By Jordan Rice
BU News Service
Crawling under the train, Captain Jim Gomes worked calmly and meticulously to save a man trapped at the Harvard Square subway stop. Whether this man’s action was a decision to end his own life or simply an attempt to cross the tracks was not important. Gomes knew that he had to pull the man out from beneath the train — and quickly. This mission ended as a rescue, but that is not always the case.
Over 16 years as paramedic and firefighter, Gomes has participated in many rescues. As the Captain of Rescue 1 at the Cambridge Fire Station Headquarters, he works three 24-hour shifts leading crews of five to six Rescue 1 workers.
While he loves his job, being a paramedic and firefighter was not always Gomes’ chosen profession.
While studying psychology and biology at Boston University in the early 1990’s, Gomes worked as an Emergency Medical Technician (EMT) to pay for his education and bolster his application for medical school. But after receiving rejection letters from 19 medical schools in a single day, Gomes realized that he was destined to save lives in a different way.
“There’s a mysterious way the world works, and it kind of pushes you where you are supposed to be,” he said. “This is what I was supposed to be all along.”
After spending a year in the emergency department at Beth Israel Deaconess Medical Center working various roles, Gomes attended Northeastern University to earn his paramedic degree.
Paramedic programs are rigorous, requiring more than 2000 hours of classes and clinical work in multiple hospitals. At the end of their training, paramedics are certified to perform more complex procedures than EMTs, including inserting intravenous lines, administering medication, reading electrocardiograms, delivering babies and intubating patients.
Because of the intense training paramedics receive, job options after training are expansive. According to the U.S. Department of Labor statistics, there are nearly 250,000 paramedics working in the U.S. with a 15 percent projected growth in the next 10 years.
Paramedics can work at hospitals, on ambulances, in emergency and intensive care units, on cruise ships or oil rigs and at fire stations.
Back at the Cambridge fire station, it’s 6 p.m. — dinner time. Making their way down the line, plates piled high with chicken parmesan and garlic bread, the men settled in to eat just as a call came in that an 85-year old woman is having trouble breathing.
“Let’s go guys!” someone shouted and five men, including Gomes, jump up and dash to Rescue 1. The ambulance had already arrived when the crew got to at the assisted living home, so they returned to the station.
This is a fairly common occurrence for Gomes and his team, when they are expecting the worst, but upon arrival find the ambulance has already taken care of the problem or the patient has a minor injury. Gomes estimated this happens roughly three to four times out of 20 calls.
Rescue 1 responded to 2359 calls in 2016, but only two percent of those calls were fire related. Gomes estimated that about 70 percent of the calls they receive are medical related.
Their responses include saving people trapped in elevators, transporting injured people down from high-angle terrains — such as skyscrapers — with ropes and pulling people out of confined spaces like manholes. Gomes and his team must be prepared to diagnose a patient’s situation quickly in order to provide the necessary attention before an ambulance arrives.
In the case of a suspected fire, Rescue 1 is dispatched only if the first response truck confirms the fire. During these calls, the team’s job is to search the building and get people out safely.
Throughout the 16 years Gomes has worked in the Cambridge area, he has witnessed many deaths. One that still haunts him occurred during his EMT days in college.
On a routine call, he took a woman to the hospital who was experiencing complications from a knee replacement. She mentioned to Gomes that the mounting medical bills brought her great stress. A few weeks later, Gomes was on a call for a house fire. He recognized the address but could not place how or why he knew it until he came across the woman.
“As I was moving her from the ground onto our backboard I felt her knee brace,” he said. “And I went, ‘Holy God I know who this woman is.’”
Her husband, who was carried out of the house with a shotgun blast to his cheek, had shot both his son and wife to death.
“Twenty or thirty years later, it still bothers me,” he said.
These types of stressful calls, along with low salary and injury, are leading to a high attrition rate in private ambulances.
“I think the decrease in numbers [for private ambulance companies] comes from two areas: people are getting the education then moving on to higher paying occupations, or they are moving on and working for fire services [with] a higher rate of pay,” said Nicholas Cardellicchio, EMT and paramedic program director at Bunker Hill Community College.
However, the need for quick medical response, due to the ever-growing elderly population and drug abuse epidemic, is resulting in a need to hire more firefighter/paramedics in fire stations.
“It wasn’t as common when I first started, but obviously it’s getting much worse,” Gomes said about the drug abuse epidemic. These overdoses range from synthetic opiates like heroin and fentanyl to prescribed opiates like OxyContin and Vicodin.
According to the most recent statistics, EMTs and paramedics have an injury rate that is three times higher than the national average. Gomes mentioned a minor back injury, along with the bruises and scrapes that come with the job, but he feels fortunate never to have had a serious injury nor witnessed an on-duty death or major injury of one of his co-firemen. His greatest fear, he said, is not a fire-related, but a blood-transmitted disease like Hepatitis B or AIDS.
Despite their stressful job, Gomes and his co-workers keep the mood lively and upbeat in the station.
“You come in, you’re having a down day and they pick you up,” said Jeff McGourty, firefighter and paramedic on the Rescue 1. The sense of purpose the job provides gives them a feeling of personal fulfillment.
“This is where I’m supposed to be,” Gomes said.