A couple of weeks ago I wrote my first article on my memories of the funeral home ambulance service.  My friends, trust me, what a ride it was working on the funeral home ambulance service.

Last time I shared a funny story about one particular ambulance call, and I have more where that one came from, but yesterday I had an experience which made me think back more than 30 years ago to one particular call we had which was not funny in the least.

First let me share with you what I witnessed yesterday. As I was driving back from lunch, I pulled over for a fire engine, and the right behind the fire engine, an ambulance.  Of course the ambulance was much different than the ones I worked on.  Today I believe the modern ambulance is literally a moving emergency room on wheels – and thank God the service evolved into what it is today.  I believe many lives are saved because of the advancements in ambulance service that we almost take for granted today.

However, in the past, while our vehicles and training could not compare with the present day sophistication, nonetheless we ran smack into terribly difficult and life and death calls on a regular basis.

Yesterday as I turned the corner going back to the funeral home, the fire engine and ambulance had all lanes in the direction I was going blocked, and a police officer was on the scene stopping traffic.  In a short time, one of the paramedics came out of the house and I could see that he was carrying a baby in his arms.  In quick order the infant was whisked into the back of the ambulance the doors were shut, the fire engine moved out of the way, and traffic resumed.

Maybe other drivers felt a pang and chill witnessing that scene, I don’t know, but I do know that I felt hollow inside .I felt the tremors of anxiety that only someone who has been involved with an injured and ill infant can feel.  My memory went back to 1969 in North Omaha.

From routine to emergency

As dramatic and traumatic ambulance work was, after a while calls do become somewhat routine.  Not callous routine, but after 1,000 calls the siren gets tiresome, battling traffic gets tiresome, and the calls in reality are usually not life and death.  In fact my boss, in moments of ambulance exasperation, used to yell that “We are running a glorified and FREE taxi cab service.”  His exasperation was well founded, for once we got an “emergency” call from a grocery store and when we arrived the old lady simply wanted us to help her take her groceries home in our $45,000 new ambulance.  

However everybody who knew anything about ambulance work also knew full well that just about the time you relaxed, just about the time calls got boring, just about the time you got complacent, BAM, WOW, SMACK, some call would come in that would derail your comfort level and alter your psyche forever.

This happened to me on several memorable occasions.  Here is one of them.

It was hot in Omaha, blistering hot.  The heat certainly helped the corn grow tall, but it made ambulance work a nightmare.  We dreaded daytime calls because the air conditioner in the back end of the rig simply could not keep up with the doors being opened and closed constantly.  Night calls were better, or so I thought.

One summer evening the sun had disappeared and it had started to cool off wen we received a residential call.  This was not a police call.  Police calls were almost always a safer type of call to respond to, simply because if the police were on the scene somebody (usually the police, but not always) had a gun.

So off we went to North Omaha.  The neighborhood was rough, many burned out buildings, because there had been a couple of assassinations the summer before that motivated people to react with anger and furor, and the neighborhoods bore the scars. The area was full of blight and poverty; it was a tough place.

It was about 8:30 p.m. and as we pulled up in front of the address I could not see anything amiss.  Oftentimes in really tough calls, people are screaming, running round and basically going nuts – but not this time.  Everything was quiet.  It was still so hot that even the neighbors didn’t come out to see what was going on.

I was in the passenger seat and got out of the ambulance.  Out of the blue, like a shot in the dark, this young woman came flying out of her front door, ran down the front steps, and tossed a small bundle in my arms.  It happened so damned fast that my buddy who was driving had not even gotten out of the vehicle.

I looked down at the small bundle and pulled the blanket back. It was a little baby, not more than three months old.  The young woman started shrieking and yelling at the top of her lungs, and then she started punching me in the arm.  I froze.

Finally my buddy pulled the hysterical woman away from me and as I took the infant into the back of the ambulance I could tell without question that the baby was not breathing.  I was mortified.  Advanced first aid had covered CPR, but hell, I never thought I would run into this situation in a million years. But then I was a kid, and what does a kid know, particularly working on the ambulance? But as God is my witness, this night I learned fast.

My buddy looked at me and did not say one word.  He jumped into the driver’s seat, I shut the back door and off we went to the nearest Omaha hospital, which fortunately in those days was only maybe 20 blocks away.

We had purchased an “Emerson Resuscitator” which in 1969 was the state of the art in emergency breathing equipment – or so we thought.  Looking back, however, the bloody thing didn’t work.  There was an adult mask, and a child’s mask, but no infant mask, and even with the masks, if you did not create a perfect seal on the mouth the machine would just click repeatedly with oxygen escaping through the cracks in the supposed seal.  Also the machine weighed 100 lbs.

The baby was not moving, and I was trembling.  I thought, “Lord, help me!”  Finally I bit the bullet and started mouth-to-mouth resuscitation and heart compressions.  It was difficult to do this in the back of the old ambulances, because room was tight, and on night my buddy the driver was so freaked out that he was driving 70 mph going up North 24^th Street, which is a major avenue in Omaha.  The result  was that I was getting tossed about hither and yon in the back end and could not get a strong foothold.

I don’t know why I did this – ignorance, desperation, stupidity, I don’t know – but I decided to pick that infant up and smack its bottom.  I imagine any EMT reading this is just having a conniption fit, but that it what I did.  I smack the baby’s bottom and then turned him around and started CPR.  In a few second the baby vomited – I hope this doesn’t gross you out – but the baby vomited right in my mouth.  I can’t say I handled that every well, because I also threw up. (I was a true professional.) 

Suddenly we were under the canopy at the hospital ER and my buddy had hysterically raced like a wild man into the ER yelling and screaming about our desperate situation, and before I knew it three nurses had taken the infant out of my arms and into the ER they carried him.

It is interesting that a crisis seems to end about as quickly as it starts.  One moment I was getting vomit in my mouth and the next minute I was sitting safely in the front seat of the ambulance, having now no control at all over the situation and feeling damned happy and relieved that I did not.

For about 20 minutes my buddy and I just sat in the ambulance looking at each other.  I almost started to cry, and all my buddy could say was "god– , god–" over and over again.  Then we looked at each other and burst out with a goofy stupid laugh.  Certainly the situation was not funny, but that is what we did.

When I returned to the funeral home, I told my boss about the call, and he very sympathetically looked up and said “Oh hell, buck up son; it can get worse.”  My friends, he was telling me the truth. I did go on worse ambulance calls over the years.

About a month later, we had another call and ended up at the same hospital again.  One of the three nurses who had rescued the infant from my incompetent care came over to me and told me that the baby had lived, he was alright.  Then she looked at me and said, “You know, you did a good job.”  I don’t know to this day whether that comment was accurate, whether it was sympathy, or whether she was teasing me.  I don’t know.  I know at the time I thought that I was in way over my head on this ambulance call, but it taught me a valuable lesson – be prepared for anything in the funeral profession.  Complacency is high-risk behavior; the concept of “routine” in reality does not exist in funeral service.

When I saw that little bundle being taken from the house yesterday, my memories immediately went back to North Omaha.  I know in the end that the crack medical team at the hospital did the real work, but I have always taken comfort in the terribly kind words the nurse said to me.  She didn’t have to do that.

There are more ambulance stories, and I hope the readers will not bore too easily going down memory lane with me.

Truthfully the ambulance experience made me a better human being, and hence I improved my skills as a funeral professional.  I didn't become perfect by any means, but these types of ambulance calls did improve my sensitivities to the tenderness and fragility of human life.  

And in the end if funeral directors are not sensitive and tender and aware of the fragilities of human life, what do we have left?

Anyway that’s one old undertaker’s opinion. TVB

In 1992 I published an article in one of the professional journals entitled “The History of the Funeral home Ambulance Service.”  Actually it was one of the few attempts I have done at writing that caught some attention, well attention from veteran funeral directors anyway.

Over my years of writing and doing seminars I have often asked funeral director groups how many of the attendees worked on the funeral home ambulance service.  Thirty years ago many hands went up, and those who raised their hands were also shaking their heads, and rolling their eyes.  The baby funeral directors in the group had no clue as to the veteran’s reaction when the subject of the ambulance service came up.  The baby funeral directors would just look bewildered, and some even confessed to me later that they were totally unaware that funeral homes even operated ambulance services.  Such is the case of generational disconnect.

However today when I ask the question of funeral director groups about operating the ambulance service the number of hands that get raised has clearly dwindled, but still the ones that do raise their hands (they all look a lot like me - you know, white hair, etc.) still shake their heads, and roll their eyes, and still the baby funeral directors just sit seemingly baffled by what this old grumpy undertaker (meaning me) is talking about.

For some this blog item will be going down memory lane.  For others it will probably sound like total science fiction – a story or stories that Todd just pulled out of thin air – but trust me, my friends, what I am about to recollect is NOT science fiction, in fact the ambulance service was for many years as an entrenched a part of the typical American funeral home as were embalming, caskets, funeral vehicles, and funerals!

From the mid 1960s to the mid 1980s I was involved with ambulance service, and our ambulance service WAS NOT simply invalid transportation (as it used to be called).  Our ambulance service was heavy duty, emergency, day and night ambulance service, and as strange as this sounds in 2010 with paramedics and basically moving emergency rooms, in the period of time I am talking about our ambulances were state of the art.

In fact when I decided to become a funeral director I just took it as a matter of course, without even thinking about it, that the ambulance service was a part of the scene, it was part of the career, and I found out quickly that it was a big part of the career.

I need to explain something quickly concerning my use of the term “state of the art” in reference to the funeral home ambulance service.  The funeral home ambulance service was indeed “state of the art” in say 1966, but not by today’s standards.  The basic qualifications to operate the ambulance were nothing.  Some, like me, had advanced first aid – but folks that was it.  The emergency medical technician program was still a decade away when I started on the ambulance.

State of the art in funeral home ambulance service was basically simple.  The impact of the idea of state of the art was actually connected with the appearance of the ambulance itself, and the appearance and the type of vehicles used as funeral home ambulances were literally all over the map.  There were no minimum standards, those were entirely up to the owner of the funeral home and ambulance.

The first ambulance I drove and worked on was a great 1959 Miller-Meteor, and it was a tank.  The second was simply a converted station wagon.  Then I worked on a 1960 Oldsmobile combination (which served as both a funeral coach and ambulance) and then in Boston I drove some really nifty Cadillacs.  

I drove ambulances out in western Nebraska, in the city of Omaha, in rural Iowa, and in the city of Boston.  I worked for the last funeral home in the metro area of Boston to operate an ambulance service when I was a student at the New England Institute, and what an experience that was – driving a ambulance through the streets of Beantown.  WOW!!!!!

In reality our ambulance care for the patients was a kind of “load and go” approach.  We would often times advertize quite boldly “FULLY EQUIPMENT EMERGENCY AMBULANCE SERVICE – 24 HOURS DAY OR NIGHT – OXYGEN EQUIPPED – TWO-WAY RADIO.”  The advertisements read well and sounded great.  We indeed looked grand and great going down the street, because no matter the type of ambulance we had, we had most every emergency light and siren that had ever been invented on those vehicles.  Funeral home ambulances were often times flashy, fast, impressive and above all loud, really loud.

For a young man it was a dream job come true.

However the truth is that our “Fully Equipped Emergency Ambulance” was really not that fully equipped.  Here is what I remember about being fully equipped; we usually had a couple of towels, some ace bandages and 4 x 4 gauze pads, a stretcher, some old Timmons splints (which needed to be seen to be believed – I always felt sorry for people with broken bones), and a tank of oxygen – sometimes full, sometimes half full, sometimes . . . . . . . . . .  Oh, yes, and we had a little plastic bowl called an “emesis basin,” which we were supposed to use when people were vomiting.  The emesis basins, anyway the ones we had, were very small and my patients when I was sitting in the back of the ambulance usually missed the basin totally and threw up on me.

As I mentioned, in the mid 1960s we knew no different, and while by today’s standards people laugh at the idea of a funeral home running the ambulance service let alone at our equipment and how we responded and took care of call, I believe that laughter is really out of ignorance on their part. They really don’t know what they are talking about, and trust me, WE TOOK THE AMBULANCE SERVICE VERY SERIOUSLY.

There were no pagers, no beepers, no answering services, no voice mail, no nothing except for the land line funeral home phone which had to be attended to in person twenty four hours a day, seven days a week, and 365 days a year.

I believe the Federal Wage and Hour Act had been passed and was law of the land in the mid 1960s, but you would never have had inkling that there was even a concept like Wage and Hour in the funeral home world.  We were on call constantly.  Days off?  What are days off??? Who ever heard of such a ridiculous idea – days off?

Add to this that in every funeral home I worked in or even the ones I owned, the ambulance calls always were higher in number than the funeral calls.  Always.  Too often people that were just as ill at 2:00 in the afternoon waited to call the ambulance until 2:00 in the morning.  There is something about the sun going down and the increase in ambulance calls.  Night work was where the action was – most always.

When you operate an ambulance you see the heights of the human spirit, but you also see the utter bottom of human depravity.  Time and space do not allow me to even touch on some of the rawest of the raw calls, and in today’s cultural sensitivities some of my case memories would be offensive – I can’t even tell my family about the real rough ones, but on this tender subject any veteran funeral director who operated the ambulance service will know precisely what I am talking about.  We were in the thick of some of the most distasteful and stressful of human events in our community.

However the flip side of this was some of the most hilarious things happened to me on the ambulance.  A funny story here is appropriate.  When I was a student in Boston we transported an old lady from Don Orione Nursing Home in East Boston to Massachusetts General Hospital.  We hauled her back and forth, back and forth, back and forth.  This lady was so small and meek and she sounded like a faint little mouse when she would talk – she was just a sweetheart, we liked her very much.  Every time we picked her up she would say over and over again “Don’t hurt me, don’t hurt me.”  I always assured her that we would not hurt her and off we would go to the Mass General.  Her name was May.

One afternoon we were called to haul her back to Don Orione, so into Boston we went and put her on the cot.  As we were leaving the ambulance entrance area, before we made it out into the parking lot it started to rain and rain hard, just a down pour, raining cats and dogs, a monsoon in Boston.  Our standard operating procedure in rain like that was to take the blanket and cover the patients head and make a run for the ambulance.

I learned over to her and said “May, I am going to cover your head with this blanket, so you won’t get wet – it’s raining really badly.”  May replied “What did you say?”  So I go through the plan one more time.  I take the blanket and cover May’s head, but honestly it was raining so hard that my associate and I did not want to get soaked so we decided to wait “just a little bit” till it lightened up.  Not a good idea, and there good old May lay her head covered with the blanket and not saying one word.

In a short time a little crowd of people had gathered who also were leaving the hospital, but they too decided to wait a little bit for the rain to let up.  As I looked around at this little crowd it was evident that everybody thought we had a corpse under the blanket, because no one was saying a word, everyone was somber and reverent and all this time the rain just got worse and worse.

It might have been ten minutes that our little group of people afraid to go out into the rain were all standing there, and I remember one woman who was holding a vase of flowers looked over at me and gave me that real sympathetic smile which is always a nonverbal communication that she wanted us to know that she knew we were removing a dead person.  

Out of nowhere, I mean out of nowhere, we all hear this little meek voice said from under the blanket “I think I am going to suffocate.”  It was May talking under the blanket.

It scared the b’jesus out of the entire group waiting for the rain to lighten up, and the nice lady who had sympathetically smiled the moment before at me actually was startled so much that she dropped the vase of flowers and broken glass scattered all over the ambulance entrance.  I looked at my associate and gave the nod saying “let’s get the hell out of here” and rain storm or not off we went to the ambulance.  It must have been a bumpy ride for May.

I was laughing so hard that tears were running down my cheeks.

So friends, there you have a brief memory of the highs and lows of the funeral home ambulance service – I could and probably will write more on the subject.  It was the experience of a lifetime, and while we eventually had to get out of the service, which was the right thing to do, I look back today and would not change a thing about my experience.  The ambulance was a headache, a tension producer, and at times a literal nightmare, but it also was an opportunity for a young man to see the raw data of life, and realities of the human condition, and the ambulance stories make marvelous cocktail party chatter – people love the ambulance stories.  The ambulance service forced me to continue to grow up.

Maybe some of the readers can share their own memories of this significant chapter in funeral service history.  TVB