SCHENECTADY — The call comes in like so many others: short on detail and only hinting at how much danger the patient faces.
A woman sits gasping and clutching herself outside her Hamilton Hill home, crushing pain in her chest.
Heart attack? Indigestion? Panic attack? There are clues but no firm answer.
Rescue 1 rolls onto Veeder Avenue just as it will 3,500 other times this year, two firefighter paramedics heading out to help someone in distress somewhere in the city.
The firefighting profession decades ago expanded beyond fighting fires to providing medical assistance, and the Schenectady Fire Department evolved with it.
Every member of the department is now also a paramedic certified in advanced life support, rather than an emergency medical technician certified in basic life support. Medical calls constitute two-thirds of the work the department does.
Rescue 1 is the busiest fire truck in the city, by far, and Firehouse magazine consistently ranks it one of the busiest of its kind in the nation. With 3,500 medical dispatches and 2,000 fires or other non-medical incidents, it will respond to about 5,500 of the department’s anticipated 18,000 calls this year. Depending on the situation, its crew may roll solo or it may join some or all of the department’s six other trucks.
Rescue 1 is usually run by the most junior members of the department — they have the most to learn about the job, the most to learn about navigating the city streets when seconds count, and hopefully the most stamina.
At the wheel this evening is Edward Harasiemowicz III, who at 23 is one of the city’s youngest and newest city firefighters. He’s fine with having the busiest job in the department.
“You learn the streets, you go to every serious call, every fire, and you get all the exposure,” he said.
The premise behind Rescue 1 — call 911 and two paramedics will show up at your door a few minutes later at no cost — is a foreign concept in most of the world and even in much of New York. But it’s what people can expect in Schenectady, unless there are too many other emergencies unfolding at the same time.
“Going into EMS, I was always told it’s a thankless job, but I’ve definitely gotten my fair share of thank you’s and hugs,” Harasiemowicz said. “The Schenectady residents love us.”
The Hamilton Hill chest pain call is priority one/delta, meaning it’s urgent, so Harasiemowicz hits the lights and siren and, as much as is safe on the narrow streets, the gas pedal. As he arrives, he lights up the scene with the roof-mounted flood lamp.
The patient isn’t having a heart attack. She’s having a really bad day, vomiting and hyperventilating after she came home to find the door locked and her possessions on the porch.
“She locked my service dog up in the house,” she tells Harasiemowicz, who’s doing a quick evaluation to be sure nothing more than anxiety is at play here.
“I’d be pretty worked up, too,” he replies.
Harasiemowicz uses the calming voice that patients need to hear in these moments. He’s had to learn and practice that voice, but he’s not just saying the words — he’s a dog lover. He and his fiancee share their home with two.
Harasiemowicz started out as an emergency medical technician with his hometown Rotterdam EMS and joined the Schenectady Fire Department in the summer of 2021.
At the opposite end of the experience ladder is Deputy Chief Douglas Faulisi, commanding officer of Harasiemowicz and the rest of 2nd Platoon. After 30 years, he’s the second-longest serving current member of the department.
“I was an EMT when I came on, then the city sent me to paramedic school,” he said. “I was on rescue rigs about nine years.”
Faulisi said the mission has expanded since he was the young guy answering medical calls.
“The serious calls still seem to be the same, your heart problems, your fires, your traumas, your shootings, there seem to be the same amount of those calls, but there seem to be more of the other calls,” he said. “People now call for less-serious things. People call 911 for stuff that they would have handled on their own before.”
Many Rescue 1 calls — the panic attacks, slip-and-falls, stomach pain — are not screaming emergencies. Except, that is, to the person experiencing them. This is what informs the paramedics as they do their work, Harasiemowicz said: That person may not be in a severe medical crisis but they may nonetheless be having the worst day of their lives.
“Just to be able to help someone in their time of need, no matter what it is, it definitely feels good,” he said. “That’s why all of us get into this career.”
A lieutenant always rides in the passenger seat of Rescue One, and for part of this shift it’s occupied by Lt. Dan Morgalis, a 17-year veteran of the department.
He floats from one role to another within the 2nd Platoon, and likes it that way: If his paramedic skills got rusty he couldn’t give his patients the best care, and if his firefighting skills got rusty, he or his partner could be in danger at the next blaze.
Morgalis also has the soft skills of an ambassador, able to take the edge off a situation or keep an edge from developing in the first place. It’s something that is taught and rehearsed in paramedic school, but not everyone pulls it off as well. He figures he developed it earlier, as a teen-aged supermarket cashier.
“What’s going on, pal?” he asks a patient who called 911 for abdominal pain. “Tell us what you want us to do.”
The patient has a number of challenges in life, and Morgalis has knocked on his door many times before.
“I’ve had him apologize for calling, [and say] ‘I just couldn’t do it myself,'” Morgalis said.
When Morgalis and Harasiemowicz complete their evaluation, and determine the patient is not in immediate danger, a Mohawk Ambulance crew takes him to Ellis Hospital so a doctor can look at his stomach.
Neighbors greet the two firefighters as they walk out. When a woman three decades older than Morgalis starts flirting with him, he deftly redirects her attention to the graybeard from The Daily Gazette who’s tagging along this evening.
“He might be closer to your age than me,” Morgalis says, laughing along with the group.
He shouts a farewell: “Take care, guys!”
A much more subtle touch is called for when patients are struggling with internal crises, Margolis said, such as the one Rescue 1 is summoned to police headquarters to evaluate.
“We do have mental health training, as in how to deal with such emergencies, because that’s where you need to tread very lightly,” he said. “You have to understand what that person’s trying to communicate to you, you have to understand that person’s concern, because that situation could turn really bad if you say the wrong thing or do the wrong thing.”
Harasiemowicz drives Rescue 1 to the police station priority 2/alpha — no lights or siren, no running through red lights. The patient’s only physical complaint is minor cuts, so there’s no need to create risk by rushing to the scene. And as it turns out, he’s not even bleeding. But he does appear to have some mental issues.
The decision is to detain the man for mental health evaluation. Harasiemowicz and a police officer climb into the ambulance with him, in case either of their skill sets are needed during the short ride to Ellis Hospital.
Morgalis follows at the wheel of Rescue 1.
“We’ll be right back in five minutes,” Morgalis says as he, Harasiemowicz, the police officers and the ambulance crew walk the patient into the Emergency Department.
Twenty minutes later, Morgalis emerges with an apology for taking so long: Ellis is swamped, and they can’t just leave the patient alone in the waiting room.
It was a busy Friday evening all around, actually: From 4 to midnight, Schenectady police responded to 72 incidents and the Ellis ED had 67 patients arrive for treatment.
Rescue 1 responded to 18 calls in the 2nd Platoon’s 24-hour tour of duty, 15 of them in 16 hours.
It’s almost never an orderly process with an even pace — the calls usually come in clusters.
At one point, Harasiemowicz actually pulls a perfect 360 on Veeder Avenue in front of fire headquarters: Rescue 1 is dispatched to another call just as he’s pulling in from the mental health call, so he turns around. Rescue 1 is called off three seconds later, so he just keeps turning.
The lull that follows gives time for pizza and coffee, and time for members of the most fraternal of professions to catch up.
The chatter wanders from the set of tires and rims Harasiemowicz wants to sell, to whether his asking price is realistic, to the duty trades needed to get the firefighters with young children time off on Christmas day, to a recent call that rolled up on a victim with multiple gunshot wounds.
Every firefighter present has ridden on Rescue 1. They’ve all had the rare quiet day on the rig, and each has a personal record for busy: 25 or even 27 calls in one 24-hour tour.
Fifteen per day is about average.
Back-to-back fire calls end the lull this evening. Lt. Jeffrey Huth has relieved Morgalis and is riding now with Harasiemowicz in Rescue 1. Both are sporting heavy flame-resistant fire gear over the lightweight summer clothing they wear to medical calls.
The Rescue 1 crew has many potential roles at a fire scene — get victims to safety, run ladders into place, put out the flames and treat anyone who’s injured. They dress for the worst so they can do it all.
Neither fire call evolves from threat to crisis, however. On this evening, Rescue 1’s crew will give medical assistance rather than douse flames.
A CALMING FORCE
Faulisi says the record-keeping and reporting are much more involved now than when he was doing Harasiemowicz’s job, and the calls are much more numerous.
“Also what takes more time is so many people go to the hospital now [for things] that they normally would have gone to their doctors for, and the hospitals are overwhelmed so the paramedics will wait a long time to turn their patient over because there’s not a room available or a nurse available,” he said.
On the Hamilton Hill call, Harasiemowicz squats with the patient outside her home, listening as much as talking.
Both are only a few years into adulthood, the same age but at different places in life. A listening ear and some reassuring words are the best thing he can offer her right now.
She grows visibly calmer with each minute, and the electronic readout on his portable monitor shows her pulse and blood pressure settling down as they talk.
With her blood oxygen level at 100%, the patient isn’t in any immediate danger. Harasiemowicz and Huth clear her for non-emergency transport to the hospital via Mohawk Ambulance. A friend remains at the scene, awaiting a police officer who will try to sort out the mess that triggered her crisis.
Harasiemowicz is a second-generation city firefighter who spent a lot of time at the firehouse as a child. But familiarity with the job did not magically make him able on Day 1 to translate his internal compassion to something external that patients could see or feel.
He seems to have made a lot of progress toward that, however.
“It takes time,” he said. “There’s definitely people gifted with the ability to talk to people and get a read on them really quickly. At the beginning of my EMS career I really struggled, it was new to me. I had great teachers.”