Aug 122015

Inhabiting my current world is a cadre of emergency care providers who are often less than half my age. I feel humbly grateful to have the health and well-being to remain in their midst, and to feel accepted as one of them despite our generational differences.

It occurs to me, though, that as an elder in this crazy, wonderful world of providing assistance to those who call for help, I have perspective that they cannot. Although history sometimes seems irrelevant to those who have not lived it, perhaps it doesn’t hurt to be reminded, now and then, that today’s status quo didn’t come without someone proving it could be done.

The moment I heard the term “Emergency Medical Technician” in 1973, I knew instantly it was what I wanted to do. It took until 1976 to be in one place long enough to get my EMT certification. In January, 1979, when I graduated from paramedic training, the world of prehospital care was still being invented. Along with my colleagues at the City & County of Denver Paramedic Division (as it was named then), we had that heady, somewhat arrogant, full-of-ourselves energy that came from being at the front end of a brand new thing. Those were the days of organizational adolescence for EMS, and it was sometimes a wild, hairy ride—but it was seminal and serious, too. We expected great things of one another, and we delivered. With the backing of exceptional physician advocates (Peter Rosen, MD, Norm Dinerman, MD, Gerald Gordon, MD, Peter Pons, MD, and many others), we forged and sculpted a prehospital system whose reputation endures today.

The Patch

On August 7, an impressive gathering of aging, now mostly-retired paramedics from those early days gathered to honor Bob Marlin, one of the original DGH paramedics and for many years our Chief Paramedic. Bob died on the August blue moon after a short, surprising illness. His passing is a jolt, a wrench, a terrible emotional tug for everyone who knew him. An inspiration to hundreds of EMS providers at emergency response agencies throughout Colorado’s Front Range and an educator of the highest calibre, Bob had a well-attended send-off that spoke volumes about his legacy.

Just some of the emergency vehicles at the service

The invention of prehospital care gained its real footing in the mid-1970s, when Bob graduated from the first paramedic program in Denver, a hybrid effort between Denver General Hospital’s “Alpha” class and St. Anthony Hospital’s “Cycle 1” class. In January 2016, they will begin Cycle 99, yet how well I remember feeling like such a rookie when I emerged from that pressure-cooker of a course in January 1979 as a member of Cycle 7.

As I began my paramedic career, it was to Bob Marlin and three other inspirational, capable, and wise paramedics (Art Kanowitz, Paul Fuller, and Jim Dernocoeur) that I looked for ways to do this work right. Many of the 7-10 calls in our 10 hour shifts made us collectively worthy of our nickname: the Knife & Gun Club. The field instructor program wasn’t quite up and running yet, so these amazing men were my partners and my teachers. Time and again, they showed me by their example and instruction the way to find the compassion, patience, caring, and calm in the face of the horrendous things we witnessed and handled. Those four men did more than anyone else to frame the world of EMS in the warm light of competence—no, excellence—for me. What a gift for me to have the opportunity of carrying their messages through my work as an EMS journalist out into the wider population of prehospital care providers. If you have ever read Streetsense: Communication, Safety and Control, or any of my articles in JEMS, Emergency, EMS World, or any street-related advice which has inevitably trickled into the national curriculum and EMS textbooks over time, you have already met these four men. They are the ones who showed me—us—how to do this job right. You, too, are part of Bob’s legacy.

Because the medicine is the easy part. We can all learn the medicine. It really doesn’t change that much, one chest pain or fracture to the next. What changes are the circumstances. The patients. Their families and loved ones. The neighbors. The territory: private homes, public stages, mean and crazy streets. Our own responses shift the dynamics, too, depending on the time of day and how hungry or tired we are, as does the way we interact with the first responders, law enforcement, and others.

Bob and Art and Paul and Jim gave me the interpersonal tools to use on those streets. And now Bob has left us. It’s hard, both because he’s gone, and also, so are those times. The world of EMS—as happens when organizations mature—has its systems and processes in place. There’s a logic to the order now that was just being developed then. And none of us can believe we’re getting, ok, older. (Bumper sticker: “Inside every old person is a young person wondering what the hell happened…”)

And so we gathered just after the blue moon not just to honor Bob, but also to honor the pioneering work we all did together “back in the day” with him at our helm and with the guiding hands of people like Paul, Art, and Jim. Those were the sort of times that frame entire lives, as ours have been framed—with memories of doing amazing things in amazing times. I wish that everyone could find for themselves a chance in life to feel amazing, they way these men taught me to do.

It was a sad reason, but a good visit with former DGH colleagues

Our former medical director, Norm Dinerman, wrote the following in homage to Bob:

“If at the end of the day our face is the last human visage a patient sees, and our hand is the last touch that they feel, are we worthy of that trust and the sanctity of that moment? Bob would ask nothing less of us. To the extent we can answer in the affirmative each day, we will continue to honor him in our lives. Let us endeavor to do him proud, forever.” Indeed.


  3 Responses to “In Honor of Great Teachers”

  1. Yes! History IS good! And the internet needs to remember a few things that are… gasp… more than 15 minutes old. Good article.

    In a similar vein, can you believe that the hospice movement is “new”?? Odd, really, it didn’t exist earlier, given that back when it was unknown, we had fewer treatments to offer the dying. Thank heavens someone WOKE UP and got that going, too.

    And thank heavens for an end of the old scoop and run. Even with no paramedic training, and even at a young age, I thought it uncomfortably ironic that ambulances were just hearses painted white.

  2. Kate – A great summary of the many names I recall and some of whom I knew, albeit from a hundred miles away from another growing EMS system on the western slope. Having gone through the Swedish paramedic class in ’79 I remember well my first ride along with DG. While we were taking a quick break at a fast food on north Colorado we heard gun shots from across the street. The paramedic driver called it in, “shots fired near Church’s Chicken north CO Blvd.” As we cleared the parking lot I could see 2 bodies in the nearby parking lot, a third hanging partially out of a car, the doors open, car halfway to the street. Backup was on the way and we scooped the most serious, cops not yet on scene; IVs enroute as we cleared traffic back to DG, the hand off to the ED team, the struggle for a life. What a first ride in the big city! And if only I could remember the names of that crew.

    During those brief moments of chaos I was reminded of my time as a platoon leader in SE Asia in the late 60s and later with Marine Recon. I had not shaken the adrenaline hangover from those years and here I was, immersed in a new culture of young lions creating the landscape of modern EMS and showing me the aggressive actions needed to save lives. But now, it was more than adrenaline, more like Norm Dinerman’s comment, “Are we worthy of that trust and the sanctity of that moment?”. I took those lessons from the city and while my 30 years was more car crashes than knife and gun club, I am forever grateful to the many people you mentioned in teaching the lessons of trauma care and respect for the profession.

    I regret I did not have the opportunity to get to know Bob personally but we did talk on the phone a few times over the years, likely me asking him advice on some EMS matter or another. I can only imagine your tribute to Bob and the sharing of memories and nostalgia from those years. You were all pioneers and leaders of that era. Thanks for sharing the names and faces.

  3. Wonderfully written, Kate! I can feel the warm, respectful bond you have for teachers and especially these teachers in this place of work that was just learning its foundation.

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