November 2004 Letters

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Mail: EMS, 7626 Densmore Ave.
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We received an overwhelming response to Mike Smith’s Beyond the Books column, What’s Up At the Airport?, in the July 2004 issue of EMS. We appreciate your input on the issues Mike raised, as well as the effort he has taken to respond to everyone’s comments (see Mike’s comments in italics). Watch for more letters on this hot topic in the December issue. —Ed

What’s Up at the Airport? When I first read your “editorial,” the anger and indignation were almost overwhelming. I read it again and actually laughed. Then I thought to myself, “this guy is scary” because it is obvious that, based on your vast experiences, “three calls, three different airports over the years,” you have chosen to take to your bully pulpit and castigate a group about which you apparently have very little knowledge.

First, let me say this. If you indeed observed shoddy clinical practices in the field, and were “blown off” as you tried to point them out; or you observed negligent medicine and a possible incident of malpractice, I would think that as head of an EMS program and also an editorial board member of your magazine, you would have reported the incidents to the proper authorities. But apparently you find it’s easier to use your forum in the media to try to correct what you perceive to be a problem.

As for your lawyer friend, I question her opinion that three times is a pattern. If you use your three experiences at as many airports over the unspecified amount of time (how many years?) as an example, then three homicides by three people in three different cities over the same unspecified amount of time gives us a serial killer.

Second—I and seven of my peers are airport medics at the Philadelphia International Airport. We did not receive our assignments to the airport because we were not good street medics and had to be dumped somewhere, and in my case it was definitely not by seniority (four years with the PFD). On the contrary, we were thoroughly screened by several EMS officers and ultimately approved by a deputy fire commissioner.

Third—Your credentials are admirable, but the arrogant undertone of your editorial suggests to me that something humane, just and fair may have been lost in the translation over the years. Perhaps those medics noticed it also and were just totally turned off by you.

Fourth—I would think that as an educator, you might have developed a better research plan to study what you perceive to be a problem. Stop me if I’m wrong, but shouldn’t you have come up with a template that could be used across the board so that all of your incoming data could be charted and tracked? Instead, you decided that a problem existed and would be best addressed by going on a fishing trip. Ha!

Finally, should you ever have an occasion to come through Philadelphia, I hope you will, with fairness, see that there are many medics who do their jobs at the highest professional level. Some will even go beyond the traditional textbook, clinical and field application by praying for you. Uninformed, inflammatory editorials such What’s Up At the Airport? serve no purpose other than to stir up misconceptions about our profession and belong at the supermarket checkout counters, not in a professional magazine such as yours.

Robert G. Clarke, Jr., EMT-P
Philadelphia (PA) Fire Dept.

Mike Smith replies: Before I go into a detailed reply to your letter, let me address the comment in your last paragraph regarding what you termed “uninformed, inflammatory editorials.” Unlike a fairy tale that starts out “Once upon a time,” this is a true story and as such starts out, “This is no bullshit. I was there.” In fact, I was there on my knees, having done CPR and applied the AED. I was less than a foot away when I saw some of the worst airway management and decision-making in my 30+ years in EMS.

Now that we have that cleared up, let’s move along. For the sake of clarity, I’ll reply to your items one at a time, in the order that you sent them to me.

In reply to your first point: As you might or might not have noticed, at the end of the piece I went out of my way to solicit input from our readers in hopes of finding out if what I had seen was a fluke three-times-over or possibly something much more problematic in our profession. Being that I’ve been flying almost 100,000 miles a year for 20 years, I have actually cared for many patients on planes. The overwhelming majority were minor in nature and did not involve follow-up care from EMS. I was concerned about my three experiences involving critical/serious patients and the negligent care/malpractice that each one of them received. I am not passing judgment. I was simply looking to find out from our readership what was going on.

As for your serial killer comparison, that is so weak as to not be worth addressing.

As far as using the media, I think you are a tad over the top here, Robert. The media to me is the newspaper, television or radio. This was published in a professional journal. That to me is a dialog between myself as an EMS professional and our readers, who are EMS professionals. I’d venture a guess that if we have any lay public readers at all, it is a fraction of a fraction of 1%.

In reply to your second point: I am very pleased to hear that you were not “dumped” at the airport, nor simply placed there because of seniority as a retirement venue. Again, this is what I was hoping to hear by raising the question that I did to our readership.

In reply to your third point: I consider myself a consummate EMS professional with an unswerving commitment to patient care. I will qualify that by saying that in the almost 20 years that I was a card-carrying paramedic, never once did I have a patient-care complaint lodged against me. Whether I was working in south Cook County on the south side of Chicago, or in the crack district of Tacoma, I have gone out of my way to treat my patients with care and compassion, and to treat my colleagues with respect and professionalism.

In reply to your fourth point: I did develop a research plan. I asked EMS professionals in a professional, not public, forum as to what their experiences with airport EMS had been in comparison to what I had encountered. It was by no means a fishing trip. I asked the question because of the unfortunate medicine that I had personally witnessed.

In reply to your closing comments: In my travels, I do occasionally get to fly through Philly, and should I be involved in caring for another patient that ultimately involves working with your department, it is my hope that I see caring, competent care rendered.

That is what I always hope for, whenever I care for patients and have to interact with another EMS agency. Unfortunately, in the case that prompted the writing of the column, that just wasn’t the case.

In closing, I’d like to thank you for taking the time to write and share your views. With professional dialog, we’ll get to the bottom of this.

Correction

In New Guidelines in the Works for Pelvic Injury Devices in the September issue, we incorrectly identified board-certified orthopedic surgeon and member of ASTM Subcommittee F30.01 on EMS Equipment as Seth Scheinberg. His correct name is Sam Scheinberg, MD. We apologize for any confusion.

—Ed