Monthly Archives: August 2012

The Default Solution is Always More

My wife announced that there wasn’t enough money in the checking account again. The obvious solution to her was that I simply needed to add more money to it each month and that the problem would then go away. Any attempts on my part to question where the money is being spent is considered completely offensive simply on face value. There are so many details that I would just not understand. After all, I simply need to know that we are talking about meeting the needs of our family. How could I even consider not addressing those needs? Do I want a child to go without an education? Without shoes or food? It could happen she warns, if the funds are not provided. Oh, and I can’t reduce the family size either by letting any of the kids (or even my wife) go. Alright, maybe I took that analogy to an extreme there at the end, but replace my wife with the fire chief or union leaders, my kids with union firefighters, and make me a politician or simply the public and the story is replayed all over the country and even across the world. ?If we don’t have more money, someone could die!?

I was thinking about this economic routine when I read the article City asked to boost fire resources in wake of slowing response times. I was prepared to blast it as another of the “how can you put a price on a life? stories. But to my surprise, “city administrators? in this case started discussing “restructuring? – they even got to specific issues by pointing out that it was “chute time? that was slowing down even though the actual travel times were improving. However, the familiar refrain still finally appeared, the Alderwoman in this particular story “plans to bring forward a notice of motion asking the city to look at what she calls a general lack of resources within the department.?

While I cannot diagnose why the response time compliance in this specific situation went steadily down from 64.7 percent in 2007 to just 54.7 percent last year, I also cannot concur automatically that it is by default a lack of money. Even the Deputy Fire Chief “expects a number of factors have played into the slowed turnout times since 2007,? before admitting “but he welcomes additional resources into the department, including more firefighters.?

Again, I admit that I don’t know all of the details surrounding the specific question in this next case asking Should City Merge Emergency Operations? But the first thing that struck me was that the city was looking to take over a nonprofit ambulance service in order to save money. I understand that the city is a major contributor to this service and that the fire department attends one third of their calls yet the city is the one complaining of the duplication of effort. The assumption is that the entire amount of support currently being given to the volunteers would be considered savings and could mean a new fully equipped ambulance after a merger. It seems to me that the money that was being used for operations would still be needed even after the fact.

A final article I read on the topic was New Toronto Fire Chief Says Merger with EMS Eyed. In this story, the City Fire Chief acknowledged that the existing fire model was broken saying “The status quo … is not an option. It just isn’t.? Part of his initial attack of the problem was reducing the number of firefighters to save money while an official service review is conducted. Once that review is completed,?every single truck in every single location? will be examined to determine the most “efficient? route forward. It was exciting to hear an administrator keeping the options (outside of the status quo) open. But the next line in the story asked about the recommendation of an accounting firm to merge with the more profitable EMS agency. Then I began to hear that common refrain begin again when the chief responded, ?I’m not opposed to anything that improves service for citizens.? However, he changed the melody a little by saying ?You’ve got to build a model that fits this city. We need a ‘Made in Toronto’ solution.? there was no talk of “quantitative easing? or government agencies “too big to fail.? It was, I hope, straight talk about finding real solutions in a bad economy. It may still be the money in the end, but let’s keep those options open until then. And I hope more agencies look at “locally grown? solutions before defaulting to money or taking over EMS.

Oh, and just for the record, I would never really compare my wife to a union boss. It was just an analogy, Sweetheart.

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Filed under Administration & Leadership, EMS Topics, Firefighting Operations, Funding & Staffing, News, Vehicle Operations & Apparatus

MCIs and "The Downwind Walk"

I never really considered doing book reviews on this blog or writing about specific horrific incidents either, but I finished reading “The Downwind Walk: A USAR Paramedic’s Experience after the Terrorist Attacks on September 11, 2001? by Steve Kanarian just hours before the shots rang out at a movie theater in Aurora, Colorado. Let me say upfront that this will also probably not be the sort of book review you might expect, but I doubt the book will be what you expect it to be either. The book at least, is much more than it appears. Steve is a Paramedic, a retired FDNY EMS Lieutenant, and now I am happy to call him my friend as well. He has given me a gift through his pain and I hope you will take it as well.

From the title I was expecting a journal of the messy details written by a “Forrest Gump?-type character who was always in the right place at the right time and would take me into the depths of the response that day. What I discovered was an even more real experience than I imagined. It was his exact experience including the hours and days of simply waiting to be of use. Most surprising was that the greatest interest of the book for me became the continuation of his story long after the actual event and even after his final day working at ground zero. It was the story of every first responder who is called to action at any Mass Casualty Incident (MCI) anywhere.

During my own initial training as an EMT, my instructor dutifully covered the section on stress management from the AAOS guide including Critical Incident Stress Management (CISM) and without hardly a breath broke out of instructor mode and told us flatly that he was required to say all that, but that in reality it simply never happens. I don’t know how it is in very many different services on this topic, but I suspect my instructor was not an anomaly. As both a professional and as a human, my heart goes out to all of the responders in Aurora and elsewhere who have had to clean up the messes left by mass murderers. I believe so strongly that they need to hear his story that I would be happy to send my own copy of the book to anyone who responded to the theater shootings if you cannot get a copy yourself. I think it is genuinely that important.

Sure, it was clear that this was his first book and the publisher made some mistakes in the printing, but for me, the story was well beyond the words. It was the call to action – not to help others, but to know your limits, understand yourself, and be willing to seek help when you need it. Your value as a Paramedic, an EMT, a firefighter, or a police officer is not your strength but in recognizing your limits. Thanks, Steve!

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Filed under Command & Leadership, EMS Topics, Firefighter Safety & Health, Mass Casualty Incident