On any given evening, under the cover of night, the city of Thunder Bay, Ontario is drunk on cheap beer, high on Oxys, and struggles to bear the burden of having the worst homicide rate among any major Canadian city.
Picking up the pieces are Superior North EMS paramedics, who deliver life-saving medical care on the front-lines of the trauma, trying their best to delineate between the dying and the dead.
It all starts on the first call: the scene of a stabbing where multiple bodies are found spread over 400 square feet, lying in an empty downtown apartment, insides bleeding out.
A grisly scene for your average person, to be sure, but for the gang of tired paramedics I'm following around for one night, this is just another night of work in one of the nation's most recent murder capitals.
Welcome to Thunder Bay.
When the call comes in, the McChicken combos go down and all of a sudden its lights on, sirens blaring, and $150,000 worth of taxpayer-funded machinery hitting the pavement at full throttle.
I'm with primary care paramedics (PCPs) *Gale and *Benson—a pair of Superior North EMS medics who've agreed to let me ride along with them.
"This is the best part of the job," Gale yells as we fly his ambulance along the Harbourview Expressway, while negotiating a safe trajectory through four lanes of traffic with the windows down, drowning out Iggy Azalea's "Fancy" in the background. It's a high-pressure ride, especially if it's lunchtime and all Gale had to do so far is drop off some old-timers for their morning constitutionals. He blasts his horn at the inattentive motorists in front of us, all the while offering me a blow-by-blow crash-course on the nature of his job. "A lot of people view us as the harbingers of death you know," he states philosophically, careening through traffic at what feels like 100 kilometers per hour. "But this job is really just like any other, except for these complete moments of human chaos."
"Just don't get us killed, alright?" Gale's partner Benson responds, jolting up with alacrity as he feels the brakes slam for the umpteenth time. He's seen this whirling dervish routine from Gale before and knows that he hasn't even reached his top gear yet.
"This is what the guy is like at half mast," he says to me calmly, and I believe him. There's a sort of manic quality that comes along with managing these kinds of daily extremes—of transitioning from moments of the most mundane musings to matters requiring life and death urgency—that Gale's maniacal driving strategies somehow capture perfectly. The concerned looks that passersby give us as we navigate around and through them, over curbs and behind alleyways is enough to give me pause, but I can tell you this: If I was lying in a pool of my own blood in Thunder Bay, I'd want Gale to be the guy to get the call.
In an instant, we arrive as the second ambulance at the scene and disengage the vehicle only to hear the painful moans of those a couple floors above the apartment entrance.
After stepping over the remnants of smashed beer bottles and spilled alcohol, we find the first patient to be in particularly bad condition.
"This guy's critical," a medic who arrived ahead of us calls out. "We gotta plug holes and go." Benson is moving very quickly now—heart monitor, kit bag—doing everything with an automated precision, managing to maintain complete composure the entire time.
"Always take the approach that you are trying to be like a duck," he tells me later at the hospital. "On the surface you're calm, but underneath, your legs are kicking like crazy." Back at the hospital, Benson is given the tough assignment of loading up his rugged field laptop to fill out the ACR (ambulance care report). This leaves Gale with 15 minutes to cover some curriculum on what it's like working in a city with a high rate of social determinant problems.
"You try to rationalize why people end up doing these sorts of things to themselves and a lot of it comes back to social isolation and addiction," he says, referencing Thunder Bay's concomitant tidal wave of poverty, substance abuse, and violence.
What upsets Gale and Benson the most is the fact that the hopelessness and depravity seem to be never ending. Twenty-five thousand calls are fielded each year (almost one for every four residents). The paramedics talk about this demand for resources and the cost of handling their ambulances at a cost of $240 per ride.
The Night Shift
Flash forward to the night shift, and now I'm with 10-year vet *Kacey Mueller and his partner, the rookie, *Jack Gingras. Kacey admits he's not surprised the constant stream of abuse has taken its toll on those in his profession. In the past 12 weeks, 13 of Ontario's first responders have killed themselves according to the Tema Conter Memorial Trust, an organization dedicated to promoting mental-health awareness among Canada's first responders.
Kacey points to the high rates of suicide and rising levels of Post Traumatic Stress Disorder (PTSD) cases as key indicators of the pressure his colleagues are under. "Currently we have a committee of paramedics, mental health professionals, and administrators trying to come up with a plan for PTSD, but we still don't address it as much as we should," he says. "In terms of home life, you can try your best, but it's hard to just leave all of these things you've seen completely at work."
The cost and personal toll of engaging in this profession are probably incalculable, but for a paramedic, they are the price for doing business. But it's not all just a simple matter of dealing with the dregs of society. Paramedics don't get paid particularly well (for Kacey and Jack, they'll receive around $30 an hour). They can't always be with their kids on the evenings or the weekends; their marriages break up as frequently as anybody else's.
His partner Jack, a 21-year-old on his first month on the job, is beginning to understand exactly what Kacey's talking about. At about 4:30 AM that night, we'll all be summoned to help an old lady who called 911, but won't buzz us into her apartment when we show up. The city will receive 8,000 calls from senior "super-users" this year, though many of them will at least be for good reason. "On a scale of 1 to 10, this call is shittastic," Kacey grins, shaking his head. "It's nice to know we are making a difference."
Jack fires up the laptop and begins to write up the call report. The hospital will issue a $45 bill out to the woman, but the cost of the whole experience is somehow more than that—every day, the weight of the city's problems—its poverty and aging population—weigh on the city a little more.
Back with Benson and Gale, the stabbing has been taken completely off their plate. The doctors are taking over now, and the paperwork's been filed. On the very next call, they'll be brought out to another apartment—this time to handle domestic abuse—a female has been struck in the mouth. The inside of the residence looks like something out of a scene from Hoarders and the injured woman keeps apologizing to the policemen for taking up their time. Her young daughter is there attempting to console her, but her sentences aren't making any sense. The entire scene is miserable and filled to the brim with despair.
But Benson and Gale are kind. Gale gently ices the woman's bruised and swollen face. Benson asks some difficult questions with impressive grace.
On our way to the next call, I ask how the two men just processed what they saw.
"I feel sorry for the daughter, 'cause seeing this is really going to fuck her up," Gale says, in the same calm and collected tone he used when dealing with the victims at the stabbing. "But when guys hit their girlfriends, we're going to be the ones who get the call."
"It fucking sucks," Benson replies, despondently. "It really fucking sucks."
The radio cackles and another code four comes in, the highest priority call. Benson cuts himself off just in time to gun it through another intersection as the sirens fire up and trumpet into the sky.