Island Emergencies Are About the Here and Now
“What do you do,” the summer visitor asks, “out here on this rock, if somebody gets sick?”
Matinicus does have a tiny little EMS service. We don’t have an actual ambulance, we cannot offer any sophisticated care, or even a guaranteed trip to the hospital (it’s all about the weather, as usual,) but the patient is not necessarily on his own.
Every November at the Samoset Resort in Rockport, hundreds of emergency responders assemble for the annual Mid-Coast EMS Council Seminar — five days of training sessions, meetings, and social events. They come from all over Maine and a few from out of state. As EMTs, we are required to attend a certain amount of continuing education events in order to renew our licenses. We sit together in all kinds of classes — basic and intermediate-level EMTs, paramedics, some also firefighters, others ski patrollers, emergency-department nurses, or members of the military. Some are full-time paid city employees, sharply in uniform; others wear a firefighter’s work shirt and work part-time or per diem for three or four area towns or agencies. Some are volunteer rural responders who get called out, by dispatcher or by neighbor, from their other job, their farm, their woodlot.
I write between classes—this year, topics like pediatric emergency care, taking a better patient medical history, toxicology, emergency childbirth. My classmates are EMTs and paramedics from Portland and Lewiston and Bangor and Waterville. They respond to heart attacks and street fights and truck wrecks and death. I’ve been an island EMT (emergency medical technician) for fifteen years, since we started Matinicus Island Rescue in 1994, but sometimes I sure do feel like a rookie. I may just be the state of Maine’s most senior beginner. Emergencies, thankfully, are very rare on Matinicus where the population is under 100 most of the year. Most of my patients just need oxygen or an ice pack, reassurance or bandaging, the “loaner crutches” or a blood pressure check or for me to get out my reading glasses and go for that nasty splinter. Few need to be transported to the mainland; fewer yet will permit it. Those who are transported will be met on the other side by an ambulance from South Thomaston or from Rockland.
The difference between my quirky and limited experience on Matinicus Island and that of most of the students became clear as we began to talk. One urban paramedic, with a busy schedule and a high call volume, describes his exasperation at spending more than five minutes trying to coax a patient into coming to the hospital. He knows he’s potentially holding up other people in trouble by messing around with a reluctant victim (in this case someone who had ingested a highly toxic dose of an over-the-counter medication and wasn’t desperately ill yet, but would be soon).
“What?” I remember thinking. “You feel that fifteen minutes on scene is a long time?” I describe how the job of convincing somebody to accept emergency transport sooner rather than later is a big part of an island responder’s world. Even for stable patients, with illnesses and injuries that are far from critical, we spend a lot of time worrying over the transportation. There is no ambulance, no ferry, no mail-boat. There is often only the flying service, or perhaps a lobsterboat. Go now, we urge, go before the storm comes.
Let us take you to the mainland now, we plead, before the snow starts, before dark. Go while you can get off without the Coast Guard, or without a dangerous, thumping lobsterboat trip across in the gale. Go while you don’t have to climb down an icy ladder or be lowered in a basket into a boat. Go now, before it gets bad, before you can’t breathe or you’re in shock and you need the LifeFlight helicopter at many thousands of dollars. Go now, so that we aren’t calling out a pilot for a medical flight at night, with people going on ahead to light kerosene smudge-pots for the runway, with 2 a.m. pre-flight inspection of an airplane in Owls Head and kicking a radioman out of his warm bunk to run the communications on the mainland, for no pilot flies alone.
Go now, we beg the patient, who really doesn’t want to miss a day to haul or a day of his vacation and really doesn’t want to spend the money; go now while you can, before it hurts like hell in the middle of the night. We have no pain relief to give you here, not as EMTs. If you go and get yourself drunk to deal with the pain, the complexity of our medical call only increases, and we know that such a reaction is common, almost inevitable for many. Go now, without the Marine Patrol, without the sound of a truck speeding down the island road in the wee dark hours in the drizzle and you in the back of the pickup under blankets. Go quietly, when it can be your own business, without the neighbors all calling each other to find out who’s injured, without needing the help of twenty-five people to get to care, without endangering a captain or a pilot or a responder. Go before it gets any worse. Look up, look at the sky. It looks like rain soon. Please, go.
The city paramedic just looked at me.
Eva Murray (the author of this blog), Clayton Philbrook, and Robin Tarkleson are wilderness EMTs on Matinicus Island.