Over the weekend, I attended a doofy and charming steamboat-centered event on the Potomac River, featuring lots of replicas of old boats faithfully built by people who seriously love old boats. There was the replica James River bateau, once used to move goods through the shallows of the central Virginia river, which must be poled slowly and painfully against the current. The boat is like an enormous, flat-bottomed canoe, and although it drafts only a few inches it is incredible stable. Unfortunately, it was also stunningly heavy when fully loaded with human cargo, and its captain had the tendency to place a long thick wooden pole in the hands of the more able-bodied passengers and allow them to provide the locomotion for the jaunt from shore. He took particular enjoyment in loading and firing a small replica cannon, which was not, I believe, typical armament for a James River bateau, but produced a noise so loud that it knocked the wind out of you at five paces.

In addition to the human-powered boats, there were several replica steamboats, small craft weighed down with what looked like a cross between a small potbellied stove and a nineteenth-century time bomb. They were not paddle-powered, but used the steam to produce a kind of jet propulsion through hollow keels. When they were being fired up they looked prone to explode any minute, expelling spouts of steam through innumerable valves, but once underway they were completely silent and quite spry on the water.

I was stepping off the floating pier for a short ride on one of the small craft when I noticed a man on board hunched over and puffing furiously. His breathing was growing shorter and more rasping, and I saw he was clutching a fistful of inhalers. Hoo boy, I thought, and sent Susan off to have someone call an ambulance. The man was barely able to get out of the boat, and sat down heavily on the pier, unable to make it to shore. He was having an asthma attack and had already gone through his inhalers with no effect.

It's funny how different this all feels from when I have a stocked and staffed ambulance with me. When I saw the man's lips beginning to turn a little blue, I started considering how I might position him on the dock if he coded, and who I might press into helping with CPR. There wasn't really anything else I could do but keep him calm and try to get a medical history in case he lost consciousness by the time more help came. I almost never get scared on an ambulance call -- things happen, you deal with them. However, this was making me pretty nervous.

Fortunately, help soon came in the form of an off-duty EMT and a former police chief, who had a small oxygen talk and a non-rebreather mask. They let me know a medic was on the way. I looked up once and saw Susan and our friend Tana standing on the bank and thought, well, it's kind of nice that Susan finally gets to see what I do all those times I leave home in my uniform.

The medic unit came, and I helped them carry the man off the pier, up the bank and on to their cot. Then I just stepped back. I thought about how I seldom spend much time focusing on the other people present at an emergency scene -- they supply crucial information, possibly a helping hand, and then they're gone. It felt odd and faintly ridiculous to be a bystander now.

The boat captain asked if we still wanted that ride. We said no, this was sufficient excitement for the day. As we were strolling out, we ran into the former police chief who'd helped out on the dock. We chatted for a while, and he promised to send me a patch from their department. Exchanging patches is a big thing among some Fire/EMS people, who build large collections of insignias from other departments around the nation. I have never done this, but a patch seemed like a fitting reminder of the event. I told him to come by and ride along if he was ever in the vicinity of my rescue squad.

I have responded to asthmatic attacks before and barely batted an eye at them. But these events left me so keyed up that I had trouble sleeping that night. It's so different when you don't have an ambulance and colleagues. You can't hide behind all the things that protect you: uniform, professional identity, jokes with fellow members, the next call. I felt fully exposed to the toxins of the world's sickness. And I felt magnificent, as if I'd been lucky enough to really do something more useful than almost anything else I've done.

I can count these moments of sudden, dizzying contact with the tragedies of strangers: 2 people pulled out of car wrecks, 1 recovery from a seizure in the middle of the street, and 1 asthma attack on a floating pier. I don't know what they add up to, but it's probably a good percentage of my good works on earth.