New York, New York
When author Patrick McDonald first began medical training in the late 1970s, he was among the first paramedics in the nation, lit up with zeal to save lives in a way not imagined even a few years before. Now, after 20,000 EMS calls for help, his view of his own profession is jaded by ethical dilemmas, and he has written a book that focuses on the power struggles between physicians and paramedics – battles that at times have fatal results. He also describes what he calls the “Immutable Laws,” which reign supreme in the Twilight Zone world of EMS.
McDonald, who has labored in the trenches of rescue for more than three decades, details story after story in which rules and policy get in the way of rescuers simply doing their job. Some success stories are brilliant, such as when he was dispatched to the first paramedic-level EMS call in San Diego in 1979, saving a patient stricken with a dissecting aortic aneurysm. But other events, including some in other countries, point out the consequences of policies that hinder rescue efforts. The author himself once nearly lost his license, after authorizing a non-EMS helicopter to fly out critically injured Girl Scouts in a bus tragedy. Sonny Bono (who had been on the scene) saved the day.
“The Pedigree of a Paramedic Heretic: Immutable Laws and Ethical Illusions” drives home McDonald’s argument that saving lives is no longer rescue priority. Instead, following policies, protecting oneself and avoiding lawsuits – all trump patients lives. The book boldly challenges numerous myths, such as lights and sirens Code-3 driving (and details dozens of ambulance crashes); the “Golden Hour” of patient care; and the futility, in nearly all cases, of CPR. Some of the greatest problems, McDonald writes, are the drug-rampant prescriptions, unnecessary surgeries, medical records fudging, as well as paramedics not questioning doctors’ orders for fear of losing their jobs. Saving lives, in the end, has become much more about capitalism than heroism.
Author Patrick McDonald knows of what he speaks. He was appointed the City of San Diego’s first EMS supervisor and created one of the nation’s first STAR teams – Special Trauma and Rescue. McDonald, a graduate of University of California-San Diego School of Medicine’s original advanced field medicine program, has served as a consultant to the U.S. Secret Service. He co-authored the “National Waterpark Lifeguard Training Manual” and wrote “America’s Dumbest Doctors: Ever Wonder About Yours?”
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The Pedigree of a Paramedic Heretic: Immutable Laws and Ethical Illusions
K. Patrick McDonald
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