The Broken Front Line

[Nevilledog]

https://www.propublica.org/article/inside-an-emergency-medical-system-on-the-brink-of-collapse

It was 4:32 p.m. and Mike Diaz was almost halfway through another punishing 24-hour shift when the call came over the ambulance radio. Nine miles away, a man had lost consciousness. “We’re en route from Palmdale Regional,” Diaz told the dispatcher, pushing away the thought of grabbing some food, as he flicked on the lights and sirens and sped off into the suburban maze of the Antelope Valley. He had worked as an emergency medical technician here in the northernmost part of Los Angeles County for over a decade, but he still experienced the same thrum of adrenaline on urgent calls. Lately, however, on January afternoons like this one, his excitement was overpowered by a sense of futility and dread.

A few minutes after the dispatcher’s call, Diaz backed the ambulance into the driveway of a single-story house with a white picket fence. He and his partner, Alexandra Sanchez, followed a paramedic from the fire department into a dim living room, where an old man was stretched out on a cot, grimacing in pain. As Diaz crouched to check the man’s vitals, a middle-aged woman said that she had first noticed her father, who was 88, becoming less coherent around a week ago. The man was more confused than usual, and contractures had stiffened his thin legs into tent poles. Their primary care doctor wasn’t picking up the phone. Still, the family held off on dialing 911 because they feared that sending him to the hospital would expose him to the coronavirus. Only now that his condition had worsened had they decided to make the call.

As the daughter spoke, Diaz uttered short affirmative phrases. At 31, he is brawny and compact, with a smooth face, alert eyes and spiky black hair that lends an extra inch to his height. He was used to the brutal rhythms of emergency medicine in the Antelope Valley. The bustling community of 450,000, an hour’s drive north of Los Angeles, has only two hospitals and some of the county’s poorest and sickest residents. Diaz was overworked and proud of it, driven by the intoxicating rush of saving lives. Even when the 911 system was under strain in the past, he could take for granted that there would be enough resources — supplies, space and staff — to tend to patients. What he lost in sleep and free time he’d always earned back in the satisfaction of helping people. In a job that paid low wages and demanded extreme sacrifice, he’d come to rely on that feeling.

Now he could no longer count on it. The recent explosion in coronavirus cases — an over 900% increase in LA County from November to January — had left the health care system on the verge of collapse. In this new climate of scarcity, the more people there were who needed help, the less EMTs could do to help them. Peering down at the pale old man before him, Diaz was gripped by doubts: Could he still call himself a caretaker when he couldn’t properly care for his patients?

*snip*