The Risks We Take

The ambulance that volunteer EMT Tonya Mallard rode to her final crash scene carries her casket in a procession to a memorial park on Oct. 4.
The ambulance that volunteer EMT Tonya Mallard rode to her final crash scene carries her casket in a procession to a memorial park on Oct. 4. (By Katherine Frey -- The Washington Post)
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By Benjamin Opipari
Special to The Washington Post
Tuesday, October 14, 2008

Late last month, after volunteer EMT Tonya Mallard died in the crash of a Maryland State Police medevac helicopter transporting two teenagers from a car accident, people started asking me questions: "How come a volunteer was on that flight? You're just backup, aren't you?" they'd say. Or "It's not really volunteering, right? You get paid, don't you?"

Getting on that flight was not part of Mallard's normal duty. These helicopters are typically staffed by only a pilot and flight paramedic. But she volunteered anyway, just as she'd volunteered to serve the Waldorf volunteer fire department, and just as she'd volunteered to leave her family that night.

Like me, she was in her late 30s, had been married for eight years and had two children, so her death carries special resonance. I'm aware that beyond the sense of satisfaction we volunteer emergency medical technicians reap from serving our communities and saving lives, there's a rush of adrenaline that comes from performing under pressure. And with that adrenaline comes the potential for danger. And, no, we don't get paid. Unless you count the occasional discount at a local restaurant.

I began my volunteer career in a rural college town in Upstate New York. Both the ambulance and fire services were all-volunteer squads. Equipped with pagers, we served six-hour shifts, and while on duty we could not be more than three minutes from the station. Because I lived only seconds away, this was not a problem. On overnight shifts, I was often roused at 2 in the morning to head out on call.

Our station consisted of a number of college students, and when they left for the summer we often had only a skeleton crew. This meant that many of us were on call around 60 hours per week. If we did not respond, our ambulance simply would not get out.

Here in Montgomery County, the operation is different. In some stations, volunteers operate side by side with career firefighters at night. Other stations are staffed entirely by volunteers on weekends and evenings.

Professional firefighters are also EMTs. On a call, two ride an ambulance, a driver and an aide (the person who rides in the back with the patient). Volunteer EMTs take the place of the aide, who then moves over to ride the fire engine and is able to boost what at many stations is the bare minimum staffing. Volunteers in Montgomery County serve one 12-hour shift a week.

Volunteer EMTs are certified in the same manner as professionals; we take the same classes, and it's often during the training that volunteers begin to understand what can happen if things go awry. We learn what to do if we are stuck with needles or exposed to blood-borne pathogens; we are taught how to respond to a WMD attack or a hazmat incident; and we are reminded how to call for help if our own lives are in danger.

Most of what we do isn't life-and-death stuff. But being an EMT requires riding in the back of an ambulance with someone suffering from whooping cough, or bracing yourself at 2 a.m. in a blizzard while you careen down dark country roads.

It also comes with death's vacant stare as you approach a car that has just slammed into a tree. It comes with sitting in an ambulance with a woman who has a ruptured aorta, fully conscious and talking to you, whom you know will be dead before the helicopter can take her to hospital. You talk about how bad it is snowing outside, knowing that it's the last snowfall she'll ever see. And it comes with caring for a woman whose face is beaten so badly that it has swelled to twice its size while her wheelchair-dependent husband could do nothing but watch the savage assault.

After this, volunteers go home knowing that they have had a direct impact on someone's life -- or death.

A volunteer EMT faces far less danger than firefighters or law enforcement officers. And that is what makes Mallard's death so tragic.

Volunteers -- EMTs or otherwise -- aren't supposed to die.

Tanya Mallard climbed into that helicopter, I feel sure, without any trepidation. Some accounts say she was holding the hand of one of the patients, to calm the girl's nerves. But as she scrambled inside, I have to wonder: Was she was thinking about how she could have been at home with her family? Was she thinking how she could have volunteered in a million other safer environments? Was she wondering if it was all worth it?

Benjamin Opipari, a volunteer with the Glen Echo Fire Department, is the writing instructor at the D.C. office of the law firm Howrey LLP. Comments:health@washpost.com.


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