Greg Carter didn’t keep many souvenirs. But a person doesn’t work four decades on Toronto’s streets as a paramedic without accumulating a few tangible mementos.

There are citations for lives saved, lapel pins to acknowledge babies delivered, and letters from grateful patients. All tucked away somewhere, tokens of a career well served.

But there is one memory he never wanted. One he’s never been able to shake.

Each time Carter puts on a surgical mask, he breathes in the sickly scent of charred flesh.

That triggered flashback dates to when Carter, who just retired at 60, was a teenaged student taking the ambulance course and doing clinical work at East General (now Michael Garron) Hospital.

On his first day, he was asked to helped treat the survivor of a car fire; a man who decided to wash the vehicle’s engine with gasoline. The motor was hot enough to ignite the gas, and he suffered third-degree burns to 70 per cent of his body.

“He was one of the worst burns that Toronto East General treated who lived and went home,” recalls Carter, who became part of the team administering follow-up care. The threat of infection meant anyone near the patient had to wear gloves and masks.

“He was burnt to the point that he didn’t even have any pain; his nerve endings were burnt. The only thing he really felt was hot and cold. They were treating him with a method where they would put cream on him and then once a day, they would put him in a bath and scuff off the cream and the dead skin. The water had to be so hot that you could hardly put your hands in, and he still felt cold in the water.

“If I was to put a mask on right now, I could smell him. But it was tremendous to see he went home.”

It was a grim introduction to the harsh realities of medical care but also a hopeful reminder of its potential to heal. For more than 40 years Carter would help countless others who were injured or sick to go home as well.

Through that time, Carter observed Toronto from a perspective few see while in a profession that evolved from ambulance driver attendant in what was mostly a transportation service in the early 1980s to being a paramedic in modern ambulances that are equipped with life-saving medications, monitors and equipment. Carter didn’t even have a defibrillator in those early days to assist someone suffering cardiac arrest. Back then, it was just about getting a patient under a blanket, onto a stretcher and to the hospital, perhaps providing oxygen if needed.

“Basically, we did CPR,” he says. “Now, it’s more like taking the ER to the house or to the highway or wherever it needs to be.”

As he heads into retirement, Carter reflected on what it’s like to spend a working life racing towards human suffering in a career that ended in a most humane way; a final shift during which he, in Gordie Howe-like fashion, rode with his two sons who followed in his footsteps as Toronto paramedics.

All those chats around the dinner table shaped the children in the image of their parents. The boys, Andrew and Scott, are riding in ambulances while daughter Shannan is a nurse, like her mother Mary Lynn. Together, they are sort of a first family of health care.

“Everybody in the family has a really strong stomach,” says 25-year-old Andrew, who has been a paramedic for almost four years.

“We’d hear lots of funny stories that usually ended up having to do with bodily fluids, the stuff you’d expect would be funny for a kid. That kind of stuff never bothered us at all.”

Carter, a soft-spoken man who exudes calm, started his career by taking the one-year ambulance and emergency care course at Centennial College after an older friend, already working in the field, recounted how he’d helped deliver a baby.

“I thought, ‘That’s crazy,’ ” the Scarborough native recalls. Carter also thought he’d like to help people in the same way.

That altruism, he believes, was ingrained in him growing up as the only child of two blind parents who had a peer group made up mostly of people who were also visually impaired. Carter’s dad lost his vision through malnutrition as a prisoner during the Second World War while his mother was blinded as a teenager by a brain abscess.

“It’s not that they needed my help. My parents were self-sufficient, but being around people (with disabilities) probably led me to where I worked in an ambulance,” he says.

Upon graduation in 1979, Carter worked briefly in Cobourg, Ont., where his first call was to a construction site. A man in his early 20s was knocked over by a backhoe, fracturing his femur.

“A long bone fracture can be very serious,” he says. You can bleed out and the chance of infection is very great.”

“I was shaking in my boots. Here was this young, healthy kid in a lot of pain and we had no pain medication whatsoever back then. Luckily I had my partner to rely on. We splinted him up and took him to Cobourg General. I was very anxious and very, very excited. It was a fairly big call for me.”

Another Cobourg incident that is stuck in Carter’s memory was from a Christmas Eve head-on car crash on Highway 28. The collision resulted in two deaths but the image that lingers in his mind is of a frozen turkey lying on the highway; the occupants of one of the cars were on the way home from shopping for Christmas dinner. That and the visual, humorous under other circumstances, of an off-duty OPP officer dressed as Santa directing traffic, interrupting a celebration of his own to help at the scene.

With a job opening in Toronto, Carter moved home to work the west side in 1980 and almost immediately spent a summer night helping at a nursing home fire in Mississauga. Twenty-one people died in that horrible scene. Many of the victims were bedridden, unable to do anything but cry for help before dying. Another 177 were rescued, 35 of them going to hospital.

Carter helped with the evacuation, racing residents on stretchers across the road to the emergency department at Mississauga Hospital. It was quicker than loading them into an ambulance.

“It was amazing. That’s what you were trained for and lived to do. I mean, I was really caught up in it,” says Carter, who believes he transported 10 to 20 seniors that night.

“It’s kind of weird but I think we all have it. When you get the big call, you get that adrenaline rush and it’s exciting. You do a lot of calls that are repetitive and you don’t remember those. But this was definitely an eye-opener with me being new to the big city.”

The reality of the job sank in even more when Carter then helped transfer the bodies of the deceased to a makeshift morgue at an arena.

Rather than be haunted by the death and injury he has witnessed, Carter says he is aided by an attitude that others describe as optimistic, good-humoured and unflappable. He’s also been married to Mary Lynn for almost 30 years. She has spent most of her soon-to-be 40 years as a nurse in a hospital emergency department. So neither lacks for someone with whom to commiserate.

Carter says he’s also had a supportive working relationship with his ambulance partners including one, Jacques Hins, who he worked with for more than a dozen years.

He says he has never suffered from PTSD.

“I’m one of the lucky ones,” says Carter, who retired as a Level 2. Levels one through three indicate additional hours of training and skill sets.

“Everyone reacts to other people’s trauma in different ways,” he says. “How you view something and how I view something is totally different and how we react is totally different. I’ve been fortunate I haven’t reacted that way.”

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There are, however, “very tough” calls that clearly hit him hard. He remembers assisting a young woman who didn’t realize she was pregnant delivering a set of very premature twins. Both died.

“The mother was bleeding very heavily, and that was a life we could save and we did,” he says.

On another call, Carter and his partner encountered a distressed male in need of psychiatric care on the 21st floor of an apartment building. As they spoke to the man, he bolted down the hallway and into an open apartment. Carter followed, arriving just in time to see the man’s feet disappearing out a window. He says it was horrifying.

Shifts aren’t always that stressful, he says. The job also has its share of mundane moments including offloading delays that could take hours as hospitals try to find appropriate beds for arriving patients.

“But I think we’re really making an impact on someone’s life every time we do a call,” he says. “It could be something as simple as an elderly patient who has fallen, fractured her hip and is in pain. It doesn’t have to be a life-saving situation every time.”

But some are certainly dramatic. Such as the senior who was hit and pinned by a streetcar. Carter crawled under the trolley and spent more than 20 minutes calming the woman and starting an IV until equipment arrived to lift the streetcar.

Or the time Carter and his partner raced through a back laneway to a “baby-not-breathing” call only to be intercepted at the last moment by two police cadets. The cadets waved down the ambulance to say it wasn’t an infant in distress at all. Instead, at the top of the stairs that the paramedics had planned to charge up was a man with a shotgun, waiting to take out any first responders.

Carter worked through the SARS outbreak in 2003, a time when several health care workers contracted the sometimes fatal respiratory illness. While he didn’t get sick, he remembers living with “the fear of the unknown because nobody knew what it was all about or how it was passed on.”

He believes paramedics now are better prepared for coronavirus because calls are prescreened better and there is improved personal protective equipment for them including fitted masks, gloves and gowns. Plus, history has made everyone more diligent.

Imagine any situation in which people do each other or themselves harm and Carter has probably encountered it. Especially, he notes, in a city that’s become “more of a dangerous place in some ways,” where there are more gangs and drugs, and more confrontations that involve guns.

“When I first started on the job, part of the thrill was doing these calls like a bad accident that, to somebody else, is terrible. (But) we live for stuff like that. Because it wasn’t like “Emergency” on TV; those things didn’t happen all the time,” he says.

“When they did, it was an exciting part of the job. To go to a shooting or stabbing or a subway jumper, whatever it was, and I’ve had them all. But you know, after 40 years, I don’t want to see any more.”

Despite the results of violence that he has seen, and seeing people in the city at their most vulnerable, Carter still calls Toronto “a place I would want to live.”

“Overall, people care about their neighbourhoods, they care about their neighbours, they care about the kids in the neighbourhood and they care about their families growing up in a safe place and, for the most part, Toronto provides that.”

While Carter expresses surprise that his sons Scott and Andrew opted for the same career, he probably should have seen it coming. Of course, there was all that shop talk at home, says Andrew, about “all the crazy things that can happen to people and they pull through.”

But also, having a paramedic dad brought a certain prestige, especially when he’d swing by with the ambulance, sometimes interrupting a road hockey game, to let them look inside.

“I just felt like the cool kid on the street with the cool dad with the cool job,” says Andrew.

Scott, 28 and a paramedic for just over five years, says it wasn’t unusual for people to drop by the house looking for medical advice or help. When he was four, he recalls running with his mother to a neighbour’s house where she helped someone having a heart attack.

“I remember riding my bike and doing all the jumps and stuff. You kind of felt a little more invincible than the next kid because you had somebody there to fix you,” says Scott.

So it was a joyous day when the proud dad and the two boys he inspired headed out together on Carter’s last day of work.

“It was the ultimate ending to my career,” says Greg.

And the last call? A woman who complained of feeling dizzy at a No Frills and collapsed. The three of them transported her to St. Joseph’s Hospital.

So it wasn’t a shooting or a stabbing or anything else to get the adrenaline pumping, but Scott says that throughout their day together, “none of us could stop smiling.”