When Matthew L. Tripp '96-'97 joined the Professional Ambulance Service this fall, he knew he'd be bandaging wounds and putting patients on stretchers.

But he didn't expect to be digging fingers out of mashed potatoes.

"There was this employee in a restaurant in Harvard Square," Tripp says of a recent medical emergency. "One of the cooks got his hand caught in a potato-masher; there was mashed-potato and blood all over the wall."

"I had to fish around in the pink mashed-potatoes for his fingers. Luckily, they managed to reattach all of them," he adds.

Tripp, who will graduate in January, has been working as a paramedic at the ambulance service 24 hours a week this fall, while writing an honors thesis in social anthropology.

"He's someone that's getting right in the middle of the blood and the beer and is doing great work," says Bill C. Mergendahl, operations director of the ambulance service.

A number of other students, though not professional paramedics like Tripp, are also riding with ambulances and helping to provide medical care on a voluntary basis.

These students see a different side of Cambridge--and of Harvard--as a result of their experiences.

Along for the Ride

Phillips Brooks House's "third rider" program--a joint effort between PBH and Professional Ambulance Service--allows Harvard volunteers to experience the life of a paramedic or emergency medical technician.

The Professional Ambulance Service, known as Pro, is a private emergency services provider located in Alewife, which supplies ambulance service for most of the medical emergencies in Cambridge.

Students participate in Pro through the third rider program, which lets them volunteer as assistants on Cambridge ambulances and see first-hand the medical emergencies that happen everyday in large cities like Boston.

The program, which has been in place for about five years, typically involves about 10 to 20 students, says program head Rod N. Bennett '97.

Bennett says most of the third riders are pre-meds, although anyone is welcome to join the program. Riders typically volunteer for a six to eight hour shift per week. The time commitment is discouraging for some people, he says, but volunteers need to work a long shift in order to see a significant number of calls.

"It's six hours, so it's kind of a pain, but once I get out there it's usually a lot of fun," says Stephen J. Lukasewycz '99.

Bennett, who has been involved with the program for three years but did not ride this semester because of medical school applications, says being a third rider hasn't required a huge time sacrifice.

"I get more homework done [at the ambulance garage] than in my room," he says.

Many volunteers say their experiences as third riders are nothing like the popularized "ER" and "Rescue 911" images of the emergency medical profession. Long hours are often spent transporting patients from one hospital to another or waiting in the ambulance garage.

"It's not really what I expected," Lukasewycz says. "I thought there'd be a lot more trauma."

Other students agree that their real-life experiences are less dramatic than the TV shows.

"I've been working for the past two summers at home in the biggest trauma center in the state, so I guess I was kind of spoiled," says Alden J. "Chip" MacDonald '00.

Despite the time commitment, most of the third riders express satisfaction with the program.

"It was kind of shocking at first," says Kristen E. Radcliff '00. "We picked up this mental patient and I got in the front of the ambulance. Then I thought, if I want to do medicine I'd better get in the back. [The program] not only showed me what helping people really means, but I also found that that's what I want to do."

Cambridge Perspectives

Tripp says Harvard students tend to possess little perspective on the Cambridge community outside the Square, and his experiences working at Pro have shown him a side of Cambridge that most students never see.

"I think that a lot of people at Harvard go through their four years thinking that Cambridge doesn't go beyond the Square," he says. "They look at things with a sort of tunnel vision. I've been thankful enough to have a job that exposes me to all sides of Cambridge."

Tripp says riding on ambulances exposes students who might be interested in medicine to the realities of the profession in a way that Harvard classes never could.

"It's kind of hard to come back from a night-shift dealing with people that can't even pay the rent and feel bad for the people that are upset about a late problem set," he says. "Just because you get an A in orgo [organic chemistry] doesn't mean you're going to be a good doctor. I think that's why the third rider program is so good."

Tripp, who worked as a volunteer EMT at home in Maryland before working in Boston, stresses the differences between professional and volunteer organizations.

"The volunteer service I worked for in Maryland catered to bankers or lawyers who wanted to dress up and play military," he says.

Tripp plans to continue working at Pro after graduation, but says he'll probably go to medical school sooner or later.

"I see the obvious path leading to a further education in medicine, but I'll never give up being a paramedic," Tripp says. "Most of being a doctor involves working in a totally controlled environment, but being a paramedic means you get to play in the street."

Another Side of Harvard

Emergency medical technicians and paramedics who serve the Harvard community say they see Harvard students and faculty at their most vulnerable.

Rather than viewing Harvard students as America's gilded elite, most employees at Pro say the students they pick up tend to act just as stupidly as any other Cambridge residents.

"Most of the calls around Harvard are drunks, especially freshmen," says Richard H. Powers, a paramedic at Pro. "They tend to be obnoxious."

Harvard cases range from the mundane to the dramatic.

"General illness is probably the biggest thing; by that I mean heavy flu-like symptoms," Mergendahl says. "You also see plenty of drunks. The calls really run the gamut."

Harvard is certainly not immune to tragedy though.

"Up until recently we've had an average of one suicide a semester, especially around finals time," says Joel S. Jacobson, a paramedic.

Students are not the only ones served by the ambulances though.

"I've treated [Dean Epps] before," Jacobson says.

Mergendahl says he vividly remembers two high-profile cases at Harvard--the alleged food poisoning two years ago and the murder-suicide in the spring of 1995.

"Health Services, which is supposed to handle 20 to 30 people, had 120 people stacked into the hallways [during the food poisoning epidemic]," he says. "There were people doubled over in the halls of the houses and lying in the streets. We took about 30 people out that night."

Jacobson and Powers both responded to the highly publicized murder-suicide involving two members of the class of 1996. The day before students left campus in the spring of 1995, Sinedu Tadesse stabbed her roommate Trang Ho before hanging herself in the bathroom.

"[The call] first came in as a laceration," Powers says. "Then it came in as someone, who stabbed someone else, that they hadn't caught yet."

"We basically followed a trail of blood up the stairs," he says. "When we found the first patient there was no blood in her body; it was all on the floor. Then we walk into the bathroom and there was hanging in the shower."

As a current student, says he sometimes finds himself an awkward situation when he to calls at Harvard.

"I've done calls on I know and walked into their and they didn't even recognize me," says. "You see people at their When you see somebody face in a pool of vomit you don't hold it them."

Pro has a positive relationship with University Services, Mergendahl says.

"We have very good relationship with Harvard Health Services overall and Harvard University Police as well," he

But paramedic says students often go UHS for serious medical problems they would be better off at a hospital.

"People that are go [to UHS] and they shouldn't Powers says. "Their health is

Paramedic

Being a paramedic some notorious side effects, including odd sense of humor.

"I a unique job, and it's much like being a firefighter or a police officer," Mergendahl says. "The people that it attracts are naturally people that have to deal with all sorts of strange circumstances. Consequently, I don't know if it's a defense mechanism or what, you develop an odd sense of humor and a slightly strange way of looking at things."

Tripp says he has experienced a similar phenomenon.

"Everyone talks about paramedics' gallows humor," he says. "It's just a way of coping. If you didn't laugh, you wouldn't survive."

Tripp also says anyone who plans on being a paramedic should do it for the love of the job, not the money.

"This profession is under-paid anywhere you go," he says.

Pro, like most ambulance services, collects income by billing the patients it picks up, but does not discriminate against those who don't have health insurance or aren't able to pay.

"We probably absorb 30 percent of the cost of everything we do," Mergendahl says.

"On an emergency basis we don't question billing at all, and for people that have no insurance we always work with them by either reducing the bill or making a payment plan."

Pro typically charges about $400 to $500 for an ambulance trip, depending on the number of miles travelled by the ambulance. When they deal with health care providers, however, Pro must accept the company's standard rate of pay for ambulance trips. That can vary from anywhere between $90 and $700 per trip depending on the provider, Mergendahl says.

During the day Pro has four Basic Life Support (BLS) ambulances and two Advanced Life Support (ALS) vehicles on call at all times, Mergendahl says. At night that number is reduced to one BLS and one ALS vehicle.

But Boston has a large network of emergency care providers that sends units to areas that are understaffed at any particular moment.

The students who work with Pro as "third riders" are required to have CPR certification before joining the program, and must also sign a waiver form releasing Pro from liabilities in case of injury.

According to Bennett, the biggest change in the program during the past five years has been a greater emphasis on teaching CPR skills to interested students at Harvard.

"The way we've changed it is that we've tried to teach CPR more frequently," Bennett says. "We've trained five extra CPR instructors and we'll be teaching the course more next semester."

Bennett also says the courses are open to all members of the Harvard community, not just third riders. The program asks for a $15 donation to cover course expenses, but if students are short on cash they may take the course for free.

"Just because you got an A in orgo doesn't mean you're going to be a good doctor. I think that's why the third rider program is so good."

--Matthew L. Tripp '96-'97CrimsonAnna-Marie L. Tabor