Much like a nagging health condition — gasping while climbing flights of train stairs that didn’t used to feel like a challenge at all — can one day become an urgent problem, the Emergency Medical Service workers who’d respond if you had a heart attack are facing their own crisis call. New FDNY Commissioner Robert Tucker has been publicly sounding an alarm about how the nation’s largest public pre-hospital care agency — one that’s been part of the city’s Fire Department since 1996 — is in “critical condition” now as it’s been “overlooked and under supported” while responding to a record 1.6 million calls last year. “When I tell people I don’t sleep at night, this is why,” Tucker said in a speech last month. “Our EMS system has operated on an unsustainable model for years, and without immediate attention and proper investment it could soon collapse.” There’s no one cause of or fix for that unsustainable model as emergency personnel unions try to negotiate a new contract while continuing to work under the terms of one that expired in 2022 at the same time they’re pursuing a class-action lawsuit against the city.
 

It’s a physically and emotionally taxing job that joins the intensity of working as a first responder with the draining set-up of a taxi driver — if your driver also performed CPR before carrying you from your walk-up apartment into their cab, and with no hope of collecting a tip for that effort. The job comes with a limited number of use-them-or-lose-them sick days, a big pay disparity with other uniformed service workers, a culture that’s nearly as isolated as a firehouse is intimate and a rapidly churning workforce mostly there because it’s a four-year backdoor to becoming a firefighter. I followed up after that speech with Tucker, who’d run a private security firm and also served on the FDNY Foundation Board before Mayor Adams brought him on in August as the department’s 35th commissioner and who says he wants to bring a CEO’s mentality to his public position. In a phone conversation on Thursday, he elaborated about “what’s been sort of the tale of two cities” inside the FDNY between fire operations and EMS operations: “They’ve never adequately been merged. They wear the same patch, but they hardly operate under anywhere near the same conditions,” Tucker said, adding that EMS members “still do a phenomenal job despite the setup.”
 

The commissioner was frank about the problems facing EMS, including longer response times — “you only have to look in the Bronx to where I think it’s a challenge to get an ambulance” — without pretending to have the full solution to what he called “the biggest public safety crisis that nobody’s talking about in New York City”: “it starts with the recruits — you know what their motivation is to be there — because it’s very hard to manage a workforce that’s essentially a four-year workforce. You know from the moment they get there, they’re focused on leaving.” He continued: “The next thousand people in probation on the fire operations side are going to come from EMS. I only recruited 300 to replace them. If that doesn’t sound an alarm…” The EMS workers who are there, he said, “essentially come to work when they want to, because they make so little that it doesn’t really move the needle to show up or not show up. By the time you really drill this thing down, I don’t know who set it up but I gotta tell you we need to reset it.” To do that, “My number one goal is to improve the quality of EMS from A to Z: the morale, the culture, the equipment, the training. It all needs a good, hard look.”
 

That’s “nice to hear” from the new commissioner, said Anthony Almojera, a 21-year veteran of the EMS service and a vice president of its officers’ union. But, Almojera continued, that won’t solve problems a mayor needs to address at the bargaining table to fix what Almojera described as an increasingly miserable job. “This is happening to the citizens of New York. That’s not hyperbole,” he said. “People are dying because of the inexperienced and underfunded resources we have, including the personnel. The chickens came home to roost.” Tucker, for his part, concluded our conversation by saying that “I need everyone to realize the start of fixing something is pointing out there’s a problem.” Siegel (harrysiegel@gmail.com) is an editor at The City, a host of the FAQ NYC podcast and a columnist for the Daily News