Still, in pleading their case for a more formal medical role, firefighters often cite Winnipeg as an example of their services being maximized. There, after a decade-long attempt to amalgamate EMS and fire, the services reached an agreement in 2007. Though two separate streams, they are headed by a single chief, and dispatch is coordinated from one centre. Significantly, there is a cross-trained firefighter-paramedic on every pump truck: if firefighters find that EMS is not needed, they can tell ambulances, which are often in short supply, to turn back.
The new arrangement seems to be working. Last year, the fire trucks handled some 10,000 medical calls on their own. But the partnership didn’t come easy. The attempted merger saw relations between the firefighters and paramedics degrade to the point where, by the time a deal was reached, three unions had become embroiled in formal labour disputes with the city. According to Fire and Paramedic Chief Jim Brennan, the difficulty came from trying to homogenize two distinct workplace cultures, with different seniority structures, uniforms and senses of identity. Brennan, who in the 1960s worked for Frank Pantridge, the Belfast cardiologist who pioneered paramedicine, says he has a unique understanding of changing something as simple as a rank insignia: “When you do that, someone appears to have lost, and that causes conflict.”
But even informally, the cultural divide between fighting fires and tending to the sick runs deep. Of the 37 firefighters Braedley interviewed, “all but four expressed sentiments ranging from discomfort to outright rejection of their work in the health care provision,” which, she says, has “shaken the hyper-masculine core of fire services and firefighting culture.” As a firefighter in her study explains: “The things they’re asking us to do are so far outside the realm of what we anticipated, that you almost feel like ‘I’m losing some of what I was really meant to be.’ ”
But regardless of any apprehension they may have, firefighters understand that, for better or worse, their role evolves according to the public need. This need, it seems, is the reason Toronto firefighters continue to bound up Maisie’s stairs. As one member told Braedley, “Some people would say she’s a nuisance, but she needs help. There is no one else. So we do it.”
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