Ambulance days

The author, left, and partner Russ Covert with Medic 79 at the downtown Phoenix ambulance station in the "hellish" July of 1976

In 1974, at the age of seventeen-and-a-half, I became the youngest registered emergency medical technician in Arizona. I started as a dispatcher at Kord's Ambulance, which had the distinction of being owned by a relative of Linda Ronstadt. Soon, however, I was gravitating to the Kord's operation in Scottsdale, where my Coronado High friend Marc Terrill was working. There, under the leadership of the legendary Chuck West, the company had established the first advanced life support unit in the Southwest. It was a sea change from the throw-and-go days of ambulance drivers. This ambulance was equipped with IVs, EKG, telemetry, defibrillator, intubation gear, drugs — all the things seen on a modern rescue rig. An RN accompanied the two EMTs, who were trained as true paramedics in a program at the old Scottsdale Memorial Hospital under Dr. Bert McDowell.

From riding along and attending classes on my days off, I wrangled a transfer to Scottsdale in the fall. I was one of "Chuck's boys" (there were two female medics, too, a major breakthrough). The ambulance itself was revolutionary: Life-saving treatments could be begun at the scene. My early time was very difficult. The old guard was dominated by former combat medics who had served in Vietnam: Men who had performed surgery after rappelling into hot landing zones and no doubt they were PTSD'd to the moon. Unlike today, they had no use for the young person in their midst. They were tough, demanding, unmindful of, and quite contemptuous of, what is now called "my self-esteem." So I had to earn it. I learned more from them in a short period of time than I ever have in my life. From not even being sure of hearing a blood pressure while the siren was wailing, I learned to start IVs, intubate, triage, do CPR right, everything. I finally merited their respect. It remains one of the most thrilling accomplishments of my life, and makes me feel sad for young people today who are tossed into over-their-head jobs because they are cheap and never given proper seasoning or mentoring, whether rough or gentle.

They taught me a useful phrase and behavior from 'Nam that has served me well: Run frosty.

In a few months, I became partners with John Jordan, who was only a little older, and the hazing stopped. We worked well together, and I was rich in such partnerships, including with Jim Whiteside, David Huish, Russ Covert, Tom Payne and Sharon Anderson. Scottsdale was a dream posting compared with "the city." We were rock stars in the media (Phoenix Fire was just ramping up its paramedic program). The public loved us. Police and fire deferred to our expertise on medical scenes. The calls were often to the homes of the rich and sometimes famous. I could flash my badge and walk onto any scene. The money was exceptional for someone my age. We were also the first responders to the Salt River rez. On one call, a 300-pound violent patient fought with me all the way to Phoenix Indian Medical Center. At one point he had me on the floor with the side door open as we cruised along Indian School Road by the canal. "Need any help?" Jordan asked. "Nope," I said as I gained the upper hand. The patient became strikingly calm when we backed into the PIMC emergency entrance where four redwood-sized Indian cops were waiting.

Phoenix had five ambulance companies handing all the emergency and non-emergency calls: Associated and Kords, the two most elite, Phoenix AAA, Universal, owned by Lincoln Ragsdale, and Aid Ambulance (the old Mesa Ambulance) in the East Valley. We tended to work 24 hours on, then have a day off, with every other weekend off. I was working my way through ASU, too, so many was the time when I went 24, 48, even 70 or more hours without sleep. I grew up fast and saw much more than someone that age should have seen. But I was also proud of my skills and — given the washout rate from this high-stress job — soon I was a veteran. We had saved many lives that only a few years before would have been lost, although not nearly as many as depicted on television. Most people my age felt invulnerable. I did not. I had seen too much death, the too many ways bodies could be sabotaged from within or torn apart from outside by guns, knives, hatchets, baseball bats and high-speed blunt trauma. I knew the feel of dried blood and cold, dead skin.

These good days couldn't last. West left Kord's to establish a paramedic program in northern Nevada and a few of us went with him. I stayed a few months that included rescues on Lake Tahoe, then came back home. Now "Chuck's boys" were persona non grata at Kord's (whose internal politics were always murky and could result in sudden firings). So I signed on at Phoenix AAA. This was the former Phoenix Ambulance Co., one of the first outfits to be a freestanding operation outside of funeral home-provided ambulances (at one time, Phoenix Police ran ambulances, too). Unlike Kord's, there was less emphasis on patient care, more on collecting ambulance bills and cutting costs. The owner was an unpleasant man who would mutter, "you gotta screw them before they screw you," regarding his employees. He usually avoided us, with Bill Hayden, an irascible old-school ambulance driver, as general manager. Bill liked me because I could drink him under the table.

Here the environment was much more intense. We were based downtown, responding to the most challenging and dangerous calls. Phoenix seemed like a very menacing place, and I was shot at and stabbed at multiple times. I still have a scar from one time a knife connected. The last of the Deuce was still operating and the old barrios and projects were still standing. (I was off duty the night Ernesto Miranda bought it). My command of Spanglish reached its height. Dead bodies discovered in old downtown hotels in high summer washed out many a rookie. We would fly code three up 7th Street, our northbound avenue of choice in the largely freeway-less city, and always play a tune on the siren for the pretty flower girls on the corners.

I was one call rotation away the day Arizona Republic reporter Don Bolles was bombed — we caught an auto accident with injuries (a 962) at 16th Street and Southern; my friend got the Bolles call. A good night allowed you an hour's sleep. One hellish July shift, when the asphalt was hot enough to produce second-degree burns on exposed skin, Covert and I ran 24 calls in 24 hours, a record that stood for many years. Soon, at age 19, I found myself A-Shift supervisor. The outgoing/fired shift boss told me, "always look out for your people," an axiom I have followed, not always to my advancement.

The crews at Phoenix were almost universally (and Universally, for by that time we were operating Ragsdale's ambulances) great people and fine medics. Although I was still one of the younger people, I was the most highly trained and among the most experienced. We were not choir boys and girls, except in the Wambaugh sense. Off-duty pot smoking was heavy. We had no Christian love for the homeless or the poor, for whom we were the primary care givers. Some of them lived in hovels with dirt floors, within sight of the downtown skyscrapers. The entire central core was shabby and in dramatic decline (although full of great bars and buildings with promise, now lost). We saw everyone at his worst. Away from the earshot of civilians, our language was filled with profanity, the more creatively used the better, as well as shocking (to my ears now) ethnic slurs, including from EMTs who were minorities themselves. On-duty sex in outlying stations between male and female partners was not unknown. The wild and gross stories could fill many blog posts, but the ability to tell an entertaining tale about a real call in the squad room was highly valued.

What I can say is that we gave fine, professional care amid very difficult circumstances. So paltry were the supplies in the ambulances that many of us brought our own lavishly equipped jump bags on duty. Unlike many, I kept up my Kord's habit of attending hospital in-service classes and pulling shifts in the ER, anything to keep learning. I became an instructor-trainer for the Red Cross and Heart Association. Under the old rules, I should have "moved up" to driver. But I preferred to be in the back with the patient.

There were two kinds of EMTs: Trauma medics and lizard medics (lizard being the slang for an elderly patient). I was emphatically a trauma medic. The bloodier and more dangerous, the better. All I want for Christmas is a Greyhound bus wreck...or a 747 going to a hemophilia convention crashing into a glass factory. I don't say that as a boast, for the lizard medics probably gave much more loving care. We tried to save lives — or just have a drunk vomit on us as the cops and firefighters laughed — and then moved to the next call. With trauma, you didn't have time to meditate on mortality or the fragility of this human shell. No time to weep for the maimed and dying. You were always thinking: What can I do next to help this person.

Like any endeavor that puts young people together under intense pressure, we were very tribal. We spoke our own language, a combination of radio codes, medical terms, inner-city slang, sexual innuendo etc. We lived by military time — 1 p.m. was 1300 hours. Anything was liable to be absorbed into our lingo: The slogan for a Walter Matthau movie was turned into, "The laughing paramedic is never amused." We had tribal customs. Code Seven — mealtime — was precious, and Phoenix was abundant in wonderful mid-century coffee shops, now almost all gone, as well as pretty waitresses to flirt with. We also ate at the Mexican dives in the barrio, where the home boys would protect the unit while we chowed down. In the era before cell phones, the dispatcher would have every restaurant's phone number. You dreaded hearing the phone ring, the waitress holding the receiver out and calling, "Kord's!" or "Triple A!"

Your valued personal items included bandage scissors, boot shears, hemostats and pen light, all in a holster. Uniform boots that resisted violent patients' kicks. The uniform came with a badge and company and REMT patches — if on Code Seven we saw a "high risk factor" person walk in, we would make an elaborate move to slink down in the booth and cover our patches, the better to be concealed if he or she coded out (it was a joke). One's wardrobe was fairly easy: Two or three uniforms rotated through the dry cleaners, and backup scrubs if you got too bloody, or wet on a drowning call. In addition to our jump kits, Covert and I equipped A-Shift Medic 79 with an ice chest stocked with sterile water for burn victims, and a briefcase full of Physicians Desk Reference, Merck Manual, metal patient chart clipboard, etc. And a riot baton tucked behind one of the seats. Happiness was the night-time, when the bosses and the sun were gone, we could run "silent three" without the siren and only using the emergency lights, which played mesmerizing reflections off the buildings. Late at night, we would blow off steam with stupendous water-balloon fights. Everybody had a nickname. (At Kord's, mine was Lizardman, after my imitation of disc jockey Wolfman Jack only spinning out calls; afterward, it became B.A., for bad attitude).

Phoenix Fire was following the lead of Seattle in establishing a "medic one" program and took over dispatching and responding to emergency medical calls. This caused much conflict and difficulty. Many firefighters didn't particularly want to be EMTs, and the culture and skillsets were poles apart (one doesn't "fight" a heart attack). There were outright fights over who was in charge of a scene, particularly when some arrogant fire captain would greet us upon arrival with "getchurgurney" — translation: bring the stretcher — without even telling us the nature of the call. Watching PFD paramedics and firefighters "learn" on live patients was particularly maddening, especially for one like me who had to earn my way with the old combat medics and been given first-class training at the SMH emergency department. It was a fraught time. We cherished our grievences. That said, many engine companies and PFD medics were a pleasure to work with. Once, an unnamed fire crew and Covert and I (in Medic 79) had a "steal off." The goal was to grab as much of the others equipment at various ERs. The loser would buy the winner dinner. (We won when I snagged a PFD Hare Traction Splint, a very expensive item).

Decades later I would laugh about this with by-then Chief Alan Brunacini, who became a good friend. At the time, we felt disrespected and degraded from our employers on down. Phoenix Fire got all the good press. We got plenty of contempt from nurses and firefighters who viewed us as little more than taxi drivers (although the cops still liked us). Indeed, for a brief period, Jordan left and drove a real taxi driver until a customer tried to kill him and he came back to the relative safety of the ambulance. We fantasized about the companies we would build if only we were in charge, the well-equipped ambulances, etc. How the private-sector could handle this better. How the company would actually make more money by investing in the best equipment, people and training. This would not be the last time in my careers when this dialogue would go on. Southwest Ambulance went on to actually do this, but I was gone from Phoenix by that time. Being stationed downtown was a burnout track and I finally quit. This was a relief to the owner, who always suspected that I was scheming with the Teamsters to unionize the ambulance crews (I wasn't, but good idea).

My next year was spent working for Aid in Mesa, Tempe, Chandler and Apache Junction. The pace was somewhat slower than downtown — anything would be — but many of the calls were harrowing, especially when we were alone in the middle of nowhere. More than once I had a physician say, "I couldn't do what you guys do." Here the owner was also a jerk, reveling in having on-duty EMTs wash his car. But the East Valley wasn't even the East Valley then. Most of our geographic territory was citrus groves, farms, ranches and desert. Lake and mountain rescues were common. We had great freedom when we weren't stationed at the mother ship in downtown Mesa. Our black humor remained and saved us. Tom Payne and I put ambulance lyrics to folk songs and performed as "Gilbert and Southern, coming to you dead from the glamorous autopsy room of the Maricopa County Port-Mortem Lab." (Gilbert and Southern being an intersection). Another time, we realized illegal immigrants had broken into the run-down motel that served as the Apache Junction station. They often had to sleep in the citrus groves. Our response was characteristic: We found a band uniform for a Hispanic EMT, and he stood in front of an ambulance we parked in front of their room one night. We lit up, hit the siren and spotlights, and he announced on the P.A. in Spanish, "This is Col. Nava of the Federales. Come out with your hands up." They scurried out the back door. The jokes, as always, are best not shared with a general audience of civilians.

My mother was terrified that I was so addicted to the rush, and the relatively good pay, that I wouldn't finish college. But I did, working part-time at Kords again — management had changed and all was forgotten and forgiven. I had come full circle. I finally moved on, left Phoenix for what I assumed would be good, and took a teaching job at a small college in Oklahoma. The coda was helping the county there set up its first EMS operation. The state accepted my Arizona credentials, so I also worked a couple of night shifts a week to keep my skills up and passed along the knowledge I had learned what seemed so long ago from the combat medics. And there was the rush.

It took months of hard work to clean up my language and stop thinking in radio codes. I still call people "sir" and "ma'am," still in that authoritative cop voice. It required more years before I could really talk about some of the things I had seen, before I even cared to see where a siren was heading. Years to unharden my heart. Perspective was long in coming, too. It is stunning to think that babies I delivered are now in their thirties, much older than I was then. And the stories I can't bear to tell, especially involving child abuse. In the late 1980s, well into my journalism career, I wrote a novel about the experience, Response Times. It never found a publisher.

Read more about old Phoenix in the Phoenix 101 archive.

 

 

Comments

[pat L]

And Response Times wouldn't find a publisher now?

[AzRebel]

I don't think finding a publisher is the issue.

Finding someone with a Dictaphone tape reader is the problem.

(:-)

[morecleanair]

Jon: while other guys your age were chasing babes, you were treating some of the least among us. Sounds gritty but noble! Certainly it helped make you the unique person you've become.

[jmav]

Great read!

[doYourMath]

Jon,

You are one of the real heroes. I knew that even before I read this post.

Thank you.

[Tina]

Really engaging piece, Jon. Thanks.

[Gary O'Brien]

Good stuff, Jon. A couple of questions - when were you working in the East Valley? I suspect you were gone by the time I got there in '83.
And I'm not getting the "Run Frosty" reference.
Thanks for the window into the past :)

[Rogue Columnist]

Gary, I was in the EV in '77-'78. And "run frosty" means always be calm and cool, never freeze. Or as we played off the title of a Walter Matthau movie at the time, "The laughing paramedic is never amused."

Of course much of this is tribal. You had to have been there...like the great newspaper days.

[cal Lash]

If there's not a book here I'll kiss your Amble ass.

[eclecticdog]

Great post Rogue! You probably ran into my uncle at St. Luke's a few times (he was an x-ray tech there on the night shift). He finally got tired of all the blood and changed fields.

PS -- very '70s pic.

[soleri]

Jon's post put in mind of this forgotten epic: http://en.wikipedia.org/wiki/Mother,_Jugs_%26_Speed

I was a medic in the Army but I experienced nothing as remotely energizing as Jon's career. I didn't go to Vietnam, which was good since I was convinced I would have collapsed under pressure. The medic training was first-rate but there's no substitute for real-world experience. An incompetent or disliked medic might be "fragged" under some circumstances, at least according to lore.

I was garrisoned with a motley assortment of humanity, including conscientious objectors (all religious - Seventh Day Adventists and Bahais mostly). It was tedious in its grind but fascinating for the characters. When you're young, every moment is lucid with discovery. I can look back now and treasure that, but it's not something I would have freely chosen. Life chose me instead. For a brief if intense period, I almost forgot whose story it was.

[Petro]

Great read! I was going to mention that it was occasionally evocative of a certain Nicolas Cage movie, until I read the last two sentences. ;)

[Edit: Completely forgot about M,J&S, soleri - going to have to re-screen that one.]

---

I arrived in Phoenix in July of 1976 (hitch-hiking from Pittsburgh), the year you were leaning on the grill in the photo. I was also 19 years old as well.

[cal Lash]

Seems like the medic thing was a little epidemic back in the days of the draft. To avoid being drafted as a dog foot soldier I became an Air force corpsman stationed at the hospital at Luke AFB in 62.

During that time I also worked at the State Hospital as an aide to Winnie Ruth Judd and other assorted characters. Moving on I became a cop in 68 as I needed a job with bene’s.

As a cop I probably ran across Jon somewhere. I remember the ambulance service that hung out next to the old Brookshire's police Substation at 3rd Street and Dunlap. Bob Sparks rode one of those ambulances until he joined the PPD.

As for Ernesto Miranda I was a night detective and I was the first cop on the scene as he bled to death on the dirt floor of the Amapola bar. There was no Phoenix Fire paramedic’s just private Ambulance service. But Ernesto was cut too bad by the National he had egged on, too live. The guy that killed him is still out there. I got a call a couple of years ago from PPD cold squad wanting to know if I recalled the incident. Seems a warrant had never got issued for the suspect and he was coming back and forth from Mexico with no problem.

I was off duty when Bolles got blown up but later became involved in the case in a number of ways including cops that were hiding evidence. Today I eat on a regular basis at El Gallo Blanco inside of the Clarendon hotel where Don was murdered. His story is on the hallway. And if you must I can show you where Bolles car was parked when Jimmy the Plumber hit the detonation button.

The paramedics or EMT’s on site did a hell of a job keeping Bolles alive and became a part of the case.

The car is now in the Smithsonian in DC. I heard Bolles widow did not agree with that placement.

Here’s to going CODE THREE into the dark abyss of human circumstances.
Ondelay Cabrone.

[Emil Pulsifer]

"cal Lash" wrote:

"As for Ernesto Miranda...The guy that killed him is still out there. I got a call a couple of years ago from PPD cold squad wanting to know if I recalled the incident. Seems a warrant had never got issued for the suspect and he was coming back and forth from Mexico with no problem."

http://news.google.com/newspapers?id=cjIPAAAAIBAJ&pg=6150,1736687

[cal Lash]

http://news.google.com/newspapers?id=cjIPAAAAIBAJ&pg=6150,1736687

Old press. He got out and fled to mexico. Never prosecuted.

[Emil Pulsifer]

"cal Lash" wrote:

"As for Ernesto Miranda I was a night detective and I was the first cop on the scene as he bled to death on the dirt floor of the Amapola bar."

Miranda was stabbed shortly after 6:30 p.m.:

http://news.google.com/newspapers?id=6-0NAAAAIBAJ&sjid=hG0DAAAAIBAJ&pg=4644,2072&dq=miranda+stabbing&hl=en

Would the night shift start before 8:00 p.m.? Also, why would a police detective be the first officer on scene in a Skid Row bar stabbing? Wouldn't that be work for area patrolmen?

[Emil Pulsifer]

"cal Lash" wrote:

"Old press. He got out and fled to mexico. Never prosecuted."

That wasn't the issue. You said that a warrant had never been issued, whereas the newspaper reported the suspect's name and the fact that he was being sought by the police, who also (according to the article) assumed that he had fled to avoid arrest. How can a named suspect who has fled to avoid arrest be "sought" by the police without the issuance of a warrant in a capital murder case?

[cal Lash]

Do your own research. And the answer will come to you.

[jmav]

1974 was a crazy year. The Vietnam War was over, Rogue had a draft card but wasn't a lottery participant. AIDS was unknown. No death penalty. The most rabid Bircher had his tail between his legs. US unilateral economic hegemony was ending. It was a great time to be young and alive.

[morecleanair]

jmav: 1974 also featured the economic malaise from the oil embargo . . . a full-fledged retail disaster for me. Today, the Birchers have been re-formed (like Lord Valdemort in Harry Potter) and have linked up with the Tea Party in AZ's lackluster legislature. Sometimes, the more things change . .. . the more they are the same!

[jmav]

Absolutely Morecleanair. The cyclical nature of things is amazing.

[Emil Pulsifer]

The Arizona Republic had a terrible op-ed in today's edition, following recent "the sky is falling" news stories on the Medicare trust fund.

http://www.azcentral.com/arizonarepublic/opinions/articles/2012/04/27/20120427editorial0428-hard-choices-made.html

Here's a copy of my comment (the initial quote is from the text of the op-ed):

"To make it solvent for its long-term future, the Medicare payroll tax would have to increase by at least 84 percent from the 2.9 percent at which it stands now."

It isn't clear from the text whether this refers to the cash finances of the Medicare program (which are critical) or to the so-called solvency of the phony trust fund (which is irrelevant since it pays for nothing). Assuming for the moment that it's the former, let's do the math: 84 percent of 2.9 is 2.44; this means the Medicare tax would need to increase from a rate of 2.9 percent to a rate of about 5.3 percent. Since the tax is split evenly between employers and their employees, that means an increase in the Medicare tax rate of each employee from the current 1.45 percent to about 2.7 percent. That is scarcely a "financial nightmare", nor is it "unsustainable".

Part of the job has already been done, since included in the Health Care Affordability Act (aka "Obamacare") was a provision to raise the Medicare tax on high-income households, increasing the combined employer/employee rate currently at 2.9 percent, to 3.8 percent; it furthermore broadens the tax base by including (for high-income households only) investment income, (e.g., profit from the sale of stocks and bonds, rent collections, dividends, etc.). This takes effect in 2013. Note that these provisions only apply to household income above $250,000 ($200,000 in the case of a single return).

The op-ed fails to explain why projected technical insolvency in admittedly bogus "trust funds" is a calamity. It also fails to explain that such funds can be made solvent simply through the expediency of increasing the "interest" they are paid: the government counts not only tax collections toward trust fund balances, but also bogus intra-governmental interest payments made by the government (but only in an accounting sense) on the "balances". Since these rates of "interest" can be increased at will by Congress without increasing either tax collections or the deficit, there is not even a technical accounting problem of any significance. It wouldn't be the first time: for example, in 1981 "interest" was 1.6 percent of the total income of the Social Security trust fund; in 2010 it was 15.9 percent. The perennial "trust fund" solvency issue is merely a cudgel which both parties use for partisan purposes: Republicans to press for spending cuts, and Democrats to press for tax increases.

The op-ed does raise one valid issue: Medicare and Medicaid spending, currently accounting for about 19 percent of federal spending, are projected to account for 41 percent by 2050. The cause is healthcare inflation, which is well in excess of general inflation. The reason is simple: private healthcare providers, medical suppliers, and pharmaceutical companies have every incentive to charge as much they can get away with, because their duty to their shareholders is to maximize profits. Private insurance companies have the same incentive, which means they not only pass along cost increases from healthcare providers, but also add their own increase when possible, to improve their profit margins. Unlike every other major developed country from Canada to Europe, where healthcare is provided by a public, not-for-profit system, the United States remains mired in a system where public tax dollars subsidize private profits. This means you're not just paying for healthcare, you're paying to make fat-cats richer.

[pat L]

Had a gathering of several Rogue followers at Gallo Blanco, including cal Lash, Petro, AzRebel, and,electicdog. Group consensus emerged on two issues: food at Gallo Blanco is reliably good, and we can solve the Valley's ongoing water crisis by air- dropping cases of bottled water everywhere. Or at least can get rid of a few tourists, and land developers that way!

[Petro]

Now there's a good use for the drones, pat L...

[morecleanair]

Emil: wish you could/would write a guest column in the Republic about the relative plusses and minuses of Obamacare. Many of their editorial writers are "limited" (to be kind) and there's no Talton there to do the research. They just went thru the newsroom and offered early retirement to a bunch of people. Unfortunately, the terminally inept Doug MacEachern survived . . indicates he must have a photo album in the vault!

[soleri]

Emil's excellent post should remind us one thing about the ongoing Obamacare debate: there is no shortcut to a fairer and more affordable system precisely because crony capitalism conspires to maintain the advantages of the current system even if means bankrupting citizens - and by extension - the nation itself. The idea that the "free market" is working here on our behalf is nearly insane. It's working for shareholders and providers because their economic interests matter more than our health. It's why supposedly "pro-life" conservatives tell us no one "deserves" health care. Your right to live matters less than their right to profit.

We have the world's most expensive health-care system in the world for one reason: making big money is this nation's one sacred creed. At 18% of GDP, the health-care industrial complex is ravaging both the public weal and the private purse. It's only going to get worse. It's an example of our collective denial that we blame the one part of the system - Medicare/Medicaid - that actually drags the cost curve. This is not an accident. The right sees an opportunity to completely privatize the system for the benefit of capitalism's most ravenous pirates.

Even if you believe the wrong people will get health care, it's in your economic interest to support a regulated health-care sector. What we have now is the worst of both worlds - a system obedient only to its own ever-increasing profitability and a citizenry less and less able to pay its exorbitant fees. If you use this system in any way at all, you're paying through the nose. I pay $600 a month for health-insurance, in effect, a tax that goes directly to the health-care industrial complex.

[cal Lash]

Health care and education? I am sure the Arizona legislature will pass a bill to do away with both. My friend attended the women's rally at the AZ state capital. Not many folks there and the event had a low energy level.

Soleri, Emil, Phxsunfan and you all we missed you at the beer festival at Gallo Blanco. Hope you all can make one of Jon's book signings. Poison Pen on the 17th and Urban Bean on the 19th.

[AzRebel]

There is no country or health care system in the world that will be able to cope with the dual effects of extended longevity of life and the maturing and physical breakdown of the baby-boomer population. We are too big of a lump traveling through the body of the snake. Our collective lump of 75 million souls is about to reach the snake's anus and it's going to take one hell of an enema to get us through.

[Kathleen]

Jon, I remember you reading "Response Times" to me in my living room back in 1990, from a typewritten hard copy. You don't still have that? You may have given me a copy, which I kept for a long time in its box. If I still have that somewhere, would it be useful to you? I thought it was a great story, full of great details just like this post, and always hoped it would get published. I can honestly say that I've never looked at the EMTs racing by in their ambulances the same way since.

[AzRebel]

I've been in an am-ba-lance twice.

Each time I asked the dudes to run the sireen.

Each time they said no.

For $800 to $1,000 for a 2 mile ride, you should get the sireen experience.

[soleri]

Azrebel, I don't know if industrial civilization is on the precipice of doom. I'm not by instinct an optimist but I do think we have to behave as if alternatives exist. If we don't, then nihilism starts bubbling to the service. What's the use of doing anything if we're only going to die in the end?

In regard to health care, the nations that do it best will also control the costs, ration appropriately, counsel prevention, and at times, practice triage. What we shouldn't do is simply decide to make the rich richer because Ayn Rand wrote a couple of bad novels, or because other people suck.

The US pays the most for health-care of any advanced nation by far. We have the highest obesity rate this side of Qatar. And we have the most citizens uncovered, along with the most citizens filing for bankruptcy because of unpayable medical bills. In other words, the crisis is already here. If you think doing nothing is a good idea, just wait.

[AzRebel]

Soleri,

I'm not promoting doing nothing, I'm just pointing out that the math doesn't work. No matter how you look at it.

Take me for example.

Over the past three years here is my math:

Premiums I paid for health insurance:

$10,800

Health benefits I used and the cost to the system:

in excess of $350,000

Magnify those numbers by the rest of the Baby Boomers and you have quite a math problem.

[soleri]

Azrebel, thanks for your honesty about this. Most people don't even begin to tell the truth about their own situation, which then causes them to imagine that it's always the other person who's to blame.

Yes, the situation as constructed is unsustainable. The problem isn't that you got too much care - and very expensive care - but that our entire system is predicated on making itself profitable at the expense of society at large. Not knowing the details of your care, I wonder what it would have been in Britain or France, where health care is not simply an orgy of greed and profit. Imagine if we made some other public good, like clear air and water, a private product of the free market. Or imagine a society where every good was valorized in dollar signs and allotted according to the ability to pay.

The sin that is killing us is selfishness. It would rather design a cumbersome and inequitable health-care system than simply do what every other advanced nation has done and make it a public good. And because of that, we will hasten our national bankruptcy and social breakdown. Even stranger, we accord respect to the very people counseling this sociopathic remedy. If we can choose, wouldn't Canada or Sweden or France be a better guide than Somalia? Why do we choose to follow the worst examples? Why are we deliberately damaging ourselves for the sake of an ideological daydream?

[Emil Pulsifer]

Soleri wrote:

"It's an example of our collective denial that we blame the one part of the system - Medicare/Medicaid - that actually drags the cost curve. This is not an accident. The right sees an opportunity to completely privatize the system for the benefit of capitalism's most ravenous pirates."

Excellent point. Many doctors are refusing new Medicare patients because providing care for them just doesn't pay as well as privately insured patients. From a doctor's blog:

"Nationwide, physicians are paid 20% less from Medicare than from private payers. . . Mayo Clinic has said it will not accept Medicare payments for primary care physician visits. . . Instead of Medicare payments for clinic visits, Mayo will start charging patients a $2,000 fee for patients to be seen at their Glendale, Arizona clinic. Much like a “retainer”, this fee will cover an annual physical and three other doctor visits. Each patient will also be assessed a $250 annual administrative fee."

http://www.kevinmd.com/blog/2010/01/mayo-clinic-refusing-medicare-patients.html

Are his comments about "losing money" with Medicare patients true, or medical industry propaganda designed to camouflage simple greed? And if true, what are the reasons? And if 70 percent of hospitals "lose money on Medicare patients" what about the other 30 percent? What's the difference, and how can the problem be Medicare payments per se rather than fundamental price structuring in the hospitals in question, if a third of their industry peers made money with Medicare? These are important questions: I wish I knew more.

Soleri wrote:

"I'm not by instinct an optimist but I do think we have to behave as if alternatives exist. If we don't, then nihilism starts bubbling to the service. What's the use of doing anything if we're only going to die in the end?"

Another good point. Perhaps what AzRebel's remarks about extended longevity and the aging of the Baby Boom generation illustrate is that sometime the choice is between bad and worse, rather than good and bad. The Baby Boomers are going to age. Life expectancy is going to increase because of improved technology, pharmacology, detection and treatment. The question is, will the financial strain of these events be handled by a system that has a built in financial incentive to maximize profits, as at present, or by one that sees medicine as a public service whose goal is maximizing health gains through prevention and the rational allocation of resources instead of the expensive machine that goes "bing"?

http://www.youtube.com/watch?v=arCITMfxvEc

"AzRebel" wrote:

"Our collective lump of 75 million souls is about to reach the snake's anus and it's going to take one hell of an enema to get us through."

We could always try the lottery system used in Logan's Run. (You go first.)

[Emil Pulsifer]

For Petro (and others):

One major measure of the relevance of a protest movement is how seriously the establishment takes it: what kind of resources are they prepared to invest to oppose it?

Bloomberg News ran a story three days ago about how banks have united against a revival of Occupy.

The good news is the movement's prognosis, as judged by this heavyweight Pinkerton spook:

"After evictions and arrests from Manhattan’s Zuccotti Park to London that began last year, the movement against income inequality and corporate abuse will regain strength, said Brian McNary, director of global risk at Pinkerton Consulting & Investigations, a subsidiary of Sweden’s Securitas AB (SECUB). He works with international financial firms to "identify, map and track" protesters across social media and at their assemblies, he said. The companies gather data "carefully and methodically" to prevent business disruptions."

They're spying on them, infiltrating their meetings and message bases, identifying the leadership and classifying the followers by level of dedication and activity, collecting personal information about them, and cross-referencing it all in private databases, shared not only with one another but with law-enforcement agencies. This means they take Occupy seriously. So should the media.

". . . Last year’s anti-bank protests were “like a big forest fire that was suppressed and put out,” Chris Swecker, the former head of security at Bank of America, said in an interview. Firms are studying protesters because “there’s also the opportunity for spontaneous fires to spring back up again,” said Swecker, who runs a security-consulting firm in Charlotte, North Carolina."

The banks understand that they can't do everything using private spooks:

". . . Starting in 2010, JPMorgan gave the New York City Police Foundation the largest donation in the group’s history, the bank’s website shows. The gift, valued at $4.6 million, included 1,000 patrol car laptops. “These officers put their lives on the line every day to keep us safe,” Chief Executive Officer Jamie Dimon, 56, said in a statement on the website. New York companies have provided services and equipment for decades and are proud to show their support, Browne said. The foundation is the department’s fundraising arm. Goldman Sachs, News Corp. and Barclays Plc (BARC) were among 16 donors who gave at least $100,000 through the year ended June 30, 2010, according to the foundation’s website. Dozens of others gave less."

The recipients of largesse recognize their benefactors: "At a 2009 U.S. Senate hearing, Police Commissioner Raymond Kelly descibed a partnership with financial-district firms that gives his department “access to hundreds of private-security cameras."

They have even assigned military style operational names to their projects: "Private-security teams in London have become an “incredible army” and “the eyes and ears of the city” thanks to a coordination program called Project Griffin, according to Rachel Briggs, policy director at the London-based Institute for Strategic Dialogue. The organization develops responses to security challenges."

". . . The heads of security of most of the major banks there have formed a group called “sister banks,” said Ian Mansfield, a London police counterterrorism security adviser. They do more than gather and share information with one another and the police, he said by e-mail. “Sometimes we will ask for a high- visibility deployment around premises basically as a ‘show of strength,’” he wrote. "

". . . Spokesmen for Goldman Sachs, JPMorgan, Bank of America, Citigroup Inc. (C), Morgan Stanley (MS), UBS AG (UBSN), and Credit Suisse Group AG (CSGN) wouldn’t describe security measures for the protests. One likened commenting to telling al-Qaeda about the bank’s continuity plans."

Ha! About as preposterous as comparing themselves (banks) to elks set upon by wolves and clinging together for strength, but it does suggest something about the resilience of Occupy.

http://www.bloomberg.com/news/2012-04-26/wall-street-tracks-wolves-as-may-1-protests-loom.html

[Rogue Columnist]

The essential book to understanding our health-care mess and what must be changed to fix it is Maggie Mahar's "Money Driven Medicine."

Thanks to all re "Response Times." I have the manuscript and could write it much better now. The problem is finding a publisher. And that's nearly insurmountable, even for someone who has been published as a "genre fiction" writer.

[AWinter]

http://www.nakedcapitalism.com/2012/04/how-overpriced-is-us-health-insurance.html

[soleri]

http://www.nytimes.com/2012/04/29/opinion/sunday/unexceptionalism-a-primer.html?_r=1&hp

[cal Lash]

Well,I tried making a poster out of your Ambulance Days piece. But I quit when I got an E-mail from Obama that a Seal 6 team was on the way to take me out for copyright violations. The photo will make a great cover for the book.

[cal Lash]

Two best magazines of this week, Adbusters with "Regime Change In America" and New Times with the Sheriff Larry Devers story.

[AzRebel]

cal,

if you go to K-Mart, the photo above is on each package of wife-beater
t-shirts. You can take the package and copy it on a scanner, then make your poster.

[AWinter]

I assume the bloodletting on the streets of Phoenix was worse back in the 70s. Has AZ become more civilized/pacified over the decades?

http://www.cnn.com/2012/04/29/us/stand-your-ground/index.html?hpt=hp_c1

http://mediamatters.org/blog/201204270011

[cal Lash]

The US may have a President that is a democrat and there are a lot of really good people out there but make no mistake between the religious right and the gun nuts the Kooks own the country. And there are those among us that have no problem killing you for disagreeing with them. I can guarantee you there are people out there eagerly waiting for an opportunity to shoot someone and claim "I had to do it." I wonder how many young men see Ted Nugent as their I gotta gun, hero. He very easily illegally shot a bear. After all it was just a bear. But makes me wonder if that easily jumps to shooting a black man that you appear to hate.

I think the world is going to need a lot of parmedics.

Knowing Jon was a professional I am sure he always tried his best to save everyone while riding the streets and alleys in his ambulance.

[Emil Pulsifer]

Mr. Talton wrote:

"In the late 1980s, well into my journalism career, I wrote a novel about the experience, Response Times. It never found a publisher."

And:

"Thanks to all re "Response Times." I have the manuscript and could write it much better now. The problem is finding a publisher. And that's nearly insurmountable, even for someone who has been published as a "genre fiction" writer."

According to one online bibliography, your first novel (Concrete Desert) was published in 2001. I don't know if you had non-fiction or non-genre works published before that, but if not, it isn't surprising that you had such difficulty getting offers for a non-fiction personal memoir as a non-published, non-agented writer.

Autobiography, or anything like it, is generally limited to the famous, or to relatives of the famous, or to those whose activities are so exceptional as to pique public interest simply from the subject on its face. Everything else goes to the "vanity press" or remains unpublished. I suspect that this is even more true today given the decline in book sales and the bottom-line mentality of many corporate publishing houses.

The job of ambulance driver, no matter how interesting the underlying reality, or how stylishly the gritty anecdotes are presented, is tough to market to a general audience, though the "calls to the homes of the rich and famous" angle has possibilities.

Still, I suspect that as a successful, published author with an agent, you might have better luck today. I haven't read your original manuscript, but your blog item certainly was written with elan. The problem is picking your publisher. You might try houses specializing in Arizona history.

It had better be a labor of love because the printing run will be small and so will the payment, considering the type of house involved.

http://authors.omnimystery.com/talton-jon.html

[Rogue Columnist]

Emil,
The previous generation of throw-and-go were "ambulance drivers." I didn't go through several hundred hours of class and clinical training, much less run several thousand calls, to just be an "ambulance driver."

;-)

[cal Lash]

Code Three into the nite
Cheeks Tite
My job is to make it right!

Ondelay Cabrone

[Petro]

Senor Talton:

Thanks to all re "Response Times." I have the manuscript and could write it much better now. The problem is finding a publisher. And that's nearly insurmountable, even for someone who has been published as a "genre fiction" writer.

But... you could self publish at Amazon! (ducks behind couch)

http://www.poisonedpenpress.com/the-stand/

[Emil Pulsifer]

My apologies, Mr. Talton, for the infelicitous description. It was casually employed, without malice. By the time the belittling overtones of the term occurred to me, it was too late to correct.

[Allen Weiner]

Your storytelling talents are close to being without peer. I'd love to host a radio show and have you as the only guest each week to spin your yarns.

[LZ]

This is wonderful! Can't wait for more.

[Pam Goronkin]

This is great reading, Jon...thanks so much for sharing this aspect of your youthful experience...wow! I hope you find that dictation tape reader...I used to transcribe from one of those in the Dean 's office at Phoenix College! Maybe they still have one! I'll volunteer to transcribe! P.S. LOVE the photo...what a hoot!

[Judy Nichols]

Jon, I was unaware of this part of your past. Great storytelling. I loved reading about the state of paramedic/ambulance services back then. I recently read The Knife and Gun Club: Scenes from an Emergency Room, about Denver General Hospital's program to train and integrate first responders with the ER. Great read and amazing photos. I so respect those of you who come to help us when we need it. I would love to read your book.

[George Roberts]

I realize this is an old post, but I just found it. I was an EMT in SE Arizona in the late 70's and a "Scottsdale Medic" in 82-83. (Moved to Tucson in '83 and worked for Kord's
for 13 years.) Reading this post really brought back some excellent memories!

[Cecelia Klinger]

Just Keep Writing, Jon!

Ceil

[Pike Oliver]

Glad you republished this. Fantastic narrative and perspective.