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Three Percenters

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A couple of weeks ago, we celebrated Independence Day, the 235th anniversary of the birth of our nation. On that July 4 and the days immediately preceding it, our Founding Fathers pledged their lives, their fortunes, and their sacred honor to the cause of freedom, to the establishment of an American nation.

They followed through on that pledge, and for many of them, it did indeed cost them their lives and their fortunes. I believe their sacred honor remains intact, however, as long as we today remain true to their ideals. In the generations since the signing of that document, we have become the beacon of freedom for the entire world.

We are also ridiculed and reviled by allies and enemies alike; we vain, naive, idealistic, arrogant, hedonistic, greedy, exceptional Americans. For the most part, we have been content to ignore such condescension, mainly because we were too busy doing the things those older, wiser and more enlightened countries were unable or unwilling to do for themselves. Today, 235 years later, we take our freedom for granted. Indeed, we even relinquish much of it willingly in return for false promises of security.

And we forget how, during the American Revolution, how remote the likelihood of victory really was.

It is estimated that only 3% of American colonists took up arms against England. Only 10% of American colonists actively supported the fighters with arms, munitions and materiel. Only 20% or so of their neighbors even supported their cause at all. Fully a third of the American colonists considered themselves loyal British subjects, and a third more had no strong opinions either way.

Yet they prevailed, and in so doing, threw off the yoke of the most powerful nation on the face of the Earth.

Right now, you're thinking, "Hey, AD, the time for the treatise on American exceptionalism was a couple of weeks ago."

Bear with me, I'm going somewhere with this.

More than anything else, the success of our American Revolution is testament to the ability of a small but dedicated group of individuals to prevail against overwhelming odds. History is replete with momentous events and accomplishments brought about by dreamers who were too damned naive or stubborn to realize that what they proposed was impossible.

There's a lesson in there for us as EMS providers, if we choose to see it.

As TOTWTYTR put it in comments to this post:

"Progress is generally only made by irrational people who won't go along with the herd."

A bunch of malcontents founded our nation. In their day, at least a third – perhaps even a majority – of their neighbors viewed them as traitors. Yet 235 years later, history has judged them more kindly. In my EMS1 column entitled EMS 2.0: Where's Our Martin Luther?, I put it this way:

On October 31, 1517, a mad monk named Martin Luther nailed The 95 Theses to the door of the All Saints Church in Wittenberg, Germany. He was one man, a heretic and malcontent reviled and ridiculed by the hierarchy of his faith, who dared to challenge the teachings of the Catholic Church, the closest thing to a superpower in the Middle Ages.

One man dared to challenge the biggest religious and political organization in the world, and in so doing, sparked the Protestant Reformation. And heck, he didn't even have Twitter, Facebook, and YouTube to help spread his message.

You want other examples, closer to medicine and EMS? Fine, I got 'em.

Back in 1956, most experts thought that, once your heart stopped beating, there was no way to restart it. Peter Safar and James Elam thought otherwise, and today everyone knows what cardiopulmonary resuscitation is, and a significant portion of laypeople even know how to do it. And despite all the whiz-band advances in medical technology and new medications, CPR is still the only thing that we know works.

In 1953, Watson and Crick barged into the Eagle pub in Cambridge, UK, and boldly proclaimed, "We have found the secret of life!"

How many pubgoers do you think even paused their game of darts or looked up from their pints? I suspect those that did were rolling their eyes. Most scientists in their day knew that DNA was the building block of life, but none knew how it was arranged. The structural models proposed by their peers were all wrong. James Watson and Francis Crick went a different direction, and in 1962, they were awarded the Nobel Prize for their discovery.

Just over 40 years later, we've mapped the entire friggin' human genome, and the effects of Watson and Crick's discovery will still be expanding for generations to come.

R Adams Cowley was, in his day, considered an arrogant ass by many of his peers. Doctors used to transfer patients to Cowley's "Death Ward" when they considered it certain that those patients would die. By letting Cowley have them, they kept administrators happy by keeping the mortality rates on their units comfortably low. And what better way to do that than by transferring them down the hall from the morgue, to the arrogant surgeon who thought he was so much smarter than everyone else?

Except that, well, Cowley inconveniently saved a bunch of these patients. His numbers didn't suck as bad as you'd have thought. No one knew what he was doing differently, but Cowley did.

Now, he's considered the father of modern trauma care. He once sketched out an idea for a PR campaign on a cocktail napkin, musing on how he'd convince the embyonic EMS systems of the day to bypass the smaller hospitals and bring patients directly to him. Today, the Golden Hour has practically become an article of faith for generations of emergency medical providers.

Back in November 2010, I spoke about Three Percenters at the Texas EMS Conference. It's arguably the biggest state EMS conference in the country, yet its 3500 annual attendees barely represent 7% of the EMS providers in that state. If only half of those attendees were to bitch as long and loudly about the things that matter to the people who matter, instead of arguing the trivial amongst themselves, they could totally transform EMS in their state.

The same holds true for your EMS agency and your state organization. We have the power to affect change within our organizations, if only we'd learn to bitch about the things that matter. Instead, we cut our own throats.

The thing that dooms most revolutions to failure is not the power of the despot they're rebelling against, but the internicine warfare that often erupts within the rebel ranks. The revolutions that succeed are the ones where disparate factions can put their conflicting agendas aside to rally for the greater good.

Paid medics look down on volunteers as unskilled amateurs.

Volunteer EMTs sneer at private EMS, because you know, volunteers are morally superior because they provide their services for free.

Municipal third service EMS agencies zealously guard their turf from fire departments, because everyone knows that fire departments view EMS only as a means to an end.

Fire department medics demonize private EMS contractors, as if their corporate mission is to put heroic firefighters out of work, and probably starve their children to death if they can get away with it.

Now imagine if only 3% of each of those factions united in a common voice to lobby elected officials and policy makers for the things our profession needs.

Instead of whining about the lack of respect from our peers in health care, or pretending that the name of this blog influences those opinions, what if they lobbied for higher educational requirements?

Or if, instead of bitching impotently about being overworked and underpaid, they advocated for reform of the reimbursement system that drives EMS salaries?

If just three percent of the nation's EMS providers would just agree to tackle one issue of interest to our profession, and lobby ceaselessly to fix it, I can't help but believe that issue could be resolved relatively quickly. After it's done, we can turn our eyes to one more issue, and one more after that…

… until one day we look up to discover that EMS is finally the profession we always wanted it to be, and everyone is happy.

Well, everyone except that 33% who thinks that things are just fine the way they are now. As our American Revolution demonstrated, history will judge those 33% as being the shortsighted and ignorant ones.

Provided, of course, that we Three Percenters fight long and loud enough.

 

 

Everything You Ever Wanted To Know About Medic 999…

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… over at Confessions of An EMS Newbie.

As an added bonus, no Ambulance Driver to listen to!

While I was recuperating from the effects of an inadvertent haz-mat exposure (long story here), Ron interviewed JEMS Fire/EMS blogger Mark Glencorse about EMS in the United Kingdom.

Mark answers questions on everything from what EMT training entails in the U.K., to medical direction, to differences in the U.K. EMS systems that allow paramedics to triage patients to places other than the ED, to the fact that Mark wears David Beckham pajamas, and was a founding member of Wham! before being replaced by Andrew Ridgely.

Okay, I might have made those last two up, but still, it’s a fascinating interview. You should give it a listen!

Calling All EMS Peeps

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Only three days left to submit your entry to the EMS Week “I Was There” contest hosted by EMS1. Entry deadline is May 16. Get your submissions in!

On Sunday, May 16, the gang at Chronicles of EMS will hold a multi-city meetup to celebrate EMS Week, during which there will be screenings of the Chronicles of EMS, and the new LAFD EMS documentary, Firestorm.

The Happy Medic will be your host in San Francisco, at the Gordon Biersch Brewery #2 Harrison Street on the Embarcadero, at 6:00 pm.

CKEMT-P of Life Under The Lights will be your Chicago host at Fado’s Irish Pub, 100 W. Grand Ave, at 7:00 pm.

And for you East coast types, Fado Irish Pub in Philadelphia, 1500 Locust Street will be your location, starting at 8:00 pm.

If you live in any of those areas, why not join your fellow EMS’ers in kicking off EMS Week in style?

For You EMS Types…

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EMS Today After Action Report

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After last Tuesday’s round of recoil therapy and ballistic mood enhancers, TOTWTYTR and I ventured south Wednesday morning to Baltimore, site of EMS Last Week Today.

[Editor's nip at the hand that feeds me: JEMS, you do a great job at this conference. The exhibit hall is great, the show is well-organized, with nationally known speakers presenting interesting topics, and for the attendee who gets to attend but one show every few years, it has excellent educational value...

... but, for the attendee who comes to EMS Today every year, or the ones who attend multiple EMS conferences per year, it's getting a little, well, stale. For the past several years, I've perused the list of speakers and topics, and with the exception of a small handful of slots, my overwhelming reaction has been, "Meh. Seen that speaker/topic/presentation before. Even the slides look recycled."

It's not the speakers that are the problem, either, although you do need some new blood. I've seen most of them speak multiple times, and they're all good. But they've got better stuff than the topics you're choosing. I've seen their good stuff before, just rarely at EMS Today.

My suggestion: court a little controversy. Book some speakers nobody has ever heard of. Choose some topics that haven't been discussed and debated ad infinitum in various other forums already. Sure, you risk offending some of your attendees, but trying to concoct a dish that pleases everyone's palate ultimately only makes for a dish that is so bland that it pleases no one. It's the EMS educational equivalent of hospital food.]

Aside from my (admittedly) jaded view of the educational content, I was really looking forward to taking advantage of the real value of EMS Today: meeting people and networking. On that score I was not disappointed.

Once again, TOTWTYTR and I enjoyed the hospitality of a genuine EMS legend, Lou Jordan. Lou’s a lovable old coot with an abiding hatred of skateboarders (he blows the Claymores at the first sight of baggy pants and backwards-facing ball caps), but walking the exhibit hall with him takes hours:

[Walk ten feet]

Lou: “Hey guys, let me introduce you to So-And-So! He was the lead instructor in Jesus’ First Responder class! Taught it from the original Nancy Caroline text, written on papyrus leaves!”

So-And-So (modestly): “I just issued his patch. Jesus had the whole healing thing down pat before he even got to class.”

[Thirty minutes later, walk ten more feet]

Lou: “Hey look, it’s Sumguy, the fella that thought up rotating tourniquets!”

Sumguy (modestly): Well, I owe a lot of that to you, Lou. You’re the one that convinced me leeches were so 19th century…”

Lou’s a walking, talking EMS history lesson, no doubt, and there’s nothing better than drinking beer and listening to Lou and guys like Rick Kendrick swap stories (for you EMS whippersnappers who don’t know who Rick Kendrick is, I’m pretty sure you’ve used a device he invented).

However, I was looking forward to meeting a few EMTs from a more recent generation. Despite being the owner of arguably the biggest online EMS bookstore on the web, Lou is a bit of a Luddite. He still does his personal computing on an abacus, fer Chrissakes, and he’s never quite grasped this whole “blogging thing,” as he calls it.

So we ventured forth onto the exhibit hall floor in search of a couple of guys who, in recent weeks, have demonstrated the power and potential of social media in EMS. Way over by the Zoll booth, tucked into a little cubbyhole were Justin Schorr and Mark Glencorse, the two stars of the Chronicles of EMS.

I was disappointed, frankly. If Patrick Swayze weren’t dead, he’d definitely tell the folks at Zoll that nobody puts Baby Justin and Mark in a corner. But the young lady from Zoll was much cuter than Jerry Orbach, so I let it pass.

This time.

They didn’t seem to mind, though. Justin was busy autographing the boobs of some groupie, and Mark was fielding a call from A.J. Heightman, but eventually I was able to tear Justin’s attention from the boobage, and Mark told A.J.’s people to call his people and perhaps they’d do lunch, and I introduced myself and TOTWTYTR to the Johnny and Roy of the Twitter generation. Justin introduced me to Ted Setla, the man behind the filming of Chronicles of EMS.

Hands were shaken, manly hugs ensued, and much unseemly fawning was done. Sure, Mark Glencorse is an uncommonly charming and ruggedly handsome bloke, but from my buddy’s reaction, you’d have thought Glencorse was the fifth Beatle and TOTWTYTR was a pre-pubescent girl.

Honestly, I had to pry him away before he vapor locked on me, and thus I was unable to let Justin finish signing my boobs.

Disappointing, that.

As we talked, I was struck by how much shorter Justin seemed to be in person, but eventually I realized that was only because I was standing on a small, hobbit-like creature that turned out to be Chris Montera. He brushed off my apology, said something about some podcast thing or another he was doing, and scurried away.

Nice guy, that Chris Montera, even if he hasn’t invited me to be on his show (hint, hint).

While we were moseying about the exhibit hall, we met a few other luminaries of the JEMS EMS/Fire blog network, like John Mitchell and Rhett Fleitz, co-hosts of the Firefighter Netcast. And yes, they do remind one of Chris Farley and David Spade. And they dig at each other like an old married couple, too.

Got to reunite with Mike Ward the Fossil Medic, the man I suspect is largely responsible for the wonderful reception paid us bloggers by JEMS and George Washington University, and met Jamie “Podmedic” Davis from MedicCast. Jamie and Chris did a podcast live from the exhibit hall floor, and Dave Konig was a guest.

Got to hug a tall, smokin’ hawt redhead, namely Epi Junky from Pink, Warm and Dry, and chat with Chris Kaiser from Life Under The Lights, who is neither as tall nor nearly as hawt as Epi Junky, but still a redhead. Friday night at the big blogger meetup, I introduced Chris to Rick Kendrick, and watched him go all fanboi for a few minutes.

Which wasn’t as embarassing as watching TOTWTYTR throw his panties at Dave Statter, but close. In what may be the first such instance in recorded history, someone else scooped Dave Statter on an EMS or fire story. A couple of bloggers managed to get up their posts about the blogger meetup before Dave did.

Enjoy the feeling, guys. It won’t happen often.

Got to meet and talk for quite some time with a guy I’ve been a fan of for years, the EKG Yoda himself, Tom Bouthillet of Prehospital 12-Lead EKG. Chatted at length with Rogue Medic, the Don Quixote of the EMS blogosphere. Shared a great meal with shooter, raconteur and one of the truly good guys of the blogosphere, Old NFO.

Reconnected with a number of friends and met some new ones, among them Bryan Bledsoe, reader Stephanie Goddard, James Laidlaw, EMS1 editor Kris Kaull, Ronnie Grubb of First Due Medic and his lovely wife, NJDivemedic, reader Jared, Nate the EMT-B, and probably a couple dozen others I’m forgetting.

Since I had to fly home Saturday morning, TOTWTYTR and I decided to forego the post-blogger meetup pub crawl, but I’m told it was epic. No one got their Edgar Allan Poe on, and a good time was had by all.

In all, it was a great time, and I thoroughly enjoyed meeting in person some of the people whose blogs I read on a daily basis. Hopefully, we’ll do it all again at EMS Expo in October!


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