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They stay everyone rides in the box at least once. Some people like to speed things up.

Depending on location, a fire apparatus, with a firefighter/paramedic crew member on board, could arrive on scene first, or an ambulance, often times referred to as the “box”, with a paramedic and emergency medical technician (EMT) on board, could be in the lead. Regardless of who is first, the other half of the equation is not be far behind. Once on scene, all personnel team up to provide rapid, efficient and professional medical care for patients.

Past New Year’s Eve celebrations in San Diego have found paramedics and EMTs busy, so staffing levels have been increased as 2009 comes to an end.

To see what goes on, I rode with Brian Hubbell, a operations supervisor and paramedic. We began the evening with a general briefing about just what being a paramedic or EMT is all about. In no time, Brian’s enthusiasm is bubbling over, not only for what he does, but for the people he works with. Hubbell cannot say enough about the levels of professionalism, dedication and motivation he finds with everyone he works with. He’s quick to let me know that those qualities make everyone a cut above, creating a caliber of employee most employers in town wish they could find. And it’s that cutting edge that puts San Diegans who are in need of emergency care ahead of the curve.

As we hit the road for the evening, San Diego is acting like a party town without a party. Past years show it could be a busy night, and everyone is prepared, but dispatch is not adding many calls to the MDT in Brian’s rig. Two big party spots, Pacific Beach, with the smallest crowd Brian has ever seen, and the Mexican border, are quiet. But the other party hot spot, The Gaslamp Quarter, located in the center of downtown, is filled with nightclubs and is rapidly filling up with people. It’s the place to be to bring in the New Year.

As last few hours of 2009 begin to fade, we get our first call. A woman is unconscious at a motel off El Cajon Boulevard, northeast of downtown. We arrive after Medic 66 and Engine 18. Called in as an unconscious person, the woman is actually having chest pains. While the medics and firefighters are evaluating her needs, another motel patron feels the need get out of Dodge fast, making a fast exit in their SUV, barely clearing the bumpers of the engine and ambulance. While his departure did not seem like an effort to help, it does make it easier to get the patient down to the street using a stair chair. She is then placed on a gurney and on the way to the hospital in fast order.

Our next call involves a three-day old baby who reportedly is not breathing. Medic 11 is on scene when we arrive. The parents only speak Spanish, so there is a language barrier, but luckily, a neighbor is assisting with the interpretation. What began as a very emotional event is rapidly scaling down to an almost normal conversation, thanks in large part to the confident and soothing voices of Paramedic Randall Stark and EMT Bradford Green. They have determined that the child’s vital signs are fine, and feel that dim lighting and a new mother’s worries are most likely more at the heart of the matter than the baby not breathing. But just to make sure, baby and mom are transported to the hospital.

As the clock closes in on midnight, we arrive back at the Gaslamp and make a run for the first party related call. A young woman, dressed to the nines, began her serious partying far too early, and her ETOH condition is controlling her evening. Medics from Medic 67, with an assist from Engine 4’s crew, access her condition and get her into an ambulance. Her New Year’s celebration has ended early with her party being a ride in the box.

Our next call takes us west of downtown, to the YMCA, for an assault victim. We arrived seconds before Truck 1 and Medic 69. We found a Marine in pain on the floor. He stated he had been attacked from behind and is complaining of neck and back injuries. He’s evaluated, fitted with a neck brace and taped to a back board. In just a couple of minutes, he has been evaluated, loaded into Medic 69 and one his way for medical treatment.

Time moves on. Another call from The Gaslamp, so we headed back east, this time to 4th Avenue, to locate a woman passed out in the back seat of a cab. Engine 4 and Medic 67 are on scene again. We heard that the woman’s friends may have tossed her in the cab and went on their merry way, leaving the unconscious woman to trust in the cab driver. Luckily, he stopped the cab and called for help. It’s a tight area to work in; the sidewalks are filling up, and leering onlookers just add to the tension. Medics and firefighters form a protective shield around her as she is checked out, shielding her from prying eyes. Her vital signs are strong, but she’s under the influence of something pretty powerful, possibly a date-rape drug, and is in no condition to fend for herself. Most importantly, she’s safe. She’s loaded into the ambulance and on the way to the hospital, taking a ride she probably never dreamed she would take.

We took another call, a block south of us. Because of our position, we had to circle the block, and when we arrived the crews on Medic 65 and Engine 201 are working on an assault victim. Two men made their celebration personal, beating each other up. One was standing against the side of a police car, wearing hand cuffs, while the other, who got the short end of the stick, sat on the curb, wearing hand cuffs and sporting a trophy-size gash under one eye. One went directly to jail; the other got a ride in the box.

As we waited for the next call, 2010 arrived with yelling, screaming and a few displays of extremely passionate sidewalk celebration from the people packed deep on both sides of 5th Avenue. It was a short-lived break for us as we head to another assault call. Coming up on Medic 67 and Engine 1, it wasn't clear what has happened, but a puddle of blood in the street was a precursor of things to come. Inside one of the buildings, a man sat in a chair, handcuffed and bleeding into a bucket. He was dazed with severe head trauma from a fight. As medics and firefighters began to access his injuries, his friends tried to tell their side of the story to anyone who would listen. Their efforts were wasted; everyone on scene has but one goal; to help the victim. There is no time for stories.

Suddenly, the man gagged and began to vomit. Everywhere. It was a mad dash to get medical gear and people out of the way. And somehow, everyone avoided the deluge. Because of his injuries, the man was loaded onto a gurney sitting up. He was dazed, remembered nothing and was in no condition to do anything, so the cuffs came off, with a warning that he has to behave. He was wheeled outside and placed in the ambulance. Several onlookers, all under the influence, looked on wide-eyed at the man’s injuries, but the medics and firefighters get him inside and the ambulance doors close behind him, keeping his situation as private as possible. When he began his evening, a ride in the box probably never crossed his mind.

Our next call was a stark contrast to the last. A man was unconscious on Broadway. As we pulled up, a crowd has gathered and I expected to see someone hurt, but we found a well-dressed man curled up and sleeping next to a planter. Medic 67 and Engine 4 arrived. He’s loaded on the gurney and placed inside the ambulance in just a couple of minutes. Medic 67 took him to a much safer location to sleep off the evening.

It was back to 4th Avenue once again. A man, apparently intoxicated, has crossed the street at the wrong time, walking in front of a vehicle which hit him and kept going. He ended up face down in the street, with severe facial and impact injuries. Medics and firefighters arrived and began rendering aid. He’s the worst injury of the evening and it took a few minutes to get put him in a neck brace and onto a back board before he’s ready for transport. The driver of the vehicle, who was also intoxicated, made it a few blocks to a sobriety checkpoint, where he was arrested.

It’s now well past 2:00 a.m. The bars have closed and people were making their way towards where ever home is. A few get into fights, but most move on unsteady feet. Some are lucky enough to be guided by those who are steadier, others are carried. Those desperate enough to risk life and limb tempt fate by standing in traffic trying to flag down cabs and private vehicles that speed past.

Paramedics and EMT’s have answered the call for those who need help and stood by for those who could have. Hangovers will be the injury for most the next morning, but for those select few, it will be a New Years Eve remembered not so much for what happened, but for what cannot be remembered, with days or weeks of medical rehabilitation to remind them of the night they sped up their ride in the box.