Nurses Who Rock
Volunteers form the backbone of an emergency medical system that offers an array of services to help concert- and festivalgoers keep their groove on

By Janet Wells
August 12, 2004

A young woman — face pale, eyes wide and frightened — crouched in the corner of a small side room at Shoreline Amphitheater in Mountain View, Calif. A few steps away in the concert arena, The Grateful Dead played one of their signature songs, “Uncle JohnBand,” but the woman didn’t listen to the music. She clutched a blanket with one hand as the other hand fluttered in front of her face. Her breathing was shallow and rapid.

“She’s tripping for the first time in her life,” said Michele Ferreira, RN, a volunteer with Rock Medicine, a nonprofit group that provides medical treatment at concerts in Northern California. “She did not intend to [take drugs], and she’s not comfortable with it. She’s starting to hyperventilate.”

Ferreira sat next to the woman and talked quietly, holding her hand and telling her she was safe and that the drug would eventually wear off. Apparently, Ferreira told Kathy Ferris, the head nurse on duty, the woman and her companion had inadvertently bought an LSD-laced cookie in the parking lot just before the show.

Ferris responded with a knowing smile: “Don’t buy anything in the parking lot of a Dead show, especially if it’s called a ‘Kindness Cookie.’”

Ferris, RN, should know. She has been a Rock Medicine volunteer for more than 24 years. She has attended hundreds of shows and treated thousands of concert patrons. She’s seen it all, from minor to serious: headaches, bruises, cuts, sprains, broken bones, drug and alcohol problems, insulin shock, heart palpitations, head injuries, and asthma attacks.

During the busy concert season — from April through October — Ferris volunteers to work one to three concerts a week. That’s in addition to her full-time job as the infection control coordinator for the Contra Costa Regional Medical Center and Health Centers.

“Rock Med gives me a great chance to combine my two passions: nursing and music,” said Ferris, wearing a vibrant purple and blue tie-dye Rock Medicine T-shirt. Dozens of concert tour pins adorned her ID lanyard.

“It’s a chance to do patient care again. And for many of us volunteers who have been around a long time, it’s a chance to see your friends. And you have patients come to see you because you helped them in the past.”

Fortunate fans

Mass gatherings — whether it’s a four-hour rock concert or a weeklong festival in the Nevada desert — are, in effect, temporary cities. At these events, volunteer nurses like Ferris and Ferreira form the backbone of an emergency medical system that cares for participants.

Although most large music and sports venues in the country provide some level of first aid, the majority don’t have the staffing or resources to do anything but “rack and roll” — stabilize patients long enough to send them by ambulance to the hospital. That can mean, at the least, a ruined evening — and at worst, big medical bills and run-ins with the police if a patient’s condition is drug-related.

“Our goal is to take care of the patient right here, right now and avoid getting them into trouble with the law,” Ferris said.

Northern California concert patrons may not know how lucky they are. Few other programs in the country provide medical care at large events, and none come close to offering such a broad spectrum of services for about 2,000 people at nearly 200 events a year.

Rock Med started in 1973 when Bill Graham, the late concert promoter, asked the Haight Ashbury Free Clinic in San Francisco to staff a tent at Grateful Dead and Led Zeppelin concerts. Still an arm of the clinic, Rock Med evolved into a mobile triage program with a full array of medical personnel — including more than 100 volunteer nurses.

At each show, Rock Med sets up a triage area — at Shoreline, a cluster of three small rooms for intake, treatment and recovery. Close by is Rock Med’s famous tie-dye-festooned “space tent,” where nurses and counselors trained in psychiatric care “talk down” patrons who have an adverse drug response. More than 100,000 concertgoers a year stop by Rock Med’s “convenience items” table and help themselves to free aspirin, Advil, Band-Aids, tampons, Maalox, condoms, Sudafed, Jolly Rancher candy, and the ever-popular earplugs.

Many patients end up at Rock Med because of drug- and alcohol-related illness or injury: vomiting, dehydration, cuts, and bruises from fights or falling down. “Alcohol is involved in more stupid behavior than anything else,” Ferris said, “because it is legal and sold at the venues.”

But there are many other factors that come into play: musculoskeletal injuries from “mosh” dancing in front of the stage, claustrophobia from crowd syndrome, diabetics who want to inject insulin in private, disabled patrons who need assistance and public health issues.

“If it’s a camping show, there might be dog bites, lice, scabies,” Ferris said. She added that Rock Med volunteers have delivered babies at shows and even treated a few animals: an iguana, a horse, a dog that was dosed with LSD.

Other than a Rock Med T-shirt and the occasional post-show beer, Ferris and her colleagues receive no payment for their time. Although most volunteers are ardent music fans, as nurses they are often so busy that they don’t see or hear any of the show.

“If you thought you were going to be backstage seeing the stars, no. You’re taking care of patrons. It can be amusing at times, but it’s not glamorous,” Ferris said.

But volunteers are appreciated. A middle-aged woman in a pink satin beaded cape and rhinestone tiara thanked Rock Med staff at Shoreline for caring for a friend of hers last year. In a letter posted on Rock Med’s website, a fan named Barbara couldn’t “thank your team enough for their patience, understanding and caring” in treating a diabetic friend. “Because of your staff,” the letter continued, “they saved my friend and we were able to enjoy the day.”

Desert oasis

Helping people is what motivates Seth Schrenzel, LVN, to volunteer each year at the Burning Man festival in Nevada. “I really find fulfillment in being available to people who could use my help and who otherwise could suffer serious consequences,” said Schrenzel, who works in the urgent care clinic at Kaiser South San Francisco.

Set in the isolated and treeless Black Rock Desert 100 miles northeast of Reno, Burning Man draws more than 30,000 participants for a weeklong cornucopia of art, music, performance, and radical self-expression.

Temperatures that are well above 100 degrees during the day can plummet below 40 degrees at night, and winds can whip the desert’s fine dust, reducing visibility to zero. The participants are in wild costumes — or nothing at all, depending on the mood and weather. The event culminates with a mesmerizing display of fire dancing and the torching of a 60-foot-tall wooden man.

Dozens of volunteers

It’s an “anything goes” kind of event, but the organizers are anything but cavalier when it comes to health and safety. The fire and medical branches of Burning Man’s emergency services are staffed by dozens of volunteer professionals, with response coordinated through a centralized radio dispatch center.

Kate Gonnella, RN, a charge nurse in the ER at Kaiser Medical Center in Santa Rosa, Calif., first volunteered to work at Burning Man three years ago.

“The first time you go, there are no words to describe the scene. My jaw was at my knee. But as a nurse, when stuff is going down, you’re not really thinking about whether someone has clothes on or why their skin is dyed blue. You’re thinking, ‘Are they breathing? What’s their heart rate? Why are they so pale?’ Your clinical skills come roaring out.”

Basic care

Because medical personnel must be licensed in Nevada to perform advanced life support, volunteer nurses such as Gonnella stick to providing basic care.

Burning Man provides a higher level of on-site care by contracting with the Regional Emergency Medical Services Authority, Reno’s 911 services provider.

With 80 nurses, EMTs, and physicians staffing the medical tent and trailer, as well as ambulance and helicopter transport on standby, “REMSA creates an entire EMS system in the middle of the desert,” said Alan Dobrowolski, RN, the authority’s clinical director.

The most common complaints include soft-tissue injuries — often from banging toes or shins against exposed rebar, dehydration, eye problems, cracked skin, and blisters, as well as strains and sprains.

Last year, in addition to the 2,011 patient visits to REMSA’s site, there were several serious injuries — including five people critically injured in two plane crashes — and a woman who died in a car-related accident.

Although REMSA passes transport and hospital costs on to the patients, Burning Man participants receive free treatment on-site as part of the $200 ticket price.

“One of our jokes is that we save a lot of time because people come in skimpily dressed,” Dobrowolski said. “So you don’t have to ask them to get undressed.”

REMSA staffers are paid minimum wage when they are on duty, as well as free entry to the event. Dobrowolski, who first worked at Burning Man in 1997, said he looks forward to the event every year.