Gerald Gordan, MD, was a legendary educator of paramedics, especially in the area of cardiology. He was much-loved by legions of early EMS providers in Colorado. I remember feeling both honored and a bit terrified to interview him for Colorado's "EMTAC Star" (the newsletter for the EMT Asso. of Colorado) in 1984 or 1985.

The gentle man and quiet doctor who has struck terror, nonetheless, into the hearts of many a paramedic student who wished not to be asked to interpret a particular EKG strip, sat with me for an hour of reflection on his role in EMS in Colorado. Dr. Gerald Gordon, an attending physician at Denver General Hospital (DGH) Emergency Department, and long-time paramedic instructor, has always expected — and got — higher than standard abilities to rapidly read EKGs from his students. He is hard to pin down, but when you do, out comes the ubiquitous pipe and a distinctly grandfatherly aura.

Dr. Gordon wrote the entire curriculum for the "alpha," "beta," and "gamma" classes at DGH in the early 1970's. Those pilot courses were, he said, "a lot of hours. Much more than today. But they were hours well-spent, because the guys were just super-good in the field."

He decided from the outset to teach cardiology in depth. First, telemetry wasn't available. Second, he said, "l think the electrocardiogram is a beautiful, non-invasive tool. It gives you an awful lot of information . . . You don't have to go to medical school to do it."

In about 1975, Dr. Gordon went to Pittsburgh for a meeting at which the DOT curriculum was unveiled. "We chewed it over for a week. I came back from the meeting with an idea that I would have to have a lot more organization in training paramedics, and that it would have to be aside from work, somehow." His association with the St. Anthony Emergency Training Institute began at that time, with paramedic Cycle #1. The school is now up to Cycle #28. Dr. Gordon estimates he has taught about four or five hundred paramedics.

The number is impressive, of course — but is also troubles him. He originally thought the students in the three original DGH classes would be all, that they would then stick with their chosen profession. Now, he is concerned about what he calls the "half-life" of the paramedic. "As that becomes shorter, then it is not cost-effective to train the student in a lengthy program. You either have to decide that you don't want paramedics doing everything we think they should do, or we have to hone in on some areas and make it cost-effective. It is expensive to train people."

Another concern of his is that, unlike the early paramedic students, who had considerable skill before they came to school, "what we're looking at is people who don't. Their background experience and skills are weak. And I'm convinced that you can only remedy that to a limited extent in the classroom, that there is no substitute for skill except doing it. In clinicals, you don't learn that much because you're not doing it. You're not out there alone, making decisions."

Thus, he feels. paramedicine is in its heyday right now, and that some retrenchment is inevitable - possibly to a more wide-spread and less capable intermediate level of care.

"I know I've been disappointed that a great many of the people I've trained are no longer in the field. I'm very pleased that some 13 or 14 have gone on to medical school, and others to other departments or into administration. There's a natural attrition: people migrate to something better. But I see some 5-year men. They're burned out. They don't like to teach; they're comfortable doing their job, but they're not really turned on," he said, speaking of the paramedics that he sees from all the different ambulance services.

Regarding the purpose and importance of paramedics creating and belonging to their own professional organization, Dr. Gordon said, "I think a professional organization is desirable. There's apathy in the masses about ever.)' professional organization. But I think it has the role of speaking for the profession with a collective voice, and addressing issues that arise in the interface between the profession and those it is beholden to: the state, the physicians, emergency department administration, ambulance owners and administration, legal interfaces, and interfaces with the consumer. I think a profession grows up when it has a study population that is interested in it."

Dr. Gordon hasn't got a lot of time to devote to personal interests, but he makes it a priority nonetheless. He is father to seven children ("and I'm only 28!"), and grandfather to four. He enjoys exercise easily shared with his wife, such as bicycling, fishing, and going to the mountains. Most of his other free time is devoted to church activities, reading, and "I just love to fix things up around the house."

In his years as a cardiologist, he said, "the world has changed." He came to Denver General in 1965, and started its coronary care unit in 1967. He had taken his medical training at Harvard, followed by internship at Barnes Hospital in St. Louis and residency at Duke. A fellowship in cardiology at University of Pittsburgh was followed by two more years of fellowship at University of Colorado. He tells stories of making house-calls on post-myocardial infarction patients too sick to go to his office for follow-up appointments. Not a few cardiac-arrested while he was there. There were, of course, no portable monitors. There wasn't even basic CPR in his early days of practice.

"The world has grown up," he said. "It's become more complicated in technology, more hospital-centered. There becomes a more cut-and-dried technical exposition of the problem by the physician, and not so much of the human kind. I think that's what's been lost. My colleagues are well-intentioned, and they work very, very hard. But it you have a lot of procedures to do and you have a lot of patients to see, you just can't become so involved with their problems."

Not true, through, of the man with the pipe and white lab coat embroidered Gerald Gordon, M D, who somehow signals that his awareness of the human dimension of life to a patient, a paramedic student, even an afternoon interviewer — is still sharp, and clear.