Andrew Magnuson

Journalism

Dr. Bednar

Fall 2000

Local Heroes

• Kevin Tisdel, Williamson County EMS Paramedic, Firefighter, and Medivac Paramedic

It’s 3:00 p.m., and Mike Kanipstein, Captain of the Williamson County Emergency Medical Service, is only one quarter of the way through his twenty-four hour shift. He chats with Jeff Hayes, the Director of Operations, about the day’s events and other various administrative issues. Mike’s job as Captain is supposed to be mostly administrative, although he tries not to spend too much time behind his desk. He prefers to be out in the field, "playing in his truck" and riding out with the other paramedics he supervises.

By 3:30, he is on the road going to Round Rock when his beeper goes off. He picks up a large cellular phone hanging on the ceiling and dials a number without looking, keeping his eye on the road and his ear tuned to the random chatter coming from the CB system. After confirming his location and destination, he hangs up and interprets the dialogue that had been coming from the CB while he had been talking on the phone. It appears that an older man out in Weir had been working on some machinery that had exploded, leaving him with several facial lacerations. "Too bad that one is too far from us. The Medivac would probably be taking off right as we were driving up." More remote locations such as the one in Weir (a full 21 minutes from the Georgetown station) often require the use of Medivac, an EMS helicopter loaded out with all the accessories found in your standard ambulance and able to get to any of the 1,124 square miles within Williamson County within ten minutes. This can be much easier than navigating the hundreds of miles of county roads that interweave throughout Williamson County. "Sometimes when you’re trying to find some remote household," explains Mike, " Dispatch will give you directions like, 'take a right past Joe Blow's farm, and then a left at the old cow.' The only problem is that you don't know who Joe Blow is, and by then the cow has moved."

Mike Kanipstein is a young, wiry man whose easy disposition and composure convey a maturity that is not typical of many 26 year-olds. His eyes seem to hold a sort of wisdom and compassion that invoke a quick sense of trust. When asked why he wanted to become an EMS Paramedic, Mike states simply, "as cliché as it sounds, it is what I've always wanted to do since I was a little kid. I guess I just watched too much of that ambulance show on t.v., Emergency."

After graduating from high school in Lexington, he went to Austin Community College, because of the excellent EMT program for which the school was known. After two years, he graduated at the top of his class with a grade point average that was the highest the program had ever seen. He worked for Hays county for six months in San Marcos (his girlfriend and now fiancé was attending Southwest Texas State), disliked it, and transferred to one of the stations in Round Rock. After two years, he became eligible to be promoted to sergeant, who is responsible for all the Paramedics within a station. He got the job, and within two years, he became eligible to get a promotion up to lieutenant, who is responsible for the two or three stations within the area. After two years serving as lieutenant, he was faced with the opportunity to become a Captain, the highest-ranking officer in the field. There is only one Captain on duty during any given time, and that Captain is responsible for all eleven stations, twenty-two Paramedics, and eleven hundred and twenty-four square miles of Williamson County. He debated taking the position, one of the reasons being that it meant that he would not get to go out into the field as much. He would no longer have a partner, and he would be responsible for desk duties that most Paramedics would rather intubate themselves over then take on. But he took it anyway, and six months ago he became the youngest Captain in the state of Texas.

This doesn't mean that Mike is going to just stick himself behind a desk. No way. He loves the field, lives for helping people. On his days off, he works one day a week at Round Rock Hospital. Tomorrow, after he gets off of his twenty-four hour shift at 8 a.m., he will take a shower, eat a sandwich, and then suit up for a twelve-hour shift at the hospital, from eleven a.m. to eleven p.m.

At 4:03 Mike pulls into Round Rock hospital, where he is greeted by Rueben Moreno, a Paramedic from Unit 306 who has known Mike for five years. Rueben tells Mike of the guy they just dropped off, a man who received a herniated disk in his back by moving around office furniture. The man was in so much pain that when Rueben's partner tried to move him onto the stretcher, the man ripped the EMS patch clean off of her left sleeve. He tells the story with a laugh, and then hurries back to meet his partner, who is jokingly threatening to leave him behind.

Two weeks earlier, Unit 806 had responded to a call that the Dispatch had described as a car collision on Sam Bass Road. The ambulance arrived at the scene, where a blue Toyota Corolla had collided at over 65 miles per hour with a full-size pickup truck as it was coming over the blind side of the railroad tracks. One person in the Corolla was obviously D.O.S., or Dead On Scene, but another person and a baby boy were still alive in the back. When Rueben went up to check on the survivors, he actually saw the face of his newborn baby son on the baby in the back seat. He stalled for a moment, but was able to go into action and secure the injured passenger and child. When it was over, he was shaken, and although Mike told him it would be okay to go home and see his wife and kid, Rueben refused and said that he just wanted to stay on the truck and get the next call.

"People deal with it different ways," explains Mike, "During a call, you just put your game face on, the training kicks in, and you go to work, almost in automatic pilot. After a bad call, some people want to stay on, others need to take a break and see their families. We really try to help them deal with it in the best way possible."

"Unit 306, please respond, we have a man with chest pains at the Comfort Inn on Williams," scratches the CB.

If one Unit goes on a particularly ugly call, the Captain will recommend a debriefing and help the two partners talk it out. "We really just don’t want them to carry bad stuff around for a long time only to have it come out later on. That's the kind of thing that can lead to early burnout." EMT school begins to desensitize you to some of the images, but the nature of the game tells you early on that you can never fully prepare yourself for what you might see.

People who work in Williamson County EMS are like a family, and they don’t want to see the people they work with burn out. In other counties, most people give up EMS after about 5 years. In Williamson County, people are retiring out of EMS after entire careers as Paramedics, which is almost unheard of anywhere else.

After scouting for calls for a while, Mike pulls into one of the Round Rock stations around 5:15, where the Paramedics are housed together with one of the Fire Departments. This is a common setup, and Mike explains that there is a pretty strong bond between the Paramedics and the Firemen. "Many times, the fire truck will arrive on the scene before the EMS, and it’s always nice to have those guys secure the scene by the time you show up." Mike goes inside the station, walks past a couple of recliners and a couch facing a t.v., and sits down at a large, picnic-style bench that is littered with issues of the Austin-American Statesman, the Williamson County Sun, and People Magazine. Down the hall are the dorms, where four sets of small bunk beds lay made, next to an adjoining room where there are two beds separated by nightstands for the on-duty EMS partners. On one of the nightstands lay a copy of the Dean Koontz book Survivor. Robert "Menudo" McCaney, one of Mike's old partners, is telling the story of the time he almost loaded up and took the wrong elderly lady from the nursing home to the hospital.

"The real reason we call him Menudo is because we think he's gay," chimes in one of the firemen.

"You only think that because you were the first one to hit on me," responds Robert, along with the laughs of everyone at the table. Mike shakes his head while laughing quietly. Another Paramedic uses her athletic tape scissors to cut out a picture in the Williamson County Sun of her sixth-grade son's football team. The talk turns to the happenings of the day. One Paramedic, Mark, tells about a women he saved four years ago who came up to him in an H-E-B with a batch of cookies. Another Paramedic, Susan, comes back with a story about how she saw an elderly man at the movies whom she had saved two weeks ago. The man proceeded to come up to her and blamed her for losing his false teeth. So it goes. Some people remain grateful for the second chance they are given, others simply cannot be pleased. The Paramedics do their job, and are thankful either way.

It’s 6:00, and Mike is back in the field, and starting to feel the pangs of hunger. He radios another nearby unit, Unit 813, and the make arrangements to meet at a local Mexican restaurant, the Rio Grande Restaraunte Y Cantina. "One of the things that you learn pretty quickly is to figure out all of the smaller mom-and-pop joints to eat.

The CB again interrupts: "Dispatch, we need one more Unit out here, we have one more injured on the scene. Be advised, is a pediatric male of about four years."

"You never know when you are going to get called out," Mike continues without pause, "so you never really have time for a place that’s always crowded, like Chili’s. We also like good food. If you see an EMS team sitting down and eating at a place, chances are good that the food’s alright." He pulls into the restaurant, a small place wedged between a furniture store and a baby clothes store, and notices that Unit 306, Rueben’s unit, has also decided to join them.

Inside, the five paramedics order their food in Spanish (at Rueben’s request), and they start to talk about the events of the day. It has been slow, and a few guiltily admit that they would not mind seeing some sort of action tonight. This is the heart of the agony-ecstasy problem that Paramedics live with. Most are admitted adrenaline junkies, and they live to be on the scene and in action. At the same time, no one enjoys situations that turn out badly, as some inevitably do. On the other hand, many enjoy the down time that they get to spend with their partners and the other people with whom they work. They get to watch movies, work out, read, or do just about anything that does not take them away from their post. However, there are not too many Paramedics out therethat don’t begin to get fidgety after a few hours and start hoping for a call.

The food arrives, and all five Paramedics down the food within 10 minutes, while maintaining a steady conversation on the benefits of being bilingual in the medical field and the drawbacks of Middle Eastern medicine. They finish dinner, and the bill, which has been discounted by 50%, is presented. Rueben takes the bill and informs his friends that dinner is on him, at which all of the other Paramedics begin to protest and fish out their wallets. "No, no, no guys," Rueben buts in , "You just get the tip. Help this guy out, he’s always taken care of us." This is a common scenario. Although most places will take a bit off the top for Paramedics, they never assume or expect a discount.

7:00. "Fifty-nine year old male with chest pains. Unit 809, can you respond?" asks the CB. Mike is back in the field, meeting up with Unit 812, which is on standby at the 7-11 on Williams. A Unit is put on standby if a number of other Units are out on call in a disproportionate area within the county. It’s a lot like being on a stakeout, in that you just sort of stand there and no one knows exactly why they are there. Paramedics don’t really look forward to being on standby, which is why Mike decided to drop by and keep them company.

Besides Don Thorton and Chris Giddeon, the two Paramedics assigned with Unit 812, Dr. Steve Benold, the EMS overseeing physician is riding along. Dr. Benold has been with the EMS since its inception in 1975, when the entire county only boasted 3 Units. Since he retired from his family practice a few years ago, he has been able to ride out with Units about twice a week for twelve-hour shifts, and he just couldn’t be happier. Occasionally, the other Paramedics joke that they sometimes have to throw water on him to douse him out because he gets so excited. Along with the standard Paramedic uniform, he wears a badge on the right side of his chest that reads: Dr. Benold, Director of EMS – with a line under that reading in smaller lettering: Dr. Steven Benold, Director of Emergency Medical Services.

7:36. The beepers worn by everyone ring sharply, and the CB comes alive: "Unit 812, please respond, we have a pediatric with an allergic reaction, repeat that’s a pediatric with an allergic at apartment 525 San Gabriel complex on 1935 and Leander, over."

"This is Units 801 and 812, that’s a copy and we’re on our way, over," responds Mike into the Motorola talkie mounted on his shoulder. With no repeat of address needed, both Units are flashing and blaring their way down I-35. By 7:41 the Units roll into the apartment complex and immediately draw the attention of neighbors, the "walking rubberneckers" who inevitably make their way to the scene of the action.

Apartment 525 is upstairs, and Don and Chris run upstairs to meet a stairwell full of commotion. The Fire Department had made it first, and several men in T-shirts, suspenders, and rubber boots were trying to console a young woman who was sobbing uncontrollably. Two Georgetown police officers were directing questions toward a young Hispanic man-perhaps the father-, and another was speaking with an older lady, maybe fifty, who seemed to be a neighbor and was asking, "I’ve taken care of him before, and I’ve never seen his face puffed up like that. Why isn’t anyone taking care of him? Where are those people?"

Inside the apartment, a playpen lay in the middle of a den that is littered with baby toys. The Fox Family Channel is playing on the t.v., and there are several cardboard cutouts of witches, ghosts, and what looks a lot like Count Chocula hanging on the walls. The small dinner table at the left is cluttered with plastic Tupperware plates that hold various amounts of roast beef, corn, and peas. The cans from the corn and the peas lay next to cans of empty Diet Dr. Pepper, and at the end of the table is spread a baby tray with small amounts of mashed something drying next to cut pieces of roast beef.

In the middle of the room another older woman is sobbing and clutching an eleven-month old baby to her chest. The baby shrieks occasionally, and is obviously alarmed by the sudden number of people who aren't mom that are in his apartment. Two more Firemen are talking with the lady and trying to keep her calm when Don and Chris move in, introduce themselves, and spread out their Medkits. In a calm yet assertive manner, they allow the woman to hold onto the child while they check for breathing difficulties and attach a device to the baby’s big toe which reads the oxygenation of the blood level. If the baby is still showing signs of an allergic reaction and had difficulty breathing, they will have to intubate the child, which is essentially to create a stable airway in the tracheae by placing a plastic tube down the throat of the baby. Mike makes no move to help the two partners, he has faith in their abilities and allows them to do their job. Here is here to supervise, to help if needed, to not be behind a desk, to be in the field.

Dr. Benold is explaining to the woman why he doesn’t think that this is an allergic reaction when the younger woman, still sobbing heavily, makes her way inside and assesses the situation. "Why the FUCK are all these people in my house? Why are there firemen here? There’s no fire! I didn’t call for you people! Why are you here GET OUT!! Unless you are saving the life of my baby, get out of my apartment get out, oh please just leave." This is also not uncommon. Mike says that at about eighty percent of calls, there is at least one person who does not want them there. Drunk people will fight, relatives will argue, and parents can be hysterical to the point of being worse off than their children. People begin to shuffle their way out of the door at her request, and Dr. Benold assures the woman that her baby is just fine and will be okay. "My baby is NOT fine!" she interrupts, "look at how puffy his face is! His face is never that swollen. I don’t understand why we aren’t on our way to a hospital, can we please just get to a hospital?"

Don, Chris, and the Doctor load the young mother into the back of the ambulance, and while the two paramedics secure the mother, the Doctor explains, "In situations like this, the mother almost always knows if something is wrong with her baby. If she says that his face is still swollen, then it’s swollen, and we need to transport to the hospital."

8:20. Back at Georgetown Hospital, the mother and child have both been diagnosed by the attending ER physician that they will be just fine. While Dr. Benold is quizzing Don and Chris about what to do if the situation had been more serious, the CB informs all paramedics on duty that Williamson County is at Level 3. Level three is announced when there are only three available units in the entire county. While the two Paramedics hurry to get their ambulance ready, Mike walks toward the EMS office inside the hospital, and Dr. Benold again chimes in, "I would be totally stressed out at Level 5, but Mike is so good that it doesn’t even phase him when we are down to just three Units."

The EMS office/lounge is just inside the emergency room door. It is about eight feet by eight feet, has a few files stuffed in organizers on the wall, a broken-in and comfortable couch against one wall, and a t.v. hanging in the corner of another wall. There is a bathroom with a shower stall, but the shower stall has been converted to a storage area, holding file cabinets, bottled water, extra intubators, and I.V. bags. Under the t.v. is a desk with a Motorola CB unit that Mike will use to reroute the available units. A map of Southwestern University is taped front of the CB, with the names of all the buildings written in with red marker. "Unit 809, this is 801, we’re going to need you to move into standby over at Westinghouse, over; Dispatch, how long does 803 have on that scene? We’re going to need them over near Jollyville in about fifteen minutes, over."

"Unit 803 has about five more minutes," replies the faceless voice over the CB.

"Great, can you put them over near Jollyville? Unit 807, I need you over at 195 covering that north end until 805 gets back into Sun City. Dispatch, I also need 815 on standby near Leander, it’ll be at least fifteen minutes until 806 will be back from that wreck in Cedar Park."

He does this effortlessly, re-routing units to the most needed areas while figuring out how long other units need until they can be back in the field, while anticipating the needs of other units at accident sites. This is what he does. Mike is in his element, and he is very good at it. He does it without glory or fame, and chances are pretty good that the person whose life will saved at the next call will never know his name. He works tirelessly for his County, for his crew, for his Dispatcher. And he thanks them.

-Brad Bradford, former pilot and Williamson County EMS Paramedic

Behind the Article

My biggest dilemma in writing this paper came in deciding which paramedic to include in the story. I actually went out with two different Captains, Mike Kanipstein and Angela Noelle, but in order to capture the all of the details that would make the experience tangible to the reader, I could only include one Captain’s story. I finally decided on Mike’s story for two reasons: the calls we got during my ride with him were more interesting, and I felt that his story about becoming an EMS paramedic symbolized a more child-fulfills-lifelong-dream storybook feel about it. This was a really tough, call because Angela had a extremely interesting personality and charisma about her. Also, I was able to visit with some members of the Round Rock Fire Department while with Angela, which also would have been an interesting aspect to document, but there was simply too much material to include all emergency workers, so I had to stick with Georgetown EMS.

Another problem existed in how I was actually going to accurately document my experience out in the field with these people. Obviously it was not appropriate to go out to an accident scene with notebook in hand, lean over the victim and ask "Describe how you feel right now. Try to use adjectives, I want to make it tangible to the reader." I also did not want to crowd the paramedics or get in the way of allowing them to do their job. So I made a conscious effort to make as many mental notes as possible while at a scene, and then write everything down like mad once we were again secured inside the ambulance.

Surprisingly, both Captains were very supportive of my involvement at the scenes, encouraging me to help wheel people on the gurneys and speak with the other paramedics about what they were doing while they were doing it. When we arrived at the very first call we had received for the night, the teenage mother, who was understandably upset, made it very clear that she wanted all people who were not saving the life of her baby out of her apartment. So I made for the door and was not but two steps outside when Mike leaned out and said, "Hey, it’s okay. Come back in. You should see this." Every paramedic during my experience with them was very excited to tell me about what they do. I was almost overwhelmed with the enthusiasm with which these people did their jobs. It was ultimately that enthusiasm that I wanted to capture, along with the dedicated professionalism with which these paramedics did a job that burns most people out in five years.