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First on the Scene

Hometown heroes met their calling by accident.

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Thirty years ago, Vince Duren was working as a mail carrier in the tiny Wisconsin village of Cazenovia when he happened upon the wreckage of a head-on collision a half mile south of town. The driver of one car had been killed, and the other car carried a mother and her young daughter, who had a compound fracture.

"The way ambulance service worked here at that time was the same system as in a lot of rural places," Duren recalls. "The funeral director, who in our case was in Reedsburg, 17 miles away, provided transportation to the hospital for people in Cazenovia and the surrounding area." But the funeral director had gotten out of the ambulance business because of the cost of insurance. As a volunteer fireman, Duren had been trained in first aid by the Red Cross, but he didn't think he was adequately trained for a situation like this one. He and the accident victims had to wait an agonizing 40 minutes before a police squad arrived and took the injured child and her mother to the hospital.

"I realized after that experience that our situation for giving or receiving emergency services was not good," says Duren. "It meant having to wait 40 minutes and then another 20 or 30 minutes to get to the hospital. And then the squad would have to come back and make multiple trips if there were several people injured. It didn't make any sense."

Through the fire department he learned that a statewide initiative would offer training for emergency medical technicians who would not only transport people to the hospital but also treat them on the scene and in transit. He signed up immediately and in January 1972 began driving 22 miles to Richland Center every week for a three-hour class. By November he'd been certified. "My license number was 1215, so I was one of the earliest EMTs in Wisconsin."

At 76, Duren has retired from the program as well as his job as village postmaster, but Cazenovia, a hamlet of 300 people, now has an 11-member EMT team living within a three-mile radius. "In the city most people may not know their neighbor who lives at the end of the street," says Irene Barreau, a 24-year veteran of the team. "But here in Cazenovia we do, we know everyone. Generally, if you live around Caz, it's going to be someone you know who shows up to get you through a medical emergency."

EMTs are certified through the state's department of health and social services, which requires 130 hours of training. As recently as three years ago trainees paid for their own instruction, to be reimbursed by the volunteer Fire Association if they passed the license exam. But now the state subsidizes the cost, and recently EMTs began receiving a nominal fee for each ambulance run.

According to Barreau, the Cazenovia EMT squad answers 65 to 80 emergency calls a year from as far as ten miles away. "Everyone calls us, including the Amish. We've had buggy accidents and other accidents involving horses that were quite serious. There are very serious farm accidents as well, involving machinery and confined spaces like silos." Calls to 911 go through the sheriff's department and are forwarded via radio and pager to each EMT in the caller's treatment area. "Usually within six minutes from the time of the first page, our EMTs would be on the scene or on the way." Patients are transported to one of four area hospitals.

The system wasn't always so streamlined. Duren had to lobby Jim Kahun, the village fire chief, to purchase an ambulance of some kind, and at first he had to settle for a converted milk van. Then he and Kahun solicited donations from town boards in the area and bought a panel truck that the association turned into an ambulance. Finally they were able to buy a real ambulance being offered for sale in Verona, Wisconsin.

At first, Duren was the only EMT in Cazenovia, and while the other firemen had Red Cross training similar to his, he was essentially on his own. His first call was a head-on collision in Germantown, a mile away. "He was driving one of those cab-over-vans," says Duren. "He was pinned in the vehicle, and both of his lower legs were severely smashed. The driver of the automobile who hit him wasn't hurt too bad; he was shaken up, though. The only thing we could do to get the guy in the van out was to pry the brake pedal and clutch pedal off of his legs. He had lost a tremendous amount of blood, and the only thing that I had at the time to stanch the flow of blood were six or seven old Turkish towels. So I wrapped his legs up in those towels and drove him to Richland Center. They took him to Madison and the surgeon put those bones back together. I saw the fellow not too long ago and he was walking around pretty good."

Another head-on collision that occurred shortly thereafter was even more gruesome. Two women had severe facial cuts, and one of them had an eyeball protruding from its socket. "We put a Styrofoam cup over the eye and taped the cup down," says Duren. "You don't try and put the eyeball back; you leave that for the doctor to do." A third victim had been impaled when the handle of a tire jack had been driven through the back of his seat. Duren and the firemen placed him prone on a stretcher, leaving the jack handle in place for the emergency room to deal with, and immobilized him as well as they could so the jack handle wouldn't move. Through his training he'd learned how to extricate someone from an accident, how to treat wounds, how to evaluate bleeding, respiration, and broken bones. But EMTs aren't doctors: "Just don't hurt anybody, don't make them any worse than they were when you extracted them from the accident."

Before Cazenovia joined the 911 emergency system three years ago, calls came in through the fire department, which relayed the information to volunteers. "Unless they can inform you over the phone, you don't know what you're going to be dealing with until you get there," says Duren. "You've got to be prepared for anything." But his biggest problem was bystanders giving free advice; usually he'd ignore them or direct someone else to keep them away. "Those bystanders are actually more disturbing to the person who's been injured than anything else. Relatives seem to get hysterical. To do the job you've got to be calm, and that helps calm everybody else down a little bit."

After a few years Duren recruited six or seven other volunteer firemen as EMTs, and they would respond in crews, which were always formed on the basis of who reached the ambulance first. If the accident had taken place out on the road, everyone available would report to the scene, some going directly from their homes. "They were pretty much people with the same kind of intent, to be good neighbors, and to try and help the community a little bit and give something back to it," he recalls. "The EMTs are looked on pretty much as angels."

Don Adelman has been chief of the area's ambulance crew since it was formally established in 1976. "I was elected as crew chief by the rest of the ambulance people at the time," he says. "I guess until I quit, which I've threatened to do already, they've just kept me reelected." He says that in the last 25 years the squad has gotten only two calls it didn't respond to. "Those two calls were just transfers to the hospital, situations where a nurse was at a home and wanted to transfer someone who was sick. In those situations we called for mutual aid from another ambulance group because there weren't enough of our EMTs around to man the ambulance. We try not to go with less than three people, one driver and two EMTs. To do CPR we need two people in the back when we're driving down roads and going around corners; it can be done by one person, but it's difficult."

What makes a good EMT? "If I could figure that out I'd be calling them every day," says Adelman. "I think people have to know that themselves and want to do it before they ever get into it. It's not something where we say, 'Come on, we need you,' because some people can't do that kind of work."

Senior squad members recall the neighbor who'd lit himself on fire with gasoline. The crew members who responded hadn't been told anything about the call before they arrived and had no real experience with severe burns. They tried to make the victim comfortable while transporting him to an emergency room as quickly as possible; he talked to them all the way to the hospital and later died.

"It makes a difference when you know people," says Adelman. "It's very difficult to keep yourself cool, calm, and collected and do your job. Anyone who tells you differently from that isn't telling the truth. Afterward you can't hold the experience in....The State of Wisconsin has begun sponsoring counseling programs for EMTs who have had particularly unsettling experiences. But one thing we have a little bit over on a city group is that, when we get done with our ambulance runs, we have half an hour to come back home; we have time to sit and talk about it. A lot of groups have three minutes to the hospital and they're back to their shop."

Despite the emotional pressure of having to treat one's neighbors in times of crisis, the rewards can be just as great. As Irene Barreau puts it: "You'd be surprised the number of people we have helped who come up to you a week, a month, a year later and give you a great big hug and a smile and they say, 'Here I am, thank you, my helping hands.' It's just a good feeling when that happens."

In a village the size of Cazenovia, even an EMT might find himself needing his neighbors' care. Ten years ago, Vince Duren was out on his farm cutting logs into firewood with a chainsaw. "The saw got away from me and jumped up in my face, and my chest was cut open," he recalls. "It knocked me over backwards. Fortunately I didn't get my arms cut by it. I got the chainsaw, the chain was stuck in my shirt. I shook the chain out and then stuffed my shirt into the hole in my chest and drove myself into town about a mile and a half away and went to one of the bars in Cazenovia. It was on a Sunday, and I walked to the door of the place and said, 'I think I need some help.'

"There happened to be three or four EMTs there. They did yeoman work. The best ambulance crew in the country took me to the hospital. In the emergency room they had to reinflate my chest and give me seven units of blood. Later they sent me by helicopter to the university hospital in Madison. And I'm fine. That day I was pretty happy that I had the EMT training, because I knew what my body had to have. I was awake enough that I could be evaluating them all at the same time I was being treated. It was interesting to say the least. I spent six days in the hospital, came home, but I really wasn't feeling up to snuff for six or seven months." 7

For more on Cazenovia see the Visitor's Guide on page 36.

Art accompanying story in printed newspaper (not available in this archive): photos/Robert Drea.

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