BURNSVILLE, N.C. — In this remote corner of western North Carolina, some of the people whom paramedics Evan Carroll and Nicole McKinney serve don’t have cellphone service, and bridges that once took the two to isolated homes deep in the mountains were washed away by Hurricane Helene. And instead of simply responding to emergencies, Carroll and McKinney make old-fashioned medical house calls for nonurgent care. They help elderly patients monitor their high blood pressure and other chronic conditions. They advise people on what they should be eating, even dropping off meals and produce. They set up transportation and help make sure people are following doctors’ orders.
As Yancey County community paramedics, they are some of the area’s most important health care providers.
On a recent morning, Carroll and McKinney loaded up their SUV and stopped by the farmers market to pick up bags of fruits and vegetables before heading out on their rounds.
One of the first stops was with 79-year-old Calvin Peterson and his wife, Shirley, who relies on oxygen for her COPD. Helene washed away the bridge to their home last year, turning what should have been a short trip into a three-hour journey. After arriving at the house, Carroll changed the filter on Shirley’s oxygen machine while McKinney checked Calvin’s blood pressure. They chatted about the crops and asked after each other’s families.
Carroll and McKinney serve as responders, care coordinators, social workers and trusted neighbors, making sure people get the help they need before an emergency arises. They see up to 120 patients a month, most of them previously “frequent fliers” in the emergency room, as part of a program aimed at reducing unnecessary hospitalizations. The Community Paramedic program in Yancey County is part of a nationwide effort to reduce nonemergency calls that emergency medics respond to and to close health care gaps.
The Petersons enrolled in the program because emergency medics would often get called to the home, only to find that Shirley wasn’t using the prescribed oxygen therapy required for her condition.
At the next stop, Carroll and McKinney visited Wanda Higgins, who is in her 70s and lives with kidney failure, congestive heart failure, mobility issues and COPD. Cut off from the world for months after Helene hit, and without a phone, Higgins greets the paramedics like family. They check her vitals, the swelling in her legs and catch up on each other’s lives. Later, Carroll shared that his mother used to play softball with Higgins.
Later, they met Phil Hoover, a 57-year-old veteran recovering from a stroke. He was referred to the Community Paramedic program by Yancey County’s Department of Social Services. His home was destroyed by Helene, and he now lives temporarily in a mobile home while waiting for a new manufactured home to be set on his land. Carroll put a cold compress on Hoover’s recently twisted ankle. Carroll later helped to check the home’s electrical hookups to make sure they would be ready when the new housing arrived.
When Helene devastated the county last year, Carroll and McKinney loaded up their personal side-by-sides (small off-road vehicles) to reach cutoff residents. The medics crossed rivers, freezing in the mountain air, and got coated in dust from shattered roads. They both developed respiratory illnesses from breathing in all the dust.
After the hurricane, they returned to work, helping people navigate medical appointments, follow preventive care and manage chronic conditions.
Between blood pressure checks and oxygen readings, much of what Carroll and McKinney do is simply talk and show compassion. Their patients light up with the news of a visit. Sometimes the visits feel like social calls, the kind that keep loneliness at bay in a county where the nearest doctor might be hours away. Between calls on this particular Wednesday, a former patient texted McKinney, checking in on her and her family, and just saying hi.
“We should go by for tea,” McKinney said to Carroll.
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