In almost every major tragedy you see them in the backgrounds of newscasts, doing the work most can’t even stomach. You hope you never have to see them, but when you do, you’re glad their there.
“We see people on the worst days of their life,” said Juan De La Cruz, a paramedic with Hidalgo County EMS.
De La Cruz been a paramedic for seven years, but has worked in emergency medicine for about a decade. Although, time does not necessarily make his job any easier.
“That’s the difficult part of EMS,” he said. “Being able to see people on the worst days of their life, and then be happy and cheerful with the next patient who just stubbed their toe. In one call you may have just seen a small child who passed away and in the next call you’re just talking to somebody like it never happened. I guess you just get accustomed to that kind of work environment.”
It might be that they don’t have time to dwell on tragedies. It seems like De La Cruz is always mid-sentence when he gets scanned from dispatch, alerting him of someone in need. They scan his vehicle, giving him a location and a basic description of the patient’s needs.
As he’s driving away from the home of a patient who just had a seizure, he’s told that he needs to make his way to Plaza Sports Center to treat a child with “possible head injury.”
With that, they can start thinking about what the patient might need. But sometimes the symptoms they describe through the phone can be deceiving, he said, so they need to be prepared for anything.
He turns his siren on and drives with “due regard,” which is much like defensive driving, while occasionally dipping into the left lane to get through traffic. By now, he’s learned to navigate every city in his company’s jurisdiction, stretching from Edcouch to Sullivan City.
It’s not always easy finding people, especially at night in rural areas where light is scarce and houses aren’t labeled with their addresses, De La Cruz said.
He arrives at the scene -- on an emergency rescue vehicle -- and the ambulance has already arrived.
The EMTs treating the child remain calm, and try to maintain the boy’s body in a flat position. They transport him from the synthetic grass in the indoor soccer field to a plastic board, then onto a stretcher.
He’s surrounded by his teammates -- who are both concerned and amused by the presence of emergency medics -- and his mother, whose face is painted with fear. Once they navigate through the curious crowds and get the child onto the ambulance they begin to treat what they believe is a clavicle injury.
As a paramedic, he’s only able to give a differential diagnosis, where they treat “what they believe the injury to be,” until they reach a hospital where a physician makes an official diagnosis, De La Cruz said.
They ask him questions about the incident and what parts of him hurt. For the questions that require more nuance than a head nod, the boy answers in a quiet, shaky voice of a shy child.
But the medic’s calmness is contagious, and the boy sees his friends are jumping up and down toward the small windows of the ambulance so they can catch a glimpse. With that, he cracks a smile and begins to deliver more confident responses.
Soon, the ambulance transports him to a hospital where he’ll receive definitive care, and their job there is finished.
What was probably one of the scariest moments of his short life, was just one of the lighter calls out of a 24-hour shift for the EMTs treating him.
The more intense calls tend to be car accidents, De La Cruz said. According to the Texas Department of Transportation, Hidalgo County saw roughly 15,000 of them in 2016 alone.
“There are so many car accidents that happen on a daily basis,” he said. “That’s not something you really see as a civilian, but we see it on a regular basis.”
That said, keeping calm like they did for that child isn’t always so easy.
“There’s some people that have been in EMS for years now that still get nervous,” De La Cruz said. “Now, feeling nervous versus showing nervousness, that’s a little different. Most of us hold our composure well.”
Becoming a certified paramedic takes earning a two-year associate degree. The first semester they earn a EMT basic certificate, where they learn things like performing CPR and how to use an automated external defibrillator (AED). In the second semester, they learn how to start an IV and perform intubation, then earn an EMT intermediate certificate.
In the last year, they go into cardiology and learn how to administer the few medications that paramedics are able allowed to give, before earning their paramedic certificate.
“In class, they teach you one of everything, but they can’t specify on everything you’re going to be treating,” De La Cruz said. “They’ll teach you how to treat someone who amputated their finger, but they won’t go too much into detail on what happens if it’s more than one finger or if they’ve been bleeding out for an hour or so.”
Not everyone is cut out for a career in emergency medicine. It takes a person who isn’t the “type who like to have an office job,” De La Cruz said, adding that adrenaline-junkies are usually the ones that find their way onto the ambulances.
“This is a good job for people who like that adrenaline rush because from one second to the next you’ll be asleep, then you’ll be up doing CPR on somebody,” he said. “If you’re the type of person who enjoys an adrenaline rush, you’ll definitely have your share of that doing this.”
Ironically, the same things that make the job so difficult are what make it so rewarding, De La Cruz said.
”You appreciate life more,” he said. “You understand that things are spontaneous, anything can happen at any time, and random things happen to random people.”