Re-opening of ‘Killer King’ Hospital Spurs Paramedic Memories

Compton Medics
Compton EMS Crew Discusses the Old Days

The daily life of paramedics in the city of Compton California is about to get a little more interesting, with the opening of Martin Luther King, Jr. Community Center – a revamping of an old ghost facility with a new name, new paint and new management.

The new King hospital, smaller than its predecessor, King/Drew Medical Center, which closed its doors in 2007, started scheduling patients in June. The emergency department is expected to open within the next 45 days.

However, unlike the old hospital, this new one will not be a trauma center to treat critical injuries from gunshots and car accidents, which has been a point of contention among community members. Trauma centers cost tens of millions of dollars more, with the requirements of round-the-clock surgical teams, a helicopter pad and more,

For the veteran paramedics in the area, the new hospital churns up memories of past friendships and experiences not easily forgotten. Those memories take them back to their early years of EMS, working with nurses and doctors at an ER with the nickname, “Killer King.”

“Because of where it was and the people it served, King was always overcrowded and many times people were nearly dead when they arrived,” paramedic Mark Hollomon, recalls. “I saw those nurses and doctors do so much with so little. We medics would treat critical patients in the hallways. It was amazing.”

Located 10 minutes from Compton, the Martin Luther King Jr./Drew Medical Center shuttered in 2007 following investigative reports of gross mismanagement, preventable patient deaths and other scandals involving the hospital administration, medical staff and the Department of Health Services.

The hospital had been created in the wake of the Watts Riots in 1965, with the hope that health care services would help rebuild a community riddled with gangs, violence and drugs.

Born and raised in Compton, Hollomon has spent the last 23 years as a firefighter, 18 of them as a paramedic, in his hometown where he and his crew began to build friendships with the trauma center staff members of King Drew.

Hollomon remembers those days as a time when the number of trauma victims got worse and worse, due to gang activity. King’s crowded halls began to feel like a war zone for Hollomon. He and his fellow paramedics saw the harshest wounds and sometimes performed rather creative medical care.

The opportunity to help save lives made them feel they were part of the same team, with both the doctors and nurses. That camaraderie grew even as some began to realize the hospital did not always follow the rules.

“They didn’t play by the book because there was no book for what was going on in Compton back then,” Hollomon said. “They had to make their own book, especially when you had situations like a constantly crowded ER and back-to-back trauma victims.”

The men remembered a time when several gunshot wound victims from rival gangs were brought in after a shooting in the streets. Members of the respective gangs waited in the wings inches away from each other. Hollomon recalled the doctors and nurses trying to do their job while hoping the shooting didn’t continue into the hospital. Luckily for them, it didn’t.

As the medics mourned the loss of their local hospital, they also saw an increase in travel times. The nearest hospital became 15 minutes away – not five.

The old hospital was plagued by incidents of poor care, earning it the nickname “Killer King.” In one of the most notorious cases, a woman was left writhing in pain on the floor of a waiting room for 45 minutes, as a janitor mopped around her and other staffers walked past. She subsequently died, and the county paid a $3,000,000 settlement to her family.

Jennifer Bayer, vice president for external affairs for the Hospital Association of Southern California, said nearby hospitals should not be worried that they will lose patients to the new King hospital.

“There are enough patients to go around,” she said.

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CPR’s Unrealistic Portrayal on the Small Screen

Goofy CPR scene

“Ah, c’mon! There’s no way they would ever do that!”

A resounding Shhhhhhhhhhh! from the multitude cuts me off. “Seriously?” I continue, undaunted. “That patient doesn’t even have an . . . .”

A now capitalized SHHHHHHHH! reverberates off the living room wall, accentuated with a hail of Orville Redenbacher popcorn leveled toward my person, missing my mouth completely.

This is just a small playback of what it was like back in the day, when I was a fiery fresh medic watching a medical-themed TV show with my family. After all, I wanted to impress my kinfolks with my vast knowledge of newly acquired emergency medical protocols and medical terminology that had more than two syllables. It was my civic duty to point out the medical inaccuracies I bore witness to, in the scripts and actions of the TV characters while at the same time ruining the entertainment factor.

Medical shows during that time were just turning the corner from portraying doctors like Ben Casey, Dr. Kildare, and Marcus Welby – the purely altruistic, modest, always accessible, flawless heroes (without personal problems) to a cast of newly defined medical sorts who had their own issues of bad health, bad rivalries, bad relationships and bad breath. Though refreshing, revealing doctors as being human with vulnerable souls can be a little disconcerting, if one is a patient about to get a vasectomy from a physician who just found out her boyfriend cheated on her.

An added benefit to these new medical TV series, such as St. Elsewhere, ER, Chicago Hope and House, was the medical consultants to actually make an attempt at following medical guidelines. (Grey’s Anatomy had so much sex going on that nobody had time to treat anyone unless an STD was involved.)

Regardless of this somewhat decent attempt to entertain yet educate the audience to the detailed innards of emergency medicine, there are still a few scripted practices that get on my nerves – regardless of my ability to appreciate the fact that maximum drama impact will always supersede medical facts.

A few notable inaccuracies include: a patient diagnosis made within minutes of arrival to the ER and without a team consult; doctors actually performing procedures themselves; doctors ever yelling “stat” or stethoscopes not angled forward in the ears; coma patients with nasal cannulae; patients in flatline being defibrillated; patients’ survival dependent on a bullet being extracted immediately; gunshot wounds to the shoulder or leg considered minor inconveniences and, finally, EMS providers portrayed as mindless stretcher-bearers having performed no prehospital care whatsoever prior to their destination.

As television screenplay writers continue to strive to make their storylines more clinically precise (thank you, WebMD), there’s still one cinematic medical procedure no one seems willing to amend despite its blatant inaccuracy from both a physiological and psychological level.

You know the scene I’m talking about: The patient is pulseless and apneic and yet within a few minutes of bystander CPR and occasional words of encouragement (slapping optional), the patient, with beautiful skin color by the way, elicits a few coughs (sans emesis), blinks their eyelids as if waking from a nap and then says in a neurologically intact kinda way, “What happened?,” all the while never grabbing their now freshly fragmented and misaligned thorax. Such successful resuscitations transpire 75% of the time, assuming you’re fortunate enough to code on TV as a nonexpendable character. Clinically dead patients brought back to life is a central component to medical shows, but when it comes to CPR, fact and fiction often become blurred.

This kind of CPR (clean, pretty and reliable) differs so much from my usual CPR (can’t possibly recover) that despite the ongoing changes I’ve been trying to keep up with in regard to evidence-based CPR protocols, I’m beginning to think maybe EMS needs to take a page from Hollywood to enhance patient survivability from a cardiac arrest. This might include a new verbal algorithm when all other scientific-based efforts of resuscitation have failed. Hey, what can it hurt after your fourth round of epi and 10,000th chest compression?

Medic: Patient is still pulseless and apneic.

Team Leader: Raises shaking fist to the sky, yelling. Not today! Not on my watch!

M: Still asystolic.

TL: Grabs patient’s collar with both hands. Don’t quit on me (patient name)! Fight, damn you! Fight!

M: Still negative on the pulses.

TL: Looks toward the heavens, howling. Why him/her?! Why? Why? Why?!

M: Still got nada.

TL: Don’t take him/her! Take me instead! … No. Wait! Points to partner. Take him instead!

M: Gasp! Cough! Gurgle!

Seriously, I believe the falsehoods of CPR (cinematic pulseless recovery) have created a community disservice for the sake of highly impressionable entertainment. The film industry should take on the civic responsibility to enhance the perception of CPR factually–especially when dealing with scripts of surviving family members struggling in their effort to seek realistic expectations of full code resuscitation for a dying loved one. Even if the patient survives a cardiac arrest following CPR, full neurological recovery is not as cut and dry as portrayed on the screen. Now that the viewing audience has openly embraced the explicitness and particulars of medicine being put out by the film industry, let’s not skirt the complicated medical and ethical issues of CPR the medical community, patients and family members need to consider. At least not on my watch.

(We thank Steve Berry, a Paramedic with Southwest Teller County EMS in Colorado. He is the author of the cartoon book series “I’m Not An Ambulance Driver.” His work can be seen at: www.iamnotanambulancedriver.com)

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EMT in Detroit Refuses to Respond to Dying Infant Call

“Romeo 33, Medic 51. Be advised CPR is being performed on your scene. Romeo 33, Medic 51. CPR is being performed by the baby’s mother.” (Detroit EMS Dispatch)

In one of this nation’s most tortured cities a 10-year EMT has lost her job for her failure to do exactly what she was trained for, on Saturday, May 30.

Detroit Fire Department EMT Ann Marie Thomas’ refusal was documented on a 911 recording, when she answered the dispatcher that, “I’m not about to be on no scene 10 minutes doing CPR. You know how these families get.”

Thomas and her partner were approximately one mile away at the time. They were dispatched to resuscitate an 8-month old girl whose mother had called 911. The baby, born premature and on home oxygen to keep her alive, had apparently gone limp and was not breathing.

According to a Detroit city press release, the dispatcher can clearly be heard saying, “33, I’m going to need you to make that scene.” The dispatcher, who was in fact an EMS supervisor, repeated to Thomas,”You have to make patient contact.”

Investigators learned that Thomas, the senior EMT, pulled her EMS truck to the curb about one street away from the baby. The team typically responds to calls in an SUV as a “first response” unit, with a Paramedic ambulance to follow. But in this case, Thomas refused to go immediately to the child.

Detroit Fire Commissioner Edsel Jenkins reported this week that, “Ann Marie Thomas’s employment with the Detroit Fire Department has been terminated.”

Here’s another look at this regrettable case:

http://www.opposingviews.com/i/health/8-month-old-baby-dies-after-emt-refuses-respond-scene

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Paramedics & Nurses & the World We Live in

BE a NURSE

The following note once hung on the wall of the nursing lounge at Mercy Hospital, San Diego. We pulled it down long enough to make a photocopy. You see it here first:

To all new staff nurses – make sure you understand the following:

  • 25% of doctors are a poor excuse for protoplasm.
  • If it’s too dry, add moisture.  If it’s too wet, dry it. Congratulations. You’re a dermatologist.
  • Always remember to never say always or never.
  • Bleeding is fine. It’s the natural fluids that kill you.
  • Treat all patients exactly the same, until they piss you off.
  • “Too stupid to live” will someday be a recognized diagnosis.
  • Some patients are demonically possessed.
  • Learn how to play, “specimen, who’s got the specimen?”
  • It is entirely possible to order food from the O.R. phone.
  • For some patients, a referral to Doctor Kevorkian is totally appropriate.
  • There really is such a thing as a, “shallow gene pool.”
  • In this place, we restrain folks even when it isn’t sexual.
  • Considering the cooties in hospitals, you will either die young or develop immune systems that can attack kittens on your front lawn.
  • When you get home tonight, build a shrine to the makers of Haldol.
  • Fine dining is anywhere you can sit down to eat.
  • At least once a month, you’ll get to hear an administrator muttering, “who in the hell is in charge of this place?”
  • Gambling on hospital property is forbidden.  Betting on the blood-alcohol level of adolescent male trauma patients is a respected art form.
  • Please contain your laughter until you exit the patient’s room.
  • Don’t worry. The lab understands if you call to order a “dumb-shit” profile.
  • As a condition of employment, you’ll be expected to sign the petition demanding aerial spraying of Prozac over downtown.
  • You will learn to compute the brain-cell-to-tattoo ratio.
  • Refrain from uttering “great veins” when meeting family members. It just makes them nervous.
  • Someday your nursing shoes will be enshrined at the CDC.
  • If you choose to slap a doctor for grabbing your breasts, try to wait until after the procedure.

God bless nurses. They stand on the front lines with no firearms at all.

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“What’s it Like to be a Paramedic?’ – Read “The Paramedic Heretic”

GHOST MEDIC

“I had the idea for this image recently while having a busy shift on the ambulance. We were dealing with several high acuity calls when we were called to a simple hospital transfer. I was thinking that if our patient knew what had happened on the stretcher she was sitting on, just moments ago, she wouldn’t be as at ease with where she was.
I then starting thinking of all the things that happen in the back of my ambulance when I’m not on shift.
If these walls could talk.”
(We thank Paramedic Becky Arnold Arbuckle for this poignant graphic)

Why Write “The Paramedic Heretic?” Oh, You Really Need to Know This Stuff

Hippocrates
Hippocrates

I certainly did not start out a skeptic and I would guess that almost nobody does. In my formative years I was as goofily naïve as anybody:

  • I stood convinced that health care was fairly insulated from petty infighting so prevalent in less meaningful professions.
  • I was certain that saving lives was the highest of its priorities.
  • I took for granted that scientific integrity was somehow a given; that there were too many safeguards to allow fraudulent research to harm patients.
  • I believed physicians were held to the loftiest of discipline standards.
  • I was sure the most prolific drug profiteers on the planet were tucked away in jungle hideouts.

And it was revolting – quite viscerally painful – to concede that not a single one of those beliefs happens to be true.

So what is the purpose of the Paramedic Heretic? Simple. It is time for somebody in my field of expertise to shout “gardyloo!” from the belfry. It is time that you – health care’s ultimate consumer – gain the perspective of just how distorted our corner of medicine has become. The goal here is entirely uncomplicated. You will almost certainly have need to call 911 for medical help at some point in your life, so you might want to read up, because we just don’t think like you do. Before this book is finished you  will know exactly how we think, which might come in handy on your next personal emergency.

What you have here is a veteran medic’s unvarnished 30-year critique. A professional bloodline; a pilgrimage to heresy. If you are wise beyond your years, you will become a heretic, too. At the very least, when you put this book down you will know – as the marvelous Paul Harvey used to say – “The rest of the story.”

Make no mistake. Much of what goes on within the monastic world of medicine is brainsick beyond belief, fashioned in part by some rather ignoble dynamics. For brevity, we call these the Immutable Laws.

You won’t be hearing about the Immutable Laws on the network news. You will not absorb them from the internet. If you happen to have medical friends it is unlikely they will fess up, either. In fact, we in EMS don’t even admit the Immutable Laws exist.

Until now.

Time for the cleansing light of day.

Oh, and one more thing? We always spell Paramedic with a capital ‘P’. We think we’ve earned it.

(Excerpt from the book, “The Paramedic Heretic”)

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