Driven by compassion: The unlikely heroism of TriMet's operator amid ambulance shortage

PORTLAND, Ore. (KOIN) — A TriMet bus driver had to step up as a hero in a pinch during a medical emergency on New Year’s Eve. 

“I've had other people have medical crisis on the bus. Never quite so dramatic,” TriMet Bus Operator Joseph Wiggins told KOIN 6 News. 

Wiggins explained it happened when he reached the “end of the line” of his route in the Lents neighborhood when the “last passenger” started having difficulties and asked him, “Would you please call 911 for me?”

“And so I said, 'What's the problem?' And he said, 'I'm having chest pains.'”

With no ambulances available, only Portland Fire and Rescue responded to the call in the early hours of New Year’s Eve. KOIN 6 broke the initial report of how the fire crew, with one paramedic and one emergency medical technician (EMT), made the call to use the TriMet bus to transport the patient to the hospital.

“I applaud them for thinking on their feet,” said Rob McDonald, the operations manager for American Medical Response (AMR), the ambulance service for Multnomah County. “We were really disappointed that the event had to occur. And we've said time and time again to anybody who will listen, this is a problem that can be fixed. We just need to get the permission to fix it.”

Due to a shortage of nearly 60 paramedics, McDonald advocates for temporarily allowing a switch from the two-paramedic requirement to a system of pairing one paramedic with one EMT. This is also referred to as a 1:1 system.

Multnomah County Chair Jessica Vega Pederson has been vocal against that option, though Commissioner Sharon Meieran recently vocalized her support for the idea in a KOIN 6 investigative report last week, unraveling this crisis.

"It's literally life and death every single day, every hour and the failure to act, in my view, is a moral outrage," Meieran said.

AMR says they’ve focused on actively recruiting new personnel through scholarships. Since 2021, AMR reports they've sponsored 34 scholarships, representing over $600,000 in tuition.

“While they do yield fruit...the fruit is ripe a year and a half from now. It's not something we can do today,” McDonald said.

AMR reports the ability to have half a dozen more ambulances out a night if Multnomah County leadership would allow a switch to the 1:1 system right now.

Realistically, McDonald thinks it will take two years to get back to being able to fully staff the county with dual paramedics per ambulance.

AMR reports other recent initiatives to recruit and retain staff:  

• Pay increases for current staff up to 30 percent through 2025.   
• Shift stipends for current Multnomah County employees 
• In addition to overtime pay, paramedics receive a $350 stipend per 12-hour overtime shift, EMTs receive an extra $250 per overtime shift.  
• Paramedic scholarships for existing employees. 
• Diversity scholarships which cover the cost of tuition, books and course fees for EMT and Paramedic training.  
• Relocation assistance up to $5,000 

AMR is offering paramedics straight out of school $71,000 annually with pay increases of more than $93,000 a year, in year twelve. These salaries do not include overtime earned.

Though Wiggins acknowledges the broader issue of the emergency medical system and ambulance service failing, he said the bus rescue was simply a matter of staying focused on his duty. 

“I just saw a man in trouble and did what any of the other drivers and TriMet would have done,” he said.

Memories of a similar medical situation that impacted Wiggins’ family flooded his mind from behind the wheel that night. 

“I thought of my family at the time going to the hospital for the same reason. My father was sick with a heart attack. I was the one who drove him to the hospital and it was exactly the same. He needed help and I helped him. Nothing big,” he said.

The Multnomah County Health Department released a statement over email to KOIN 6 News, via spokesperson Sarah Dean, addressing their reaction to the bus rescue amid the ongoing ambulance shortage:

AMR is the transport provider and is responsible for determining how many staff are necessary to meet their staffing needs to have ambulances on the street. You would need to contact the company to find out why no ambulance responded.

The County takes all delays in response time seriously and have been working to strengthen the system, to pilot ambulances with different staffing and ensure AMR is staffing ambulances and meeting EMS benchmarks. 

While we can’t comment on the specifics of the case due to patient privacy, we can tell you that Portland Fire and Rescue was innovative in this situation and medically-trained staff accompanied the patient the whole time they were transported and the patient got safely to the hospital.

Portland Fire, Gresham Fire, Port of Portland, Corbett and Sauvie Island Fire all provide medical first response. Our partners at the fire departments are a valuable piece of the EMS system and we are grateful for all of these groups, who are working long and hard shifts without full staffing.