[Brackett is addressing a legislative committee to promote support of the bill to allow paramedics to operate]
Dr. Kelly Brackett M.D.: Gentleman, you are all in danger. If an earthquake or a bomb should hit this room right now, I might be the only doctor available to all of you. Oh sure, independently owned ambulances with attendants would be here in a few minutes, and rescue units from the fire department. But all they could do is carry you off to where another doctor is waiting. I wonder if you could all last that long. Now, what about first-aid? Sure, these men are permitted to render some elementary first-aid. Like your mother did when some kid bloodied your nose, or your wife when she pulls a sliver out of your finger. Have any of you seen a freeway accident lately? I mean up close, where you can't tell the bodies from the steel. Or, have any of you had a heart attack recently? Seventy percent of all cardiac cases never live long enough to reach a hospital. How do you think your mother, or your wife, or the good-guy next door would make out under those conditions? Well, those *are* the conditions we're talking about. Now, I've given you the impression I'm in favor of fire department personnel, with a crash course in emergency medicine, taking human lives into their own hands. I am not. I'd like to see a specialist handling every bloody nose, so we'd know whether it's the result of a good right-cross or a tumor. I'd like to see a cardiologist on the scene every time someone drops in the street with a killing pain in his chest. But, you can't ask someone not to die while you're trying to find out what's wrong with him. And they *do* die, gentlemen; on the way from where it happens to my hospital. They die by the hundreds every year; not from mortal wounds, but from neglected wounds. Not from incompetence or indifference but from time, from lack of time. I'm in favor of more doctors, more hospitals and better equipment. And, I'm also in favor of this bill until those other things come along, because it *will* save lives. Maybe a dozen lives, maybe a thousand, maybe just one. And, who knows which one? Thank you, gentleman, for your time.
Battalion Chief: Gage.
Paramedic John Gage: Yes sir?
Battalion Chief: That special training program. Remember? We were talking about it a couple of days ago?
Paramedic John Gage: Yes sir. The para-something-or-other...
Battalion Chief: Paramedics. The first class just finished last week.
Paramedic John Gage: Good.
Battalion Chief: I'm supposed to encourage all our young rescue personnel to volunteer for the next class.
Paramedic John Gage: Yes sir. Wellll, I guess I'm just too stupid to take advantage of such an opportunity.
Battalion Chief: I know it's work. No raise in pay. But, it just might be worthwhile.
Paramedic John Gage: It might be, if I wanted to be an ambulance attendant; but I don't. Chief, I'm a rescue man. I trained to be a rescue man and I like being a rescue man. Now, why should I die from improvements?
Battalion Chief: Why should you?
Dispatcher: [tones sound] Squad 10. Truck 127. Possible high-voltage electrocution. 13270 Flower. 13270 Flower. Cross street Third. Time out, 07:51.
Battalion Chief: You like being a rescue man.
Paramedic Roy DeSoto: This application isn't signed.
Paramedic John Gage: I wanted to talk to you first.
Paramedic Roy DeSoto: Sure. What do you want to know?
Paramedic John Gage: You went through that first class of special medical training, right?
Paramedic Roy DeSoto: Right.
Paramedic John Gage: If you rolled on a rescue call now. Today. Could you use that training to treat a victim on the scene?
Paramedic Roy DeSoto: No.
Paramedic John Gage: Then why should I, or anybody else, spend twelve weeks, or twelve minutes, learning to do what we can't do?
Paramedic Roy DeSoto: Because you said *today*. There's a bill before the state legislature right now, Assembly Bill PM 11307, that will permit qualified fire department personnel to administer medical assistance in the field.
Paramedic John Gage: *If* it's passed.
Paramedic Roy DeSoto: You've asked a few questions before you came in here, didn't you?
Paramedic John Gage: I want to find out if it's a job, or just a title.
Paramedic Roy DeSoto: It's a job all right. It's going to be the most important advance in emergency medicine in the last fifty years.
Paramedic John Gage: Going to be. Well, maybe you'd better just hang-on to that application until it is.
Paramedic Roy DeSoto: That'll be too late. We're already late. Gage, there are over six-and-a-half million people in Los Angeles County right now and not nearly enough doctors to handle them even under normal conditions. When you get into an emergency situations: freeway accidents, drownings, heart attacks and a thousand others, people are dying at the scene! People who could stay alive if there was somebody at the spot who knew what to do!
Paramedic John Gage: But they won't let you fuction.
Paramedic Roy DeSoto: They will. They'll have to. Look, if that bill passes in the Legislature today, do you know how many people we have ready for the job?
[Gage shakes his head "no"]
Paramedic Roy DeSoto: Just me, and five other guys who took the training course. Six men for six-and-a-half million people. No, we can't wait for the go ahead and then train our people. If there's once chance in a million that bill will be passed, we have to be ready.
Paramedic John Gage: Use your pen?
[Gage signs the application]
Dr. Joe Early: [Talking to Brackett after Gage and DeSoto were forced to treat victims on their own, after Dixie was injured] That woman with the busted fibula, she's coming out of shock now. She might have stayed there if it hadn't been for those two ninety-day Kildares. I looked over Ferguson's shoulder in the cast-room, the immobilization of that guy with the broken legs. Pete could have phoned it in. No distal blood problems, a piece of cake. And then there was Dixie. I don't know, Kell... Dixie might be in a sliding door in the cold room if those two hose-jockeys hadn't known what they were doing out there. Call it their internship. I know I thought I knew it all when they handed me a diploma. They made the same mistake about that nameplate we pinned on them.
[turns to leave]
Dr. Joe Early: One things sure, isn't it? The program *really* works.
Nurse Dixie McCall: Kell.
Dr. Kelly Brackett M.D.: Yes?
Nurse Dixie McCall: 51 on the link.
[indicates communication radio link to field paramedics]
Dr. Kelly Brackett M.D.: What do they want?
Nurse Dixie McCall: Help.
Dr. Kelly Brackett M.D.: [into transmitter link] 51, go.
Paramedic Roy DeSoto: [over biophone] We have a male, tunnel worker, approximate age 60, was trapped under a digging machine. Patient had a cardiac history. He is now diaphoretic. Vital signs: 80 over 50; rate: 100 and irregular; respirations: 12 and shallow.
Dr. Kelly Brackett M.D.: Do you have your EKG hooked up?
Paramedic Roy DeSoto: Affirmitive, doctor.
Dr. Kelly Brackett M.D.: Send me something so I can get a reading.
[turns on EKG printer]
Paramedic Roy DeSoto: This will be Lead 2.
[turns on ELG transmitter]
Dr. Kelly Brackett M.D.: [reads EKG strip] Multiple PVC's.
[sees reading change]
Dr. Kelly Brackett M.D.: V-Tac.
[reading changes again]
Dr. Kelly Brackett M.D.: He's starting to fibrillate.
Dr. Kelly Brackett M.D.: Defibrillate! 400 watt/seconds!
Nurse Dixie McCall: Kell! They're not authorized to...
Dr. Kelly Brackett M.D.: [into link] Are you receiving? Come on, 51! You've got a dying man on your hands.
Paramedic Roy DeSoto: Doctor, if we administer shock and we lose him...
Dr. Kelly Brackett M.D.: You're losing him right now!
Paramedic Roy DeSoto: You said yourself it wasn't worth risking the program for one case!
Dr. Kelly Brackett M.D.: I just heard from Walski in Sacramento. The bill passed late last night.
Nurse Dixie McCall: Kell... You never heard from Walski.
Dr. Kelly Brackett M.D.: Yeah, well I should have.
Nurse Dixie McCall: Do you know what you're doing? If that bill doesn't pass Kell, they'll crucify you.
Dr. Kelly Brackett M.D.: [looking at EKG strip] I don't care about that. We're not at a party or talking to a committee. That man's dead right now.
[into communication link]
Dr. Kelly Brackett M.D.: Zap him, dammit! Zap him!
Paramedic Roy DeSoto: [watches as Gage applies the defibrillator paddles to the man's chest] 400 watt/seconds!
[Gage shocks him]
Dr. Kelly Brackett M.D.: [reads strip] No conversion.
Dr. Kelly Brackett M.D.: Hit him again!
Paramedic Roy DeSoto: 400 watt/seconds!
[Gage shocks the man again. At the hospital, Brackett sees the EKG adopt a normal rhythm]
Paramedic John Gage: [Gage learns that the man he rescued had worsened beyond hope in transit to the hospital because his team was not able to medically stabilize him first] Rescue, Hell! All we rescued was a corpse.
Paramedic John Gage: Sixth and Kenmore. That's over near 10's. Hang a left, I know a shortcut.
Paramedic Roy DeSoto: I know a better one. We swing right to Rampart Emergency.
Paramedic John Gage: What for?
Paramedic Roy DeSoto: Get a nurse on board. You forgot: we're the impotent wonders.