Saving Lives: All in a Day’s Work

in Bern, Switzerland

144: The emergency number. Tatiana Mattmüller is one of the many people behind this service. As a paramedic, she delivers first aid and saves lives in and around Bern.

«We have a P2 for Mattmüller Tatiana and Zaugg Sascha, thanks.» It is exactly 08:05:08 at the Bern ambulance service and team 5 is receiving its first call this Saturday. The big double doors open and the ambulance zooms out of the garage, blue lights flashing, and disappears around the next corner. Only its siren is still audible from a distance. I stand amongst the bright yellow emergency vehicles in the garage and feel a bit lost. It looks like a few local patients have chosen this chilly October morning to have their medical emergency.

A few hours earlier. Tatiana gets up at 5:30 for her day shift. She lives in the idyllic farming village of Salvenach, in canton Freiburg’s see district, near Kerzers, where she grew up. She has a deep connection to the region and feels good in the country; this is where she has roots, her friends and family. We take the still empty highway towards Bern. The ambulance station, which was built three years ago, is in Holligen, a suburb of Bern. Tatiana has been a paramedic for the Sanitätspolizei, or «Sano», as she calls her employer, for five years. She is an energetic 32-year-old with an infectious smile and a quiet charisma; her presence makes you feel safe and secure.

The station’s hallways are still quiet this early in the morning. Most of the people on night shift have retired to the sleeping rooms; those on day shift are slowly arriving. In the locker room, Tatiana puts on her uniform of reflective trousers, a T-shirt and a fleece jacket. Even the indoor shoes are standardized: all the paramedics are wearing Crocs. In the kitchen, the station’s social heart, a few tired looking people sit one of the long tables. They look glad to see the next shift arriving, it means it’s almost 7:15am, time to finish for the night – or rather, the day. Sitting at the table with coffee, yogurt or a piece of bread, they discuss the previous night’s events, their Bernese accents and laughter growing steadily louder. Then, at 7:29, like clockwork, the 18-strong team rises from the table, shaking off the last of their early morning tiredness. A minute later, they are briefed on the tasks of the day by the team leader: Sliding door 3 is jammed, so careful when driving out; some vehicles need a wash and on the same note, the kitchen could do with a thorough clean, too. All chores are allocated and the team gets to work.

Both the day and night shift begin with the same task: all emergency vehicles must undergo a thorough inspection. Are all the oxygen bottles full? Does the defibrillator have enough power? And very importantly, is the «poison cabinet» completely stocked with medicines? A missing vial of morphine will cause concern at the station. No one wants to break any narcotics laws.
While Tatiana is showing me the radio and the computer in the driver’s cabin, a gong rings out through the hall. She immediately switches to «life saver mode», swaps her Crocs for bulky safety boots and pulls on her paramedic’s jacket. There is no panic, though; Tatiana acts fast, but with a clear, well-practiced routine. This somewhat unexpected calm in serious situations is normal for members of the team and very important. Hysteria wouldn’t help anybody.

Statistically, there are fewer emergencies on weekends than on week days.

The garage empties shortly after day shift begins. Almost all the teams have been sent on their first call. This gives me some time to explore the station: Beside the large kitchen, there is a common room with a TV and comfortable armchairs and sofas. On quiet nights, this room makes an impromptu cinema. Today, though, I won’t see a single member of staff in here. Statistically, there are fewer emergencies on weekends than on week days – but that’s just statistics.

Speaking of which: In 2015, Bern’s emergency medical service responded to 17'682 calls, an average of 48 per day. They have a fleet of 33 vehicles, 15 of which are ambulances. They also have specialist emergency vehicles like an ambulance which safely transports patients with potentially infectious diseases, Ebola for example. They operate in 38 municipalities around the city of Bern.

A jet of water spurts from the hose. Despite her reflective gear, Tatiana almost disappears in a cloud of steam. Returning from her first call today, she took the ambulance straight to the station’s own washing facility. Paramedics are not just heroic life-savers, they also take on other tasks: washing vehicles, vacuuming floors, piles of administrative work after every call. Not quite what comes to mind when you picture her job. Tatiana agrees that the common perception of her job is different to what she actually does: «My friends and my family really respect what I do and are really appreciative. Most people are very curious and I have to be careful not to go into too much detail about what I do. Some things I’ve seen can be quite hard to stomach, after all.»

Then, some action: An ambulance pulls up outside the station, a team of three jumps out and runs straight to the next vehicle, responding to the next urgent call. The team is on its way out again after only 30 seconds. Tatiana takes over the clean-up of the standing ambulance. Even as an outsider, I can tell the vehicle has been used. I have to take a few deep breaths when I see the defibrillator’s cables lying on the stretcher and a suction pump full of blood. Used needles, tubes, infusion bags and other medical debris are scattered inside the ambulance. I can’t help but imagine what must have been going on in this narrow space only minutes ago.

«Usually I can let go of these kinds of thoughts when I take off my uniform and change back into my everyday clothes.»

Calls like these are run-of-the-mill for Tatiana and her colleagues. How does she handle it? There is no one size fits all solution, she says: «Usually I can let go of these kinds of thoughts when I take off my uniform and change back into my everyday clothes.» Tatiana is strict with herself and doesn’t allow any weakness. But sometimes, after particularly desperate situations she can’t quite let go of, she runs through them again in her mind. «Did I forget anything? Could I have done anything differently?» She doesn’t always find an answer to these questions, she says, but in these moments her team’s support is invaluable. They don’t see asking for help and support as a weakness, their motto seems to be: «Talking helps.»

«Gosh, what a mess. That’s not raspberry syrup, is it? Did things get out of hand?» a colleague jests at the sight of the bloody pump. Despite the seriousness of their job, the mood at the station is cheery. While some anecdotes I’m told or things I see make me feel queasy, they are everyday occurrences for the team. It does make the job easier, not taking it too seriously. But although the paramedics like to be a bit silly, they are highly professional and alert when things get serious. Trust is the most important thing in this job, which is easy to see in the team’s interactions with each other. Every member of the team needs to know that the rest of the team will act by the same rules.

«The responsibility is not a burden, it’s a privilege.»

I am surprised that there is only one doctor at the station, so most teams don’t have an emergency doctor with them. Isn’t this a big responsibility for the paramedics? «It is,» Tatiana confirms, «but for me it’s not a burden, it’s a privilege.» This is exactly why she finds the job so interesting. Tatiana enjoys the high level of autonomy and the wide range of competencies she is able to use every day. And she’s never alone, she says; at least two paramedics are always dispatched together. «I am the first person to reach people in an emergency. I can help them through pain and frightening situations. I feel good about that, and also a bit proud.»

Becoming a paramedic wasn’t her dream job or even a particular goal. It’s more of a coincidence that she now saves lives on a daily basis. She had always been interested in medicine, but had lacked the motivation to study, so instead of university, she chose to pursue a secretarial course, which she enjoyed. But after working in an office for a few years, she felt like a change, and found the perfect alternative in the paramedic profession. Being accepted for a training position was tough, there are only around 30 training positions a year in Bern. The candidates need to prove their agility and sports skills, and have broad general knowledge – no problem for Tatiana. But that was just the start. The three year training course alternated between blocks of theory and practical experience, both general and in the ambulance. She was sent on calls from day one and spent weeks at a time gaining practical experience on a psychiatry ward, with Spitex (a community nursing service), in emergency and intensive care wards, and watching operations. She describes this phase of the training as "difficult and intense, but unbelievably valuable and educational.»   

Tatiana finds it very important to pass on knowledge and experience, which is why she was a mentor for apprentices in the company she worked for before she joined the emergency medical service. Now, as a paramedic, she can use her talent as an educator in different ways. On one hand, she runs first aid courses for beginners, and on the other, she has been mentoring paramedics in training for the past two years. Tatiana, the teacher? She laughs; no, she doesn’t see herself as a teacher, «more a coach or a guide, I prefer that role.»

Half way through her salad and tarte flambée, the loudspeaker calls them back to the ambulance.

Life returns to the station around lunch time, when most teams are back and get to work in the kitchen. The mood is lively, like they’re all part of a big family. But they all know that the next call could come at any time, bringing lunch to an abrupt end. Tatiana eats more energy bars than she would like, but this too is part of the job, you get used to it. It’s no different today: half way through her salad and tarte flambée, the loudspeaker calls them back to the ambulance.

While waiting for Tatiana to return, I visit the emergency call centre. Whoever dials 144 in the canton of Bern will be put through to the four people in this room. (Only the regions Biel, Berner Jura und Oberaargau are covered separately.) So a jogger in Burgdorf who hurts his ankle or an elderly lady in Lyss who can’t get up after a fall – all emergency responses are coordinated and dispatched from here. Beat Friedli, an emergency call operator, calmly talks me through emergency procedures and shows me forms, codes and call lists on his four monitors. All the blinking lights make me nervous and I feel like there’s constantly a phone ringing somewhere. The names of the teams show up red on the screen, meaning they’re all out answering calls and unavailable right now. What happens if there is a dire emergency right at this moment? With the calmness of over 30 years of experience, Beat says, «you can’t get nervous, you just have to find the best solution.» It’s a bit like playing chess.

Over coffee later, Tatiana tells me that they had been called into the city of Bern, where a heavily intoxicated elderly man had found his way into the front garden of someone’s house and had, well, it wasn’t really clear what he had wanted to do there. It’s Saturday afternoon, not even 4 o’clock yet. «And this is just Bern, in Zurich they do this kind of thing before lunch time!» one of her colleagues quips. In any case, Tatiana had managed, with the help of the police, to take the man to the nearest hospital. She’s not unhappy that she only spends around an hour with each of her patients: «There are some cases you’re glad to hand over.»

«What was going on today, is it death day or something?»

Tatiana’s shift isn’t over yet. She and her colleague get another call, the fifth time they leave the station this Saturday. Emergency calls don’t care about work hours, so the shift goes on. Another team has also had a tough day. Of the three patients they had been called to resuscitate that day, they had only managed to save one. «Once we got there, there was nothing else we could have done, they were already pretty dead.» – «What was going on today, is it death day or something?»
Open communication is especially important to the team on days like these. They ask each other, «how’s your morale, are you coping?» I don’t doubt for a moment that the team would take care of anyone who seemed a bit low. «We look out for each other.»

Tatiana says that she was lucky to get a training position for her dream job. But watching her work, it is clear that it wasn’t just luck; she worked hard for it. There are some personality traits that you can’t learn, you either have them or you don’t. She treats patients firmly, but with the empathy and delicacy of feeling that people in dangerous situations desperately need. She is precise in everything that she does, without losing sight of the bigger picture. She leaves nothing to chance but trusts her team mates implicitly. As I’m leaving, I call them «everyday heroes», but Tatiana and the other paramedics don’t really like the term. She says:

«All we’re doing here is our job – voilà.»

Want to know more about Tatiana Mattmüller? Read her Profile