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Ambulance Days   3 comments

Posted at 7:01 pm in EMS

I wrote this article in 2011 as a contribution to the newsletter of the Public Safety Writers Association. During a discussion on the PSWA listserv, it turned out that I had worked in EMS at the same time and in the same general area as some of our members. Below is the article I wrote about that time, and some photos from the same early 1970s era.

Like many of you, I put myself through college. I washed dishes, ran tests in a veterinary medical lab, and worked the counter at a convenience store chain. That job provided inspiration for my law enforcement career. After being shot at three times in the space of less than a year, I wanted a job where I could shoot back. By far, the most memorable of my college jobs was as an ambulance jockey, an EMT, on private ambulance services around the San Francisco Bay Area. If you want some insight into what it was like to work on an ambulance in those days, get a movie called Mother, Jugs and Speed. The film depicts the lives of employees of the fictional F&B Ambulance Service in Los Angeles.

Your author, age 21, in 1974.

Your author, age 21, in 1974.

The outfits I worked for weren’t nearly as professionally run as F&B. The one that was most memorable was in San Mateo, CA–Silva’s Ambulance. The ambulances were pink, because that was the owner’s wife’s favorite color. Pink bed linen, and when I got there, they were just moving away from pink shirts, as they were too difficult to find. Bob Silva never bought a new ambulance. They were all used Cadillacs, as he believed a used Cadillac was much classier than a new van-type that actually ran. I was taking a woman in labor to a hospital in San Francisco when the tranny gave up the ghost in Hunter’s Point. I’d told Bob the day before that it was on its last legs, and he advised that I should shut up and drive what I was given to drive. We were dead in the water, and just barely within radio range to call for another rig to take our patient.

The county came out with some new regs for gear that had to be on the rig, and one requirement was an obstetrics kit. Pre-packaged OB kits from Dyna-Med were $7.50 each. Silva bought one. He put it on a rig, sent it to be inspected, then brought that one back and put the same kit on the next rig to be inspected. When it was finally left in the rig he usually drove, he wrapped it in strapping tape to discourage anyone from actually using it. It wasn’t like we didn’t need OB kits. I delivered three babies while I worked there.

The electronic sirens we’re so used to now were just coming into widespread use in the 1970s. Most of our ambulances were equipped with mechanical sirens that wound up slowly when activated. They had brakes on them, and if you forgot to brake the siren before you left the rig, it would take a minute or more to wind down, growling the whole time. The big daddy of these mechanical sirens was the Federal Q2. Some of these are still in use on fire engines. The Q2 is a massive thing, and drew so much power that the engine would knock when you leaned on the button too long—the spark plugs didn’t get enough voltage. Few man-made things are as loud as a Q2. One day, while en route back to the station with a new attendant, I stopped at a Safeway for some groceries. I left the attendant in the rig, telling him to tap the siren if we got a call. When the call came in, he didn’t tap on the horn ring that activated the siren—he held it down. The ambulance was parked facing the store and its large plate glass windows. I heard the siren, then heard the window start to reverberate in its frame as it resonated with the blast of sonic waves—“whap-whap-whap-whapwhapWhapWhapWHAPWHAPWHAP.” I made it back to the rig, screaming ineffectively, before the window shattered.

Between the mechanical siren, separate heater for the rear compartment, more blinking lights than a Vegas casino, etc., the ambulances needed a lot of electrical power. A single battery would be dead before you got to the hospital, so most ambulances had two car batteries, cross-connected via a big rotary Cole-Hersee switch. The switch, which looked a little like the access cover to your house’s sewer cleanout pipe, had four positions: Battery One, Battery Two, Both, and Off. “Both” was the usual setting, but when the rig was parked, it was common to switch it to “Off,” so the batteries wouldn’t be drained if you had forgotten to turn something off. This effectively disconnected the batteries from the rest of the rig. If you wanted to have some fun with another crew, you could turn everything in their rig on, but leave the Cole-Hersee switch off. When they turned it back on, hilarity would ensue.

The gear we had in these ambulances was very basic, and most of us purchased and brought our own equipment to work, rather than provide inferior care for our patients. I bought my own stethoscope and sphygmomanometer (blood pressure cuff), chemical cold packs, wire ladder splints, ammonia “wake up gizmo” ampules, etc. Consumable supplies, such as self-adhering Kerlix bandages and waterproof tape, were stolen from the hospitals. The bandages we had on board, furnished by the company, were made of crumbling linen material from the Korean War era. Oropharyngeal airways were supposed to be either used once and discarded, or autoclaved between patients, but we had neither replacement airways or an autoclave, so we wiped them clean with alcohol and hoped for the best.

Our suction apparatus was powered through the engine’s vacuum manifold. Suction power went to zero when the engine was accelerating. If you were trying to clear gunk from a patient’s airway while your driver was flooring it, you’d tell him to coast until you had made some progress.

We weren’t allowed to say someone was dead, even if the flesh was falling from their bones. Law enforcement officers could make that determination, but doing so meant they would have to remain at the scene until the coroner arrived, which could take hours. This being the case, many officers chose to see some glimmer of life in corpses long past resurrection. We responded to an “11-80” (traffic accident with serious injuries) attended by a member of the California Highway Patrol to find a pickup truck that had rolled over with an unfortunate passenger in the back. The passenger had not quite been decapitated, as his head was hanging by a few strips of flesh. This was one of the more obvious dead people I had encountered, but the Chippie ordered us to run him in. Getting the body onto the gurney had the same effect achieved in kosher slaughterhouses, where the neck veins are severed and the blood is allowed to drain from the carcass. By the time we got to the hospital, the floor of the rear compartment was literally awash in blood, with it sloshing over my boots. I called the office and told them we would be out of service for a while.

This pre-dated the AIDS scare, and even though hepatitis and other bloodborne pathogens were just as nasty then as now (and there was no vaccine), we had no latex gloves to wear. Back then, gloves were worn by medical people to protect the patient from infection. There wasn’t a lot of thought given to protecting the caregivers. I remember cleaning up after an especially gruesome call and thinking that I wasn’t just cleaning something, but rather someone, out from under my fingernails.

One case where we didn’t have to transport was at the home of an older gentleman. I never knew the circumstances that prompted the call, but we arrived a few minutes after the fire department and before the cops. As we walked up to the house, the firemen were walking out, chuckling to one another. “He’s dead!” they said with some amusement. We entered the bedroom to find an older man lying supine on top of his bed, naked. Rigor had set in, so he had been gone for some time. What the firefighters found so funny was that the man had expired while engaged in an act of self-pleasure, and still had the weapon in hand. My partner and I looked at each other and registered much the same expression the firemen had. As we walked out, the cops were just arriving. “He’s dead!” we told them. I suppose there are worse ways to go, but that’s not how I want to be found.

I ran a lot of calls at Silva’s. The shifts were 120 hours long–yes, five days straight. You got paid straight time ($2.00/hour in 1974) for the first eight hours, a guaranteed time-and-a-half for five more hours, and were unpaid for three hours of meals, whether you actually got to eat them or not. Between midnight and eight in the morning, you got overtime for the time you were actually in service on the call. If you rolled and were cancelled two minutes out–which was common–you got two minutes of overtime. I swear some of those rigs could find their own way home, because there were many nights I have no memory of having driven them there. When my days off finally arrived, I would usually sleep through at least one of them.

The full Silva’s uniform was a sartorial delight. Each time they would give me a new uniform article, it would fall to a mysteriously tragic end, so I wore a white shirt, navy blue knit slacks, and a nylon bomber jacket. If you wanted to show you were management material, the required outfit consisted of a white (formerly pink) shirt with royal blue trousers and Ike jacket. The trousers had white piping down each leg, as did the cuffs of the jacket. On each shoulder of the Ike jacket was a huge purple and gold patch, proclaiming the wearer to be employed by Silva’s Ambulance Service, the words spelled out in metallic script. One was also obliged to wear a royal blue CHP clip-on neck tie. Mandatory accessories to the ensemble included a gold metal nametag, white belt, and white leather shoes. Worn on the shirt or jacket was a shield-type gold badge, about the size of a soup plate. All the badges identified the wearers as “Technician,” except for Bob Silva’s. His said, “Owner.” There was a $20 deposit on the badge. Those who were really in with the in crowd had huge custom Western-style belt buckles with their first names spelled out diagonally, and the corners adorned with red crosses, stars of life, or tiny ambulances. However, the crowning glory accessory–and I only saw one of these–was a gold tie bar, wider than the tie itself, with a fine gold chain attached to either end of the bar. Dangling from the chain was a pink Cadillac ambulance. Its wearer was extremely proud of this, and wouldn’t tell anyone where he got it, lest someone steal his thunder.

Employee turnover was around 200% annually, and I was a prized employee because I always showed up on time and sober. I was able to work full time on school vacations and summer, and from Friday evening to early Monday morning, when I’d leave to make it to my first class at San Jose State. It wasn’t uncommon to have an employee go AWOL, and have the cops show up a day or so later, looking for them. You had to be fingerprinted to get an ambulance driver’s license, but all you needed to work as an attendant was a first aid card, which management would procure for you for a small fee.

Bob Curry, in almost the full Silva's uniform (no badge), posing with a "new" ambulance, formerly used by Allied Ambulance in Oakland.

Bob Curry, in almost the full Silva’s uniform (no badge), posing with a “new” ambulance, formerly used by Allied Ambulance in Oakland.

There was one very senior employee whose name was also Bob. Bob thought he was the manager, and would tell you he was if asked, despite advice to the contrary if one of the Silvas was listening. Bob was very possessive of “his” ambulance, which was always the newest one (given that they were all used, “new” was a relative term). One night, I had just come in to work, and a call came in. The dispatcher told me to take it, so I grabbed an attendant and got in the first rig I saw. It was Bob’s, of course. When I returned, Bob screamed my face, lest I forget that that particular rig was HIS ambulance, and I had better stay the hell out of it if I knew what was good for me. Bob had an apartment near the main station, so he didn’t have to sleep at the station when he was on duty. If you were Bob’s attendant (Bob never worked in the back unless there was some real hero stuff going on), you were allowed to drive Bob’s ambulance to his place, where you switched seats. That night, a co-conspirator and I did a little customizing to Bob’s rig. When he got in the next morning, he found the handle on the driver’s door adorned with some adhesive tape, reading “Bob’s Door Handle.” Inside, more tape indicated Bob’s Steering Wheel, Bob’s Cigarette Lighter, Bob’s Gearshift, Bob’s Turn Indicator, Bob’s Accelerator, Bob’s Radio, Bob’s Other Radio, and so on. Tucked under Bob’s Sun Visor was a card on a little string, trimmed to drop to eye level: “Hi, Bob.”

Silva’s didn’t have the market cornered on odd employees. A rival company employed a guy we called Captain Action. Captain Action worked for a company that had more traditional uniforms, but still included a badge. The issued badge wasn’t up to Captain Action’s high standards. He had his own badge made up. It was a thing of beauty. It was a gold seven-point star (the most common style of police badge in those parts), but much larger than most police badges. It put the Silva’s badge to shame on size alone. I remember it had a big California State Seal in the middle, and a lot of text on the banners and inner ring. There was so much lettering on the badge that I never got to finish reading it, although I saw it often. Captain Action also wore a police-style Sam Browne belt with various snaps and cases, including a cuff case, handcuffs, and a baton ring. I never saw a baton, but I’m sure he had it around somewhere.

Captain Action loved to talk on the radio. Each ambulance had two radios, one on the company channel, and one that broadcasted on a shared, county-wide channel, called County Control. There was no direct channel to the hospitals, so one was obliged to tell County Control what you had and where you were bringing it, so the dispatcher could give the appropriate ER the heads up. An appropriate message might be something like, “County Control, Ambulance 3335, en route Code 3 to Peninsula Medical with an unconscious head injury.” Captain Action preferred to be somewhat more detailed, and made liberal use of the phonetic alphabet. “County Control, Ambulance 3330, en route Peninsula Medical Center with a 33-year-old white male with a history of cardiac myopathy, I spell CHARLES-ADAM-ROBERT-DAVID-IDA-ADAM-CHARLES-BREAK-MARY-YELLOW-OCEAN-PAUL-ADAM-TOM-HENRY-YELLOW…”

After one of these lengthy naratives (keep in mind that there were ten or twelve other ambulances in the county that used the same channel), the dispatcher was oddly silent. Captain Action made another try to ensure his message made it through. “County Control, Ambulance 3330, did you copy?”


Ah, the good old days.

Written by Tim Dees on January 1st, 2015