other people's emergencies: random thoughts of an urban paramedic

For more than twenty years I've worked as a paramedic for the city of Boston, Massachusetts. The opinions expressed in this diary are mine alone, and do not represent the views of Boston EMS. Names, dates, locations, and physical characteristics have been changed to ensure patient confidentiality.

Monday, April 20, 2009


Today brings the 113th running of the Boston Marathon. As of this moment, I'm still trying to decide whether to run.

No, I'm not joking. I've run the Boston Marathon four times already, and I've run nineteen marathons in all. I qualified for Boston a couple of years ago, at the Chicago Marathon. I couldn't run Boston last year because of my military duty, and so my entry was deferred to this year. I have my number, and all I need to do is show up at the start.

But I don't know whether I will.

Training this year has been difficult. Between the winter weather, military duty, and other obligations, I haven't run long distances as often as usual. Part of me wants to run today, but part of me worries that it will be a mistake to try. I'm going to wait until the last minute to make my decision.

Meanwhile, my Boston EMS colleagues will be out on the course, providing medical support to the runners and spectators. This is a massive undertaking, involving hundreds of EMS personnel, dozens of ambulances, bikes, "gators" (six-wheeled ATVs that carry a stretcher), and fully staffed medical tents. The medical tent at the finish line is always a zoo. Runners come in by wheelchair, with everything from calf cramps to heart attacks, and somehow they all receive treatment.

Even so, whenever I'm not running the marathon, I like to work at it. The last several years I've had the same assignment, patrolling the course by bike between the top of Heartbreak Hill and Cleveland Circle, about five miles from the finish. Not only does this give me a front-row seat when the leaders go by, but it allows me to people-watch while getting paid.

Of course, it's not all fun and sitting around. Sometimes there's plenty of work to do. When the race day is warm, runners get into trouble, and the number of ambulances can't possibly keep up with the demand. On a particularly warm day several years ago, I was working on the Bike Unit, and I was directed to a spot, ironically, near the Boston College Cemetery, where a runner had collapsed. He'd lapsed into unconsciousness, but with every ambulance tied up, I was on my own for a while. I started an IV, checked the runner's blood sugar (which was normal), and then just monitored his condition, since I certainly couldn't transport him on a bike. While I waited, another runner collpased right in front of me. He, too, was unconscious, so I started another IV and checked that runner's sugar as well. Forty minutes went by, but there was no good solution--despite all of the planning and all of the resources that had been dedicated to the event, there was simply too many runners getting sick, and not enough ambulances to attend to them. Fortunately, they both started to come around, and they were wide awake by the time an ambulance came to take them away.

So, for those of you running the race today, I wish you the best of luck. Hopefully, you won't have any need for the EMTs and paramedics stationed along the route, but you can take heart in the fact that they will be there if you do require their assistance.

And for those of you who come out to watch, maybe I'll pass by you, and maybe I won't.

I'm still trying to decide.


Blogger Dani B. said...

If you do run good luck! I'll be working as an EMT at the finish line so keep an eye out.

6:41 AM  
Anonymous Anonymous said...

i would have loved to meet you at the finish line, however, for the 1st time in my career I was denied OT...so, so much for my marathon event tradition...good luck if you run, I wish you well

6:51 AM  
Blogger Norma said...

WOW! Didn't know you were a marathoner but somehow I'm not all that surprised! I'm just a casual runner @ the moment (doing my first 5K next month) with high hopes of building up to long distance glory some day. Have a great marathon Monday, whatever you end up doing!

7:46 AM  
Blogger Renee said...

To quote a famous company... "Just Do It".

Ironically, the type of EMS I provide is event medicine. Thank you for providing a glimpse to others of the incredible need for EMS to work standby at events. We've learned that you never know what will happen at these events. I've dealt with heart attacks, dehydration (very common in the Sacramento, CA region in summer), sepsis in a runner, complications of pregnancy, fractures (also very common), abrasions and lacerations, heat stroke in 67 degree weather, you name it...

8:24 AM  
Blogger amusings_bnl said...

all of you are there already, those working or running. my Eagle Scout from my troop is working communications at Kenmore Square... it's his first year working with the marathon.

if you see a kid with really really big curly hair at mile 25, that's jason. say hi and congratulate him on his eagle.


10:03 AM  
Blogger Michael A. Burstein said...

I see from the tracking on the website that you made it to the 5k checkpoint at 26:40. Good luck!

10:54 AM  
Anonymous Anonymous said...

Being one of those runners in 2005 that required EMS and transport to a Boston hospital, please give me (finialy) the chance to say "thank you"

Keep up the good work-

11:56 AM  
Blogger Renee said...

So, how did TS do? Or is he still out there?

2:18 PM  
Anonymous scannerbuff1 said...

4 hours, 11 minutes, according to the BAA website.

Congratulation, TS!

2:49 PM  
Anonymous Ryan said...

Well first I would like to Say that Ive followed the blog for a long time and as a 6 Yr vet as an EMT and Newly minted Paramedic it is a great read that helps pass the time in Iraq where I am with the PA Army National Guard. Also people watching is one of the best parts of this job that along with having a great partner is what makes this the best job in the world

3:33 PM  
Blogger TS said...

Thank you all for your kind comments and good wishes.

I decided at the last minute to run after all. I wrote this post before bed last night, and scheduled it for automatic posting today--hence my referring to the race as both "today" and "tomorrow."

As I mentioned in the post, I was grossly undertrained for this marathon. My goal, for the first time in years, was simply to have fun and finish. And I did. It was the third-worst time of a my marathoning career, but at least I did finish.

I'm on vacation for the next several days, so I'll write a more detailed post about this tomorrow.

11:01 PM  
Blogger Jon said...

Congrats on finishing the marathon... and thanks for talking about event medicine.

6:40 AM  

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