With Students at the Helm, Ambulance Stands Ready

Five years ago, if you called on campus for an ambulance, the MIT Police would show up. The officers dispatched to help you would be fully-certified emergency medical technicians, but they still carried badges. These police EMTs might take you to the hospital, but they might also write you up afterwards.

“There was absolutely a conflict of interest between policing and taking care of people,” said Nicolas A. Wyhs ’05, one of the founding members of MIT Emergency Medical Services, a student-run group that started in 2002 to take over the Institute’s emergency medical response service from the MIT Police.

Nowadays, only students staff the ambulance. Their mission is unambiguous: Get patients to the help they need, fast. No judging, no hassle, and certainly no gossip about it a week later.

These 79 trained and licensed EMTs, mostly undergraduates, are ready to take calls at any hour of the day. In an academic year, they answer over 700 emergencies, spending nearly 20,000 man-hours on duty in three-person shifts. With funding from the Institute and the Association of Student Activities, they own their ambulance, they buy their own supplies, and they schedule their own training. In nearly every sense, they are a professional ambulance service.

An independent ambulance

The MIT-EMS bunk room is a home-away-from-home deep in the bowels of the Stata center. This is where the EMTs laugh, chill, study, and wait to be dispatched.

From inside, it’s just like any other dormitory lounge. Brown pleather couches crowd around a modest television. There’s a DVD player and Playstation, an Athena computer, and a desk for working on problem sets. There’s a bathroom and bunks for the overnight shift.

Just next door is the long hallway that leads to the Stata loading dock, a cavernous warehouse of trucks and forklifts and rolling blue bins. The EMS ambulance bay is here, a closed-off garage within a garage.

Both the bay and the bunk room are new, constructed in 2006. They are signs of just how far MIT-EMS has come, from its origins as a part-time service operating out of an old borrowed ambulance to today’s full-time, fully-staffed operation.

In 2000, Michael R. Folkert ’98, then a graduate student in Course XXII, got the idea that students should run MIT’s emergency medical service.

It wasn’t that radical of a thought. MIT’s then police-run ambulance was something of a curiosity, while student-run ambulances, though uncommon, are far from rare. Columbia University has an undergraduate ambulance team, as do Pennsylvania State University, Virginia Tech, and Rutgers University. The National Collegiate EMS Foundation has registered 52 such student ambulance teams.

The difference between a police-staffed ambulance and a student-staffed or professional ambulance is a matter of duty — duty to the patient or duty to the law. Student EMTs are concerned only with a patient’s well-being. Potent privacy codes prevent them from discussing details with anyone not directly involved with the patient’s care.

MIT’s officer EMTs were also concerned with the health of patients. But after they safely drove patients to Medical or another hospital and their job as EMTs was done, their duty became to investigate any illegal behavior and file a report.

This policy made students involved with under-aged drinking or other drug-related offenses wary of calling x100. If they could make it to Medical on their own and avoid the police on the way there, the doctors and nurses would keep mum. But if the students needed the campus police to take them in the ambulance, they risked follow-up disciplinary action.

With strong support on campus for confidential medical transfer, Folkert began laying the groundwork for a student takeover of the ambulance service. He arranged the first emergency medicine class for Independent Activities Period 2001 to build up a team of student EMTs. In the meantime, Samuel A. Schweighart PhD ’05 and Wyhs helped make pitches to deans and other administrators.

“It took a lot of convincing,” Wyhs said. “Sam and I gave at least 20 presentations. We were lucky that there were some people that were really for it.”

Among those enthusiastic about MIT-EMS was Dean for Student Life Larry G. Benedict, who offered the group funding from the Division of Student Life, and then MIT Police Chief John DiFava. William M. Kettyle, director of MIT Medical, also gave his support. “We all felt strongly about student empowerment and that a student run service would have a lot of credibility with our students,” Benedict said.

A lot of the work in the beginning involved reassuring that there wouldn’t be any shenanigans. “We had to instill confidence in the administration that we weren’t just a bunch of cowboys, that we weren’t going to just jump at the wheel of this moving death trap,” Wyhs said.

The police officers themselves were supportive of a student-run ambulance, DiFava said. They recognized the awkwardness in serving both as enforcers and caretakers.

“I had problems with the MIT Police doing [ambulance work],” DiFava said. “It’s a model that I’ve never heard of before … you have cops and they’re doing police stuff and they’re also running the ambulance.” And overtime pay for serving as an EMT was lousy anyway — a mere 65 cent per hour bonus on top of their wage, according to an old Tech article.

By summer 2002, Folkert, Wyhs, and Schweighart had hammered out an agreement with MIT’s administration and the campus police. Starting in July, student EMTs began riding along with the police EMTs on calls. Slowly, over the course of the school year, the police began to allow students to respond to calls by themselves. “It got to a point that the police would choose the calls they took,” Wyhs said. “If it sounded pretty minor then they might say ‘Okay, you guys take this.’”

In 2003, after a year of riding with the MIT Police, an opportunity came up: The MIT ambulance was due for its regular state inspection. The vehicle that the police had been using was over 10 years old and couldn’t pass muster. With funding from MIT Medical, MIT-EMS bought itself a new ambulance and an ambulance bay near the Medical building.

“That’s when we really cut the cord,” Whys said.

The team passed the inspection handily, earning their certification which was issued in their own name. MIT-EMS was no longer operating under the police. It had become its own, licensed ambulance service.

High staffing, full shifts

Today, MIT-EMS runs out of its new quarters in Stata. Membership, which started out in the mid 40s, has nearly doubled. Every year, over 40 prospective EMTs take the IAP training class. Most continue on to get their certification and work for MIT-EMS.

One sign of MIT-EMS’s success is its packed shift schedule. Just a couple of years ago, the service only operated on weekend nights — there weren’t enough people to staff the ambulance during the week. Now, the junior members race each other to sign up for coveted shifts on the ambulance, which runs 24 hours a day, seven days a week.

MIT-EMS Chief Jonathan Liu ’08 said, “We’ve come to the point where we have so many EMTs that want to work that not all of them can work the amount of time that they want to work — they’re so enthusiastic and they want to put a lot of energy into it, but we only have one truck and only 24 hours in the day.”

Jose L. Villa-Uribe ’11 is one of MIT-EMS’s newest members. He took the training class in January and recently received his state certification. So far, he has spent nearly 70 hours on duty.

Villa-Uribe first heard about MIT’s student-run ambulance when he saw them at the activities fair during Campus Preview Weekend. “I never considered the idea of being an EMT,” he said. “I don’t think I even knew that MIT had its own ambulance system.”

But given the opportunity, Villa-Uribe jumped at it. He filled out his application in December and got an interview. Right before the end of the semester, he was delighted to find out he had gotten into the IAP training class.

Because spots in the January IAP class are limited and so many students apply, MIT-EMS has to screen applicants. “It’s actually a fairly competitive process,” Liu said.

For the students who do get in, the IAP class is a crash course in emergency care. The students learn CPR, splinting, spine immobilization, trauma assessment, and how to administer basic drugs. Most EMT classes spread the material out over six months. The MIT class does it in just under one.

“It was a lot of fun, but it was really intense,” said Sarah C. Wilder ’10, another incoming EMT. She recalls volunteering during one class to be backboarded — restrained against a rigid plank so she couldn’t move around and hurt herself.

Wilder said: “I was the first person they did it on, and I didn’t know what to expect so it was really creepy when [the instructor] said ‘Okay, we’re going to pick you up now.’ I freaked out a little, because you have the spinal collar on and you can’t move or anything.”

Both Wilder and Villa-Uribe have been riding along in the ambulance since January. Being new, they usually take patients’ blood pressures and vital signs and fetch equipment for the other two EMTs on the ambulance. Mostly, their job is to watch and learn.

“The material is taught really well, so that wasn’t really the challenging part,” Wilder said. “It was getting used to it, getting used to working with patients. It’s a lot different in the back of the ambulance.”

A world apart from the classroom

Both Wilder and Villa-Uribe emphasize that the back of the ambulance is a world apart from the classroom. There, the walls didn’t rattle and the floor stood in place. Tasks that were easy in the classroom take on new dimensions of difficulty while swerving at 40 mph.

“The first time I took vitals I was really worried,” Villa-Uribe said. “You’re in the back of the ambulance and it’s really bumpy, and it’s hard to hear the blood pressure and differentiate that from the bumps on the road.

“The streets of Boston and Cambridge are really bumpy,” he added. “That’s something you notice a lot.”

That is the challenge of being an EMT. Liu will be the first to admit that EMTs do not carry out complex procedures (nor do regulations allow them to). They cannot start IV lines or intubate patients; they cannot offer pain medication aside from aspirin or Tylenol. The medicine is not the hardest part of the job: It’s keeping patients calm when they are hurt or bleeding; it’s trying to do the simple things learned in EMT class while the sirens are blaring and people are running around.

“Most of the things we learn in class, it’s just common sense,” Villa-Uribe said. “It’s just that, because we’ll be working in stressful situations, we have to practice them over and over.”

The job also takes an emotional toll on the students. “The blood doesn’t bother me, so that’s good,” Wilder said, “but with real patients, especially when they’re in pain, it’s like ‘I don’t want to touch [the injury], but I have to touch it, it’s my job to touch it.’ That’s hard.”

MIT-EMS plans to respond to MIT 911 calls

Next year, Liu hopes to integrate MIT-EMS with municipal services. The only way to reach MIT-EMS now is to call the campus emergency line, x100 or x3-1212. A 911 call summons a professional ambulance service. Recently, MIT-EMS bought radios that can tap into the Cambridge emergency network, and Liu says they are working with the city’s emergency call center to get added to the dispatch list.

“Don’t get me wrong, the city ambulances are great and I love them,” said Liu. “But if they come here they might not know where 10-250 is, or what the best accessway into a lab is, or what precautions you have to take when you’re going in.”

The student EMTs, on the other hand, train exactly for those kinds of situations. Every year, Liu said, they practice responding to a call at the campus nuclear reactor, donning the safety suits and learning how to get in and out safely. Once a year they also meet for a sports injury refresher (on campus, sports injuries are among the most common reasons for an ambulance call) where they learn skills like the best way to remove football gear, or how to move a patient off the ice rink without tripping and falling.

The reward for the hours spent training and the hours spent waiting in the back of the ambulance is the feeling of having helped someone. “Being an EMT is not a one way street … it’s not just for yourself,” Villa-Uribe said. “You’re doing a good thing.”

Though the EMTs, by law, are not allowed to talk about their patients in any kind of detail, their patients talk about them. “We have had no complaints … not one patient complaint ever,” said Maryanne Kirkbride, clinical director for campus life at MIT Medical. Instead, they routinely send Kirkbride letters of their appreciation.

One such letter reads: “I’m writing to say that my experience with MIT-EMS was TERRIFIC! They were like a breath of fresh air, after the way I’d been treated by some people at MGH. They were professional and serious and careful and respectful, but also fun and enthusiastic; they really could not have been better.”