Text & Photography © Robin Andersen / Magnesium

When I was an EMT trainee I did a series of ride-alongs on the ambulances of the San Francisco Fire Department. I noticed that the majority of calls were for those referred to as “frequent fliers” or repeat patients of the EMS system–primarily poor, homeless, mentally ill, disabled, alcoholics and drug abusers. Their perpetual requests for emergency care are predominantly for non-life-threatening emergencies, and the constant attention costs tax-payers millions of dollars a year.*

I later realized that I needed to go back out on these calls with a camera. I feel it is important to capture the magnanimous dedication of the San Francisco Fire Department’s EMS Division and hope my photographs will (unofficially) support the Homeless Outreach and Medical Emergency Team (HOME) program—a collaboration between the SFFD and the Health Department that joins social services and medical care to help the recurrent patients get the help they need without having to call 911. In some cases I did not gain permission to show the patient’s face, and I needed to creatively block the shot. Most of the time they were willing when I told them why I was shooting.

This is a work in progress.

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One night of repeats #1 …

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We rolled up on this man as he was being cuffed by SFPD. According to the caller who reported him, he was under the influence of narcotics and running around in circles in the middle of an intersection. He was determined to be under the influence of psychopathic narcotics and taken to San Francisco General Hospital.

Later in the evening we had a call at the Montgomery BART Station, where a man had a complaint of chest pains. We found him on the floor and loaded him into a chair and took him out to an ambulance for transport.

One night of repeats #2 …

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This shift started out with a multiple vehicle rollover accident on the 101/280 split. Accidents are common here as drivers race across all lanes to get on the 101 from the previous onramp from 280.

Later that night we had a call from an intoxicated homeless man who called about chest pains which really ended up being a scab on his hand. He was quite a character. He noticed my camera and played the air guitar for me. A friend of his came by, taunted him, sung along with him, and gave him a dollar and a slice of watermelon.

One night of repeats #3 ...

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This man was just woken up from an overdose. He wasn’t too happy to see us, but calmed down a bit when we let him know that he would have expired if we hadn’t been called by his friends. He was then transported for further observation.

Special Thanks for this project goes to:

• Paramedic Captain John Cavanaugh, SFFD
• EMS Division Chief Pete Howes,  SFFD
• Paramedic Captain Niels Tangherlini, SFFD, HOME Team Director

* “According to figures obtained from the Department of Public Health, in 2007, 108 individuals cost the city $4.6 million in ambulance and emergency room fees. That’s an average of nearly $43,000 a year for each person.” City finds funds for money-saving program, C.W. Nevius– SF Gate, page  B – 1  (1/6/2009)

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