2007: 52 RDO-2 Kennedy gate hold TWA's eight hundred heavy we're lifeguard ah we're ready to taxi out delta alpha with tango.
2008: 01 GH TWA eight hundred all right contact ground one two one point niner for the taxi inform them that you are lifeguard.
2008: 04 CAM-3 after start checklist complete.
2008: 07 RDO-2 roger.
2008: 13 RDO-2 Kennedy ground TWA's eight hundred heavy lifeguard comin' out delta alpha with tango.
2008: 24 RDO-2 yes sir.
2008: 25 GND you know every day you come out and we don't know that you're a lifeguard and then you tell us you are and ah if you could tell company to ah you know ah put that in their flight plan ah it would help us out alot.
2008: 38 RDO-2 TWA's eight hundred understand I don't think they knew it either until the last minute.
2008: 41 GND all right TWA eight hundred taxi right on alpha and hold short of echo.
Last minute arrangement, as the crew notes in the above CVR excerpt. The company wasn't aware of the lifegaurd status, and hadn't put it on the flight plan.
AirDisaster.Com: TWA 800 CVR Transcript
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When I flew air ambulance, for international movement of patients sometimes it was more convenient to purchase a block of seats and install a bed or stretcher in their place. Patients with special needs who are ambulatory are sometimes moved this way too, and a lifegaurd status attached to the flight.