In my role as EP Medical Director at EHS (the province-wide EMS system in Nova Scotia) I get to be involved in hurriedly-assembled responses with little or no lead time. EMS responses, unlike those of health authorities, are not constrained by fixed sites and roles: we are able to adapt, improvise, reconfigure. On December 8th we provided medical oversight for 265 Afghan refugees arriving in Nova Scotia in the midst of a snow storm. We used the federal NESS supplies to configure and supply rooms at the hotel being used. We had our MCI plan ready to launch if there were more than 5 sick patients coming off the plane. We had ICS-209 style reporting metrics configured for sitreps at the start of our operational periods. But what I'll remember most is carrying suitcases - lots of suitcases - from the fleet of buses, through the wind and snow, into the back door of the hotel. I'll also remember the steady stream of tired travellers emerging from the buses, safely at the very end of one long road... and at the very beginning of another.