EMS Community Loses an Icon

The news spread quickly throughout the EMS community. Mike Smith, BS, MICP, educator, author, columnist, speaker and EMS advocate, was dead. Smith suffered a fatal myocardial infarction early Sunday morning, October 13, just shy of his 61st birthday.

He was born in Alabama, but moved with his family to Chicago, where he grew up. In the early 1970s he served as a volunteer firefighter in Harvey, IL,  while working full time. It wasn’t long before he was hired by the fire department. During that time he became an EMT and, eventually, one of the first paramedics in the area. Although the 6-foot-6 Smith enjoyed firefighting, he found he had a special gift for providing patient care.

From Illinois, Smith moved his young family to Iowa to take a position at the State of Iowa EMS Division. A year later, he joined Mercy Medical Center as an instructor and established its first paramedic education class. In 1988, the family moved again, this time to Tacoma, WA, where Smith headed up the paramedic program at Tacoma Community College, where he served until his death.

Smith also embarked on a prodigious writing and speaking career. He wrote regular columns for JEMS, and later EMS World Magazine. With the humor of a consummate comedian and the passion of an evangelist preacher, he crisscrossed the country, logging nearly 100,000 miles annually to deliver keynote speeches in large lecture halls and teach seminars in small rural communities.

Throughout the years and across the miles, one theme remained clear: Always deliver excellent patient care and always be nice.

Smith summarized his philosophy in a column published in EMS World’s June issue titled, “Show Me the Professionals.” “I believe we each need to make a concerted effort to continually exhibit professional behavior, which can be distilled to two basic elements: be competent and be nice.”

Nice wasn’t something Smith experienced as a child growing up on the south side of Chicago, under the iron fist of an authoritative father. It was an outlook he embraced, having viewed the alternative.

Wherever he was, he extolled the virtues of making sincere human connections with both patients and colleagues. In his final column, published last month, Smith’s last sentences were, “…making an effort to step outside the sterile world of medicine for just a brief moment can be a very positive experience and will serve to enrich your medical practice. You just need to give a little to get a little.”

Smith made connections wherever he went, and he went everywhere. When his life on the road brought him to every state in the U.S. and parts of Canada, he befriended taxi cab drivers, waitresses, baristas, hotel clerks and shop owners. If he liked a meal, he’d ask to meet the chef. Then on return trips he would stop by the same restaurant and ask for the chef by name.

Being nice did not mean Smith was always patient. He could be a formidable foe when provoked. Nothing could get his south-side-of-Chicago bile churning like a perceived injustice, especially when it came to the delivery of quality patient care. Smith took on all comers regarding this issue. There were no excuses. “Be nice.”

Yet, for all of his roles in EMS, none could match the pride Smith took in being a teacher. One of the greatest contributions he made to our profession is the education of an estimated 1,000 paramedics who passed through his programs. One would be hard pressed to find a transport service or fire department in the Pacific Northwest that doesn’t have at least one of Smith’s former students on staff.

Training the next generation of EMS providers was a mission for Smith and he fiercely held to the highest standards. Even when pressed by administrators he would not back down from his principles.

To help ensure the education of those outside of the Pacific Northwest, he even took on the daunting task of helping to rewrite a seminal EMS textbook, Nancy Caroline’s Emergency Care in the Streets, Seventh Edition.

While Smith’s death is a painful loss for the EMS community, it’s felt most keenly by his family, including his wife, Sylvia, daughters, Valerie Smith and Melissa (Bill) Thurman, and 7-month old granddaughter, Kate.

A man of Smith’s sizable stature isn’t missed all at once. His loss is felt over and over in a thousand small ways—a page where his column should be, a silent stage at a lecture hall, a vacant bench seat during a student’s ride-along, an empty chair at his favorite restaurant. But even as the EMS community grieves his loss, we are comforted by the words he wrote and the lessons he taught that remind us that we must at all times aim to do our jobs well, and always, always “be nice.”

Teresa McCallion, EMT-B,  is a freelance public safety writer living in Bonney Lake, WA.

I first met Mike Smith as a new speaker at a conference in Albuquerque. I had read his columns for years and was impressed that after talking to you for a few minutes, it was as if he knew you forever. I was glad to see him and share a dinner in Bend, OR, only days before his passing.  

Among the wonderful things about Mike was his willingness to promote new instructors and speakers and help them perfect their craft.  He certainly helped me when I was getting started, giving my name and recommending me to his many contacts in the EMS conference universe.

It was apparent that his commitment to quality EMS education would be his enduring legacy.  Whether it was training fledgling paramedics or discussing an EMS  legal case we were both involved in, I could always count on Mike for a passionate and stimulating discussion.  

You will be missed, my friend.
Paul A. Werfel, MS, NREMT-P, Director, Paramedic Program, Clinical Asst. Professor of Health Science, School of Health Technology & Management, Asst. Professor of Clinical Emergency Medicine, Dept. of Emergency Medicine, Health Science Center, Stony Brook University, NY

 Mike Smith was the kind of guy who, even if you didn’t know him, felt so familiar. No matter how long it was between meetings with him, just catching sight of him across the room made me smile. Wherever he was, he filled the room, and that essence had a way of reaching across and tapping me on the shoulder or, better yet, pulling me into a virtual hug soon to be replaced by the real deal.

Actually, it didn’t quite start out so harmoniously. It was the 1980s or so, and I saw that this guy, Mike Smith, was making his way around the conference circuit liberally helping himself to titles and content from my book, Streetsense. We needed to chat. Of course, as soon as we did I was as smitten by Mike as the next person who witnessed his unbridled passion for doing this thing we do—EMS—with all the right interpersonal and safety tools in hand.

Everyone loved to listen to Mike. There was no other path than to be enthralled by his charm. He was direct and clear: The only way to be an outstanding EMS provider was to treat people right; he could help anyone understand how to do that, and why. Our job wasn’t just medicine to Mike. It was ever so much more.

One thing that always amazed me was Mike’s immensity—and I’m not just referring to his physical size. He was a good man who made a big difference in our lives, and through us, on the many thousands of patients who benefited from Mike Smith-induced care. RIP, my friend. I wish we’d had time for just one more laugh together.
Kate Dernocoeur, Educator and Author

Most of us will never forget our first meeting with Mike. For me it was 1991 when we were both working for a private ambulance in Tacoma.
As a new medic I decided we needed to do some form of peer review. I reviewed some of Mike’s calls. Some of my colleagues thought it ostentatious—not Mike. Rather than question my legitimacy, he graciously asked me about the peer review process and thanked me for my comments. It was the beginning of a lifelong friendship.

The next year I was lucky enough to have Mike allow me to do some teaching for him. This grew into a wonderful collaboration. He was always full of great ideas—usually way ahead of their time. We began conducting preceptor workshops, 12-lead classes, paramedic refreshers and introductions to EMS research. I eventually served on the paramedic program advisory committee.

Mike had a “do or die” policy for completing the paramedic program. You had to pass his written and practical final to pass the course. Some felt it extreme, but everyone knew the rule. A local fire chief was upset that someone they sponsored had failed the exam and contacted the college president to demand a retest. This would be the first, but not last, time we were forced to stand up for each other’s beliefs and principles when we encountered those who preferred to rest on their laurels.

One of our monthly debates centered around how long you stay and try to instill change in an inherently dysfunctional system before you finally cut your losses and go somewhere where excellence is the norm, not the exception. Mike was always a stay-and-fight guy. You can look at some of the titles of his recent columns to see this: “Show Me The Professionals;” “How to Diagnose Complacency;” and “Conquer the ‘Us vs. Them’ Mind-Set.” His ethic was inspirational. His passion for quality was never-ending and infectious.

I once lamented to him about an article in an EMS magazine that suggested an EMS system was beyond reproach. He basically challenged me to write a letter to the editor. The title of the published response was called “Redefining Arrogance.” It gained me a bit of notoriety. It wasn’t till much later that I realized Mike had gently guided me into being part of the next generation to get involved, speak out and constantly strive to do our best. He has done this same thing for thousands of us.

Joseph Campbell advised his students to follow their bliss. Few of us are as lucky as Mike in this regard. His bliss was teaching and EMS. His friendship, laughter, insightfulness, compassion, mentorship and enthusiasm will be missed by so many. Or as one of his former students (and Star Wars buff) said to me, “Now I know how Luke felt when Master Yoda died.”
Fritz Fuller, REMT-P, PA-C, MPH&TM,  Medical Attaché, U.S. Embassy, Tashkent, Uzbekistan