Berthoud can be treacherous. Winding through the Rockies with hairpin turns and switchbacks, it can be awfully frustrating when you are tucked behind a Winnebago gasping along a two-lane road at 25 mph - especially when there is fresh powder.
With impatience reaching fever proportions, the young and restless ones sped up and, while attempting to overtake the chugging RV on a curve, plowed head-on into a minivan.
Witnesses used cell phones to call 911. It took 15 minutes to summon no fewer than seven emergency vehicles from spread-out Grand County. Even so, the pass was blocked, and there was no way to transport the critically injured victims to a Front Range hospital. Rural Grand County's medical resources are not equipped to handle such devastating trauma.
The drivers and passengers were transported by ambulance to the base of the ski area where, within another 20 minutes, a blazing orange A-Star 350-B2 Flight For Life helicopter churned its way to the landing pad. It would fight fierce winds, turbulence, and downdrafts as it made its way across the peaks. Within the next half-hour, the injured would be in the hands of the emergency room team at St. Anthony's in Front Range.
This is it. This is what emergency medical services (EMS) pilots and crew do. It is a taxing, nerve-wracking, scary, but infinitely rewarding job. It can be a career path marked by hours of boredom spent sipping coffee and playing computer games. But when all hell breaks loose, the highest form of human drama plays out. It requires unshakable nerves and skill to guide a megaton flying machine into schoolyards, between high tension lines, into a median on a jammed interstate, to hover above a boat in distress, or to plop into a crowded mall parking lot.
Broadly speaking, medical transport has two main objectives: emergency response to a life-threatening situation or conveyance of patients to distant treatment centers. Helicopters are usually deployed in emergency response scenarios because of their maneuverability. Cabin-class airplanes as well as rotorcraft are utilized to carry the ill to distant clinics and hospitals where advanced care can be administered. Each aircraft is specially equipped much like a land-based ambulance, providing patient security and enough supplies to perform basic but essential medical procedures to sustain life until more comprehensive services can be provided.
Since the E in EMS stands for emergency and since helicopters are the vehicles of choice in the majority of medical response circumstances, the focus here is on EMS rotor flight.
Dawn Mancuso is the executive director of the National EMS Pilots Association. She says, "There are about 400 EMS flight programs across the United States, and they can be configured in various ways. First, a hospital can itself own and operate an EMS program. Utilizing a helicopter in its EMS mission, the hospital is the federal aviation regulations Part 135 'Air Taxi Certificate' holder. They employ pilots, technicians, and maintenance personnel. Also, a hospital may simply lease an aircraft and perhaps a crew from a provider. Additionally, there are independent companies that are in the business of offering patient transportation services. Further, a medical center may simply outsource the entire function to a company in the business of providing such services." In certain locales, local and county governments perform medevac functions as well.
The number of pilots employed by these various programs is in the "low thousands." Each rotor-wing operation normally has six to seven pilots on staff. The National EMS Pilots Association tracks the activity of this service industry and provides useful profile information for anyone thinking about a career in this field.
The terminology is somewhat unique to the profession. What most would call a chief pilot is designated a lead pilot. Other pilots working within the organization are referred to as line pilots. Recent surveys have shown that EMS line pilots range in age from 27 to 61, with the average age being about 45. Overall, 88 percent of pilots have a military flight background with the majority coming from the Army. The current roster of industry line pilots has spent an average of seven-and-one-half years in the business. They log about 200 hours annually in their aircraft. The average line pilot receives an annual salary ranging from $40,000 to $50,000, but nearly a third of those surveyed earned more than $50,000 per year. Salary is in addition to normal health and time-off benefits.
One of the premiere providers of airborne medical transport services nationwide is Denver-based Air Methods. Operating in some 14 states, Air Methods serves more than 40 hospitals, operates a fleet of 45 turbine-powered Bell helicopters, and maintains a small stable of three cabin-class twins and three turbo-prop, single-engine Pilatus airplanes. Since launching its enterprise in 1980, Air Methods has logged more than 151,000 medical missions flown. The company employs about 140 pilots who are based at sites throughout the Air Methods network.
George Schofield is the supervisor of pilot training and screens applicants for employment consideration. The demanding work of the EMS pilot is reflected in the company's preferred hiring minimums. According to Schofield, "Due to the nature of our flying, which can be quite challenging under difficult conditions, EMS work is far from an entry-level position. Thus, we prefer a minimum of 3,000 hours in category, whether rotor or airplane. Turbine time is also important. We do like to see an applicant with an ATP certificate; however, we will hire those pilots who come to us with a commercial certificate and a substantial amount of instrument and night time. A four-year degree is a definite plus. We also require that a pilot be a non-smoker because of the medical environment in which we operate."
Air Methods' pilot population mirrors the survey quoted previously. "By far, the majority of our folks come from a military background," says Schofield. The non-military aviator does have a somewhat tougher time of it. Normally, we find that the civilian track to the kind of experience we need includes CFI work initially, followed by Part 135 charter or tour work, and perhaps flying for the off-shore oil companies. The drawback, though, is very little of that time is IFR and/or night."
Air Methods recruits pilots for a particular program site. For example, if the company needs a pilot at its San Antonio base, the recruitment effort will be aimed at filling that position. Air Methods advertises locally, in industry journals, and on its Web site ( www.airmethods.com).
Once an applicant is prescreened with a preliminary telephone interview, the pilot will first travel to the site location to meet with key local personnel such as the lead pilot and hospital staff. The next phase is a two-day interview and briefing at the company's headquarters in Denver. If hired, that pilot participates in five to seven days of ground school training in Denver followed by on-site flight training in the aircraft to be flown.
Schofield says that there will continue to be a modest need for pilot talent. "We are seeing that the Vietnam-era helo pilot who has spent most of his civilian career in this kind of work is reaching retirement age. Much like the airlines, we do need to look at civilian-only applicants because the military pilot is in short supply."
He also offers this advice to those thinking of a career in EMS: "Persevere. Compared to all of the professional pilots earning a living flying, there are relatively few EMS aviators. This is a business where timing does count. Stay in touch with prospective employers. I recall one instance where it took a year or more before we brought in one chap. It took that long for an opening to develop. However, once it did, I knew where to find him."
Pat Shaub, who has spent more than six years as an EMS rotor-pilot for Austin/Travis County (Texas) Starflight, offers a look at life flying the lifeline.
As a young Naval aviator, he initially wanted to be a fighter pilot. Then, a childhood friend was shot down and killed while conducting a medevac operation during the Vietnam conflict. That changed his life. "This is something I knew I had to do," says Shaub.
"The shift work can be rugged. My routine is this: four days on followed by four days off then back on for four days. For the first part of the rotation, I am on duty from 7 a.m. to 7 p.m. After my four days off, I come back and work the 7 p.m. to 7 a.m. schedule for four days.
"Even during periods of rest, I am always 'wired' because I never know when the alarm could go off. I remember timing myself once. From half-sleeping in my jammies to launch, it took me less than 3.5 minutes."
The upside? "I think flying is great. No doubt about it. But I could never see myself driving an Airbus. Maybe it's corny, but having a chance to fly and make a difference in somebody's life - I mean, there just can't be a higher calling for a pilot."
The work is varied, to say the least. "I recall responding to the backyard of a suburban home because of a report that a teenage girl was having difficulty breathing. Once I landed with my team of paramedics, we discovered she had been fighting with her mother. She was merely hyperventilating. On another occasion, we were about to transport a gentleman to a county hospital who was complaining of a severe headache. He died in my arms of a stroke."
There is a personal price to pay for these special flyers. Shaub continues, "Post-traumatic stress disorder is a real phenomenon, and the industry as a whole has not paid all that much attention to it. Until this day, when I drive around Austin, there are mental monuments in my mind that I cannot shake loose. There is that intersection where a 5-year-old was killed by a drunk driver....Over there is that playground where a youngster had a seizure and nearly choked to death. There's the bridge that a young girl fell from and ended up paralyzed. Sometimes it is so very hard to focus on the job of safe flying when you see so much heartache around you. But then, there are the rewarding moments when a terrified victim is rescued and ultimately resumes a normal, happy life because he was lifted from a dire situation in that rotor-bird."
Sound like a career for you? Although many EMS employers look for a minimum of 2,500 hours of rotor-wing experience, Shaub says, "You know, I had about 5,000 hours of time in helicopters earned mostly in the service and some Part 135 work, and I still felt inadequate. Placing a helicopter down near a dark highway in drizzle at night where the rotors need to slip beneath a power line with police cruisers and gawkers dashing about - that is on-the-edge flying."
Entering the EMS ranks from the civilian side without the benefit of a military helo background can be a daunting task. Advice? Shaub echoes the sentiments of Air Method's Schofield. "Fly helicopter Part 135 and a lot of it - from air tours in Maui to oil rig work in the Gulf of Mexico. It can be done."
The job hunt, though, is similar to locking down a pilot position in corporate aviation. Network. Shaub says, "I cannot think of one acquaintance who earned a job flying EMS merely with a resume." The rotor world is a small, close-knit community. Friends get friends jobs. Attend conventions and seminars put on by Helicopter Association International ( www.rotor.com ), the National EMS Pilots Association ( www.nemspa.org ), and Air Medical Transport Conference ( www.aams.org ).
The EMS pilot is a member of a rare breed, to borrow a cliche. Thus far, it has been difficult to refrain from using the term hero. It is a word that is overworked and trivialized. You'd be hard-pressed to find any of these pilots who would acknowledge the name anyway. "It's just my job," they say. But to that family plucked out of the wreckage on that slick mountain pass, well, they will always be heroes.
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