The emergency alarm went off just before sundown. For the oilfield medics of Loving County, Texas, that sound means your world is about to get a shot of adrenaline. One minute you might be lounging on the couch with the guys on call, watching Lethal Weapon 4, nursing a post-brisket food baby, and the next you’re in the back of an ambulance, watching a ribbon of West Texas highway unspool behind you, cursing yourself for not using the restroom before hustling out of the clinic. Which is exactly where I found myself one stormy Friday evening last July.
An emergency medical technician named Justin Esthay was behind the wheel. Beside him, Anthony Luk, a paramedic trained for more-complex procedures, radioed to dispatch for directions. We were speeding toward a fire in a far-flung corner of the Permian Basin oil patch. Lightning had ignited a tank of crude, and a nearby drilling crew had called in the blaze. Several days of heavy rain had transformed the dry arroyos and bar ditches into churning rivers. A wind shear had blown through a few nights before and razed two dozen telephone poles like a sickle moving through hay. Line crews had worked day and night to restore power and clean up the mess. Now the roads, already in bad shape, were washing away into the muddy desert.
The ambulance we were in belonged to Occupational Health and Safety International (OHSI), a company based in the Houston area that operates a scrappy medical network in this sparsely populated part of the patch, including the clinic we had just come from, near Mentone, about one hundred miles west of Midland. The medics and EMTs who work there treat everyone from oilfield workers with critical injuries to cowboys with broken bones to old-timers with indigestion. They also run Loving County’s ambulance service. If you’re sideswiped by a sand hauler or T-boned by a welder on one of the region’s few blacktop roads—one of which is known as “Death Highway” because of its lethal oilfield traffic—the members of an OHSI crew are your best shot at making it to a hospital alive. But first they have to make it to the scene alive. On this call, I wasn’t sure we would.
We were barreling north on County Road 300 when the driver’s side tire sank into a crater. The ambulance lurched to one side, and we skidded to a halt. Behind us, the lights of a semi grew closer and closer. The driver managed to stop before slamming into us, but just barely. A little farther down the road, we passed another ambulance. It was hobbled on the shoulder with a blown tire and twisted rim. That crew, hailing from another OHSI clinic in nearby Culberson County, had been the first to respond to the alarm. But they’d been less lucky with that pothole.
We finally turned off the asphalt and drove for another half hour down mud-choked caliche roads. At 10 p.m., just over an hour after the call came in, we arrived on the scene. Legs numb, I stumbled out and looked around. The drilling crew, smoking and chatting in dirty coveralls, was huddled around their company pickup waiting for the all clear to return to the rig. The only signs of fire were flares burning natural gas and the glow of the roughnecks’ cigarettes.
There was no sign of a proper fire engine either. Just an ancient, battered brush truck with “Balmorhea Volunteer Fire Dept.” on the side. We shook hands with two dudes leaning against the vehicle who were dressed more like farmers than firefighters. They’d come about a hundred miles from Balmorhea. Other departments nearer to the fire had refused to make the trip, unwilling to risk the flooded low-water crossings. Between thick streams of tobacco juice, the men told us the blaze had nearly burned itself out by the time they got there. A good thing, considering they had little more than a couple hundred gallons of water and some shovels on their truck. The oil company had asked them to stick around until a drone equipped with a thermal camera flew over the area to look for hot spots. Having already made the trek, we were asked to stay as well.
Even though I had worked as a roughneck for a short stint after college, this was the most remote and isolated place I’d ever been in the patch. There was no cell service. It was pitch black save for our headlights, a few flares, and the glowing pillars of drilling rigs scattered across the dark desert floor.
It was early summer, and I was nearing the end of the second week of three that I spent in Mentone, embedded with the medics of Loving County. I knew that this was where we’d be spending the rest of our Friday night. I’d been on several ambulance runs at this point and had learned that out here a single call could last 12 hours. The previous weekend, Anthony had rushed two gunshot victims, one of whom had brain trauma, from the town of Pecos to two different hospitals, hours apart, in Lubbock and Midland. He’d left the clinic at 2 a.m. and hadn’t returned until 4:30 p.m. the next day.
This call was a cinch in comparison. I’d already been around long enough to appreciate our good fortune. Because, when the emergency alarm rings, disasters far worse than snuffed-out fires often await the crews at OHSI.
At last, after two and a half hours, a rep from the oil company confirmed that the drone had detected no heat. As members of the drilling crew piled into their truck to head back to the rig, one of them, as if acting in some oilfield drama, hollered, “Let’s make some hole!”
As we loaded back into the ambulance, it occurred to me that the OHSI crews weren’t so different from the oil and gas workers they were here to help. The hard living, the time away from family, the macho culture, the insider lingo, the physicality of the job. Those who work in emergency medical services are essentially the roughnecks of health care. Although their job requires a high level of skill and knowledge, compared with other health care gigs it is undeniably blue-collar and often treated as less than. But at least roughnecks are paid well, with many banking at least $75,000 a year. The same can’t be said of EMS workers, who on average make less than half that. And yet here they were, EMTs and medics, proving their guts and grit in the heart of nowhere, their work known only to each other—and the people they save.