Latest / Revisionist History / Running Hot
Transcript
- 0:15Speaker 1: Pushkin.
- 0:20Speaker 2: Hello, Hello everyone. This is the first of what are
- 0:23Speaker 2: going to be a couple of episodes in this mini
- 0:25Speaker 2: season from my colleague Ben Adaph Haffrey. Ben is the
- 0:29Speaker 2: guy when you're hiking through the wilderness who says let's
- 0:33Speaker 2: go this way and there's no trail and you think, oh,
- 0:36Speaker 2: I'm going to get eaten by bears, and then no,
- 0:38Speaker 2: you find some lost civilization and large piles of glittering gold.
- 0:44Speaker 2: Ben started telling me this story and I stopped him
- 0:47Speaker 2: halfway through and I said, oh, Ben, this is a spandrel.
- 0:51Speaker 2: And what's a spandrel? One of my all time favorite concepts.
- 0:55Speaker 2: Invented by Stephen J. Gould, the spandrel is a thing
- 0:58Speaker 2: that doesn't have a function, but which hangs around like
- 1:01Speaker 2: a random hitchhiker, because it happens to be riding along
- 1:05Speaker 2: with things that do have a function, like your ear lobes.
- 1:08Speaker 2: I mean, what are they there for? Doesn't it seem
- 1:11Speaker 2: like they were all just along for the ride with
- 1:13Speaker 2: a part of our ear that actually does useful things.
- 1:16Speaker 2: Or your chin? What's up with the chin. We look
- 1:20Speaker 2: at a spandrel and we assume there has to be
- 1:23Speaker 2: a reason for it, and there isn't They're just spandrels.
- 1:30Speaker 2: My name is Malcolm Gladwell. This is Revisionist History, my
- 1:33Speaker 2: podcast about things overlooked and misunderstood. In this episode, my
- 1:37Speaker 2: colleague Bend daph Haffrey investigates a spandrel. You don't even
- 1:41Speaker 2: realize you've been living with something that none of us
- 1:43Speaker 2: would ever think to question, because it's such a bedrock
- 1:46Speaker 2: part of our world. We all just assume it has
- 1:49Speaker 2: to be there, and it doesn't. I'm talking, of course,
- 1:55Speaker 2: about sirens.
- 2:10Speaker 1: Walk me through. No, you really do walk me through
- 2:16Speaker 1: what we're looking at here. I'm talking with my wife
- 2:18Speaker 1: Julia Conrad, who happens to share an apartment with me
- 2:21Speaker 1: on quite a noisy street in Brooklyn.
- 2:23Speaker 3: This is a log that you created. Although I am
- 2:27Speaker 3: represented in it, I think it looks like we only
- 2:30Speaker 3: did it for one day. Of how many times we
- 2:33Speaker 3: heard the siren and where we heard it. Wow, what
- 2:36Speaker 3: a day.
- 2:37Speaker 1: Julia and I live opposite this grocery store that's all local,
- 2:41Speaker 1: small batch whatnot. So instead of getting just one delivery
- 2:44Speaker 1: a day, they get like fifteen, sometimes from trucks bearing
- 2:48Speaker 1: I assume one sprig of artismal basil next door there's
- 2:52Speaker 1: a noisy playground and crucially a fire station, a really
- 2:56Speaker 1: active fire station. What happens is the grocery store trucks
- 3:00Speaker 1: block traffic, which means the fire trucks can't get out,
- 3:03Speaker 1: and so sirens all the time. This, for me, as
- 3:12Speaker 1: a writer, podcaster and light sleeper, is a problem. So
- 3:16Speaker 1: I decided to do some research. I made a spreadsheet.
- 3:20Speaker 1: We counted from nine am till ten at night, and
- 3:23Speaker 1: we heard a siren twenty four times. Twenty four times,
- 3:28Speaker 1: and this is reliable data. Julia is a data scientist.
- 3:32Speaker 1: She works for the New York City government, and she
- 3:34Speaker 1: has held my spreadsheet to the highest of standards.
- 3:37Speaker 3: First, I have to say I never understand your way
- 3:40Speaker 3: of doing Google sheets because the color coding seems to
- 3:43Speaker 3: just be aesthetic. It's not actually representing anything in the data.
- 3:49Speaker 1: I don't need this in it. I could get enough
- 3:51Speaker 1: of this in my job. I don't hear from you.
- 3:53Speaker 1: I will confess that the spreadsheet, consisting of mauv baby blue,
- 3:57Speaker 1: puked green, a cheery yellow, and several pleasingly varied shades
- 4:00Speaker 1: of red, isn't even complete because it does not count
- 4:03Speaker 1: the times we heard the siren in the middle of
- 4:06Speaker 1: the night when there is no one on the road.
- 4:09Speaker 1: Maybe you didn't realize this, but emergency vehicles will sometimes
- 4:12Speaker 1: run their lights and sirens even if there's seemingly no
- 4:15Speaker 1: one around. Sirens can run anywhere from one hundred and
- 4:19Speaker 1: ten decibels to over one hundred and thirty That is
- 4:22Speaker 1: ear damagingly loud. The classic fire siren sound like what
- 4:26Speaker 1: you hear in your head if you imagine a fire
- 4:28Speaker 1: truck right now. Is called the Federal Q TWOV, and
- 4:31Speaker 1: it's a whopping one hundred and twenty three decibels at
- 4:34Speaker 1: one hundred feet away. There's an actual corporation that makes
- 4:38Speaker 1: the siren. Federal Signal Fans post videos about the siren online.
- 4:42Speaker 1: Here's what it sounds like. Maybe turn your volume down.
- 4:46Speaker 4: As we say, it's not a firetruck unless it's got.
- 4:48Speaker 1: A key siren. According to a helpful chart from Yale University,
- 5:08Speaker 1: one hundred twenty three decibels is just two decibels lower
- 5:12Speaker 1: than the point at which quote pain begins. This would
- 5:17Speaker 1: all be fine, except I kind of need my ears
- 5:20Speaker 1: for my job, and this is why I began the log.
- 5:27Speaker 1: The log has fields for all relevant data date, time,
- 5:30Speaker 1: branch of emergency service. Location in the house from which
- 5:34Speaker 1: we have heard the siren.
- 5:35Speaker 3: Well, there's really just two possibilities. You're either in the
- 5:39Speaker 3: front of the house or the back of the house.
- 5:41Speaker 3: But actually some of these entries are logged for front
- 5:44Speaker 3: and back, so that's when you know it's a really
- 5:46Speaker 3: big siren.
- 5:48Speaker 1: There's also a field for reporter Ben slash Julia and
- 5:52Speaker 1: another for notes and then what is the final column.
- 5:56Speaker 3: The final column is called dog question mark.
- 6:00Speaker 1: This is the only field that matters. You See, there's
- 6:04Speaker 1: a dog in my neighborhood who howls almost every time
- 6:08Speaker 1: the siren goes off, and he sounds like this, a
- 6:21Speaker 1: dog who, by the standards of people on my block
- 6:24Speaker 1: is practically famous. Have you heard a dog who howls
- 6:27Speaker 1: every time the sirens go off? Yeah? I have.
- 6:30Speaker 5: I mean they're pretty consistent with it.
- 6:32Speaker 2: They're they're dedicated to their.
- 6:36Speaker 5: Howling.
- 6:37Speaker 4: I think I feel like my wife has heard the dog.
- 6:39Speaker 1: But there's a guy, Kevin that lives after that garage
- 6:43Speaker 1: right there, and he does so he's talked about this
- 6:46Speaker 1: dog here. Yeah, what does he say? Oh, he's ready
- 6:48Speaker 1: to do something about it.
- 6:52Speaker 3: It starts really low and guttural.
- 6:54Speaker 6: I thought it was like a wearwolf or something.
- 6:56Speaker 7: Oh.
- 7:03Speaker 1: I decided to take a two pronged approach to my
- 7:05Speaker 1: siren problem. Planet I had to see if I could.
- 7:09Speaker 1: I proved that the sirens in my neighborhood were dangerously
- 7:12Speaker 1: unnecessarily loud, and Plan B. I needed a sympathetic face
- 7:16Speaker 1: for my cause. Nobody really cares about podcasters, but everybody
- 7:22Speaker 1: cares about dogs. And I had to assume that that
- 7:25Speaker 1: dog was howling along with the siren because he was,
- 7:28Speaker 1: like me, in serious pain. So find the dog, stop
- 7:33Speaker 1: the siren. It'd be that simple, except the dog was
- 7:37Speaker 1: not immediately forthcoming. So I pushed ahead with Plan A
- 7:42Speaker 1: noise research, which led me straight to doctor Arlene Bronze Aft.
- 7:49Speaker 7: We're going to take you into the noise troom.
- 7:51Speaker 1: What's the noise troop?
- 7:52Speaker 8: Oh?
- 7:52Speaker 7: Okay, no, see when you get there.
- 7:54Speaker 1: Sarah doctor Bronze Aft, is an eighty nine year old
- 7:57Speaker 1: environmental psychologist who has been called the noise Queen of
- 8:01Speaker 1: New York City. She's done major noise studies worked for
- 8:04Speaker 1: five mayors. She grew up in Brooklyn and lives in
- 8:07Speaker 1: a lovely tidy apartment on the Upper East Side someone
- 8:11Speaker 1: was jackhammering the street outside the building, and yet you
- 8:14Speaker 1: couldn't hear a thing. Double glazed windows. Of course, she
- 8:18Speaker 1: took me to her noise room. The noise room sounds
- 8:21Speaker 1: possibly like the opposite of what I mean.
- 8:23Speaker 7: Let me tell you it is a very quiet room.
- 8:31Speaker 7: This is quiet.
- 8:34Speaker 1: Wow. How did you get it so quiet? Oh?
- 8:37Speaker 7: Did I help make it quiet? Answer? Yes, I did
- 8:40Speaker 7: have a role and making it quieter than it would
- 8:43Speaker 7: have been. Can you see the cooling units?
- 8:47Speaker 1: Yep?
- 8:47Speaker 7: Are they all closed?
- 8:49Speaker 1: Yep?
- 8:49Speaker 7: Who do anythink made that request?
- 8:52Speaker 1: Bronze Aft started her work during the golden age of
- 8:54Speaker 1: noise control the nineteen seventies, when the EPA began regulating noise.
- 9:00Speaker 1: Her early work demonstrated that noise isn't just annoying. They
- 9:03Speaker 1: can get in the way of kids learning in school,
- 9:05Speaker 1: and she just kept going from there. When the city
- 9:08Speaker 1: updated its noise code in two thousand and seven.
- 9:10Speaker 7: In fact, it was my suggestion that they updated, it
- 9:14Speaker 7: carried quite a bit of weight. However, the literature that
- 9:17Speaker 7: they were depending upon was it was older. So today
- 9:22Speaker 7: we have much more solid literature on the link between
- 9:27Speaker 7: noise and health. That's critical, and that includes mental health.
- 9:31Speaker 7: As well in learning that.
- 9:34Speaker 1: All checked out for me. Of course, the sirens are
- 9:36Speaker 1: too loud, but it can take a while for the
- 9:38Speaker 1: research to make its way into policy. Now we have
- 9:41Speaker 1: research linking even small changes and overall noise to significantly
- 9:45Speaker 1: increased risk of heart disease, to say nothing of stress,
- 9:49Speaker 1: poor sleep and its associated elements, and crucially the effective
- 9:53Speaker 1: noise on easpirated podcasters.
- 9:56Speaker 7: Now you mentioned sirens, all right, that deals with safety,
- 10:02Speaker 7: That deals with getting someone to the hospital on time. However,
- 10:06Speaker 7: the sirens in Europe are less offensive, are less intrusive.
- 10:13Speaker 7: Europe mean people aren't dying, aren't they. The point is,
- 10:17Speaker 7: if Europe can have quiet at once, you could come
- 10:20Speaker 7: up with a method of quieting the sirens and still
- 10:25Speaker 7: be as effective. I have not seen a study I
- 10:28Speaker 7: has shown that if you have a less offensive intrusive
- 10:32Speaker 7: siren that more people die.
- 10:35Speaker 1: Have you no? So here?
- 10:38Speaker 7: I am, I'm a data person. Show me the data.
- 10:44Speaker 1: I left that meeting full of hope. There's no doubt
- 10:47Speaker 1: that sirens are dangerously loud. I just need to find
- 10:50Speaker 1: the data to back this up and figure out a
- 10:52Speaker 1: new solution. Like Arlene said, I went straight to the
- 10:55Speaker 1: library and started digging around. But the more I saw
- 10:59Speaker 1: about how clear it is already that these sirens are crazy,
- 11:03Speaker 1: the less I believe that that data was going to
- 11:05Speaker 1: make any difference in the world. And then I found
- 11:09Speaker 1: a different set of data, not something about noise, but
- 11:13Speaker 1: something that undermined the very foundation of the sirens existence.
- 11:20Speaker 1: We'll be right back. Barrion County, Michigan, sits on the
- 11:39Speaker 1: southeastern shore of Lake Michigan. It's not too far from Kalamazoo,
- 11:44Speaker 1: quaint lake front towns, golf courses, quiet unless you work
- 11:49Speaker 1: as a paramedic.
- 11:50Speaker 4: I have like four jobs because it doesn't everyone. And
- 11:54Speaker 4: I'm like, right now, I'm at the Barrion County Health Department.
- 11:56Speaker 1: Jonathan Byer, former EMT and now medical director for the
- 12:01Speaker 1: Barrion County Health Department.
- 12:03Speaker 4: I am not speaking on behalf of the Barian County
- 12:05Speaker 4: Health Department.
- 12:06Speaker 1: Buyer was a boy scout, scrupulous. The reason he was
- 12:09Speaker 1: speaking to me is because, in his capacity as the
- 12:12Speaker 1: EMS medical director of the Baryon County Medical Control Authority,
- 12:17Speaker 1: he is responsible for the ambulances of Barrion County, and
- 12:21Speaker 1: that means he's thought a lot about the noises that
- 12:24Speaker 1: those ambulances make and he's arrived at a very controversial position.
- 12:29Speaker 4: There is no evidence that lights and sirens helps anybody.
- 12:32Speaker 4: There's plenty of evidence that it hurts people.
- 12:34Speaker 1: No evidence that lights and sirens helps anybody. This, even
- 12:38Speaker 1: to me an inveterate complainer about sirens, was a huge surprise.
- 12:42Speaker 4: I started life as a paramedic before I got demoted
- 12:44Speaker 4: to doctor. I was a paramedic for eleven years. And
- 12:47Speaker 4: when I was a paramedic in the Philadelphia area, we
- 12:50Speaker 4: responded lights and sirens for everything. Like you called nine
- 12:53Speaker 4: to one, we just let you know, there we go.
- 12:57Speaker 4: When I got here to Michigan, they had two sets
- 13:02Speaker 4: of priorities, Priority one in Priority two.
- 13:05Speaker 1: A lot of ems across the country has a similar
- 13:07Speaker 1: kind of tiered into system, a way to rank every
- 13:11Speaker 1: incoming nine to one one call based not on its
- 13:14Speaker 1: importance but on its time sensitivity. In Barryon County, they
- 13:19Speaker 1: would tag a call with priority one or two, depending
- 13:22Speaker 1: on what the issue was.
- 13:24Speaker 4: There are more calls for service than there are ambulances,
- 13:26Speaker 4: so we have to find some way to prioritize them.
- 13:29Speaker 1: Except the system wasn't really working.
- 13:32Speaker 4: And a lot of these triggers for things were like,
- 13:36Speaker 4: if you ever complained of shortness of breath in any way,
- 13:39Speaker 4: shape or form, it made it a Priority one. The
- 13:42Speaker 4: problem is shortness of breath or do you feel like
- 13:43Speaker 4: you're having trouble breathing? An incredibly subjective question, and so
- 13:48Speaker 4: the medics were coming to me complaining. It's like, why
- 13:49Speaker 4: are we getting Priority one dental pain because the person's like,
- 13:53Speaker 4: I have a toothpain. Oh yeah, it's making hard to break.
- 13:56Speaker 4: We were about fifty to fifty for Priority ones, which
- 13:58Speaker 4: were lights and sirens, and Priority twos, which were not
- 14:02Speaker 4: lights and siren. Speed of traffic.
- 14:04Speaker 1: So you only have a certain number of ambulances, but
- 14:07Speaker 1: if a full half of your calls are coming in
- 14:09Speaker 1: as urgent, how do you fix the problem? How do
- 14:12Speaker 1: you get all those ambulances where they need to be. Well,
- 14:15Speaker 1: an easy way is to get more places faster, which
- 14:19Speaker 1: theoretically you can do very easily if you're exempt from
- 14:22Speaker 1: all typical traffic laws, precisely why we have sirens. But
- 14:26Speaker 1: it's a little more complicated than that.
- 14:29Speaker 4: So when you drive your car, you're used to things
- 14:31Speaker 4: like red lights. Everyone's going to stop. Once something interferes
- 14:35Speaker 4: with that, the chances of an accident increase.
- 14:39Speaker 1: Specifically, it increases your chance of an accident by over
- 14:43Speaker 1: fifty percent, which is crazy. This is according to a
- 14:47Speaker 1: peer reviewed twenty nineteen study published in the Annals of
- 14:51Speaker 1: Emergency Medicine. The risk is even higher when transporting a
- 14:54Speaker 1: patient than when initially responding. But either way, the chance
- 14:58Speaker 1: of an accident is a lot higher when you're using
- 15:00Speaker 1: lights and sirens than if you're not. Also, these are
- 15:04Speaker 1: very often bad accidents. Ambulances are heavy, not a risk
- 15:08Speaker 1: worth taking if you're just responding to a toothache.
- 15:12Speaker 4: I started going, why are we responding to dental pain
- 15:15Speaker 4: priority one? So myself and I have a residency program here,
- 15:19Speaker 4: and I had a couple of my high performing medics
- 15:21Speaker 4: and another EMS position and myself. We spent a couple
- 15:24Speaker 4: of weeks going through hundreds of these determined codes, going
- 15:28Speaker 4: does that really need priority one?
- 15:30Speaker 1: So there's the accident's risk. But also, and this is
- 15:34Speaker 1: really surprising, using lights and sirens doesn't actually save that
- 15:38Speaker 1: much time on your route to the patient. For decades now,
- 15:42Speaker 1: studies have shown that lights and sirens seem to save
- 15:45Speaker 1: on average between forty two seconds and three minutes and
- 15:49Speaker 1: forty eight seconds. It's about one and a half minutes
- 15:52Speaker 1: of savings if you're in a city, and a little
- 15:55Speaker 1: over three and a half minutes if you're in the country.
- 15:57Speaker 4: On average, yes, it's about forty five seconds or three minutes.
- 16:02Speaker 1: And there are that's not a critical that's not a
- 16:05Speaker 1: critical interval most of the time for.
- 16:07Speaker 4: Most disease process. Cardiac arrest is one that I would
- 16:11Speaker 4: put in the that's the time makes sense because in
- 16:14Speaker 4: cardiac arrest, for every every minute that you go without
- 16:18Speaker 4: CPR being done, there's about a ten percent increase in
- 16:22Speaker 4: mortality and decrease in survivable brain function coming.
- 16:26Speaker 1: That's huge. Yeah, serta's huge. But heart attacks are actually
- 16:29Speaker 1: one of the few exceptions, not the rule, and yet
- 16:33Speaker 1: they are the exception on which the rule is largely based.
- 16:37Speaker 1: So all of these factors led Buyer to do something big.
- 16:41Speaker 1: He restructured the tears.
- 16:43Speaker 4: I tell the medics, and this is how I presented
- 16:45Speaker 4: it is consider lights and sirens a medical therapy. Right,
- 16:49Speaker 4: there's for every medicine that you give, there is an
- 16:52Speaker 4: indication and there's a contraindication.
- 16:54Speaker 1: Right.
- 16:55Speaker 4: If I were going to say I'm going to give
- 16:56Speaker 4: you up an effort, well, why would I give you
- 16:58Speaker 4: epin effort and the benefits have to outweigh the risks.
- 17:01Speaker 4: So I wanted to think of lights and sirens that way.
- 17:03Speaker 4: It is a high risk procedure. When are we going
- 17:07Speaker 4: to do it when the risks are outweighed by the benefits.
- 17:11Speaker 1: They ran through their data on all the calls that
- 17:13Speaker 1: they had responded to Priority one lights and sirens, and
- 17:16Speaker 1: they reassessed whether those really needed to be lights and sirens.
- 17:20Speaker 4: So cardiac arrest, people choking, respiratory arrest, things where seconds
- 17:26Speaker 4: could make a difference, yep, that is worth the risk
- 17:30Speaker 4: to try to get someone there quicker. But other things
- 17:33Speaker 4: like well she fell and broke her hip, Okay, that's
- 17:36Speaker 4: an emergency and that person needs to get to a hospital.
- 17:38Speaker 4: I don't doubt that is the three minutes going to
- 17:42Speaker 4: make a difference in that person's outcome.
- 17:45Speaker 1: No, So with all this data, Buyer and his team
- 17:49Speaker 1: changed how the calls were coded.
- 17:52Speaker 4: I wiped out about fifty percent of the Priority one
- 17:54Speaker 4: calls in burying down.
- 17:56Speaker 1: Let that sink in ambulance lights and sirens and Barrion
- 18:00Speaker 1: County were sounding half as often as they had before.
- 18:05Speaker 1: Now even I was wondering, could you really know that
- 18:08Speaker 1: this switch was putting anyone at risk? Well, eventually they
- 18:11Speaker 1: followed up on the people the ambulances had picked up
- 18:14Speaker 1: in the field to see how the hospital coded the
- 18:16Speaker 1: patients as they came in. So if you went to
- 18:19Speaker 1: someone as a priority too not that urgent, and they
- 18:22Speaker 1: showed up to the hospital as a priority one, that
- 18:25Speaker 1: would mean that you'd made a mistake. How much more
- 18:28Speaker 1: often was that happening under the new coding system than
- 18:31Speaker 1: the old It was the same number. Wow, there was
- 18:34Speaker 1: basically no difference, as in, he had the number of
- 18:40Speaker 1: lights and sirens responses in Barrion County. He reduced the
- 18:43Speaker 1: risk of accidents as a result, and it cost the
- 18:46Speaker 1: people of Barrion County nothing.
- 18:52Speaker 4: When I instituted the change, I didn't really have much
- 18:56Speaker 4: of a problem. Nine to one one didn't have a
- 18:58Speaker 4: problem with this because it just was a difference in
- 19:00Speaker 4: coding for them.
- 19:01Speaker 1: It didn't affect them.
- 19:02Speaker 4: The medics themselves really liked it because the medics were like, yep,
- 19:06Speaker 4: most of these things we were going on are not
- 19:07Speaker 4: priority on board.
- 19:09Speaker 1: The paramedics are on board. Smooth sailing, except what ended.
- 19:14Speaker 4: Up happening and I'm not exactly sure how this got out.
- 19:18Speaker 4: It went through all the proper channels on my side,
- 19:21Speaker 4: like medical control in the hospital in the county, so
- 19:24Speaker 4: that was okay, But it started getting publicized, and I
- 19:28Speaker 4: don't exactly know how, but it started showing up on
- 19:31Speaker 4: the hospital Facebook page about Burian County medical Control is
- 19:36Speaker 4: killing people with slow responses, and oh boy.
- 19:40Speaker 1: Unbeknownst to Bayer, word had gotten out to the people
- 19:43Speaker 1: who call ambulances big problem.
- 19:47Speaker 6: Hey, if you're drive in Barrian County, you won't see
- 19:49Speaker 6: as many lights and sirens as you're driving. Ambulances will
- 19:52Speaker 6: be using them only for time sensitive cases like a
- 19:55Speaker 6: heart attack.
- 19:56Speaker 1: The local news began doing man on the street interviews.
- 19:58Speaker 4: Literally, they were out on the bluff overlooking Lake Michigan,
- 20:01Speaker 4: just interviewing people walking by, going what do you think
- 20:04Speaker 4: about ambulances coming to your house slower?
- 20:05Speaker 1: And of course people explode over what did they say?
- 20:09Speaker 4: It's like, I can't believe this, and you know that
- 20:11Speaker 4: this is terrible. Of course I won't ambulance there fast.
- 20:14Speaker 4: And the hospital started getting a lot of flack, some
- 20:17Speaker 4: of it was very nasty. So people started on Facebook
- 20:20Speaker 4: attacking the hospital. Oh this is Lakeland just killing patients again?
- 20:24Speaker 4: You know, just very bad vitriol.
- 20:27Speaker 1: At the time, though Bayer was blissfully unaware any of
- 20:30Speaker 1: this was happening. Other jobs were keeping him very busy.
- 20:33Speaker 1: But then one morning he got a call.
- 20:36Speaker 4: I'd done a six p to two am shift and
- 20:39Speaker 4: at eight am I got a call from the administrative
- 20:42Speaker 4: assistant to the CEO of the hospital. Hi there, doctor Buyer,
- 20:46Speaker 4: It's eight am. What are you doing at eight thirty?
- 20:49Speaker 4: I'm like, and I'm still swaking up because again I've
- 20:51Speaker 4: had four hours of sleep, and she's like, doctor Hamill.
- 20:55Speaker 4: At that point, the CEO of the hospital would like
- 20:57Speaker 4: to speak to you.
- 20:58Speaker 1: Buyer gets dressed in hurries to doctor Hamill's office.
- 21:02Speaker 4: And I'm met by them in the hospital attorney and
- 21:06Speaker 4: being shown this Facebook page and they're like, what did
- 21:08Speaker 4: you do? This is terrible?
- 21:11Speaker 1: Buyers stunned, and then he begins to lay out the
- 21:14Speaker 1: case against Sirens in a very doctor buyer way.
- 21:17Speaker 4: I try to explain what I had done. Is have
- 21:21Speaker 4: you ever taken physics?
- 21:24Speaker 1: Buyer explained his move, maybe a little inefficiently, by using
- 21:27Speaker 1: the equation for velocity distance divided by time changed to
- 21:32Speaker 1: solve for time or Tea. It amounted to this, If
- 21:36Speaker 1: you're trying to get time down and you can't reduce
- 21:38Speaker 1: the distance between you and a patient by putting more
- 21:41Speaker 1: ambulances on the street, because it's expensive, the easiest way
- 21:45Speaker 1: to get it done is to increase your velocity, which
- 21:48Speaker 1: means running your lights and sirens. But the problem is,
- 21:51Speaker 1: we now know that running lights and sirens significantly increases
- 21:55Speaker 1: the risk of an accident, So maybe you don't want
- 21:57Speaker 1: to do that either. Then the thing to do is
- 22:00Speaker 1: to take a second look at tea. Does time really
- 22:04Speaker 1: need to come down by the small increment that we
- 22:06Speaker 1: now know lights and sirens is going to reduce it?
- 22:09Speaker 1: Not for most things.
- 22:11Speaker 4: I showed him some of the studies. He's like, your
- 22:13Speaker 4: science is sound. You may you go next time, do
- 22:16Speaker 4: a press conference. Oh I had a press conference, which
- 22:19Speaker 4: is what you saw.
- 22:19Speaker 1: Online Buyer confronted the outrage masses.
- 22:23Speaker 4: And once that went out, all complaints disappeared in six
- 22:25Speaker 4: weeks and I've heard not a thing since then. In fact,
- 22:28Speaker 4: now we are considered we right now are the leader
- 22:31Speaker 4: in Michigan for the lowest rates of lights and sirens
- 22:33Speaker 4: use in the state of Michigan.
- 22:34Speaker 1: For ems. Things worked out for buyer in the end.
- 22:37Speaker 1: But I'm interested in that initial freak out because it
- 22:41Speaker 1: reveals a basic assumption people make, myself included. Everything is urgent,
- 22:46Speaker 1: so we accept this social loophole where you can break
- 22:49Speaker 1: all known traffic laws provided you possess a device that
- 22:52Speaker 1: emits the loudest, shrillest sound imaginable. What kind of world
- 22:57Speaker 1: does this? I'm not arguing that we shouldn't have sirens
- 23:00Speaker 1: at all, but it seems to me that they're not
- 23:02Speaker 1: only too loud and crazy sounding, but like we use
- 23:05Speaker 1: them way more often than is necessary because we're unwilling
- 23:09Speaker 1: to let go of them. But of course, Barrion County
- 23:14Speaker 1: is just one place. Approximately twenty thousand the MS calls
- 23:18Speaker 1: a year, and paramedics are just one branch of the
- 23:21Speaker 1: emergency service. I shouldn't get ahead of myself. I was
- 23:25Speaker 1: left with two big questions to answer. Next, where did
- 23:30Speaker 1: we get the idea that sirens are so necessary? And
- 23:33Speaker 1: exactly how unnecessary are they? A good place to look
- 23:39Speaker 1: is the same place we fell in love with the
- 23:42Speaker 1: MS once upon a time. We'll be right back.
- 24:05Speaker 8: If you would have asked eighteen year old Jeff when
- 24:08Speaker 8: I first drove lights and sirens. I would have said
- 24:11Speaker 8: that they are always life saving and we absolutely need
- 24:16Speaker 8: to use it. But I'm not eighteen anymore.
- 24:18Speaker 1: Jeff Jarvis the chief Medical Officer for the Metropolitan Area
- 24:23Speaker 1: EMS Authority in Fort Worth, Texas, an emergency medical service
- 24:28Speaker 1: that serves over a million people in Fort Worth and
- 24:31Speaker 1: fourteen surrounding cities. He's been a paramedic since the nineteen eighties.
- 24:36Speaker 1: He served around New York City in Austin. So eighteen
- 24:39Speaker 1: year old Jeff who's made his decision to begin to
- 24:43Speaker 1: be a paramedic. So let me ask you. Let me
- 24:45Speaker 1: ask you a question. In the nineteen seventies, did you
- 24:49Speaker 1: ever watch the television show Emergency?
- 24:52Speaker 8: Oh?
- 24:52Speaker 1: Of course? And did that have an effect on your
- 24:56Speaker 1: becoming a paramedic?
- 24:57Speaker 8: It did. I thought it was the coolest thing ever.
- 24:59Speaker 1: In nineteen seventy two, NBC began airing a television show
- 25:03Speaker 1: called Emergency. That's got an exclamation point at the end.
- 25:06Speaker 1: By the way, the theme song is the music they'd
- 25:09Speaker 1: play in my version of Hell. The show is about
- 25:21Speaker 1: Johnny and Roy, two young paramedics working out of fire
- 25:24Speaker 1: Station fifty one in Los Angeles, except they're not paramedics
- 25:28Speaker 1: in the beginning that.
- 25:29Speaker 9: Special training program.
- 25:31Speaker 8: Remember we were talking about it a couple of days ago.
- 25:33Speaker 1: Yes, sir, the para something or other paramedics. The series
- 25:38Speaker 1: begins in a world where there basically aren't any paramedics,
- 25:42Speaker 1: which was our world fifty three years ago. Fifty three
- 25:46Speaker 1: years in nineteen seventy one, there were a slim twelve
- 25:50Speaker 1: paramedic units in the entire country and it was kind
- 25:54Speaker 1: of a Wild West situation. Details varied from place to place,
- 25:58Speaker 1: but in some areas it was illegal to give someone
- 26:00Speaker 1: medical care if you weren't a doctor or a nurse.
- 26:03Speaker 1: So about fifty percent of ambulances were just hearses driven
- 26:08Speaker 1: out of funeral homes by morticians whose sole purpose was
- 26:12Speaker 1: to get patients to doctors as quickly as possible. In
- 26:15Speaker 1: that failed back to the funeral home, you go. This
- 26:19Speaker 1: is actually how it worked. Emergency was a show dreamed
- 26:23Speaker 1: up in partnership with the father of modern ms, a
- 26:27Speaker 1: guy named James Page who worked at one of the
- 26:29Speaker 1: first firehouses with a paramedic unit in Los Angeles, and
- 26:33Speaker 1: the show was literally meant to make the case for paramedics.
- 26:37Speaker 1: Every Saturday night nationwide on NBC thirty million viewers at
- 26:42Speaker 1: a time, not a few of whom became paramedics.
- 26:45Speaker 9: People at dying at the scene, people who could stay
- 26:48Speaker 9: alive if there was somebody on the spot who knew
- 26:50Speaker 9: what to do.
- 26:51Speaker 1: Look, if that.
- 26:52Speaker 9: Bill passed the legislature today, do you know how many
- 26:54Speaker 9: people we'd have ready for the job?
- 26:56Speaker 8: Six men for six and a half million people.
- 26:59Speaker 1: I learned about emergency in a brilliant essay by UCLA
- 27:02Speaker 1: emeritis law professor Paul Bergman, where he traces the profound
- 27:06Speaker 1: influence the show had not just on par metics, but
- 27:10Speaker 1: on lawmakers too, by dramatizing just how urgent every single
- 27:15Speaker 1: nine to one call is.
- 27:17Speaker 8: We almost head him back.
- 27:18Speaker 9: Damn it, we almost head him back.
- 27:20Speaker 1: If you could have been defibrillated the moment they pulled
- 27:22Speaker 1: him off the wire. This is from the first episode,
- 27:25Speaker 1: right after a maintenance man gets electrocuted and eventually dies.
- 27:29Speaker 1: The doctor and nurse, who by the way, are of
- 27:32Speaker 1: course romantically involved, are talking.
- 27:35Speaker 9: Somebody should have been there with a machine in their bucket,
- 27:38Speaker 9: not somebody The paramedics again.
- 27:43Speaker 1: Call him paramedics a rescue team. That doesn't matter.
- 27:47Speaker 9: Cal if somebody with the right equipment and trained to
- 27:49Speaker 9: use it.
- 27:50Speaker 8: Had gotten to this man in time, he'd be alive.
- 27:52Speaker 9: Now, I won't use this situation that justify setting amaters
- 27:55Speaker 9: out to practice medicine on the street, trained amaters trained
- 27:59Speaker 9: by you, and doctors like you, amateurs, Dixie. I spent
- 28:03Speaker 9: twelve years in school and residency and I'm still learning
- 28:05Speaker 9: my trade.
- 28:06Speaker 1: It's a doubleheader pilot, and both episodes are full of
- 28:09Speaker 1: these situations that dramatized the resistance to paramedics, which was
- 28:13Speaker 1: very real. But the show argues that we need paramedics
- 28:17Speaker 1: and why do we need them because there are so
- 28:20Speaker 1: many accidents where if only someone had been there in time,
- 28:24Speaker 1: we could have saved.
- 28:24Speaker 5: Them, including myself, and thought it could possibly be a success.
- 28:31Speaker 9: Well, or arm may not function as well as it
- 28:33Speaker 9: used to, but at least it'll be your own.
- 28:36Speaker 1: You're getting out here as fast as you did. Made
- 28:38Speaker 1: the difference, Randy, to have around, doc, you gotta give.
- 28:41Speaker 8: Us a try.
- 28:42Speaker 1: Bergmann, the law professor, talked to the legends of ems
- 28:46Speaker 1: and he heard all these emergency references. Dug through California
- 28:50Speaker 1: hearings on the Paramedic Act, and he found emergency references
- 28:54Speaker 1: letters from senators emergency references. In the early years of
- 28:59Speaker 1: the show, forty six states legalized paramedicine. To be clear,
- 29:04Speaker 1: this was a movement that was already in process, but
- 29:07Speaker 1: emergency was a big part of establishing the cultural expectations
- 29:11Speaker 1: for what those units would look like. And it looked
- 29:14Speaker 1: like lights and sirens to every call, because every call
- 29:19Speaker 1: was all about time.
- 29:21Speaker 9: But you can't ask someone not to die while you're
- 29:23Speaker 9: trying to find out what's wrong with him. And they
- 29:25Speaker 9: do die, gentlemen, on the way from where it happens
- 29:28Speaker 9: to my hospital.
- 29:31Speaker 1: This is from the second part of the pilot episode,
- 29:33Speaker 1: when the skeptical doctor has come around.
- 29:36Speaker 9: They die by the hundreds every year, not from mortal wounds,
- 29:39Speaker 9: but neglected wounds, not from incompetence or indifference, but from time,
- 29:44Speaker 9: from lack of time. I'm in favor of more doctors,
- 29:50Speaker 9: more hospitals, and better equipment. And I'm also in favor
- 29:54Speaker 9: of this bill until those other things come along, because
- 29:57Speaker 9: it will save lives, maybe a dozen lives, maybe a thousand,
- 30:03Speaker 9: maybe just one.
- 30:06Speaker 1: He's looking directly into the camera, those thirty million viewers,
- 30:12Speaker 1: and who knows which one time, time time, And if
- 30:19Speaker 1: you succeed at convincing people that every situation is urgent.
- 30:24Speaker 1: They're going to come to expect lights and sirens every
- 30:27Speaker 1: time they call nine one one, And how many of
- 30:29Speaker 1: the calls in emergency do they respond to with lights
- 30:32Speaker 1: and si.
- 30:34Speaker 8: Absolutely, so think about it this way. On Emergency, every
- 30:38Speaker 8: call was a life threatening emergency. Now I say that
- 30:41Speaker 8: knowing the first call they went on was not but
- 30:45Speaker 8: in the team the first episode of the pilot, but
- 30:47Speaker 8: the vast majority were life threatening emergencies. So sure people
- 30:51Speaker 8: got that that notion and expectation that that's what would happen.
- 30:57Speaker 8: There are a lot of paramedics who joined up for
- 31:00Speaker 8: those life threatening emergencies only to find out that eighty
- 31:03Speaker 8: five percent of the calls is holding somebody's hand.
- 31:08Speaker 1: Sirens are all over the show. You may recall that
- 31:11Speaker 1: the literal theme song of Emergency features sirens, and I
- 31:15Speaker 1: think a lot of this time sireen obsession is due
- 31:18Speaker 1: to the fact that early ems departments were part of
- 31:21Speaker 1: fire departments, and a fire is a very specific kind
- 31:24Speaker 1: of emergency. If you don't contain it, it spreads. So
- 31:29Speaker 1: every fire is an urgent situation, and according to FEMA, anecdotally,
- 31:33Speaker 1: firefighters use their sirens way more often than the police.
- 31:38Speaker 1: But these days even the fire service in most places
- 31:42Speaker 1: seems to be based on an outdated sense of its mission.
- 31:46Speaker 1: As of twenty twenty three, less than four percent of
- 31:49Speaker 1: all nine one one calls firefighters responded to or for fires,
- 31:53Speaker 1: most or for ems and rescue. So then it looks
- 31:59Speaker 1: like the argument about siren reform broadly applies to firefighters too.
- 32:04Speaker 1: The US Fire Administration actually cited a bunch of studies
- 32:07Speaker 1: about reducing siren u usage just last year. Sirens are dangerous,
- 32:12Speaker 1: they save time, but not that much, and things are
- 32:16Speaker 1: often less urgent than they appear.
- 32:19Speaker 8: Sometimes that three or four minutes is clinically valuable. Most
- 32:22Speaker 8: of the time it's not.
- 32:25Speaker 1: Jeff Jarvis did a massive study on lights and sirens
- 32:29Speaker 1: using something called the ESO data set, a national collection
- 32:32Speaker 1: of emergency calls with unbelievably granular data attached.
- 32:37Speaker 8: Seven and a half million records. Five point nine million
- 32:41Speaker 8: of those were non Wollown responses. We analyzed every one
- 32:44Speaker 8: of those and calculated the proportion that used lights and sirens,
- 32:48Speaker 8: and eighty five point eight eighty six percent of them
- 32:51Speaker 8: responded to the scene with lights and sirens.
- 32:55Speaker 1: Oh my, God.
- 32:56Speaker 8: The fundamental question we ask is of those responses where
- 33:00Speaker 8: you use lightcense sirens, how many of them did we
- 33:03Speaker 8: do something potentially life saving? And what we ended up
- 33:07Speaker 8: finding is six point nine of those nine one one
- 33:10Speaker 8: lights and sirens responses, did we do something even vaguely
- 33:15Speaker 8: potentially life saving? And we were rather generous with our
- 33:19Speaker 8: description of what potentially life saving is.
- 33:23Speaker 1: So this is crucial. Paramedics are responding with lights and
- 33:27Speaker 1: sirens to around eighty six percent of calls when only
- 33:31Speaker 1: seven percent of them are resulting in a vaguely potentially
- 33:36Speaker 1: life saving intervention, So why were they urgent? That means
- 33:41Speaker 1: that in the United States, we're using lights and sirens
- 33:44Speaker 1: somewhere between eighty percent and ninety percent more often than
- 33:48Speaker 1: we need to. The question I have that I can
- 33:52Speaker 1: imagine people who are skeptical might ask, is, well, how
- 33:55Speaker 1: much do you really know from the call? Can you tell?
- 33:59Speaker 8: Most folks are using some type of emergency medical dispatch
- 34:03Speaker 8: where there are scripted questions, and they will give each type.
- 34:08Speaker 1: Of call.
- 34:10Speaker 8: A number and a letter, and the letter is called
- 34:13Speaker 8: the determinant and it goes from your echo level calls
- 34:17Speaker 8: which are most likely to be life threatening down to
- 34:20Speaker 8: Omega level calls which are not very likely at all
- 34:24Speaker 8: to be life threatening. And those criteria have been evaluated
- 34:29Speaker 8: multiple times with multiple data sets. Again, they're not perfect,
- 34:33Speaker 8: but they are pretty accurate. For example, there is a
- 34:38Speaker 8: call nature called eye problem. Zero point sixty seven percent
- 34:43Speaker 8: of those calls resulted in a potentially life saving intervention.
- 34:47Speaker 1: And how many do people run hot to all of them?
- 34:50Speaker 8: It's just dangerous, and it's dangerous, and it's not really
- 34:55Speaker 8: doing what we think it is. So it seems like
- 34:57Speaker 8: it is an intervention whose time has come and gone.
- 35:01Speaker 1: So I want to play for you again a very
- 35:03Speaker 1: specific moment from the pilot episode of Emergency and the
- 35:06Speaker 1: speech that doctor gave to the legislature about why we
- 35:10Speaker 1: need ems.
- 35:11Speaker 9: I'm in favor of more doctors, more hospitals, and better equipment,
- 35:16Speaker 9: and I'm also in favor of this bill until those
- 35:18Speaker 9: other things come along.
- 35:19Speaker 1: But those other things have come along. More doctors, advances
- 35:25Speaker 1: in the ways we take nine to one one calls,
- 35:27Speaker 1: better in more emergency rooms, better in more emergency medicine, better,
- 35:32Speaker 1: and more paramedics to use Buyer's formula. We have reduced distance.
- 35:37Speaker 1: Paramedic units are all over the place now in a
- 35:40Speaker 1: way they just weren't in the world of emergency. But
- 35:44Speaker 1: it seems to me like in our minds and on TV,
- 35:48Speaker 1: it's as if nothing has changed since the nineteen seventies.
- 35:52Speaker 1: Emergency was the most significant early example of an entire
- 35:55Speaker 1: genre of TV show that dramatized the emergency services. Before
- 36:00Speaker 1: there was Cops or Rescue nine one one, there was emergency.
- 36:03Speaker 1: And here's the trick. All of those TV shows are
- 36:07Speaker 1: based on the narrative conventions that emergency pioneer, a world
- 36:11Speaker 1: in which the TV show had not yet done its work,
- 36:14Speaker 1: and help was always too far away and always came
- 36:17Speaker 1: with lights and sirens blaring, because that's what firefighters did.
- 36:22Speaker 1: And these shows are everywhere. Rescue Me, sky Mett, Live Rescue,
- 36:28Speaker 1: Helicopter Heroes, Island Medics, Air Ambulance Er, a show that
- 36:33Speaker 1: was literally called Sirens, which is what they'll play on
- 36:36Speaker 1: TV in Hell for me. They even make this stuff
- 36:40Speaker 1: for kids. This is what Paw Patrol is, start them young.
- 36:47Speaker 8: There is in emergency departments everywhere I see as there's
- 36:51Speaker 8: this concept called alarm fatigue, where when everything is an alarm,
- 36:56Speaker 8: nothing is an alarm. To paraphrase, The Incredibles, the Car
- 37:01Speaker 8: Chain movie. So you just get immune to these sirens
- 37:05Speaker 8: that are not doing the job.
- 37:08Speaker 1: So Jarvis, like Buyer, reduce the use of lights and sirens.
- 37:13Speaker 1: He cut them by about a third. Did their response
- 37:16Speaker 1: time increase, Yes, by a median of six seconds, and
- 37:21Speaker 1: in the vast majority of cases by less.
- 37:25Speaker 8: So it's turning out it's not making that much of
- 37:27Speaker 8: a difference in we're being much safer.
- 37:29Speaker 1: And this I realized this is purely in the realm
- 37:32Speaker 1: of hypothesis, but it seems to me common sensical that
- 37:37Speaker 1: were lights and sirens reserved for truly emergency use, you
- 37:41Speaker 1: would see a more potent reaction to them, and likely
- 37:45Speaker 1: then it would it could it could possibly decrease response times.
- 37:49Speaker 8: So I'll put my scientist hat on and say that's
- 37:52Speaker 8: an interesting hypothesis that needs to be tested. I will
- 37:56Speaker 8: put my realist in my pragmatic public health hat on
- 37:59Speaker 8: and say, absolutely, giddy up. I absolutely think you'll see that.
- 38:04Speaker 1: I like that hat. That's a very stylish hat. You're
- 38:06Speaker 1: all right, So here it is. Lights and sirens are
- 38:11Speaker 1: a tool that currently seem to be way overused, and
- 38:15Speaker 1: that overuse has real consequences. Most of all, for our
- 38:19Speaker 1: burnt out, overstretched first responders who go to work to
- 38:23Speaker 1: save lives and wind up responding to everything as if
- 38:26Speaker 1: it's a crisis, wearing themselves out and losing their hearing
- 38:29Speaker 1: in the process. In twenty fifteen, fifteen hundred firemen sued
- 38:36Speaker 1: that company Federal Signal, the one that makes the iconic
- 38:39Speaker 1: fire siren, for causing mass loss of hearing. A lawyer
- 38:43Speaker 1: opposing them said, and I, quote, what's their solution. If
- 38:48Speaker 1: you don't have sirens, people would get mowed down in
- 38:51Speaker 1: the streets. The siren works exactly the way it should
- 38:56Speaker 1: end quote. I could not disagree more. And you know
- 39:02Speaker 1: who else disagrees that's right? I found him. Okay, I
- 39:25Speaker 1: am approaching Davy's house, which is coincidentally directly behind my house.
- 39:35Speaker 1: I was just walking down my street one day when
- 39:38Speaker 1: an ambulance rushed by and I saw this dopey yellow
- 39:41Speaker 1: lab stiffening owl. I'd know that owl anywhere. I rushed
- 39:46Speaker 1: over it and I was like, hey, I've got a
- 39:47Speaker 1: question about your dog, and his owner was very obliging.
- 39:51Speaker 1: His name is Joe. The dog's name Davy, And a
- 39:55Speaker 1: while later I came by their house for an interview
- 40:08Speaker 1: that was a very that was very satisfied. Sniff said,
- 40:11Speaker 1: I got Jen and Joe live one street over from
- 40:14Speaker 1: me and Julia, a beautiful brownstone, two kids, and a
- 40:18Speaker 1: noisy dog. We sat down at their kitchen table. I
- 40:22Speaker 1: am curious if you could tell me about when you
- 40:27Speaker 1: realize that you had a sort of eccentric dog. Well,
- 40:34Speaker 1: I guess it.
- 40:34Speaker 6: Was like the first time we heard him howling at sirens,
- 40:38Speaker 6: because he didn't seem particularly distressed by it. Like a
- 40:40Speaker 6: lot of times his tail wags and he does get
- 40:45Speaker 6: quite a reaction from like the neighbors, like the neighborhood,
- 40:48Speaker 6: Like everyone usually turns around and stops and like laughs
- 40:53Speaker 6: and was there, like I've never heard that before.
- 40:56Speaker 1: It turns out Davy is starting a movement.
- 40:58Speaker 6: His dog walker always like posts like sends us emails
- 41:02Speaker 6: like describing their walk. So you know, sometimes Davy has
- 41:05Speaker 6: gotten his his co his co partners in walking the
- 41:08Speaker 6: other dogs to start to howl with him.
- 41:11Speaker 1: But he's always the first towler.
- 41:13Speaker 6: It's definitely always the first howlur. But I think he
- 41:15Speaker 6: has taught some of the other dogs like how to
- 41:17Speaker 6: maybe start doing this, so.
- 41:19Speaker 1: Their owners must be thrilled. Jen is a psychologist, Joe
- 41:23Speaker 1: is a composer for film and television, so together they're
- 41:26Speaker 1: experts on mammalian behavior and sound. So I'm inclined to
- 41:30Speaker 1: believe their analysis of Davy's views on the sirens subject.
- 41:33Speaker 1: He's not in distress, which means he's not going to
- 41:36Speaker 1: be the poster child for my anti siren campaign. But
- 41:40Speaker 1: I hadn't given up yet. Do you share this view
- 41:42Speaker 1: of Davy's howl origins or what? So?
- 41:46Speaker 5: There's there's another theory, which this is the one I
- 41:49Speaker 5: think I if I had to choose one that I
- 41:51Speaker 5: would like to believe the most, it is. It is
- 41:53Speaker 5: that the sirens harken back to a lost dog who
- 41:59Speaker 5: has been separated from the group, and they are howling
- 42:02Speaker 5: to reconnect with the pack like a like a call
- 42:06Speaker 5: and answer from a lost dog. That's one of the series,
- 42:11Speaker 5: And that Davy is saying, we're over here. Come on,
- 42:15Speaker 5: lost buddy, this is where we are.
- 42:18Speaker 6: He is a very nigh early dog.
- 42:20Speaker 5: It loves to hang.
- 42:22Speaker 1: Jen and Joe are very neighborly people. I'm glad to
- 42:25Speaker 1: know them now, even if their dog is a huge disappointment.
- 42:29Speaker 1: My anti Siren cusade, seeing as he really love sirens.
- 42:34Speaker 1: But it makes sense. It goes back to that evolutionary
- 42:37Speaker 1: theory Malcolm was talking about at the top of the episode,
- 42:41Speaker 1: the idea of the spandrel and the things in our
- 42:43Speaker 1: bodies and our worlds that we think we're selected for
- 42:47Speaker 1: but actually are just there and maybe not doing us
- 42:52Speaker 1: a whole lot of good. Davy's howl isn't quite a spandrel,
- 42:56Speaker 1: if we're being banantic. It's more like a vestige. He
- 43:00Speaker 1: thinks he's living with a pack of dogs in the wild,
- 43:02Speaker 1: but he's not. He's a house dog who lives in Brooklyn,
- 43:07Speaker 1: a block away from a busy grocery store or a playground,
- 43:11Speaker 1: a frustrated podcaster, a New York City government employee and
- 43:15Speaker 1: a fire station, a celebrity ignorant of his own fame,
- 43:20Speaker 1: and a howler who howls just because that's what he's
- 43:23Speaker 1: always done. Revisionist History is produced by me Ben matt
- 43:48Speaker 1: of Haffrey, Nina Bird Lawrence, and Lucy Sullivan. Our editor
- 43:53Speaker 1: is Karen Chakerji. Original scoring and theme by Louis Garra,
- 43:58Speaker 1: Additional scoring by Jake Gorski. Jacob Smith is our executive
- 44:02Speaker 1: producer engineering by Marcelo d Olivera. I relied on quite
- 44:07Speaker 1: a few studies in researching this and put a link
- 44:10Speaker 1: to the bibliography in the show notes should you want
- 44:12Speaker 1: any references for starting your own local movement. Special things
- 44:15Speaker 1: also to Douglas Koupas, whose work helped launch the field
- 44:19Speaker 1: of sign reform studies, Mike Tageman, Helen k Rosenthal, Stephen Solomon,
- 44:25Speaker 1: and Paul Bergman. I'm Ben Mattahaffrey. The really Alarming music
- 44:44Speaker 1: You're hearing right Now was composed by davi's owner Joe
- 44:48Speaker 1: Saba for the trailer of the Michael Bay film Ambulance.
- 45:30Speaker 2: Get add free episodes of Revision's history by subscribing to
- 45:33Speaker 2: Pushkin Plus. Sign up on the show page on Apple Podcasts,
- 45:37Speaker 2: or at pushkin dot fm, slash plus. Pushkin Plus subscribers
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