The 12 firefighters from B shift at Los Angeles County Fire Station 8 in West Hollywood sat around the long rectangular table in the station's kitchen drinking coffee and sodas and talking. The subject was AIDS.
The conversation turned to the recent well-publicized story out of Sonoma County in Northern California--where a volunteer fire brigade had refused to answer an emergency medical call because the patient was a baby with acquired immune deficiency syndrome.
"At this station, rather than ask who has treated a person with AIDS, a better question would be, 'Who hasn't?' " one young man said.
A Common Experience
"Everybody here has worked on somebody with AIDS," confirmed Glenn Mutch, captain of the B shift firefighters, several of whom are also paramedics. "From somebody in full (cardiac and respiratory) arrest to somebody who was hit by a car. Some of them tell us they have it; some of them don't. But that doesn't mean they won't get treatment like anybody else."
Most L.A. paramedics and firefighters acknowledged, directly or indirectly, an undercurrent of concern about contracting AIDS--as well as hepatitis and other serious communicable diseases--from the people they are trying to help. The fear is there, they say, but it hasn't translated into the hysteria and incidents of outright refusal to treat patients that have been reported from other parts of the country.
(Although both county and city fire departments have firefighters and paramedics who have been exposed to the HIV virus and are being monitored through periodic blood tests, none has tested positive for the virus that causes AIDS. In fact, according to national statistics, no emergency medical worker in the United States has ever contracted AIDS on the job.)
Two experiences offered by firefighter/paramedic Rodney Cooper may typify the daily challenge of emergency rescue work in West Hollywood, a city with a large gay population.
Cooper, who has been at Station 8 for three years and has worn latex gloves routinely on most rescue calls since 1983, said, "One guy refused to let me treat him because I had gloves on."
Another time, Cooper had not yet put on his gloves when he reached a patient. "The patient said to me, 'I have AIDS. You should be wearing gloves.' It was very kind of him and I appreciated it." All in all, Cooper said, the incidence of notification that someone has AIDS is "almost 50-50. Some are cooperative and tell us, others won't."
Despite the risks, the B shift firefighters said, no one in their purview has been refused medical aid. And, while there have been earlier, scattered incidents of panic among paramedics, police and fire emergency personnel, the difference in Los Angeles, they said, has been an aggressive education program for emergency personnel.
Educational Programs Stepped Up
Both county and city fire departments have recently stepped up their AIDS educational programs. They have made AIDS awareness videos to be shown at fire stations, issued guidelines on protection against various communicable diseases and are currently equipping all paramedic ambulances and fire trucks with communicable disease kits containing goggles, masks and gowns.
The county Fire Department, through the office of health programs coordinator Marguarite Jordan is now planning management training courses about AIDS that will be conducted by physicians. "Those will be for battalion chiefs and assistant chiefs," said Jordan, a nurse employed with the department since 1985. "Then the information will be filtered down through the captains to the firefighters."
Both departments distribute pamphlets on AIDs awareness and protection to their personnel.
City and county paramedics, Jordan pointed out, receive far more extensive information on AIDS and other communicable disease than do firefighters because the county requires paramedics to have 64 hours of continuing education in emergency medical health care during a two-year period.
"I would say there is some general apprehension on everyone's part (about AIDS)," said Chief Lyle Burkhart, who sat in on the discussion at Fire Station 8. "And justifiably so. . . . But here (in Los Angeles) it's not going to be the way it was up north because our people are educated about it. The bottom line is there is not one person I have ever witnessed who has received second-rate care."
For example, engineer/paramedic Dave Barros said, "On Saturday, there was a guy hit in the car wash next door. He was pinned up against the wall and his legs were opened up. There was a lot of blood, but everybody had gloves on. We don't know if he had AIDS or not, but he got as good treatment as the President of the United States would get."
Even, or perhaps especially, at Station 8, such calm acceptance of the risks of duty has not always been the rule.