In retrospect, he was obviously going to go. Never mind that almost everyone closest to him thought it was a bad idea. Never mind that Paul Cary — longtime firefighter and paramedic, possessed of a bad back and a walrus mustache — was 66 years old with a health condition, and preparing to drive his ambulance straight from his home in Colorado into New York City to help out at the very height of the COVID surge in the spring of 2020.
At that point, Colorado itself was just beginning to get hit with the virus, but New York City’s case counts were already in the tens of thousands, its death toll in the hundreds. First responders were falling ill; the 911 system was overloaded; people were waiting hours for ambulances only to get delivered to overwhelmed hospitals. One doctor at hard-hit Elmhurst Hospital in Queens described the scene as “apocalyptic.” None of this would have been Cary’s problem except that, like many emergency workers, he felt a calling to be there for people on their worst days. And at that moment, the worst of the worst was in New York.
Cary was part of an extraordinary outpouring of support and sacrifice at the very beginning of the pandemic in America, one that, two years later, feels in some ways like it happened a decade ago. This was when New Yorkers were still leaning out their windows at 7 pm to applaud health care workers at shift change, and about 250 ambulances and 500 emergency workers descended on New York City from all over the country — Virginia, Tennessee, Illinois, Colorado — to help relieve the city’s overwhelmed hospitals.
They took grueling road trips in their ambulances to wind up in parking lots at Fort Totten and the Bronx Zoo, ready to shoot out all over an unfamiliar, shut-down city and rescue the sick. And on April 30, 2020, Cary was the first out-of-town paramedic to die in that effort. He died after contracting COVID-19,
Today, as the US hurtles toward 1 million COVID deaths and bitter debates over masking and vaccinations drag out, putting us well beyond the “we’re-all-in-this-together” moment of early 2020, it might seem quaint to remember and elevated people like Cary. But elevating someone like him, who lived and died by America’s best values, is especially essential now, for it reminds us that this country is more than its failures and divisions. Cary’s example can remind us to carry that decency and unity forward.
Cary’s colleagues at a private ambulance company called Ambulnz told me the word went out over the company Slack, sometime in March 2020, that the Federal Emergency Management Agency was looking for EMTs and paramedics who could go to New York pretty much immediately. Paul by then was “retired,” kind of — he’d left the Aurora Fire Department where he’d worked for decades before moving to the private sector. Like other such companies around the country, Ambulnz was joining an unprecedented effort to build a new, huge auxiliary emergency service in New York.
Such “mutual aid” deployments, in which emergency workers traveled to supplement local ambulance services overwhelmed by disaster, weren’t unusual for floods and hurricanes. But these disasters were often short-term affairs, the workers offering assistance for an aftermath. COVID was an ongoing disaster, getting worse day after day, and emergency workers were being asked to drive straight into the storm.
Of course Cary put up his hand. He was beloved in the Aurora medical system, where everyone in the emergency rooms seemed to know him, where he asked after nurses’ families and kept an eye on patients he’d brought in. One former colleague of his told me that, in addition to being a “great educator and father figure to most,” he was also a “s–t-magnet”: Somehow he always ended up responding to the worst calls, the gunshot victims, the septic patients.
On shifts, he’d call home for his sons’ bedtime when they were young while washing blood off his hands. He knew that in his line of work you couldn’t save everybody, and oftentimes you lost more than you won. What he lived by and taught colleagues was that you still showed up to play.
New York at the height of spring 2020 brought many, many losses. Cary was doing a lot of “hospital decompression,” which meant taking patients from overfull hospitals to slightly less overfull hospitals, or to the Javits Center which the Army Corps of Engineers had turned into a field hospital.
Extreme chaos stalked every corridor and trauma bay he visited. Multiple ventilator alarms would be going off at once, a ghoulish music box accompanying the near-impossible task of getting patients out of a thicket of beds. Still, he kept going. He had signed up to extend his tour, having already served three weeks, when he started to feel sick around April 19. Colleagues told me he was reluctant to go to the hospital; he was supposed to be there helping the sick, not taking up scarce resources by being sick himself.
A few days later, he was on a ventilator, and a few days after that, he was gone.
He is one of thousands of health-care workers, including hundreds of first responders, to have lost their lives serving others in the US during the pandemic. Incredibly, there is no full accounting of the exact number: An investigation by The Guardian and Kaiser Health News found 3,607 total US health-care deaths, but the project stopped last spring; the CDC’s latest countof 4,120 deaths, discloses major gaps in data availability.
We do know that COVID-19 has been a leading cause of death among first responders for two years running. We also know that many health-care workers continue to suffer from the trauma of those first disease surges even though the days of cookie and pizza deliveries to ERs are long gone. And we know that hundreds of thousands of health-care workers have simply quitfrom stress, from lack of support, from exhaustion.
Though the US has made some notable strides since the pandemic’s early days in protecting its health-care workforce, notably in building up PPE stockpiles and prioritizing frontline healthcare workers for vaccines, the pandemic has exposed chronic underinvestment in the people who save lives, and it won’t be fixed by chanting about “healthcare heroes” or slapping a mural up in Midtown.
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It’s telling that the federal government hasn’t managed to get a reliable accounting of all the lost health-care heroes of the pandemic: Americans don’t even know the true extent of their sacrifice. And while Congress recently passed legislation to support mental health in the medical profession, too little is being done to address why members of the profession are suffering a mental-health crisis in the first place. Nurses were begging Gov. Cuomo to address a worker shortage in his field back when it was Mario Cuomo, in 1989.
Maybe if educating future health-care professionals were easier and more affordable, maybe if for-profit hospitals weren’t determined to keep wages down, maybe if state and federal governments would take seriously the need for biodefense resources for our first responders, our “heroes” wouldn’t be overworked and underequipped for an epochal infectious-disease crisis, and wouldn’t need so many federal dollars for therapy. Maybe more would stay in their jobs, and maybe more would survive them.
On the blustery Thursday when Paul Cary died, his “end of watch” call went out over the radio: “This is a last call for paramedic Paul Cary. Dispatch will now show paramedic Cary out of service, but not out of our hearts and memories…We have the watch from here.” Firetrucks and ambulances lined the route to the Staten Island funeral home, and colleagues stood in the rain to salute as he rode by. He’d known what he and his immediate family stood to lose with his trip to New York, and he stepped up to play anyway.
One lesson of Cary’s story, and that of the many others who gave their lives to help others in the pandemic, is that in a context of institutional failure, individuals can muster astonishing grit and courage against impossible odds. We owe them our gratitude, and they deserve to be celebrated — especially now that our national swell of goodwill for “essential” workers has faded.
But it’s not enough for individuals to step up, and it’s not enough for the beneficiaries to feel thankful. It’s time for institutions to step up too, and make sure that the individuals who continue to protect us, in this crisis and the next, have the odds in their favor. That’s what it would mean to keep the watch from here.
We all know how much we’ve lost in this pandemic and continue to lose. But Paul Cary’s example shows us that even in the face of impossible odds, we can still strive to be healers. Let’s keep the watch for him, and for one another.
Gilsinan is a journalist and the author of the recently published book, “The Helpers: Profiles From the Front Lines of the Pandemic.”