An employee of the city of Boston was fired Friday for taking part in protests on I-93 in Milton on Thursday that snarled traffic for miles and diverted an ambulance, according to Boston Mayor Marty Walsh.
The youth communications specialist with the Department of Youth Engagement and Employment was arrested Thursday and charged with resisting arrest, conspiracy and willfully obstructing an emergency vehicle, according to Walsh.
Walsh did not provide the name of the employee, but did confirm they were a contract worker who had been employed by the city for two months.
On Friday, a hearing was conducted with the employee which resulted in the termination of their employment, according to Walsh.
“Mayor Walsh strongly respects the right to protest and the right to free speech, however finds it unacceptable for a City employee to put public safety at risk,” a statement Saturday from Walsh’s office read.
The protests shut down Interstate 93 northbound at East Milton Square south of the city, and I-93 south at Mystic Avenue north of the city.
Some of the protesters in Milton were sitting on the highway with their arms shoulder-deep inside sealed 1,200-pound barrels that appeared to be filled with cement.
Due to the backup caused by the protests, an Easton ambulance was forced to take Richard McGrath, an 83-year-old Easton man with “life-threatening” injuries, to a hospital less-equipped to treat the patient.
“… Firefighters first had to cut down a tree and then extricate McGrath from the vehicle, the chief said. That took about 20 minutes, and McGrath was on board a department ambulance at 8:02 a.m.
The diversion occurred about a minute later…..”
“Easton Fire Chief Kevin Partridge said firefighters driving the ambulance with McGrath on board were en route to Boston Medical at 8:03 AM when they were alerted to the bottleneck created by protesters who closed off the Southeast Expressway.”
Back in the day, I used to know an awful lot about ambulances and long-distance ambulance transfer and life-threatening emergencies and such like.
When I was a area and regional EMS planner/coordinator/administrator charged with the development and improvement of an EMS system, I used to be a heavy proponent of what was called EMS Grand Rounds.
Yes, lil ole me actually wrote the first statewide plan for EMS in Massachusetts, working for Sylvia Queen, who’d been appointed by Governor King. I was a junior assistant ‘royal court bailiff’ for the office of emergency medical services in the state department of public health who was recognized to have the ability to write coherently in volume, and I was given the 15 components of an EMS system and a typewriter and a desk.
[Eventually, I also wrote the first set of first responder training regulations, a position paper that insisted on standards for free-standing emergency care centers, and an effective regional mass casualty incident response plan. For four years, I ran medical conferences in emergency medicine and trauma management for emergency physicians and emergency nurses.]
I’d cut my teeth in the ambulance business working for a large private ambulance company in the Springfield/Chicopee/Holyoke area and was the shift supervisor/dispatcher when the call came in from Boston:
“Send me everything you got; we just had a plane crash at Logan.” [Delta Flight 273]
I said “no!”.
I’d driven the Mass. Pike many times, sometimes two or three times a day, transferring people with “life-threatening” emergencies from local hospitals to the big centers like Massachusetts General Hospital.
I’d pilot a Cadillac ambulance over-stuffed with attendant/EMT, the patient, extra special equipment, a nurse or doctor (sometimes both) at 120 mph.
The day that phone call came in about Flight 273, I had at my command a fleet of 8-10 of these.
If you want to make way in a hurry on an Interstate highway at that kind of speed, there are certain techniques:
- all lights flashing, especially the white headlights (illegal if installed on a personal vehicle);
- no sirens;
- straddling the line between lanes.
You’d think a police escort could be used but experience shows they are are much more risky than helpful; we simply notified the State Police of our route and departure time and they watched for us as we streamed by, as did the State DPW vehicles who also had radios and could also call ahead (or backwards) to have key traffic routes identified, routes re-drawn, etc.
At 120 mph, the ride into Boston still took an hour. (You can’t do 120 for every inch of the trip. The record was fifty-five minutes. Hey, Norm! )
Nowadays, ambulance design and structure is more strictly regulated by the U.S. Department of Transportation and they look like a box. This is beneficial because the box has a lot more room for gear and people and it can be turned into a hospital room in miniature when necessary.
But the boxy nature of the vehicle makes it far less likely to be driven at 120; I doubt there are many situations in which such a vehicle is brought to that kind of speed. The rollover risks would double with every added 5 mph, particularly if there’s a curve, another driver who didn’t see you, etc. With a patient with a possibly-fractured neck or spine, you’d be looking for the least bumpy road.
But that’s okay because in today’s EMS system they’ve replaced the need for long emergency transfer by highway with trauma helicopters sometimes called MedFlight. The big trauma centers have them. Trauma is big money. Everyone wants a bigger slice.
This “Ferrari” was an upgrade to the old pick-up truck used by the trauma center in the center of the state.
But the icing conditions that morning grounded the birds.
On a different day, that old fellow would have been in a trauma center very quickly; these things cruise in a direct line, without having to stop for anything, at 160 mph. The birds are hummingbirds. Landing zones are pre-planned, and drills with local EMS squads are routinely done.
So the super-sophisticated tools weren’t available; ack! what now?
Well, the system is designed with multiple brains. You use time to think, and you ask others to help you think in parallel.
[Note that I’ve also read almost three hundred books on performance psychology, team-building, and coaching, and digitized much of it into blog entries, an e-book, and more. A re-mastering of that product line should be underway soon.]
The first brains are the people in the ambulance; the second rank are the officers and dispatchers who are aware, as we see here:
But the fire chief wasn’t thinking fully. Yes, he was properly concerned for the patient, and the public he serves.
He may have also been stuck in the rut of thinking that his asset and its cargo were headed into Boston, and Boston must be the destination. Boston has a very high concentration of trauma centers and because of the hub-of-the-wheel nature of the road net and the city, they’re all within blocks of each other.
Here are two lists of trauma centers in Massachusetts. We are proud of our capacities here in Massachusetts.
Hooray for our side.
Scroll down past the application to the attachment.
Remember I mentioned EMS Grand Rounds?
Nobody in Massachusetts EMS ever wanted to do them. Why?
Grand Rounds in the world of medicine are where people get called to discuss and account for their mistakes.
You’ve undoubtedly seen a few of them on some TV medical show. They are meetings. There’s a hierarchy, and it will make itself known soon enough.
The meetings are ones in which certain cases are presented slowly so that those in attendance can think along with the man or woman who was wearing the decision boots that day (and, yes, in medicine, and in EMS, lots of people wear decision boots across the space and time involved).
The Department of Medicine at the Yale School of Medicine sponsors a “Writing and Medicine” Grand Rounds which features various physician-authors.
Grand Rounds are designed for learning. Humility is your trump suit if you’re in attendance.
I should have been called to present my case that day I said “no”.
I can still defend that decision.
When you are on the carpet in a Grand Rounds, the heat under your collar goes up. You are under the spotlight of your peers and your teachers.
A Grand Round is designed to examine the way you were thinking, the questions you asked, the answers you got, and the anticipated and outcomes of your decision. When attended by many people from throughout the system and the state, everyone learns more.
Here, in this case, we had a number of people involved.
[Note that my experience also includes the early development of CME events online for physicians, learning about building “communities of practice” online, as a beta-tester for the e-mail based six-week-long “Games of Games” developed by a consultant in organizational development, and being the subject matter expert in the development of a PC-to-PC five-play game focused on emergency management.]
My distress as a knowledgeable blogger is that the politicians got involved after the fact; the system leaders spoke out sharply, like the Mass. State Police colonel.
The Mayor of Boston found a scapegoat so he could send a message to city employees. But neither the Mass. State Police colonel nor the Mayor of the City of Boston had or have a role in the case, or in the EMS system.
A third and wholly-different brain is involved in EMS and it serves as the system’s corpus callosum.
Called CMEDs, there are five of them scattered throughout the state and their role is to enable controlled conversation among numerous parties, especially between doctors and ambulances. CMED stands for central medical emergency direction. A CMED maintains numerous status boards and can tell at a glance or with a radio or phone conversation what is going on anywhere within the state.
CMED Centers play a role in coordinating EMS communications by:
assisting EMS field personnel with communication during emergencies
managing Medical radio channel usage
maintain a clear procedure for EMS communications within a region
connecting EMS field personnel to local Emergency Departments and Medical direction
providing interoperability with other public safety agencies
CMED (Central Medical Emergency Direction) relies on a network of radio towers set up strategically throughout [the state].. Through these towers… an ambulance can contact CMED via radio and request entry notification to a hospital of destination. This provides physician access and ensures that the emergency department is aware of the patient’s pending arrival. CMED also plays an important role in coordinating EMS response to Mass Casualty Incidents and patient distribution from the scene to the hospital. CMED is crucial to the coordination of communications between ambulances and hospitals and ultimately contributes to optimal patient care.
So the other thing you need for your Grand Rounds case notebook is a map of Massachusetts and perhaps a modicum of familiarity with its road net. But you can work with simple distance scales and you’ll have everything you need. Get out your favorite online mapping tool, zero in on Southeast Massachusetts, and place the pins or colored dots where you need to, and think through the process.
Remember you have a little time (the poor fellow had to be carved out of his vehicle before they could load him into an ambulance and, meanwhile, at least three of four nerve centers of the state EMS system could have been put to work thinking out the simple answer.)
[The simple answer is in one of the links; I’ll provide it to you at the end.]
So I call bullshit on the politicians and everyone else on down and say simply “spend more time making your system work and the diversion would not have had to have happened”. Instead, like so many things these days, this case has been turned into a political bludgeon.
Should the protestors have been chained to the barrels in the middle of the highway at rush hour?
Before I answer the question, I’d ask the State Police colonel in a uniform widely-recognized and respected, and the Mayor of Boston in his first term of office in a city where black kids get shot regularly on the streets, to consider that, just six weeks ago, a former USAF pilot in special operations, someone among Esquire Magazine’s “Best and Brightest”, and author of a book on open source warfare, published a blog entry with clear directions on the use of GPS-guided drones which could carry a payload of over half-a kilogram of caltrops that “can shut down automobile traffic on major highways for hours.”
Good thing terrorists can’t read this stuff, I guess, huh?
Oh, look, another reason to shut down the Internet, the global grand rounds for everything.
“Will the FAA effort to control drones protect against this type of disruption? No. It won’t.”
So my answer to the question “Should the protestors have been chained to the barrels in the middle of the highway at rush hour?” is
You wanna know why?
Because most of what passes for leadership these days has to be hit over the head with a 2×4 just to get their attention.
Sometimes it takes repeated application. Politicians have forgotten how to communicate.
Because they are so busy being hung up on their own role or their own image or their own power, they haven’t a frickin’ clue about how good this society could be if it didn’t spend its time making war, war weapons, standing up to hide war criminals, criminalizing rights that are supposed to be engraved within the Constitution, or otherwise providing justice and simple direct service to its people.
They don’t have the slightest idea how to achieve excellence.
They are mired in petty and destructive mediocrity, and people are getting sick of it.
For me, this isn’t about disrespecting authority, or being an anarchist.
This is about somehow, despite everything that has gone down in the last decade and a half, still maintaining a kernel of respect for authority and government.
That kernel has been beaten down into the size of a tiny seed, but it’s still a seed; there is still enough respect for authority and government to ask them to do a better job.
The answer to the question about what the ambulance/firefighter crew should have done, by the way, is simply thinking outside the box.
In the actual event, there should have been a steady and calm cross-talk among dispatchers, State Police traffic status systems, CMED’s, and emergency/trauma doctors.
Everyone that day was thinking inside the box.
The distance from Easton to Boston is 29 miles and requires an estimated 40 minutes driving time, according to http://distancescalculator.com.
The distance from Easton to that other trauma center is 28 miles and requires an estimated 33 minutes driving time.
That other trauma center is in one of the oldest cities in the United States and is the third-largest city in the New England region after Boston and Worcester. A religious exile from the original colony named it in honor of God’s merciful Providence.
Mr. McGrath would also have found the required medical mercy at Rhode Island Hospital, a Level I Trauma Center located in Providence, RI.
Maybe the rest of us can find manifestation of divine care or direction, prudent management of resources, and foresight
when the politicians stop talking and start listening.