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License to Die

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“License and Registration, Please”

First, thanks to everyone who read (and commented) yesterday about the “no-CPR” incident.   This update from the press:  ”Lorraine Bayless had chosen to live in a facility without medical staff and wanted to pass away without life-prolonging intervention, her family said Tuesday.”

Most, but not all,  commenters were somehow related to the health field.  But,  several folks shared their own experiences with a loved one which was quite valuable.

Common words were legality, professional, Do Not Resuscitate(DNR), duty, and licensing.  Even writers that were quite concerned about the ramifications of not acting expressed the need for people to die with dignity and freedom.

It’s hard not to conclude that in our litigious and buttoned-down society that the DNR order has become a license to die.  Without it, you risk ignominy or worse.  According to the Pasadena News, “City fire officials say Bayless did not have a “do not resuscitate” order on file at the home.”  Conservatives worth their salt and any libertarian should be aghast to know that you now need the city’s permission to die.

A Pioneer Death

She’s in the Parlor

Many of us are fortunate to have people in our lives who can recall a death at home where the corpse never left the house until the burial.  They were washed and dressed and placed in the parlor for folks to come and pay their respects.

Such a thing is probably illegal now but it illustrates how the process of death these days routinely includes transfer to a hospital, which should seem a little odd.

In one sense, this “we die at the hospital” mentality has now been walked back to the point that you are not allowed to die outside the hospital unless you have your DNR passport.

The emergency response system, including EMS, fire and 911 call takers are now part of the “you must die at the hospital” culture we live in.  In fact, Bakersfield became a story over a call taker’s “heroic” efforts to recruit a CPR provider.

The Last Trip

As a society we have created an environment where the universal last, great trip is being robbed of its ambiguity, grace and freedom.  In fact, the current system, especially for those content to go, argues in favor of a solitary death where the risk of interference is minimized.  We are all ultimately alone at the end, but that is a high price to pay.

I have several people in my life who “are ready.”  And, I have known others.  I hope that when their time comes that they make their transition free of pain, but with grace and dignity.

Thanks, again.

 

Posted by on March 6, 2013 • Filed under: Different, History, Religion and Spirituality, Values and Ethics, Words

Let’s Live…FOREVER!

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“Harrowing” and “Horrifying”

The Associated Press reported yesterday that an 87-year-old Bakersfield, CA, woman collapsed at the dining hall of her assisted living facility and that staff refused to perform cardio-pulmonary resuscitation (CPR).  She died.

Now, all hell is breaking loose.

Never-mind that the “residents of the facility are informed of the policy (no CPR) and agree to it when they move in.”

A nurse is being vilified by the ignorant media, politicians and others needing to score points as she was simply doing her job and adhering to policy.  The policy is not a “do not resuscitate” but rather a “will not resuscitate.”  No difference, just they are telling you instead of the other way around.

This situation highlights the fact that apparently healthy people, especially the elderly,  can die of natural causes and not need or want resuscitation.  This potential eventuality had been explicitly addressed without the need for the “DNR” order.  There are many ways to skin the cat.

We westerners think we will live forever and that every sentient being should go to the great Walmart in the sky with four broken ribs, a lacerated liver and a tube jammed down our throat.

From California Advocates for Nursing Home Reform: “Independent living facilities should not have a policy that says you can stand there and watch somebody die…How a nurse can do that is beyond comprehension.”

From the California Board of Registered Nursing: “The consensus is if they are a nurse and if they are at work as a nurse, then they should be offering the appropriate medical care.”

And this bon mot from Assemblywoman Mariko Yamada, chair of the California Assembly Aging and Long-term Care Committee, “This is a wake-up call.”  (Not so much.)

This is shaping up as another example of the “Hot McDonald’s coffee/I’m stupid so i’ll sue you”  world we inhabit.  Frankly, it’s 2013, if you are in any facility and they lack one or more Automatic External Defibrillators (AEDs), they aren’t serious about “sudden death” lifesaving regardless of what they say or who knows or will administer CPR.

If I defy the odds and live to be eighty-seven and am in the dining hall and go into cardiac arrest, I’ll sue all right.

I’ll sue whoever dares to touch me.

 

 

Posted by on March 5, 2013 • Filed under: Dispatch & Communications, EMS Dispatch, EMS Topics, Values and Ethics

March 4, 1908: Catastrophe in Collinwood

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Are Our Children Safer?

Lake View School
Collinwood, Ohio

One hundred and five years ago this morning, disaster struck Lake View School in Collinwood, Ohio.

Fritz Hirter, school custodian, had arrived near dawn on a late winter’s day,  to fire up the school’s coal burning furnace.  The children were let into the building around 8AM and the fire was reported by a student at about 9:30.

The next minutes were a panicked blur as fire ascended the open 3-floor staircase trapping students and causing a blinding rush for the few exits.

Bodies piled up at the doorway to the point where pulling the children out was impossible.

 

Collinwood Memorial

172 students and two adults were killed in minutes, some as they were forced to jump from upper floors.  Bodies were so badly burned they were unidentifiable and were buried in a mass grave at Lake View Cemetery.

Where fire is concerned, today’s schools are some of the safest buildings in America but our children are not much safer.

A Collinwood parent, circa 1908, would doubtlessly be astonished to learn that in 2013, the number one threat to children is murder by gun fire, often in mass killings and frequently at the hands of fellow students or young adults.

What would they say from their vantage point afar?  No doubt they would marvel at both our schools and our unwillingness to keep our children safe in them.

As, indeed they should.

 

 

 

Posted by on March 4, 2013 • Filed under: History, Major Incidents, Mass Casualty Incident, Sculpture, Statuary, Outdoor Art, Values and Ethics

Joan, the Holocaust and Hot Heidi

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Can Tragedy Be Funny For a Reason?

Joan Rivers

Joan Rivers, the nearly octogenarian, outrageous comedian, recently observed regarding Heidi Klum that, “The last time a German looked this hot was when they were pushing Jews into the ovens.”

The response has been predictable, including from the (Jewish) Anti-Defamation League, who said, “This remark is so vulgar and offensive to Jews and Holocaust survivors, and indeed to all Americans, that we cannot believe it made it to the airwaves…”

Rivers is Jewish and is refusing to apologize for the comment.   Does her tribal heritage provide a license to shock?  Rivers has said in part, “I can assure you that I have always made it a point to remind people of the Holocaust through humor.”

Indeed, when I read what she said I 1) laughed out loud, 2) felt guilty for doing so and then 3) thought about the Holocaust.

In the very near future holocaust survivors will be a thing of the past.  The power of a living connection with such a horrible event will be gone forever.   Anyone who has ever met and spoken to a Holocaust survivor can attest to the power of being in the presence of such a person.

The Holocaust will no longer exist as a memory but only as a historical fact.  The problem with these facts is that they seldom elicit an emotional response.  Something more is needed.

Rivers with her irreverence creates an emotional chain reaction that can result in some people connecting with the Holocaust  in a manner that is both unconventional and personal.  My own started with a laugh and resulted in a reflection.

Don’t forget, as Mrs. Lincoln once said, “Other than that, the play was great.”

 

 

Posted by on March 3, 2013 • Filed under: Different, History, Religion and Spirituality, Values and Ethics, War and Peace, What We Call "Race", Words

Fire Politics: Hagel’s Squeaker

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You Can Call Me Mr. (Barely) Secretary.

Chuck Hagel
24th Defense Secretary

In the last 35 years all but one nominee for Defense Secretary has been easily confirmed.  The exception, John Tower, US Senator from Texas, was rejected in 1989 by a vote of 47 to 53 because of his drinking and carrying on.  The other ten were confirmed with unanimous or nearly unanimous votes.

As an example, in 1997, Bill Clinton nominated another Republican Senator, William Cohen of Maine to be Defense Secretary.  Cohen, a Republican working for a Democrat was confirmed 99 to 0.

A swing of nine votes would have spelled defeat for Chuck Hagel as he faced a withering barrage of opposition to his nomination, including a filibuster.  In fact, he received the smallest margin of any secretary since the position was created in 1947, according to the NYT.

Those Democrats must have been REALLY pissed off to go after Republican and Vietnam Veteran Chuck Hagel.

Wrong.

It was Senate Republicans who used all in their power to discredit and defeat their former colleague.

Hagel’s in the conservative dog house for taking an independent position on the war in Iraq and for having the temerity to suggest that the US can have a foreign policy independent of Israel’s.  (By the way, this just in: the war in Iraq is not over, we just left.  The country is still racked by sectarian murder and non-stop bombings where hundreds are killed.)

Senate Republicans and conservatives should have welcomed Hagel at Defense.  He has the experience and he is his own man.  He was a Deputy Administrator at the VA in 1982 when he resigned because he felt that Vets were being dis-respected.  He isn’t afraid to walk away which gives him freedom and power. Likely as not, and if history is a guide, he will wind up giving Obama a fit, to boot.

Got a question for you: Would that same crowd have vetoed Hagel joining the US Army Infantry to serve in Vietnam?  (“Lindsay Graham, R-SC, was describing himself on his website as an Operation Desert Shield and Desert Storm veteran. In reality, he never left South Carolina.”)

If Hagel’s defense agenda isn’t the Republican’s, just what is their agenda?  If Hagel isn’t their guy, who is?

By the way, isn’t Chuck Hagel just the kind of politician that all Washington politicians say they are (or want to be):  independent-minded, tough, willing to take a stand?  And yet, when confronted with the opportunity to support one for an essential post, they resort to trying to ruin him.

This crowd is so low that they will eagerly impair our ability to wage war, for we are at war, in order to destroy the guy in the White House and our country, along the way.

Now, that’s leadership.

 

Credits: Wiki, NYT, 538, Wapo

 

 

Posted by on March 1, 2013 • Filed under: Command & Leadership, Firefighter Politics, Values and Ethics, War and Peace

Responder Safety: When Attention is “Tunnelled”

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American Airlines 2253

Does what we expect to happen influence our awareness?

Why is constant monitoring essential?

AA 757-200 Over-run
(AP)

Snowy Day

2253 was a Chicago to Jackson Hole, Wyoming (JAC), flight with experienced pilots flying in challenging but typical winter conditions.  (The Captain had extensive experience flying into JAC.) JAC is located at an altitude of 6,400 feet and the active runway was 6,300 feet long.

Weather conditions were better than forecast with light snow and winds though the aircraft would be close to maximum landing weight.  The flight crew conducted a very thorough en-route briefing evaluating runway conditions, weather and aircraft capabilities.

Runway conditions deteriorated during the final third of the length so the plan was to touchdown in the first 1,000 feet and come to a stop quickly.  The aircraft slows and stops using a combination of main gear hydraulic brakes, engine thrust reversers and “speed brakes” or “spoilers.”  These speed brakes cancel wing lift and allow the weight of the aircraft to settle on the main gear so the hydraulic brakes will be fully effective.

Deployed Thrust Reverser

Approach

Engine thrust reversers are manually deployed by the flying pilot after touchdown and the speed brakes can be “armed” for automatic deployment or manually activated at any time.  In addition, the aircraft has a system that automatically confirms that it is on the ground so that deployment is appropriate.

The aircraft was configured for landing, the first officer was the flying pilot and the captain was tasked with monitoring pertinent systems.  He would confirm and call out successful deployment of reversers and speed brakes, a common procedure.

 

Looking Aft

“Two in Reverse”

The aircraft touched down exactly as planned and the Captain called out “deployed” and “two in reverse” suggesting that the speed brakes and thrust reversers were operating.  In the split second after touchdown the “on the ground” sensing system cycled from ground to air to ground again at the exact moment that the flying pilot was manually deploying the thrust reversers.  They froze in mid-deploy position.  In addition, because of an undetected fault in the speed brake system, they also failed to activate.  The aircraft was barreling down the runway, unable to stop and heading for a sketchy runway surface.

Two things were wrong but the pilots noticed and focused only on one–the thrust reversers.  The National transportation Safety Board (NTSB) referred to this as “tunnelled attention” since the pilot responsible for monitoring the “big picture” allowed his focus to be drawn to one area.  The problem with the speed brakes could have been instantly resolved by manually moving the lever to the deployed position.  Activating speed brakes even with late deployment of the thrust reversers would have stopped 2253 on the runway.

“Big Picture”

The NTSB discussed the inability for either pilot to pull back to focus on the “big picture” even though both commented that they were not slowing down.  One of the aspects touched upon is our tendency to expect automated and highly reliable systems to always function correctly.  (The Captain saw the speed brake handle start to move and assumed the rest.)  Our analogous examples could include SCBA, fire pumps or patient monitoring systems.)

Luckily, 2253 rolled to a stop in heavy snow about 500 feet past the end of the runway.  Their ski trip started early.  We can profit by training ourselves to keep the big picture and by not falling into the trap of expecting systems to always function flawlessly.

 

Posted by on February 27, 2013 • Filed under: Administration & Leadership, Command & Leadership, EMS Health & Safety, EMS Topics, Fire Rescue Topics, Firefighter Safety & Health, Firefighting Operations, HazMat, Safety and Health, Technology & Communications, Training, Vehicle Operations & Apparatus

Who We Are: Pickles, NO Dark Chocolate and that 3/5 Thing

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Pass the Midgets

Pickles, Small

A mother from the “midget” state, literally, has taken taken great offense at the calling of pickles “midgets”.  Rhode Island’s Chelley Martinka has a no doubt lovely daughter Adelaide, born with dwarfism.  This fact apparently underlies her crusade to stop purveyors of small pickles from referring to them as, well, you know.

It seems that Ms Martinka has here-to-for led a life of cucumborial bliss ignorant of the crushing degradation meted out to innocent gherkins and dills.  Her new found situation affords her the platform from which to make war on words she finds offensive.  She actually caused one weak-kneed vendor to drop the word “midget” which, the last time I checked, meant something “much smaller than usual.”

Next up in this linguistic campaign of fascist terror: “half-pint”, “itsy-bitsy” and “teeny-weeny”.

 

 

Will that be black or white?

Hitler’s Health Care

Meanwhile, over in Flint, Michigan, Hurley Medical Center seems to have “honored the wishes” of a “swastika-tattooed” man to not have black nurses care for his child.  Hospital staff posted a note in the chart saying,’No African American nurse to take care of baby.’

In Flint, the hospital operates much like a confectionery where you pick your chocolate from the many varieties available.  We hear that where chocolate is concerned, some whites pass for black and vice-versa.

Who can seriously claim that we live in a post-racial environment when an admirer of Herr Hitler dictates the color of his nurse, and gets away with it?

 

Scene at the Signing
Howard Chandler Christy

Emory’s Wagner Invokes the 3/5 Clause

Emory University’s President James Wagner wrote a column last week lauding the constitutional clause counting 3/5 of the slave population for purposes of apportioning congressional representation.  He was using it as an example of compromise.

Wagner has spent the rest of the week at a Georgia “wood shed” as he wrestles with being defined as a racist.  He has referred to his writing as, “a clumsy and regrettable mistake.”

Wagner, to the best of my knowledge, does not advocate slavery.  According to the New York Times, students and faculty have labeled the article as “insensitive.”  (They should hang out at the Hurley Medical Center for awhile.)

The truth is that Wagner cited the kind of “hold your nose” compromise necessary to create America.  Being called out on it makes about as much sense as dropping “midgets” from that jar of gherkins.

Forest for the Trees

Sensitivity around human dignity seems to be about as sloppy as making our Constitution.  The “midgets” and “Wagner” stories give rise to the thought that correctness, in its many idiotic shades, will win out over the once adult requirement to view and think about things in context.  It is not a political correctness because it lacks a clear political definition.

Do we now live in a society where anyone, courtesy of technology, can cry foul at a word or a thought and demand change or retraction?  It seems so.

“You Tube Culture”, Facebook, and the “Walk and Text” world now facilitate information at the expense of wisdom as the actual evils of racism, discrimination and hate march steadily along.

 

 

 

 

Posted by on February 24, 2013 • Filed under: Administration & Leadership, Command & Leadership, History, Values and Ethics, What We Call "Race", Words

Irony: Alive and Well at the Holocaust Museum

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The Rules Will Be Followed

United States Holocaust
Memorial Museum

I have been working these past few years as a Washington, DC, city guide.  It’s a bit like working for the fire department.  Every day is different, nothing ever goes quite as planned, and you meet a lot of people along the way.

In addition to “interpreting” the city and its history, part of the job is acting as escort to help out-of-town folks negotiate unfamiliar territory as they visit the sites and the museums.  Whether it’s the White House, Capitol, Supreme Court, Mount Vernon or any of the other dozens of locations they all have their way of dealing with visitors.

Some require a security screening that may be largely cursory all the way up to the “no non-sense” operation at the Capitol.  Most balance the need for order and security with the idea that visitors should have the best experience possible as part of the objective of learning and civic engagement.

The United States Memorial Holocaust Museum (USMHM), federally supported with the mission of  teaching the history of the Holocaust and keeping us ever vigilant to the occurrence of genocide, takes an unusual approach to the visitor experience.  Students of history or even those who have seen a film such Sophie’s Choice, based on the best-selling novel by William Styron, will be familiar with the officious, unforgiving, bullying nature of death camp guards towards those arriving there.

I very recently took a group of young folks to the USMHM during a cold snap for a pre-arranged appointment.  We were right on time and had 90 minutes to spend there.  It was a blustery day with temperatures in the 30′s.  I had the kids stand in the sun as I went to make contact with the visitor representative.

He was dressed in a parka fit for the South Pole complete with the hood up.  I identified our group and our number(56)  and he studied his clip board only to announce that I could not enter until a second group of some 56 more arrived on another bus.  We knew not where the other bus was nor exactly when it might arrive.

As the kids shivered in the cold I pointed out that we had to go through security anyway so why not allow us to do so to speed up the process, save time and get them warm.  ”No” was the answer.

I tried speaking with other personnel.  When my unyielding “guard” was finally told to allow us to enter by a supervisor, he turned to me and said, “If your group goes in you will be forfeiting the reservation for the other 56.”   For those who have in fact seen Sophie’s Choice, I was in a similar situation.  In allowing my group to enter, I would prevent the others from doing so.  Of course, I declined and we cooled our heels (literally) until the others arrived.

All 112 of us now made our way through security before being allowed to queue up for the elevator that would take us up to the exhibition level.  We originally arrived with 90 minutes to experience the museum and 34 minutes had now ticked by as we waited to start.  I pointed out to a colleague that earlier that day we had toured the Washington National Cathedral in less time than it was taking us to enter the USMHM.

It’s hard to imagine that the USMHM can believe that it is fulfilling its mission by treating visitors in such a way.

But, rest assured–the rules were followed.

And, at long last, the elevator finally arrived.

 

Posted by on February 20, 2013 • Filed under: (Almost) Hidden DC, Books, Different, History, Travel, Values and Ethics, War and Peace

Of Villainy and Religion

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To Apologize for Kindness

Christ Falling on the Way to Calvary
Raphael

You may recall that after the Newtown massacre where 20 children and six adults were murdered, an inter-faith memorial service was held.

Reverend Rob Morris, a Newtown Lutheran Minister, one of whose young parishioners was among the dead, gave the benediction at the service.

Reverend Morris was subsequently forced to apologize to his church leadership for participating in the service since mingling with different denominational ministers violated their prohibition against joint worship with people of other faiths.

The man who demanded the apology, Lutheran President and Reverend Matthew Harrison eventually apologized for his original demand offering up a contorted rationale.

 A Civil Society?

The Church and the State form two of the most important institutions underpinning modern or civilized life.  Both are associated to varying degrees with compassion.  Many citizens, religious or not, would see the role of the pious as teaching, modeling or extolling the virtues of compassion, kindness and comity as a key tenet of earthly life.  Faith relies on the future while kindness exists in the moment before us.  And, few acts of kindness are more powerful than comforting the bereaved.

How jarring then, in the midst of such a devastating catastrophe as Newtown, to have God’s minister rebuked and forced to apologize for an act of healing and kindness.  What aspect of that reinforces the concept of mercy or the sanctity of human life?

Villainy

It’s fancy for “wicked” which is a powerful word.  It basically connotes an evil willfulness.  Demanding what would effectively be a public apology from Reverend Morris for his kindness was an act of villainy.  He was forced to betray his personal sense of kindness and sense of community in order to satisfy the peculiar tenet of a religious doctrine.

God created “man” and we have created an endless series of sects and divisions jostling and preening for first place in the eyes of the great one.  Though it has long since been proven that we are all essentially the same, the role of much religion is to somehow convince us that we are actually different, and damned because of it.

Power

The synonyms for power are better than the word itself:  might – force – strength – potency – authority.  In the world we inhabit, it seems that no institution, of God or man, can long exist without some combination of strength and authority.  Institutions of power are characterized by hierarchy, status and the ability to punish.  Punishing human compassion is an exquisite abuse of power normally associated with the cruelest of regimes.

Tragically, the cost of power-based organized religion is the requirement to subordinate the inclination to be kind or merciful in order to reinforce  a sense of difference or specialness.

Christ En-route  to Calvary

Look, or look again, at Raphael’s masterwork but see the faltering Christ as the grieving people of Newtown.  See the beseeching Mary on the right as those who would offer compassion including Rob Morris.  Lastly, see the towering and unmerciful guards, centurions who willingly inflict pain to protect their power as the kings of religion.

Thus has the message of mercy and kindness been subverted by religious dogma and the lust for power and control.

 

Posted by on February 14, 2013 • Filed under: Art, History, Religion and Spirituality, Sculpture, Statuary, Outdoor Art, Values and Ethics, What We Call "Race"

Words: Your Horse is Gay

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Warning: May Offend Gays, Police Officers, Horses or Those Who Love or Hate Them

Possibly Gay Horse

Brit Sam Brown, a student at Oxford, was arrested a few years ago during a night out, when he ask a mounted police officer “Excuse me, do you realize your horse is gay?”

He was charged under Section Five of Britain’s Public Order Act for uttering in this case, a “homophobic insult.”

Apparently the unsolicited observation of the horse’s sexuality was deemed an insult as if it is automatically insulting to be gay.

 

 

Enter Mr. Bean

Mr. Bean

Rowan Atkinson, a.k.a., Mr. Bean, has been in the vanguard of encouraging a change to the public law that would result in the word “insulting” being removed.

Bean, incurably silly, is the perfect person to lead a crusade on the absurd.

But the real issue is not the notion of an “insult” but rather, how police officers misuse laws to punish petty or boorish behavior they seem not to like.

In Britain, at least, laws are being amended to protect the citizens from the police.

 

 

Posted by on February 12, 2013 • Filed under: Uncategorized