In response to High Performance EMS' Post: We Need Some New Stories.
I’m a little weary of hearing that EMS is a new discipline. Of course, no one can deny the impact of WW1, and it’s true that the White Paper is still less than 50 years old.
Formal, shiny ambulances are a new fixture to our streets that our grandparents grew up without. But emergency responders have existed throughout history. Many of them were the midwives and wise women who are consistently marginalized in historical study. For example, it’s hard to ignore the parallels between Martha Ballard, 1785-1812 (who delivered babies, answered medical and trauma calls, dispensed pills, encouraged public health during epidemics, transported the dead, and answered false alarm calls), when compared with modern responders. Community paramedics? It’s been done. And she would run circles around us today.
This is one reason why I cringe when I hear statements about doing away with the old stories. Our history is a grounding, a critical foundation of our larger understanding of medicine. It allows us to see and take pride in our growth, and at times, it can remind us of truths--even scientific truths--we may have forgotten. Modern leech therapy, anyone?
We should never be afraid to try the new, but concurrently, we should never be afraid to try the old, either. How else would tourniquets have come back?
Evidence-based medicine must be emphasized. I should probably repeat that or highlight it in bold. We must make decisions based upon science and not tradition. We should never be afraid of change. However, we must also be painfully aware of the limitations of what we call ‘science.’ Too many variables, a skewing of the data, a missed decimal, or a misapplication can result in the implementation of faulty protocols and, in the end, morbidity and mortality increases once more. Only by critically, yet open-mindedly, examining the past can we recognize and change our missteps.
It’s difficult to overlook personal biases--anecdotal evidence, if you will--when making decisions about the viability of technique. If there is evidence of system status management’s effectiveness (or it’s effectiveness in some form or another), we should strive to consider it, to see past the limitations of personal experience. I’ve spent too many uncomfortable nights posted in a dark parking lot outside of a bar on the bad side of town to look at evidence of the effectiveness of SSM with full impartiality. This is why peer review, objective third-party input, and collective decision making is so important. We want to avoid groupthink, but ‘there is wisdom in the council of many.’ When the culture allows all to speak, grants free reign to the flow of ideas (even ideas that begin with ‘back in the day’), and promotes brainstorming with follow through, we have the greatest opportunity to advance care.
Our history is critical and provides fodder for the future. Only as a group of the old and the young working in tandem can we gain access to the full range of ideas and concepts that will propel the field forward. Instead of simply banning the phrase, ‘but that’s how we’ve always done it,’ let’s strive to say, ‘that’s how we’ve always done it, and here’s why...’
I’m a little weary of hearing that EMS is a new discipline. Of course, no one can deny the impact of WW1, and it’s true that the White Paper is still less than 50 years old.
Formal, shiny ambulances are a new fixture to our streets that our grandparents grew up without. But emergency responders have existed throughout history. Many of them were the midwives and wise women who are consistently marginalized in historical study. For example, it’s hard to ignore the parallels between Martha Ballard, 1785-1812 (who delivered babies, answered medical and trauma calls, dispensed pills, encouraged public health during epidemics, transported the dead, and answered false alarm calls), when compared with modern responders. Community paramedics? It’s been done. And she would run circles around us today.
This is one reason why I cringe when I hear statements about doing away with the old stories. Our history is a grounding, a critical foundation of our larger understanding of medicine. It allows us to see and take pride in our growth, and at times, it can remind us of truths--even scientific truths--we may have forgotten. Modern leech therapy, anyone?
We should never be afraid to try the new, but concurrently, we should never be afraid to try the old, either. How else would tourniquets have come back?
Evidence-based medicine must be emphasized. I should probably repeat that or highlight it in bold. We must make decisions based upon science and not tradition. We should never be afraid of change. However, we must also be painfully aware of the limitations of what we call ‘science.’ Too many variables, a skewing of the data, a missed decimal, or a misapplication can result in the implementation of faulty protocols and, in the end, morbidity and mortality increases once more. Only by critically, yet open-mindedly, examining the past can we recognize and change our missteps.
It’s difficult to overlook personal biases--anecdotal evidence, if you will--when making decisions about the viability of technique. If there is evidence of system status management’s effectiveness (or it’s effectiveness in some form or another), we should strive to consider it, to see past the limitations of personal experience. I’ve spent too many uncomfortable nights posted in a dark parking lot outside of a bar on the bad side of town to look at evidence of the effectiveness of SSM with full impartiality. This is why peer review, objective third-party input, and collective decision making is so important. We want to avoid groupthink, but ‘there is wisdom in the council of many.’ When the culture allows all to speak, grants free reign to the flow of ideas (even ideas that begin with ‘back in the day’), and promotes brainstorming with follow through, we have the greatest opportunity to advance care.
Our history is critical and provides fodder for the future. Only as a group of the old and the young working in tandem can we gain access to the full range of ideas and concepts that will propel the field forward. Instead of simply banning the phrase, ‘but that’s how we’ve always done it,’ let’s strive to say, ‘that’s how we’ve always done it, and here’s why...’
