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Selects: How Paramedics Work · Stuff You Should Know

• 0:00
  Speaker 1: Hi everybody. Chuck here, I just.
• 0:03
  Speaker 2: Realized I have almost cut my finger off while I
• 0:07
  Speaker 2: was playing with a pocket knife just now, and it's
• 0:11
  Speaker 2: bleeding quite a bit. So I'm gonna call nine one one,
• 0:15
  Speaker 2: and in the meantime, I'm going to listen to this
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  Speaker 2: episode from April twelfth, twenty eighteen, how Paramedics Work.
• 0:20
  Speaker 1: Oh, thank god.
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  Speaker 3: Welcome to Stuff You Should Know, a production of iHeartRadio.
• 0:37
  Speaker 4: Hey, and welcome to the podcast. I'm Josh Clark with
• 0:40
  Speaker 4: Charles W Chuck Bryant, and there's Jerry Jerome Roland and
• 0:44
  Speaker 4: this is Stuff you Should Know The Emergency.
• 0:48
  Speaker 1: Real Rear Rear.
• 0:50
  Speaker 4: War er er aw.
• 0:57
  Speaker 3: We should have a new podcast called Sirens Are the World. Yeah,
• 1:02
  Speaker 3: it's just annoying show.
• 1:03
  Speaker 4: Ever, it would be pretty annoying, but there'd be some
• 1:06
  Speaker 4: subset of people who like just really despise themselves that
• 1:09
  Speaker 4: it'd be popular.
• 1:10
  Speaker 1: Among so we would love it.
• 1:13
  Speaker 4: Uh, we don't hate ourselves, do we tell me? I
• 1:16
  Speaker 4: need to know?
• 1:17
  Speaker 1: No? Okay, So it depends on the day.
• 1:20
  Speaker 4: I didn't want to hate myself.
• 1:21
  Speaker 1: Sometimes I want to punch myself. Does that count?
• 1:23
  Speaker 4: No? I know exactly what you mean. Man. Sometimes I'm
• 1:26
  Speaker 4: just like I am so sick of myself? Is that
• 1:30
  Speaker 4: is that what you're talking about?
• 1:32
  Speaker 1: That was a good song. Remember that song? No sick
• 1:35
  Speaker 1: of myself? No, that was Matthew Sweet.
• 1:39
  Speaker 4: Oh yeah, wow, that's weird that this is going on
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  Speaker 4: right now, because Matthew Sweet just popped up like randomly
• 1:46
  Speaker 4: in the last couple of days, and like an article
• 1:49
  Speaker 4: I was reading, I was like, I forgot about him,
• 1:51
  Speaker 4: haven't heard about him in twenty years, and then bam,
• 1:53
  Speaker 4: bottom mine hoff, here he is again.
• 1:55
  Speaker 1: Well he's still around, he's in Atlantic. Guy.
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  Speaker 4: You know, I didn't know that. Yeah, well that's cool. Yeah,
• 2:01
  Speaker 4: I know. I think I think that's like the way
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  Speaker 4: it goes. Just because you had one hit in the
• 2:06
  Speaker 4: world came and like listened to you and then moved
• 2:08
  Speaker 4: on doesn't mean like you're like, Okay, well I guess
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  Speaker 4: I'll go bury myself alive now in my own backyard.
• 2:13
  Speaker 4: Usually usually the artist like keeps going.
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  Speaker 1: Yeah, you know, yeah, he had two hits.
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  Speaker 4: Stuff, I know, girlfriend, and then the other one you're
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  Speaker 4: talking about.
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  Speaker 1: Yeah girlfriend, that's a great song.
• 2:24
  Speaker 4: Yeah it's a good song. Okay. So obviously what we're
• 2:29
  Speaker 4: talking about today are paramedics, para medicine really is what
• 2:34
  Speaker 4: we're talking about, yeah, which is it's actually a pretty
• 2:39
  Speaker 4: interesting topic because you kind of look into it, You're like, oh,
• 2:42
  Speaker 4: these people save lives. That's great. Here's some of the
• 2:46
  Speaker 4: life saving techniques that they do. Fantastic, But there's like,
• 2:50
  Speaker 4: actually so much more too. It's got a really interesting history,
• 2:54
  Speaker 4: it's got a a a it's one of those things
• 2:57
  Speaker 4: where it's way worse off than it should be as
• 3:00
  Speaker 4: far as like funding and like logistics and stuff like
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  Speaker 4: that goes. I just find it interesting. It's it's interesting
• 3:07
  Speaker 4: to kind of poke into a topic and then find that, oh,
• 3:12
  Speaker 4: this is even more interesting than I thought, and have
• 3:13
  Speaker 4: it poked back yep with forceps.
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  Speaker 3: So I guess we should say right off the bat
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  Speaker 3: that the word paramedic para means alongside, so alongside medicine,
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  Speaker 3: I guess, which I'm not quite sure what that means.
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  Speaker 4: So what I think it means is, as follows Charles,
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  Speaker 4: these people paramedics. They are not doctors, correct, but they
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  Speaker 4: work with and alongside and really honestly as an extension
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  Speaker 4: of a doctor. An So that's what I think it means,
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  Speaker 4: because it's not like what they're doing is a different
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  Speaker 4: type of wacky medicine. Like they're actually doing the same
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  Speaker 4: type of medicine that an er doctor, an er nurse
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  Speaker 4: would be doing in an er they're just doing it
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  Speaker 4: out in the field.
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  Speaker 3: Could you imagine how disconcerting it would be to be
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  Speaker 3: like on the ground and have a paramedic come up
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  Speaker 3: and like blow green dust in your face.
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  Speaker 4: You're like, what are the chicken bones for?
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  Speaker 3: Man?
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  Speaker 4: Oh man, blow green dusting. I don't know, it would
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  Speaker 4: depend on what the effect of the green dust was.
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  Speaker 4: It's true, so I think that's what paramedic means. Right, Okay,
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  Speaker 4: we can go we can go further back actually and
• 4:33
  Speaker 4: describe what ambulance means. We know that one for certain.
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  Speaker 3: Yes, that came around in fifteenth century Spain during the Inquisition.
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  Speaker 3: They clearly had a lot of need for medical work yea.
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  Speaker 3: And they actually had field hospitals that were called ambulancius right.
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  Speaker 4: It was just basically like a mass unit out in
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  Speaker 4: the field. And then eventu the French shortly after, I
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  Speaker 4: think under Napoleon they innovated on the ambulance and said, well,
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  Speaker 4: that's great, that's neat that we have these things out
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  Speaker 4: in the field. But there's some guys way over there
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  Speaker 4: who are injured, and they probably wouldn't die if we
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  Speaker 4: could get them to these ambulances, these field hospitals, right, correct.
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  Speaker 4: So they came up with basically mobile ambulances, which is
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  Speaker 4: this idea of a flying or a moving ambulance, which
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  Speaker 4: is like a little medical facility that they would put
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  Speaker 4: the people into and move them away from battle to
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  Speaker 4: go patch them up, rather than waiting for the battle
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  Speaker 4: to end.
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  Speaker 1: Well.
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  Speaker 3: Yeah, and before that, even during the Crusades, and they
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  Speaker 3: also had a great need for medical care, there were
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  Speaker 3: the Knights Hospitaller Hospital.
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  Speaker 4: Or I think Hospitalita.
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  Speaker 1: Oh whoa, is.
• 5:58
  Speaker 4: There an extra I might be putting an extra bull
• 6:00
  Speaker 4: in there. Well, that's a right I'm known to do.
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  Speaker 1: That's pastime time, Knight's Hospitaller.
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  Speaker 3: That's what I'm gonna say of the Order of Saint
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  Speaker 3: John of Jerusalem. And they were the first kind of
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  Speaker 3: the first people to practice emergency medicine on the battlefield.
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  Speaker 1: And they even invented the what we.
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  Speaker 3: Now call the stretcher, although it's still called a litter
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  Speaker 3: in some circles.
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  Speaker 4: Yeah, it's a pretty intuitive thing, but it's it works.
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  Speaker 1: Someone had to think of it.
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  Speaker 4: A couple of sticks with some canvas stretch between them.
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  Speaker 4: Throw a person on there, you can pick them up.
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  Speaker 4: Two people can pick them up and get them off
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  Speaker 4: of the battlefield, lickety split.
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  Speaker 1: Hooray.
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  Speaker 4: So yeah, so this is the idea of emergency medicine
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  Speaker 4: grew basically exclusively out of warfare over the centuries.
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  Speaker 3: Well yeah, but what's remarkable to me is that from
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  Speaker 3: that time I had the right idea, let's get these
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  Speaker 3: people out of here quickly. It took about one hundred
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  Speaker 3: and thirty years all the way until the mid to
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  Speaker 3: late nineteen sixties until they said, hey, wait a minute,
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  Speaker 3: if we actually put trained medical people in these things
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  Speaker 3: and weren't simply driving people to a hospital, we might
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  Speaker 3: have even more luck.
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  Speaker 4: Yeah, that was the late sixties and then amazing it is.
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  Speaker 4: And at the time it was so a lot of
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  Speaker 4: medicine was practiced through house calls, right, including emergencies Like
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  Speaker 4: if there was an emergency and you could get a
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  Speaker 4: hold of a doctor, the doctor was expected to go
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  Speaker 4: out to that emergency and do what they could, but
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  Speaker 4: more often than not, either the cops or local morticians
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  Speaker 4: were tasked with basically was called like a scoop and
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  Speaker 4: scoop and run or scoop and carry, where you just
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  Speaker 4: basically get the person out of that car wreck or
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  Speaker 4: from the bottom of that ladder or whatever just happened
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  Speaker 4: to them, throw them in the back of a car,
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  Speaker 4: a cop or a hearse. I would looked it up.
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  Speaker 4: The ECDO one the Ghostbusters ambulance is a modified Cadillac Hearse.
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  Speaker 3: Oh yeah, so they would dress the sinking feeling. It
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  Speaker 3: really was for a mortician to show up in ahearse
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  Speaker 3: and be like, I'm gonna take you to the hospital.
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  Speaker 3: Depending on what happens, you may be back in the
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  Speaker 3: same car.
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  Speaker 4: Yeah, and talk about a conflict of interest, you know
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  Speaker 4: what I mean.
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  Speaker 1: Oh, that's a good point.
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  Speaker 4: Hopefully not but yeah on paper, yeah right, Or they
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  Speaker 4: just you know, casually put their hand on the person's
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  Speaker 4: nose and mouth in the backseat. Dry. The thing is, though,
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  Speaker 4: is whether the mortician or the cops were getting you
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  Speaker 4: to the hospital. Even when you got to the hospital.
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  Speaker 4: It's not like there was such a thing as an
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  Speaker 4: er room. E Ers didn't come about really until like
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  Speaker 4: the mid seventies, where you could find them in fair
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  Speaker 4: abundance around the United states like ers just didn't exist.
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  Speaker 4: It was here you go, doc. I know you delivered
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  Speaker 4: a baby and you treated somebody else for angina, but
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  Speaker 4: now you've got to put this person's head back together.
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  Speaker 1: Wow.
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  Speaker 4: Yeah. And it was all just medicine at the time.
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  Speaker 4: So yeah, the idea of getting somebody to a hospital
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  Speaker 4: and having a medical person, a professional in the car
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  Speaker 4: that's transporting them. It came out of Ireland, I think, right.
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  Speaker 3: Yeah, big shout out nineteen sixty seven to doctor J.
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  Speaker 3: Frank Pantridge of Belfast. He had a study. He published
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  Speaker 3: a study that said, hey, you know what, we have
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  Speaker 3: more success saving people's lives when our mobile units have
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  Speaker 3: a physician or a nurse inside.
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  Speaker 5: Right, And everyone went, huh, never really thought about that,
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  Speaker 5: but there it is, there's a study. Yeah, pretty cool.
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  Speaker 5: So he definitely set the stage for this.
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  Speaker 4: And then the year before there was a report I
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  Speaker 4: think it was a year earlier, right, the one from
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  Speaker 4: Congress in America.
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  Speaker 1: A couple of years sixty five.
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  Speaker 4: I think it was like the National Academy of Sciences
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  Speaker 4: or somebody basically got together with another group and said,
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  Speaker 4: let's study accidents. And what they came up with was
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  Speaker 4: this idea that there was like this overlooked disaster that happened.
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  Speaker 4: Like accidents were a huge, major leading cause of injury
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  Speaker 4: and death in the United States, and this inquiry determined
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  Speaker 4: that we weren't doing much about it, and specifically a
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  Speaker 4: lot of people died who otherwise wouldn't have if there
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  Speaker 4: had been something like an emergency medical service to attend
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  Speaker 4: to them at the accident scene and on the way
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  Speaker 4: to the hospital, and then having the hospital actually know
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  Speaker 4: what they were doing as far as emergency medicine goes.
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  Speaker 1: Yeah, it's just staggering to me.
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  Speaker 3: It seems so intuitive and I can't believe it took
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  Speaker 3: that long for this to happen, you know. And in fact,
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  Speaker 3: the Emergency Medical Systems Act was signed in nineteen seventy three,
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  Speaker 3: which basically said.
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  Speaker 1: We need a standardized system here.
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  Speaker 4: Yeah, a nationwide That was after that paper came out
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  Speaker 4: in nineteen sixty six.
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  Speaker 3: Yea many years later. I mean that's a speed of government,
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  Speaker 3: I guess. And then in nineteen seventy seven the publication
• 11:19
  Speaker 3: of the first very first national standard Curriculum for EMTs
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  Speaker 3: and Paramedics seventy seven.
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  Speaker 1: Yeah.
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  Speaker 4: And then so alongside this para, this they there were
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  Speaker 4: people like around the country, at universities around the country
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  Speaker 4: and around the world who were kind of all recognizing
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  Speaker 4: all of this at the same time that there's a
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  Speaker 4: lot more that could be done for people who were
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  Speaker 4: injured in accidents. And so you had the people at
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  Speaker 4: pitt University of Pittsburgh taking up the cause.
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  Speaker 1: Panthers.
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  Speaker 4: Yeah, they started is that the Panthers, Yeah, huh. They
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  Speaker 4: started creating some of the first curriculum for paramedics, some
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  Speaker 4: of the earliest tests for paramedics. The University of Cincinnati
• 12:08
  Speaker 4: came up with the first curriculum for training physicians in
• 12:11
  Speaker 4: er medicine. I think the University of California was an
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  Speaker 4: early entrant into the world of teaching paramedicine. And then
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  Speaker 4: I think they were the first one to be accredited
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  Speaker 4: in nineteen eighty, Like they had their operation going for years,
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  Speaker 4: but they were the first one to say, hey, somebody
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  Speaker 4: take a look at this and make sure we're kosher,
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  Speaker 4: and then we can say we're an accredited training facility
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  Speaker 4: for paramedics.
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  Speaker 1: Amazing, it is pretty amazing.
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  Speaker 4: And then the problem is this, So the federal government
• 12:45
  Speaker 4: got into the act in nineteen seventy three, with the
• 12:48
  Speaker 4: Emergency Medical Services Act. But by nineteen eighty one there
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  Speaker 4: was an omnibus budget that said we're out, We're done,
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  Speaker 4: We're not funding emergency services anymore. And then from that
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  Speaker 4: point forward, the emergency service system in the United States,
• 13:03
  Speaker 4: whatever had been developed to that point, broke into patchworks
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  Speaker 4: of state, local county programs, sometimes multiple ones within a
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  Speaker 4: single county. I think there's a county in Michigan that
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  Speaker 4: has like eighteen different emergency services and that has kind
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  Speaker 4: of created this where we are now, which is people
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  Speaker 4: doing the absolute best they can in what amounts to
• 13:28
  Speaker 4: a broken system in a lot of ways.
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  Speaker 3: Should we take a break, sure, all right, when we
• 13:33
  Speaker 3: come back, we will put the broken system behind us momentarily.
• 13:37
  Speaker 3: Talk about e mts and paramedics.
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  Speaker 1: All right.
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  Speaker 3: So if you want to ride in an ambulance or
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  Speaker 3: drive an ambulance and get on the scene and help
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  Speaker 3: someone out who's in need, there are a couple of
• 14:18
  Speaker 3: ways you can do it. You can be an EMT
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  Speaker 3: emergency medical technician. And this is the person who has
• 14:28
  Speaker 3: undergone about between about one hundred and twenty and one hundred.
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  Speaker 1: And fifty hours of course work there.
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  Speaker 3: They are well trained and all kinds of life saving procedures.
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  Speaker 3: If you need CPR, if you need oxygen administered, if
• 14:42
  Speaker 3: you were having some bad allergic reaction, that your life
• 14:46
  Speaker 3: is in jeopardy. But there are limits to what they
• 14:49
  Speaker 3: are allowed to do. So one thing they cannot do,
• 14:52
  Speaker 3: even in the case of giving shots is they can't
• 14:56
  Speaker 3: break the skin, right, which is super interesting.
• 14:59
  Speaker 1: I never knew that.
• 15:00
  Speaker 4: Yeah, I didn't know that either. But you can consider
• 15:03
  Speaker 4: an EMT like an entry level paramedicine professional, right, that's
• 15:09
  Speaker 4: where you would start. And in fact, I think you
• 15:11
  Speaker 4: have to start as an EMT to go on to
• 15:13
  Speaker 4: the next level, which would be paramedic.
• 15:15
  Speaker 1: Right for sure.
• 15:15
  Speaker 4: Yeah, so if you're a paramedic, you have about ten
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  Speaker 4: times the amount of coursework in schooling under your belt
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  Speaker 4: by the time you're a paramedic. And I think you
• 15:24
  Speaker 4: do have to have about six months at least of
• 15:28
  Speaker 4: immediately prior EMT experience to start becoming a paramedic as well,
• 15:34
  Speaker 4: which I'm sure is the way most people go. As
• 15:36
  Speaker 4: you start out as an EMT and then you move
• 15:39
  Speaker 4: on to the next level, which is paramedic.
• 15:41
  Speaker 3: Yeah, which, like you said, ten times, so that's about
• 15:44
  Speaker 3: anywhere from twelve hundred to eighteen hundred hours depending on
• 15:47
  Speaker 3: your state or your municipality to get certified. And this
• 15:51
  Speaker 3: is where the real action can happen. You can give
• 15:55
  Speaker 3: an IV, you can if someone's having a heart attack,
• 15:58
  Speaker 3: you can deal with that.
• 15:59
  Speaker 1: You can operate defibrillator, tibulator, fibrillator, fibrillator.
• 16:04
  Speaker 4: It's fun to say once you master it, they should
• 16:07
  Speaker 4: have just.
• 16:07
  Speaker 1: Called it the clear machine.
• 16:10
  Speaker 3: Yeah, the but it's a it's a lot of work
• 16:16
  Speaker 3: in a lot of hours. And one of the people
• 16:18
  Speaker 3: that they interviewed in this article said that, you know,
• 16:21
  Speaker 3: it's really grueling, and when you're in paramedic training and
• 16:25
  Speaker 3: school and doing your course work basically for a year
• 16:28
  Speaker 3: or two, you can just say goodbye to your friends
• 16:30
  Speaker 3: and family.
• 16:31
  Speaker 1: Yeah.
• 16:31
  Speaker 4: I saw that too.
• 16:32
  Speaker 1: Yeah, that's tough stuff.
• 16:33
  Speaker 4: So the paramedic is actually they operate under the license,
• 16:40
  Speaker 4: not just like like under the direction, but under the
• 16:43
  Speaker 4: license of a physician in their locale.
• 16:46
  Speaker 5: Right.
• 16:46
  Speaker 4: Yeah, there's a couple of ways that you can do it.
• 16:48
  Speaker 4: And as you'll start to see, like I saw a
• 16:51
  Speaker 4: quote that it said, if you've seen one emergency medical system,
• 16:55
  Speaker 4: you've seen one emergency medical system. They're all just so different. Yeah,
• 16:59
  Speaker 4: and the whole thing so patchwork. But there is a
• 17:02
  Speaker 4: national standard, which I think is the National Emergency Medical
• 17:08
  Speaker 4: Technician Registry Exam. That's like the national exam, and then
• 17:14
  Speaker 4: you may have to pass like a state and or
• 17:16
  Speaker 4: local exam too, depending on where you live. But there
• 17:20
  Speaker 4: is like a national accreditation and national coursework. But then
• 17:23
  Speaker 4: how the system functions and runs is what's the patchwork
• 17:26
  Speaker 4: part of it.
• 17:27
  Speaker 3: Yeah, and it'll cost you. I mean it depends on
• 17:29
  Speaker 3: where it is, of course, and what program. But the
• 17:31
  Speaker 3: example they used in art article is the UCLA Center
• 17:35
  Speaker 3: for Pre Hospital Care, and they quoted about ten grand
• 17:38
  Speaker 3: for just the tuition. And then, of course, like any
• 17:41
  Speaker 3: college or coursework, you're gonna have to pay for books
• 17:44
  Speaker 3: and equipment and uniforums and stuff like that.
• 17:47
  Speaker 1: That's exactly where they get.
• 17:49
  Speaker 4: You plaid skirt.
• 17:51
  Speaker 3: And then after that, though, the good news is is
• 17:55
  Speaker 3: that you have a really good chance of getting work.
• 17:57
  Speaker 3: I get the impression that if you have gone through
• 18:00
  Speaker 3: all of your paramedic training, you're not sitting around like
• 18:04
  Speaker 3: there's usually a job waiting for you somewhere.
• 18:06
  Speaker 4: Yeah. I saw that as well, And actually it doesn't
• 18:09
  Speaker 4: necessarily pay super well now people, So if you ever
• 18:12
  Speaker 4: see a paramedic, be extra nice to them for sure,
• 18:16
  Speaker 4: because not only are they running around saving people's lives,
• 18:18
  Speaker 4: they're not getting rich off of it at all. They're
• 18:21
  Speaker 4: doing it because it's something they care about. Yeah. But
• 18:25
  Speaker 4: despite that, despite the mediocre pay, I saw, it's going
• 18:30
  Speaker 4: to be one of the most in demand jobs over
• 18:32
  Speaker 4: the next like ten to fifteen years. I really wish
• 18:35
  Speaker 4: I could remember the statistic exactly, but I think they're
• 18:38
  Speaker 4: like expecting another like fifty three thousand EMT jobs or
• 18:43
  Speaker 4: paramedic jobs to be added to the American economy over
• 18:47
  Speaker 4: the next decade maybe. So it's definitely a growing career
• 18:52
  Speaker 4: for sure, growing profession.
• 18:54
  Speaker 1: Yeah, and you mentioned the pay.
• 18:55
  Speaker 3: If you go to the US Bureau of Labor Statistics
• 18:59
  Speaker 3: to kind of a mean salary or something, they do it.
• 19:03
  Speaker 3: It's not really they should separate it out, but they
• 19:05
  Speaker 3: lump in EMTs and paramedics, when, of course EMTs don't
• 19:10
  Speaker 3: make the kind of money they're paramedic would. But they
• 19:13
  Speaker 3: had a mean annual wage of about thirty one thousand
• 19:15
  Speaker 3: dollars a few years ago. And if you're in the
• 19:19
  Speaker 3: top ten percent, it's about fifty four thousand, and apparently
• 19:25
  Speaker 3: the state of Washington is one on the higher side.
• 19:28
  Speaker 3: You can get as high as seventy one grand in
• 19:32
  Speaker 3: the state of Washington, right, But I mean, you know,
• 19:36
  Speaker 3: that's a good living and a decent living. But it's
• 19:39
  Speaker 3: not like like you said, they don't go into this
• 19:41
  Speaker 3: because like, oh man, you know that thirty one grand
• 19:44
  Speaker 3: a year. It's sort of like being a school teacher.
• 19:46
  Speaker 3: It's a I feel like it's a calling in a
• 19:48
  Speaker 3: lot of cases for sure.
• 19:49
  Speaker 4: For sure, as I was saying about the license that
• 19:54
  Speaker 4: they operate under. Right, So if you're a certified paramedic
• 19:59
  Speaker 4: when you are are depending on the state you're in,
• 20:02
  Speaker 4: you may be operating under the license of the state
• 20:04
  Speaker 4: medical director, like that's where you have your license, or
• 20:09
  Speaker 4: you could also be operating under the license of a
• 20:11
  Speaker 4: local physician, like that physician's license covers you, covers the
• 20:15
  Speaker 4: physician's assistant, basically everything working for everyone working for him
• 20:19
  Speaker 4: or her, So you might be operating under that physician's license.
• 20:23
  Speaker 4: Or I didn't know this man during an ambulance ride,
• 20:26
  Speaker 4: so remember how just adding like a trained medical professional
• 20:31
  Speaker 4: to the ride from an accident scene to the hospital
• 20:34
  Speaker 4: improves outcomes, and we've done that since nineteen sixty six
• 20:37
  Speaker 4: at least they figured out that if you can communicate
• 20:41
  Speaker 4: with a doctor an er physician en route, you could
• 20:46
  Speaker 4: also improve outcomes. Even more so. During this transportation from
• 20:51
  Speaker 4: an accident to the hospital, the paramedic is probably in
• 20:55
  Speaker 4: touch with an er doctor who is instructing and advising
• 21:00
  Speaker 4: and consulting with the paramedic to figure out the best
• 21:03
  Speaker 4: course of action, the best course of treatment, and then
• 21:05
  Speaker 4: how to carry that out. And from what I understand
• 21:08
  Speaker 4: at that time, the paramedic is operating under that physician's
• 21:12
  Speaker 4: license in that state.
• 21:14
  Speaker 1: Would that make you feel better or worse?
• 21:17
  Speaker 4: What that the paramedic was getting instruction from a physician?
• 21:20
  Speaker 1: Yeah, Like, if you hear this going on, I don't know.
• 21:25
  Speaker 4: I would say.
• 21:27
  Speaker 3: Part of me is like better because it's a doctor
• 21:29
  Speaker 3: telling you that, But the other part of me is like,
• 21:31
  Speaker 3: don't you know right? And you would hate to hear
• 21:33
  Speaker 3: the doctor say we'll get the something something and for
• 21:36
  Speaker 3: the paramedic to say the what.
• 21:39
  Speaker 4: You're right, I don't know what that is. I've never
• 21:41
  Speaker 4: seen this before ever.
• 21:42
  Speaker 1: Have you ever had to take an ambulance ride for yourself?
• 21:45
  Speaker 4: No, no, Thank goodness, I.
• 21:47
  Speaker 3: Didn't think I had either, but then I did. Remember
• 21:50
  Speaker 3: when I was thirteen or fourteen, my brother was sixteen
• 21:54
  Speaker 3: or seventeen, we were in a car wreck. There were
• 21:57
  Speaker 3: eight people in a g and my brother's jeep that
• 22:02
  Speaker 3: was once my dad's cheap and that was definitely not
• 22:05
  Speaker 3: safe to do to begin with. But we were going
• 22:08
  Speaker 3: to a movie after church on the Sunday night.
• 22:11
  Speaker 1: A bunch of kids in.
• 22:11
  Speaker 3: Youth group piled in my brother's jeep wasted, no just kidding,
• 22:17
  Speaker 3: completely sober wasted on the Lord.
• 22:21
  Speaker 1: We were and it was raining really hard.
• 22:23
  Speaker 3: And you know at Ponce de Leon Avenue here in Atlanta,
• 22:29
  Speaker 3: everyone that doesn't live Atlanta probably laughs.
• 22:31
  Speaker 1: That we pronounce it that way instead of.
• 22:35
  Speaker 4: H.
• 22:36
  Speaker 3: But on Ponce where it kind of if you're leaving
• 22:40
  Speaker 3: from Atlanta, it's that big curve where you go over
• 22:42
  Speaker 3: that large stone archway. Yes, kind of headed toward into Decatur.
• 22:48
  Speaker 3: We were coming down that way nowhere near North Lake
• 22:51
  Speaker 3: Mall where we were supposed to be headed. We were
• 22:54
  Speaker 3: lost and my brother we hydroplaned, hit a curb and
• 22:58
  Speaker 3: turned the jeep over on its side, and I ripped
• 23:01
  Speaker 3: through the canvas ceiling or whatever it's made.
• 23:03
  Speaker 4: Oh man, you got thrown.
• 23:05
  Speaker 1: Oh yeah, we were scattered all over the street.
• 23:07
  Speaker 4: You are lucky. I know.
• 23:09
  Speaker 3: It's the only time I think that I've been knocked unconscious,
• 23:13
  Speaker 3: and I just remember waking up, you know what would
• 23:16
  Speaker 3: have been probably seconds later in the pouring rain, and
• 23:19
  Speaker 3: looking around and seeing my friends like scattered within like
• 23:22
  Speaker 3: twenty feet of each other in various places.
• 23:24
  Speaker 4: Oh man, that is scary stuff.
• 23:26
  Speaker 1: It was scary.
• 23:27
  Speaker 3: So in the end, the good news is no one
• 23:30
  Speaker 3: had like I think the worst injury was like a
• 23:32
  Speaker 3: broken collar bone. I broke my finger. There were little
• 23:37
  Speaker 3: cuts and scrapes, but nobody was hurt bad.
• 23:41
  Speaker 1: But I do remember this, Oh my brother doesn't listen
• 23:43
  Speaker 1: to this one.
• 23:45
  Speaker 3: In the ambulance on the way, My brother was just
• 23:48
  Speaker 3: sort of catatonic, and they said they were trying to
• 23:51
  Speaker 3: get information, and they asked what his name was, and
• 23:55
  Speaker 3: he said Ahole.
• 24:00
  Speaker 1: He said Ahole. He said, the real world is so bad. Yeah.
• 24:03
  Speaker 3: I think he was just sort of out of it
• 24:05
  Speaker 3: and felt terrible. Of course, Scott and he didn't curse
• 24:08
  Speaker 3: at all at the time. It still doesn't even curse much.
• 24:11
  Speaker 3: But it was just it's weird that that is what
• 24:14
  Speaker 3: stands out of my mind.
• 24:15
  Speaker 1: I wonder if he remembers that.
• 24:16
  Speaker 4: Actually, well that's a big one, especially if you didn't curse,
• 24:18
  Speaker 4: you know, so funny man, that's a that's you were
• 24:21
  Speaker 4: a great storyteller.
• 24:23
  Speaker 1: Was that a good story?
• 24:24
  Speaker 4: Yeah? I was like, I was seriously, well, you kept
• 24:27
  Speaker 4: like going off on tangents. I'm like, no, we got
• 24:29
  Speaker 4: to get back to the story. What happened to the cheek?
• 24:32
  Speaker 1: I know you looked a little nervous.
• 24:33
  Speaker 4: Yeah, so wow, Okay, should we take a break.
• 24:39
  Speaker 1: Oh yeah? And also I forgot to mention the one
• 24:41
  Speaker 1: guy that was tragically killed.
• 24:43
  Speaker 4: Right, You're like, but did I mention? I also broke
• 24:46
  Speaker 4: my finger?
• 24:47
  Speaker 1: No, nobody, nobody was hurt.
• 24:48
  Speaker 4: Everybody's too bad. Everybody's good.
• 24:50
  Speaker 1: Everybody's good. I think my brother broke his foot.
• 24:53
  Speaker 4: Man.
• 24:53
  Speaker 1: Yeah, it was just stuff like that.
• 24:55
  Speaker 4: Heck of a story, chuck, heck of a story.
• 24:57
  Speaker 1: Thank you?
• 24:57
  Speaker 4: Uh yeah, let's take a break and regroup, shall we.
• 25:00
  Speaker 1: Yeah, let's do.
• 25:00
  Speaker 4: Okay, Okay, we're back. I'm not reeling quite as much
• 25:31
  Speaker 4: as I was. But that was a good story. Again,
• 25:35
  Speaker 4: I feel like.
• 25:35
  Speaker 3: We should mention, even though it's kind of silly that
• 25:38
  Speaker 3: emergency TV show. Oh yeah, for sure from the seventies,
• 25:41
  Speaker 3: because it seems like it definitely, like actually played a
• 25:45
  Speaker 3: part in ramping up ambulance services.
• 25:50
  Speaker 4: Yeah, so this is I think nineteen seventy one or
• 25:53
  Speaker 4: seventy two when it premiered. And remember the Emergency Medical
• 25:59
  Speaker 4: Services Act wasn't past until nineteen seventy three. That white
• 26:01
  Speaker 4: paper had come out in nineteen sixty six. So this
• 26:04
  Speaker 4: idea of like this new type of medicine and this
• 26:06
  Speaker 4: new type of like healthcare worker was really on America's mind.
• 26:10
  Speaker 4: But one of the ways it got there was from
• 26:12
  Speaker 4: that TV show Emergency, in part because it was shot
• 26:15
  Speaker 4: like documentary style. People played themselves on it, like there
• 26:19
  Speaker 4: were real dispatchers on the show acting as dispatchers. It
• 26:24
  Speaker 4: just captured America's imagination.
• 26:26
  Speaker 1: Yeah, I remember watching it, do you.
• 26:29
  Speaker 4: I don't think I ever saw an episode of it.
• 26:31
  Speaker 1: Yeah.
• 26:31
  Speaker 3: It was Emergency with an exclamation point in Mantle seventy seven,
• 26:35
  Speaker 3: and it was mainly two dudes, two firefighter characters is
• 26:41
  Speaker 3: what the story centered on. And one of them was
• 26:43
  Speaker 3: a young Kevin tig Or Tigue. He was did you
• 26:48
  Speaker 3: ever see Roadhouse?
• 26:49
  Speaker 4: Yeah?
• 26:50
  Speaker 3: He was the owner. He's a character actor he's been in. Yeah,
• 26:53
  Speaker 3: he owned the Double Deuce.
• 26:54
  Speaker 4: Yeah, he's great. Yeah, I can't remember what else it's seen.
• 26:57
  Speaker 4: I've seen him young before. I wonder if it was
• 27:00
  Speaker 4: Emergency now that you mention it.
• 27:02
  Speaker 3: Maybe, huh, maybe I have, because I'm going to ran
• 27:05
  Speaker 3: every runs.
• 27:06
  Speaker 4: For sure it did. I'm a Jack Web fan and
• 27:08
  Speaker 4: I think he produced or created it.
• 27:11
  Speaker 1: You're a big Jack Web guy, are you not. I
• 27:14
  Speaker 1: don't know.
• 27:16
  Speaker 4: He's the dude from Dragnet. He's Sergeant Friday.
• 27:18
  Speaker 1: Yeah, I guess I need to think about that.
• 27:20
  Speaker 4: Yeah, he's awesome. I'll let you know, man, if you
• 27:23
  Speaker 4: go back and watch like old episodes of Dragnet.
• 27:25
  Speaker 1: Oh my god. Yeah that was a good show.
• 27:28
  Speaker 4: Yes it was. And I think Emergency maybe Adam twelve
• 27:32
  Speaker 4: is like the direct spinoff of Dragnet. Maybe That's what
• 27:35
  Speaker 4: I'm thinking of. But I swear I know exactly what
• 27:37
  Speaker 4: you're talking about with the tigue fella from Roadhouse.
• 27:42
  Speaker 3: And then wasn't Dragnet Colonel Potter, Yes, Harry Morgan, Right,
• 27:48
  Speaker 3: we had an Emmilina had a long conversation about match
• 27:51
  Speaker 3: the other day and how that was I was a
• 27:54
  Speaker 3: mash nut and how that show was one of the
• 27:57
  Speaker 3: few to survive like major cast changes.
• 28:01
  Speaker 1: Oh yeah, like like three of them.
• 28:03
  Speaker 4: Yeah. They certainly didn't like like big stars like co stars.
• 28:09
  Speaker 4: I think. One of the few people who made it
• 28:10
  Speaker 4: through was Alan Alda, Right, he was there the whole time.
• 28:13
  Speaker 3: Yeah, and like Hot Lips I think was the same,
• 28:16
  Speaker 3: and a few others. But they had like Radar and Clinger. Yeah,
• 28:21
  Speaker 3: they co existed I think, But eventually Radar left and
• 28:24
  Speaker 3: Clinger took his job. They Potter took over for what's
• 28:28
  Speaker 3: his face, the original guy.
• 28:31
  Speaker 4: I don't remember, but he wore the fishing hat.
• 28:33
  Speaker 1: Yeah. He was, Oh man, the saddest ending ever for
• 28:35
  Speaker 1: that one.
• 28:36
  Speaker 4: What when he left?
• 28:38
  Speaker 3: Yeah, I remember he got his papers to go home
• 28:41
  Speaker 3: and everyone's all excited, and then he was killed in
• 28:43
  Speaker 3: a helicopter crash or a plane crash.
• 28:47
  Speaker 1: I don't remember that on his way out.
• 28:49
  Speaker 4: Wow.
• 28:50
  Speaker 3: And then of course Frank Burns left and was replaced
• 28:52
  Speaker 3: by Winchester, and then Trapper left and was replaced by Honeycutt. Right,
• 28:57
  Speaker 3: but it just it was still great, well you got
• 29:00
  Speaker 3: it wasn't as great at the very end.
• 29:03
  Speaker 4: I don't know, man, goodbye, farewell and amen was one
• 29:06
  Speaker 4: of the all time best last episodes out, true for sure,
• 29:10
  Speaker 4: But you're saying they pulled it together at the at
• 29:12
  Speaker 4: the end of the last episode.
• 29:13
  Speaker 3: I think I remember the last couple of seasons. It
• 29:15
  Speaker 3: was a little bit like, you know this, maybe it
• 29:18
  Speaker 3: had run its course. But that was a very discerning
• 29:21
  Speaker 3: twelve year old viewer.
• 29:22
  Speaker 4: Yeah, I guess so. Yeah, like they've really gone to
• 29:26
  Speaker 4: the hoots gin joke too many times this episode.
• 29:30
  Speaker 3: It is funny though that, like, little twelve year old
• 29:32
  Speaker 3: me thought, like the funniest thing in the world. Would
• 29:34
  Speaker 3: war surgeons drunk war surgeons?
• 29:37
  Speaker 4: Right, drunk philandering war surgeons?
• 29:40
  Speaker 1: All right, I really got off track there.
• 29:43
  Speaker 4: Yeah, maybe we should take a third break.
• 29:45
  Speaker 1: No, I don't think so.
• 29:46
  Speaker 4: I don't think we should either. So we're talking about
• 29:48
  Speaker 4: paramedics today, believe it or not. And one of the
• 29:52
  Speaker 4: things we talked about was the idea that that paramedics, well,
• 29:56
  Speaker 4: let's talk a little bit more about their job, right, Okay.
• 29:59
  Speaker 4: One of the things that paramedics are sometimes criticized for
• 30:03
  Speaker 4: is that they don't run to the scene of an emergency.
• 30:07
  Speaker 1: I've never thought about that.
• 30:08
  Speaker 4: Once you have it, I really hadn't either, But then
• 30:11
  Speaker 4: I started thinking about it, I'm like, yeah, I could
• 30:13
  Speaker 4: totally see that. Apparently, for some people who are at
• 30:16
  Speaker 4: an emergency scene and see the paramedics kind of walk up,
• 30:20
  Speaker 4: they appear a little too casual, and they want to know,
• 30:22
  Speaker 4: what are you doing? Why aren't you rushing to this scene?
• 30:25
  Speaker 4: And paramedics I think we saw a question answered on
• 30:30
  Speaker 4: KORRA or something like that, and a paramedic explains, there's
• 30:34
  Speaker 4: actually a number of really good reasons why paramedics why
• 30:37
  Speaker 4: you don't see them running to the scene. First of all,
• 30:39
  Speaker 4: they're going to park as close as they can sure,
• 30:41
  Speaker 4: so that running is only going to save a couple
• 30:43
  Speaker 4: seconds off. But really the number one reason, or one
• 30:46
  Speaker 4: of the top reasons, is that they're supposed to be
• 30:50
  Speaker 4: they're supposed to bring with them to this scene of
• 30:54
  Speaker 4: catastrophic panic, basically calm and professionalism and being in control.
• 31:02
  Speaker 1: Yeah, I get that.
• 31:03
  Speaker 3: Like, I think it would be a little disconcerting if
• 31:06
  Speaker 3: I was injured and I saw a paramedic burst into
• 31:09
  Speaker 3: the room like breathing heavy.
• 31:11
  Speaker 1: Oh my god, what's going on? What's going on?
• 31:14
  Speaker 4: Is everybody okay?
• 31:15
  Speaker 1: Yeah?
• 31:15
  Speaker 3: Plus they might get hurt running that's another one, And
• 31:18
  Speaker 3: they're usually you know or not usually, but I would
• 31:21
  Speaker 3: say probably a lot of times. It's not like they're
• 31:24
  Speaker 3: walking through a you know, a perfectly laid pathway, like
• 31:27
  Speaker 3: they could be running upstairs or through a house of
• 31:31
  Speaker 3: hoarders or you know, through the woods, like you don't
• 31:35
  Speaker 3: know what's going on.
• 31:36
  Speaker 1: You got to be careful on your way there.
• 31:37
  Speaker 4: Yeah, and you have to be going slow enough that
• 31:40
  Speaker 4: you can assess what the risks you're walking into. Are
• 31:43
  Speaker 4: as you're walking into them, sure, then running into it
• 31:46
  Speaker 4: and being like, oh, the guy who shot you still
• 31:48
  Speaker 4: here waiting for me. You know now that I've run
• 31:52
  Speaker 4: into the scene. I know that, but it's terrible. It's
• 31:55
  Speaker 4: also kind of hard to run from place to place,
• 31:58
  Speaker 4: depending on the equipment that they're carrying. Those stretchers get heavy,
• 32:02
  Speaker 4: the EKG machines get heavy, the defibrillators get heavy. All
• 32:06
  Speaker 4: that stuff gets heavy. So there's a number of reasons
• 32:09
  Speaker 4: why you won't see a paramedic rushing to the scene.
• 32:12
  Speaker 4: You will see them rushing to the scene in the
• 32:14
  Speaker 4: ambulance though, and from what I understand that driving in
• 32:18
  Speaker 4: the ambulance or riding in the ambulance is the most
• 32:21
  Speaker 4: dangerous part of the entire job.
• 32:24
  Speaker 1: Yeah.
• 32:24
  Speaker 3: And here's another tip, aside from being nice to your
• 32:28
  Speaker 3: EMT or paramedic is, don't call them ambulance drivers. Yeah,
• 32:32
  Speaker 3: because that's part of their job. And it's a weird
• 32:35
  Speaker 3: thing too that it's not like they hire a driver
• 32:39
  Speaker 3: who's super skilled at that and then they have other
• 32:42
  Speaker 3: people in there that do the work like they do
• 32:45
  Speaker 3: double duty. They have to learn to drive like that,
• 32:48
  Speaker 3: I mean while they're EMTs are paramedics.
• 32:51
  Speaker 4: Yeah, and so you know, if you've ever seen an
• 32:54
  Speaker 4: ambulance going through an intersection, they're gonna slow and maybe
• 32:58
  Speaker 4: even stop and then seed they still get broadsided very
• 33:02
  Speaker 4: frequently by people going through the intersection because they have
• 33:06
  Speaker 4: a green light and they're not paying attention. They'll hit
• 33:09
  Speaker 4: an ambulance like t bone and ambulance and the driver's
• 33:12
  Speaker 4: probably okay, or I should say the paramedic driving is
• 33:16
  Speaker 4: probably okay, But the paramedics in the back, they probably
• 33:20
  Speaker 4: aren't lashed down in any way, shape or form because
• 33:23
  Speaker 4: they're working on the patient and so they're getting thrown
• 33:26
  Speaker 4: around and can get injured and killed themselves that way.
• 33:29
  Speaker 4: So that's the most dangerous aspect of the job from
• 33:33
  Speaker 4: what i've seen.
• 33:34
  Speaker 3: Yeah, another interesting thing that I saw from that list
• 33:37
  Speaker 3: you sent was that if you're in a big city,
• 33:40
  Speaker 3: a lot of times they even have divided up between
• 33:45
  Speaker 3: EMT and paramedic for different cases. So like if there's
• 33:50
  Speaker 3: a scene of trauma going on, like a car accident,
• 33:53
  Speaker 3: then you're more likely to get an EMT, whereas if
• 33:56
  Speaker 3: you're at home and you're like my husband's having a
• 33:58
  Speaker 3: heart attack or my child having a seizure, then you're
• 34:01
  Speaker 3: more likely to get a paramedic, Yeah, which is interesting.
• 34:04
  Speaker 4: Yeah, And if in cities as well, if you're a paramedic,
• 34:09
  Speaker 4: you probably once you get into your ambulance, you're basically
• 34:13
  Speaker 4: stationed at the ambulance for the rest of your twelve
• 34:15
  Speaker 4: hour shift. You're you don't go back to like the
• 34:18
  Speaker 4: firehouse or to the ambulance clubhouse or anything like that.
• 34:22
  Speaker 4: You're you're you're like on a designated street corner, parked,
• 34:27
  Speaker 4: waiting for your next call, probably killing time somehow, but
• 34:33
  Speaker 4: you're you. There's there's not very much downtime. And like
• 34:37
  Speaker 4: in a in a city especially, the opposite is true
• 34:40
  Speaker 4: for more rural e mts and paramedics, and that there's
• 34:44
  Speaker 4: a lot of downtime so much so that this guy
• 34:47
  Speaker 4: who was actually one of the consultants on that show
• 34:50
  Speaker 4: Emergency years back, Uh, he became a Minister of health
• 34:54
  Speaker 4: I think in Nova Scotia, and he he created this
• 34:58
  Speaker 4: program for rural ems workers to use their downtime in
• 35:06
  Speaker 4: much the same way that like a country doctor would
• 35:08
  Speaker 4: have made house calls.
• 35:10
  Speaker 3: Yeah, so they like, wasn't the idea that they would
• 35:12
  Speaker 3: go to places and sort of help train like regular
• 35:17
  Speaker 3: citizens on how to avoid getting hurt and stuff to
• 35:20
  Speaker 3: begin with, right.
• 35:21
  Speaker 4: Yeah, like like doling out preventative medicine, like making sure
• 35:24
  Speaker 4: that people are taking their medicines correctly, teaching CPR classes,
• 35:30
  Speaker 4: and teaching leading exercise classes for like seniors at a
• 35:33
  Speaker 4: senior center. Like doing all this stuff to reduce the
• 35:36
  Speaker 4: number of calls that they have to go on anyway,
• 35:39
  Speaker 4: so it cuts down on their downtime, which I think
• 35:41
  Speaker 4: is actually very much appreciated by paramedics because there's really
• 35:45
  Speaker 4: nothing more boring than sitting around constantly, and then they're
• 35:49
  Speaker 4: actually doing something and also making their community a healthier place.
• 35:56
  Speaker 1: Yeah.
• 35:56
  Speaker 3: I thought it was funny when they were talking to
• 35:58
  Speaker 3: some real on the ground paramedic about the downtime, They're like, well,
• 36:03
  Speaker 3: HBO goes kind of awesome, right, yeah, like, oh, well,
• 36:07
  Speaker 3: I guess you got a pass the time. It's better
• 36:09
  Speaker 3: than Nicholas Cage and bringing out the dead.
• 36:13
  Speaker 4: What did he do? Because I remember that movie, but
• 36:14
  Speaker 4: I don't remember all the details.
• 36:17
  Speaker 1: Well, it wasn't that great.
• 36:18
  Speaker 4: I liked it.
• 36:19
  Speaker 1: He did tons of drugs.
• 36:21
  Speaker 4: Oh okay, that's a speedreak or something. I got you.
• 36:24
  Speaker 1: Yeah.
• 36:24
  Speaker 4: Yeah, he kept begging to be fired, right.
• 36:27
  Speaker 1: I don't remember it very very well at all.
• 36:29
  Speaker 4: Actually, I think he did, like that was his stick.
• 36:31
  Speaker 4: He begged to be fired. So one of the things
• 36:36
  Speaker 4: about those that downtime, the community community preventative medicine initiatives
• 36:42
  Speaker 4: have kind of spread from Nova Scotia out through around
• 36:44
  Speaker 4: the country. When you see a paramedic doing that, they're
• 36:50
  Speaker 4: they're not being paid, or at the very least their
• 36:54
  Speaker 4: unit or their county or their city is not being
• 36:56
  Speaker 4: paid for that, which is a huge problem.
• 37:00
  Speaker 3: Yeah, this is where I got a little confused.
• 37:02
  Speaker 1: The way I was reading this was.
• 37:07
  Speaker 3: Medicaid and Medicare and stuff, and insurance companies will reimburse
• 37:11
  Speaker 3: only if they have transported someone to a hospital.
• 37:14
  Speaker 1: Yes, so in other words, if you.
• 37:17
  Speaker 3: Go as an ambulance and a paramedic or ant to
• 37:19
  Speaker 3: a place and you actually can just help and treat
• 37:22
  Speaker 3: someone there and they don't need to go to the hospital,
• 37:25
  Speaker 3: then that's a freebie, yes, Or do they send a
• 37:29
  Speaker 3: bill to the people, as from.
• 37:33
  Speaker 4: What I understand, it's a freebie. I probably since it
• 37:37
  Speaker 4: is such a patchwork of systems all around the country.
• 37:40
  Speaker 4: I'm sure that you could live somewhere where you the
• 37:43
  Speaker 4: person would get a bill for that. I think as
• 37:45
  Speaker 4: a matter of fact, you do no matter where you live.
• 37:48
  Speaker 4: But Medicaid and Medicare won't pay for it. So there
• 37:56
  Speaker 4: is a substantial reason to say, keep working chest compressions
• 38:02
  Speaker 4: on a person who is obviously dead all the way
• 38:05
  Speaker 4: to the hospital. Interesting, so that you can build Medicaid
• 38:10
  Speaker 4: for that transport, or getting somebody to go to the
• 38:13
  Speaker 4: hospital even though they don't need to, so that you
• 38:15
  Speaker 4: can build Medicaid for that as well. And the problem
• 38:19
  Speaker 4: is that that leads to other problems as well, like
• 38:22
  Speaker 4: hospital ers are very much overcrowded and understaffed and overworked. Right, Yeah,
• 38:27
  Speaker 4: so when you show up with another person, that's one
• 38:30
  Speaker 4: more person they have to deal with and apparently it
• 38:33
  Speaker 4: creates a bit of a.
• 38:36
  Speaker 1: Conflict.
• 38:37
  Speaker 4: Yeah, there's a cultural conflict between the people the paramedics
• 38:40
  Speaker 4: and this EMTs bringing people to the er and the
• 38:43
  Speaker 4: people who staff the er and are accepting these people,
• 38:46
  Speaker 4: and so much so that there's it's become kind of
• 38:48
  Speaker 4: common for er rooms to issue ambulance diversions saying don't
• 38:56
  Speaker 4: bring anybody to our er, go somewhere else. And on
• 38:59
  Speaker 4: a really night in a really populated city, you might
• 39:02
  Speaker 4: find every single er room like with that diversion alert on,
• 39:09
  Speaker 4: and you've got to take somebody out to like a
• 39:10
  Speaker 4: country hospital that doesn't know anything about trauma, and it
• 39:14
  Speaker 4: takes forty five minutes to get there, and they're not
• 39:17
  Speaker 4: going to get the care they could receive at a
• 39:19
  Speaker 4: good trauma center in the city. So that's a real problem.
• 39:23
  Speaker 3: Yeah, and it's too in terms of pay, And we
• 39:27
  Speaker 3: need to hear from people on the ground because this
• 39:30
  Speaker 3: it's surprisingly confusing when research this on how it all works.
• 39:35
  Speaker 3: And maybe that's the point, but it seems like it's
• 39:38
  Speaker 3: also a fixed rate. There's no difference between I treated
• 39:43
  Speaker 3: a kid for an allergic beasting reaction to I brought
• 39:47
  Speaker 3: a guy back from the dead who had had a
• 39:49
  Speaker 3: heart attack or heart failure.
• 39:51
  Speaker 1: Yeah, is that right?
• 39:52
  Speaker 4: Yeah, so long as you transport both of them to
• 39:54
  Speaker 4: the hospital that you're going to get I think I
• 39:57
  Speaker 4: saw as low as twenty five bucks from medicaid in
• 39:59
  Speaker 4: some places. I don't understand this. The numbers just do
• 40:02
  Speaker 4: not add up. I don't get it at all. I
• 40:05
  Speaker 4: know that some places, some counties and cities, fold their
• 40:09
  Speaker 4: EMT or EMS workers under their fire departments. Uh huh,
• 40:13
  Speaker 4: so that they fall under the fire departments funding, which
• 40:16
  Speaker 4: I think fire departments tend to be way better funded
• 40:19
  Speaker 4: than any kind of EMS service.
• 40:21
  Speaker 1: Uh huh.
• 40:22
  Speaker 4: So I think that's how. That's one way that it happens.
• 40:25
  Speaker 4: But I just don't I don't get how this how
• 40:28
  Speaker 4: this actually works money wise, because it doesn't add up.
• 40:32
  Speaker 4: It doesn't make sense.
• 40:33
  Speaker 3: Yeah, I mean, it's not often that we're a little stemied.
• 40:37
  Speaker 3: So we're going to follow up, for sure with some emails.
• 40:41
  Speaker 3: But I think that's also going to vary from place
• 40:43
  Speaker 3: to place. Right, Because the other thing that I got
• 40:45
  Speaker 3: really confused about was private the privatization of ambulance services. Yeah,
• 40:51
  Speaker 3: and as best as I can tell, is in the
• 40:55
  Speaker 3: seventies and eighties, there were a lot of small private
• 40:59
  Speaker 3: ambulance companies, but then they merged into more regional things
• 41:04
  Speaker 3: and that these days there's just a few, like big
• 41:09
  Speaker 3: multinational companies that are the most dominant in the industry right.
• 41:14
  Speaker 3: But I don't get how that works, Like if they're private,
• 41:17
  Speaker 3: are they like working with only private.
• 41:20
  Speaker 1: Hospitals or can they go to a state hospital.
• 41:23
  Speaker 4: I think that they can get a contract from the state,
• 41:25
  Speaker 4: they can be they can have a license to operate
• 41:27
  Speaker 4: within a state or a county or wherever, and I
• 41:30
  Speaker 4: think they go wherever they're called to. I know that
• 41:34
  Speaker 4: there can be like competition among them, so like multiple
• 41:37
  Speaker 4: ambulances will show up at a scene. Sometimes it's just
• 41:41
  Speaker 4: it's it's it's kind of a bit of a cluster
• 41:44
  Speaker 4: as far as competing with the local EMS services, and
• 41:49
  Speaker 4: I think it's on the decline from what I've seen.
• 41:52
  Speaker 1: Yeah, but when you call nine to one one, do
• 41:55
  Speaker 1: you have a choice?
• 41:56
  Speaker 4: So what you can do? I think it's kind of
• 41:58
  Speaker 4: like uber where like the nine to one to one
• 42:02
  Speaker 4: dispatcher has a log of companies or services, like public
• 42:07
  Speaker 4: funded or private services that it can be issued to
• 42:12
  Speaker 4: and they send out the alarm and whoever takes the
• 42:14
  Speaker 4: call goes and gets it interesting. So the problem is
• 42:18
  Speaker 4: is I saw a Las Vegas Review Journal article about this.
• 42:21
  Speaker 4: Las Vegas was debating whether to just totally privatize their
• 42:24
  Speaker 4: EMS services. Their EMS just like went berserk. They're like no,
• 42:29
  Speaker 4: like this doesn't work. The private companies are late. I
• 42:33
  Speaker 4: think they were late like ten thousand plus times in
• 42:36
  Speaker 4: one year in Las Vegas. Their response time tends to
• 42:40
  Speaker 4: be less than the actual fire department or EMS is.
• 42:43
  Speaker 4: It's just not as it's just not as preferable. And
• 42:48
  Speaker 4: the reason why ambulance private ambulance services came about or
• 42:51
  Speaker 4: became widespread, this idea that you should just privatize everything
• 42:55
  Speaker 4: and then that competition will keep everything going. And that
• 42:58
  Speaker 4: hasn't necessarily panned out to be the case. And from
• 43:00
  Speaker 4: what I see, New York is actually scaling back on theirs, right.
• 43:04
  Speaker 3: Yeah, I think Juliani is one of the people that
• 43:08
  Speaker 3: really tried, and of course, you know, no surprise given
• 43:10
  Speaker 3: his politics, trying to privatize the industry. But apparently a
• 43:17
  Speaker 3: lot of those had gone bankrupt basically, yeah, and that
• 43:21
  Speaker 3: during the during the housing boom, the financial collapse. Strangely,
• 43:27
  Speaker 3: or maybe not strangely, because I don't understand it, a
• 43:29
  Speaker 3: lot of private equity firms started buying up ambulance services.
• 43:33
  Speaker 4: Yeah, that's there, you go, there's the downfall.
• 43:36
  Speaker 1: It's just so interesting.
• 43:37
  Speaker 3: I know that this is one of those where someone's
• 43:40
  Speaker 3: gonna knock our socks off with a great email.
• 43:42
  Speaker 4: Yeah. I think Also one more thing about the private
• 43:46
  Speaker 4: ambulance services. It's not like they're just a bad idea
• 43:49
  Speaker 4: all around. Sure, in a locale that is underserved, if
• 43:54
  Speaker 4: a company wants to come and set up ambulance services,
• 43:56
  Speaker 4: that would be great for that area. Yeah, because they
• 43:59
  Speaker 4: have a far you know they have They can get
• 44:01
  Speaker 4: places faster in an ambulance than they could have before
• 44:04
  Speaker 4: in a place where you've got your EMS overstretched in
• 44:07
  Speaker 4: the counties, Like, no, we're not hiring a single additional
• 44:10
  Speaker 4: EMS worker. A company that sets up shop can actually
• 44:15
  Speaker 4: take up the slack Like there are good aspects to it.
• 44:18
  Speaker 4: Like it's not just like some terrible idea, but in
• 44:22
  Speaker 4: practice that hasn't worked out as well as as one
• 44:24
  Speaker 4: would hope from what I understand. Yeah, yeah, EMS workers
• 44:29
  Speaker 4: like email us like explain this because I really like you.
• 44:32
  Speaker 4: I do not get who's footing the bill. It has
• 44:36
  Speaker 4: to be insurance companies, and then if you don't have insurance,
• 44:38
  Speaker 4: it has to be just the person, the individual.
• 44:42
  Speaker 3: Yeah, and I think we have. We waded into the
• 44:45
  Speaker 3: waters of doing a nine to one to one podcast
• 44:47
  Speaker 3: once and didn't. Isn't that correct? Because it was. I mean,
• 44:51
  Speaker 3: we'll do it at some point, but I remember thinking, oh,
• 44:53
  Speaker 3: that's a good, easy ish one and it ended up
• 44:56
  Speaker 3: like being super convoluted.
• 44:58
  Speaker 4: Yeah. I think I think we should do that. We
• 44:59
  Speaker 4: shoul should also do just eers in general too.
• 45:02
  Speaker 1: Yeah.
• 45:04
  Speaker 4: So that's a bit about paramedics. Sounds like there's way
• 45:08
  Speaker 4: more to it, right, Yeah, but you got anything else
• 45:11
  Speaker 4: for now, no, sir? Okay, Well, since Chuck said no, sir,
• 45:15
  Speaker 4: it's time for listening to maw all right.
• 45:18
  Speaker 1: I'm gonna call this we helped the dude win something.
• 45:22
  Speaker 5: Yeah.
• 45:22
  Speaker 4: I love this one.
• 45:23
  Speaker 3: Hey, guys, been listening to your show for about four
• 45:25
  Speaker 3: years and always wanted to write in, But now I
• 45:27
  Speaker 3: have a great reason. A local store was doing a
• 45:30
  Speaker 3: giveaway a few days ago, and they posted that the
• 45:32
  Speaker 3: first people to show up and answer correctly would win
• 45:34
  Speaker 3: a prize. The question was bacon and eggs was not
• 45:37
  Speaker 3: always a breakfast food and what year did it become so,
• 45:40
  Speaker 3: and who was the man behind the marketing idea. So
• 45:44
  Speaker 3: this guy sounded super excited because he knew the answer. Immediately,
• 45:48
  Speaker 3: I thought of your show and the uncanny ability of
• 45:50
  Speaker 3: mister Edward Burne's to pop up in seemingly strange histories.
• 45:53
  Speaker 3: I remembered your pr episode and knew it was sometime
• 45:57
  Speaker 3: in the twenties. So I hopped in my car and
• 45:59
  Speaker 3: took off for the business. When I got there, I
• 46:01
  Speaker 3: told him the answer with a startled look. They told
• 46:04
  Speaker 3: me I'd want a huge case of meat, and not
• 46:10
  Speaker 3: just junkie stuff either. This play sales to restaurants and
• 46:12
  Speaker 3: businesses all across the country.
• 46:14
  Speaker 4: I love that.
• 46:15
  Speaker 1: I was super stoked. Good meat.
• 46:17
  Speaker 4: He's like I won meat, and not just like terrible meat,
• 46:19
  Speaker 4: like good stuff too.
• 46:22
  Speaker 3: When they asked if I had to look it up,
• 46:24
  Speaker 3: I told them no, that I listened to stuff you
• 46:26
  Speaker 3: should know, and they retained it in the back of
• 46:28
  Speaker 3: my mind. They asked for the name of the show,
• 46:31
  Speaker 3: and they said they were going to play it for
• 46:33
  Speaker 3: all the workers there during the day, so now they
• 46:35
  Speaker 3: can get more difficult.
• 46:36
  Speaker 1: And random questions.
• 46:38
  Speaker 4: That's awesome.
• 46:38
  Speaker 1: And he said it doesn't in there.
• 46:40
  Speaker 3: I went back later in the week and the same
• 46:42
  Speaker 3: girl i'd spoken to recognized me. So they had two
• 46:44
  Speaker 3: other people come in that had known the answer from
• 46:47
  Speaker 3: stuff you should know as well. All right, even though
• 46:49
  Speaker 3: we live in super rural Utah, you apparently have a
• 46:53
  Speaker 3: large following. And that is from John Robson.
• 46:57
  Speaker 4: Thanks John Robison. I hope you have a health the
• 47:00
  Speaker 4: EMS service out there to come find you after you
• 47:03
  Speaker 4: eat that box of meat.
• 47:05
  Speaker 3: Yeah, and you know what, let's hear from Salt Lake
• 47:07
  Speaker 3: City because we have debated a live show there and
• 47:10
  Speaker 3: just didn't know if we had the support.
• 47:12
  Speaker 1: So I want to hear it.
• 47:14
  Speaker 4: Okay, so we want to hear we want to hear
• 47:16
  Speaker 4: from Utah in's and EMS workers.
• 47:20
  Speaker 3: Yeah, if we get ten people that email us and
• 47:23
  Speaker 3: say to come to Salt Lake City will come.
• 47:25
  Speaker 4: I think we should set the bar higher than that.
• 47:27
  Speaker 4: Oh okay, okay, Well, if you want to let us
• 47:31
  Speaker 4: know that you're from Utah and you want us to come,
• 47:33
  Speaker 4: or you're an EMS worker and you've got some good
• 47:35
  Speaker 4: stories for us, you can send us an email. It's
• 47:38
  Speaker 4: probably easiest to stuff podcasts at house. Stuffworks dot Com
• 47:41
  Speaker 4: has always joined us at our home on the web,
• 47:43
  Speaker 4: Stuff Youshould Know dot Com.
• 47:48
  Speaker 1: Stuff you Should Know is a production of iHeartRadio.
• 47:51
  Speaker 2: For more podcasts my heart Radio, visit the iHeartRadio app,
• 47:54
  Speaker 2: Apple Podcasts, or wherever you listen to your favorite shows.