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808 with the founder, Ernie Colling. or go to
transcendcompany .com. Welcome to the Behind
the Shield podcast. As always, my name is James
Gearing, and this week it is my absolute honor
to welcome on the show flight paramedic Mark
Cresswell. Now, on this conversation, we discuss
a host of topics, from his journey into EMS,
entering the world of aviation, responding to
Hurricane Katrina, the Deepwater Horizon tragedy,
working as a paramedic at the Burning Man Festival,
and so much more. Now, before we get to this
incredible conversation, as I say every week,
please just take a moment, go to whichever app
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Leave feedback and leave a rating. Every single
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And this is a free library of over 1 ,100 episodes
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so I can get them to every single person on planet
Earth who needs to hear them. So with that being
said... I introduce to you Mark Creswell. Enjoy.
Well, Mark, I want to start by saying two things.
Firstly, thank you to our mutual friend, Michael
Booman, for making this connection. And secondly,
I want to welcome you onto the Behind the Shield
podcast today. Yeah, thanks for the invite. Mike's
a great guy, man. I'm glad we have a mutual friend
in him. Absolutely. He's actually brought several
people onto the show, so I've got to give him
credit for that. Very first question, where on
planet Earth are we finding you this afternoon?
So I'm at Lafayette, Louisiana. I'm the director
of Air Med Services. It's a division of Acadian
Ambulance. And I'm at my office at the airport.
Fantastic. Well, we will get to what you're doing
now, but I'd love to start at the very beginning
of your journey. So tell me where you were born
and tell me a little bit about your family dynamic,
what your parents did, how many siblings. Yep.
So born and raised in Abbeville, Louisiana, 1970.
Regular family, daddy. Was in the oil field.
Mom was involved in like school activities and
things of that nature. Have a brother. Went to
a Catholic school my whole life in Abbeville
and graduated in 1988. Talk to me about what
your dad did as far as the oil industry back
then. What were the highs, the pros of that profession
and the working environment? And then if any,
what were any cons? Yeah, so my pop was working
offshore. He was like a mid -level manager of
offshore installations. A little bit later in
his career, when I was growing up, like in the
70s, he took an office job, five and two, and
he was a superintendent for Union Oil Company.
And he specialized in oil field transportation.
And one of those things was helicopters. And
that's kind of where I whet my appetite for helicopters.
I can remember him a long, long time ago coming
in from offshore and they would crew change in
Lafayette. And they actually pit stopped on our
family property to drop daddy off in like 1974.
I grew up around helicopters the whole time.
He retired in 1996. after a successful career
with Unical. I guess I learned hard work from
him. I mean, he was really dedicated to his work,
but he was really dedicated to us too. And he
taught me one thing, do what's right, not what's
popular. And I kind of try to live by that. Absolutely.
What, if any, conversations have you had as far
as the metamorphosis of health and safety in
that industry? With dad? Yeah, I mean, through
that lens that he's had over several decades,
because when I think about oil rigs in the North
Sea when I was growing up, every so often you'd
have these horrendous disasters. So I would imagine
there was an evolution, you know, through sadly
loss of life in that industry. Yeah, unfortunately,
dad was involved in several helicopter accidents
offshore. One of them involved my best friend's
dad who lost his life. And they actually came
and told us at football practice. One thing that
dad told me was, you know, always, always be
safe. Be cognizant of what your people are telling
you and listen to them. I'm proud to say that
I really took that to heart. And I've got six
months left here at work. And in my nearly 30
years at work for Acadian Air Med, you know,
been accident free. So I'm really proud of. of
learning safety through my dad. My dad was one
of the first pioneers teaching water survival
offshore. He learned that from someone from the
North Sea, Margaret McMillan, and started a water
survival training for all field people before
it became a commercial training thing down here.
Him doing it in a swimming pool at a high school.
And they would bring everybody in and they would
practice. But even before they had those trainers,
before OSHA and before all these other things,
they were walking them off the side of platforms
and letting them drop in the water before all
the regulations started. They were really real
-life training people to survive in the Gulf
of Mexico. Interesting way of doing that. I'm
sure the realism was amazing, but I would imagine,
God forbid, there might have been some accidents
around that. I think that's the way things were
in the 70s. All right. Well, we'll get to how
that ties in with one of the rescues that you
were a part of later on. You mentioned football.
What kind of games and or exercise were you doing
when you were in high school age? You know, I
played football, played baseball. I was never
really competitive, to be honest with you. I
was doing it because that's where all my friends
were. And we actually had more fun than anything
else. I didn't do a whole lot of track. I played
basketball, although I was pretty short, but
it was just to hang around with friends. And
I guess because of that athleticism kind of led
me into joining the military right out of high
school. So talk to me about that. What made you
choose the military in general and then why that
branch specifically? I just never wanted to be
a burden on my parents, and I wanted to go to
college. So I just decided to join the military
to be able to get access to college funds. I
joined the Army because that's what a bunch of
my friends were doing at that time. Coincidentally,
the next year, all of my friends in the class
behind me, they all joined the Marine Corps.
So I don't know. I guess I was just a victim
of herd mentality at that time. I wanted to just
get in, do my part and get out and go back to
school. And which years did that span? 87 to
1991. Okay. Did you find yourself deployed or
was it mainly training based? No, we got activated
for Desert Storm the day after Thanksgiving of
1990. And then we were out of there in May of
91. I've had... some pretty interesting perspectives
with that because obviously that was a lot shorter
you know um uh combat or conflict excuse me than
than the 20 years that we saw more recently what
was that particular conflict like through your
eyes well you know to be quite honest like we
were getting ready to be deployed overseas we
were being held at fort hood texas uh and we
never really got to make it uh we we loaded up
all of our vehicles on the railhead and uh Thank
God it was just a hundred hour war and they didn't
need us. So for me, it was it was pretty safe,
but kind of anxious, too. You know, like what
was this going to be like? Absolutely. All right.
So what then made you transition back out the
other side? So I knew I wanted to do something
medical and I'll go back a little bit. My grandfather
had some really bad legs and he had hurt himself.
and he was transported by ambulance and it was
the same guys and i'd always ride in the front
of the ambulance and we live way in the country
so to get to the hospital we take all the back
roads they let me sit in the front play with
the siren you know that that really got me excited
um when i got out the military i got into an
emt class and i had been out about a week and
we were roping horses and um excuse me, roping
cattle on horseback. And one of my co -ropers
fell off the horse. The horse fell on him, broke
his back, paralyzed him from the waist down.
So I'm like, I'm fresh EMT. I don't know nothing.
I ain't got nothing to keep him warm. We don't
have a cell phone. So I unsaddled his horse,
covered him with a blanket. I rode my horse as
fast as I could, several miles down the road.
And when I got back, the helicopter was landing
and Ed Murray was the paramedic. And I asked
Ed, I didn't know him then. I was like, hey,
can I ride with you to the trauma center? So
that was my first ride on AirMed. And I can remember
at the hospital telling him, I'll come and do
your job one day. And five years later, I did
his job. So you found yourself working for a
company that had a multitude of different operational
outlets. How did you find Acadian specifically?
And then what was your kind of front door experience
like? Yeah. So back in the day, there were no
other ambulance services around where I lived
at. You just knew Acadian Ambulance. You never
said call an ambulance. You said call Acadian.
So, you know, I applied there. Tommy Dion was
the recruiting person. And he got me in the door,
went through orientation. And it was eye -opening.
I've worked hard all my life, you know, growing
up around the oil field and growing up, you know,
in the farm industry and doing manual labor.
And this was just so different. While there were
long days, you didn't work really, really, really
hard. But you got to dress nice. People really
respected you back then. down in louisiana it's
a very welcoming community a lot of times we
would go to hospitals and people would have food
waiting on us so it was a really great time it's
interesting the perception of hard work because
i grew up on a farm so i can absolutely relate
i was bailing hay and stone picking and mucking
out stables and all those kind of things when
i was young but what we do now especially on
the fire side you know there is a lot of um you
know time where you're not physically working
you're not roofing all day but i don't think
what people understand is when you have to use
that exertion it's extremely high level even
even from the ems point of view you know god
forbid there's a shooting or something or we
all know you know some of the cardiac arrests
happen in the toilet and they're wedged between
the you know the toilet and the shower and so
this kind of perception that first responders
need to be constantly working you know this busy
time mentality um is such a kind of misnomer
because if you look at the zero to a hundred
element of what we do, it's so unique and it
requires rest recovery training to be ready for
those extreme moments. You know, I'm one of the
only, I would say there's five or six directors
at Acadian right now. And I think I'm one of
the only one that still does work. I've worked
on an ambulance not very long ago, but I can
tell you From way back then to right now, the
op tempo is drastically different. We would work
a 24 -hour shift, and you'd run two or three
calls, sleep most of the night. And I know right
now you'd work a 12 -hour shift, and you'd get
those first three calls within the first three
hours. And it's not uncommon to run 10, 12, up
to 14 in a 12 -hour shift. So while I say you
didn't work hard back then, man, you really work
hard now. So you found yourself, correct me if
I'm wrong, you were in the admin side before
you got in the EMS side. Is that correct? No,
I was on the ambulance up until about 1995. And
I became a paramedic in 93. In 1995, I was selected
to join the air program. So I joined part -time.
And a full -time spot came open in 1999 for me.
But I knew I just didn't want to be just a paramedic.
I wanted to be well -rounded. And I just begged
and pleaded with every department head to let
me come and train and do something. So I trained
in dispatch on my days off. I taught orientation
on my days off. I was in the education department.
I just did a lot, a lot of stuff for Acadian
all my day off to round myself out. And I'm really
glad I did that because I can see things from
different lenses that people that didn't do that,
they just have a single vision of the company.
So I think that was probably one of my wisest
choices when I was at Acadian. put my fingers
involved in all aspects of operations, support,
so on and so forth. So what was some of the career
calls you remember from that chapter when you
were on the ambulance and doing some of the dispatch
stuff? You know, myself and Bill Gerard one day,
he was my partner. We were two paramedics on
an ambulance and we responded maybe 20 miles
out in the country for a car accident. And there
was a guy there. who had run through a hurricane
fence. And if you're familiar with hurricane
fences, they have a top pipe. And it went through
the windshield, through the steering wheel, into
his chest, and it impaled him against the back
of the truck. You got to remember, very rural,
long response times. We didn't have fire department
there. We called for them, but they were still
going to be 20 minutes away. So we devised this
plan. to at least take some of the pressure off
of him. So there was a welding truck there, and
we latched onto the back of the truck with lots
of gauze to stabilize it, to get him from being
pinned up against the top of the truck. And in
our efforts, the guy who was driving the welding
truck backed up way too far, and we pulled the
pipe out of his chest. Retrospectively, it probably
saved his life. Because immediately... when that
happened the helicopter landed we packed it full
of gauze and took him to the trauma center and
the guy actually survived i don't smoke cigarettes
and i needed a cigarette after that call but
um you know we uh we were given the distinguished
service award for that it's it's awarded very
very infrequently um for saving somebody's life
um But on a positive note, and I always like
to look at the positive side, making impacts
to patients, not just necessarily doing treatments,
but just how you treat them is very important
to me. And I can remember this one guy. He was
well into his 80s, and we were bringing him home
way out in the country, and he was going home
to die. He was terminal. And he said he wanted
to see his cows one last time. And we asked him
where his barn was at, and it wasn't far down
the road. So we backed the ambulance. down this
gravel road up to this barn. And when we got
a feed bucket and we're beating the feed bucket
on the back of the ambulance with the doors wide
open and all his cows came and saw him one last
time. And often tell that story because a lot
of people think that everything you need to be
a paramedic is in that bag of goodies that we
have. And often tell people the most powerful
drug you have in a lot of your patients, not
your patients that are really sick, but most
of them. is this hand right here. Take that hand
and put that on their shoulder and reassure them
and tell them they're going to be all right.
The majority of the time, that's what a lot of
people need is to be human and be there present
for them. You don't need to be the best IV starter
out there to take care of a lot of your patients.
I couldn't agree more. written two books now
and I use this story in both because I think
it's so important. One of the things that we
did in on my side was what we call back to bed
calls. And all it was, was, you know, you had
an elderly couple and let's say, for example,
the wife had fallen out of the bed and maybe
she saw it herself and she's lying there. And
the husband now is in his eighties or nineties
and he's just too weak. This is the love of his
life. It's just, you know, the woman that he
used to protect when he was, you know, young
and able. And so all you do is you come in with,
you know, three or four people and you pick them
up and you clean them up and you change their
clothes and you put them back to bed. You don't
see that on backdraft. You don't see that on,
you know, Chicago fire. But like you said, we
didn't have to break the box open apart from
obviously checking her over when we were done.
But it was that kindness and compassion and the
dignity that was restored by simply cleaning
someone up and changing their clothes and putting
them back to bed. to me outweighs most life -saving
calls i've ever had couldn't agree more could
not agree more i've i've had lots of requests
and if they're not illegal or immoral i try to
do it uh even even going through a drive -through
with a patient who wanted some chili dogs one
day and it just just made his day he was at a
nursing home he's just eating just regular nursing
home food and he's like man i sure want some
chili dogs So we went to the drive -thru and
man, he was happy. How, if you've observed this
at all, how have we got away from that being
what's burning in our heart? Because it is, you
know, that desire to serve to rules and regs
and almost in a way is the kind of opposition
of some of the kindness and compassion that creates
a good paramedic or doctor or, you know, someone
in the medical field. I think it's a system problem.
I think fundamentally the majority of people
want to be kind, compassionate. I think they
want to take care of patients. But I think as
an industry, and it's not necessarily a bad thing,
we do things for reasons, but we've put so many
things in place that we have to do that takes
time away from people being a compassionate person.
Meaning, You've got these targeted on -scene
times. You've got drop times at the hospital.
You've got ticket completion times. And if you
don't complete your ticket, then you get a little
demerit. And the pace and the efficiency that
a lot of organizations work at, the system prohibits
the person many times from exercising that heartfelt,
or that heartfelt take care of the person versus
taking care of the regulations of the time or
the time watch or something like that. How do
we get back to it? Man, I don't know how you
can put all that toothpaste back in the tube.
When you were just talking, it reminded me of
MCI. So when we have a mass cash, obviously a
lot of the rules go out the window. And now,
you know, you're literally triaging a patient.
Are they going to die? Are they close to dying?
Or can they get up and walk? And that's it. That's
the end of your care. Put a tag on them, move
on. And I think that, you know, what I see, and
this is why it's very sad, because I thought
we were supposed to be trying to make America
healthy again, apolitically, just as a movement,
and I'm not seeing it. But the reason why I think
we're seeing this compassion fatigue and this
burnout is because there's just so many sick
people in the States now. And if there was a
push to actually make our nation healthy again,
you know, through everything from schools and
exercise in food and exercise in schools, through
to pedestrianization and public transport and
all these other things that will keep people
on their feet a lot more, I think you'd stop
overwhelming the medical community and then we
would have the time. But just like an MCI, there
are so many people now. I bet if you look at
the ratio. of sick people to paramedics or nurses
or doctors, it's probably just exploded exponentially
through the roof. So the answer to me isn't so
much we need just more and more and more of us,
it's we need less and less and less of them.
So how can we prevent people from being as sick?
But that's a conversation I'm still waiting to
see on a national scale. Yeah, that's a generational
change, I think. You know, I like what you said
earlier. About the rules go out the window. I'm
going to be the first one to admit I'm not black
and white. I love to operate in the gray. And
a lot of big things that have happened in my
career, you know, Deepwater Horizon, the hurricanes,
Katrina, gives you an opportunity to get rid
of that rule book sometimes. And there's been
a lot of times I've had to cross that line, a
step out of that protocol, albeit justified,
that these big things give you that freedom.
And as long as you're doing the right thing and
you can back it up, I think that's good. And
those big things sometimes allow you not to address
the regulation or the time or things like that.
And it's a great deal of freedom. Yeah, I think
it goes back to doing the right thing. That's
what I found a few times in my career. I've had
to push back, whether it's bypassing a couple
of hospitals because you want to go to a comprehensive
stroke center or a trauma center because you
suspect a certain mechanism injury or disease,
or like we said, taking a refusal, even though
your medical director tells you everyone should
go to the hospital because it would be more beneficial
for that child to be in their home or their hotel
room. than between a drunk and a psych patient
in an ER, you know, putting up with screaming
all night, you know? So you, I think sometimes
you, like you said, if you can back it up and
it's actually better for the patient, sometimes
you need a little courage too, to be able to
stand behind your decision and say, no, this,
this is what was the right decision for the patient,
regardless of what your black and white protocol
says. I think you're right. You are very right.
Well, you mentioned. a bunch of you know well
-known incidences in american history so before
we dive into some of the the large events that
you were part of walk me through the transition
from ambulance to helicopter medicine yeah man
so you know i was welcomed into the air med program
um i met with the chief flight paramedic at that
time was tony morales and i'm just gonna i'm
gonna shock the entire world right here when
i say this At that time, we were a single provider.
You had a pilot and you had a paramedic. And
that's the way we started way back when. And
it was the way we did things. And we just got
things done. I did all my training in Lafayette
and in Baton Rouge. I had some really great trainers,
Jimmy Greco, Porter Taylor. You know, just icons
of our little small world right here that taught
me how to do things right. Even so much as wrapping
up the EKG cables the correct way. I can still
remember that from 1995 so they didn't get all
tangled up. I did something to get them on my
side. I'm a big fisherman and I used to cook
fish and seafood for them every day we were at
work. So they love seeing me over there. I cleared
after about six or eight weeks and then just
kind of worked openings. At that time, we had
three helicopters, Homa, Baton Rouge and Lafayette.
I went full time in 1999. At that time, we had
a new medical director. His name was Dr. Ross
Giudice. And we were writing new protocols and
he brought me. into his office, took me off the
helicopter for a few months to write protocol.
And I just learned a lot working alongside him,
built a really great relationship. And that afforded
me the trust from the medical director to implement
changes that I thought was necessary. We've got
a new medical director. I say new. We had a new
medical director in 2010, Dr. Chuck Burnell,
and I maintained that friendship and relationship
with him. And because of that, anything that
we found was in the positive for patient care,
as long as it was scientifically based, he allowed
us to do that. And we really expanded the protocols.
We actually convinced the company to allow us
to put registered nurses on the helicopter. an
accredited provider for air medical services.
And our scope of practice now looks nothing like
our scope of practice in 1999. What are some
of the biggest innovations that you've seen as
far as the helicopter specifically? So we were
flying in BOCAL, BO -105s, VFR, meaning visual
flight rules. And you had a bunch of gauges and
they all had little needles on them. We didn't
realize how unsafe we were until we got into
the new EC -135. The FAA regulations at the time
were 500 feet and a mile, and we were flying
that at night without night vision goggles. We
were using landing lights to go into scenes at
night, just going real slow, real deliberate.
And, you know, we did it. We did it incident
-free. being in technologically advanced aircraft
that are able to go ifr with night vision goggles
with all of the other things that that make the
operation safe it's like holy cow how did we
do that back then and i was in the aircraft a
couple years ago front seat with a set of nods
on and we were circling a scene i said i just
want to see what it was like And I went off in
nods after announcing it, and I'm like, holy
cow. I mean, this was suicidal back then. And
the industry is better for technology. As much
as you probably don't want to hear the government
is here to help you, they did help the industry
a lot, mandating all of the different things
that we now use. And I think we're all the benefactors
of that, and it's definitely made the industry
safer. Did you have any of these pilots that
I heard a lot about, especially earlier in my
career, that were former Vietnam turned to EMS
pilots? Yes. Any interesting experiences with
those particular people? You know, they all had
colorful personalities. They lived through some
stuff. Back then, we didn't know anything different.
You know, so you'd pull the aircraft five feet
off the ground, you'd nose it over, and you'd
go burning across the ground until you hit 60
or 70 knots and then pull in some collective
and then just shoot up into the air. And we do
things so much different now. But at the time,
that was normal. And when we changed to an EMS
takeoff where you hover above your... nearest
object, then nose over. It was so unsettling
because you hadn't done it that way forever.
And we still do running takeoffs when it's really
hot. We've got a lot of fuel and a lot of patients
on board, but you're so accustomed to going vertical
that when you do a running takeoff, it's like,
oh God. I got to tell you, we have a mix now
of about 50 % military and 50 % civilian. And
they both have really good qualities. To be honest
with you, though, getting in an aircraft now,
I really can't tell what the guy's background
is. Yeah, it's interesting to hear. I just heard
it exactly like you're saying, you know, these
crazy maneuvers they were doing. And they weren't
even trying to, you know, be dicks or anything.
That was just how they were flying in the jungles
of Vietnam. Yeah, I mean, it was not uncommon
during the day to shoot a descent towards a scene
and just stand it up on its tail. and just slow
the aircraft down and come in and set it down.
And now that's like totally unheard of. What
about from the EMS side? I was just talking to
Dr. Peter Antevi a few weeks ago about whole
blood now actually on ground ambulances, which
is exciting, and all the successes they're having
to the point where he said even people that are
considering retiring are staying on because they
want to be part of the success too. So what about
from the EMS innovation the last three decades?
I was telling an interesting story the other
day. Somebody was saying, did you know you could
give this medication nebulized? I'm like, well,
back in the day, in a cardiac arrest, if you
couldn't get an IV, we were putting epinephrine
and atropine down an ET tube and in large volumes.
And come to find out, we were actually harming
people. And to go from that to video laryngoscopes.
And we really thought we were doing a great job,
you know, intubating people until we started
quantifying data because of canes. And we really
found out how terrible we really were. And video
laryngoscopes has just made things so much better.
Our first time pass rate is in the high 90 percentile
now, where we really thought we were doing really
good way back in the day, just doing visual.
We've been carrying whole blood now for probably
about six years. We're going to administer somewhere
in the neighborhood of 500 units this year. That's
what we're on pace to do. Made a huge difference.
Without exposing a whole lot, we have just gotten
a second grant to try and use drones to deliver
blood where it takes ambulances a long time to
get to. But it's too close for a helicopter.
So, you know, a 20 minute urban response to a
gunshot wound where we can launch a drone and
have it fly at 70 miles an hour and drop an ice
chest to an ambulance to be able to administer
it. That's what we're working on now. You probably
ask, why don't you put it on every ambulance?
When you run an 800 ambulances a day. And they're
in different capacities and they're getting off
late. It's really hard to manage a blood program
over four states. So we think that this drone
project could probably be a good adjunct to that.
I had Richard Browning on the show. He's the
creator of, I forget the name of the company
now, but if you've ever seen the guy, basically
like an Iron Man suit, he's holding two jets
in his hand and he's flying. And what really
caught my eye originally is they did one for
paramedics. So you think about mountain rescue,
you can literally fly to the patient with just
a regular medic bag and then package the patient.
But the FAA won't allow you to fly a patient
back. So the solution that they're proposing
is a stretcher carrying drone. because that in
theory would circumnavigate, you know, issues.
And then the person follows a drone down and
now that lands by the ambulance. And now you've,
you know, I mean, literally saved probably hours
in that particular example. So seeing whether
it's a delivery of a medic, a stretcher, drugs,
you know, whole blood, it's exciting to see,
you know, arguably sometimes military technology
being used to help people rather than kill people.
You know, one thing I learned, probably halfway
through my career, is never say, oh, you're never
going to see that out in the field. Because you
actually do see innovation in the field. Sometimes
it's not at the pace that you want. But I don't
think five years ago, anybody would be talking
about drones and integrating into EMS. And now
it's like, that's a lot of people are working
on it. Yeah, that's exciting. It really is. I
think, again, being shackled by, you know, A,
the way we've always done it, air quotes, and
then B, you know, protocol and procedures and
red tape. I think COVID did a good example for
it. good job, for example, with the whole telehealth
element. And it really freed up, you know, telemedicine.
I think that's another way we can help minimize
some of the low acuity calls that we get called
for and do a lot more treatment in place and,
you know, medical consultations and even scheduling
urgent care appointments and sending lifts and
Ubers. I mean, again, all this technology, it's
really going to help, I think. what they GMR
refer to as a three -tier system. So you have
your ALS, you have your BLS, and then you have
your non -emergent. So I think between making
the nation healthier and then helping the people
with low acuity issues, I think we'd make a massive
dent. And then that would give us more manpower
to get to these higher acuity calls. And like
you said, still have enough time to add the human
element with the compassion and empathy rather
than having dispatch. chirping in your ear saying
you need to get available again and get to the
next call. Yeah, that's something we just stuck
our feet into a couple of years ago. Acadian
is doing some of that telehealth and I don't
have anything objective to measure it against,
but I do know it does take a burden off the 911
system. Absolutely. Well, you mentioned about,
you know, oil rigs and then we'll get into the
hurricanes in a little bit. Deepwater Horizon.
you tell you are telling um you know that the
person that that uh you rode with that one day
i'm going to have your job now you actually have
that job and now you're responding to oil rigs
the very kind of journey that your father used
to take so talk to me if you want to throw some
some other incidents in first and then i'd love
to obviously hear about that particular incident
as well including the backstory because i don't
think a lot of people know the full story of
what happened yeah sure so um It wasn't very
long into my air medical career that I got my
first offshore call. And for you guys that don't
know this, there's a large portion of the workers
that go in on boats. And they have to get them
off the boats a certain way because, you know,
the boats heave and whatnot with the waves. And
there's a thing called personnel baskets. And
it's just this rope thing that's on this circular
flotation deal. And you just step on it and you
just hold on for dear life. And a crane picks
you up off the back of the boat and hoists you
150 feet in the air. There's a lot of our casualties
offshore that are injured on boats. So one of
my first calls offshore, first off, when you
land on an offshore platform, it's not made with
solid decking. It's made with grating. So you're
walking, but you could see the water below you.
So, man, I'm like a cat. Trying to get up. And
they said, hey, the guys on the boat. I mean,
you could see the boat heaving and rolling. And
they got this personnel basket. And I've never
grabbed on to anything tighter in my life. I
don't understand how OSHA doesn't regulate this
thing. Like, you're not tagged on. You're not
secured. There's no door that locks. You just
hang on. And they just put you over the water
and drop you to the boat. And we got the casualty.
put him on the personnel basket and put him on
the back of the helideck. And I'm just flying
back thinking, oh, my God, like I just did that.
But after that first time, it just becomes normal.
Contrary to popular belief, not a lot of people
get really, really significantly injured offshores.
It's mostly medical calls. Patients that fail
to manage their diabetes, their hypertension,
or have an acute issue like a stroke or heart
attack. And at one time, we were probably going
offshore about 80 to 100 times a year. So you
got a good deal of exposure to it. You had to,
a lot of times, enlist the help of the crew.
And I will never, ever forget this one guy who...
It was a cardiac arrest in the wheelhouse of
this offshore platform. And there were probably
20 or 30 workers. Now, you've got to remember,
these guys work on the same shift. They eat,
supper with each other every single day. It's
kind of like a frat house, for lack of a better
term. And their buddy just died. And they had
formed this chain of chest compressors. And about
every two minutes, each one of these guys' friends,
was doing chest compressions and just rotating
through it. We've all gone to homes where the
family's really distraught. You see two or three
of them. You got to imagine being in this offshore
environment where they've worked with this guy
for five, six, seven, ten years, and they just
did CPR on them, and you load them up, and there's
20 guys on the heliport just waving. They're
on their knees praying. It's pretty dramatic.
It leaves a mark on you. Absolutely. Yeah, that
shared suffering I can imagine again on the oil
rig. And then if I'm not wrong, they're pretty
brutal long days too, aren't they? Yeah. Dad
used to tell me it was not uncommon to work 14,
16 hours a day or even 24 if something went really,
really wrong. Back in that day, they didn't have
shifts. Now they do. But deep water horizon,
pretty interesting. So British Petroleum had
this discovery way out in deep water. Had this
huge modular drilling unit. They were doing a
test to see if they could set cement in it and
stabilize it. For whatever reason, they chose
not to put the number of spacers needed to make
sure that the... cement was in the right place
and through a series of events that cement got
destabilized you started having high pressure
condensate and whatnot flowing back up to the
rig there's this big giant device called a blowout
preventer and for whatever reason batteries didn't
work on it there's this thing called a blind
shear that cuts the pipe and clamps it that way
the rig can get away from the blowout that didn't
work and when all of that hydrocarbon came back
up it's blowing natural gas in the the ambient
air there's no power lines that go out to these
things they have massive diesel generators that
generate their power when that hydrocarbon was
inhaled by those diesel engines they just revved
way beyond design limit The explosion started
and a huge explosion rocked the rig where it
killed, I believe, 11 outright. But there were
a lot of people on that rig that either departed
by personnel basket or they departed by jumping
off the rig and they were scooped up. There was
a... platform near it it was another bp platform
called nakika that's where a lot of the casualties
were going so i get this phone call one day that
night of the wife of somebody that worked for
us who was offshore on shell horn mountain and
they had saw it so i called our comm center asked
if they had this big explosion in the Gulf of
Mexico. We called Coast Guard sector out of New
Orleans. And they told us that there indeed was
a huge explosion, that they were working it and
asked if we had any medical aviation assets that
we could send. I'm in Abbeville, Louisiana. The
helicopter's in Lafayette. So we activated it.
They flew to Abbeville, picked me up, and we
loaded up all of the extra MCI supplies and whatnot
and myself. Dale Ducote, Raymond Mouton, and
Seth Gardner, we flew out to Nikika. And there
were literally casualties all over the place.
Part of our service, we provide medics to Bristow,
who is another helicopter operator out there
that does search and rescue for these big operators.
And Bristow, at the time, was Cougar Aviation.
They were there with an S -61. I forgot how many
they loaded up, but they went to University of
South Alabama. We had loaded up patients from
inside the command structure, a blast proof shelter
that was blown off of its foundation. And we
took a couple of those guys over to New Orleans.
I can remember flying out there with night vision
goggles and we could see the flames. Some 60
miles away with night vision goggles. We flew
past it to go get fuel at a Murphy platform called
Thunderhawk. I think we passed about seven miles
away and you could feel the heat coming through
the window. It was a hell of a far. So we worked
that night. We recovered the next day. Obviously,
we did all the TV interviews and whatnot. we
still had the bristo assets and they were flying
top cover when that rig started to sink and they
were sending video feed back and we got to see
it actually go underwater at that time we thought
well we're finished it's it's over and done with
and then this oil started coming up and not just
a little oil like lots of oil And it started
to come to the Louisiana coast. And obviously,
it put oil all over Mississippi, Alabama, Louisiana.
Acadian has a group called Safety Management
Systems, which is the oil field group that we
have for medical safety and whatnot. And they
were tasked with providing hundreds and hundreds
and hundreds of safety techs, medics on site
on the beaches. I would probably say they kept
that thing in the middle of the summer or the
end of the summer. Deepwater Horizon happened
in April. Probably for about six months, we emptied
out every clinical person we could to support
that oil cleanup. The air med medics that were
off duty would get off duty. They would run down
there for two days. or we would work things out
where we could back shifts, back to back, and
the medics would work down there for seven days
straight. It was a huge, huge endeavor. It seems
like every time you hear about a big disaster,
there's always this retroactive element of realizing
that there were some corners that were cut. And
then more often than not, you know, for money.
I don't know if that was the case here, but I
just watched a documentary on the Grenfell fire
in London. And the cladding originally that they
were supposed to use on the building was going
to be zinc, non -combustible. And to save, I
think, 5 ,000 pounds, they used this one that
had petroleum products between two layers of
aluminium. And it caused this inferno and took,
I think it was 73 lives. So, you know, like you
said, what was the reason for the spaces not
being put in? Was it just oversight and pure
accident or was it some sort of, you know, corner
cutting? But the downstream effect is always,
you know, an infinite amount, well not infinite,
but numerous times more expensive than the original
cost. And I would say it's the same, you know,
in staffing in our professions too. People are
cutting and cutting and cutting until... If firefighters
die, you know, a helicopter goes down, whatever
it is. And then they're like, oh, maybe we should
hire more people rather than, you know, proactively
saying, well, hey, let's learn from other people,
other disasters and make sure it doesn't happen
here. Yeah. The hearings with BP have well established
that there were costs. There were cost issues.
There were time constraint issues. They label
this the well from hell just would never work
right. And, you know, they're budgeted for certain
times and budgeted for certain dollars and they
were way over on cost. They were way behind on
time. And there was some hierarchical bias where
people just caved to the pressure of, you know,
the time constraints and the budget constraints.
Yeah, that's the important thing. I mean, this
has already happened now. How can we learn from
this? Whether it's staffing, whether it's wars
that we seem to get in over and over again, whatever
the thing is, again, it's not political, it's
human. How can we learn from human errors in
the past so we don't keep repeating the same
mistakes? Yeah, unfortunately, I think time has
a way of softening up some of those lessons.
And then you become the victim of what we call
normalized deviance, where you do things perfectly.
And then one day you do it like this and you
get away with it. And then you do it like this
and you get away with it. And before you know
it, then this becomes normal because you got
away with it for so long. The space shuttle is
a perfect example of that. Yeah, exactly. Well,
that was the oil rig then. Let's talk about hurricanes
because I know that you've deployed to many of
them and obviously the part of the country you're
living in, it's a frequent occurrence. Talk to
me first about Katrina and then we'll love to
explore some of the other ones. Yeah, so, man,
we were in the convention center for EMS Expo.
I can't remember which one, but either way, we'd
been there since Wednesday. We had the Lafayette
helicopter on display there. And we could see
this thing coming. Well, they called for the
evacuation on Saturday. And we extracted that
aircraft on Saturday, equipped it, and we started
evacuations Saturday and Sunday. Not just by
air, but by ground. Lots of low -lying areas
around there. So, you know, when a hurricane
happens, it's all hands on deck until it ends.
You know, there's no... and you're gonna work
a couple days and then you'll be off you just
you just work so we flew the last group of nursing
home patients out of uh st bernard parish about
four o 'clock on the afternoon of uh on the afternoon
before landfall and there was this big giant
projection tv had to be 60 inches or so and like
the whole hurricane took up the whole screen
when we were walking by it And I can remember
going outside and we were having some 20 mile
an hour sustained winds with some 25 mile an
hour gusts. And I'm just thinking, man, I sure
hope all these helicopters start because I don't
want to leave one here. But we flew out with
a flight of six. We recovered back to Lafayette
and we watched everything unfold on the Sunday.
And then the Monday, the levee started to fail.
Got a phone call from Mike Sonier, who was in
the comm center, like, Tuesday morning, y 'all
are going out there. Myself and Tony Kramer,
a flight of, I think we had six aircraft that
were on duty at the time. We flew to Tulane Hospital.
Tulane had all of its generators on the ground.
The water had already flooded that. I can remember
going to the administrator's office, which was
on the ground floor, walking through water. to
find out patient count, patient severity. And
we elected to implement a triage system, which
I'm glad we did. We took NICU patients out first.
Because the elevators weren't working, we were
hauling them in isolettes and going up the stairwells
of the parking tower. Tulane did have a helipad
and Mike Saunier and all of his geniusness that
night. asked the two -lane security personnel
to take the light poles off of the parking garage,
which made a makeshift landing area. And at one
time, we were landing six helicopters on that
top floor at a time. And we pulled out all of
the kids probably by one o 'clock. And then it
was on to the next destination, which was Baptist
in New Orleans. And for those of you who... You
may have seen that was the infamous hospital
where they so -called euthanized patients. But
at that time, we were taking out the critical
patients. And there were fresh cabbages, people
still on ventilators, no medical records. They
were out on the roof because the hospital was
out of electricity. There were no operable windows.
It was just stifling hot. There was no there
was no like picking up the phone and organizing
a transfer. It's like you got this guy and all
he has is a wristband and a fresh cut and and
he's being bagged. We were taking those patients.
And you got to remember, there's a lot of patients.
There was some estimates of 900 patients that
was stuck in these hospitals and trying to transport
them long distance. just takes assets away. So
we were short hauling them to small community
hospitals and rapidly getting people back and
just constantly moving patients to Baton Rouge,
Napoleonville, Napoleonville, Assumption Community
Hospital, a lot of these small places. And we
just did that for days, improvising, coming up
with new ways of moving patients. until Friday,
until we evacuated all of the patients out of
the metro New Orleans area. Most of those patients
wound up at the New Orleans airport. Now, the
New Orleans airport became a marshalling area
for the United States Air Force. And at that
time, the Air Force didn't have that critical
care capability. So anybody that was really critical
stayed at the New Orleans airport. And on Friday,
we began evacuating the airport. So it took us
three days to evacuate the airport, five days
to evacuate all of the patients out of the hospital.
And at that time, then we would kind of just
sit around and wait and rescue the rescuers that
may have gotten hurt because there were no medical
facilities in New Orleans. When I think back,
I was at Anaheim Fire Department. I can still
say it now, Station 6 in the kitchen. And we
just had 9 -11 a few short years prior. And so
many beautiful images came out of that after
the fact, obviously after the tragedy of people
coming together, the community. And that was
kind of the message on the TV, as far as I remember,
at least. When Katrina happened, I felt it was
the opposite. And for example, there was that
kind of undertone of, oh, they're just getting
the white people out. And I remember one time,
speaking of helicopters, I've talked about this
before. I'll never forget this. Geraldo was effing
and blinding. He said he's under this bridge
and this family is still here. I was here two
days ago and this family is still here. And I
just remember looking at TV going, why the fuck
didn't you take him out then? So it wasn't like
the... outside of Louisiana, what we were getting
the rest of the world, I found was a very negative
report. Yet some of the Anaheim Five, one of
our captains almost got killed with a wash from
a helicopter to pick up a pallet and hit him
in the head. So I knew that my friends were out
there risking their lives alongside you guys,
but it wasn't being relayed, I think, through
a lot of the news stations. So talk to me about...
You mentioned the euthanasia, like what were
some of the fallacies that were being reported?
And what was some of the actual heroism that
you were hearing from the people on the ground?
You know, I like to think. And I think that a
lot of people would agree that that negative
things go on the news a lot easier than positive
things. And and I saw a lot. Now, you got to
remember, I was separated from the TV for about
about 10 days. But after the fact, I'm like,
you know, there was some of that going on. You
know, Chris Kyle shooting snipers and snipers
shooting at helicopters. There was no helicopter
that got hit. Obviously, there was a helicopter
around and there was gunfire. We heard gunfire.
But there was just so many acts of kindness and
cooperation that weren't reported. You know.
I'll tell you the story of the first kid. It
was this young kid that had a heart surgery on
the Friday at Tulane. And we brought her up.
It was me and Tony Kramer. And mom and dad were
there. I can say it because it's been published.
Brandy and Steve Schaff. And their child was
an infant. the child out we'll put them in the
helicopter and we had to tell mom and dad there's
no room for you and they're like where are you
taking my kid so we told them and obviously mom's
upset um but trying to defuse the thing you know
i had i had hungry pilots and paramedics that
were flying in and out i took brandy and i took
steve and i'm like hey would you do me a favor
i brought this ice chest could you make sandwiches
and hand a coke or something to the pilots And
you know what they did? They did it. And they
did it with a smile, and it kept them occupied.
And I made them a promise. As soon as I can find
you a ride, I'm going to get you a ride out of
here. And later that afternoon, there was an
empty aircraft that was going back, and we put
them in, and they were reunited with their kid.
There was just so many acts like that that didn't
get reported. that just come to mind that humans
want to help people and they actually did. Were
there some bad actors? Of course, there's bad
actors today. There's bad actors in every place
that gets reported. I just wish the media would
find more positive stuff to push out to people.
Yeah, well, there was so much. I mean, this is
the beautiful thing about this podcast is I get
to hear from the people that were boots on the
ground, everything from natural disasters and
some of the incidents that we talked about today
through Iraq and Afghanistan and Syria and all
these places where, no, these men and women are
either from that country or deployed to that
country. And the number of stories of kindness
and compassion, because I always ask our soldiers.
And it's amazing what our military does, wearing
their uniform in these places too. But like you
said, I always kind of state, you either have
the kill them all, let God sort them out, or
they're all baby killers. And in the middle are
the human beings that are our rescuers, that
are our war fighters. But we don't get that reported
because it doesn't fit the narrative. And then
the problem is, it doesn't matter if you lean
one way or the other, it's the extremism at the
end. that is the machine that we're feeding and
they don't want to say they it's like it's not
a conspiracy but the overall movement has become
well if we talk about kindness and compassion
and humanity well we're we're giving the middle
80 percent of voice we don't want to give them
those are the normal people we want to keep we're
not going to sell newspapers or advertising on
fox or cnn if we talk about the kindness let's
talk about the nastiness so it's so great with
this medium to simply hear stories and people
like yourself are the ones that can tell us You
know, what was actually happening down there,
you know, regardless of what was being reported?
Yeah. In regards to the the alleged euthanasia,
I'll be very honest. I was in that hospital.
I was not on that floor. I never integrated with
anything that happened, but I was interviewed
by Sherry Fink for the book about that hospital
episode. And the subsequent documentary that
went with it. And I got a, you know, they prosecuted
that physician. She was acquitted. That was a
political stunt by the attorney general's office.
Everybody knows it. But I have to think that
on that day when they made those decisions, which
was the Wednesday. Remember, they've been out
of power since Sunday. The windows. There were
no opening windows, stifling hot. I really believe
that lady provided the maximum level of comfort
that she could up until the line. And did a few
patients die? They probably did. Did she intentionally
do it? I don't think she did that. Absolutely.
If technology is keeping them alive and that's
being robbed from them, then, you know. And you're
back to the natural state of things and the body
is either going to carry on or it's not. Yeah,
that's my belief. And she was put in a tough
decision, man. That was a tough, tough, tough
thing to be in. And I think she did what she
thought was right. And I think she pushed it
right up to the line. Yeah, absolutely. Well,
it goes again, it goes back to what we're talking
about, the protocols and moral courage, what
was right for the patient at that time. And that
includes palliative care sometimes. Yeah, I tell
you, Katrina taught us a lot of lessons. The
company benefited from it, from learning that
we needed infrastructure. And we're so much better
for it now in all the subsequent hurricanes.
We've got high -water vehicles. We have comfort
facilities for employees. You've got to remember,
when a hurricane hits an area, it don't just
hit the civilians. It hits the paramedics, too.
So it takes their houses. So we've got laundry
facilities. We've got sleeping accommodations.
That way, they can continue to live and they
can continue to come to work to provide for the
area that's been harmed. So that's all I want
to learn from a lot of hurricanes. What about
some of the other hurricanes that you had? What
are other notable responses and rescues? Yeah,
so, you know, no mystery about it. Louisiana
is a Category 4 hurricane magnet. And just in
one year, we had four strikes. You know, I got
a person that works for me that is going to take
my place. And I messed up really bad and I learned
a lesson. And there was a hurricane and and this
person wanted to run it. And I'm like, let you
run it. And there was some things that didn't
go just right. And that was my fault. I messed
that up because I wasn't there to to. assist
and provide guidance so what i did learn was
the next hurricane we could be screwed at the
hip we're going to do this together and we were
in lockstep the whole time and and she learned
a lot and the next one she ran and and she's
been running the air department for hurricane
since then um they are a hurricane is is it's
employee devastating to make a make a some sort
of a relation to it. Not only do their houses
get affected, but their families get affected.
And the op tempo at work is very, very hard and
very high. So there's a lot of aftercare that's
required. Again, like I told you, like to operate
in the gray. So we're not wearing, you know,
normal uniforms. We're not. doing normal things.
And when you get that freedom of doing that,
then you have to corral them all back up and
get them on the regular way of doing business.
And that takes a few months after. But I got
to tell you, in these things, our group really
comes together and everybody, you know, people
along the coast need to evacuate their families.
So people that don't live near the coast are
willing to work for them so that they can evacuate.
Just a lot of teamwork. And, you know, everybody
comes together for that. I've heard the rhetoric
a lot in police and fire, you know, oh, the brotherhood
is dead. And I disagree. I really do. I think
that, again, that that is absolutely burning
in us. Now, sadly, you know, you overwork and
sleep deprive the group for a long amount of
time. Maybe some of that compassion is burned
out of people, but you give them the rest and
recovery will definitely refine that. One of
the things that I've seen, like my whole career,
is people are already working a large amount
of hours. Someone's going to get hit with a mandatory
overtime. They'll be like, I'll just take it
for you. Go be home with your kid. So I see that
over and over again. But the problem is it's
then thrown back in people's faces because they'll
be like, oh, well, they only had this amount
of mandatory overtime. So they would have had
a lot more. But because of the kind of people
that you've got in your department, they're jumping
on the grenade for their men and women so they
can go home. Yeah. One thing that I've got to
see, it used to be just me. I was the only manager
of the department. And now since we've gone to
dual provider and accreditation and so on, we've
had to expand that management structure. And
when you have a hurricane that hits and it's
really, really bad, the whole management team
is in that area. And it's usually where we have
a helicopter, and it usually affects operations.
We've lost three stations in about the last seven
years where it just completely just mows everything
down. And having to get operations back up, these
guys are just like, they're awesome. They pull
together. They just get it done. We've done it
so much now where you don't need to point and
tell. It's just automatic. It's just do. What
do your shifts and work weeks look like now?
You talked about the increasing op tempo. For
the pilots and or the medics, how many hours
are they working a day and then how many hours
a week? We're on a modified 24 -48. It's a regular
24 -48. They swap all Fridays and Thursdays.
Pilots on a six -day schedule where they work
12 -hour shifts. Midweek, they swap from days
to nights. The medics generally and the nurses
are generally reporting at 5, 6, 7, or 8 a .m.,
depending on what station. The op tempo is probably
six launches a day per aircraft and capturing
around 40%. meaning we do a lot of first response.
Our comm center is the PSAP, Alliany, 911 rollover
from all of these counties and parishes. So at
the same time that an ambulance is dispatched,
a helicopter is dispatched based on the acuity
and the severity. So they're launching five to
six times a day, and they're transporting two,
two and a half patients a day. The issue with
transporting these patients is whenever they
transport one, they're usually out of the station
for five hours or so. So it takes a long time.
So we monitor crew times a lot. We allow them
to call off, you know, no fault. Just you need
to take a break, take four hours and get a rest.
We monitor that very close. So we look for people
that have higher than normal call -offs to see
what kind of lifestyle changes or what activities
at work that they're doing. We have a lot of
people in school, so they're using up a lot of
their time to study. So we try to offer them
better solutions so they can be ready for that
next call. You said two and a half patients.
The half patient doesn't sound like it's worth
taking to the hospital. They're already deceased.
Yeah, that's a good one. I'm averaging things
out. But 10 bases getting ready to open the 11th.
Every station has four pilots, two mechanics,
and six practitioners with some part -time people.
So we've got a staff of about 100 direct reports
and about 150 indirect. Metro Aviation is our
provider of aviation services, so they provide
mechanics, pilots, training, so on and so forth.
So there's about 250 of us. The 2448, is that
like literally one on two off? So it's like a
56 hour work week for those guys? Correct. Okay.
Because there is a movement happening now in
fire and EMS. I mean, it's really taken off in
Florida where, you know, for us, it was a recruitment
crisis. It was all the health issues where we're
actually starting. And this is early days, but
it's happening. the 2472 to give these men and
women a full 72 hours to recover from the ship.
So tell me, so I've heard, does it require one
extra set of crews? It does. It does. But what
they're seeing, I mean, I don't know, it's interesting,
you know, in your perspective, but in the municipal
fire world, there's such a recruitment crisis
now because like you said, the op tempo is just,
you know, increased exponentially that. So many
people are working their regular 56 already and
then volunteer and or mandatory overtime. So,
you know, more often than not, that's an 80 hour
plus work week. And it's dissuading a lot of
people from wanting to join the profession. Because
when you look at it on paper in 2025, when you
can access all this information, you have all
the amazing stuff that we do. But then you have,
you know, everything from how long you're away
from your family to the divorces and alcoholism
and heart attacks and cancers. suicides etc so
between the health of the responder and um you
know this the money saving element because you're
paying everyone time and a half to fill these
spots and you're breaking your people a lot of
the progressive departments are realizing is
actually you know proactive investing at the
front you're saving money downstream interesting
point so yeah but it's it's interesting depending
on where you know obviously you're you're in
a private sector as well but When you're a different
geography, like what I just presented to California,
it wasn't deliberately supposed to be that topic,
but I brought it up in a conference because I
was asked to speak and they were blown away.
They're like, I've never thought about not working
this, but this is a problem. Like you said, what
worked 50 years ago doesn't mean it works now.
This is the evolution of the industry. So, yeah,
I think, you know, if we want to operate at an
even higher level, there's a great opportunity
to maximize not only performance, but health
as well. After this podcast, maybe we can get
together. You can point me in that direction
of somebody that's doing it. Absolutely. 100%.
All right. Well, then let's go to Burning Man.
So that's how you and Boomer met. How did you
find yourself from all these other things that
we've talked about to being a medic in a music
festival? So I'm just going to lay the groundwork
so y 'all can see the dichotomy in it. Obviously,
I'm Catholic. Obviously, I'm Southern. Obviously,
I'm conservative. And now I'm in exactly the
different place. And it is absolutely phenomenal.
I will tell anybody that wants to try something
new, you ought to try Burning Man. One day I
was flipping through something and I ran into
a guy that I kind of knew. And he was talking
about, hey, we're getting ready to staff up for
Burning Man. I think it was 2017. And I reached
out and that was the first year that I went.
And I'm talking about I was I was I was blown
away just walking in there. You know, you're
in a desert that didn't nothing existed two weeks
before. Now there's 70 ,000 people. And the music
is, is there the, the freedom of expression is
there. I mean, it was just overstimulating. And
we ran a couple of calls and I ran into Mike
and man, he's just Johnny on the spot. Like he's
got his, he's got his kilt on. He's got his tight
shirt on his big old bald head. I mean, he's
really posing big muscle guy and he's just. just
helping us and i just i just kept thanking him
and then right before we got off it's eight o
'clock at night remember it's my first night
there still don't understand what's going on
we responded to a guy that was a little weak
he was on the ground um tall thin individual
and i asked him to sit up took his bottle signs
put the monitor on him we going ahead we sat
him in a chair And challenged his vitals again.
Everything was going well. So I said, well, let's
do an orthostatic. Let's get him to stand up.
And we stood him up. And while the blood pressure
cuff is going up, he started braiding down. So
we quickly got him to the ground. And he just
skipped AFib altogether. He just skipped VFib
altogether. He went from like a rate of 40 to
asystole. And we're in this tent. It's dark.
It's the David Hasselhoff tent. So there's a
picture of David Hasselhoff that we're looking
at. It looks like Michelangelo painted it. And
we jump on it. And all of his friends are standing
by. And we did a solid minute of DLS. And all
of a sudden, he gets a heart rate back. And maybe
20 seconds later, the guy opens his eyes, took
a deep breath. and wanted to know what happened,
and he wanted to get up. We wouldn't let him.
So we put him on a stretcher. Mike's helping
us, and we get back to the pack of the ambulance,
and we went to load it up, and the stretcher
would not, the legs would not fold underneath.
There's so much dust at Burning Man, it just
plays havoc with everything mechanical. So I
looked at Mike, and I'm like, let's just grab
the stretcher pad. So we grabbed it, and we put
this gentleman on the floor of the ambulance.
closed the doors, microed in with us. And there's
a speed limit at Burning Man. Doesn't matter
what's going on. It's five miles an hour. If
you have 10 people in the back of your ambulance
in cardiac arrest, you drive five miles an hour.
And we were probably a half mile from the medical
center. And it seemed like it took us an hour
to get there. I saw Mike the rest of the week.
We just jammed really, really good together,
and I wound up giving him a Christmas ornament
of an AirMed helicopter, and we just kept in
touch. And I saw him subsequent years. This is
the first year he didn't go. I really missed
him, but a really great dude. Did you ever find
out the underlying condition of the Brady? You
know, we didn't, but we flew him out. So at Burning
Man, you have a full -blown medical center. like
I see level it's ICU level. It's, it's certified
with the state of Nevada. We can do a lot of
stuff. Um, but there's about 40 to 60 patients
a year that we fly out to Reno. He was one of
them. We did find out that he spent two nights
in a hospital. He caught a plane and he flew
back home fully functional. Amazing. Yeah. Yep.
So all these times you've been at Burning Man,
we can be the medical side or even just the sites
themselves. What other things stick in your mind?
Man, there's so much stuff at Burning Man to
talk about. The medical care is excellent. It's
absolutely excellent. We're running a mixed system
right now. We were running all ALS. We changed
to a mixture of BLS and ALS with ALS sprint capabilities
to make a basic truck. into an ALS. That's worked
really, really well. Seen a lot of devastating
injuries. Seen a lot of just people just having
a bad day and everything in between. I mean,
everybody's heard all the bad things that happened
at Burning Man, but there's so much good stuff.
You meet people from all over. Obviously, the
Israeli conflict right now is really big. But
even when Israel and its enemies were going at
it years and years ago, Burning Man has a way
of placing camps next to each other. I like to
say things that conflict work together. And I've
been in the middle of Israelis and Palestinians
now hanging out, talking with each other. And
there was never no issue. A couple of years ago,
there was a Russian camp. And it was right next
to the Ukrainian camp. It's like people separate
politics over there. And they're not really concerned
about what the government's doing. They're just
living in the moment. So many random acts of
kindness. I can honestly say I've been treated
much better at Burning Man. Not that I've been
treated bad by the public. So much graciousness
at Burning Man. They're so thankful that you're
there. Not even people that are injured, just
people walking and walk over and say, hey, man,
thanks for being here. Thanks for taking care
of us. That's amazing. It's funny you talk about
that commonality. I play football, pick up game
of soccer every Sunday. And it is such a diverse
group from, you know, South Central America through
to Europe. You know, there are Palestinians.
I mean, Middle East, all. walks of life but we
all go together because we like playing footy
that's what binds us it doesn't matter of religion
or you know politics or anything like that it's
just a bunch of lads that want to play football
and it's the same with this i mean how many times
has music brought people together that we have
been told are supposed to hate each other there's
just uh so many little cool things like i really
tell people if you planned and you had shelter
and you had enough water you didn't bring any
food If you planned it outright, you could live
at Burning Man for a week. There's people that
make food and give it away. People are very welcoming.
I tell people to try everything twice because
one camp may not be perfect. The other camp may
have it knocked down. But there's so many good
art installations to see. There's just so many
different people, and it's worldwide. So many.
people there to meet and hear their story is
just you never want to leave it sounds amazing
well mike obviously is very passionate about
the mental health side i didn't actually even
ask you yet as you sit here now in 2025 you know
this 30 plus year career that you've had you
know have there been any highs and lows for you
on the mental health side and if so what are
the tools that you've used to navigate that oh
So, yes, I'm a firm believer if you do this for
any period of time, you're going to be wounded
in some capacity. I mean, like from the neck
up. I know I'm a wounded individual. I think
one of the key things to being a first responder
and surviving this is self -awareness and knowing
when you're on the X. And that X is an ambush
point and, you know, life throws you all kind
of ambushes and you have a choice. You can stay
there and you can get shot or you can maneuver
off the X. And I think key to being a first responder
is knowing when you're on the X and maneuvering
off of it and going get the help you need, whatever
that help is. I've seen a couple of different
therapists. I've tried it. I've tried different.
types of EMDR, guided imagery, all kinds of different
things. And they all play their role. But the
number one thing I think that prevents serious
mental illness from traumatic situations is not
isolating. Having a support structure around
you, whether it's friends, whether it's coworkers.
whether it's family, not isolating, isolating
compounds it and makes it worse. And I'm probably
my worst enemy sometimes where I just want to
handle it on my own, but I can tell a difference
in my mental health when I'm actively engaging
with people who I can relate to. I often tell
people, Tell everybody, hi, good morning, thank
you, something like that. Because you don't know
who you walked off the edge. That edge could
have been right there and you just pushed them
back over to safety. Because you never know what
other people are going through. Love it. I agree
100%. You're getting ready to transition out.
a lot for a lot of people can be jarring as well
you know you've had this whole uh identity you
know you've got this tribe you had this purpose
what are your projections of your transition
and what are you going to next you know to be
honest with you i'm a little nervous um but i
did grasp on to a navy i'm really big in the
special warfare and listen a lot of podcasts
especially resiliency And Andy Stumpf, who was
a Team 6 guy, whenever he was going through it,
he's like, being a SEAL, that was a part of my
life. I'm not a SEAL. Being a first responder
was part of my life. It was a large part, but
it doesn't define who I am. I'm getting ready
to enter a new role in my life, and I don't know
where that role is going to take me. But I'm
a little nervous, but I got a good support structure
around me and I know it's going to be fine. Yes,
I'm leaving Acadian, but I'm not leaving EMS.
I'm going to stay credentialed until I can't
credential again and still do special work, you
know, Burning Man, special events, disaster work.
So I'll still stay a little involved. Beautiful.
Well, I want to throw some closing questions
at you before I let you go. That's OK. Yeah.
All right. The first one I love to ask, is there
a book or other books that you love to recommend?
It can be related to our discussion today or
completely unrelated. Yeah. So Kyle Carpenter,
Kyle Carpenter was a was a Marine and he put
himself on a grenade to save his. his buddies
and it's a remarkable book about resiliency and
coming back and just never quitting it made so
much of an impact on me when i went to mount
everest 2022 i went to everest base camp i carried
an american flag and had kyle's name on it just
to remind me of how How bad he was injured and
eight months later, he ran the Marine Corps Marathon.
And if Kyle can do that, like just a few months
before that, it took him 10 minutes to put on
each sock. Like if Kyle can do that, then I can
do this. So that was a really, really good book.
The other book that I live and die by is Jocko
Willick and Leif Babin, Extreme Ownership. Everything
is my responsibility. And how do I, as a leader,
take ownership to prevent the next incident or
the next person from resigning or whatever that
case is? Extreme ownership is just great. And
I live it. Love it. Yeah. I've had Jocko and
Leif both on the show. And then Kyle actually
is someone I've been meaning to reach out to
because I know he's a Medal of Honor recipient.
So I had one of the guys that put together the
Medal of Honor Museum come on the show not too
long ago. So, yeah, I need to reach out to him.
What about films and documentaries? So I like
to go down the YouTube rabbit hole and just see
where it takes me. But invariably. It always
takes me back to Jocko's page, Andy Stumpf, some
Eric Prince things, a lot of military documentaries
I really, really enjoy. Film? I'm a Top Gun fan,
man. I really, really enjoy Top Gun. Anything
by... quentin tarantino i really enjoy i'm a
pulp fiction addict it's amazing yeah i had a
john travolta on the show a while ago now but
um you know through my eyes you saw him in all
the 70s films and then i hadn't kind of really
been exposed to much of his his work and then
when pulp fiction came out we were like wait
a second that's The same guy from Saturday Night
Fever. Amazing. So, yeah, great, great film.
Yeah. All right. Well, then the next question,
is there a person that you'd recommend to come
on this podcast as a guest to speak to the first
responders, military and associated professions
of the world? Yes. And he was a former medical
director of ours. He's board certified in psychiatry
and neurology. And Dr. Ross Giudice, he was our
medical director from the late 90s to 2010. And
y 'all are probably thinking, why did Acadian
Ambulance have a psychiatrist as a medical director?
He was absolutely the right person at the right
time. And what an awesome guy. Really great dude.
And I'll be happy to connect you with him. That
would be amazing. Thank you so much. All right.
Well, then the last question before we make sure
everyone knows where to find you and Alcadian
as well. What do you do to decompress? So I've
got a Harley Davidson. Love to ride. I've got
a camp out in the marsh that, you know, you have
to take a boat to get to. And it's very limited
on electronics. Honestly, spending time at work.
I just find work is not work. It's more of a
passion. And I like my team a lot. I feel comfort
with them. And I'm going to miss them a lot.
But I know I'll always be able to pick up the
phone and give them a shout, too. They're going
to inherit something really great, and they're
going to probably make it a lot better than when
I had it. Brilliant. That's the goal, isn't it?
Always make everything better, man. No matter
if you have work or, I mean, hell, that's why
I call it a home improvement store. Well, for
people listening then, if they want to reach
out to you, learn more about you or Acadian,
where are the best places online? Hey, so I'm
on Facebook, Mark Cresswell. I don't know if
anybody does this, but do reach out 337 -298
-0487. I'm happy to talk to you. I'm happy to
talk to you if you're having a really bad day.
So if you feel like you're up against that wall,
I love to talk to you. Beautiful. Well, I want
to thank you so much, Mark. It's been such an
amazing conversation, such an interesting career.
And some of these kind of perspectives, you know,
we rarely get to hear about. But good luck with
the transition. Thank you so, so much for being
so generous with your time and coming on the
Behind the Shield podcast today. Yeah, man. Thanks
for having me. It was a pleasure. This is my
first one.