Does this story sound a bit ridiculous? It should, but the sad fact is that it is a true story. Every single day, thousands of people that do not require any type of emergency or even basic medical care use ambulances for transport. You may be asking yourself, “How do people afford to pay for these transports?” The simple answer is that in almost every instance, the “patients” carry Medicaid for payment.

Medicaid, sometimes referred to as “The Gold Card” by medical service professionals, was designed to help make sure that even those that cannot afford health insurance receive needed medical treatment. Though Medicaid is funded by a joint effort between state and federal programs, the costs are ultimately placed upon taxpayers.

What is a paramedic?

Paramedics are among the most highly tried emergency medical professionals, outside of a hospital. Their training is centered on providing treatment to critically ill and injured patients. Due to the amount of time and effort required to complete the paramedic program, they are also some of the most sought after emergency professionals. Most cities employ only a small number of paramedics in comparison to other levels of responders. In most cases, especially in small to medium sized cities, there will only be one paramedic on duty that is responsible for providing coverage to their contracted area.

The training required to become a paramedic is rigorous. Aside from classroom hours, paramedics are also required to volunteer long working hours at hospitals and on ambulances under the guidance of mentors or preceptors. Their training allows them to utilize advanced airway systems, provide cardiac monitoring, applying various pharmaceutical treatments, and performing advanced trauma care. They are masters at treating patients in any type of emergency situation, and are often called upon, even by skilled doctors, to use their skills to start difficult IVs or obtain compromised airways. Many medical professionals, such as nurses and doctors, will freely admit their admiration for a paramedic’s ability to perform such techniques in the back of a moving ambulance with such precision.

Although there are a great many “career” paramedics, many others are using their experience as a paramedic to help propel and guide them into advanced emergency and medical careers. Some go on to become doctors, while others move on to advanced careers in Emergency Management. Paramedics often proceed to become nurses, utilizing a paramedic to rn program.

So why do people so often use a paramedic ambulance as a taxi for non-emergent transports?

There is no simple answer as to why so many paramedic ambulances are used on non-emergent, or convalescent transports. If you ask a paramedic, he will probably tell you there are a few reasons.

• Often times, the person requesting the transport cannot afford to drive themselves, or may not own their own transportation. It simply becomes too easy for them to pick up a telephone and schedule the ride.
• Many ambulance providers see these types of transports as “guaranteed money.” Since Medicaid is funding the transport, the provider is guaranteed payment. That means the provider will rarely have to worry about using the legal system to obtain payment.
• The system Medicaid has in place, allows providers to simply complete the needed paperwork, and then file the payment request online. Most times, this means that the request for payment and processing is made on the same day as the transport. Quite simply, it is fast, easy, and guaranteed money.
• Many times, the people abusing the Medicaid system lack the sort of responsible decision making skills that prevent others from doing the same.
• Medicaid continues to allow this type of abuse. Since it is considered a covered expense, many are more than willing to take full advantage of it.

The scenario described earlier in this article is not the only one of its kind. Each day, paramedics are called for emergency responses only to find patients openly abusing the system. While talking with Jerry, the paramedic noted at the beginning of this article, he began to tell me of other instances.

Jerry recalled a response recently where he was called out during the middle of the night for an unconscious male patient lying on a sidewalk. Upon arrival, jerry noted that the patient was a “frequent flyer”, a patient who calls often and sometimes daily for creative reasons. On this occasion, Jerry noted that his patient first complained of chest pain. After providing basic treatment, the patient refused more advanced care. Jerry loaded the patient in the ambulance and proceeded to transport him to the hospital.

After arriving at the hospital and turning the patient over to hospital staff, Jerry began to complete his documentation. Shortly after starting his documentation he noticed the patient was no longer in his hospital room. Upon inquiring with hospital staff, jerry found out that the patient had signed himself out of the hospital without any medical treatment given. It was then Jerry realized that the patient had a new address, and was now living across the street from the hospital. Jerry could only surmise that the patient had simply used the ambulance as a means of transporting him across town, so he could be closer to his home. Since then, the patient has made many more calls for similar reasons. All of the calls end in a similar fashion. It is now obvious to Jerry and his co-workers that this patient uses the ambulance service, and Medicaid, as a means to gain transport from one side of town to the other.

Why is this abuse of Medicaid allowed to continue?

Medicaid abuse occurs because current laws protect those who abuse it. Using the patient above that uses Jerry’s ambulance as a means of getting across town, let’s imagine this scenario. Suppose this same patient would call for an actual emergency. Is it really feasible to allow the paramedics to refuse treatment or transport? The scenario brings forth a sort of “Boy who cried wolf” situation. If the paramedic refused transport, the patient could suffer dire consequences and possibly even die as a result. This is just too much of a liability and no paramedic or ambulance provider is willing to take that risk.

Patients willing to abuse Medicaid also have rights that protect them from being refused. Currently, it is unlawful for a patient complaining of an emergency symptom to be denied medical care. According to Medicaid, ambulance transport is included into the scope of “medical care.” And, since Medicaid providers are required to perform all medical interventions covered by Medicaid, they risk losing the ability to charge for Medicaid covered services.

How can we stop the blatant abuse of our Medicaid system?

The current economy in the U.S. dictates that we must find ways of improving our government expenditures. Finding ways to curb government spending, thus putting money back into the pockets of Americans, is the only way to recover from the current financial situation. If we want to ensure the financial security of our great nation, we must find ways to stop frugal spending and outright abuse that has caused so many problems.

Some possible ways of eliminating or reducing Medicaid abuse and fraud are:

• One of the first things that could be used to stop Medicaid abuse is a comprehensive audit system. Although there is currently a system in place to perform audits on Medicaid spending, the system is obviously failing.
• Create a closer working relationship between Medicaid, and providers of Medicaid services. There is no doubt that online filing and billing systems have streamlined procedures between providers and Medicaid, but they have also lessened the contact between the two. With such a robotic system in place, contact between them has been diminished.
• Stop the current “blanket” coverage that Medicaid currently has in place. By forcing all treatments to first be audited, before being approved for payment, fewer people would be willing to risk having to pay the bill themselves.
• Enforce consequences to those found to abuse Medicaid. The more people realize the consequences, the greater the chance they will resign themselves from abusing the system.
• Create a county level Medicaid audit system that can interact with providers. Leaving all of this to a system that is often hundreds of miles away from a provider causes problems.

As long as there are people and options, such as Jerry and Medicaid, there will always be those who try and abuse them. As time goes on, people become smarter and more effective in their endeavors to cheat and abuse the systems that are in place. Only by due diligence and persistent measures can we hope to combat these types of abuses. We have a responsibility to our children’s future to help create a secure and stable financial system for them. We must constantly adapt to needed changes, and stay educated in the means it takes to prevent things like Medicaid abuse.

As for Jerry, he says that he plans to retire as a paramedic. Doctors, nurses, and paramedics alike, have all voiced their concerns with the healthcare system in the United States. But, despite his frustrations with a broken health care system in the U.S., Jerry claims that he still truly loves his job. He says that the personal satisfaction he gains from helping those that need him will always outweigh any political and social problems that medical professionals face each day.

Share your thoughts on Medicaid abuse.

For the next year I volunteered my time. On almost every shift I volunteered, I was placed on a truck with just myself and a tech. I loved it, and learned the ropes of EMS along the way. It did not take long to realize what I wanted to do for the rest of my life, and I enrolled in the first EMT course I could find.

Becoming an EMT

In late 1990, I completed my EMT-Basic course. Although I did not immediately get hired into the department I had been volunteering at, I had no problems finding work at other departments. It seemed that almost every EMS department around was in dire need of EMTs, and having any kind of experience was something that none of them cared about. I took a full time position and without any type of “warming up” period, I was now beginning my new career.

The new service I was working for was much like the previous. I had a certification, and that was enough. Despite my lack of experience as an EMT, my partners often had even less. While no issues ever came up, I knew even then that something in the system was flawed.

Becoming a Paramedic

Just 1 year after becoming an EMT, I began to look for any Paramedic programs that had openings. In 1992, I was accepted, and by mid 1993, I was a full-fledged Paramedic that was ready to jump into my new position.

I was immediately hired back on to the county 911 service I had originally volunteered at. The training process was little more than riding a few hours with an experienced Paramedic to prove I was capable of handling things on my own. In fact, I had only ridden a total of 24 hours, when an emergency came in while we were short staffed. I was immediately cleared to function on my own, and was now cleared for “solo” duty.

I spent many of my adult years working as a Paramedic. Along the way, I met some really brilliant Paramedics and EMTs. However, I also met many more than I knew really had no business working on their own. The problem is that guidelines must be followed, and until someone makes a serious mistake, there really is not anything that can be done.

A mistake: What does that mean when dealing with the lives of patients?

Why I feel modern EMS is broken

I retired from EMS in 2006. I have to say that I truly loved the career, and to this day, I am still pro-active in supporting EMS. However, I do believe that changes need to be made, as NOTHING seems to have changed since I first started driving ambulances in 1989. Here are some examples of my views and opinions.

1. Training processes at all levels of EMS need some serious reconsideration: Every instructor I ever had or met was brilliant. The problem with EMS training lies in the requirements for completion, and even more, the requirements of various providers on releasing EMTs and Paramedics onto the streets. At every stage in the process, there are entirely too many people that have the ability to make subjective decisions on whether or not an EMT or Paramedic is capable of being released to work on their own. It leaves too much room for error, and even worse, it leaves too much of a margin of error. It also leaves too much leniency for liability.What needs done: Training requirements need to be more standardized. A person should NEVER be released to perform patient care without being fully trained and proven to be able to provide it in a more prudent manner.
2. Liability: If a cleared Paramedic is right out of school and is working the streets, then who is liable for his/her actions? During my career, I never met, or heard of, a Paramedic carrying liability insurance. It was just assumed that we would either never be held liable, or the service we worked for carried it for us. This is not the case. In fact there are some gray areas in laws that are taken advantage of when it comes to liability. Sure, the service we worked for carried liability insurance, but only to protect them. Had I ever made a serious mistake, I would have been held liable for my actions without having any type of malpractice insurance coverage to protect me. There is no requirement for it, and there should be.What needs done: There needs to be clarity on liability of EMS professionals. There should not be any gray area around this topic. We live in a world that includes people who are willing to sue, just to try and get rich. With the current situation, a frivolous lawsuit upon a Paramedic or EMT would not make anyone rich, but would perhaps ruin the career and financial security of a great person.
3. There was a time when I thought I might like to work in another state. Surprised to find out that the state I wanted to work in required licensure for their Paramedics. This meant that my current Paramedic certification was nearly useless, if I wanted to move. The reciprocity procedure would have required me to pay some money, take some tests, and then take an additional course to become “updated.” Huh? I thought I had already taken all the tests needed to be a Paramedic. Am I to believe that a sick person in Tennessee gets different treatments than a sick person in Indiana?What needs done: training of all EMTs and Paramedics in the nation needs to be more standardized. It also needs to be governed by a single body that outlines proper procedures. This is something that is detrimental to patient care, and should be a top priority in insuring that ALL EMS professionals are trained in the same patient care techniques and receive the same updates, across the country.
4. There is a National Registry of Emergency Medical Technicians, but why? If you ask them who they are, they will absolutely deny that they set any kind of standards or regulations. All they will claim to be is a group that does testing. Many states require a NREMT certification to become certified in their state, but yet they do not require you to keep the NREMT cert updated. In the state I worked in, I carried 2 certifications: One for the state, and one for the NREMT. After I was tired of paying the $45 re-certification fee to the NREMT, I stopped re-certifying it. There was no need. It was not a requirement to maintain in my state, and it did not really help in reciprocity to another state, so why even bother with it? Also, a Paramedic or EMT can let their cert expire for many years, yet only be required to take a very short refresher course to become certified again. There is no way that a person can retain enough information after such a long downtime that a ‘refresher’ course can get them back up to speed.What needs done: I feel that the current situation regarding the National Registry is a joke. There really is no other way for me to say it. I do not think we need an entity like the NREMT to “just do testing”. I think what we need is someone like the NREMT to handle teaching, testing, and governing, all done by one single entity. For lack of better words, EMS needs to have fewer “hoops” to jump, so that the focus can be primarily on training, and not on legalities.
5. While talking to a Paramedic from another state, I was shocked to find out that Paramedics in their state were not allowed to intubate. What? Isn’t intubation a staple in the Paramedic’s lifesaving care that is the top priority of all Paramedics? After all, the first thing they teach you is the ABC’s: airway, breathing, and circulation. Intubation is often required to maintain a clear airway. Why is it that some states allow Paramedics to do some skills they have been trained to do, while other states do not? Should a paramedic be a Paramedic, regardless of where they are?What needs done: Treatment of patients by EMTs and Paramedics across the country should only change when it is necessary for environment or region. In other words, providing oxygen to a patient in Alabama is no different to providing it to a patient in Missouri, so why do the treatments vary so much?
6. Documentation is extremely flawed. While chatting with a Paramedic from another department, after a mutual aid run, I was shocked to see that their paperwork was a mere 3 forms to fill out. The service I worked for had a whole bundle of paperwork that needed completed after each run. Why is it that requirements for details and patient information are different, depending on the service and location? Also, it is my belief that documentation protocols are directly related to how easy we can make it on the billing secretary of the provider. The most time consuming part of paperwork is done for billing purposes, and has nothing to do with the transfer of important patient information between health care professionals.What needs done: Paperwork and documentation procedures need to be the same across all EMS platforms. One service should not be required to gather different information than another. Too many times, we see that a volunteer service that does not bill patients are required to only document patient care, yet other services spend thousands of dollars a year on documents that help billing purposes.
7. Protocols are something that are created in tandem between the sponsoring hospital and the service provider. However, protocols vary widely between one service and another. This is wrong, and we have known it for years. Obviously certain treatment protocols are bound to vary a little, depending on the treatment guidelines of each hospital, but why are Paramedics in some services given the “go ahead” for multi-dose Epinephrine, while others are required to use bare minimums. Why do some services promote the “stay and play” philosophy, while others emphasize “load and go”?What needs done: the way protocols are currently in place, leaves too much variance between providers. When involved in a mutual aid run, there should not EVER be a reason for the two departments to argue “My protocols say we get to sit on the scene and stabilize the patient”, while the other states “our protocols say we have to load the patient and get them to the hospital quickly”. The idea of scene time is only the beginning of the arguments on why protocol procedures need changed, but in my opinion, it is a good start.
8. Supporting certifications are additional certifications that can be obtained by EMTs and Paramedics. Examples are, ACLS, BTLS, PhTLS, PALS, etc… Not all services require the same supporting certifications. In fact, many only require their state’s minimum. In the state I worked, the only supporting cert. we were required to carry were CPR and ACLS. However, many other providers required a whole different set.What needs done: All EMS providers should require the same set of supporting certifications among EMTs and Paramedics. The only variance on this would be to suit environmental or regional needs. An example would be that if a Paramedic is working for a pediatric hospital, then PALS would be required. However, in my opinion, there is no reason why the basic supporting certifications should not already be included in a Paramedic program, and re-certified automatically by completing re-certification for your Paramedic cert. Examples of the basic supporting certifications would be: CPR, ACLS, and PALS. Having all of the current supporting certifying bodies does nothing but offer a means for those governing bodies to make money from courses and re-certification processes. A Paramedic should know how to perform CPR, and it should be the most basic requirement for Paramedic certification each year. We do not need the American Heart Association or the American Red Cross to be separate certification options. Pick one as the standard for a Paramedic cert. include it in the EMT or Paramedic program, and include the re-certification in the annual or bi-annual re-certification or licensure for the Paramedic, not a separate cert.
9. If you really stop to think about it, the job of a Paramedic is really a “dead-end” job. Because of the extreme differences between states in requirements, there is no real way for a Paramedic to insure his/her future in medicine. Some states require certification, others require licensure. Some states require NREMT certification, while others do not. Some providers are beginning to require college level education, while other never will. All this does if blur the lines of whether or not an EMT or Paramedic is a legitimate profession, and offers no real means for a Paramedic to advance. Because of this, pay rates for EMS are nearly frozen in time, as providers know that there are so few choices.What needs done: Currently, the only viable options for EMTs and Paramedics are: Using their experience to get one of the few jobs at a fire department, which may offer more alternatives in the future. Taking advantage of the few actual college programs, such as the EMT to EMS Management or the Paramedic to RN. EMS training needs revamped to give EMS professionals a long standing future. The current design, for lack of better words, is designed for young people that can afford to spend some time in EMS before moving on to a new career which would provide for a family. Training needs to be designed so that it provides a means for EMS professionals to advance.
10. Lastly, let’s discuss patient care. Patient care is the single most important factor in why we are even on the streets. Why is it that there has never been a standard in how QA is performed among providers? QA/A&R is an integral part in ensuring that proper patient care is always being performed. It COULD be a way that EMTs and Paramedics learn from medical directors and peers. Instead, in many providers, it is simply a way that other EMTs and Paramedics can subjectively pick apart another’s patient care or documentation. Rarely do Paramedics and EMTs get “Official” treatments that are new. In other words, I cannot recall a single time in my career where my certifying body contacted all Paramedics to say “We have discovered something new that all EMTs and Paramedics need to learn.” Instead, once you receive a certification, the knowledge you gain from then on is left up to you and your sponsoring hospital. This makes it difficult to stay up to date on new patient care techniques, and to maintain the ability to provide the very best care to our patients.What needs to be done: QA/A&R should be a requirement across all providers, and not just an option. It should also be redeveloped into a standard format that is provided as a learning tool, and not as a tool that can be used as a contest between EMS crews. I once overheard the crew from one shift bragging about how only 2 of their run reports had been pulled for A&R; while the crew from another shift had 4 of theirs pulled. This is a detriment to patient care, and it only serves to either boost the egos of some or derail the confidence of others.

The rest of the story

In 2006, I not only retired from EMS, but I also allowed my certification to expire. I have since remained active in the EMS community. I love the career I had. In fact, I would say that I am extremely passionate about it. I loved every aspect of it, including the people I worked with, the patients I had the pleasure of meeting, and even the training I had to undergo. However, it saddens me to see that nothing really changes. Many brilliant people fought so hard to carry EMS from the 1960s to what it is today, yet nothing has really changed in the past 20 years. Sure, new equipment, new trucks, better radios, better ways to diagnose (oops, did I just use the “D” word while talking about EMS?), but has anything really changed?

I will forever be happy that I had the opportunity to be involved in such a remarkable career. It taught me things about myself, and about “the ways of the world” that many people live sheltered from. I had the opportunity to be part of a “brotherhood” that will forever remain in my heart. I love what I was able to do for patients, and how I may have affected the lives of countless people in the world. But most of all, I like knowing that I may have saved the life of someone who may someday save the life of another.

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From reading the article, it is alleged that an EMT acted not only illegally, but extremely unprofessionally. Thankfully, the driver of the ambulance involved reported the incident, even before the patient did. So, I think the driver deserves recognition for upholding the high standards that represent public servants.

Reading the comments of the article, you can already see how the actions of a single individual can have such a negative impact on the profession. Already, there are people screaming to change ambulance services for the town. It is depressing to know how hard EMS has fought to gain the respect of the community, and how easy it can be torn down by a single act of one person. One commenter claims it places a “black eye” on the profession as a whole. Regrettably, I could not agree more.

Emergency responders need to consider a few things when going out on call. We are there to help those that rely on us. When our car, truck, engine, ambulance, or even helicopter leaves the station, all eyes are on us. You have to not only conduct yourself in a legal manner, but all of us in public service need to act in a manner that brings pride on our profession.

I certainly hope the patient/victim of this incident can move past this and use it to help promote something positive. I also hope that if this EMT is guilty, he pay for his actions in not only the eyes of the law, but also for the hurt and shame he has brought upon the rest of us.

Read the full report by the paper here.

Written by: HemiMedic

Contributing Author Public Safety Blog

Holidays in the U.S. will almost always have a historical meaning. However, how we as individuals relate to holidays may sometimes not necessarily be in accordance with the true meaning of the holiday. For many, the idea of Christmas means shopping, giving and receiving gifts, snow, Santa Clause, and seeing the excitement of children’s faces as they open their presents on Christmas morning. The true meaning, the celebration of the birth of Christ, is somehow recognized but not really the forefront of the celebration.

The Fourth of July, or Independence Day, is one such holiday. While a good many people do recognize the holiday for what it truly stands for, most Americans do not really stop to put a lot of thought into the holiday as it comes to pass.

Memories of Independence Days past

When I was a child, Independence Day meant going to the local fair and barbecues with the neighbors. That tradition has carried on throughout my life, and each year, it is something to look forward to. The smell of charcoal grills in the neighborhood, hearing kids laugh and play with others, and the Fourth of July celebratory Parade that rolls through town are all a part of the excitement in the area.

As a teen, the Fourth of July meant meeting up with friends or even girlfriends to go to the local fair. There was Lemon Shakeups, hot dogs and sausages, and cotton candy to be had, and all while hanging out and having a great time with peers. Even the sound of the old rickety Ferris wheels still spark some fond memories of first kisses and the thrill of getting stopped at the top.

As we become adults, the Fourth of July still carries many of the same values and traditions. If you are like me, you spend a good part of the year buying fireworks and saving them to put on “the ultimate fireworks show” for the neighbors to see. It also means grilling hamburgers and hot dogs, and eating grandma’s potato salad. A good part of the excitement is just having friends over and sitting out by the campfire until the late hours of the night, reminiscing about days gone by.

All of this is just part of traditional Fourth of July celebrations in my life, but the true meaning of the Fourth of July, though we do honor it, is somehow not what we all gather to celebrate.

The true meaning of Independence Day

Last night, I sat on the bank of a river, fishing and enjoying the company of my parents. We sat and watched small fireworks from the neighborhood, and listening to the stomach rumbling booms of the large displays a couple of miles away. Every now and then, we could even catch a glimpse of some of the large rockets as they appeared above the trees.

As I sat there, I started to envision a few things that I think are important for us all to remember on Independence Day. The small bangs of firecrackers and bottle rockets were becoming sounds of musket fire repeatedly going on in the distance. In my mind, I could see fields of tall grass covered in a haze of smoke. I could see the soldiers marching through the tall grass, and stopping to fire their muskets at figures on the other side of the field. What I was seeing was the history of our countrymen, fighting for Independence. There they were, willing to die, in order to become a sovereign nation that was Independent from Britain. The shots continued to ring out, and with each distant bang, another soldier had fallen.

I continued to play out this movie in my mind. Eventually, as the larger fireworks started to erupt, the musket fire turned into machine gun fire. It became more rapid and a bit louder. I pictured our soldiers struggling to make their way through the jungles of Vietnam. Though they were not necessarily in a battle for the freedom of Americans, they were still fighting for freedom. They were there to fight for the freedom of a suppressed country. Of people that wanted nothing more than what we Americans fought for so many years ago.

I could see mortars and grenades going off and soldiers dying in the field. When the bottle rockets took off, I could envision planes making their way to drop bombs down on unsuspecting enemy. My heart sort of stopped for a second when I thought back of the time I visited the Vietnam War Memorial in Washington DC. I remembered the thousands of names on the wall, and was thinking of what they had gone through, in the name of Independence. It saddened me as I started to realize just how much of the meaning of Independence Day had been lost on me over the years. I spent so much time celebrating and had failed to remember that a large part of this holiday is filled with so much sadness.

The large fireworks were in full swing now. Though they may have been a couple of miles away, it did not prevent the reverberation from rumbling so loud we could feel the earth shake with each explosion. My mind began to play out what our soldiers might be going through today. I could see large bombs exploding off in the distance. Enemy mines and car bombs going off, killing entirely too many innocent people. Our soldiers are fighting an enemy that will kill at any cost, even if it means murdering their own countrymen, women, and children in the process.

I could see the large plumes of smoke from huge bombs on the desert horizon. I could see our soldiers desperately trying to identify the enemy that has chosen to disguise themselves as ordinary and innocent townsfolk. I was imagining what our soldiers must be going through, suffering the elements in a country they are not accustomed to. The agony caused by sand fleas and insects that relentlessly continue to bite. The overwhelming heat and the dryness of the sand filling their lungs are almost unbearable.

I could see ships on the ocean, firing rockets at targets they could not even see. I could also see children with smiles on their faces, and they were happy to see our soldiers. Citizens of the country are holding out a dim hope that the Americans could somehow restore their lives to something even close to livable conditions in a war torn country. This war was playing out in a way that seemed there was no way to win, but our soldiers do not give up. Our soldiers continue to fight for the very same reasons that our soldiers have been fighting for centuries. They are fighting for freedom, not for us, but for a country that has never seen the real face of freedom. They are fighting for the rights and liberties of a people that still do not fully understand the reward that could be waiting for them in the end. They are fighting this fight so that others in the world can experience the freedom given to us Americans so many years ago.

Honor our soldiers

As I am writing this article and most likely as you are reading this, one of our soldiers is in the battle field. He is scared, tired and wanting nothing more than to do this job and go back home to his own family. He is ready to put his life on the line in the name of freedom and leaving that family he hopes to return to.

Independence Day is not something that should be celebrated only once a year. The struggles, pain, death, and sacrifice that so many of our soldiers have given in the name of freedom deserve more than just remembrance once a year. We, that have never risked our lives for freedom, can at least offer our respect and honor for those that have. Remember the fireworks every year, and remember that soldiers all throughout history have lived those explosions. Remember that with each explosion, one of our soldiers was killed, injured, or even just scared, in the name of freedom.

Later that evening while sitting with my 5 year old niece, who I adore, she asked me what my website was about, and so I told her I write stories about heroes. Her little face lit up as she replied, “You mean like superman?” I laughed a bit, shook my head and replied, no honey, I write stories about, real heroes, not make believe ones. She looked puzzled, so I tried to explain.

I started by asking her if she knew what a hero was. Tilting her head while grinning up at me as if I was an idiot, she responded by telling me “Heroes are people like Spiderman that are real strong and can fly. They save people and dogs.” Her answer was about what I expected, and, while it did make me chuckle, it also made me wonder about a few things, so I decided to pursue the subject a bit further. “Not those kinds of heroes, I said, but real heroes – people who do good things like saving people’s lives. Don’t you think those are heroes too?” “Stop being a silly Uncle Jamey”, she giggled, “Those are just regular people doing great things, not real heroes like Spiderman! “This is what pushed me to wonder about a few things I had believed in, but never really given a lot of thought to.

Would I Have Done What The Man At The River Did?

Are heroes born or are they created? Is it something that is just inherently inside a person, or is it possible that someone who has no intentions of ever doing something heroic could simply just end up in a situation that turns them into a hero? I started to think back to the river incident, and asked myself- “Would I have jumped into the raging flood water to save that woman?”

I know with certainty that I have saved the lives of many people throughout my years as a Paramedic, and I recall many a time when a victim would have surely died had I not been there to provide treatment. Looking back though, it occurred to me that I’d never been involved in a situation that involved heroism. I was only doing what I was trained to do, and it was my job to do it.

One of the most important things Public Safety responders are taught is to always watch out for the safety of yourself and your crew first, and then take care of those you are trying to rescue. We are taught to never put the life of our patients or others before our own. What this means is that we are to always make sure the scene is safe, and if not, our first goal is to make the scene safe.

Police officers are trained to secure and neutralize unsafe situations in the safest manner possible and to always weigh the consequences of a situation by the benefits. In other words, an officer is taught to use every safety precaution available and to use forethought before making a move.

Firemen, being trained along the same lines, always use safety precautions before entering burning buildings. Fire retardant clothing, breathing apparatus, tools, and knowledge are only a part of what they have to arm themselves with. When they go into a burning building, they know that they, and their crew, have taken every available measure to ensure their own safety first.

Every branch of Public Safety is trained to put safety first. It’s what ensures that they are able to do their job and live to be able to do it again the next time as well.

So What Makes Someone Become A Hero?

After talking to my niece, I had to ask myself a question. What if a trained rescue diver had witnessed the woman’s car going into the river? What would he have done, and would the outcome be the same or different? Would the rescue diver have taken the time for precautionary measures they are trained to take before diving into the flooded river? I believe he/she would have. Here’s what I think may have happened in that case:

The diver sees the accident. They pull over to help, but not before contacting local 911 or dispatch. Next, they would have put on any safety equipment they happened to have with them, perhaps even grabbing ropes and life preservers. Before entering the river they would use precious moments to think through the situation, tie themselves off to a tree, and take every other possible safety precaution in order to help ensure their own survival first. It’s just what they are trained to do, and it is what everyone else in Public Safety is trained to do as well.

So, does it make a difference in whether or not a person should be considered a hero if they utilize their training to ensure their own safety before they rescue someone? What if both results were the same? The untrained man simply jumped into the water without thought for his own safety, yet was still able to save the woman, while the trained professional would have taken the time to set up safety procedures before doing the same. Does that mean they are both heroes, even though the trained person used a few “cheats”? Does that make him less of a hero?

Now let’s think back again. Would the trained diver have gone in to rescue the woman if he had no training to do so? If not, then I think it may define what a hero really is. Could it be that a hero is someone who risks their own life in order to save another’s? Someone who acts on sheer instinct and goes in regardless of the outcome to their own wellbeing?

Is it possible to create a hero by giving them the training, tools, and knowledge needed to perform a rescue and still insure their own safety? Or, is a real hero one who would run into a burning building with the odds of returning stacked highly against them. Is the real hero one who would have performed the rescue with or without training? If so, that means that a real hero is one who would risk their own life to save another without regard to their own safety.

September 11, 2001

Heroes arose and tragically, many heroes surrendered their lives on that tragic September morning. Office workers, cooks, and passers-by went into the chaos and smoke alongside the brave police and firefighters that day, as they risked their lives, and in many cases gave their lives in order to save others. Trained rescuer workers by the score marched into the buildings to try to save the lives of those still inside – despite knowing that the buildings could very likely collapse. Many of those rescuers gave their lives that day doing the job they were trained to do.

What Defines A Hero?

After giving that question a great deal of thought, I think a hero is best defined as a person that, in a time of crisis, has an overwhelming urge to save the life of another. Whether trained or not, a true hero will see a situation and every ounce of their being tells them to go and help. Perhaps training can offer tools to be a hero more safely, but I do not think it takes away from the basic instinct a hero has to save the life of another.

In the World Trade Center tragedy, we saw trained rescuers put themselves into a situation where the odds of surviving were enormously stacked against them. I believe these people would have done the same, with or without any professional training. Although their training gave them the ability to save even more lives that day, it was not that training that made them run into a situation of almost certain death. It was something deep within themselves that they would not have been able to resist. It was the hero inside them that walked them up to those buildings, and despite any fears they had, it pushed them further and forced them to give whatever it took to save the life of another.

Heroism is something inside a person that takes over in a time of crisis. In an emergency situation, it dampens fear’s ability to deter them and it pushes them to give anything and everything to see another survive.

My niece was right in her answer. Heroes are regular people that do great things.

Let’s take a look back in history

In 1989, the Exxon Valdez oil tanker spilled about 11 million U.S. gallons of oil into Alaska’s Prince William Sound. In 2007, a study by NOAA determined that as much as 26 thousand gallons still remains on the shores, and is only degrading at a slow 4% each year.

Also, in a similar report by NOAA almost 11 years after the spill, this excerpt stands out to me.

“Buried or subsurface oil is of greater concern than surface oil. Subsurface oil can remain dormant for many years before being dispersed and is more liquid, still toxic, and may become biologically available. A disturbance event such as burrowing animals or a severe storm reworks the beach and can reintroduce unweathered oil into the water.”

In this report from the Exxon Valdez Oil Spill Trustee Council severe problems still remain. Although many wildlife inhabitants have returned, many are still slow to come back to pre-spill numbers and few faced near extinction numbers. Also, local communities that relied on fishing as an industry have had to seek other means. Many of the hatcheries in the area have never reopened or have never seen supplies return from their pre-spill status. Think about it. It has been more than 20 years since this spill occurred and the effects are still very real. If we see this same trend in our Gulf of Mexico, it would mean that a 10 year old child of the area today could still be dealing with these problems well into their 30’s.

BP’s responsibility and costs

British Petroleum (BP), the owner and responsible party to the oil rig that caused this spill, has issued statements time and time again of how they will “make it right” in the Gulf of Mexico. They have even pledged 20 billion dollars towards a fund to assist in the cleanup and recovery efforts for the residents, businesses, and environment. But, even if that money remains available, is it enough?

In this independent report by the Getner Consulting Group, it outlines losses that could be expected in ONLY the sport fishing and charter fishing industries. In this report, it states that it is possible to see losses of revenue for these businesses in excess of 14 billion dollars. That’s just for sport fishing!! If this report should show true, then nearly all of the money pledged by BP would go towards only this industry! This does not even begin to cover the loss of wages from the more than a quarter of a million jobs lost.

In the case of the Exxon Valdeez, it was ordered originally that Exxon should pay $287 million in actual damages and $5 billion in punitive damages. However, after several appeals, the costs incurred to Exxon were reduced significantly. Does this also mean that we may be facing a time when BP appeals their claims and ends up not even having to pay what it has already stated it was responsible for? In the case of Exxon, the final litigation came down to whether or not the Exxon spill was of accidental cause or caused by malice.

Other costs will be incurred by the disaster. Among some of them will be cleanup costs, payment for lawsuits, costs associated with wildlife conservation and preservation, and not to mention any costs created by human health issues during cleanup and future illnesses. Can BP actually fulfill its responsibility?

What about the outcome of family and tradition. The fishing industry is an industry of heritage. Fishing and even tourism business is largely passed from generation to generation. Due to this oil spill, many family owned and operated businesses will be closing their doors for good. How will that affect the future of their children? Can a cost really be placed on tradition and heritage? It’s doubtful, but it should still be considered as the when realizing the overall consequence of what has happened.

Is British Petroleum even capable of covering the costs?

Despite what it says right now, I think that valid questions should be raised in regards to BP’s ability to cover all of the costs associated with this spill. In fact, I think it could be reasonable to assume that it cannot even come close to covering them. BP has been a profitable company, without question. However, when looking at the short and long term costs, one has to assume that there is not a company on this planet that can truly afford to make those restitutions.

Trying to predict the outcome

One thing we can be certain of is that despite what anyone claims, the Gulf of Mexico will NEVER recover fully from this disaster. The loss of even one species of life due to this disaster could leave devastating effects. Already, we see closures in business, and struggles among residents along the affected coastal areas. Many complain that they have not received any aid or even very little.

Let’s inject this very realistic scenario, and even submit that BP may make every possible effort to “make things right”, as they have claimed. What if the costs just simply become too much for one company to handle? What if BP should fall to bankruptcy? Seeing their stock prices already reach lows of nearly 50% makes bankruptcy not out of the question. I saw a report a few days ago that suggested that nearly 6% of the world has some ties to BP stock. That number is simply astonishing. Who picks up the slack in payments and costs if this should happen?

Even if BP should continue to stay in operation and remain able to keep up in the cleanup and recovery effort, we have a lot of dismay to look forward to. If the Exxon Valdez disaster is any example, even the next generation of adults will still be working to clean this up. This also means that nearly all of the current BP execs would be either retired or facing retirement.

Also, we know that in the case of Exxon, later court appeals significantly reduced the liability of Exxon. Surely we cannot sit here and expect that BP will not also be filing some of those same appeals. In fact, if one watches the responses and actions of BP presently, it almost seems as though they are already leaving themselves set up for those appeals. The recent Senate hearings asked many questions of BP CEO Tony Hayward. Among those questions were some that attempted to get Mr. Hayward to accept responsibility of BP for the full extent of the disaster. His answers left even more questions. In most cases, he deferred his answer pending an investigation done by BP! This leaves a person to speculate that BP is already trying to limit their legal liability. Is this perhaps for future litigation?

My predictions of the Gulf Oil Disaster and its impact on the future

This disaster will continue to affect the daily lives of U.S. residents for years, and the residents of the gulf coastal areas can expect to see these effects last possibly 20 to 30 more years. I will speculate that if BP even survives, they will almost certainly not be able to cover its responsibility, and in the future, they will even spend a great deal of money trying to escape much or a majority of their liability. I would also predict that the government of the U.S. will end up bearing the majority of the costs, which will undoubtedly be pushed right back to the citizens of the entire country. This will no doubt cause a great deal of debate in our country over taxes that would have to be imposed to help recoup the costs, and costs of any new laws that will undoubtedly become real as a result of this disaster.

10 years after the well is finally capped, we may start to see the beginnings of return to our fishing and tourism industries in the gulf. Cleanup efforts along the coast will still undoubtedly be underway and even more expensive efforts will be going to clean the sea floor. We will also be just getting a glimpse of the huge impact on the ecosystem in the Gulf of Mexico. We will probably still be spending large amounts of money to attempt to save many species from extinction or endangerment. We will also only begin to understand how this spill has affected the land, air, and sea environment as a whole. By now, the U.S. has will also have imposed taxes on oil companies themselves for drilling in U.S. waters, as a result of this spill.

In 20 years after the oil well is capped, our children of today will be realizing the devastation that has been left for them. Though much of the work towards recovery and cleanup will most certainly be done, we will no doubt be leaving some of this for our children to attend. There will still be existence of loose oil buried in the sands of some coastlines and sea beds. They will not have the luxury of seeing some of the marine life in the area that exists today. They will still be spending a great deal of money to continue our current efforts in recovery. They almost certainly will be using this spill as a pretext for future legislations and their children (our grandchildren) will be reading of this disaster in text books.

25 years after the oil well is capped cleanup and recovery efforts will be mostly complete. However, American citizens will be realizing that the taxes that were imposed 20 years earlier will continue to be paid. Yes, our children could likely be paying for the costs of this disaster for the rest of their lives. Perhaps in this time line, our dependency on oil related energies will be much lower. However, any that do still exist will still be paying higher taxes as part of the restitution of a spill 25 years earlier.

In closing

Obviously, I think that we will be paying for this disaster for a great many years to come. I also think that BP itself will, in the grand spectrum of things, payback very little. I think that because of our country’s lack of aggressively seeking out alternative resources to oil, our children will be left with a great burden, and the Gulf disaster will most likely only play a small role in that burden. I believe that at this date, we have no concept of the realities and role that this disaster will leave for us. Even the extinction of a microbe can hold dire consequences for us. If there is a life that relies on it, a chained disturbance is caused by its disappearance. All we can do right now is speculate as to the tragedy that is before us in the Gulf of Mexico. Only time will tell.