Geeks, Packagers, Pitchmen, EMS and You: Part V

firetender

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Conclusion of the 5-part series; Geeks, Packagers, Pitchmen, EMS and You!

Part I, Part II, Part III, Part IV

Some things seem meant to happen. In early, 2011, I was walking out the door of my local library in Makawao, Hawaii when I spotted the image of an ambulance on the cover of a book in the “Friends of the Library” section. These are books being taken out of circulation and up for sale. I was surprised to discover that “Harthrob” was the story of the beginnings of our profession, and its author, Tom Corbin, had written and published it while living in my little town.

In the writing of my own book, I recognized EMS as a potent metaphor for a shift in Medicine as "practiced" in the U.S. from hands-on to hands-off; from patient oriented to mechanical diagnostics/drugs/procedures/operation oriented, all directed by profit and litigation concerns and with shrinking human-to-human contact.

Tom’s book supplied me with an incredibly timely “Missing Link”. His story de-mythologized what we medics have always assumed; the lifesaving techniques that allowed the paramedic program to begin were brought to us through doctors concerned with saving lives. There were many more "market forces" at work.

The truth is it took a tremendous amount of effort by those in the engineering, manufacturing, and promotion communities to “convert” those in the best position to use the technology for the benefit of our citizenry. But I was soon to learn that was only “Level 1” of the process of bringing these innovations to the public.

After a couple of reads of the book, I sought out Mr. Corbin and found he was living in Arizona. I e-mailed him and his initial response was to send me on a journey to learn about Dr. Kouwenhoven’s work. Here, he said, was the hub of the wheel, of which Tom was only a spoke.

Tom realized that if such innovations were to be made easy-to-use, dependable, and packaged and priced rightly maybe enough professionals would buy and use them so a whole lot of people’s lives could be changed for the better – that was his nuts and bolts job. As far as he was concerned Kouwenhoven and his team were the real miracle workers.

Tom was really at the prime of men making machines to serve people; Innovation that’s outcome-driven rather than innovation morphed by profit concerns. It was amazing how damn hard he had to work to get doctors to accept the idea of saving lives! Nothing less than the total package he envisioned and developed would have gotten the concept of EMS off the ground

His was the story of a relative greenhorn catching a glimpse of the future and somehow identifying most of the elements that it takes to make a huge innovation real. He just put one foot in front of the other, responded to what was needed at each juncture, and cobbled together something incredibly useful!

It became clear to me Tom’s involvement was anything but profit-driven. He was looking at this as a gateway into a true Entrepreneur’s dream; to be able to spend a lifetime designing and improving machines that would benefit many lives. Designed and executed properly, they would, based on their own merits and value, generate the capital necessary to keep going further. The cost/benefit ratio was so skewed to the benefit side, who could possibly resist?

And that was the story Tom told; just how much resistance there really was, from within the people and companies with whom he was associated through the doctors themselves.

The external cardiac defibrillator, in order for it to be useful, had to come in after enough time had been stolen from death to get the apparatus in place. For Tom that was the greatest revolution of all; CPR meant that anyone could steal that time until the professionals arrived with the apparatus that he refined.

In our correspondence, and as is reflected in the book itself, I began to understand what may have been the biggest frustration of Tom’s life. He was passionate about having CPR made available to the public-at-large, and at the time of his involvement, that wasn’t ready to happen and he wasn't the one to do it.

He had another role to fulfill and he did it well, but the exigencies of business and his place in the development of the hi-tech end of the delivery system prevented him from personally having an effect on the spread of CPR. His job, you could say, was working through the primary layers of resistance in the medical community. It took others to make it stick.

A Google search “inventor CPR” shows Dr. Peter Safar (deceased). Here’s part of what it says in the Lemelson-MIT Program, Inventor of the Week Archive:

Throughout his life Safar was hesitant to take credit for “inventing” CPR. The way he saw it, he merely brought to light effective procedures that humans had already discovered, putting them together into what he called “the ABCs”—maintaining a patient's Airway, Breathing and Circulation. He worked hard to popularize the procedure around the world and collaborated with a Norwegian company to create “Resusci Anne,” the first CPR training mannequin.
By the time the “Popularizers” had come about and began to gain traction, first with the medical community and then with the public, Tom had left the field and gone on to other pursuits. The reality is he had burned out on the business. Corbin-Farnsworth was absorbed by Smith, Klein and French as a medical products division, and then, through a series of restructures and whatnot, Tom had less and less control of his products and destiny.

And, as business goes, there were a number of cardiologists who jumped on the bandwagon and sought credit for the authorship of CPR, pacemaker, and defibrillator. In their maneuvering for position, Tom’s name got lost, along with his partner, Farnsworth, and mentor Kouwenhoven, the engineer.

The image that has been put forward is that of a cadre of very concerned physicians coming together to bring these new technologies to the people. Without denigrating any of their contributions, it’s important to acknowledge the shoulders upon which they stood.

Tom’s experience was a great springboard for me to further explore the current day paradoxes that medics face as they struggle with issues of “Man vs. Machine”. I’m here to challenge medics (not only in EMS but of all stripes) to take the time to learn the roots of the technology they use, and to apply those lessons to making it work for the people.

If there is a major lesson to be learned here it is that if the Geeks, Packagers and Pitchmen of Tom’s day had been less resilient, less persistent or less bold, EMS would still be “Load and Go!”

And perhaps that is the core message for all of us; if EMS is to actually become a profession, we’re going to have to innovate, mold it into a form that works, educate ourselves and promote, promote, promote to get the people behind us. Any less effort and we will go backwards in time and be “Load and Go!” once again.

Much of this installment has been taken from correspondence that Tom and I had over the course of this project. In the grips of Parkinson’s disease, he was unable to use the phone, so I never got to follow through with my original intent which was to do a Podcast with him.

There was about a year’s delay before the series appeared here. As soon as I had the installments written, I sent them off to him. Unfortunately, Tom’s health had deteriorated and he was under Hospice care. Elliot Farnsworth, his partner, passed on in January of 2012, before I could reach him.

On December 5th of 2012 I received this e-mail from Tom’s beloved wife, Shirley:

Hi Russ: I am sorry to tell you that Tom passed away peacefully the morning of Nov 30. He was at home being cared for by Hospice and his long-time caregiver Becky and me. The last few days of his life, Becky was reading your installments which he seemed to enjoy very much. Thank you for that. We will not be having a service but will have a memorial some time after the holidays.
Well, he knew we were listening, and I suppose that’s the best we could ask for at this late date. Attention was never anything he craved and, in fact, a large part of his replies to me were to direct my attention toward others!

Tom’s Obituary can be found here. There is a guest book for comments and I’m sure, if you’re so inspired, the family would appreciate a word or two.

(REFERENCES)

 
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