It’s June 26, 2026, in Flint. Dominique Fischer is getting ready for her evening shift as a Genesee County deputy medic – she’ll be the only deputy medic on duty tonight. She prepares her medical supply bags, drug bag, three firearms, her vehicle, and does several channels of radio checks.
Deputy medics like Fischer are both certified law enforcement officers and licensed paramedics—a hybrid role that was incepted at the Genesee County Sheriff’s Department in 1978.
“This job is not for everyone,” said Fischer, who is nearing her third year in the role. Attaining the position required successful completion of the police academy, passing paramedic school and the licensing exam, and simultaneously gaining required experience working in the Genesee County Jail system, and the capstone of the position: working alongside a Field Training Officer (FTO) until her superiors felt she could confidently handle “Tier 1,” or the highest priority medical emergencies in the county, by herself.
Before the mid-1970s, national emergency medical services, or EMS, was nearly unrecognizable compared to how it functions today. As EMS gradually became more structured and regulated, if someone was traumatically injured or seriously ill, their transport to the local hospital would often be delegated to funeral home staff, as they were sometimes the only municipal entity with a cot and vehicle to transport patients.
As EMS grew, the desire to reduce interruptions and delays in patient care continued to evolve. The uniqueness of the county’s deputy medic program allows the first person “through the door” to be certified law enforcement personnel and a trained, licensed paramedic. This allowed for crime scenes and traumatic events to be declared safe sooner and people to receive life-saving interventions much faster. Today, there are fewer than 20 programs like Genesee County’s nationwide.
“You have to be able to take that hat on and off,” Fischer said. “I have had calls where I show up as a paramedic, and I had to hurry up and take that medical hat off and be the police.”
Fischer’s first call of her shift is a patient having stroke-like symptoms. When she arrives on scene, an Advanced Life Support (ALS) crew has already staged. She enters the apartment complex stairwell and begins her patient assessment. While the ambulance crew loads the patient onto the EMS stretcher, Fischer simultaneously introduces herself to the patient, gathers primary assessment information, and obtains a brief but pertinent patient history.
The EMS crew informs the patient’s family which hospital they are heading to. Fischer, while riding in the back of the ambulance and hitting what looks like every pothole in the city of Flint, continues to collect vital signs, perform a blood glucose check, establish a peripheral IV, and transmit a radio call to a local hospital almost synchronously. Her bedside manner is calm, collected, kind, and cool. She completes all the required tasks to assess and stabilize a stroke-like patient, compliments the patient on her Golden Girls t-shirt, and intently listens to the patient reminisce about when their own mom had a stroke decades ago.
“Why are the police following us?” the patient asks from the stretcher, looking out of the rear windows of the ambulance. The EMT who arrives on scene will often drive the county medic’s vehicle behind the ambulance to the receiving hospital for the deputy. Fischer is scrunched down at the patient’s side, preparing to insert an IV catheter into the patient’s right arm. She pauses, looks over her left shoulder, and peers out the same window. She lets out a brief laugh.
“That is my car. I am a police officer, too,” Fischer replies with a smile.
“Well, you go, girl,” the patient responds.
“You know how many times in a night I have to say that?” Fischer says, explaining that often, when she arrives on scene to an emergency in a deputy’s uniform, she has to reassure community members, “I am a cop, but I am not here as a cop right now.”
According to a study published by the Vera Institute for Justice, in most cities, including nearby Detroit, fewer than 3 percent of calls involve a violent crime. The Deputy Medic Division is tasked with a complicated and complex role in the community when responding to any call. The scope of their presence on scene can wax and wane—from life-saving interventions to assisting with mental health crises—and can even run concurrently with their law enforcement duties. Fischer believes her background empowers her to be the best medic she can.
In addition to her many responsibilities on the road, Fischer is also a mother and a Flint native. The many dualities of her role, juxtaposed with her background and the community-level responses that often present on scene at violent events or medical emergencies, are something she takes very seriously.
“I know what it’s like to be a mom in situations and how I would react,” Fischer said. “[Being a mom] helps you be more empathetic towards people.”
After the first medical call of her shift, Fischer begins to return to her posted area near downtown Flint when an SUV with three young people inside and one sticking out of the sunroof pulls past her. Her lights and sirens flip on as she gets behind the vehicle; it turns and slows to a stop.
“Now, you guys know why I pulled you over,” she says with the demeanor of a very disappointed mom, her hands calmly at her sides. She is running their license and registration when a shooting is dispatched through her radio. She quickly and professionally returns to the SUV and issues a verbal warning to the occupants. As she speeds past the parked SUV, the young driver yells out, “Thank you!”
When county medics are dispatched to a Tier 1 medical emergency, they depart from wherever they are in Genesee County en route to the scene. During this shift, Fischer responds to several back-to-back calls on opposite ends of the county. While additional EMS services are dispatched to the same scenes, she is required to respond to the most severe calls.
Fischer arrives at the shooting scene six miles away from the traffic stop. As she steps out of her vehicle, the brakes on her truck are hot, swelling up the immediate area with the smell of sharp, sulfur-like air. Arriving at the scene with her feels as though she has time-traveled at light speed. She steps to the back of her vehicle, opens the lift, grabs her medic bag, and heads into the apartment complex to take care of the person who has been shot.
The apartment complex appears chaotic. Young children and families sit on their front steps just feet away from where the shooting victim lay in the grass near a congregation of local police agencies. With the scene secured, she can focus entirely on life-saving interventions rather than scene safety and security. The crowd of police and firefighters parts so she can see her patient. Her primary assessment focuses on any uncontrolled bleeding. Once the patient is in the back of the ambulance, she exposes the patient with her trauma shears to assess for additional injuries, noticing a makeshift tourniquet made out of a torn T-shirt a bystander placed on the scene before EMS arrived.
“Your peoples did a good job,” Fischer says to the patient, referring to the tourniquet.
In May, Fischer responded to a driveby shooting in Mott Park that resulted in the death of a 9-year-old girl.
“After that, I got off work Friday morning, and I literally laid in bed Saturday and Sunday. I just couldn’t shake that call,” said Fischer, noting that mental health is prioritized not only by the sheriff’s department but also by her leadership team. “As far as mental health goes, they take it very seriously.”
Deputy medics are required to attend therapy with a licensed therapist during working hours at least twice per year. Mental health services are available on an as-needed basis, and call debriefings are mandatory after tragic calls like the loss of a child or the shooting at the Church of Jesus Christ of Latter-day Saints last fall in Grand Blanc.
Fischer addresses the unique challenges her role presents, explicitly noting the obstacle of arriving at a medical emergency only to hear bystanders say, I did not call for the police.
“But when I show up on a scene, I think it gives people a sense of comfort when they see someone who is like them and has had experiences like them,” Fischer said.
Being a Flint native and a Flint Schools graduate — she averaged 18 points per game and also led the team in assists as a senior point guard at Flint Southwestern — is part of what motivated Fischer to become a medic. Being a born-and-raised Flint product is not just a point of personal pride; it is the ultimate asset in the community. It allows her to cut through the inherent tension that often exists between a community under duress and someone showing up in a police uniform.
“It’s a little awkward, honestly, because I kind of stick out. So I can’t mess up,” Fischer said. “When I show up, and they see that I look like them, they’ll ask me, ‘Hey, where’d you go to school?’ and I tell them I’m from Flint. I am a product of Flint and Flint Schools, so I understand what it’s like. Being able to work in a place where I grew up, went to school, and know people is why I did this job. I can’t see myself doing anything else.”
Sustaining that presence in Flint and surrounding neighborhoods relies heavily on community backing. This August, Genesee County voters will decide on a 10-year renewal for the millage that serves as the primary funding source for the Sheriff’s Paramedic Division. The resolution maintains the current levy of 0.4689 mills ($0.4689 per $1,000 of taxable property valuation), requiring no tax increase to keep deputies like Fischer on the front lines.
“That is one of the reasons why I wanted to do this job,” Fischer says, reflecting on her hopes for the future of the department. “Because I wanted to be able to work in the community where people look like me and where I live, and give them that voice.”
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