The call comes over the radio as a cardiac arrest, but when the squad members arrive on scene — an art deco-style home in Wyandanch, Long Island — it’s a crime scene instead. The situation is what EMTs call a “signal 50,” or “dead on arrival.” No one will be leaving in the back of the ambulance, which waits with its lights still flashing outside the home.
The deceased is a 25-year-old male who was found by his parents following a heroin overdose — a bulky man, curled in the fetal position, a needle lying next to his arm. On his wrist is a medical bracelet from the rehab center that released him the day before. Pamphlets for Narcotics Anonymous are sprinkled throughout the home.
Police officers and EMS workers nimbly attend to protocol in a front yard overwhelmed by topiaries and lawn kitsch. A neighbor hovers near a Toyota SUV with vanity plates that assert a love for camping, then walks up and asks if the family’s youngest son is dead. He says he heard screaming and called 911.
A Sedan swerves through the mass of emergency vehicles and stops in the middle of the street. A man wearing a work uniform with an embroidered logo jumps out of the car and runs inside the house. No one makes a move to stop him. He is the victim’s older brother. Inside, another EMT reports the dead man’s mother is on the phone screaming at the rehab center for sending her son home.
The neighbor provides a briefing on the Wyandanch he knows as a middle-aged white man living in a wealthier pocket of this majority African-American town; a place that has become notorious for its gang affiliations and high poverty rate. The Suffolk County Planning Department named Wyandanch the most economically distressed community on Long Island in 2001, and things haven’t gotten much better since then.
“My wife met blacks who moved out, they were so scared,” the neighbor, who did not want his name published, says. “I don’t even let her wait at the train station alone.”
The train station to which he refers is the desolate Wyandanch stop off the Long Island Railroad, about a block away from the ambulance base and a major hub for gang activity, according to Wyandanch-Wheatley Heights Ambulance Corp. Chief Tommy Cronogue.
Pulling away from the scene of the overdose, Second Lieutenant Jeffrey Allen, 42, with long black braids, thick-rimmed glasses and fading tattoos, says the squad has received multiple calls to that house in the past. The man had probably not been dead long when he was discovered, based on the body’s degree of lividity, or discoloration.
“Rich or poor, doesn’t make a difference,” adds Lieutenant Ron Lopez, a 36-year EMS veteran who has been with the squad for a decade. “It’s that new, cheap crap going around,” he says, referring to an inexpensive but easily obtainable and dangerous type of heroin with which the squad members are all too familiar.
Back at the base, the officers are laughing quietly and joking with one another in the lounge. Paramedic Michelle Koone digs into a sandwich. Another paramedic is stretched out on the couch playing a noisy game on his phone.
“Everyone who touched the body washed their hands, right?” someone yells out to the room. For the EMTs gathered here, this sort of call has become routine.
Koone has barely started on her sandwich when the tones sound again, reanimating the room—they’re getting another call. Almost mechanically, she drops the sandwich on the table and heads for the ambulance bay at the back of the base.
Wyandanch—or “The Danch” as it’s known to locals—is four square miles of rundown buildings and empty storefronts; pop-up churches, barber shops and liquor stores punctuated by the occasional bodega. The factories spread sparsely throughout the town used to produce rocket ship parts; now they churn out beer and Frito-Lay products.
A hamlet within the town of Babylon in Suffolk County, “The Danch” is a former 1920s German resort town that seems all but forgotten by some of the ritzier areas surrounding it. An early developer of Wyandanch solicited African-American residents moving out of Harlem in the 1950s, which prompted a “white flight” to surrounding suburbs. Recent decades have seen the area beset by waves of drugs and gang violence.
As a jittery, blonde-haired family exits an SUV, each member toting their own cup from Starbucks, and makes its way toward the train stop, they seem almost comically out of place. For one, there are no chain stores in the confines of Wyandanch—as Cronogue notes, “Even KFC went out of business here. How does that happen?”
Of Wyandanch’s approximately 10,000 residents, 60 percent are African-American, 30 percent Hispanic and about five percent Caucasian. Chief Cronogue says Wyandanch is the most medically underserved community on Long Island, and he may well be right—there is only one practicing doctor in town. It also has the busiest ambulance squad per capita in the entire state, with about 2,500 calls per year. The squad was the first in New York to provide an Advanced Life Support (ALS) first responder car, as well as the first to use supervisors’ vehicles to enhance operations.
Cronogue and his crew lament that people in Wyandanch often treat their ambulance squad as a taxi service, or simply a place to turn when a case of the “miseries” (a term dubbed by the responders to denote ambiguous complaints) strikes. The squad has taken to calling their more regular patients “frequent flyers.” These are Wyandanch residents who are mentally impaired, who wander in to the base simply for a place to go—often out of loneliness—or those who use the ambulance if they see a neighbor receiving free services, such as a warm meal.
Eddie McKnight, 58, a driver who’s been with the squad for nineteen years and who everyone lovingly refers to as “the grumpy, old guy” says they have to answer every call, but sometimes the frequent flyers present a real problem. “It’s a waste of resources,” he says. “We’ll be driving in a toothache and then the call comes in for a gunshot and we’re tied up.”
The situation is understandably frustrating, especially as a large percentage of EMS workers, including all the officers, have full-time jobs and volunteer their time here, often shuttling in from other towns to offer up their services. Long Island has the largest emergency volunteer system in the world.
Koone, a petite, quiet 24-year-old resident of neighboring Deer Park, works 80 hours a week, picking up shifts at a variety of ambulance corps, sleeping sometimes only three hours in between. She hopes to land a full-time ambulance job in the near future, but for now, she hasn’t had two consecutive days off in over a year.
While the frequent flyers annoy Koone, who says “EMS” can stand for “Every Minute Stinks,” her passion for the job is evident, whether she’s joking with an elderly COPD patient whose tiny house literally crumbles around him, or fingering the complex artwork of a tattoo on a nervous chest pain patient in the back of the ambulance.
To be sure, many of the calls that come in are neither frivolous nor unique to Wyandanch. Koone is on call for a choking baby, for instance, a blue rag doll by the time it is thrown into her arms. Thanks to fast action by Koone and her colleagues—Koone later demonstrates how she held the baby in her arms in the back of the bus, patting it firmly on the back and then breathing for it—the baby survives.
Chief Cronogue, who works for Cablevision during the week, says many Wyandanch residents lack health insurance and are hesitant to contact the authorities, but have developed close bonds with the EMS workers. All EMS services are available free of charge to uninsured patients. It’s not uncommon for EMTs to memorize the addresses of regular patients.
Allen, an energetic, familiar face around town, grew up in Wyandanch and knows someone wherever he goes in town, whether it’s at the 7-Eleven just outside the Wyandanch border or on the stretcher in the back of the ambulance. He tends to put residents at ease when he pulls up in his EMS van, and while many EMTs never find out what becomes of patients once they’re deposited at the hospital, Allen likes to follow up on calls in any way he can.
Allen started working with the squad when he was seventeen, before growing dispirited and leaving in the early ‘90s to pursue a variety of other career options.
“We had a bad succession of calls,” he says. “I started to wonder, do I want to do this as a career? Do I want this day-in-day-out?”
Allen couldn’t stay away though—he returned to Wyandanch, and the ambulance squad, as a volunteer thirteen years later.
“I always said when I had time to give back again I would come back here,” says Allen. “This is where I’m from, this is where I grew up. No matter where I go in the world, I’ll always be proud to say I’m from Wyandanch.”
Driving around town, Allen points out people he remembers going to school with, some of whom now walk the streets as “crack prostitutes,” or wound up on what he refers to as “celebrity row.” These are the former prom kings and queens, he says, who sit idly under a tree on the side of the road all day.
Midday, a handful of scantily clad women, who Allen says are prostitutes, can be seen regularly wandering the roads, occasionally in boisterous packs but often alone. One woman stands in front of a boarded-up church with an overgrown, unkempt yard, staring blankly up into a tree with her arms raised above her head as though reaching for something.
“I mean, who would want to pick her up?” says Allen.
Elsewhere, men play cutthroat games of dice in the street. On another block, young kids ride motorbikes—eagerly showing them off to passersby—and jump excitedly at the jingle of a Mister Softee ice cream truck wobbling down the street.
“That’s Dave,” says Allen, referring to the driver of one famed ice cream truck, which seems to garner more service than the rest. “He’s been around since I was a little kid.”
The Mister Softee headquarters, a dilapidated, fenced-off lot about a block from the base, has a line painted down its central building indicating which side of town permits Bloods and which side is Crips territory, explains Cronogue.
Wyandanch is “owned” by the Farmingdale sect of an El Salvadoran gang known as MS-13, but it’s also home to the rival Bloods and Crips, Latin Kings and a variety of other local gangs like the Strong Island Boys.
“You wanna see the gritty side of Long Island?” Cronogue asks. “You’re in it.”
But there is also a strange juxtaposition here. A massive estate is being constructed right next to a wooded area notorious for gang violence, multiple rapes and drug-related activity. The home of former German SS officer Bill Lyons, who lived in the area following World War II, is now a mosque for black Muslims. A significant portion of homes in Wyandanch are Section 8 government housing, but, as several EMTs are quick to note, often outfitted with flat-screen TVs inside and a Mercedes out front.
Driving through Wyandanch, Cronogue points out homes that have seen multiple homicides and drug overdoses; homes with marijuana farms in the basement and stockpiles of AR-15s; and homes where transients live in groups of 20 to 30. He points out empty playgrounds and wooded areas where cops will only enter in groups of at least eight. He passes a gas pump where a parish priest was robbed at gunpoint.
One home has only a blue tarp where the roof used to be. “People live there,” says Cronogue.
He points to a wooden fence tagged by gang graffiti. “Dark Gang Bitch,” it reads. “That means the young lady who lives there belongs to the Dark Gang,” he says. The family is afraid to clean the tag for fear of gang retaliation.
“Really, this place is just a microcosm of the problems that face America, though,” he adds. While Cronogue says there are certainly decent, hardworking people in the town of Wyandanch, there are many, as he puts it with dead seriousness, who deserve to be “summarily executed.”
Not everyone has such a gloomy perception of Wyandanch or, at least, some offer a more dimensional assessment.
“It’s really not that bad here,” says 19-year-old EMT Nakiya Jenkins, who can’t weigh more than 100 pounds, as squad members sit outside the base one night shooting the breeze. “It’s no worse than anywhere else.”
Shortly thereafter, fireworks are mistaken for gunfire, sending even some of the squad’s more hardened members running for cover.
While areas like Wyandanch in the center of Long Island originally cropped up along the train line and were designed for car-based living, there are plans to rejuvenate its urban core in the near future and make it more walkable. Local governments and private developers hope to move town residents into multistory buildings, with the hope that commercial space around the train station can breathe new life into the town. They call this project “Wyandanch Rising.”
Most Wyandanch EMTs are skeptical of this program’s prospects for success. To them, more people means more calls, and multistory buildings just mean more difficulty navigating a stretcher up and down stairs.
It’s a grim job, to be sure. One common practice on the squad is the “morgue fold,” which Allen demonstrates in fastidious detail—a means of preemptively tucking the sheet on the stretcher to make it simplest to wrap around a dead body.
Squad members have a variety of motivations for showing up day after day. Some cite the adrenaline rush—Lopez joined the squad after leaving nearby Farmingdale because Wyandanch was getting all the action. “I couldn’t remember the last shooting we had in Farmingdale,” he says, “but Wyandanch had had a shooting just the night before.”
Others cite the desire to beef up a med school application, but most just report they want to help people in need. Geri Smith, 58, talks about rewarding experiences like the time she served in court as a witness for the prosecution in a domestic violence dispute after showing up on scene.
“They asked me, ‘What do you remember?’” says Smith. “I said I remembered she was beaten up and had a chunk of hair missing that he ripped out with so much force it was obvious he really hated her. I remembered she smelled like a beer and when I asked if she’d been drinking, she said he threw an open beer bottle at her.”
Even the most committed of the responders have their concerns. Koone voices a common one: many EMS workers ultimately get hurt in the line of duty, not in diffusing violent situations, but due to years of muscle strain from handling patients. The average work lifespan of an EMT is five years, though some stick around much longer despite the injuries they accumulate.
The emotional trauma suffered by EMS workers, however, is often far worse than anything they encounter physically. The team has seen many probationary officers, or “probies,” quickly come and go; one of Smith’s daughters quit the Squad after a call that “scared the bejeezus out of her.” The officers recall another probie who promptly quit after one particularly disturbing call—he witnessed police officers sticking pencils in the 16 bullet holes on a shooting victim’s face, in order to count the wounds and help determine trajectory.
The regulars do, however, find ways to blow off steam. They riff with one another in often gruesome detail. Driving through Wyandanch looking for action, Cronogue at one point loudly jokes: “Come on, somebody shoot someone.”
“We take so little seriously because everything here is so serious,” says Cronogue.
While such an outlook can at times be jarring, overall, the atmosphere among the group is familial. When Lopez’s infant granddaughter totters into the base one night, the EMTs who can joke with ease about brain matter spilling onto asphalt all stop to coo at her and swing her playfully in the air.
One thing all of them would agree on, as Cronogue puts it, is that “if you can treat patients here, you can do it anywhere.”