers at Fontana - Taylor say you really have to like it. Alan Hoffman used to sell cam- eras at Sears, but quit because he hated it. He thinks you should put your heart into whatever you do. He describes his attraction to am- bulance work this way: "You turn on the siren and go screaming out into the night. Your patient, when you get there, has a heartbeat of 120, blood pressure of 80 over zip, respiration two, and he's lost three units of blood - which is a lot of blood. What he needs is liquid. You stick an I.V. in, and he swells up and takes a breath. 'Ah,' he says, I feel fine. Say, what happened to my arm?' "Of course, it's not always like that. But when you do save a man's life, he might come up to you after and say, 'Thank you. Thanks to you I'm alive.' That's really every- thing." Both Alan and Kel dream of starting their own ambulance services. Alan plans to go through medical school, and develop emer- gency care "one step beyond where it is now." Kel, who is a Cherokee. Indian, wants to eventually estab- lish a service on the reservation in North Carolina where he grew up. There is no emergency medical care in the area, he explains. "There was a veterinarian who used to suture cuts and things like that. But I heard recently that he died." * * * Jay, driving, flicks on the siren and guns it. Inside the ambulance, two stretchers are neatly made up -white sheets, pale blue blankets. The interior of the ambulance is quiet except.for the tapping of two oxygen tanks, which play a bell- like counterpoint to the nervous song of the siren. The van pulls into the parking lot of a small, modern apartment development. A man stands outside one of the doors, beckoning. A 12-year-old girl sits on a couch by herself, her arms crossed, her legs stuck out straight in front of her. On the other side of the room, several adults and children are sitting and standing, like a jury. Jay squats next to the girl, Kel stands at her other side. "TELL HIM WHAT you took," a woman commands. "I didn't take nothing." "That ain't what you told me." "I told you to keep your hands off my neck." "Did you spank her," a man asks. "Yes, I spanked her." "Okay," Jay says to the girl quietly, his voice more high-pitch- ed than usual. "Let me ask you something. We're not the police. Did you take any pills or drink any medicines?" A shake of the head, no. "Can I check you out to make sure?" Jay asks, taking the girl's small wrist, and pulling out an in- strument with a little light from what looks like a big toolbox. "She don't obey her mother and father," a man rumbles. "There's absolutely no sign that she's taken anything," Jay an- nounces after a minute. "She took a bottle of aspirin once," the man retorts. "You better take her to the hospital and have her checked out. I want her check- ed out." down?" She shakes her head, no. This isn't a medical problem. The ambulance takes off at normal speed for St. Joseph Hospital. "Did you really take anything," Kel asks while taking her blood pressure. "No." "Just like me. If I'm upset about something I tell- my wife, 'Oh, I'm fine.' Are you sure you didn't take anything?" A nod, yes. "Would you tell me if you had?" A nod, yes. "I do believe you're telling me the truth. Well, you know what? You're healthier than I am." He writes her vital signs on a slip of paper. "Do you like school?" "No. But I like the boys at school. "You got a boyfriend?" A nod, yes. "You got two boyfriends?" An- other nod, yes, and a smile. "You're pretty when you smile, you know that- You should smile more often." AT ST. JOE'S, JAY describes the situation to a doctor who hard- ly looks at him, and who walks off almost before Jay finishes speak- ing. "He's heard it all before," Jay comments. "I've been through that whole ball of wax myself with my par- ents," Jay says to Kel as they leave. "Who hasn't? It's up to the two of them, the girl and her mother, to straighten it out. She's 12 years old. Her mother spanks her - that an invasion of her new- found privacy. What kind of reac- tion did she expect?" The two men get back in the am- bulance, to drive back to the post, gas up, and drive to dinner. It's six o'clock, but the day isn't half over for the two men. Who can tell what tonight will bring. Somethinv everyone at Fontana-