Imagine going to work each day not knowing what to expect. You only know that you'll have to deal with people at the worst times of their lives, and many will not appreciate what you do. Your job requires physical strength, technical skill and the ability to smile through it all. Welcome to the world of the paramedic.

It takes a certain kind of personality to do this work well and to enjoy it. These are men and women who wouldn't dream of being stuck behind a desk. They enjoy the excitement and unpredictability, and take great pride in what they do.

Kevin Burgess, EMT-Paramedic, and Joey Giovingo, EMT-Paramedic, have been working in emergency medical services for 20 and 15 years, respectively. Joey is a second-generation EJGH paramedic following in his father's footsteps. The two have been working together for so long, they can often work a scene without speaking. They both have a great sense of humor and a talent for putting patients and families at ease.

The Day Shift
7:55 a.m.
Their first call of the morning is a sad one. Kevin and Joey are dispatched to the address of a hospice patient who has passed away in his home as he and his family intended. The paramedics' job is to run an EKG and confirm the man has died. As family members gather at the home, they become the ones who need attention. Comments such as "Are you all right?" and "Call us if you need anything" let the family know that someone cares and understands they are going through a difficult time.

"Death is always hard on a family, even when it's expected," says Joey.

9:38 a.m.
Their next call brings them to an apartment complex they are both familiar with. Their patient is a man who looks far older than his 59 years. He has numerous chronic health problems, including kidney failure, diabetes and heart disease. Today he's not feeling well and his anxiety level is very high. His hands shake and his voice cracks when he tells the paramedics what's wrong.

In the ambulance, Joey starts an IV and checks the man's blood sugar. He places EKG leads on the man and the monitor shows a rapid heartbeat. Joey talks to the man, telling him exactly what he is doing. He uses a bit of humor to help calm his patient. The heart rate on the monitor slowly drops to normal.

11:22 a.m.
No shift would be complete without at least one visit to the Kenner jail, and that's where Kevin and Joey are headed next. It's not uncommon for prisoners to complain of health problems to get some time outside the cell. Nonetheless, each complaint must be taken seriously by prison staff and paramedics. Today's visit is for an inmate complaining of a dog bite. When paramedics look at the wound, they see a fairly well healed bite mark (it looks more like a human bite than a dog bite) with no sign of infection. The inmate will have to finish his sentence before he sees daylight.

Today is fairly calm, but Friday the 13th is on the horizon. Are paramedics superstitious? "The only thing than concerns me is a full moon," says Kevin. "Statistics show that we're busier."

"I'm only superstitious about two things: when we sit down to eat and when our shift is about to end," adds Joey. "That's when a call will come in."

1:17 p.m.
With that said, another call comes in. This time it's a man having a seizure at his workplace. Patients with seizures are unpredictable, and a few present a danger to paramedics. The danger can come after the seizure when some patients become confused and anxious, and sometimes act out violently. Today's patient is a big guy, about 6 feet, 4 inches tall, which puts the paramedics on guard. Fortunately he spends his post-seizure time sleeping and is awake and lucid by the time the ambulance reaches the hospital.

It's not all thankless, backbreaking work, of course. There are calls that remind the paramedics of why they chose a career in emergency care. Kevin relates a story of a mother in labor with her first child. A doctor at a downtown hospital told her she was nowhere near delivery and sent her home. Shortly after arriving at her home on the West Bank, she realized the doctor was very wrong. She tried to make it back to the hospital, but there wasn't enough time. She met the ambulance at a Shell gas station, where the paramedics quickly realized they would be delivering a baby in the back of their truck. Fortunately, there were no complications and the mother delivered a healthy baby girl. Joey suggested she name the baby Shelly in honor of her birthplace (mom disagreed). When the ambulance arrived at the hospital, they were greeted by the same physician who sent the mother home earlier that day.

"Come here," the mother said to the doctor. "I have something to show you."
"It's calls like that," says Kevin, "that make it all worth it."

Many of the calls paramedics respond to aren't really emergencies at all. This is a source of frustration, as it takes up time and resources that could be used to help someone in a life or death situation. What's even more frustrating, though, is when a patient who should be transported to the hospital refuses treatment. Joey and Kevin's final call of the day is just that.

4:26 p.m.
They go to a residential neighborhood in Metairie where an older man has passed out while talking with his neighbor. He really should go to the hospital for an evaluation, but refuses. Joey does his best to convince the man that his condition could be serious, and that he's not comfortable leaving him. Unfortunately, there's nothing Joey can do to change the man's mind; and because he is alert and not disoriented, the man can't be forced to go to the hospital. Joey talks to the man's wife, who assures him that the man's physician will be informed of the incident and that she will call 9-1-1 if it happens again.

"I'll really wish he'd gone to the hospital," Joey says shaking his head.

The Night Shift
As daylight fades and most people are winding down from a hard day of work, Linda Thompson's day is just beginning. Linda is an EMT-Paramedic and the night shift supervisor, responsible not only for delivering patient care, but for overseeing all the crews on the street. She drives an SUV rather than an ambulance, moving from call to call and providing assistance when necessary. She also covers situations, such as public assistance calls or calls that require stand-by time, that will tie up an ambulance. Linda has the equipment to provide patient care and can call on another crew if she needs help. In addition to all this, Linda resolves staffing issues, processes paperwork and checks equipment.

"I do this work because I love it," she says. "I love working for East Jefferson General and being part of the 9-1-1 service." She adds that many of the paramedics she works with feel exactly the same way. Many say they have considered nursing or medical school, but have decided against it. "Why bother going back to school?" comments a paramedic as she clocks in for her shift. "Being a paramedic is all I want to do."

7:10 p.m.
Linda's first call of the night is a grease burn. A woman was heating cooking oil and started a grease fire. She has burned her hand severely. Linda wraps the woman's hand in gauze and offers to take her to the emergency room. The woman refuses, saying she has already called a friend to take her. Linda explains that she must have the burn examined and cleaned by a doctor, or serious infection will likely result. The emergency room can also help control the intense pain of the burn. "If your friend doesn't show, please call us back" Linda instructs the woman.

8:28 p.m.
The next call Linda takes is a public assistance call. A public assistance call is when someone is not injured or ill but needs assistance, such as getting up after a fall. Tonight, a man has fallen out of his wheelchair. He doesn't have enough strength in his legs to hoist himself back into the chair, and neither does his wife. Linda realizes she will need another paramedic's help to lift the man and calls for assistance. While waiting, she talks to him to ease his anxiety and assures him he has no reason to be embarrassed. The paramedics arrive and they use a bed sheet to lift him into the chair. This method is easier and safer for the paramedics and much more comfortable for the patient. Linda asks the man if he needs anything or needs help getting somewhere. "Nope," he says sounding very relieved, "I'm going to bed."

"Private services won't even do that," Linda says after the call. "We get opportunities to really help people who don't know who else to call."

9:35 p.m.
With the man safely back in his chair, Linda heads back to the office to complete another part of her job. To comply with government regulations and hospital policy, paramedics must complete several pieces of paperwork for each patient they see, even if the patient refuses treatment. Making even a minor mistake could cause billing and insurance problems. Linda and the other supervisors check the paramedics' paperwork line by line for accuracy before it is submitted. The job is tedious, but necessary.

While Linda works in the office, a crew comes in after a difficult call. Erin Phillips, EMT-Paramedic, and Christine Bass, EMT-Basic, have just returned from a home where a wife has discovered the body of her husband. He died of a heart attack that occurred sometime earlier in the day, when he was home alone. The crew responds to the wife's 9-1-1 call within five minutes and pronounces the man dead; there is nothing they can do. The wife is devastated by the death of her husband, who was in his mid 50s and had no history of heart problems. Her grief is expressed in anger toward the paramedics. Erin and Christine turn the other cheek to the woman's verbal attack, knowing she is overwhelmed with grief and that it isn't personal.

In addition to verbal abuse, paramedics are often physically assaulted as well. "I've been bitten, punched, kicked and spit on," says Erin. She and her colleagues show incredible compassion and empathy when these things happen. They understand that stress and illness can provoke such reactions from patients and their families in the emotionally charged atmosphere of a medical emergency.

12:42 a.m.
Linda gets back in the truck to respond to the next call. One of her crews has responded to a 9-1-1 call from a woman who says three masked men broke into her apartment and hit her in the back of the head. The ambulance is on standby while Sheriff's Deputies search for the men and secure the scene. This is one of the scenarios where a supervisor can take over to keep a crew on the street and ready for an emergency call. Linda heads to the location.

12:50 a.m.
Before she can get to the scene, Linda is diverted to a nearby location where a young woman has had an asthma attack and possibly a seizure. The complex where the woman lives is a poorly lit maze of courtyards and parking areas. Because it is adjacent to the crime scene, Linda asks that a Deputy enter the apartment with her. When Linda finally locates the correct apartment, she finds the woman to be more inebriated than anything else. She is with her brother, who tells Linda that they were drinking in the French Quarter when the woman had a seizure and that the asthma attack occurred when they returned home. Linda finds the woman to be breathing well and can find no sign of a seizure. She leaves the woman in the care of her brother to sober up.

2:19 a.m.
Part of the unpredictability of the paramedic's job is that they may not get the whole story before they arrive on the scene. Their information comes from dispatchers who speak with the patient or a family member, friend or sometimes complete stranger. A caller may not know what has happened, or may be too emotional to communicate clearly with the dispatcher. Sometimes, callers try to conceal the cause of an injury that resulted from illegal activity.

When Linda responds to a sleeping pill overdose, she knows the information may not be totally accurate.

"This could actually be a heroin overdose," she says. "Someone might be trying to protect the person by saying they took sleeping pills, which are legal, instead."
At the scene, the paramedics find a bottle of prescription sleeping pills and are reassured that heroin or other drugs are not involved. The overdose turns out to be accidental, and not a suicide attempt.

3:06 a.m.
Linda now heads for the scene of the robbery, which is just a block away, to relieve the crew on standby. Unfortunately, something has happened to complicate an already confusing scene. The crew, Gaynell Martin, EMT-Paramedic and Jamal Green EMT-Basic, has a baby in the back of the truck. They have no idea who the child's parents are, and the babysitter responsible for his care is handcuffed in the back of a police car. Gaynell takes a deep breath and explains.

When Gaynell and Jamal arrived on the scene, Sheriff's Deputies instructed them to stand by until the area was safe. Jamal got impatient and opened the ambulance door intending to ask the police officers about the situation. The three gunshots he heard next convinced him to shut the door and continue to wait. Many residents of the complex were loitering in the courtyard area, either barred from entering their apartments or just curious. One of them was a young woman with a baby. It was cold outside, and Gaynell handed the woman a blanket to wrap the baby in. A few minutes later, though, the baby was in the arms of a police officer and the woman was handcuffed in the back of a cruiser. The woman, they would find out later, was the child's babysitter, and the officer suspected she had a connection to the crime. After detaining the babysitter, the officer handed the baby to Jamal and walked away.

At this point, no one in the ambulance is complaining too much about their adorable little patient. The baby is healthy and happy, and immediately takes to Gaynell. He coos, chews on his blanket, plays with his toes and eventually falls asleep on Gaynell's shoulder, blissfully unaware of the chaos around him. Linda is concerned that the baby's mood might change for the worse if he gets hungry or needs a diaper change. She heads to East Jefferson General for some formula and diapers, and a chat with the social worker on call for advice on what to do if they can't locate the baby's mother.

At the end of this two-hour adventure, the baby's mother returns home from work and takes her son. The baby's father was one of the men arrested, although he was not involved in the original robbery. The babysitter is released and, slowly but surely, the courtyard begins to empty. Through it all, the baby sleeps peacefully. Luckily for him, he has no understanding of what has happened this evening.

5:30 a.m.
Night is now turning back to day. As the sun comes up, the paramedics head back to the office to regroup and debrief before heading home. The day crews are already hitting the streets.