It is a positively blustery November evening. Sitting in cramped room 121 of Sansom Place East, members of Penn’s Medical Emergency Response Team sit and wait for a call that will alter the course of the night’s heretofore quietude.
“Requesting medical assistance: injured female at Sansom Place West between 36th and 37th Streets.” Almost instantaneously, the three EMTs on duty leap to their feet. Jackets are grabbed, helmets are thrown on, bicycles are awkwardly maneuvered out of the close quarters in which they find themselves. In under two minutes, they’re off: out of the squad room and into the metaphorical fire.
The EMTs arrive on the scene only to be greeted by the injured female, her wailing friend and a cop. The policewoman has been attempting to control the situation herself, but is obviously relieved once MERT has arrived. Quickly parking their heavy bikes, the EMTs rush to the girl and begin by asking her preliminary questions.
The girl is shivering, blatantly suffering from the intense cold that pervades the nocturnal air. Without hesitation, the crew chief, Sourav Bose, W’11, throws off his jacket and wraps the girl, something he will later claim is standard procedure “considering the blankets at hand aren’t really of much use.” Having assessed the extent of the girl’s neck injury, and considering that she is somewhat intoxicated — despite her friend’s insistence on their having had just two sips of a beer — the MERT crew chief makes the decision to call the paramedics to the scene.
When the paramedics arrive, they take into consideration all of the information that MERT has gathered before asking a few additional questions. They then begin the elaborate process of “boarding” the patient — that is, placing the injured party on a board, then stretcher, all to facilitate her embarkation onto the ambulance that will transport her to the closest available hospital. “Boarding is definitely a collaborative effort,” says Jaime Fineman C’10, an experienced member of Penn’s MERT. With this in mind, the patient makes it onto the stretcher and into the ambulance.
Twenty-seven minutes, three EMTs, two paramedics, one ambulance and one cop ensured that one woman was carted off responsibly to a medical facility. And while the “injured” girl had been merely a stand-in during a practice drill, this faux-call was tame compared to the chaos of Penn MERT’s typical nights.
Founded in 2006, Penn’s Medical Emergency Response Team is a student-run service organization that provides emergency pre-hospital treatment to the university community. Primarily, MERT serves to supplement the Penn Police Department and the Philadelphia Fire Department’s emergency services. With working hours that extend from 7 p.m. to 7 a.m. seven days a week throughout the entirety of the Penn academic calendar, MERT provides a dependable and crucial service to the university community.
MERT’s board is composed of 12 students. Tackling everything from training incoming members to coordinating with Penn’s administration, these students help make the 41-strong EMT staff, a cohesive and highly-efficient unit, able to hold their own when faced with the tremendous responsibility of running an operational medical emergency service. This is an impressive feat considering how fledgling the organization is. Fineman explains that this academic year is “the first not to have a founding member on the board.”
The idea of MERT emerged as a result of one particularly prolonged ambulance response in the Quad, witnessed by MERT co-founder Andrew Mener, C’07. Along with Evan Silverstein, E’06, Mener decided to be proactive about the state of delayed emergency medical care on campus. They sought students with EMS training from all of Penn’s undergraduate schools, the medical school and the law school to assemble a leadership team that would help establish MERT as a permanent institution on campus. They met with university administrators, physicians from Student Health Services, the Fox Leadership Program and the Vice Provost among others to draft a proposal that would meet the needs of the Penn community. Still, despite their cost-efficient proposal that Penn MERT would be a special-equipped EMS bicycle unit, the university was reluctant to back Mener and Silverstein; the administration saw only liability issues and hemorrhaging costs.
But with the pledged support of the Fox Leadership Program and a strong campaign by the UA, the administration finally gave the project the green light. Along with two friends, Mener and Silverstein established a year-long pilot project starting in April 2006 that ultimately resulted in what is now Penn MERT.
The walls of the squad room are acridly beige with just a hint of neon yellow, enough to keep eyes alert in the event of a call but not attractive enough to be distracting. This is MERT headquarters: a matchbox-sized facility, filled to the brim with equipment, bicycles and — most importantly — candy.
With an equipment room used for bicycle storage, a common room-cum-bunkbed-room complete with cable TV, a quiet room where the real resting occurs and a bathroom overflowing with spare bike parts, room 121 is a force of its own that betrays the frenetic pace that characterizes MERT. But despite the cramped quarters, there is nothing but laughter and dynamic energy afloat in the room.
At the heart of this vivacious organization lies a somewhat diverse group of individuals. Although many of MERT’s members are pre-med or Nursing students, several of them hail from Wharton and Engineering. And while it is unsurprising to hear that many of the EMTs on staff are either Biology or BBB majors, it is still shocking to think that what they do is merely an extra-curricular activity and not a full-time job, considering the intensity of the shifts that they pull.
In spite of this, you’d be hard-pressed to extract a peep of negativity concerning their chosen activity. When asked whether it was difficult to balance classes and MERT, the unanimous response was “not really.” Fineman claims that “balancing MERT and school isn’t too bad because we get time to study during shifts.” Although, it's hard to imagine much work gets done in the cramped space. “Either way, we’re only supposed to do 24 hours on duty a month, which is basically two separate shifts. And seriously, two nights a month wouldn’t slow me down.”
It is undeniable, though, that this is an exhausting occupation, if not for the 41 members of the EMT rotation, then for the crew chiefs and board members involved. Bose claims that “you do get tired; we’re human after all.” The crew chiefs, more senior MERTs who have clocked more hours, are in charge of running each shift. But with 41 EMTs and only seven crew chiefs, these MERT leaders essentially work one full night each week, if not two.
Bose is adamant, however, that this is the nature of MERT; everyone knows what they’re getting themselves into. “One of the benefits of a volunteer-based membership is that everyone, or almost everyone, is motivated by patient interactions and not by money or academic credits.” This is a fundamental tie that binds all the MERT members together.
Fineman’s reasons for joining were simple enough: she “wanted increased exposure to patients and medical care” so that her future experiences in medical school would be supplemented by technical knowledge in the field. In a similar vein, Bose explains that there is a system of instant gratification: “you get immediate results and immediate rewards. What more could you ask for?”
Most poignantly however, the EMTs believe that “they provide an indispensable service” says Bose, “because most of the time, students are scared when they are in an emergency situation and it’s nice to be able to provide them with help from someone of the same age and with similar experiences here at Penn.” “It’s really a peer support system,” adds Fineman.
This is a particularly important feature of MERT, seeing as 56 percent of their calls come from College Houses. “Students are terrified to tell paramedics that they have been consuming alcohol,” says Fineman, “and even though they are resistant at first, eventually they realize that they are more comfortable telling MERT that they’ve been drinking, rather than the paramedics who respond to a higher power.” And considering that over 49 percent of MERT’s calls are from students seeking help for alcohol or drug-related intoxications, the medical amnesty policy — that no student seeking medical assistance for an alcohol or drug-related emergency will be subjected to university discipline for reporting it — has definitely served to increase patient trust in MERT.
“We definitely feel like we’ve had to earn the university’s trust, but I consider that we’ve achieved that,” says Adriana Gobbo, C’10. It’s been a somewhat arduous process, but MERT’s relationship with the university is comfortable at this point. Considering that they’ve only been an operational unit for less than four years, the responsibilities with which the university has endowed them are huge, especially with the mass of liability implications that a student-run medical service inevitably takes on.
The reason the university has been able to increase the delegation of responsibilities to MERT is precisely because of the proficient and professional service that the EMTs have proved they can perform through a complex review system. This is owed in part to MERT’s work during Spring Fling and other university-wide events. Fling sees a much more autonomous MERT. Providing extra medical care for the event, MERT has become a significant asset to the university administration as a cost-effective alternative to hiring external medical staff. MERT has also provided extra staff at the meningitis and H1N1 clinics of the past year.
Despite its shaky beginnings, MERT members agree that the Penn administration, as well as the community at large, is highly supportive and receptive to the services they provide. This is partially due to the good relations that MERT holds with Penn Police. Before MERT’s founding, Penn Police bore the responsibility for all medical emergencies within the campus’ patrol zone. Considering that the typical response time of the paramedic units is approximately 13 minutes compared with MERT’s three to four, the campus and Penn Police have benefitted from the medical service.
MERT’s relationship with non-Penn entities, however, isn’t quite so established.
“There is a mixed-bag relationship with Philadelphia Paramedics,” says Bose. “A lot of them don’t even know we exist, so don’t trust the information that we provide for them on the scene,” he continues. “They feel the need to ask all the basic questions over again, which basically means a less efficient system of patient care and more frustrations all around.”
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As copious amounts of sweet treats get passed around, there is a palpable sense of camaraderie in MERT’s headquarters. Whereas MERT’s primary concern is providing medical care, there’s a definite fringe benefit found in the spirit of community.
Shifts provide the bulk of the EMTs’ bonding experience, however it is probably the extensive training programs that establish the strongest sense of community within MERT.
While prior EMS training is sought out, many current MERT members only become certified EMTs through MERT’s EMT training course. Offered twice a year, this 10-12 week class, in conjunction with a mandatory four-day bike training course, are all that’s needed to become a fully-fledged member of MERT. However, the training doesn’t end there. MERT’s board and staff members are required to attend a weekly meeting as well as weekly training sessions where different areas of EMS are explored or clarified. This ensures that the EMTs are up-to-date in their practices and it provides a forum for relaxed interactions with other MERT members.
It is this emphasis on training that MERT’s board hopes will establish the organization’s longevity and professionalism on campus. However, this is only one aspect of MERT’s longer-term goals. Hoping to become a stronger presence on campus, MERT has recently gotten UA approval for a change in headquarters location. Sansom Place East is just too removed and too downhill from the 40th Street block of campus – where the bulk of MERT’s calls come from – and acts as a definite hindrance to the efficiency of the system. Despite the rapidity of MERT’s response time, the simple but necessary act of maneuvering the bikes within the tiny squad room slows down the entire process.
However, according to Bose, the acquisition of an ambulance is currently the most pressing goal. Penn’s MERT was established as a bicycle-only-unit as an efficient and cost-effective starting point. However, there is no doubt that obtaining an ambulance would significantly improve the status of the organization. Moreover, it would serve to formalize the relationship between the city and Penn MERT, a necessary step if MERT is to increase its stake in the field of patient care in the Penn community.
MERT’s members are unphased by the hefty responsibilities that come with running a medical emergency organization. While their current geographical positioning might not be ideal, it certainly doesn’t hinder their enthusiasm. With new headquarters and concrete plans for expansion in the works, it seems the sky’s the limit for MERT. And if anything, the incentive for staying on the job is clear, according to Gobbo: “It can be really fun talking to drunk people.”
