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Five Questions With: Lillian Bonsignore, Chief of FDNY EMS

On May 7, 2019, the Fire Department of New York City (FDNY) swore in Lillian Bonsignore as the new chief of EMS. A 28-year veteran of the department, she steadily marched up the ranks throughout her career, previously holding the position of the chief of EMS Training Academy. Bonsignore is also notably hailed as the first female and openly gay chief donning four stars on her class A uniform. EMS World spoke with Chief Bonsignore about her vision for the future of EMS and how she aims to bring that to fruition in her new role.

EMS World: It’s a huge accomplishment to be named the FDNY’s first openly gay woman as chief of EMS, but some people seem to be glossing over the fact that the skills and competence you possess are what actually led you to your promotion. What has that dialogue been like?

Lillian Bonsignore: People who know me remind me that I didn’t get this promotion because I was a woman or because I am openly gay. I got this job in spite of those things. For three decades, I have dedicated my life to serving others. I have worked my entire career for this moment. Throughout my career, I have accumulated a lot of experience and have always tried to share the lessons that I learned with my colleagues. I climbed the ranks due to hard work and determination. For those that do not know me, I am celebrated for two things that I literally put the least amount of thought or work into but we must acknowledge; it is unusual to see a woman, or an openly gay woman, break through to such a high ranking position in a male-oriented profession. Those people see me as an example or role model. I am a reflection of real possibilities that didn’t exist before. It starts a conversation that is long overdue. I am honored to be that person.

What advice do you have for other women who are trying to move up the ranks in EMS and the fire service?

I would say don't believe the hype. Don’t believe what people tell you about not being able to do it. It’s something that is not always easy but if you stick with it, you can achieve any goal. Our girls need brave women to be trailblazers and go all the way in a job like this. Women already have many additional challenges to face in the workforce. Emergency responder jobs come with very unpredictable schedules which can make it even harder for women to stay committed for the long haul, particularly if they are also raising children. I would say to these women: If this is your calling, do what you want to do. You are capable. It is possible for you. You already have the power—you just have to let everybody else know it.

There were certain times during my career when things got a little more difficult. There were a few men in my path that believed a woman should know her place, and the fire department was not it. I disagreed. I focused my energy on staying professional, giving back to others, providing quality pre-hospital care, learning, mentoring and standing my ground. It worked. I am respected for my efforts and supported by my peers, male and female.

When you started out in EMS, did you ever think that you were going to be the chief of EMS? Was that your goal from the beginning? 

I was a dreamer when I was young. My dream was to become the chief of the EMS Academy for the fire department. As it turned out, that dream actually came true. Prior to this promotion, I was the chief of the EMS Academy for three years. I thought that was the most spectacular thing that could ever happen to me. Right from the beginning of my career, I absolutely loved the EMS training arena and in 1996, I became an instructor. No matter what rank I held, I contributed to training in one way or another.

Along the way, I would joke around about becoming the chief of EMS. Alvin Suriel, who became my assistant chief, and I would joke that we were going to run this place someday. I never thought I would really be here. I was so satisfied and excited to know that I was the chief of the EMS Academy. I never thought much about going any further until I realized that I was one of the top five ranking officers of the EMS command. At that point it was technically possible, but no woman had ever made it that far. When that opportunity came knocking, I jumped on it! What better job is there than being able to lead such an amazing group of people? I'm finishing my 28th year right now so I can retire today if I wanted to, but my intention is for FDNY to pull me out of here kicking and screaming in about 28 more years! This is the honor of my life, to be honest. I just couldn't imagine any job better than this. 

What do you want to accomplish in your new role? What's your vision?

There are certainly some technical things, but the first thing I would like to start applies to all of EMS, not just FDNY. I want to shine a light on EMS. I really want people to know who we actually are and what we actually do as a profession. We are not just ambulance drivers. We are highly trained medical professionals. We are dedicated civil servants. We are here to take care of strangers. We are willing to leave our own families to answer the call for people we don't even know. I am not so sure that people get it. I don’t think there are many that really understand the difference that we make. It may be because we're still relatively young as a profession compared to the fire service or police departments. Those organizations have a hundred years on us as a structured emergency service. They are easily recognized, so we have some work to do. While continuing to provide the highest quality of care for our patients, we will work to help educate the public.

We're also going to put some focus on making sure that our CFRs, EMTs and paramedics know how appreciated they are and how important they are to the communities that they serve. This is a tough job and there are lots of challenges, but we should stand together to push through those things. We can always do a better job taking care of each other. We never, ever give up on what we're here to do, and that's to care for and to serve those people around us. I expect that we will continue to give 110% for each and every person that calls for our help.

How do you think we can go about achieving that for the EMS community? 

First we have to accept who we are as a profession. We are a profession of service and that is not always easy. People that come to EMS are generally compassionate and self-sacrificing but they also need support. The people we have to encourage the most are the people doing the job—our EMTs, our paramedics, and our CFRs across the nation. Help them understand that the job they do is important. EMS is a profession that leads first responders to somebody's side at their worst possible moment. Generally, there's no party being thrown for us. People are anxious, scared and angry and it's not a great work environment. If you're doing this every day, all day, it could be a little defeating. First responders may not always understand how critical they are and how important they are to society. EMS providers also need to know that they are important, too. We need leaders to go out and talk to them, encourage them, support them and just see them as real people.

I've said this before, and I'll say it again: EMS is like the power service. You never really think about having lights or electrical power until you don't have it. Nobody thinks about EMS until they call 9-1-1 and if they didn’t show up, they sure would be missed.

EMS professionals must continue to push the profession forward in a positive light. Recognizing the contributions we make to society is one that they cannot live without. We don't have to pat ourselves on the back after every job, but we do have to accept the responsibilities that come with a profession like this. We are the answer to their call for help. We are EMS!

Part of the work is really getting our message out there and letting the communities that we serve know who we are and not just showing up when times are bad. We should be showing up when times are good. If you have time, go to a community event and get to know the people. Have the kids see your ambulance, and let them know that this is a great profession filled with possibilities.

Lillian Bonsignore, Paramedic, CIC is the former FDNY Chief of EMS Academy and recently-promoted FDNY Chief of EMS.

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