24 hours in the heart of a crisis
This is what a shift entails for firefighters of skid row’s Station No. 9, where safeguarding L.A.’s most vulnerable can be a Sisyphean task
Aman in tan cargo shorts is lying on the pavement, turning gray with his shirt pulled up to his chest. An ambulance from Los Angeles Fire Department Station No. 9 shoots down an alley and comes to a stop. Firefighters Brian George and Nicolas Calkins pop out and grab an assortment of medical gear.
“It’s probably heroin, dude,” George says to Calkins, even before kneeling. They get to work. “He’s breathing,” Calkins says. “Narcan?” “Yeah. I think heroin.” George checks the man’s pulse while Calkins looks for a vein. The man is not breathing well. They inject naloxone, often referred to by the brand name Narcan, into his neck to counteract the overdose. It doesn’t work.
George, Calkins and their colleagues respond to thousands of calls like this every month while working at one of the busiest fire stations in the nation, in the heart of one of the most troubled places in Los Angeles: skid row. They are the unlikely rank and file on the front lines of California’s escalating homelessness crisis.
The roughly 60 firefighters at Station No. 9 regularly respond to everything from epileptic seizures and overdoses to stalled elevators and full-fledged fires, crisscrossing a district defined by extreme poverty and powerlessness alongside extreme wealth and
power in downtown L.A. With residents who are often victims of crime, crippled by addiction and psychiatric disorders from years of living on the street, the firefighters do the best they can with the little they have to offer. Yet the needs are overwhelming.
In 2019 alone, Station No. 9 logged nearly 22,800 emergency calls across just 1.28 square miles — about 7,500 more than the city’s next-busiest station.
Taking care of L.A.’s most vulnerable residents has given these firefighters a unique perspective on the homelessness crisis. Most are empathetic. Some feel isolated or frustrated about the city’s inability to fix what’s happening outside their front door. But rather than dwell on those larger forces or their feelings about it all, they train constantly and joke around with a camaraderie shaped by their shared commitment to one of the city’s most intense jobs.
“We see things that people never see in their lifetimes — we’ll see multiple times in one day,” said Ian Soriano, a firefighter and apparatus operator at Station No. 9.
This is 24 hours at a skid row fire station.
5:30 a.m.: Fire Station No. 9
Just before sunrise that day, Dan Martinez pulled his Audi A4 onto the sidewalk outside Station No. 9 at 7th and San Julian streets.
The area around the station is abuzz for so much of the day. But at 5:30 a.m., when the C shift arrives, it’s quiet. Martinez, who planned to work 48 hours straight, was the first to show up.
A few minutes later, Jacob Gibson, an attendant on one of the station’s ambulances, came in and started prepping a meal for the 19 firefighters on duty. Tall with curly red hair and a round face, the second-generation firefighter joked about what he thought was the hardest part of his job.
“Cooking for this many people is a pain in the ass,” he said.
Gibson began to cut peppers and whisk eggs as the shift change kicked into high gear. Members of the B shift ambled down from their quarters as members of the C shift lined up their cars in the parking lot next door and waited to cram them behind the station.
5:39 a.m.: Outside the station
An elderly homeless man walks by wearing a faded gray sweatshirt. He stops and turns toward a firefighter.
“My flesh is on fire,” he says. “Put me out.”
“You’re not on fire,” Capt. Branden Silverman responds.
The man keeps walking.
Most of C shift is in the station by 6:30 a.m., but if firefighters don’t arrive even earlier, by 5:45 a.m., others will give them hell. Each member has a job to do. In the morning, they check the gear they’ll be using that day, and situate their pants and boots near the firetruck they’ll be riding in, so they can move quickly when a call comes in.
7:35 a.m.: 632 St. Vincent Court
The man in tan cargo shorts is lying on the pavement, his skin gray.
Calkins, trying to reverse the effects of a heroin overdose, finally finds another vein in the man’s arm and asks for another dose of naloxone. “If you do it, just go half,” George says. George rubs the man’s chest and pulls him by his pants onto a gurney. Soon afterward, the man is alert in the ambulance and on his way to an emergency room.
Station No. 9 responds to more medical calls like this than any other fire station in the city, according to the LAFD.
Over nearly two years beginning in 2018, almost 14% of the people that the LAFD took to emergency rooms citywide were homeless. That works out to roughly 81 homeless people a day. For Station No. 9, that ratio was 59%, or about 12 homeless people being brought to the ER every day.
Sometimes firefighters administer naloxone by intraosseous infusion, in which a hole is drilled just below the knee and the drug is injected directly into the patient’s bone marrow. This is the quickest way to bring someone back from an overdose. There’s a futility in this ritual, though. On skid row, these firefighters have watched homelessness grow, with the citywide population topping 36,000 as of last year. They’ve seen drug addiction rob many of those same people of their health, making it harder to achieve a stable future away from the street. Yet all George or Calkins or anyone else at Station No. 9 can really do is take them to the emergency room.
Firefighters say they’ve noticed that overdoses often occur when a person with a history of drug addiction gets out of prison or jail and thinks he or she has the same tolerance for heroin as in the past.
“You think your body is used to it,” George said. “You OD a lot quicker.”
In an effort to reduce the workload, the LAFD recently launched its Sober Unit to transport intoxicated people to a center on skid row. Also, a modified wildland firefighting truck known as a “fast-response vehicle,” or FRV, now prowls downtown responding to calls.
The department has heavily publicized these pilot programs. The problem is neither operates on weekends.
“They really push the FRV units,” Capt. Raymond Robles said, “but we’re here every day.”
8:15 a.m.: Back at home base
By 8:15 a.m., the C shift had received 10 calls for help. In the previous 30 minutes, there had been five, nearly all of them on