It’s 7.10am at the Cayman Islands Hospital. I’m sitting in the Accident and Emergency waiting area, aptly enough, waiting to meet the Emergency Medical Technician with whom I’ve been paired for the day.
The door swings open and Tracy Gibbs, dressed in a navy and blue shirt with a white stripe down the sleeves, spots me, introduces herself and tells me we’re going on the road straightaway. There’s been a call out to the dock where a cruise ship passenger needs assistance.
“She’s fully vented. We don’t see that often,” says Gibbs, a paramedic, as she hurries toward the ambulance parked outside, where I meet her EMT partner Georgette Smith.
Together, for today at least, these two women make up “Medic 3”, one of three ambulance crews servicing Grand Cayman.
“Every day is different,” says Smith as we set off. “Sometimes you get in at 6.50am and get a call straightaway that someone’s not breathing. Other days, you might not get a call for hours.”
It’s a short run from the hospital to the dock and traffic is light, so there’s no need for the siren and lights. At the dock, medical staff from the ship, along with family members, surround a woman on a stretcher. She is unconscious and breathing with the help of a ventilator.
Gibbs and Smith talk with the ship’s young doctor, who will accompany them with the patient to the hospital, collect the woman’s paperwork – her passport and medical records – and put her in the ambulance.
We’re back at the hospital within three minutes. The EMTs roll the stretcher into the emergency trauma room where a team of doctors and nurses take over her care.
Smith says the EMTs are regularly called out to deal with sick cruise ship passengers first thing in the morning after the ships arrive.
The teams work on 12-hour shifts, from 7am to 7pm and 7pm to 7am and work four days on, four days off.
Three ambulances operate on Grand Cayman at any given time, and there are two spare ambulances. It’s now 8.10am. A call comes in from 911, saying an elderly woman at the Pines Retirement Home is experiencing pains in her arm and needs to be transported to the hospital.
Smith deftly manoeuvres the giant ambulance out of the hospital’s parking area, backing into a tight spot using the vehicle’s mirrors and an in-built camera in the rear-view mirror. The camera is needed because the back windows of the ambulance are opaque.
Again, there are no sirens or lights for this short run – the Pines is just seconds away from the hospital. “It’s so near, we’d almost have been faster just wheeling her bed here,” jokes Smith.
But there’s no joking as the two women quickly get to work to carefully and gently transfer the frail, 95-year-old patient from her bed onto the ambulance stretcher, calling her by her name and reassuringly telling her she will be ok, that they’re just taking her to see the doctor to find out what’s wrong with her arm.
They place her in the care of the hospital’s medical staff, and then Gibbs and Smith are back on the road again – this time to refuel the ambulance. It’s still so early that we hit the morning rush hour. There’s a quick stop to pick up breakfast and then it’s back to the hospital. They know they have a busy day ahead, as today a mock emergency exercise is planned at the airport.
At 9.30am, the exercise emergency call comes over the radio in the EMT’s little room at the hospital. A Boeing 733 with 30 people on board has been struck by lightning, its landing gear is not working and it’s about to land, the operator announces.
“Here we go,” the EMTs say, grabbing their radios on the way out the door.
At the airport, we’re told to wait at the runway entrance and we wait for clearance that the plane and site has been checked by firemen and that it is safe to proceed.
As we sit there, another call comes in – a real one this time. A 14-year-old schoolboy is experiencing breathing problems. Medic 3 is told to attend. Seconds later though, Medic 1, which is normally based in North Side, but is already in the vicinity of George Town, responds that it will take the call.
At 10.08am, we start to move to “plane crash” site, an area far from where planes normally land. It’s a bumpy ride as Smith winds the ambulance around potholes and rocky terrain on the dirt road inside the perimeter of the airport to get to the end of the field.
There, “victims” with grotesque injuries – supplied by makeup artist Jimmie DeLoach, the man responsible for creating the zombie masks and makeup for the movie Zombie Driftwood – are triaged on the field. Lots of medical staff, fire fighters, police and Hazard Management people are there, practising for an accident that everyone hopes will never really happen.
One of the “injured” is placed in the ambulance. Gibbs, who is one of the coordinators of the exercise stays behind, while Smith takes the “patient” to the hospital. The exercise continues for another couple of hours.
The next real call of the day is again to the George Town dock. A captain of a cruise ship has had a seizure while hosting a lunch for members of Cayman’s Olympic Committee. He’s taken to the hospital, but is conscious and talking.
It’s now 2.20pm and, while things seem a little quiet, the women reckon it’s a good time to get some lunch. But, before they can even climb into the ambulance, a woman runs towards them, saying a passenger in her car, parked near the Accident and Emergency entrance, is dehydrated and in pain. They find a wheelchair, help him from the car and push him into A&E.
“Let’s try this again,” says Gibbs as they get into the ambulance and pick up a takeaway from a Chinese restaurant that they quickly eat it back at the EMT room. Other EMTs from the other crews are there and it’s clear this group enjoys working together from the banter, laughter and rolling of eyes that go on while they’re briefly together before emergency calls put them back out on the road.
Then it’s time to transport an elderly female patient for a scheduled MRI at a private doctor’s clinic. Once they’ve dropped her at the clinic at 3pm, things finally slow down a bit for the team.
Wh
ile they’re waiting to take the patient back to the hospital, Smith says it’s times like these that she hears people complaining that they see EMTs sitting around when it seems they should be answering emergency calls. The ambulances are used for emergencies and for routine patient transfers. During transfers like the MRI check today, they’re required to wait for the patient to take him or her back to the hospital.
“People have to realise that we are human beings too and we’re not robots. We need to get our lunch. Oftentimes, it’s on the road. People will see you somewhere and say “you need to eat?”. We run on the same fuel as they do,” says Gibbs.
Canadian Gibbs started out as a firefighter in Alberta, Canada, where she underwent EMT training. “I recognised that I could become a paramedic by becoming an EMT. That was what I wanted to ultimately do. I was an EMT for a couple of years and went on to paramedic school,” she said. She had heard from friends about working in Cayman and when someone showed her a job advertisement in a local paper, she applied for it and got it.
Smith became interested in EMT work through her next door neighbour, who is an EMT. “I always heard him outside talking about it. I thought that was cool. I started doing ridealongs and that was it,” she says. She trained to become an EMT when she was 22 years old.
Gibbs and Smith say there is a lot of camaraderie and good humour involved in their job and the teams work well together. “I think everyone likes the job,” says Gibbs.
Both women say their colleagues have become like extended families. “You spend 12 hours a day with somebody, you think of them as family,” says Smith.
Throughout their years working as ambulance crew, both women have seen their fair share of disasters and tragedies, but both agree that the worst cases they’ve dealt with are the ones involving children.
“It’s the calls with the kids that always get you,” says Smith.
And then there are the “patients” who just want a free ride, like one woman from an outlying districts who calls 911 now and again, saying she needs medical help. Once she gets by ambulance to George Town, she jumps out, declares that she feels fine and thanks them for the lift. “She just wanted a ride into town,” says Gibbs.
Both have been in the job for several years and hope to stay in it a lot longer. Smith says: “You don’t get this adrenaline rush doing anything else. When you get that emergency call, even as a nurse, I don’t think you get that rush you get when you are responding to a call.”
“I have a rewarding job. It feels good to be able to feel you are making a difference,” says Gibbs.
“You actually help save lives,” Smith adds.
At 4.45pm, the patient has finished at the doctor’s and they carefully assist her
back into the ambulance. As soon as the ambulance pulls into the hospital bay, before the crew can get the patient out of the vehicle, a truck pulls up carrying a young woman. She’s too weak to walk, so Smith puts her into the wheelchair they had taken in the ambulance with the elderly patient and wheels her into Accident and Emergency. A man accompanying the woman says she has a severe headache, has been vomiting and has collapsed once.
Moments later, another call comes in and at 5.05pm, Gibbs and Smith are on the road again. A young woman from a cruise ship has fallen while getting out of a taxi in George Town. Since it’s the middle of evening rush hour, the sirens and flashing lights go on and cars quickly pull aside to let the ambulance through. When we get to the waterfront, a crowd of cruise ship tourists have gathered as a Spanish speaking woman lies crying and in obvious pain on the ground. She has a suspected broken leg.
To complicate matters, it turns out she is two months pregnant. Gibbs and Smith try to calm her down, but as well as being in severe pain from the leg injury, the woman is clearly worried about her unborn baby and is hysterical.
Since she speaks only Spanish, Gibbs and Smith can only use soothing words and gestures to try to let her know they’re there to help and that the hospital is only a couple of minutes away.
Police at the scene are trying to find out what happened and are getting information from the woman’s mother, who is now ensconced in the front seat of the ambulance, while Smith is in the back trying to make the young woman comfortable and still trying to calm her down. After a few minutes, Gibbs tells the police officer he’s going to have to get any further information later, she’s got to get the woman to the hospital right now.
Sirens blaring, we rush back to the hospital.
Leaving the woman in the hands of the hospital’s nurses and doctors, Gibbs and Smith make their way to the EMT room where, for the first time that day, they get a chance to fill out paperwork about the patients they have brought in.
It’s now 5.50pm. They have 25 minutes to finish the paperwork as they have a 6.15pm appointment to pick up an air ambulance crew at the airport who have flown in from Miami to take the cruise ship captain brought in earlier that day back to the States.
They bring the crew to the hospital ward. As the airlift crew ask the captain questions about his condition and medical history, another 911 call comes in.
It’s 6.35pm. An elderly man appears to be suffering from facial paralysis and other stroke symptoms.
This time, Gibbs stays behind while Smith and another EMT, who has just come on duty take the call. When they get there, they find neighbours outside with the old man, who is in his 90s. They’re told he’s had the symptoms for days.
As we drive back to the hospital, Smith says cases like this of elderly people who aren’t being looked after can be as sad to deal with as the cases involving children.
We’re back at the hospital by 6.50pm, just in time for the cruise ship captain and the airlift crew to be taken back to the airport. Even though her shift is almost over, Smith says she’ll drive them to the airport, seeing the case from its start to its finish. Gibbs heads back into the hospital, ready to call it a day.
They’ll get to do it all over again tomorrow.
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