I work as an EMT (911) and resourcing is certainly a problem. In my small city, our response time is around 5 minutes, and if we need to upgrade to get paramedics, that’s maybe another 5-10.
However, if we are out on a call (and/or) the neighboring city is too, now the next closest unit is 15+ minutes away.. sometimes there can just be bad luck in that nearby units are already out on multiple calls that came in around the same time, making the next closest response much further.
for a heart attack or unstable angina, the most an EMT will do (for our protocols) is recognize the likely heart attack, call for paramedics to perform an EKG, administer 4 baby aspirin to be chewed, and monitor closely in case it becomes a cardiac arrest.
>my dad is dead, because his family members were too naive to know that the thing they were instructed to do by the state was a false thing.
We're told a lot of things by "officials" not because it's correct, but because it holds the least legal liability for official parties involved, especially anything involving healthcare. These officials also sometimes include doctors, who work to protect themselves and the system first, and then patients.
Incompetence and laziness among doctors is the biggest cause. As a professional you've probably worked with many colleagues you thought were bad. Well there are doctors like that too. Many of them. And unlike in tech, they don't get let go of they're bad. They stay around and keep "treating" patients.
Do you really think that in a high stress situation you’re going to make the best decisions?
Do you really think health workers are all concerned about legalities first?
Not moving a patient unless you explicitly know how is probably right the vast majority of the time. Sometimes that’s wrong, but how are you going to get the entire public to understand what the right situation is?
It’s so easy looking at a single case in hindsight. May we all have the ability to make the right choices all the time.
We're also told to do a lot of things by officials because it's correct most of the time, but with the benefit of 20/20 hindsight, generally correct advice can turn out to be dead wrong for you.
Sometimes doing what you're told is the right thing. Sometimes, not doing what you're told is the right thing. Sometimes, you're told to do the intuitive thing, and it's wrong. Sometimes, you're told to do the unintuitive thing, and it's wrong. It's hard to tell the difference between those situations, even when you're not stressed.
Something similar happened to a friend of mine. In San Francisco. I just sort of assumed it was just bad luck. Bad things happen occasionally even in good systems. But maybe that assumption is wrong? Is this a thing? Are ambulances just unreliable?
I’ve been reading Influence by Robert Cialdini and just finished a disturbing section about how we are wired to obey an authority figure even when it causes harm. In this instance, the 911 dispatcher was the authority figure. Sad story.
In such cases how do you in advance what causes harm? Waiting for the ambulance or driving yourself?
People died also because they didn’t wait for an ambulance.
> Last year, Toronto paramedics reported that in 2023 there were 1,200 occasions where no ambulances were available to respond to an emergency call. That was up from only 29 occasions in 2019.
> CUPE Local 416, the union representing 1,400 paramedics working in Toronto, has also reported high instances of burnout in recent years.
The federal government shifts the responsibility to the provinces, the provinces in turn try to download as much as possible onto the cities. There's not enough money for everything on every level of the government.
This also reflects on 911/dispatch systems, where there indeed might not be easy visibility of when an ambulance might be available, and even then it could be preempted by a higher priority call -- although a heart attack has to be close to the top of the list.
There are also occasional weather events, like the storm two days ago, that cause a surge in demand (>300 crashes reported and many of them needed attending to).
> The federal government shifts the responsibility to the provinces
It's not a 'shift'. Healthcare has always largely been in the hands of the provinces.
The federal government funds research, distributes money from have regions to have not regions, and sets federal standards, but the actual spending of money and provision of services is in the hands of provincial authorities.
Losing family is hard, but losing them suddenly makes it harder. Losing them suddenly because of poor advice or (in)action of people who are supposed to help is yet more difficult. I know from experience.
> my dad is dead, because his family members were too naive to know that the thing they were instructed to do by the state was a false thing.
Hindsight is 20/20.
There are also cases where people died because they didn’t wait for the ambulance. So without proper statistics that‘s a dangerous conclusion.
My condolences, very sorry for your loss.
I work as an EMT (911) and resourcing is certainly a problem. In my small city, our response time is around 5 minutes, and if we need to upgrade to get paramedics, that’s maybe another 5-10.
However, if we are out on a call (and/or) the neighboring city is too, now the next closest unit is 15+ minutes away.. sometimes there can just be bad luck in that nearby units are already out on multiple calls that came in around the same time, making the next closest response much further.
for a heart attack or unstable angina, the most an EMT will do (for our protocols) is recognize the likely heart attack, call for paramedics to perform an EKG, administer 4 baby aspirin to be chewed, and monitor closely in case it becomes a cardiac arrest.
>my dad is dead, because his family members were too naive to know that the thing they were instructed to do by the state was a false thing.
We're told a lot of things by "officials" not because it's correct, but because it holds the least legal liability for official parties involved, especially anything involving healthcare. These officials also sometimes include doctors, who work to protect themselves and the system first, and then patients.
Incompetence and laziness among doctors is the biggest cause. As a professional you've probably worked with many colleagues you thought were bad. Well there are doctors like that too. Many of them. And unlike in tech, they don't get let go of they're bad. They stay around and keep "treating" patients.
This is very conspiratorial thinking.
Do you really think that in a high stress situation you’re going to make the best decisions?
Do you really think health workers are all concerned about legalities first?
Not moving a patient unless you explicitly know how is probably right the vast majority of the time. Sometimes that’s wrong, but how are you going to get the entire public to understand what the right situation is?
It’s so easy looking at a single case in hindsight. May we all have the ability to make the right choices all the time.
We're also told to do a lot of things by officials because it's correct most of the time, but with the benefit of 20/20 hindsight, generally correct advice can turn out to be dead wrong for you.
Sometimes doing what you're told is the right thing. Sometimes, not doing what you're told is the right thing. Sometimes, you're told to do the intuitive thing, and it's wrong. Sometimes, you're told to do the unintuitive thing, and it's wrong. It's hard to tell the difference between those situations, even when you're not stressed.
Something similar happened to a friend of mine. In San Francisco. I just sort of assumed it was just bad luck. Bad things happen occasionally even in good systems. But maybe that assumption is wrong? Is this a thing? Are ambulances just unreliable?
I'm really sorry about your dad.
I bet he's proud of you for writing and sharing this to help others.
I’ve been reading Influence by Robert Cialdini and just finished a disturbing section about how we are wired to obey an authority figure even when it causes harm. In this instance, the 911 dispatcher was the authority figure. Sad story.
In such cases how do you in advance what causes harm? Waiting for the ambulance or driving yourself? People died also because they didn’t wait for an ambulance.
See also the Milgram Experiment.
Doesn’t fit here because you don’t know if obeying or ignoring causes the harm.
This is horrible. What is going on in Toronto that ambulances take 30 minutes to respond?
https://www.cbc.ca/news/canada/toronto/toronto-paramedic-sta...
> Last year, Toronto paramedics reported that in 2023 there were 1,200 occasions where no ambulances were available to respond to an emergency call. That was up from only 29 occasions in 2019.
> CUPE Local 416, the union representing 1,400 paramedics working in Toronto, has also reported high instances of burnout in recent years.
I’d assume it’s there’s X ambulances and Y calls and occasionally Y>X.
The bigger issue is the dispatcher not being aware of overloaded status nor conveying that information to the caller.
There are also things like accidents or traffic jams
TL;DR chronic underfunding of the system, here's one example article:
https://www.cbc.ca/news/canada/toronto/ambulance-response-ti...
The federal government shifts the responsibility to the provinces, the provinces in turn try to download as much as possible onto the cities. There's not enough money for everything on every level of the government.
This also reflects on 911/dispatch systems, where there indeed might not be easy visibility of when an ambulance might be available, and even then it could be preempted by a higher priority call -- although a heart attack has to be close to the top of the list.
There are also occasional weather events, like the storm two days ago, that cause a surge in demand (>300 crashes reported and many of them needed attending to).
> The federal government shifts the responsibility to the provinces
It's not a 'shift'. Healthcare has always largely been in the hands of the provinces.
The federal government funds research, distributes money from have regions to have not regions, and sets federal standards, but the actual spending of money and provision of services is in the hands of provincial authorities.
This story reminds me of how the high schoolers on the Korean ferry MV Sewol obeyed the instructions to stay in their rooms.
I don't have this one in my memory but... high schoolers? I'm not going to look that up.
There are a few docs out there on it, extremely extremely extremely insane/sad situation. https://www.youtube.com/watch?v=5_A8dq2fA5o
If the author sees this, I'm sorry for your loss.
Losing family is hard, but losing them suddenly makes it harder. Losing them suddenly because of poor advice or (in)action of people who are supposed to help is yet more difficult. I know from experience.
It does get easier to deal with, in time.
> my dad is dead, because his family members were too naive to know that the thing they were instructed to do by the state was a false thing.
Hindsight is 20/20. There are also cases where people died because they didn’t wait for the ambulance. So without proper statistics that‘s a dangerous conclusion.
>family members were too naive to know that the thing they were instructed to do by the state was a false thing
Would be interesting to see everyone who jumped in here yesterday [1] to comment on this one as well.
1: https://news.ycombinator.com/item?id=45889297
What terrifies me personally is that people with 2-digit IQs are apparently being employed to work as virologists.
So sad to hear this people who are supposed to save lives are taking lives