From the horrors of preventable deaths to sleeping in cars after 24-hour shifts: the sobering reality of being a first responder in New York City.
New York has been dealing with the aftermath of an explosive spread of coronavirus for over a year now. With the state’s cases exceeding 1.65 million — almost half of which were in New York City — and staggering estimates explaining that by late April, one in five New Yorkers had been exposed to the virus, the area was nothing short of the public health crisis’ epicenter.
While death statistics and ever-changing safety regulations have been steadily publicized in the media, little is known about the internal and external struggles of first responders in the city. Beyond the scheduled applauses, the tweets labeling them as heroes, and the churning out of highly automated-seeming expressions of gratitude by officials, it seems like we never really stopped to ask: what’s it like for them?
At the height of the pandemic, 911 calls increased by 50% while EMTs had to bear the workload understaffed, as upwards of 25% of workers would be out sick at any time, due to the higher rates of infection among emergency personnel. Meanwhile, they often slept in cars following 24-hour shifts in hospital parking lots out of fear of infecting loved ones at home — leaving children severed from their parents for months; and faced horrific scenes like finding human remains in apartments after neighbors would call about the foul smell. Yet, as mental health crises and suicides mount for EMTs during this unprecedented time of extreme stress in the field, there has been little to no financial and personal assistance by authorities and institutions: EMS personnel continue to make $35,000 less than 911 and police peers, even though they’re all under FDNY.
David Besprozvany had barely changed out of his high school prom suit when he first started working as an EMT in NYC. Three years later, at 20, the first-generation NYU junior born and raised in Queens and currently majoring in Neuroscience, was at the frontlines during the city’s turbulent response to the pandemic — often taking 20-hour long shifts while still in college with dreams of attending med school. He’s been part of the Central Park Medical Unit, an all-volunteer service free for patients, where he sits on the executive board, and also works with Northwell Lenox Hill Hospital. To shine light on the struggles and rewards of working as a first responder during the most severe public health crisis of the 21st century, Besprozvany shares his story.
Q: What made you want to join the EMS at such a young age?
A: I’ve always wanted to go into medicine, and when I was a junior in high school my mother suggested I should get a feeling for it, so I started volunteering every Saturday at the ER of the Veterans Affairs hospital. It was small, but even that brief experience taught me that there were a lot of problems within healthcare: nurses weren’t tending to patients quickly, EMTs wouldn’t advocate for their patients, and even though I was doing menial tasks — making beds or collecting blood — I had some very meaningful connections with patients. This made me want to do something more impactful within this sphere, to which my mother again suggested EMT training, which I did the minute I graduated high school. And so, when I first came to NYU, I immediately joined the Central Park unit.
Q: So, then the pandemic hits a year after you arrive — the worst crisis in New York’s modern history. What was one of your most striking experiences of being a first responder during those months when the city was averaging up to 950 deaths a day?
A: In mid-April, the NYS Bureau of EMS put out an order that said that due to lack of capacity in emergency departments, we could no longer transport patients in cardiac arrest to the hospital. They declared a ‘20-minute work-up on scene’ order, which meant I had to resuscitate this specific patient on scene, restarting their heart. If you don’t get spontaneous return of circulation — which we didn’t — you have to pronounce them dead immediately. With COVID-19 in general, we would see double or triple the normal amount of cardiac arrest we usually saw. Our system was not prepared.
Q: How did that feel?
A: It’s strange. In the moment, I desensitized myself from it, and didn’t react. Many EMTs will agree that when they put on their uniform, they’re on the job: you don’t want to get super emotionally attached to what happens, but it starts to creep in later. It’s a very sad situation but it was the reality back then. It’s what we’re trained for, we’re supposed to handle these types of situations.
Q: Speaking of the health dangers, there are some staggering statistics out there: according to a November study by the Journal of Emergency Medical Services, during the first wave, NYC’s firefighters and EMS workers were 15 times more likely to catch the virus. At one point, while the public had a 2.4% rate of virus incidence, first responders had a 36.2% rate.
How has this fear impacted the way you operate in your day-to-day life?
A: There was always an element of anxiety. The week before NYU closed in March, I was studying in Bobst, but couldn’t focus because I was concerned with what this new disease was. I kept researching, and the media terrified me: What could this do to me? Will I pass it on to someone else? That being said, I’ve always had access to PPE — even though at the start we would often reuse it — but like I said, because of the nature of what I signed up to do, I never felt like I didn’t want to do the riskier jobs. I would just think that “I’ve got my PPE, and whatever happens, happens.” And I would of course make sure no one else drove my car, that I took off my uniform immediately at home, showered, etc. There was a collective understanding within healthcare that what we were doing was bigger than us.
Q: There have been a lot of debates with what should be done about government assistance. In late March a fourth stimulus package was announced that would include hazard pay for first responders. President Trump also signed a $2 trillion bill to support EMS. However, the advocates chastised the plan, claiming it didn’t offer adequate support. Instead, they asked for direct funding and immediate protections for staff. Representatives from the EMS1 Editorial Advisory Board also stated that sustainable EMS funding is far more important that hazard pay.
With that, we can go back to what you mentioned regarding the disorganization and relative carelessness you observed in hospitals. What’s your view on this? What do you think the best way would be to support EMS from your experience and that of your peers?
A: I completely agree with the dismay. The modern EMS system is not at all efficient or as good as other parts of the world. Regarding financials, the extent of help that EMS got, especially considering lots of it was on a voluntary basis, was merely being called ‘heroes.’ I think that’s at the root of the issue: instead of investing in their employees, private and public institutions alike would rather do the PR of saying that their staff is extremely valuable and giving them small intangible rewards like free parking passes. Even worse, recently de Blasio had to think of budget cuts for the city, and he blatantly supported firing EMS workers — so this is a systematic, broad issue of austerity where institutions fail their own employees.
Q: Did that promote inequality?
A: Definitely. It put a financial burden on employees who weren’t being compensated properly, while institutions were being bailed out. I remember working with a transport company that helped get the elderly to and from hospital, and the conditions were so bad that employees would literally steal each other’s overtime. That being said, there’s definitely a range of quality of the workplace, and you could potentially be at a hospital making $27 an hour with benefits — we see this spectrum in healthcare occupations often. More importantly, however, there was a wide difference with the patients we would see. The Central Park unit is huge, and when I was located on 79th and 5th, most calls weren’t coming from the rich neighborhoods like UES, but from Harlem and the Bronx. So, we wouldn’t “last” in the rich neighborhoods: we were be pulled to the more socioeconomically disadvantaged areas and that’s a reflection of the system failing.
Q: Last August Trump signed a bill that extends disability and death benefits to public safety officers who die as a result of COVID-19.
That was a quite striking turn of events: could the government have done more?
A: The Lancet put a study out that 40% of U.S. COVID-19 deaths were preventable. And I definitely think that it was due to a delayed, or nonexistent, response from the government and the cessation of any safety regulation around June, which caused spikes. They could have done more and provided better social safety nets to people at home to prevent the spread. When citizens were in lockdown, they were losing income, which forced many to keep going to work despite the risks, as they couldn’t afford not to. This is why the lockdown could only last until May. The government drained its own economy. In what I call “socialism for the rich,” average people received no assistance while massive corporations were protected. The majority of people, however, aren’t hedge fund managers: they’re working-class people who have to still go to work and spread the virus to everybody else. In a vicious cycle then the EMS continue being overworked. So of course, the government could have done more. That being said, I do think there was only so much the government could do, because it’s such a new and unique virus. even with a robust response to quarantine we would still have issues.
Q: The mental health of EMTs has been widely discussed. According to a first-person account of a first responder, difficulties were compounded by a culture within EMS of having to not show vulnerability, preventing workers from seeking help, and having to go through the psychological burnout in silence.
How have you been able to keep yourself sane personally, and how do you destress? If you could give some advice to other first responders, what would they be? How do you manage to disconnect yourself from all the graphic horrors you see and mentally unwind?
A: I’ve never had a mental health crisis during this, beyond the collective sadness we’ve all experienced. My advice for people going into the field is that you really have to know that you want to do this. I’ve seen people who don’t like the job and are so exhausted they don’t really see the value in it anymore. Personally, I destress by considering the situation more broadly — I understand that my own experience is a small part of a giant response. I’ve always done a positive spin on everything. For example, when a patient of mine didn’t make it on the way to the hospital, I remembered the basic question of: what’s our purpose? It’s to do our best to help someone. My supervisor once said that EMS doesn’t save lives — we are in the business of changing lives. Thus, I would say whenever workers get overwhelmed with whatever they’re doing or seeing, they need to remind themselves that first, they are not alone: we’re surrounded by a community of partners at all times; and second, you should always look at the positive of what you’re doing and not let the expectation of saving someone’s life beat you down — it’s about trying your best to make it better.
