What happened to EMS? (Very Long)

[Guest guest]

What do these people have in common?

Ron Krome, Wiegenstein, Rosen, Podgorney, Rupke, R A.

Cowley, Mickey Eisenburg, Don Trunkey, Pons, Alan Dimick, Corey Slovis,

Alisdair Conn, Bob Aranosian, Leonard Riggs, Rich Cummings, Graves, Ron

Crowell, Kim Maull, Rocco Morando, Norm McSwain, Ron , Pepe, Ray

Fowler, Mark Hauswald, Briggs Hopson, Paris, Wasserberger,

Safar, White, Mike Copass, Goldfrank, Harvey Meislin, Bill Roush,

Joe Wackerle, Jeff Clawson, Jack Page, Gerry Straugh, Joe Ornato, ,

Bledsoe, Jim Page, Ken Mattox, Rick Cales, Ehrlich, Rick ez,

Leo Schwartz, Boyd, Don Gann, Mike Krentz, Kathy Handal, Jack Stout, Jon

Best, Maniscalco, Jim Seidel, Gene Cayten, Sacra, Glen , Erwin

Thal, McHenry, Wade Spruill, Drew Dawson and many others.

These are the people who founded the specialty of emergency medicine, and

founded or significantly influenced the direction of modern EMS, They are also

people that I've had the privilege of working with on boards, committees, task

groups, working groups, meetings & presentations throughout my career. Despite

their obvious professional differences and frames of reference, you could put

them all in the same room and they would immediately assume the common dialogue,

standard of behavior and professional decorum that is required to identify,

address and resolve broad issues - all in the name of the greater good.

One thing that they won't do is launch ad hominem attacks on any of the others

because their personal standards and sense of professional respect are so deeply

ingrained. Moreover, I never heard a scintilla of acrimony directed toward the

EMS workforce by any of these people. The thought would never occur to them.

Even though professional and territorial jousting was frequent, they

never-the-less subscribed to a single behavioral standard that identified them

all as leaders. And, Texas had its share of EMS leaders, too. What has changed

since those earlier times? Why is it so difficult to form associations? What

happened to the upwelling of leadership in Texas? Why is there so much

frustration, eye-poking, hair pulling and stampeding over one another going on

today?

Two behavioral philosophies have emerged and coalesced in the past 30 years that

have had a corrosive effect on the homogeneity of EMS. These philosophies, born

in the '60's and 70's are never discussed or considered in the context of

current and future planning or leadership development within the EMS industry,

even though they play an enormous role in the strength of its mainstream fabric.

Opinions, attitudes and beliefs (OAB's) are shaped by the encroachment of these,

now pandemic, cultural philosophies, which are:

Relativism: The meaning and value of human beliefs have no absolute value or

truth; all truth is relative to the individual based on cognitive, racial,

cultural and experiential grounds; all viewpoints are equally valid; and,

relativitism denies that any viewpoint is uniquely privileged over all others,

and

Egalitarianism: A trend in political, moral and ethical thought that stresses

equality of outcomes, rather than equality of opportunities; that all people are

equal in every respect; and that hierarchies within human populations should not

exist (See: Entitlement Socialism and Cognitive Partitioning)

Any casual observer can see these philosophies routinely acted out on this List.

And, while we're all focused on systems, methods, processes, curricula, politics

and professional recognition, no attention is being paid to the OAB's that spawn

and perpetuate them. But, in what ways have these behavioral doctrines

negatively affected EMS? The most common example that I see is the same tired

refrain that " we need to organize " . That would have been much more doable in the

'70's than now because what began as a truly collective and selfless effort back

then has now devolved into what Harold Rosenberg coined as " a herd of

independent minds " .

Today, most EMS workers are less inclined to establish a collective identity and

agenda, and more inclined to identify with provider organizations and their

respective provincial turfs. Thus, EMS people are left to complain about the

lack of professional recognition and economic progress without realizing the

destructiveness of their relativistic and egalitarian beliefs. The common

beliefs and standards that were once considered apodictic are now blurred into

obscurity by a combination of independently derived truths and a conspicuous

resentment of academic and hierarchical authority.

In the early days of EMS, the leadership style was messianic. When Boyd

would come to town accompanied by his band of jongleurs, ambulance people would

come out of the woodwork to hear him proselytize his young minions on what EMS

was to become. To us he was more of a oracle than a physician from DO.C., who

always seemed to have holes in the bottoms of his shoes and looked like he slept

in his suit. For the first time he was legitimizing what was a $1.60 per hour

job. He spoke. We listened. Following a few training programs, many of us were

stigmatized by our contemporaries for committing such unthinkable acts as taking

a blood pressure " Who do you think you are - a doctor? " . Significantly, we

really didn't question the validity or practicality of establishing EMS systems

throughout the U.S. We just knew intuitively that anything was better than what

we were doing at the time - and we were all on board.

Following the " Big Bang " of federal categorical funding, EMS constituencies

scrambled for supremacy in the block grant pecking order. What was once a solid

mass of collective interests quickly transformed into an archipelago of

independent, self-serving interests. Each group rushed to stake out its turf,

cloister its activities and motives under veils of secrecy and establish its

indispensability in the new world of EMS. By doing so, the common medic on the

street was cut from the equation, left to glean fragments of information from

trade journals and anecdotal reports. Driven by their own definitions of truth,

equality and parity, the national EMS leadership disintegrated into a

" confederacy of dunces " marked by uneasy and loosely-knit coalitions and

alliances formed to meet perceived threats, rather than preserve the integrity

of the industry and move it forward as a whole.

It's as though we're all trapped in a runaway stagecoach and no one has control

of the reins. Any attempt by anyone to " grab the reins " , in terms of leadership,

will be swiftly met with a ball peen hammer to the base of the skull. Why we

marginalize and subvert those who want to and should lead can be explained by

the philosophies above. To consent to leadership by others, we must first accept

that our truths aren't the only truths. Furthermore, we must acknowledge that

there might be a greater good that exceeds our knowledge, understanding and

frame of reference. Accordingly, emerging leaders should avoid motives and

actions that will characterize them as being cloven-hoofed, preening,

self-aggrandizing dysfunctional narcissists (not that I know any).

It's time for us old EMS dinosaurs to straighten up and do what we should of

been doing for the past 30 years - helping to bring along new, fresh and

talented leaders. They're out there because I see them being squelched and

squashed on this List every week. We must appreciate that their philosophies are

different from ours, thus their orientation and leadership styles will be vastly

different. We must stop trying to convince people that we're the hierophants of

some sacred mysteries, and begin to identify, inform and nurture our progeny. To

do less would disgrace the hard-fought and remarkable contributions of our

predecessors.

Bob Kellow

[Guest guest]

Amen

What happened to EMS? (Very Long)

What do these people have in common?

Ron Krome, Wiegenstein, Rosen, Podgorney, Rupke, R A.

Cowley, Mickey Eisenburg, Don Trunkey, Pons, Alan Dimick, Corey

Slovis, Alisdair Conn, Bob Aranosian, Leonard Riggs, Rich Cummings,

Graves, Ron Crowell, Kim Maull, Rocco Morando, Norm McSwain, Ron ,

Pepe, Ray Fowler, Mark Hauswald, Briggs Hopson, Paris,

Wasserberger, Safar, White, Mike Copass, Goldfrank, Harvey

Meislin, Bill Roush, Joe Wackerle, Jeff Clawson, Jack Page, Gerry Straugh,

Joe Ornato, , Bledsoe, Jim Page, Ken Mattox, Rick Cales,

Ehrlich, Rick ez, Leo Schwartz, Boyd, Don Gann, Mike

Krentz, Kathy Handal, Jack Stout, Jon Best, Maniscalco, Jim Seidel,

Gene Cayten, Sacra, Glen , Erwin Thal, McHenry, Wade

Spruill, Drew Dawson and many others.

These are the people who founded the specialty of emergency medicine, and

founded or significantly influenced the direction of modern EMS, They are

also people that I've had the privilege of working with on boards,

committees, task groups, working groups, meetings & presentations throughout

my career. Despite their obvious professional differences and frames of

reference, you could put them all in the same room and they would

immediately assume the common dialogue, standard of behavior and

professional decorum that is required to identify, address and resolve broad

issues - all in the name of the greater good.

One thing that they won't do is launch ad hominem attacks on any of the

others because their personal standards and sense of professional respect

are so deeply ingrained. Moreover, I never heard a scintilla of acrimony

directed toward the EMS workforce by any of these people. The thought would

never occur to them. Even though professional and territorial jousting was

frequent, they never-the-less subscribed to a single behavioral standard

that identified them all as leaders. And, Texas had its share of EMS

leaders, too. What has changed since those earlier times? Why is it so

difficult to form associations? What happened to the upwelling of leadership

in Texas? Why is there so much frustration, eye-poking, hair pulling and

stampeding over one another going on today?

Two behavioral philosophies have emerged and coalesced in the past 30 years

that have had a corrosive effect on the homogeneity of EMS. These

philosophies, born in the '60's and 70's are never discussed or considered

in the context of current and future planning or leadership development

within the EMS industry, even though they play an enormous role in the

strength of its mainstream fabric. Opinions, attitudes and beliefs (OAB's)

are shaped by the encroachment of these, now pandemic, cultural

philosophies, which are:

Relativism: The meaning and value of human beliefs have no absolute value or

truth; all truth is relative to the individual based on cognitive, racial,

cultural and experiential grounds; all viewpoints are equally valid; and,

relativitism denies that any viewpoint is uniquely privileged over all

others, and

Egalitarianism: A trend in political, moral and ethical thought that

stresses equality of outcomes, rather than equality of opportunities; that

all people are equal in every respect; and that hierarchies within human

populations should not exist (See: Entitlement Socialism and Cognitive

Partitioning)

Any casual observer can see these philosophies routinely acted out on this

List. And, while we're all focused on systems, methods, processes,

curricula, politics and professional recognition, no attention is being paid

to the OAB's that spawn and perpetuate them. But, in what ways have these

behavioral doctrines negatively affected EMS? The most common example that I

see is the same tired refrain that " we need to organize " . That would have

been much more doable in the '70's than now because what began as a truly

collective and selfless effort back then has now devolved into what Harold

Rosenberg coined as " a herd of independent minds " .

Today, most EMS workers are less inclined to establish a collective identity

and agenda, and more inclined to identify with provider organizations and

their respective provincial turfs. Thus, EMS people are left to complain

about the lack of professional recognition and economic progress without

realizing the destructiveness of their relativistic and egalitarian beliefs.

The common beliefs and standards that were once considered apodictic are now

blurred into obscurity by a combination of independently derived truths and

a conspicuous resentment of academic and hierarchical authority.

In the early days of EMS, the leadership style was messianic. When

Boyd would come to town accompanied by his band of jongleurs, ambulance

people would come out of the woodwork to hear him proselytize his young

minions on what EMS was to become. To us he was more of a oracle than a

physician from DO.C., who always seemed to have holes in the bottoms of his

shoes and looked like he slept in his suit. For the first time he was

legitimizing what was a $1.60 per hour job. He spoke. We listened. Following

a few training programs, many of us were stigmatized by our contemporaries

for committing such unthinkable acts as taking a blood pressure " Who do you

think you are - a doctor? " . Significantly, we really didn't question the

validity or practicality of establishing EMS systems throughout the U.S. We

just knew intuitively that anything was better than what we were doing at

the time - and we were all on board.

Following the " Big Bang " of federal categorical funding, EMS constituencies

scrambled for supremacy in the block grant pecking order. What was once a

solid mass of collective interests quickly transformed into an archipelago

of independent, self-serving interests. Each group rushed to stake out its

turf, cloister its activities and motives under veils of secrecy and

establish its indispensability in the new world of EMS. By doing so, the

common medic on the street was cut from the equation, left to glean

fragments of information from trade journals and anecdotal reports. Driven

by their own definitions of truth, equality and parity, the national EMS

leadership disintegrated into a " confederacy of dunces " marked by uneasy and

loosely-knit coalitions and alliances formed to meet perceived threats,

rather than preserve the integrity of the industry and move it forward as a

whole.

It's as though we're all trapped in a runaway stagecoach and no one has

control of the reins. Any attempt by anyone to " grab the reins " , in terms of

leadership, will be swiftly met with a ball peen hammer to the base of the

skull. Why we marginalize and subvert those who want to and should lead can

be explained by the philosophies above. To consent to leadership by others,

we must first accept that our truths aren't the only truths. Furthermore, we

must acknowledge that there might be a greater good that exceeds our

knowledge, understanding and frame of reference. Accordingly, emerging

leaders should avoid motives and actions that will characterize them as

being cloven-hoofed, preening, self-aggrandizing dysfunctional narcissists

(not that I know any).

It's time for us old EMS dinosaurs to straighten up and do what we should of

been doing for the past 30 years - helping to bring along new, fresh and

talented leaders. They're out there because I see them being squelched and

squashed on this List every week. We must appreciate that their philosophies

are different from ours, thus their orientation and leadership styles will

be vastly different. We must stop trying to convince people that we're the

hierophants of some sacred mysteries, and begin to identify, inform and

nurture our progeny. To do less would disgrace the hard-fought and

remarkable contributions of our predecessors.

Bob Kellow