Me telling an EMS war story that brings the vibe to a crashing halt.

I’m not too worried about this, tbh. I think the people that RFK attracted post-Kamala really aren’t likely to vote for Trump or Harris anyway. They’ll likely either stay home, vote libertarian, or write in Vermin Supreme

America in one picture

Acquiring bird

Hey, thanks for sharing your thoughts. Just so I know where to meet you at, do you work in EMS? Because we could get into some technical details that might not be helpful or accessible to someone outside the field.

Some quick thoughts, though:

A. It’s fairly common that we have to medicate patients without their consent. For example, someone suffering an opiate overdose is incapable of consenting to getting narcan; there are other times where patients may be in an alert but confused state that necessitates treatment while they’re not competent to assess the risks and benefits or refusing or accepting care. When I worked in a metro area, we got a decent amount of combative patients who were too confused to make their own healthcare decisions, but needed to receive treatment, including physical and chemical restraints, to stop harm to themselves or others. Somebody having a medical event that’s causing them to be confused and combative (I’m speaking generally here, not about Elijah) is usually not someone you’re going to be able to have a rational discussion with about whether they consent to getting some medicine to help them calm down. In my experience, the decision to medicate is not typically done at the request or order of police officers, and is more of a judgment call between the paramedic and the base hospital doctor they call in to; which is where I think Aurora has terrible policy, because it seems like they were deciding to medicate to support the police in their job. There is no room for cops in a provider-patient relationship, imo; the patient needs what the patient needs in order to preserve their life and come to no further harm, nothing more, nothing less, and that definitely shouldn’t be dictated by someone who isn’t a healthcare professional.

B. We don’t have scales in the field, and I don’t know if you’ve ever tried to weigh someone while they try to fight you, but it doesn’t work well. Estimated weights are what we have if the patient can’t/won’t talk to us and nobody else knows, that’s just how it goes. What I will say is that Elijah McClain was 140 lbs (that’s ~65 kg, rounding by fives), and him getting the full weight dose seems wildly inappropriate. I have a hard time imagining how that paramedic looked at a 5’6" 140 lb man and said “yeah, that’s about 100 kgs”; my guess is they either wanted to really knock him on his ass and rounded up (bad), they asked the cops and the cops lied their ass off (why would you ask the cops for a weight?!), or they were just lazy and went with a dose they knew (also terrible). It IS possible they just screwed up and really believed he was that big, but I find that a little difficult to believe because it’s such a huge weight discrepancy.

EDIT: According to this article: https://www.cbsnews.com/colorado/news/colorado-jurors-watch-recorded-testimony-aurora-paramedics-accused-death-elijah-mcclain/ The paramedic makes a few claims that seem a little strange to me. First, that the five CC strangers don’t have adequate markings for delivering a well-measured dose. All of the 5cc syringes I’ve used for drug administration are marked out to 1/5cc precision, which should have been sufficient; and if it wasn’t, they should have used a different syringe or not given the medicine until they felt they could do so appropriately. Then, he claims that they’re taught to give either 300, 400, or 500 mg based on whether the person looks small, medium, or large. That doesn’t seem consistent with any clinical education program I’ve ever been to. Lastly, he reported that he estimated that Elijah was 200 lbs and roughly 6 feet or “big”, and that since he was over the 400 mg mark, he just rounded up to 500. At 5 mg/kg, ~65 kg, an appropriate dose would have been 325 mg, not 400, definitely not 500. The paramedic fucked up here, no bones about it. I still believe that the system never should have put medical providers into this relationship with the police in the first place. If the cops want tactical sedatives, let them take that up with the FDA and DOJ, leave us the fuck out of it. After reading up a little more, though, it’s clear that the paramedic really screwed up the weight estimate. I’m willing to accept some leeway for the fact that the scene was hectic and it may not have been exactly easy to estimate his size, but they nearly doubled the weight estimate, which seems like a pretty extraordinary screw up.

If there’s any basis for convicting the paramedic, this really terrible estimate is it. Now, as for just trying half the dose and seeing what happens, that’s something we can’t do. Paramedics cannot practice medicine except under a doctor’s license, so we have written orders from doctors that indicate what we can do and how we can do it. If we just go wild catting half doses without any kind of physician guidance, that’s practicing medicine without a license and you can get in very serious trouble about that.

C. Ambulances are not ERs. We have a pretty narrow set of choices for treating any given problem, and the way those choices are applied are often firmly dictated by protocols or physician guidance. The crew may not have had other options for chemical restraint.

Broad strokes, I think the crew fucked up by using a weight estimate that should have been obviously inappropriate. However I also think that this is just throwing the crew under the bus to save a system that deserves a kick in the teeth too. Basically giving people ketamine because the cops decided to fight them is terrible practice, and, imo, fire administrative staff, law enforcement administrative staff, and the local medical director (who writes the protocols for Aurora Fire/EMS) bear a share of the blame that is at least as large as the EMS crew’s for even setting up the system to have allowed this to happen in the first place.

I don’t know that I’d agree that the EU and the articles of confederation are comparable. There were a few big differences, including states printing their own currency without a common exchange medium (as opposed to the Euro), and that the mechanism for funding the federal government was (IIRC) entirely voluntary. States could just choose to not send money without consequences, and most or all made the obvious choice of not funding the federal government. The articles of confederation also had a few things about it that were more progressive than the constitution; for example, if I’m remembering right, it offered automatic citizenship to all native Americans, which pissed a lot of the farmer-settlers right off.

This is how nations destabilize. States perpetuate themselves through maintaining the exclusive monopoly on violence and using that monopoly to secure certain guarantees for or against its people. The Roman empire saw a similar decline of administrative willpower and rises in both vigilantism and shitty little civil wars between the wealthy elite who really ran the show (spoiler alert). I’m convinced that Balkanization of the US is, at this point, inevitable. I’m not saying that’s necessarily a good or bad thing in its own right. On one hand, it might be better for both the states and the world if we went to more of an EU type structure. On the other hand, a nuclear armed independent Texas.

This is really cool, but it would have been cooler if they’d named their scouting missions Hugin and Mugin, since they’re Odin’s ravens that scour the earth for secrets to give to Odin.

Babe, wake up, we finally found left-lib killdozer

Oof. There’s fucking up, and then there’s getting banned from Wal-Mart. The only lower position is getting banned from the dollar store.

For me, Wolf Larsen represents or embodies Satan (at least, Satan as a literary figure). His ship is a veritable ship of lost souls, all of the ship’s hands are either recruited in drunkenness or fleeing something that seemed worse at the time. He’s incapable citing scripture, which would be a really uncanny thing for a captain of his day, and even curses God.

The way he finds Hump even parodies the Divine Comedy; Hump (Dante), an honest but kind of hapless writer, becomes lost. The man who would guide him comes and finds him, and lo and behold, his guide is no Virgil, but, rather, Satan. Imo, the thing that really sells this is that Hump passes out underneath the golden gate (passes through the gates of hell) and is lost and found in the fog, which mirrors the conditions in the first circle of hell, Limbo. Rather than spending their voyage showing Hump what has happened while preventing him coming to harm, Wolf puts Hump in harm’s way and spends the voyage trying to convince him of what is. By the end, the formidable captain, much like the Satan of Paradise Lost, is bound in darkness, remaining proud and sure to the end.

It’s wild how good this book is relative to how few people have read it.

“The only part I remember is ‘I now commit this body to the deep’”

Read the article, sounds like he was combative post-ictal. I’m not excusing the officer; it’s a thing, not the most common, but I’ve definitely had my share of dudes that would just hulk out after a seizure. There’s no real reasoning or logic to it, they don’t mean to be combative. I think it’s down to the lights being on while monke brain is down for the count, so lizard brain senses all the hallmarks of a fight or flight situation in the wake of the seizure and decides “fuck it, we ball”. This is definitely a situation that needed medical professionals. We’ve always managed these situations without bringing the patient to any harm, all while still protecting ourselves. Cops aren’t taught those skills, especially not since the war on drugs and war on terror allowed them to tell themselves that they’re the warriors on the Frontline, the thin blue line that seperates the good from the wicked, yadda, yadda, yadda. When you’re a hammer, everything looks like a nail, etc. The smart thing for the cop to have done would be to listen to the wife and remove himself from the situation until EMS arrived.

I fuck with this energy, let’s get it done!

What the fuck, why were the police involved at all?

Sincerely,

A paramedic

Edit: ahhh, read it again, she said he wasn’t breathing, so the officer may have been intending to perform CPR until Fire/EMS arrival. Still don’t understand how tf you bungle a situation like this so badly.

I don’t know if I can; it’s not, well, in my lane as a bicycle/pedestrian committee member. I still show up and advocate for lane narrowing and traffic calming at the city council meetings.

Edit: disregard. I thought you meant lanes, you clearly mean sweepers

I’m trying to secure wholly separate bike lanes, or at least flexi-posts, anything but a sharrow or a line of paint. Tbh, I dunno how that’ll work with a street sweeper.

Day 30 of being fucking bewildered that I, a non-voting member of my city’s bicycle commission, have stricter ethical laws binding me than those for judges and politicians.

I wish they’d explored this more in Voyager, as rationing their energy reserves was always a narrative tension throughout the series. It would have been interesting to explore a crew used to post-scarcity economics have to wrangle with switching to scarcity economics and all of the problems that come with it.