PR Urgent Press Release: “Paramedic Heretic”

“Paramedic Heretic” Exposes Curious Conundrums in EMS

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The author was not even out of medical school before he witnessed his first doctor commit murder. It would not be his last – Lord, no – but he can recall that night as vividly as though it happened last week. Few medics forget their first physician homicide.

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See what a veteran Paramedic has to say
See what a veteran Paramedic has to say

FOR IMMEDIATE RELEASE – When K. Patrick McDonald began rescue training in the 1970s, he was among the first paramedics in the nation, filled with zeal to save lives in ways not imagined even a decade before. More than 20,000 911 calls later, however, pride in his profession has eroded. So he turned to his three-decades of note-taking to scribe an imminently readable, jaw-dropping assessment of the power struggles within the cloistered world of rescue – a battle that sometimes has fatal consequences. He also defines what he calls the “Immutable Laws” that reign supreme in the business of saving lives.

McDonald, having experienced the trenches of rescue for more than 30 years, offers story after story in which rules and policy corrupt paramedic efficiency. He details some success stories, but reveals dozens of cases where the consequences of protocol short-circuit rescue efforts. In one fascinating case the author himself nearly lost his medical license because he authorized a non-EMS helicopter to fly out critically injured Girl Scouts in a Palm Springs bus tragedy – until the famous Sonny Bono (who had been on the disaster scene) saved the day. “The Pedigree of a Paramedic Heretic: Immutable Laws and Ethical Illusions” reveals that time after time, saving lives is not rescue priority. Instead, following policies, ensuring team safety and avoiding lawsuits all trump patients’ lives.

“Heretic” also points out numerous medical myths, such as ambulance sirens saving lives (they don’t); the “Golden Hour” of patient care (one doctor’s silly fantasy); and the futility, in many cases, of CPR. Some of the biggest problem areas, McDonald writes, are mistakes made in prescriptions; wholly unnecessary surgeries and flawed medical records. That paramedics remain mute in the presence of incompetent or criminal physicians, for fear of losing their jobs, is a maddening reality. Saving lives, in the end, has become far more about capitalism and power struggles, than heroism.

Author K. Patrick McDonald knows of what he writes. He was appointed the first EMS supervisor for San Diego city and created one of the country’s first Special Trauma & Rescue teams. McDonald, a graduate of University of California, San Diego School of Medicine original advanced field medicine program, co-wrote the National Waterpark Lifeguard Training Manual. He has served as a consultant to the U.S. Secret Service and performed medical services at Super Bowl XLIX.

http://www.prurgent.com/2015-02-19/pressrelease376601.htm

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“Confessions of a Medical Heretic” Book Review

Here's a book that can safe your life
Here’s a book that can save your life

Robert Mendelsohn “spilled the beans” about healthcare’s appalling death and destruction rates more than three decades ago. A pioneer at questioning the status quo, he taught us it is a far wiser path in life to become an intelligent skeptic of pretty much anyone wearing a lab coat.

I once had the pleasure & honor of being seated next to Robert Mendelsohn at a Preventive Medicine seminar in Palms Springs. We compared writing projects, and of course his “Medical Heretic” was on the bookshelves & piercing thousands of degreed egos. The man struck me as a visionary, entirely unafraid of rocking the traditional boat called health care. In less than 200 pages, this book deftly puts a dagger through the heart of his profession’s self-aggrandizement – and does so from the inside out.

The premise? Mendelsohn pulls no punches in his opener, which he calls the “Non Credo.”

“I do not believe in modern medicine. I am a medical heretic. My aim of this book is to persuade you to become a heretic, too.”

But just as important, contrary to what many have criticized him for, Mendelsohn does not tell you to stop seeing your doctor. He does tell you to not stop thinking just because you find yourself in the presence of one.

In its nine chapters, “Heretic” offers up numerous truths – many of which are as relevant today as when they were written. Here are three examples:

>  Every drug stresses and hurts your body in some way.
>  A healthy society is characterized by strong, positive family relationships and  subsequent minimal need of doctors.
>  Doctors are not trained to attack the core of any problem, merely to suppress symptoms.

As an educator, Mendelsohn knows how to turn a funny phrase in order to make a point. Here’s one of his best:

“. . . doctors’ intentions may be good. But we all know what the road to Hell is paved with.”

A few more of his more salient observations:
>  Doctors in general should be treated with the same degree of trust as used-car salesmen.
>  When I meet a doctor, I generally figure I’m meeting a person who is narrow-minded, prejudiced, and fairly incapable of reasoning and deliberation.
>  Get used to the idea right away that no single system can or should claim to have an exclusive fix on the dynamics of health.

As a Paramedic, I’ve carried copies of “Heretic” for years – in ambulances, helicopters & emergency rooms, causing quite a stir among my medical peers. Thanks to him, I too learned to view medical care with a healthy dose of logic.

I want to thank you, Bob, wherever you are in the cosmos. Through this book, your inherent wisdom has helped keep countless thousands of new physicians & paramedics ethically grounded, by providing a moral compass for those of us who happen to be – more often than not – supremely impressed by our own stethoscopes. I also thank you for giving me the strength to get “America’s Dumbest Doctors” – as well as “Paramedic Heretic” into the hands of those in desperate need of learning that in medicine, precious little is as it seems.

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UCLA ‘Superbug’: New Book “Paramedic Heretic” Details Hospital Acquired Infections

a Nurse; a doctor; a Paramedic
a nurse; a doctor; a paramedic

American healthcare: the best in the world?

Well, we know the fantasy you probably cling to like a Teddy Bear. But before you say it out loud, take a look at what Doctor Barbara Starfield told the world 15 years ago:

  • • 7,000 people dying from medication errors in hospitals
  • • 12,000 people dying from unnecessary surgeries
  • • 20,000 people dying from other errors in hospitals
  • • 80,000 people dying from infections acquired in hospitals
  • • 106,000 people dying from prescription medications

 

Care to guess what your local EMS men and women have to say about this jaw-dropping reality? Nothing. The quietest people in town when it comes to bad medicine – even quieter than nurses – are Paramedics. Our comfort meters function best in the nether-world of, “why risk my job?” So guess what? We don’t.

Dr Barbara Starfield
Dr Barbara Starfield

Here in the Twilight Zone there is very little money to be made in safety, and not much more in good health. There is, however, utter wealth in medical complications. In all four corners of bizarre world, substandard care is rewarded with serious cash in return. For those of a grab-thy-money mindset, it really doesn’t get much better than this. And when the rampallians wear lab coats, they can fool themselves – and most everybody else – by acting as though whatever they choose to do is probably right.

A Sunday afternoon visit to a cemetery is proof enough that unseeing faith in medicine has rather sobering limitations.

(Excerpt, “The Paramedic Heretic”)

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Paramedics Help Solve Murder by Refusing Doctor’s Order

 

Dr Robert Ferrante
Doctor Robert Ferrante

A University of Pittsburgh doctor was found guilty of poisoning his doctor-wife last November. And two weeks ago he learned he will be spending the rest of his life in a Pennsylvania state prison.

An Allegheny County jury of four women and eight men reviewed the facts of the case for 15 hours before convicting Doctor Robert Joseph Ferrante in the cyanide death of his wife, Doctor Autumn Marie Klein. Their verdict was unanimous.

Dr Autumn Marie Klein
Doctor Autumn Marie Klein

But a lesser-known fact in this case is this: had it not been for the sworn testimony of the two Paramedics who initially treated her, the case might never have gone to trial. Briefly, here’s why:

As his dying wife lay gasping for air on the kitchen floor on the night of the poisoning, Doctor Ferrante told the medics that he wanted them to transport her to a smaller, less-sophisticated hospital called Shadyside.  Under the circumstances, this was a ridiculous demand. Even non-medical citizens in the Pittsburgh area were aware of what Ferrante and the Paramedics knew: that University of Pittsburgh Medical Center, where the couple worked, was not only several minutes closer. It is a trauma center, far better equipped to handle critical patients, especially late at night.

Although Paramedics are routinely in charge of a medical scene, in our experience, very few possess the intestinal fortitude to countermand a physician whose wife is dying on a kitchen floor. But these medics were adamant that their patient go the most appropriate ER, and that is exactly what they did.

Shortly after the patient was admitted into the hospital, an MD ordered a blood test, which revealed an oddly high level of acid. On a hunch, the doctor then ordered the specific test for cyanide poisoning. It is highly unlikely that this check for cyanide poisoning – an extremely rare event – would have even been done at the smaller hospital, where Robert Ferrante wanted his wife taken.

Doctor Klein died on April 20, 2013. Three days later, at Dr. Ferrante’s insistence, her body was cremated. As a result, there was no autopsy.

Doctor Karl Williams, the Allegheny County Medical Examiner, based on the toxicology reports, determined that Doctor Klein had died of cyanide poisoning. The forensic pathologist ruled her death a homicide.

Cyanide kills by blocking oxygen to the cells. A lethal dose for a healthy adult can be as small as 200 milligrams – about the size of a drop of water. The poison acts quickly and is nearly undetectable almost immediately after ingestion. Had samples of Doctor Klein’s blood not been taken quickly, there would have been no real physical evidence of poisoning.

Much later, the medics testified that as they were caring for the lady on the floor, they noticed she was lying next to a plastic bag, which Ferrante said contained creatine, and a small glass vial.

Prosecutors were able to prove that Doctor Klein had swallowed cyanide-laced creatine that Ferrante had mixed into her energy drink just minutes before she collapsed.

After the trial jurors told the news media that testimony of the Paramedics was one of the key aspects of the circumstantial case that convinced them of the murderous doctor’s guilt.

In the end, the Pittsburgh-area Paramedics were not able to save this woman’s life. But they certainly helped prevent yet another lab coat lunatic from getting away with murder.

So in our view, this case underscores the fact that EMS professionals often benefit society in far more ways than the obvious. And one way is to dig their boots into the floor in the heat of crisis, stare rotten physicians directly in the eye and say, “No.”

Pity how few are willing to do so. Thus, the EMS conundrum continues . . . .

Here’s more on this all-too-common, ‘doctor kills wife’ murder case:

http://www.post-gazette.com/local/city/2014/10/29/Testimony-in-Ferrante-trial-focuses-on-cyanide-levels/stories/201410290191

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Paramedics: “School principal said ‘no’ to ambulance on the football field”

 

AMR SERVICE

(Excerpt from the book, “Paramedic Heretic”)

In San Jose California a high school principal was under fire last year as the result of following a ‘no ambulance on the field’ school policy.

Fourteen-year-old Keanu Gallardo had suffered a concussion during a Del Mar High School football game in October. But even after the American Medical Response EMS team arrived, the young player was forced to lay and wait for the medics to haul emergency gear nearly the length of the field. Then he had to be carried the same distance back to the ambulance.

Del Mar Principal Liz Seabury told reporters she was following district orders which forbid motorized vehicles on the newly remodeled field.

Days later as the young man was recovering, the incident continued to infuriate a number of local town-folks who stated they simply could not fathom a policy that would place turf value over an athlete’s welfare. Parent Debbie Musquez, who witnessed the event, said, “The child’s health needs to come first. The behavior of the principal and medics is disturbing.”

Campbell Union High School District board member Matthew Dean saw the incident this way. “It’s a failure to apply common sense across the board.”

The father of another player said, “The principal should have made a different decision, but AMR Paramedics should certainly have overridden her. They knew he had a head injury – they were told as much on dispatch. The medics are supposed to be the ‘experts’ and yet they let this non-medical professional dictate emergency procedure. That’s crazy.”

Another parent said, “What kind of environment have we created, such that three adults don’t feel comfortable overriding a rule?” he asked.

While it is now clear the delay had no negative impact on the student’s health, EMS professionals agree that when a player has a head injury, there is no immediate way to know how serious it may be, so no delay is acceptable. The school district superintendent has since responded with an apology to the injured player’s mother. And the district-wide policy has been reversed, to allow access to emergency vehicles if paramedics deem it necessary.

AMR, on the other hand, anticipates no change in protocols. The company’s policy is – and has always been – that Paramedics do not challenge anyone of authority on scene, regardless of whether such assertiveness may be in the best interest of the patient.

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Which but one reason why many thousands of Paramedics refuse to work for AMR.

 

Immutable Law #2

Saving lives is not our priority.

Following our policies is our priority.

Protecting ourselves comes next. Avoiding

lawsuits comes third. You come somewhere

after that.

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Rescue Teams Follow EMS Procedure; Watch Man Drown

(Excerpt from the book, Paramedic Heretic):

The water of San Francisco Bay never really warms up. And on Memorial Day 2011, the day 52-year-old Raymond Zack decided to end his life, the surface temperature was 22 degrees above freezing. So once his mind was made up, he simply waded out into the calm surf, stood quite still in water up to his chin and waited for the cold to stop his heart.

This particular drama played itself out at Crown State Beach in Alameda, a city-island tucked into a niche along the Oakland side of the Bay. Like most California beaches there were no lifeguards on duty, and the posted signs clearly stated, “Enter the water at your own risk.” There is never a shortage of joggers, bikers and water-sports folks however, so it wasn’t long before one of them, Sharon Brunetti, called 911 to report this fellow’s very strange behavior. The concerned caller knew that nobody in their right mind stands around in the San Francisco Bay.

The good news that day was that Alameda  City Fire and police got to the scene post haste. The great news was that they really did feel sorry for the poor fellow and wanted to help. The crappy news was that – like most all other first responders in the U.S. – they operate under strict orders to follow protocol. And the protocol in this case was that Alameda City firefighters did not enter the ocean. They were not – as their policy underscores – lifeguards. So they called the Coast Guard. Unfortunately the Coast Guard boat was far too big to access such shallow water. Worse, their helicopter was busy on another rescue.

Alameda police were in no position to help on a water rescue either. As department spokesman Sean Lynch would emphasize later, “Certainly this was tragic. But police officers are tasked with ensuring safety, and that includes their own safety, when they are sent to try to resolve these kinds of situations. We did not know whether he was violent; whether drugs were involved; whether he had a weapon. We are not ocean water rescuers.”

Alameda Fire Chief Mike D’Orazi, for his part, said, “This incident was deeply regrettable. But look at it from our firefighters’ perspective. They’re standing there wanting to do something, but they are handcuffed by policy.”

D’Orazi reminded the press that his department had recently undergone major budget cuts, so his teams had neither the training nor the cold-water gear to go into the ocean safely.

And so – if you can picture the scene – two full fire crews, six police officers, a medic unit and about 45 bystanders all on a beach, watching Raymond Zack shivering offshore, staring back at them. Alameda police estimate Zack stood silent in the water for 55 minutes before he simply fell over and died. An off-duty nurse in a wetsuit, who was also a trained lifeguard, swam out to the man on her surfboard and pulled him to shore. Resuscitation efforts were unsuccessful.

As you might imagine. plenty of witnesses were openly critical of – and at times hostile toward – rescue personnel that day. And they made their opinions known when the news cameras showed up:

“Hooray for the civilian with the guts to do something,” said Martin L. “This isn’t anything new. Last summer I saw cops and fire guys standing on a pier while civilians saved a fellow’s life with a jet ski.”

“You’d think at some point there would be real concern for him,” said witness Gary B. “Those so-called ‘rescuers’ are a complete fraud.”

Another witness, Adam G. said, “This isn’t just a problem with funding. It’s a problem with the culture, of what’s going on in our cities. No one would take the time and help this drowning man.”

“Just file this one under, nobody important got hurt. At least all the heroes got to go home. What a bunch of cowards.” (Tom R.)

“What’s happened to EMS today? Where are the dedicated individuals who were always there before?” (Erin D.)

Thus, the conundrum between what EMS is really like, and what the public thinks it is.

Immutable Law #2

Saving lives is not our priority.

Following our policies is our priority.

Protecting ourselves comes next. Avoiding

lawsuits comes third. You come somewhere

after that.

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