Movie crews get medical care from team started by Upstate-trained paramedic

Host Amber Smith: Upstate Medical University in Syracuse, New York, invites you to be The Informed Patient with the podcast that features experts from Central New York's only academic medical center. I'm your host, Amber Smith. Heather Drake-Bianchi is my guest today. She's a Syracuse native who has specialized in critical care medicine as a paramedic and who has a set-medic business called CineMedics CNY. Thank you for taking time to talk with me, Heather.

Heather Drake-Bianchi: Of course. Happy to be here.

Host Amber Smith: Now, let me start by asking, did you do your paramedic training at Upstate?

Heather Drake-Bianchi: Yes, I did.

Host Amber Smith: How long ago, and what was that like?

Heather Drake-Bianchi: Oh boy, that was roughly eight or nine years ago. And I chose Upstate because it had a longer and more in-depth, more comprehensive program. It was, oh man, I did it at the same time as doing my second master's degree, which I don't recommend, but it was one of the toughest experiences, next to undergrad, I would say.

Host Amber Smith: OK. Well now, Syracuse is becoming a bit of a film hub, where lots of movies are being made.

Did you start CineMedics because you saw a need for providing onset medical care in Syracuse?

Heather Drake-Bianchi: Yes. Myself and my colleagues, we're all movie-set production medics, providing medical support, you know, everything from small productions to hundreds of people at a time. And then when COVID happened, our scope as on-set medics expanded beyond just medical support.

There had to be a system put in place and designed from the ground up on how to keep people at work, but how to do it safely. And our background as first responders with managing large-scale incidents, especially taking that experience from working in the city as a paramedic, was instrumental on making that actually happen.

Host Amber Smith: Interesting. Well, I imagine that COVID has changed a lot of things, but I'd like to understand, what does the set medic do in normal times when COVID isn't a concern? What is your job like on the set?

Heather Drake-Bianchi: Yeah, absolutely. You hope that the medic on a movie set is largely not doing anything, but inevitably, you know, you're there for traumatic incidents and illnesses of acute nature. But what actually ends up happening is when you work with the same film crew over and over again, you become their most trusted resource for a number of their medical questions and concerns. So in addition to treating any injuries or acute illnesses that come up or helping to just make somebody feel better, a lot of times, people in the movie industry works such long hours, that money isn't their currency. It's free time, and they don't have the free time to seek out what are much-needed resources for their personal care. So a lot of it is not just acute (care), but recommendations for who they should go see, why it's important that they see their primary care physician. Helping them to navigate when it's time to go to the hospital versus when they could go to an urgent care or when they should go see their primary care doctor.

And then to a surprising degree, it's helping them navigate who's accepting new patients, when they should go, encouraging them to actually be seen, getting their yearly blood work drawn, because it just doesn't happen. They're some of the most under-cared-for population that I've come across. And that was very surprising.

Host Amber Smith: Right, because they go wherever the movie's being filmed. They're not at their home. They're not where they can go see their regular doctor, I guess. Right?

Heather Drake-Bianchi: A lot of times. The film crew locally, some people are from New York City or from other parts of the state, but even the local people end up working 16-hour days.

And so even though they're here and might know where to go, they don't have time to go. So a lot of it is being a trusted resource and encouraging them like, "Yes, you have this high blood pressure, and you know, we have been talking about your high blood pressure for six months now, you really need to be seen for that." And educating them about the importance of self-care.

Host Amber Smith: Well, you mentioned COVID, so in order for movies and shows to still be filmed, there's all these COVID protocols that you've had to put in place, and that applies to the stars and the crew and everyone on set, right?

Heather Drake-Bianchi: Yes, everybody.

Host Amber Smith: So are people generally daily tested or every week are they tested?

Heather Drake-Bianchi: So similarly to an incident command system, there's various zones: that inner zone where the talent is acting and they don't have their masks on, the people that are in that zone and around it have a more frequent testing cadence than people that are working, say, in a separate building or on the periphery of that. And so in that central zone, they'll either test daily or multiple times a week, depending on the incidence of that geographical area.

When COVID first hit, we were testing every day to three times a week. When Syracuse waned to become a low-incidence area, the frequency of testing relaxed a little bit, but as numbers have ebbed and flowed, so has the testing cadence. It's meant to be a scalable protocol.

Host Amber Smith: This is Upstate's The Informed Patient podcast. I'm your host, Amber Smith, speaking with Heather Drake-Bianchi. . She's a paramedic who founded the CineMedics mobile medical services and risk management business in Syracuse. Now your website, the CineMedics website, says that you provide event, remote and austere medical services.

What are some examples of places where CineMedics has gone? Because it's not just you, you have a whole team of people that are working with you, right?

Heather Drake-Bianchi: Yeah, there's an extensive team. They come from all different backgrounds from austere and remote paramedics, people that have been in conflict zones; there's a few of us that have quite a degree of experience in conflict zones. There are film experts, there's logistics experts, there's people that just come to make sure that they pick things up and put them down and do a lot of the heavy lifting. There's event planners. There's people that do procurement. I mean, it's a whole collaboration of different backgrounds of individuals.

And as far as where we've been, we've been all over the United States and outside of the United States. We're starting a project in London this week. I have another team member right now in Sierra Leone. We just wrapped a large project for HBO in LA. New Orleans. Florida. Boston was another big project. We were the primary medical resource and PCR (a test used to check for COVID infection) testing laboratory for the film that's coming out this week called "Don't Look Up." It's a large-scale Netflix production.

Host Amber Smith: So you've been all over, lots of travel, it sounds like.

Heather Drake-Bianchi: Yeah, we, the team, basically works and lives together. Because we're traveling at any minute of every day, but it's been an adventure. It's been great.

Host Amber Smith: Now, as a paramedic, you have all your equipment and medications and the ambulance, but if you're on a movie set, or you're out in some remote area, how are you able to fit everything that you might possibly need into something that you can carry, or a backpack?

Heather Drake-Bianchi: Part of the team is that we have a couple of gearheads who just love everything about gear, have a variety of backpacks and it's like a whole field of study. I would say I'm a gearhead as well, but that would be to discredit some of the people that I work with who are just phenomenal experts in this.

So , rather than working out of an ambulance, which is absolutely not the case, in what we do, everything is in a backpack. Everything is collapsible. Everything that can be collapsible is, without compromising the degree of medications that we carry. It doesn't compromise any of our equipment, but everything is portable.

So we have a kind of a series of packs where the medical gear is stored in backpacks, as well as personal gear.

Host Amber Smith: So, what are, can you walk me through some of the most important pieces of equipment that you have? I mean, you have some life-saving medications, but you also have some tools and equipment.

What is most essential that you need to have?

Heather Drake-Bianchi: I think the most essential things are medications or treatments for injuries and illnesses, where if you don't solve it within the next five or 15 minutes, you have a real problem. So EpiPens (to use for severe allergic reactions), for example. There's been times that we have supported a film production that's 40 minutes away from cellphone service, and that's just cellphone service. That's not even 40 minutes from help. And so you really need to have an EpiPen and then subsequent Benadryl (to treat allergic reactions). And then, to be able to treat those injuries and illnesses, obviously gross bleeding and trauma supports.

I was working on a sailing ship in the Mediterranean when there was a wave came up and blew one of the individuals back into the mast, and he actually fractured two vertebrae. Now he was fine. He didn't have any long-term problems, but managing that acutely was of the utmost importance until we could even get to the point of, not just getting to a hospital, but getting to land. And that was a four-hour trip. So you have to think about things a little bit differently than if you were working in a city or even one of the counties, because when you're hours or even days away from help, it's completely different way of approaching medicine.

Host Amber Smith: Wow. It sounds like it.

Heather Drake-Bianchi: Yeah.

Host Amber Smith: Automatic external defibrillators -- do you have those?

Heather Drake-Bianchi: We specifically look for smaller defibrillators that can fit right in the pack. But in addition to medical supplies, some of the most important equipment that we have is various types of communication. If you were to bank on always having cellphone service, you wouldn't be an austere paramedic.

You have to think of various types of communication. So we don't just think of communicating via satellite or via cellphone service, but also via satellite. And we recently integrated technology where we could text and communicate via radio waves. So there's always safety nets to our initial plan, because if there's anything that we've learned from being a completely self-sufficient logistical laboratory, it's that you have to have backup plans and that's every scope of not just medicine, but how you operate.

Host Amber Smith: So if you have an injury and you're out on a remote set that's, you know, minutes or hours away from definitive medical care, do you drive the injured person or do you call an ambulance service? I mean, how do you get the person, if they need hospital care, how do you get them there?

Heather Drake-Bianchi: It depends on where you are.

There's a couple of us that have worked on various sailing vessels, and when that's the case, you're not calling an ambulance, you're calling, if it even is close or accessible, you might call the Coast Guard. We've had to medevac patients with MIs (myocardial infarctions), or heart attacks, off of a ship in the Bering Sea before, and that, that's complicated. So you treat as much as you can site. And once you've identified that you actually have a problem that needs to be fixed immediately, you have to either call in a helicopter or you have to use local contacts more than anything because you can't be both the transportation and the medical provider. As an austere paramedic, you're not just doing the medical, but you're also doing the overseeing for logistics.

That's transportation, it's communication. It's getting in touch with the hospital, depending on how extensive the incident is, especially if it's multiple people. And then you can't forget about treating the patient in and of itself, which is an entire job. So an austere paramedic, and this goes back to why I've hired the people that have hired, you have to be able to multitask better than any field that I can think of.

Host Amber Smith: So are you in contact, or do you have the ability to be in contact, with a physician or your medical director, if you need them?

Heather Drake-Bianchi: Yes. You would kind of have to be. You can do it via satellite phone or via communication with radio , or cellphone if you have it. And if you're not calling your medical director, more so than not in an acute injury or illness, you're getting in touch with the local hospital or depending on where you are, the local medical resource.

It's not always a hospital. A lot of times it's a clinic or in some of the more difficult of situations, you are the resource, and that's very humbling.. It's a large responsibility

Host Amber Smith: I saw that you once served as a paramedic for National Geographic. What was that like?

Heather Drake-Bianchi: That was interesting. It was for both film and for National Geographic. it was something called "The Raft," where the premise of the project was that people are stranded at sea in a raft for weeks at a time. And I was the support medic, not just for the various ships that had the filming crew and the support crew, but also for these people that were stranded in a raft for weeks at a time.

Host Amber Smith: Interesting.

Heather Drake-Bianchi: It's a lot. It's a lot of not sleeping. (laughs) It's a lot of like keeping track of people over a long period of time. It's a different way of approaching things because in an, a traumatic injury, you know what the problem is in front of you, but when you are the medical support resource for a multi-week, multi-month project, the changes that you see medically, they're slow.

That's not always acute. So you can't get lazy or complacent, you have to always be on top of things. And so, a lot of that is either not sleeping (laughs) or being sure to just keep communication channels open.

Host Amber Smith: You majored in biomedical sciences at RIT (Rochester Institute of Technology), and then you got a master's in human anatomy and physiology.

When did you decide you wanted a career in science and what drew you to become a paramedic?

Heather Drake-Bianchi: When I started at RIT, I was originally a photojournalism major because I just loved connecting with people. But then as time went on, the recession, back in early 2000, happened. And so, it really changes your outlook on things.

I switched to medicine after a couple, just incidents at school, started taking science classes and finished in biomedicine. Later when I went on to get my master's in human anatomy and physiology, but I actually did a second master's degree from Syracuse University in molecular DNA analysis, as part of the forensic program.

And, that's been instrumental with COVID, but choosing to go into medicine, it comes from wanting to connect with people as much as possible and wanting to help them as much as possible and being advocates for them, especially with the local film community. It was incredibly humbling to make these close connections with colleagues and later friends in the local film community to help to advocate for them. Because that's, that's what medicine is, is helping to advocate. Whether you can help them directly or you're getting them to help. It's the same thing.

Host Amber Smith: What do you look for in a paramedic that you're going to hire for CineMedics?

Heather Drake-Bianchi: One, they have to be good with all sorts of personalities. You know, we don't just deal in medicine, but in the Hollywood industry, and they're some of the most intense personalities I've ever met. We're not an entry level company. I trust my team implicitly. I don't micromanage them. There's no trust in that. So if somebody with a work experience and people that have multiple different types of backgrounds, they don't have to have a formal education, but depending on the role, it helps. But by no means is it required. It's somebody who has actual life experience and has an opinion about things and helps to advocate for, not just patients, but for a team. But more than anything, they have to be team oriented because you don't accomplish what we have by working as a solo person, regardless as to what perspective it's coming from. It has to be integral with teammates. And that's what medicine is.

Host Amber Smith: Thank you for taking time to talk with me. My guest has been Heather Drake-Bianchi, the founder ofCineMedics mobile medical services and risk management in Syracuse. The Informed Patient is a podcast covering health, science and medicine, brought to you by Upstate Medical University in Syracuse, New York.

I'm your host, Amber Smith, thanking you for listening.