On a raw, late-winter Friday afternoon in Durham, fans are streaming toward UNH's Whittemore Center for a Hockey East playoff game between the Wildcats and UMass-Lowell. The sun drops quickly and temperatures follow. A short distance from the hockey rink, behind Zais Hall on College Road, four members of the Durham Ambulance Corps (DAC) brave the chill to perform a daily ritual--washing down two trucks that function as hospitals on wheels. Two of the men, paramedics Brian Cartier and Wayne Smith, are former UNH students. The others are current UNH students, Greg Worsman '03 and Travis Fleury '05. Both are certified emergency medical technicians, or EMTs. All are volunteers, four of a group of 60 that serves the university and the nearby towns of Durham, Lee and Madbury.

"It's part of the professional image," says Cartier after the final rinse. "No one wants to see you showing up in front of their house in a grungy, dirty truck." But there's another reason for the code of cleanliness, especially inside the vehicles: the threat of blood-borne disease makes precautions an absolute necessity.

Along with the cold, there is a sense of anticipation in the air. Because of hockey game celebrations, the paramedics and EMTs of DAC expect a busy evening, and extra care is taken to make sure the ambulances are ready to roll. The trucks--worth more than $125,000 each--are backed carefully into side-by-side bays and electrical systems are plugged in to recharge. The ambulance bays dominate the snug DAC headquarters at 47 College Road, which is leased by the corps from UNH. The place feels similar to submarine quarters, with the bays separating a small, spartan locker room and kitchen at one end, and the day room, information center and bunkroom/library at the opposite end.

Cartier's wife, Rachel Moniz Cartier '01, a certified EMT in her own right, is busy in the tiny galley kitchen, cooking up a chicken parmesan and spaghetti supper for the crew. Visitors drop by, including Karen Verny Henny '88, a 13-year veteran of the corps and an EMS instructor in the UNH kinesiology department, who is on her way to the game.

Eventually, things settle down and the wait begins. Fleury is busy at the computer, creating staff photo-identification cards. Some study; others, after cleaning the kitchen, relax and watch "The Simpsons" after a channel scan reveals the hockey game isn't on. At 10:30, all is quiet; UNH wins the game handily. A few of us, myself included, crawl into cramped but cozy bunk beds for some fitful sleep. I wonder what action the night will bring.

I'm along as a "Fourth Rider," a program that allows potential volunteers to observe the corps in action. The term comes from the ideal ambulance crew, which is three members, although Cartier acknowledges they can respond with two. The "Fourth Rider" program is how many DAC members get their first hands-on experience in emergency medical services.

Two hours later, an alarm sounds. The report: "unresponsive male, vomiting" in a Memorial Union Building bathroom. Cartier and John "Jori" Argue '03, a certified EMT whose shift began at midnight, don their dark blue DAC coveralls and jump in the front seats of DAC's A2 ambulance. I hop in back. Inside the ambulance--Cartier calls it "a miniature emergency room"--is a stainless steel, wheeled stretcher, boot camp-neat with pillows, blankets, towels and seatbelt-style straps. A saline bag hangs from railings attached to the roof. The walls are lined with supply cabinets with tourniquets, catheters, wrist and ankle restraints, cold packs, duct tape, gauze and, somewhat jarringly, a Teddy bear. Near the stretcher's head is a LifePak 12 device, a combination heart monitor, defibrillator and external pacemaker.

Today's ambulance reflects the enormous advances in the emergency medical service industry. "EMS is still a fairly young profession," says Karen Henny. "It was just getting off the ground in the late 1960s." Doctors now recognize "that we can be their hands and eyes and ears out in the field,"she adds. "There's a lot of stuff that we can do that 10 years ago you couldn't do until you got to the emergency room. Studies have shown that what we do is safe and efficacious."

Basic EMTs are now trained to operate automated external defibrillators (AED) for heart attack victims, and may administer a patient's prescription drugs. Intermediate EMTs do more detailed on-site assessments and administration of drugs, particularly those used to treat cardiac arrest, asthma attacks, anaphylactic shock and diabetics. Paramedics also have a greater array of pain medications and more sophisticated treatment techniques at their disposal, including external pacemakers and trachea tubes.

But "people still refer to us as ambulance drivers and don't see us as intervention," says Cartier. "We still have a ways to go in terms of recognition."

Shortly after 1 a.m., we arrive at the MUB and meet Worsman, who lives nearby and answers calls from home. The EMTs roll the stretcher into an elevator and we squeeze around it. Firefighters are waiting with the patient in the bathroom. Cartier, Argue and Worsman hoist a barely-conscious, 21-year-old man onto the stretcher and cover him in blankets.

Cartier determines the patient, "Fred," has been in the bathroom for more than an hour since the MUB closes at midnight. He instructs Argue to prop the patient's head up with a pillow to make sure his airway will remain clear if he gets sick again.

"Wake up, Fred, wake up. Stay with me," Cartier keeps telling him and watches to see that he gets a response each time. The young man on the stretcher slowly recounts his evening--at least a dozen shots of 99-proof, banana-flavored schnapps at a downtown bar, followed by a few games of pool at the MUB. He's not a student, but says his fiancee is.

On route to Wentworth-Douglass Hospital in Dover, N.H., Cartier initiates an intravenous drip while Argue calls ahead to notify the emergency room of our arrival. He's careful to report Fred's symptoms, but doesn't mention the conclusion that I came to--that Fred is drop-down drunk.

"That's a diagnosis and only doctors can make a diagnosis," says Worsman. At the hospital, after Fred is taken to the emergency room, Cartier fills out his run report and Argue and Worsman re-make the stretcher. On our way back, there's a call about intoxicated students at a dorm. Smith and Rachel Cartier are on the scene and by the time we arrive we're told that only one student requires care. They head off in the other ambulance to Wentworth-Douglass, where they will deliver the student to the ER. (Although UNH has extensive programs aimed at assisting alcohol abusers and UNH Health Service's staff will later offer the student an opportunity for alcohol counseling, the role of EMTs and paramedics is limited to immediate medical assistance and transportation.)

At 3 a.m., our group of four returns to DAC headquarters and the wait resumes.

Rachel Cartier says 35 years is a long time for a volunteer service to not only survive, but to thrive. To mark the occasion, the corps will celebrate its 35th anniversary on June 22 in Madbury, N.H. The private, non-profit Durham Ambulance Corps was established in 1968 in memory of the late Dr. George G. McGregor, a longtime and beloved Durham physician. The corps has seen hundreds of volunteers pass through its ranks, including more than 20 who are now physicians and dozens of others now employed as paramedics, EMTs, nurses and other health care providers, says Patrick Ahearn '78, DAC's operations vice president. Most started with DAC when they were UNH undergraduates, he adds.

DAC, like UNH, has a long list of distinguished alumni, including Donald Bliss '73, '79G, state fire marshal and director of Homeland Security. Henny says one of the primary reasons that the corps prospers "is the symbiosis between the university and DAC," including a strong EMT class.

More than half of the current DAC membership is comprised of UNH students. Fleury, for example, is a sophomore business major from Pembroke, N.H. He took an EMT course while a senior in high school, joined DAC as a freshman and was averaging as many as 90 hours a month at DAC before his class work started demanding more of his time. (All volunteers are required to be on call for at least 48 hours or answer a minimum of four calls each month.) Argue, a lanky senior psychology major from Somersworth, N.H., squeezes his DAC on-call duty between a pre-med course load, a job at the Sheraton Hotel in Portsmouth, N.H., and his work with the Odyssey House in Hampton, N.H. He hopes to attend medical school after a three-month volunteer stint with a medical clinic in Sikkim, India, this fall.

Given that there's no pay and that, not unlike being a new parent, the job requires nights of little or no sleep and a distinct possibility of dealing with unpleasant messes, what attracts people to DAC? For some, it's the camaraderie. For most, it's a desire to help. "Sometimes it's hard, particularly when you have to give up sleep or a meal," says Henny. "But it comes back to, 'Somebody needs my help--that's why I'm here.' Whether we get paid is not the motivating factor. A paycheck would be nice, but for the majority of our members it's that core feeling of being able to help somebody else out, to make someone feel better about a crisis in their life."

At 6:57 a.m. on Saturday, the alarm sounds again. Brian Cartier, asleep on a couch, rubs his eyes. "Three minutes before the end of my shift," he says, but rolls off the couch without hesitation. "The alarm goes off, and you don't think about yourself," says Rachel Cartier. "You think about the patient."

Smith, Cartier, Argue and I head off to a private home in Madbury, N.H. An 87-year-old man is experiencing sharp pain in his hip. His son-in-law found him in bed, unable to move, and we learn that he had fallen earlier. Complicating matters is diabetes and congestive heart problems. Smith asks "Leon" a series of questions that he answers correctly and then dryly observes, "Oh, I'm all there."

"The level of consciousness is key," Smith tells me afterwards. "It's always important to talk to your patients because the brain is the most sensitive organ and will be the first indication that something is wrong. Sometimes with older people who have diabetes, they can't feel the pain. So I was concerned about his heart."

Henny would have been proud of Smith's bedside manner and his on-the-mark evaluation. "Sometimes the most rewarding aspect of the job is just seeing someone who was frightened and in crisis and then seeing them smile by the time we got them to the hospital," she says. "We try to instill in our members the human component. Sometimes holding a hand is going to be just as important as taking a real fast blood pressure or other medical skill." For Henny, the most gratifying part of her job is "watching people grow as EMTs, to actually perform these life-saving skills and to see that they're up to the challenge--then you know you made a difference."

On the way to Dover, we lurch over a few frost heaves, and someone good-naturedly apologizes to Leon about the uncomfortable ride. "Not as smooth as my Cadillac," he says with a smile. How ironic, I think, that DAC's first ambulance 35 years ago was a hulking 1959 Cadillac wagon. At Wentworth-Douglass, Smith checks in with Leon one more time before we leave. "Thank you, for everything," Leon tells him. "It was our pleasure, sir," Smith replies. "You take care." ~

Brion O'Connor '83 is a freelance writer based in Hamilton, Mass. Names of patients have been changed to protect their privacy.