A falling tree ricochets off a boulder, and cracks the shinbone of the senior citizen who cut it down with a chainsaw. Alone and unable to walk, the woman crawls to her front door, drags herself up the doorstep, and over to the phone.
“Possible broken leg,” David Baker, a paramedic, and Tom Ball, an EMT, hear the dispatcher announce over the radio. They glance at each other, swiftly step into the ambulance, and are en route in seconds.
This is the start of a routine call for Baker, Ball and the rest of the Peterborough Ambulance Department, as they serve a region at least an hour away from UMass Memorial and Dartmouth-Hithcock medical centers, the two nearest trauma centers.
“In this area, it’s almost a necessary service,” said Baker, sprightly, with a wrestler’s frame, an oversized mustache and a shaved head. “We’re not next to a Level 1 Trauma Center. The travel distance sometimes exceeds the time a patient has.”
Peterborough is just one of a handful of ambulance services in the eastern Monadnock region. It serves five towns in addition to Peterborough: Dublin, Sharon, Greenfield, Francestown and Hancock. The department transfers patients between healthcare facilities as well.
On Peterborough’s roster are about a dozen paramedics and three times as many EMTs. Paramedics can administer medicine, start an IV line and provide advanced airway management. EMTs can perform every procedure a paramedic can, as long as it doesn’t break a patient’s skin or involve administering medicine.
Nearly every ambulance is staffed with one paramedic and one EMT. From 8 a.m. to 8 p.m., the department employs two of these crews. At night, it employs one and places another on-call. Though the department is proud of the service this arrangement offers, at least two of its member towns grumbled this past year over how much they pay for it.
After the department raised its fees this year in response to less revenue, Greenfield and Dublin balked at them. Greenfield was the first. “I’m in favor of proper care, but this is becoming cost-prohibitive,” said David Hall, the fire chief, when the Select Board reviewed the upcoming bill. The Dublin Budget Committee echoed Greenfield.
Peterborough, meanwhile, said it was forced to raised its fees because it receives less revenue responding to more service calls. Although it responded to about 200 more calls in 2015 than 2014, it’s net revenue was stagnant. As this disagreement will likely play out this year, Peterborough Fire and Rescue is confident in the services it provides.
“No one in the area offers the level of care we offer,” said Ball, midway through a daytime shift in February. And they make due with a facility that is anything but glamorous.
Everything in the rural fire station on Summer Street serves several roles, even its staff. David Skerry, a firefighter and the fire alarm superintendent, just installed a security system that locks the building to visitors. Once you’re let inside, you walk through an office to a conference table with TVs mounted to the walls, some with informational displays and others there for entertainment.
The smell of either french fries or stir fry wafts from the kitchen, and remnants of Dunkin’ Donuts are everywhere.
The chief or other superiors could be in their offices, open to the conference room. Baker and Ball, meanwhile, could be working their way down a checklist for supplies in the ambulance or filling out paperwork.
“Beep, beep, beep,” interrupts everything. “A 94-year-old with a possible head injury,” sounds from the loud speaker. Ball slides behind the wheel, while Baker calmly rides shotgun. The open the garage, flip on the sirens, and are off.
When they arrive at the retirement center, they are led into the man’s room. There, they start to put together a story line of how the man fell and his head broke through the drywall.
As they survey the scene, and check the patient, they give off a reassuring air, especially as Baker provides comic relief for the elderly man’s wife. “Give him a kiss,” Baker encourages the wife, as they roll the stretcher to the ambulance.
Once they’re back in the vehicle, Ball drives quickly, but gracefully. His goal, he explains, is to drive as smoothly as possible, so Baker is at ease treating the patient. In the back of the box-car ambulance, Baker straps the man to an EKG, and asks him why he feels cold.
As he later explained, he wants to make sure, the man didn’t fall for anyone underlying reasons. But, his overall goal is to stabilize the patient, so they are in the same condition as when emergency crews arrived. Once they arrive at the hospital, they debrief the nurses and doctor and turn the patient over to them. Then, it’s cleaning, resupplying and off to the next call, the woman with the broken leg.