The truck Stewart drives is outfitted with a liquid oxygen tank that he gets filled by the supplier Airgas. Wearing protective gear and headphones to muffle the noise, he replenishes movable tanks, including one at the Outpatient Center on the East Baltimore campus. The job, he says, requires a concrete surface. "You can't fill on asphalt. There's a chemical in it that could cause a flash fire if oxygen spills on it."

I'm a liquid driver. I fill oxygen tanks off my truck. I also deliver oxygen, durable medical equipment, everything in our warehouse top to bottom. We get in-services on every piece of equipment we offer. These are feeding pumps, these are the gauges, this is a suction machine, like they use in hospitals and nursing homes. These are nebulizers, these are compressors for air mattresses. You've got quantum pumps, kangaroo pumps. Each one uses different tubing. We have to know all that.

To deliver oxygen, you have to have a commercial driver's license with a hazardous materials endorsement, the same as a guy driving a gas truck. Every two years, you take a 50-question hazmat test. You couldn't just walk in and pass. You have to study hard. Which is great, because it helps you stay up on what's going on. It makes me feel better as a driver. You don't wanna get relaxed. That's when you stop paying attention and end up getting hurt.

A lot of drivers don't like doing oxygen because it's heavy-two of the tanks we deliver weigh 120 pounds, one model weighs 160 pounds. I played sports in high school. I like being physically fit. We have a lift to help load the truck at the warehouse, and we use hand trucks and wear our back braces. But to get the oxygen tanks into people's houses, sometimes you have to carry them up the steps. Maybe they have nice wood on the stairs, and they don't want the hand truck scratching it or getting caught in their carpet.

I like dealing with the public. You see the result right away. I've been doing this for 12 years, with three different companies. I've been with the Hopkins Home Care Group now for seven years. I used to work as a busboy at the Hyatt Regency and I've been a limousine driver. Being as I've done this a long time, you realize how important your delivery is. People depend on you. You're bringing a piece of equipment that's gonna save their life or help them breathe. The minute you walk in that door, they need your attention, they need your help. I put myself in their shoes and try to put them at ease when they're just coming out of the hospital.

We show them how to use the tanks, how to clean them. We go over safety precautions-no tubing under carpets because it can dry rot, and you don't wanna be anywhere near a flame within a 10-foot radius. If they have the big tank, the C-31, we always instruct them to call us if they want it moved. If it tips over, the oxygen can cause the metal part here to become so cold your hands would stick to it if you touch it. You can get frostbite from oxygen.

I try to keep it basic and not overload them with a lot of technical information. Sometimes you have to go over the instructions four or five times, and the more you train, the more comfortable they're gonna feel. After I instruct, I turn around and act like I'm the patient and have them re-instruct me. A lot of people are afraid to ask questions. They're trying to get you out. When they instruct back to me, it calms them down and makes them feel comfortable with me in their house, right from the start.
All the oxygen, ventilator and nebulizer set-ups come through our respiratory therapists. A lot of times we meet the RT at the patient's house. Our regular schedules come out three months ahead, but home care is 24/7, 365 days a year, and about every seven weeks we're on call 24 hours a day for seven days.

I usually go ahead and work the holidays. For patients who are on 2 liters of oxygen a minute, a tank lasts seven and a half days. I have one gentleman who's on 6 liters a minute. I go to him twice a week. If I missed one of his deliveries because of a holiday, I'd have to go back and try to fit him into my regular schedule.

We depend a lot on our radios, and for three or four days after Sept. 11, we did have communication problems because the airspace was taken up. Within 24 hours, everyone was put on standby notice and we used our telephone tree to keep in touch. For three weeks, we called in after every two deliveries. We did encounter tighter security in places like high-rises, but our routes stayed pretty much the same. Patients were so worried they wouldn't get their deliveries. What if you have a kid who needs a trach collar? When you're healthy and something throws you off your routine, it's frustrating. When there's a medical issue, it's a catastrophe. We let them know nothing had changed.

This is probably the best overall system and crew I've worked with. You can depend on people. In a crisis, Deeley [Middleton, Pediatrics at Home senior director] or Penny [Carey, Pharmaquip director] don't hesitate to grab a van and do a delivery. I've seen Steve [Johnson, Home Care Group president] grab tanks and say, I'll drop them off. They do the same thing you would do.

Even with all the different people going in all different houses, you start getting the same feedback from patients. They say everyone who comes through the door has the same response to what the person needs, the same pride in what they do. I know all the drivers have that attitude. You're more than just a delivery guy.

-Reported by Mary Ann Ayd