British Columbia·Night Shift

'It's one of the most rewarding jobs': A ride-along with an overnight paramedic

As a paramedic specialist, Brian Twaites is part of a medical network that doesn’t have the privilege of shutting down for the night.

The medical system doesn't shut down at night — this is what it looks like on the job

Brian Twaites works alone overnight, scanning Vancouver's streets in his medically-equipped SUV for people needing help. (Jake Costello/CBC)

Brian Twaites is trained to scan the road while he drives alone through Vancouver's dark streets on the night shift.

When he spots a man lying flat on his back on the Downtown Eastside sidewalk at 2:30 a.m., he knows exactly what to do.

"Tango Seven. Do you have a call for 300 East Hastings on the street in front of the First United?" he says into the radio.

No one has called it in yet.

Twaites, now laser-focused, asks for more support, turns on his lights and sirens and doubles back to the scene.

Drug overdoses are always top of mind for first-responders in a province where three people die per day of an overdose, Twaites says. In this case, it wasn't an overdose. (Jake Costello/CBC)

Less than two minutes after spotting the man on the ground, he's there to help in his paramedic-customized Chevrolet Tahoe.

As a paramedic specialist, Twaites, 54, is part of a medical network that doesn't have the privilege of shutting down for the night.

Typically working in solo vehicles, paramedic specialists in B.C. provide support to paramedics and patients and on-scene technical support for high-risk situations or complex events.

He's not alone on the night shift: working straight through the night is a reality for more than 61,000 people in British Columbia.

Most emergencies aren’t spotted by a paramedic driving by. (Jake Costello/CBC)

'Life goes on at night'

The man Twaites spotted, who appears to be in his 50s, had collapsed on the street. He's wearing a bandage and splint on his left arm from a previous injury.

In the short time between Twaites spotting him and returning to the scene, the man had sat up and was responding to questions — a sign his condition isn't life threatening.

Brian Twaites is one of 61,000 people in B.C. who works nights. (Gian-Paolo Mendoza/CBC)

"Hi, folks," Twaites says to the small group standing in the street as he climbs out of his vehicle.

He quickly wraps the man in a reflective blanket and, within minutes, an ambulance arrives to whisk him away. 

"At first, I thought it could be an overdose or some other situation, because of the way he was lying on the road," Twaites says.

In a province where nearly three people die each day from an illicit drug overdose, the concern is always top of mind.

But that isn't the case tonight.

Soon, three people smoking cigarettes on the street are all that's left at the scene. 

"Life goes on at night," Twaites says.

An ambulance arrives within minutes and bundles the patient away. (Jake Costello/CBC)

Risks of the graveyard shift

The graveyard shift is far from easy.

Beyond fatigue, the hours come with risks including an increased risk of cancer.

After 33 years on the job, the support of his wife and kids is the one thing that helps Twaites survive the night shift.

Bryan Twaites says the night shift has been hard on his family, but their support has made it possible to keep doing the job for the past three decades. (Jake Costello/CBC)

"Luckily for me, [they] understand and help me get through my shift work," he says.

The hours he keeps can be tough on his family, he admits, but — even though he could retire this year —  he enjoys what he does.

"I have to say it's one of the most rewarding jobs I think anybody could have."

Normal night in B.C.'s dispatch centre

Most emergencies aren't spotted by a paramedic like Twaites driving by and are instead called in.

All medical 911 calls coming from Mission to Pemberton are routed through a dispatch centre in an industrial complex in East Vancouver, one of three centres in B.C.

From the inside, it looks like the set of a Jason Bourne movie: dispatchers sit at multi-screen computers, scouring detailed maps and navigating complicated software.

Ryan Topp answering an emergency call. B.C. Emergency Health Services tries to respond to 90 per cent of the calls within 10 seconds. (Jake Costello/CBC)

"Overall, it's a very busy night," says dispatch supervisor Ryan Topp. "Everyone's on the phone. Calls are continuing through the night."

Calls range from car accidents to baby deliveries to distressed people who know they feel unwell but can't describe why.

B.C. Emergency Health Services tries to respond to 90 per cent of the calls within 10 seconds and, with 900 calls a day, it's no easy feat.

BC Emergency Health Services gets 900 calls a day, ranging from car accidents to baby deliveries to distressed people who know they feel unwell but can’t describe why. (Jake Costello/CBC)

The toll of working nights shows in Topp's eyes.

He is on the clock for two 12.5 hour day shifts, and he then flips his clock around for two night shifts on nearly opposite hours.

"Tomorrow, I'll sleep until about 2 p.m.," he said.

"I'll try to get up, have something healthy to eat and maybe go for a run or something so that day two is kind of back to normal," he says.

And then he's back at it again. 

Night Shift is a series that looks at life on the clock, around the clock. It's produced by Jake Costello and airs on CBC Radio One's The Early Edition from March 25 - 29. If you have a story about working the night shift, email or leave a voicemail at 604-669-6690.

With files from The Early Edition


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