On the mainland, a strained fire or EMS department has a release valve. When the calls stack up faster than the crews can clear them, the dispatcher calls the next town over, and the next town sends a truck. Mutual aid is the quiet machinery that keeps the system from failing on its worst days. It works because help is a few miles down a road.
John Rose, Fire and EMS Chief in Oak Bluffs, runs a department where that machinery stops at the water. There is no next town over. The nearest mainland help is a ferry ride away, and on a bad night the ferry is not running. Rose says the island version of mutual aid is a useful window into how fragile the whole concept is once you take away the road.
“Everybody talks about mutual aid like it’s a guarantee. It’s a guarantee until there’s water between you and the help. Then it’s a phone call and a prayer.”
The geography that changes everything
Mutual aid agreements assume adjacency. A department signs compacts with its neighbors, and the math works because a neighboring crew can be on scene in the time it takes to drive the distance between two stations. Take away the road, and the entire model loses its footing.
On the island, the closest off-island departments are separated by open water and a ferry schedule that thins out at night and stops in bad weather. The help exists. The path to it does not, at least not on the timeline an emergency runs on. Rose says island departments end up planning around a brutal assumption that mainland departments never have to make: for hours at a time, what is on the island is all there is.
Self-reliance as the only option
That assumption shapes everything about how Rose runs his department. A mainland chief can staff lean and lean on the neighbors. An island chief cannot. The redundancy that off-island systems push outward onto a regional network has to be built inward, into a single department that may have to handle a second and third simultaneous emergency with no one coming to help.
It means carrying equipment a department of its size would not otherwise carry. It means cross-training crews to cover roles that a larger regional system would specialize. It means treating every shift as if backup is not coming, because some nights it genuinely is not.
“We train like we’re the last line, because some nights we are. There’s no second engine coming over the bridge. There’s no bridge.”
When the transfer is the mutual aid
There is one form of outside help that does cross the water, and Rose is careful to credit it. When a patient is too unstable for the island hospital and cannot wait for a ferry, his department coordinates with the United States Coast Guard, stabilizes the patient on the ground, and hands off to the flight crew for the trip to Massachusetts General.
That partnership, Rose says, is the closest thing the island has to true mutual aid, and it works because of relationships built over years rather than because of any policy that guarantees it. He treats that as a strength worth protecting and a vulnerability worth naming. A system that depends on goodwill and long-standing relationships is only as durable as the people who maintain them.
What the mainland takes for granted
Rose is not asking for sympathy. He is asking the rest of the emergency services world to notice an assumption baked so deep into its planning that it has become invisible. Most departments assume help is reachable. They build their staffing, their budgets, and their risk tolerance on that assumption.
Island and remote departments cannot. And Rose argues they are not as unusual as the mainland thinks. Rural communities separated by long mountain roads, towns cut off seasonally by snow, and any place where the nearest help is measured in hours rather than minutes face a version of the same problem. The water just makes the island’s version impossible to ignore.
Three things that would help
Rose points to a few changes that would harden the system without waiting for a crisis to force them.
Formalized off-island compacts, with personnel and apparatus staged for rapid ferry or air transport on the days the forecast or the calendar says the island will need them, rather than scrambled together once the calls are already stacking up.
Investment in the island’s own redundancy, treating a remote department’s equipment and staffing not as overbuilt but as correctly built for a place where backup cannot arrive on demand.
And durable, written partnerships with the agencies that can cross the water, so that the Coast Guard relationship and others like it survive the retirement of the individuals who built them and do not have to be rebuilt from scratch with every change of personnel.
The phone call on the bad night
Somewhere on the mainland tonight, a dispatcher will call the next town over and a truck will roll. The system will work the way it is supposed to. On the island, on a bad night, that call ends differently, and Rose has built his entire department around knowing it.
“The mainland gets to assume help is coming. We get to assume it isn’t. That assumption keeps people alive out here, but it shouldn’t have to.”
On Martha’s Vineyard, the ferry will stop running again tonight, the way it does every night. The calls will keep coming, the way they do every night. Rose says the island has learned to live inside that gap. He would rather the system close it.
