Speaker 1: Welcome to Stuff You Should Know from how Stuff Works
Speaker 1: dot Com. Hey, and welcome to the podcast. I'm Josh
Speaker 1: Clark with Charles W. Chuck Bryant and there's Jerry Jerome
Speaker 1: Roland and this is Stuff you Should Know the emergency
Speaker 1: re Rear rear wo er er Ah. We should have
Speaker 1: a new podcast called Sirens Around the World. Yeah, it's
Speaker 1: annoying showever, it would be pretty annoying, but there'd be
Speaker 1: some subset of people who like just really despise themselves.
Speaker 1: That would be popular. I'm on so we would love it. Uh,
Speaker 1: we don't hate ourselves? Do we tell me? I need
Speaker 1: to know? No? Okay, so it depends on the day.
Speaker 1: I didn't want to hate myself. Sometimes I want to
Speaker 1: punch myself. Does that count? No? I know exactly what
Speaker 1: you mean, man. Sometimes is I'm just like, I am
Speaker 1: so sick of myself? Is that? Is that what you're
Speaker 1: talking about? That was a good song? Remember that song? No,
Speaker 1: it sick of myself? No, that was Matthew Sweet. Oh yeah, wow,
Speaker 1: that's weird that this is going on right now because
Speaker 1: Matthew Sweet just popped up like randomly in the last
Speaker 1: couple of days and like an article I was reading.
Speaker 1: I was like, I forgot about him, haven't heard about
Speaker 1: him in twenty years, and then bam, bottom mine off.
Speaker 1: Here he is again. Well he's still around. He's an
Speaker 1: Atlantic guy. You know, I didn't know that. Well that's cool, Yeah,
Speaker 1: I know. I think I think that's like the way
Speaker 1: it goes. Just because you had one hit in the
Speaker 1: world came and like listened to you and then moved
Speaker 1: on doesn't mean like you're like, Okay, well, I guess
Speaker 1: I'll go bury myself alive now in my own backyard.
Speaker 1: Usually usually the artist like keeps going. You know, yeah,
Speaker 1: he had two hits stuff. I know, girlfriend and then
Speaker 1: the other one. You're just talking about girlfriend. That's a
Speaker 1: great song. Yeah, that's a good song. Okay. So obviously
Speaker 1: what we're talking about today are paramedics, para medicine really
Speaker 1: is what we're talking about, which is, um it's actually
Speaker 1: a pretty interesting topic because you kind of look into it,
Speaker 1: You're like, oh, these these people save lives. That's great. Um,
Speaker 1: here's some of the life saving techniques that they do. Fantastic.
Speaker 1: But there's like actually so much more too. It's got
Speaker 1: a really interesting history, it's got a it's one of
Speaker 1: those things where it's way worse off than it should
Speaker 1: be as far as like funding and and and like
Speaker 1: UM logistics and stuff like that goes. I just find
Speaker 1: it interesting. It's it's interesting to kind of poke into
Speaker 1: a topic and then find that, oh, this is even
Speaker 1: more interesting than I thought, and have it poked back
Speaker 1: yep with forceps. So I guess we should say right
Speaker 1: off the bat that the word paramedic para means alongside,
Speaker 1: so alongside medicine, I guess, which I'm not quite sure
Speaker 1: what that means. So what I think it means is
Speaker 1: as follows Charles, these people paramedics. They are not doctors,
Speaker 1: but they work with an alongside and really honestly um
Speaker 1: as an extension of a doctor and empty. So that's
Speaker 1: what I think it means, because it's not like what
Speaker 1: they're doing is a different type of wacky medicine. Like
Speaker 1: they're actually doing the same type of medicine that an
Speaker 1: E R doctor and E R nurse would be doing,
Speaker 1: and e R they're just doing it out in the field.
Speaker 1: Could you imagine how disconcerting it would be to be
Speaker 1: like on the ground and have a paramedic come up
Speaker 1: and like blow green dust in your face. You're like,
Speaker 1: what are the chicken bones for? Man? Oh man, blow
Speaker 1: green dusty. I don't know, it would depend on what
Speaker 1: the effect of the green dust was. So, um, I
Speaker 1: think that's what paramedic means. Right, we can go we
Speaker 1: can go further back actually and and and describe what
Speaker 1: ambulance means. We know that one for certain. Yes, Uh,
Speaker 1: that came around in fifteenth century Spain during the Inquisition.
Speaker 1: They clearly had a lot of need for medical work. Uh.
Speaker 1: And they actually had field hospitals that were called ambu lancias. Right.
Speaker 1: It was just basically like a mass unit out in
Speaker 1: the field. Um. And then eventually the the French shortly after,
Speaker 1: I think under Napoleon, they innovated on the ambulance and said, well,
Speaker 1: that's great, that's neat that we have these things out
Speaker 1: in the field, But there's some guys way over there
Speaker 1: who are injured, and they probably wouldn't die if we
Speaker 1: could get them to these ambulances, these field hospitals. Right.
Speaker 1: So they came up with basically mob ambulances um, which
Speaker 1: is the this idea of a flying or a moving ambulance,
Speaker 1: which is like a little medical facility that they would
Speaker 1: put the people into and move them away from battle
Speaker 1: to go patch them up, rather than waiting for the
Speaker 1: battle to end. Well yeah, and before that, even during
Speaker 1: the Crusades, and they also had a great need for
Speaker 1: medical care. Uh, there were the Knights Hospitaller. Hospitaller I
Speaker 1: think hospitalier. Oh whoa is there an extra I might
Speaker 1: be putting an extra syllable in there. Well, I'm known
Speaker 1: to do uh nights hospitaller. That's what I'm gonna say
Speaker 1: of the Order of St. John of Jerusalem. And they
Speaker 1: were the first kind of the first people to practice
Speaker 1: emergency medicine on the battlefield. And they even invented the
Speaker 1: what we now call the stretcher, although it's still called
Speaker 1: a litter in some circles. Yeah, it's pretty intuitive thing,
Speaker 1: but it's it works. Someone had to think of it.
Speaker 1: A couple of sticks with some canvas stretch between them.
Speaker 1: Throw a person on there, you can pick them up.
Speaker 1: Two people can pick them up and get them off
Speaker 1: of the battlefield lickety split. So yeah, So this is
Speaker 1: the idea of emergency medicine grew basically exclusively out of
Speaker 1: warfare over the centuries. Well, yeah, But what's remarkable to
Speaker 1: me is that from that time, I have the right idea,
Speaker 1: let's get these people out of here quickly. It took
Speaker 1: about a hundred and thirty years all the way until
Speaker 1: the mid to late nineteen sixties until they said, hey,
Speaker 1: wait a minute, if we actually put trained medical people
Speaker 1: in these things and weren't simply driving people to a hospital,
Speaker 1: we might have even more luck. Yeah, that was the
Speaker 1: late sixties and then amazing it is And at the
Speaker 1: time it was so a lot of medic It was
Speaker 1: practiced through house calls right, including emergencies like if there
Speaker 1: was an emergency and you could get ahold of a doctor,
Speaker 1: the doctor was expected to go out to that emergency
Speaker 1: and do what they could. But more often than not,
Speaker 1: either the cops um or local morticians were tasked with
Speaker 1: basically was called like a scoop and scoop and run,
Speaker 1: scoop and carry, where you just basically get the person
Speaker 1: out of that car wreck or um from the bottom
Speaker 1: of that ladder or whatever just happened to him, throw
Speaker 1: them in the back of a car, a cop car,
Speaker 1: or a hearse. I would looked it up the ECTO
Speaker 1: one the ghostbusters, um ambulance is a modified Cadillac Hearse,
Speaker 1: so um, they would dress the sinking feeling. It really
Speaker 1: was for a mortician to show up in a Hearse
Speaker 1: and be like, I'm gonna take you to the hospital.
Speaker 1: Depending on what happens, you may be back in the
Speaker 1: same car. Yeah, and talk about a conflict of interest,
Speaker 1: you know what I mean, that's a good point. Hopefully not,
Speaker 1: but yeah on paper, yeah right, or they just you know,
Speaker 1: casually put their hand on the person's nose and mouth
Speaker 1: in the backseat. Dry. Um. The thing is, though, is
Speaker 1: whether the mortician or the cops were getting you to
Speaker 1: the hospital. Even when you got to the hospital. It's
Speaker 1: not like there was such a thing as an e
Speaker 1: er room. E Arston come about really until like the
Speaker 1: mid seventies, where you could find them in in fair
Speaker 1: abundance around the United States. Like e r just didn't exist.
Speaker 1: It was here you go, doc. I know, you just
Speaker 1: delivered a baby and you um treated somebody else for Angelina,
Speaker 1: but now you've got to put this person's head back together. Yeah,
Speaker 1: And it was all just medicine at the time. So yeah,
Speaker 1: the idea of getting somebody to a hospital and having
Speaker 1: a medical person a professional in the car that's transporting them.
Speaker 1: It came out of Ireland, I think, right yeah, big
Speaker 1: shout out N seven to Dr J. Frank Pantridge of Belfast.
Speaker 1: He had a study. He published a study that said, hey,
Speaker 1: you know what, we have more success saving people's lives
Speaker 1: when our mobile units have a physician or a nurse inside.
Speaker 1: And everyone went, huh, I never really thought about that,
Speaker 1: but there it is. There's a study. Pretty cool. So
Speaker 1: he definitely um set the stage for this. And then
Speaker 1: the year before there was a report I think it
Speaker 1: was a year earlier, right, the one from Congress in
Speaker 1: America a couple of years sixty five. I think it
Speaker 1: was like the National Academy of Sciences or somebody basically
Speaker 1: got together with another group and said, let's let's study accidents.
Speaker 1: And what they came up with was this idea that
Speaker 1: there was like this um overlooked disaster that happened, like
Speaker 1: accidents were a huge, major leading cause of injury and
Speaker 1: death in the United States, and the this inquiry determined
Speaker 1: that we weren't doing much about it, and specifically a
Speaker 1: lot of people died who otherwise wouldn't have if there
Speaker 1: had been something like an emergency medical service to attend
Speaker 1: to them at the accident scene and on the way
Speaker 1: to the hospital, and then having the hospital actually know
Speaker 1: what they were doing as far as emergency medicine goes. Yeah,
Speaker 1: it's just it's just staggering to me. It seems so
Speaker 1: intuitive and I can't believe it took that long for
Speaker 1: this to happen, you know. Uh. And in fact, the
Speaker 1: Emergency Medical Systems Act was signed in nineteen seventy three,
Speaker 1: which basically said, we need a standardized system here, Yeah, nationwide.
Speaker 1: That was after that paper came out in nineteen sixty six,
Speaker 1: many years later. I mean that's the speed of government,
Speaker 1: I guess. Uh. And then in nineteen seventy seven the
Speaker 1: publication of the first very first national standard Curriculum for
Speaker 1: e m T s and Paramedics seventy seven. Yeah. And
Speaker 1: then so alongside this para this, um, they they there
Speaker 1: were people like around the country, at universities around the
Speaker 1: country and around the world, who, um, we're kind of
Speaker 1: all recognizing all of this. At the same time that
Speaker 1: there were there's a lot more that could be done
Speaker 1: for people who were injured in accidents. Um. And so
Speaker 1: you had the people at Pitt University of Pittsburgh taking
Speaker 1: up the cause. Yeah, they started UM. Is it the Panthers? Huh,
Speaker 1: they started UM creating some of the first curriculum for paramedics,
Speaker 1: some of the earliest tests for paramedics. Uh. The University
Speaker 1: of Cincinnati came up with the first curriculum for training
Speaker 1: physicians in e er medicine. I think the University of
Speaker 1: California was an early entrant into the world of of
Speaker 1: UM teaching paramedicine. And I think they were the first
Speaker 1: one to be accredited in nineteen eight, Like they had
Speaker 1: their operation going for years, but they were the first
Speaker 1: one to say, hey, somebody take a look at this
Speaker 1: and make sure we're kosher, and then we can say
Speaker 1: we're an accredited training facility for paramedics. It is. It
Speaker 1: is pretty amazing. And then the problem is this, So
Speaker 1: the federal government got into the act in nineteen seventy
Speaker 1: three with the Emergency Medical Services Act. But bye, there
Speaker 1: was an omnibus budget that said we're out, We're done,
Speaker 1: We're not funding emergency services anymore. And then from that
Speaker 1: point forward, the emergency service system in the United States,
Speaker 1: whatever had been developed to that point, broke into patchworks
Speaker 1: of state, local county programs, sometimes multiple ones within a
Speaker 1: single county. I think there's a county in Michigan that
Speaker 1: has like eighteen different emergency services UM and that has
Speaker 1: kind of created this where we are now, which is
Speaker 1: people doing the absolute us they can in what what
Speaker 1: amounts to a broken system in a lot of ways.
Speaker 1: Should we take a break, all right, when we come back,
Speaker 1: we will put the broken system behind us momentarily. Talk
Speaker 1: about e m t s and paramedics change to change,
Speaker 1: all right. So if you want to ride in an
Speaker 1: ambulance or drive an ambulance and get on the scene
Speaker 1: and help someone out who's in need, there are a
Speaker 1: couple of ways you can do it. UH. You can
Speaker 1: be an empty emergency medical technician. And this is the UH.
Speaker 1: This is the person who has has undergone about between
Speaker 1: about a hundred and twenty and a hundred and fifty
Speaker 1: hours of course work. They're they're well trained and all
Speaker 1: kinds of life saving procedures. If you need CPR, if
Speaker 1: you need oxygen administered, if you were having some bad
Speaker 1: allergic reaction, that your life is in jeopardy. But there
Speaker 1: are limits to what they are allowed to do. So
Speaker 1: one thing they cannot do even in the case of
Speaker 1: giving shots, is they can't break the skin, right, which
Speaker 1: is super interesting. I never knew that. No, I didn't
Speaker 1: know that either. But you can consider an e m
Speaker 1: T like an entry level paramedicine professional, right, that's where
Speaker 1: you would start. And in fact, I think you have
Speaker 1: to start as an e m T to go on
Speaker 1: to the next level, which would be paramedic. Yeah. So
Speaker 1: if you're a paramedic, you have about ten times the
Speaker 1: amount of coursework and schooling under your belt by the
Speaker 1: time you're a paramedic. And I think you do have
Speaker 1: to have about s months at least of prior immediately
Speaker 1: prior e m T experience to start um becoming a
Speaker 1: paramedic as well, which I'm sure is the way most
Speaker 1: people go. As you start out as an e m
Speaker 1: T and then you you know, move on to the
Speaker 1: next level, which is paramedic. Yeah, which, like you said,
Speaker 1: ten times, so that's about anywhere from hours depending on
Speaker 1: your state or your municipality to get certified. And this
Speaker 1: is where the real action can happen. Um, you can
Speaker 1: give an i V. You can if someone's having a
Speaker 1: heart attack, you can deal with that. You can operate uh, defibrulator, fibulator, fibrillator.
Speaker 1: It's fun to say. Once you master it. They should
Speaker 1: have just called it the the clear machine. Yeah, the uh.
Speaker 1: But it's a it's a lot of work in a
Speaker 1: lot of hours. And one of the people that they
Speaker 1: interviewed in this article said that, you know, it's really grueling,
Speaker 1: and when you're in paramedic training in school and doing
Speaker 1: your coursework basically for a year or two, you can
Speaker 1: just say goodbye to your friends and family. Yeah, I
Speaker 1: saw that too. Stuff. So, um, the paramedic is actually
Speaker 1: they operate under the license, not just like like under
Speaker 1: the direction, but under the license of a physician in
Speaker 1: their locale. Right, there's a couple of ways that you
Speaker 1: can do it. And and as you'll start to see,
Speaker 1: like I saw a quote that um it said, if
Speaker 1: you've seen one emergency medical system, you've seen one emergency
Speaker 1: medical system. They're all just so different and the whole
Speaker 1: thing is so patchwork. But um there is a national standard,
Speaker 1: which I think is the National Emergency Medical Technician Registry Exam.
Speaker 1: That's like the national exam, and then you may have
Speaker 1: to pass like a state and or local exam to
Speaker 1: depending on where you live. But there is like a
Speaker 1: national accreditation and national coursework. But then how the system
Speaker 1: functions and runs is what's the the patchwork part of it. Yeah,
Speaker 1: and it will cost you. I mean it depends on
Speaker 1: where it is, of course, and what program. But the
Speaker 1: the example they used in art article is the u
Speaker 1: c l A Center for Prehospital Care. Uh, and they
Speaker 1: quoted about ten grand for just tuition. And then of course,
Speaker 1: like any college or coursework, you're gonna have to pay
Speaker 1: for books and equipment and uniforms and stuff like that.
Speaker 1: That's exactly where they get you the plaid skirt. Uh.
Speaker 1: And then after that, though, the good news is is
Speaker 1: that you have a really good chance of getting work.
Speaker 1: I get the impression that if you have gone through
Speaker 1: all of your paramedic training, you're not sitting around like
Speaker 1: there's usually a job waiting for you somewhere. Yeah. I
Speaker 1: saw that as well. And actually, um, it doesn't necessarily
Speaker 1: pay super well people. So if you ever see a paramedic,
Speaker 1: be extra nice to them for sure, because not only
Speaker 1: are they running around saving people's lives, they're not getting
Speaker 1: rich off of it at all. Um, They're doing it
Speaker 1: because it's something they care about um, but they're just
Speaker 1: bite that despite the mediocre pay um, it's I saw
Speaker 1: it's gonna be one of the most in demand jobs
Speaker 1: over the next like ten to fifteen years. I really
Speaker 1: wish I could remember the statistic exactly, but I think
Speaker 1: they're like expecting another like fifty three thousand e m
Speaker 1: T jobs or paramedic jobs to be added to the
Speaker 1: American economy over the next decade maybe. So it's definitely
Speaker 1: a growing, growing um career for sure, growing profession. Yeah,
Speaker 1: and you mentioned the pay. If you, uh, if you
Speaker 1: go to the US Bureau of Labor Statistics to kind
Speaker 1: of find a mean salary or something, they do it.
Speaker 1: It's not really they should separate it out, but they
Speaker 1: lump in e m T s and paramedics, when of
Speaker 1: course e m T s don't make the kind of
Speaker 1: money they're paramedic would. But they had a mean annual
Speaker 1: wage of about thirty one dollars a few years ago. Uh.
Speaker 1: And if you're in the top ten percent, it's about
Speaker 1: fifty four thousand. And apparently this to Washington is one
Speaker 1: on the higher side. They you can get as high
Speaker 1: as seventy one grand in the state of Washington, but
Speaker 1: I mean, you know, that's a that's a good living
Speaker 1: and a decent living. But it's not like like you said,
Speaker 1: they don't go into this because like, oh man, you
Speaker 1: know that thirty one grand year. It's sort of like
Speaker 1: being a school teacher. It's a I feel like it's
Speaker 1: a calling in a lot of cases for sure. For
Speaker 1: sure um as I was saying about the license that
Speaker 1: they operate under, right, So if you're a certified paramedic
Speaker 1: when you are um depending on the state you're in,
Speaker 1: you may be operating under the license of the state
Speaker 1: medical director, like that's where you have your license, or
Speaker 1: you could also be operating under the license of a
Speaker 1: local physician, like that physician's license covers you, covers the
Speaker 1: physician's assistant, basically everything working for everyone working for him
Speaker 1: or her. So you might be operating under that physician's license,
Speaker 1: or I didn't know this man during an ambulance ride.
Speaker 1: So remember how just adding like a trained medical professional
Speaker 1: to the ride from an accident scene to the hospital
Speaker 1: improves outcomes. And we've done that since nineteen sixty six
Speaker 1: at least they've figured out that if you can communicate
Speaker 1: with a doctor, an e er physician en route you
Speaker 1: could also improve outcomes even more so. During these um
Speaker 1: this transportation from an accident to the hospital, the paramedic
Speaker 1: is probably in touch with an E R doctor who
Speaker 1: is instructing UM and advising and consulting with the paramedic
Speaker 1: to figure out the best course of action, the best
Speaker 1: course of treatment, and then how to carry that out.
Speaker 1: And from what I understand at that time, the paramedic
Speaker 1: is operating under that physician's license in that state. Would
Speaker 1: that make you feel better or worse? What that the
Speaker 1: paramedic was getting instruction from a physician, Like if you're
Speaker 1: here here this going on, I don't know. I would say.
Speaker 1: Part of me is like better because it's a doctor
Speaker 1: telling you that, But the other part of me is like,
Speaker 1: don't you know? And you would hate to hear like
Speaker 1: the doctors say, we'll get the something something and for
Speaker 1: the paramedic to say the what you're right, I don't
Speaker 1: know what that is. I've never seen this before ever.
Speaker 1: Have you ever had to take an ambulance ride for yourself? No,
Speaker 1: thank goodness, I didn't think I had either, But then
Speaker 1: I did. Remember UM, when I was thirteen or fourteen,
Speaker 1: my brother was sixteen, or seventeen, we were in a
Speaker 1: car wreck. There were eight people in a jeep, my
Speaker 1: and my brother's jeep that was once my dad's cheep,
Speaker 1: and that was definitely not safe to do to begin with.
Speaker 1: But we were going to a movie after church on
Speaker 1: the Sunday night. A bunch of kids in youth group
Speaker 1: piled and my brother's cheap wasted now just kidding, um,
Speaker 1: completely sober wasted on the Lord we were and it
Speaker 1: was raining really hard and uh, you know at at
Speaker 1: Ponts ponstantly on Avenue here in Atlanta. Everyone that doesn't
Speaker 1: live Atlanta probably laughs that we pronounced it that way
Speaker 1: instead of pulse dadion. Uh. But on Ponts where it
Speaker 1: kind of um, if you're leaving from Atlanta, it's that
Speaker 1: big curve where you go over that large stone archway. Yes,
Speaker 1: kind of headed toward Intdicator. We were coming down that
Speaker 1: way nowhere near North Lake Mall where we were supposed
Speaker 1: to be headed. We were lost and my brother we
Speaker 1: hydroplane hit a curb and turned the jeep over on
Speaker 1: its side and I ripped through the canvas ceiling or
Speaker 1: whatever it's made. Man, you got thrown. Oh yeah, we
Speaker 1: were scattered all over the street. You are lucky. I know.
Speaker 1: It's the only time I think that I've been knocked unconscious,
Speaker 1: and I just remember waking up, you know what would
Speaker 1: have been probably seconds later, in the pouring rain, and
Speaker 1: looking around and seeing my friends like scattered within like
Speaker 1: twenty ft of each other in various places. Man, that
Speaker 1: is scary stuff. It was scary so uh. In the end,
Speaker 1: the good news is no one had like I think
Speaker 1: the worst injury was like a broken collar bone. I
Speaker 1: broke my finger. There were little cuts and scrapes, but
Speaker 1: nobody was hurt bad. Uh. But I do remember this.
Speaker 1: My brother doesn't listen to this one. In the ambulance
Speaker 1: on the way, my brother was just sort of catatonic,
Speaker 1: and they said they were trying to get information, and
Speaker 1: they asked what his name was, and he said a whole.
Speaker 1: He said a hole, he said the real world. Yeah.
Speaker 1: I think he was just sort of out of it
Speaker 1: and felt terrible. And he didn't curse at all at
Speaker 1: the time. It still doesn't even curse much, but it
Speaker 1: was just it's weird that that is what stands out
Speaker 1: of my mind. I wonder if he remembers that. Actually, well,
Speaker 1: that's a big one. Especially you didn't curse. You're not
Speaker 1: so funny man, that's a that's you were a great storyteller.
Speaker 1: Was that a good story? Yeah? I was like, I
Speaker 1: was seriously, well, you kept like going off on tantons.
Speaker 1: I'm like, no, We've got to get back to the story.
Speaker 1: What happened to the cheek? I know you looked a
Speaker 1: little nervous. Yeah, so, um wow, Okay, should we take
Speaker 1: a break. Oh yeah? And also I forgot to mention
Speaker 1: the one guy that was tragically killed. Right, You're like,
Speaker 1: but did I mention? I also broke my finger. No, nobody,
Speaker 1: nobody was hurt. Everybody's too bad. Everybody was good. Everybody's good.
Speaker 1: I think my brother broke his foot. Yeah, it was
Speaker 1: just stuff like that. Heck of a story, chuck, heck
Speaker 1: of a story. Thank you? Uh yeah, let's take a
Speaker 1: break and regroup, shall we. Yeah, let's do okay, check, Okay,
Speaker 1: we're back. I'm not reeling quite as much as I was.
Speaker 1: But that was a good story. Again, I feel like
Speaker 1: we should mention even though it's kind of silly that
Speaker 1: emergency TV show Oh yeah, for sure from the seventies,
Speaker 1: because it seems like it definitely like actually played a
Speaker 1: part in ramping up ambulance services. Yeah. So this is
Speaker 1: I think n Or seventy two and it premiered and um,
Speaker 1: remember the Emergency Medical Services Act wasn't passing until nineteen
Speaker 1: seventy three. That white paper had come out in nineteen
Speaker 1: sixty six. So this idea of like this new type
Speaker 1: of medicine, this new type of like healthcare worker was
Speaker 1: really on America's mind. But one of the ways it
Speaker 1: got there was from that TV show Emergency, in part
Speaker 1: because it was shot like documentary style. People played themselves
Speaker 1: on it, like there were real dispatchers on the show
Speaker 1: acting as dispatchers. Um, it just captured America his imagination. Yeah,
Speaker 1: I remember watching it, see I I don't think I
Speaker 1: ever saw an episode of it. Yeah. It was an
Speaker 1: emergency with an exclamation point in Mantle seventy seven. And uh,
Speaker 1: it was mainly two dudes, uh to firefighter characters is
Speaker 1: what the story centered on. And one of them was
Speaker 1: a young Kevin tig Ortigue. He was did you eversee Roadhouse? Yeah,
Speaker 1: he was the owner. He's a character actor, he's been
Speaker 1: in he owned the Double deucee. Yeah, he's great. Yeah,
Speaker 1: I can't remember what else it's you. I've seen him
Speaker 1: young before. I wonder if it was Emergency now that
Speaker 1: you mentioned it. Maybe, huh, maybe I have, because I'm
Speaker 1: gonna for sure it did. I'm a Jack Web fan,
Speaker 1: and I think he produced or created it. You're big
Speaker 1: Jack Web guy, are you not. I don't know. Uh,
Speaker 1: he's the dude from Drag Night. He Sergeant Friday. Yeah,
Speaker 1: I guess I need to think about that. Yeah, he's awesome.
Speaker 1: I'll let you know, man, if you go back and
Speaker 1: watch like old episodes of drag Now, Oh my god.
Speaker 1: Yeah that was a good show. Yes, it was. And
Speaker 1: I think Emergency maybe Adam twelve is like the direct
Speaker 1: spinoff of Dragnet. Maybe that's what I'm thinking of. But
Speaker 1: I swear I know exactly what you're talking about with
Speaker 1: um fatigue fella from the Roadhouse and then wasn't Dragnet
Speaker 1: Colonel Potter, Yes, Harry Morgan, right, we had a Emilina
Speaker 1: had a long conversation about Match the other day and
Speaker 1: how that was I was a mash nut, and how
Speaker 1: that show was one of the few to survive like
Speaker 1: major cast changes. Oh yeah, like three of them. Yeah,
Speaker 1: they certainly didn't like like big stars, like co stars.
Speaker 1: I think one of the few people who made it
Speaker 1: through was Alan Alda, Right, he was there the whole time. Yeah,
Speaker 1: and like Hot Lips I think was the same, Um
Speaker 1: and a few others. But they had like Radar and Clinger. Yeah,
Speaker 1: they co existed I think. But eventually Radar left and
Speaker 1: Clinger took his job. They Potter took over for what's
Speaker 1: his face, the original guy, I don't remember, but he
Speaker 1: wore the fishing hat. Yeah, he was a man, the
Speaker 1: saddest ending ever for that one. What when he left? Yeah,
Speaker 1: I remember he got his papers to go home and
Speaker 1: everyone's all excited and then he was killed in a
Speaker 1: helicopter crash or a plane crash. I don't remember that
Speaker 1: this way out. Uh. And then of course Frank Burns
Speaker 1: left and was replaced by Winchester, and then Trapper left
Speaker 1: and was replaced by Honeycutt. Right, but it just it
Speaker 1: was still great, Well, I got it wasn't as great
Speaker 1: at the very end. I don't know. Man, Goodbye, Farewell
Speaker 1: and Amen was one of the all time best last episodes.
Speaker 1: That true for sure, Um, But you're saying they pulled
Speaker 1: it together at the at the last episode. I think
Speaker 1: I remember the last couple of seasons, it was a
Speaker 1: little bit like, you know this, maybe it did run
Speaker 1: its course, but that was a very discerning twelve year
Speaker 1: old viewer. Yeah, like they've really onto the hoo gin
Speaker 1: joke too many times this episode. It is funny though that, like,
Speaker 1: little twelve year old me thought, like the funniest thing
Speaker 1: in the world was war surgeons. Drunk war surgeons, right,
Speaker 1: drunk philandering war surgeons. Alright, I really got off track there. Yeah,
Speaker 1: maybe we should take a third break. I don't think so.
Speaker 1: I don't think we should either. So we're talking about
Speaker 1: paramedics today, believe it or not. And um, one of
Speaker 1: the things we talked about was the idea that that paramedics, well,
Speaker 1: let's talk a little bit more about their job. Right.
Speaker 1: One of the things that paramedics are sometimes criticized for is,
Speaker 1: um that they don't run to the scene of an emergency.
Speaker 1: I've never thought about that. Once you have it, I
Speaker 1: I really hadn't either, But then I started thinking about
Speaker 1: I'm like, yeah, I could totally see that. Um. Apparently,
Speaker 1: for some people who are at an emergency scene and
Speaker 1: see the paramedics kind of walk up, they appear a
Speaker 1: little too casual, and they want to know, what are
Speaker 1: you doing? Why aren't you rushing to this scene? And paramedics,
Speaker 1: I think we saw a question answered on course Cora
Speaker 1: or something like that, and um, a paramedic explains, there's
Speaker 1: actually a number of really good reasons why paramedics why
Speaker 1: you don't see them running to the scene. First of all,
Speaker 1: they're gonna park as close as they can't, so that
Speaker 1: running is only going to shave a couple of seconds off.
Speaker 1: But really the number one reason, or one of the
Speaker 1: top reasons, is that they are supposed to be they're
Speaker 1: supposed to bring with them to this scene of catastrophe,
Speaker 1: catastrophic panic, basically calm and professionalism and being in control. Yeah,
Speaker 1: I get that, Like I think it would be a
Speaker 1: little disconcerting if I was injured and I saw a
Speaker 1: paramedic burst into the room like breathing heavy, like, oh
Speaker 1: my god, what's going on? What's going on? Is everybody okay? Yeah?
Speaker 1: Plus they might get hurt running, that's another one. And
Speaker 1: they're usually you know, or not usually, but I would
Speaker 1: say probably a lot of times. It's not like they're
Speaker 1: walking through a you know, a perfectly laid pathway, like
Speaker 1: they could be running upstairs or through a house of hoarders,
Speaker 1: or you know, through the woods, like you don't know
Speaker 1: what's going on. You gotta be careful on your way there. Yeah,
Speaker 1: and you have to be going slow enough that you
Speaker 1: can assess what the risks you're walking into our as
Speaker 1: you're walking into them. Sure, then running into it and
Speaker 1: being like, oh, the guy who shot you still here
Speaker 1: waiting for me. You know now that I've run into
Speaker 1: the scene. I know that, but it's terrible. Um. It's
Speaker 1: also kind of hard to run from place to place,
Speaker 1: depending on the equipment that they're carrying with them. Those
Speaker 1: stretchers get heavy. Um, the e k G machines get heavy,
Speaker 1: the defibrillators get heavy. All that stuff gets heavy. So
Speaker 1: there's a number of reasons why you won't see a
Speaker 1: paramedic rushing to the scene. You will see him rushing
Speaker 1: to the scene in the ambulance though, and from what
Speaker 1: I understand that driving in the ambulance or riding in
Speaker 1: the ambulance is the most dangerous part of the entire job. Yeah,
Speaker 1: and here's another tip. Aside from being nice to your
Speaker 1: e M. T Or paramedic is. Don't call them ambulance drivers, yeah,
Speaker 1: because that's part of their job. Uh. And it's a
Speaker 1: weird thing too that there. It's not like they hire
Speaker 1: a driver who's super skilled at that and then they
Speaker 1: have other people in there that do the work like
Speaker 1: they do double duty. They have to learn to drive
Speaker 1: like that. And I mean, while they're e m T
Speaker 1: s are paramedics. Yeah, And so you know, if you've
Speaker 1: ever seen an ambulance going through an intersection, they're gonna
Speaker 1: slow and and maybe even stop and then proceed. They
Speaker 1: still get broadsided very frequently by people going through the
Speaker 1: intersection because they they have a green light and they're
Speaker 1: not paying attention. They'll they'll hit an ambulance like t
Speaker 1: bone an ambulance. And the drivers probably okay, or I
Speaker 1: should say the paramedic driving is probably okay, But the
Speaker 1: paramedics in the back they probably aren't um lashed down
Speaker 1: in any way, shape or form because they're working on
Speaker 1: the patient and they're getting thrown around and can get
Speaker 1: injured and killed themselves that way. So that's the most
Speaker 1: dangerous aspect of the job from what I've seen. Yeah,
Speaker 1: another interesting thing that I saw from that list you
Speaker 1: sent was that if you're in a big city, a
Speaker 1: lot of times they even have divided up between e
Speaker 1: MT and paramedic for different cases. So like if if
Speaker 1: there's a scene of trauma going on, like a car accident,
Speaker 1: then you're more likely to get an e m T.
Speaker 1: Whereas if you're at home and you're like my husband's
Speaker 1: having a heart attack, where my child's having a seizure,
Speaker 1: then you're more likely to get a paramedic. Yeah, which
Speaker 1: is interesting. Yeah, And um, if in cities as well,
Speaker 1: if you're a paramedic, you're probably once you get into
Speaker 1: your ambulance, you're basically stationed at the ambulance for the
Speaker 1: rest of your twelve hour shift. Um, you're you don't
Speaker 1: go back to the firehouse or to the ambulance clubhouse
Speaker 1: or anything like that. You're you're you're like on a desk,
Speaker 1: neated street, corner, parked waiting for your next call. Um
Speaker 1: probably killing time somehow, but you're you. There's there's not
Speaker 1: very much downtime. And like in a in a city especially,
Speaker 1: the opposite is true for more rural um e m
Speaker 1: T s and paramedics, and that there's a lot of
Speaker 1: downtime so much so that this guy who was actually
Speaker 1: one of the consultants on that show Emergency years back, Uh,
Speaker 1: he became a Minister of Health I think in Nova Scotia,
Speaker 1: and he UM he created this program for rural e
Speaker 1: m S workers UM to use their downtime in much
Speaker 1: the same way that like a country doctor would have
Speaker 1: made house calls. Yeah, so they're like, it wasn't the
Speaker 1: idea that they would go to places and sort of
Speaker 1: help train like regular citizens on how to avoid getting
Speaker 1: hurt and stuff to begin with, right, Yeah, like like
Speaker 1: doling out preventative medicine, like making sure that people are
Speaker 1: taking their med since correctly, teaching CPR classes, UM, teaching
Speaker 1: leading exercise classes for like seniors at a senior center,
Speaker 1: like doing all the stuff to reduce the number of
Speaker 1: calls that they have to go on anyway, so it
Speaker 1: cuts down on their downtime, which I think is actually
Speaker 1: very much appreciated by paramedics because there's really nothing more
Speaker 1: boring than sitting around constantly, and then they're actually doing
Speaker 1: something and and also UM making their community a healthier place. Yeah.
Speaker 1: I thought it was funny when they were talking to
Speaker 1: some real on the ground paramedics about the downtime, They're like, well,
Speaker 1: HBO goes kind of awesome, right, yeah, Like, oh, well,
Speaker 1: I guess you got a past of time. It's better
Speaker 1: than Nicolas Cage and bringing out the dead. What did
Speaker 1: he do? Because I remember that movie, but I don't
Speaker 1: remember all the details of Well, it wasn't that great. Um,
Speaker 1: I liked it. He did tons of drugs. Oh okay,
Speaker 1: that's why or something I got you. Yeah, yeah, he
Speaker 1: kept to be fired, right, I don't remember it very
Speaker 1: very well at all. Actually, I think he did, like
Speaker 1: that was his stick. He'd be he begged to be fired. Um.
Speaker 1: So one of the things about those that downtime the
Speaker 1: community community preventative medicine initiatives that have kind of spread
Speaker 1: from Nova Scotia out through around the country. Um, when
Speaker 1: you see a paramedic doing that, they're they're not being
Speaker 1: paid or at the very least their unit or their
Speaker 1: county or their city is not being paid for that,
Speaker 1: which is a huge problem. Yeah, this is where I
Speaker 1: got a little confused. The way I was reading this
Speaker 1: was Medicaid and medicare and stuff in insurance companies will
Speaker 1: reimburse only if they have transported someone to a hospital. Yes.
Speaker 1: So in other words, if you go as an ambulance
Speaker 1: in a paramedic or e n T to a place
Speaker 1: and you actually can just help and treat someone there
Speaker 1: and they don't need to go to the hospital, then
Speaker 1: it's a freebee. Or did they send a bill to
Speaker 1: the people? As from what I understand it's a freebie.
Speaker 1: I don't probably since it is such a patchwork of
Speaker 1: systems all around the country. I'm sure that you could
Speaker 1: live somewhere where you the person would get a bill
Speaker 1: for that. I think as a matter of fact, you
Speaker 1: do no matter where you live. But um Medicaid and
Speaker 1: Medicare won't pay for it. Um, So there is there
Speaker 1: is a substantial reason to say, keep working chest compressions
Speaker 1: on a person who is obviously dead all the way
Speaker 1: to the hospital so that you can like bill Medicaid
Speaker 1: for that transport or getting somebody to go to the
Speaker 1: hospital even though they don't need to, so that you
Speaker 1: can build Medicaid for that that as well. And the
Speaker 1: problem is that that leads to other problems as well,
Speaker 1: like hospital e ers are very much overcrowded and understaffed
Speaker 1: and overworked. Right, so when you show up with another person.
Speaker 1: That's one more person they have to deal with, and
Speaker 1: apparently it creates a bit of a conflict. Yeah, there's
Speaker 1: a cultural conflict between the people the paramedics and the
Speaker 1: e m t s bringing people to the e R
Speaker 1: and the people who staff the e ER and are
Speaker 1: accepting these people, and so much so that there's it's
Speaker 1: become kind of common for e ER rooms to um
Speaker 1: to issue ambulance diversions saying don't bring anybody to our
Speaker 1: e ER, go somewhere else. And on a really bad
Speaker 1: night in a really populated city, you might find every
Speaker 1: single uh e ER room like with that diversion alert
Speaker 1: on and you've got to take somebody out to like
Speaker 1: a country hospital that doesn't know anything about trauma, and
Speaker 1: it takes forty five minutes to get there. Um, and
Speaker 1: you're they're not going to get the care they could
Speaker 1: receive at a good trauma center in the city. UM.
Speaker 1: So that's a real problem. Yeah, and it isn't too
Speaker 1: in terms of pay. And we need to hear from
Speaker 1: people on the ground because this it's surprisingly confusing when
Speaker 1: you research this on how it all works. Uh. And
Speaker 1: maybe that's the point, but um, it seems like it's
Speaker 1: also a fixed rate. There's no difference between I treated
Speaker 1: a kid for an allergic beasting reaction to I brought
Speaker 1: a guy back from the dead who had had a
Speaker 1: heart attack or heart failure. Yeah, is that right? Yeah,
Speaker 1: so long as you transport both of them to the hospital,
Speaker 1: that you're gonna get. I think I saw as low
Speaker 1: as twenty five bucks from medicaid in some places. I
Speaker 1: don't understand this is the numbers just do not add up.
Speaker 1: I don't get it at all. I know that some places,
Speaker 1: some counties and cities fold their e M t R
Speaker 1: E M S workers under their fire departments so that
Speaker 1: they fall under the fire departments funding, which I think
Speaker 1: fire departments tend to be way better funded than any
Speaker 1: kind of E M S service. So I think that's how.
Speaker 1: That's one way that it happens. But I just I
Speaker 1: don't I don't get how this how this actually works
Speaker 1: money wise, because it doesn't add up. It doesn't make sense. Yeah,
Speaker 1: I mean, it's not often that we're a little stymied. UM,
Speaker 1: So we're gonna follow up for sure with some emails.
Speaker 1: But I think it's also going to vary from place
Speaker 1: to place. Because the other thing that I got really
Speaker 1: confused about was private the privatization of ambulance services. Uh.
Speaker 1: And as best that as I can tell is in
Speaker 1: the seventies and eighties there were a lot of small
Speaker 1: private ambulance companies, but then they merged into more regional things,
Speaker 1: and that these days there's just a few, like big
Speaker 1: multinational companies that are the most dominant in the industry. Right.
Speaker 1: But I don't get how that works, Like if they're private,
Speaker 1: are they like working with only private hospitals or can
Speaker 1: they go to a state hospital. I think that they
Speaker 1: can get a contract from the state, they can be
Speaker 1: they can have a license to operate within a state
Speaker 1: AID or a county or wherever. Um, And I think
Speaker 1: they go wherever they're called to. I know that there
Speaker 1: can be like competition among them, so like multiple ambulances
Speaker 1: will show up at a scene. Sometimes it's just it's
Speaker 1: it's it's kind of a bit of a cluster um
Speaker 1: as far as competing with the local E M. S services,
Speaker 1: And I think it's on the decline from what I've seen.
Speaker 1: But when you call nine one one, do you have
Speaker 1: a choice? So what you can do? I think it's
Speaker 1: kind of like Uber, where like they the nine one
Speaker 1: one dispatcher has a log of companies or services like
Speaker 1: public funded or private services that that it can be
Speaker 1: issued too, and they send out the alarm and whoever
Speaker 1: takes the call goes and gets it. Interesting. So the
Speaker 1: problem is I saw a Las Vegas Review Journal article
Speaker 1: about this. Las Vegas was debating whether to just totally
Speaker 1: privatize their e M S services, and their e M
Speaker 1: S is like went berserk there like no, like this
Speaker 1: is this doesn't work? Um, the private companies are late.
Speaker 1: I think they were late like ten thousand plus times
Speaker 1: in one year in Las Vegas. Um, their response time
Speaker 1: tends to be less than the actual fire department e
Speaker 1: M S is. Um, it's just not as it's just
Speaker 1: not as preferable. And the reason why ambulance private ambulance
Speaker 1: services came about or became widespread is this this idea
Speaker 1: that you should just privatize everything and then that competition
Speaker 1: will keep everything going. And that hasn't necessarily panned out
Speaker 1: to be the case. And from what I see, New
Speaker 1: York is actually scaling back on their's right. Yeah, I
Speaker 1: think Juliani is one of the people that really tried
Speaker 1: and of course, you know, no surprise given his politics
Speaker 1: trying to privatize the industry. Uh, but apparently a lot
Speaker 1: of those had gone out gone bankrupt basically. And and
Speaker 1: then during the um, during the housing boom, the financial collapse, strangely,
Speaker 1: or maybe not straight asually because I don't understand it,
Speaker 1: a lot of private equity firms started buying up ambulance services. Yeah,
Speaker 1: that's there, you go, there's the downfall. It's just so interesting.
Speaker 1: I know that this is one of those where someone's
Speaker 1: gonna knock our socks off with a great email. Yeah.
Speaker 1: I think Also, um, one more thing about the private
Speaker 1: ambulance services, it's not like they're just a bad idea
Speaker 1: all around. In a in a locale that is underserved,
Speaker 1: if a company wants to come and set up ambulance services,
Speaker 1: that would be great for that area because they have
Speaker 1: a far you know they have. They can get places
Speaker 1: faster in an ambulance than they could have before. In
Speaker 1: a place where you've got your E m S overstretched
Speaker 1: and the county's like, no, we're not hiring a single
Speaker 1: additional E M S worker. The company that sets up
Speaker 1: shop can actually take up the slack like there are
Speaker 1: good aspects, so like, it's not just like some terrible idea,
Speaker 1: but in practice that hasn't worked out as well as
Speaker 1: as one would hope from what I understand. Yeah, em
Speaker 1: mess workers like email us like explain this because I
Speaker 1: really like you. I do not get who's footing the
Speaker 1: bill has to be insurance companies, and then if you
Speaker 1: don't have insurance, it has to be just the person
Speaker 1: the individual. Yet, and I think we have. We waded
Speaker 1: into the waters of doing a podcast once and didn't.
Speaker 1: Didn't that correct because it was I mean, we'll do
Speaker 1: it at some point, but I remember thinking, oh, that's
Speaker 1: a good, easy ish one and it ended up like
Speaker 1: being super convoluted. Yeah, I think I think we should
Speaker 1: do that. We should also do um just e ers
Speaker 1: in general too. So that's a bit about paramedics. Sounds
Speaker 1: like there's way more to it, right, But you got
Speaker 1: anything else for now? Okay, Well, since Chuck said no, sir,
Speaker 1: it's time for listening to mail. All right, I'm gonna
Speaker 1: call this we helped the dude win something. Yeah, I
Speaker 1: love this one. Hey, guys, been listening to your show
Speaker 1: for about four years and I always wanted to write
Speaker 1: in but now I have a great reason. A local
Speaker 1: store was doing a giveway a few days ago, and
Speaker 1: they posted that the first people to show up and
Speaker 1: answer correctly would win a prize. The question was bacon
Speaker 1: and eggs was not always a breakfast food? And what
Speaker 1: year did it become so? And who was the man
Speaker 1: behind the marketing idea? So this guy sounded super excited
Speaker 1: because he knew the answer. Immediately, I thought of your
Speaker 1: show and the uncanny ability of Mr Edward Burney's to
Speaker 1: pop up in seemingly strange histories. I remembered your pr
Speaker 1: episode and knew it was sometime in the twenties. So
Speaker 1: I hopped in my car and took off for the business.
Speaker 1: When I got there, I told him to answer with
Speaker 1: a startled look. They told me I'd want a huge
Speaker 1: case of meat, and not just junkie stuff either. This
Speaker 1: place sales to restaurants and businesses all across the country.
Speaker 1: That I was super stoked. Good he's like I won
Speaker 1: meat and not just like terrible meat, like good stuff too. Uh.
Speaker 1: When they asked if I had to look it up,
Speaker 1: I told them no, that I listened to stuff you
Speaker 1: should know, and they retained it in the back of
Speaker 1: my mind. They asked for the name of the show. Uh,
Speaker 1: and they said they were going to play it for
Speaker 1: all the workers there during the day, so now they
Speaker 1: can get more difficult and random questions. That's awesome, and
Speaker 1: he said it doesn't in there. I went back later
Speaker 1: in the week and the same girl I've spoken to
Speaker 1: recognized me. So they had two other people come in
Speaker 1: that had known the answer from stuff you should know
Speaker 1: as well. Al Right, even though we live in super
Speaker 1: rural uh, Utah, you apparently have a large following. And
Speaker 1: that is from John Robeson. Thanks John Robeson. I hope
Speaker 1: you have a healthy E M S Service out there
Speaker 1: to come find you after you eat that box of meat. Yeah,
Speaker 1: and you know what, let's hear from Salt Lake City
Speaker 1: because we have debated a live show there and just
Speaker 1: didn't know if we had the support. So I want
Speaker 1: to I want to hear it. Okay, well, come on here,
Speaker 1: we want to hear from Utah in's and E M. S. Workers. Yeah.
Speaker 1: If we get ten people that email us and say
Speaker 1: to come to the Salt Lake City will come. I
Speaker 1: think we should set the bar higher than that. Okay, Okay, Uh, Well,
Speaker 1: if you want to let us know that you're from
Speaker 1: Utah and you want us to come, or you're an
Speaker 1: E M S worker and you've got some good stories
Speaker 1: for us. You can tweet to us. I'm at josh
Speaker 1: um Clark and at s Y s K podcast. Chuck's
Speaker 1: at Charles W. Chuck Bryant on Facebook dot com and
Speaker 1: at Stuff you Should Know on Facebook as well. You
Speaker 1: can send us an email. It's probably easiest to stuff
Speaker 1: podcasts at how stuff Works dot com is always joined
Speaker 1: us at at Home on the web Stuff you Should
Speaker 1: Know dot com. For more on this and thousands of
Speaker 1: other topics, is it how stuff Works dot com