Relationships and Trust
Locals create a community-based and community-run EMS service to fill in gaps
It’s early, but a small group of men and women is gathered on the hot sidewalk outside the Roswell Salvation Army, hugging close to the building’s wall, standing in its small strip of shade. The sun has only been up for two hours, but it's already hot as Hades. Breakfast will be served soon, and the smell of pancakes and grease is moving past us on the dry, desert wind.
I ask around: Has anyone seen Michaela? I haven’t met her, just exchanged texts, so I can’t describe her. People murmur, some shake their heads. But when I do find Michaela Merz sitting at a folding table in the dining room at breakfast, all those same people know her and greet her. “Some people here call me Doc,” she explains as to why they may not know her name. “Or maybe the Toughest Bitch in Town.”
She has a serious face, but she cracks a slight smile.
A man leads the room in a prayer, and the food is served: juices, coffee, pancakes, and some sausage. Some people sit at big round tables chatting and catching up; one man slips bits of bacon to his dog under his seat. Others come and go quickly, silently eating their pancakes and then slipping back into the New Mexico sun.
All the while, Michaela sits attentively at her table in the corner, a large emergency medical supply bag next to her. I can tell she is being careful not to be intrusive, just present. She nods at an older gentleman, moving slowly with a cane. He nods back. She notices a young woman walking slowly, perhaps in pain, and makes eye contact.
Michaela is wearing a dark blue collared shirt that reads “Pecos Valley Public Services” and cargo pants. And that’s why I’ve come to find her today. She’s behind an all-volunteer, community-led EMS service– the first in New Mexico– that embeds itself in the community to provide free medical support to local residents.
When getting their provisional license to operate last fall, Michaela found that the service she wanted to build was foreign, alien even, to the established ways of providing medical care. It was so out-of-the-box that it was almost unclassifiable.
“When I went to register Pecos Valley as an EMS, they asked me, ‘Are you with the city or the state?’ And I said ‘Neither!’ ‘Ah,’ they said, ‘so you are for-profit?’ No– we aren’t making a profit.’ ‘Oh, so you will do Medicaid? And I said, no, just free.”
Her eyes scan the room, the way a lifeguard checks a pool. “What we want to do is simple: Be here in case someone needs us.”
Five years ago, Michaela and her husband relocated to the Pecos Valley area from Texas. They have a motorhome and spend a month at a time in the desert with their rig running off solar power. “The desert is beautiful, but a dangerous place—people get lost out here.” Wanting to give back to their fellow RVers, Michaela and her husband joined a Search and Rescue team.
An engineer by trade, Search and Rescue was new to Michaela. “I was overweight– when you do computer work it's a lot of pizza and coffee– so I failed pretty badly on my first mission,” she admits. But she threw herself into it, started hiking and getting fit. Soon, she was not only mission-ready but was begging for even more training. “I wanted to do things right, I took it very seriously.”
It is clear to me that Michaela does not goof off.
Soon, Michaela, her husband, and other volunteers started their own search and rescue team so that they could train more. Every call they got, they went out. “We were doing rescues all over New Mexico– sometimes driving three hours to go help find someone who wandered off a trail,” explains Michaela. “It’s hot here: People were dehydrated, people had sunstroke, sometimes people had been drinking. But we try to find them.”
Search and Rescue was rewarding, but Michaela noticed something when she would return from wilderness rescues and head back into town: People weren’t just lost in the desert, they were lost everywhere.
Maybe they weren’t lost somewhere remote, but certainly people were pushed to the curb. “When you are poor or marginalized, you are vulnerable. So things like heat, lack of water, the elements are more dangerous to you,” she explains. In short, Micheala saw the need for the basic assistance she had learned through Search and Rescue to be applied everywhere. “We could travel across the state to rescue someone out of the desert, but we could also do that here,” she explains, gesturing to the pancake breakfast we are sitting in. Why not invest their resources in their own community?
Micheala also saw a real gap in the medical services available to residents, not just in Pecos Valley, but everywhere in the United States.
“What we have seen over the last ten years is what I call ‘the industrialization of healthcare,’” Michaela explains. “The old relationship between you and your physician or primary care doctor– that doesn’t exist anymore. You now go to a doctor company if you have something… and you go one time and get this guy, another time and get another guy. The doctor will see you for ten minutes and then say ‘hasta la vista!’ and they won’t even remember you.”
As a result, says Michaela, patients don’t have anyone to call or talk to when they have a question or are concerned about their health, so they call 911. “People see 911 as their primary care option, which doesn’t work for the traditional EMS environment, and it doesn’t work for the patients either. It’s also the most expensive medical care a community can provide.”
Michaela imagined something new, something that could help an overburdened medical system that was also letting people down. What if there were a way to take the pressure off that system and meet people where they are? Something, as she describes it, that could “be in the middle.”
Today, Pecos Valley Public Services is all over town. Michaela has outfitted a red Jeep 4x4 with a green light on top and purchased a second-hand emergency response vehicle. Trained volunteers provide standby services at community events, such as carnivals and fairs, to treat twisted ankles, cuts, and heat exhaustion. They also attend places where the most vulnerable residents congregate, including the biweekly Food Not Bombs meal downtown and here, at the Salvation Army. Michaela and her volunteers also go out to homeless encampments, bringing hot coffee or cold drinks, to check on people living in tents or substandard housing.
In these places, Michaela is trying to make her face known and familiar. “I want people to know who we are and to trust us, to come ask us a question – maybe their heart has been racing or their wrist has been aching. We can talk it through with them, give them some ice, ask them to lay down.” The project is designed to be low-barrier – just call their phone number and ask them to come out – and for low-acuity situations. “Many of the calls are for mental health,” she explains.
“We aren’t trying to be the heroes. We are trying to be practical. We already have 911 and the EMS dispatch– they are really good guys. But we realize that the vast majority of their calls are basic medical needs– what if we can fill that with volunteers? We don’t want to run the red lights and respond to car crashes– that's what the traditional first responders are great for. We want to do the slower stuff; to create an environment that is approachable and respectful.”
Michaela tells me about one gentleman she knows who is mostly homebound without transportation. He had been calling 911 once a week to have EMS bring him his necessary medical supplies or to get a ride to the emergency room to get them. Today, Pecos Valley volunteers bring him what he needs and check in on him while they are there. “Now he asks us questions and we tell him what we know, and if it's a bigger thing we say: ‘Okay, we should call 911 about that.’”
Michaela pauses, and her eyes scan the room one more time. She nods at a couple leaving the Salvation Army breakfast, and they give her a small wave.
“Relationships,” she says, again. “The old-fashioned way.”
Creating this new way was not easy. At first, Michaela started working as a street outreach volunteer but was told she couldn’t provide medical services because she wasn’t licensed. “Okay, I’ll go to back to school,” she said.
She began studying and tried to enroll in a college program. The problem was her college degree is from Germany, and New Mexico wouldn’t accept a scan of it (and her college couldn’t find the original certificate from the 1980s). So, Michaela – a college graduate in her fifties- enrolled to get a GED. “Luckily, I’m pretty interested in US history,” she laughs.
Once she got her GED, she pursued the EMT classes, got her certifications and licenses, and then dove headfirst into the paperwork of registering Pecos Valley as a licensed EMS agency. The existing systems didn't know how to handle her idea.
“It was one thing after another. Everything was zig-zag. I would send emails and get no response. I made phone calls, and no one could answer my questions. We didn’t have a lawyer. Before this we weren’t even medical professionals! We had to build this as we went. We had to force this thing through.”
But she’s a dog to a bone; tenacious. The final certification came through eight weeks ago, and here she is, ready to respond.
“Flashing Green, We’re On the Scene” is the slogan emblazoned across the Pecos Valley Public Services brochure. They run a green light on top of their vehicles. You can call their phone number and ask them to come out, or you can request help or ask a question on their website.
“It’s all free,” says Michaela. “We need people to know that. No one should be worried that they’re going to get some big fee because they were feeling sick or scared.”
Pecos Valley Public Services has Red Cross and American Heart Association-certified CPR/AED instructors, as well as Stop the Bleed instructors certified by the American College of Surgeons. They provide these trainings to anyone interested, and Pecos Valley volunteers undergo all this training before they can work with Micheala to be dispatched or perform standby work.
The volunteer aspect of the project is important to Michaela. At the Salvation Army breakfast, she introduces me to David, a former US infantry squad commander who describes himself as a “boots on the ground” guy. He’s getting the training and will help provide services throughout Roswell with Pecos Valley. Michaela frames the volunteer nature as necessary to keep things free and bring down astronomical healthcare costs in an upside-down medical system, but David frames it differently. Like others at this Sunday breakfast, he is unhoused. “I know the streets,” he says. “I know the people here.”
In other words, people like David already have trust and recognition locally and is perfectly situated to reach those in the most need. He works at the local McDonalds and grew up here. “People respect and trust me in a way they don’t trust, say, the police. They can come to me.”
Later in the morning, I witnessed this. As David and I are talking on the sidewalk, a woman with a bruised face approaches him. Her jaw is cracked from having been punched, and she is having trouble eating. He encourages her to get antibiotics, warning her about the risk of infection.
“Listen,” says Micheala, in her stern but warm way. “I’m not a Leftie or something like that. I’m not saying “oh, these poor people.” I believe in tough love. Sure, you should meet people where they are, but you can only offer what you can offer. We offer certain medical services.”
She scans the room again. She mentions a man who may have sniffed glue before coming and that she may need to check in on him. “I’m just practical about this work,” she says. “And abandoning people is the worst thing, from a practical standpoint, that we could do.”
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