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The whole system is awe-inspiring. Have a medical emergency? We'll send a several-ton box on wheels speeding your way within minutes. If you're in a city, th

The whole system is awe-inspiring. Have a medical emergency? We'll send a several-ton box on wheels speeding your way within minutes. If you're in a city, the traffic lights will turn red as the emergency vehicle approaches to make passing safer. Paramedics trained in evidence-based pre-hospital medicine will perform the interventions most likely to save you based on their field impression. And when you arrive at the hospital it gets really cool - at a level 1 trauma center, they should be prepared to give you a CT scan and treat you in 10 minutes or less. That might involve snaking a tiny wire through your arteries all the way from your leg to your head, or administering one of thousands of drugs that has exactly the desired effect. It's easy to take it all for granted but the technology and systems in place to take care of us are amazing.

XorNot 8y ago
I have weirdly conflicted feelings when I see ambulances go by these days. Because part of me feels this sense of overwhelming pride watching that system work to save someone, people getting out of the way etc. But then I remember it's only happening because someone's in severe trouble in the first place so it's like "humanity is awesome...oh something not good is happening"
- TeMPOraL 8y ago
  I have this habit I copied off the book "Heart" by Edmondo De Amicis[0] - whenever I hear an ambulance approaching, sirens on, I'll take my hat and earphones off, pausing for a moment as a sign of respect. Respect for the person in trouble, for the people trying to save them, and for the system that allows this to happen. Thank you 'PuffinBlue and 'goodells for bringing this observation up. The civilization our predecessors built and to which we have privilege of contributing is, for all its failings, truly miraculous. -- [0] - https://en.wikipedia.org/wiki/Heart_(novel) https://en.wikipedia.org/wiki/Heart_(novel)
- TomK32 8y ago
  and then there are people who complain about ambulances blocking parking spaces or even roads... https://www.independent.co.uk/news/uk/home-news/man-paramedics-ambulance-note-drive-block-save-life-hassan-shabbir-west-midlands-a8053606.html https://www.independent.co.uk/news/uk/home-news/man-paramedi...
slg 8y ago
And if you live in the US and don't have good medical insurance the entire thing might leave you bankrupt and homeless. The ingenuity of humanity is amazing, but we still seem to get in our own ways a lot.
- um_ya 8y ago
  The biggest expense to doctors is the cost of getting sued all the time and the insurance doctors need to cover that.
  - spamizbad 8y ago
    Costs associated with medical malpractice account for just 2.4% of healthcare spending in the United States. Source: https://hsph.harvard.edu/news/press-releases/medical-liability-costs-us/ https://hsph.harvard.edu/news/press-releases/medical-liabili...
    - slg 8y ago
      That isn't addressing um_ya's point because doctors are just a part of the overall healthcare industry but bear the brunt of the malpractice costs. This is just one small piece of a broken healthcare system, but how we handle malpractice in this country is certainly broken. Fixing it wouldn't resolve all our problems, but it would definitely help.
      - spamizbad 8y ago
        I don't think it's broken at all. Tort law, in general, is what we use as an alternative to more aggressive regulation. You remove tort options, the side-effect will just be more regulatory measures.
        slg 8y ago
        Imagine a world in which a software developer was held personally liable for any work they did. First off, this would kill of a huge part of the open source community (the free as in beer software would all disappear). Employee contracts might be structured in such a way that the employee is responsible for any potential liability. Any customer who felt wronged could sue the individual developer who wrote that code. These lawsuits would then be decided by a jury of people who know nothing about software development. One of the biggest deciding factors in that case would be who could hire the best lawyers and which lawyers could bring in the best "software experts" to explain why the developer did or did not make a mistake. Even if it was ruled that the developer did not make a mistake, they would be unlikely to ever be able to recoup their legal costs. Meanwhile the payouts from the cases in the customer's favor are so large, people are now incentivized to sue over a much wider range of possible mistakes. These developers just need to accept that these lawsuits and the wasted time and stress that results from them is simply a part of their profession. Regardless of a developers skill, a majority of developers now won't be able to make it through a career without being sued at least once. Eventually the software developers turn to insurance which costs tens of thousands of dollars per year to protect them against these risks. Would you think this is a fair system? Could you see that system having a negative effect on the software industry? Do you think this would push people out of the industry who might otherwise be great developers? Would this system, that is ostensibly designed to protect customers, actually result in a better level of service?
toomuchtodo 8y ago
Northwestern Medicine in the Chicago suburbs has a mobile stroke unit; if there’s evidence you’re having a stroke, they’ll send the stroke unit along with the ambulance and will perform a CT scan in the ambulance to determine what type of stroke you’re having and administer interventions while you’re en route to the ER. http://westmobilestrokeunit.nm.org/ http://westmobilestrokeunit.nm.org/
- sxg 8y ago
  The Cleveland Clinic has the same system. https://my.clevelandclinic.org/health/treatments/17242-mobile-stroke-unit https://my.clevelandclinic.org/health/treatments/17242-mobil...
  - toomuchtodo 8y ago
    Fantastic to hear. My mother passed due to a subarachnoid hemorrhage (the more difficult type of stroke to treat), so I follow advances in stroke detection and treatment closely.
- mikec3010 8y ago
  I wonder why ambulances don't have mobile x-ray systems? I realize the radiation would have to be managed, but it seems like a great application of technology to perform the imaging and send it digitally while eh route.
  - deleted 8y ago
    [deleted]
  - sxg 8y ago
    There aren't many cases where having an X-ray done a little faster would be massively helpful. Emergency department physicians and trauma surgeons can read an X-ray for acute trauma in a matter of seconds, and doing the X-ray itself doesn't take more than a few seconds either. It's hard to think of a pathology that would show up on X-ray but not through the patient's presentation or physical exam. Going off memory, I can't think of a situation where an X-ray would be the crossroads that determines what I do next for the patient. Also, an X-ray done in a moving ambulance is probably going to be of fairly low quality. In most cases, they'd just have to redo it in the hospital. The mobile CT scanner is also not super helpful for much other than determining whether a potential stroke patient has a grossly hemorrhagic stroke. In that one case, it is beneficial, but I don't think mobile CT scanners are used for much else.
jackhack 8y ago
Awe inspiring is correct! My grandmother was born in 1888. In her lifetime, she saw the first automobile, the first airplane (propeller-driven, followed by jet aircraft!), radio, "talkies" (movies with soundtracks), television (black & white, then colour!), stereo records, indoor plumbing and electrical service, electronic computers, rockets, artificial satellites, the moon landing, refrigeration(!), vaccinations and antibiotics(!), the internet, and on and on. She lived through two world wars, and the aftermath, losing brothers and friends as a result. There were joys and horrors to be sure. She remembered seeing the first car (which she called "a noisy piece of junk"), and the first time she spotted an airplane, and her first electric appliances (refrigerator and clothes washer). For a thousand years prior, life had changed but only incrementally -- someone from the year 900 could still recognize life in 1400. However, in this short 100 year span during her lifetime, from 1890 to 1990, the transformation of civilization was so thorough and amazing that it is difficult to appreciate civilization's quantum jump. What a profound change! Just stop and imagine this for a moment: a world without automobiles, where all travel is by horse/carriage, or train, or boat, or foot. No antibiotics. The milkman delivered (unpasteurized milk to the front porch) and the ice man delivered a block of ice every few days. There was no telephone -- a telegraph was the "text message" of the day and the radio was as close to instant information as one could get. There was no telephone. Photographic news could take weeks/months to travel across a country or an ocean, and the only way to cross the oceans was a boat with cloth sales or a steam boiler and a commitment of months. So to think of the transition from a time where a little scratch could lead to an infection that kills you, or an injury to a limb means chopping it off and hoping one lives, a scientific (lack of) understanding illuminated only briefly by Phineas Gage's tamper-rod-through-the-frontal-lobe injury to a time where surgeons can cut abnormal things out of your brain and you go home in a couple days functioning normally is just astounding. We live in a time of miracles. There is no other way to say it.
- tomjakubowski 8y ago
  > someone from the year 900 could still recognize life in 1400. Where?
  - TomK32 8y ago
Waterluvian 8y ago
Emergency services are so underrated. In minutes I can have medical experts, fire rescuers, or even a small army at my door. And there's parts of the world where this is simply not a thing. We take it for granted.

XorNot 8y ago

I have weirdly conflicted feelings when I see ambulances go by these days. Because part of me feels this sense of overwhelming pride watching that system work to save someone, people getting out of the way etc. But then I remember it's only happening because someone's in severe trouble in the first place so it's like "humanity is awesome...oh something not good is happening"

TeMPOraL 8y ago
I have this habit I copied off the book "Heart" by Edmondo De Amicis[0] - whenever I hear an ambulance approaching, sirens on, I'll take my hat and earphones off, pausing for a moment as a sign of respect. Respect for the person in trouble, for the people trying to save them, and for the system that allows this to happen. Thank you 'PuffinBlue and 'goodells for bringing this observation up. The civilization our predecessors built and to which we have privilege of contributing is, for all its failings, truly miraculous. -- [0] - https://en.wikipedia.org/wiki/Heart_(novel) https://en.wikipedia.org/wiki/Heart_(novel)
TomK32 8y ago
and then there are people who complain about ambulances blocking parking spaces or even roads... https://www.independent.co.uk/news/uk/home-news/man-paramedics-ambulance-note-drive-block-save-life-hassan-shabbir-west-midlands-a8053606.html https://www.independent.co.uk/news/uk/home-news/man-paramedi...

slg 8y ago

And if you live in the US and don't have good medical insurance the entire thing might leave you bankrupt and homeless. The ingenuity of humanity is amazing, but we still seem to get in our own ways a lot.

um_ya 8y ago
The biggest expense to doctors is the cost of getting sued all the time and the insurance doctors need to cover that.
- spamizbad 8y ago
  Costs associated with medical malpractice account for just 2.4% of healthcare spending in the United States. Source: https://hsph.harvard.edu/news/press-releases/medical-liability-costs-us/ https://hsph.harvard.edu/news/press-releases/medical-liabili...
  - slg 8y ago
    That isn't addressing um_ya's point because doctors are just a part of the overall healthcare industry but bear the brunt of the malpractice costs. This is just one small piece of a broken healthcare system, but how we handle malpractice in this country is certainly broken. Fixing it wouldn't resolve all our problems, but it would definitely help.
    - spamizbad 8y ago
      I don't think it's broken at all. Tort law, in general, is what we use as an alternative to more aggressive regulation. You remove tort options, the side-effect will just be more regulatory measures.
      - slg 8y ago
        Imagine a world in which a software developer was held personally liable for any work they did. First off, this would kill of a huge part of the open source community (the free as in beer software would all disappear). Employee contracts might be structured in such a way that the employee is responsible for any potential liability. Any customer who felt wronged could sue the individual developer who wrote that code. These lawsuits would then be decided by a jury of people who know nothing about software development. One of the biggest deciding factors in that case would be who could hire the best lawyers and which lawyers could bring in the best "software experts" to explain why the developer did or did not make a mistake. Even if it was ruled that the developer did not make a mistake, they would be unlikely to ever be able to recoup their legal costs. Meanwhile the payouts from the cases in the customer's favor are so large, people are now incentivized to sue over a much wider range of possible mistakes. These developers just need to accept that these lawsuits and the wasted time and stress that results from them is simply a part of their profession. Regardless of a developers skill, a majority of developers now won't be able to make it through a career without being sued at least once. Eventually the software developers turn to insurance which costs tens of thousands of dollars per year to protect them against these risks. Would you think this is a fair system? Could you see that system having a negative effect on the software industry? Do you think this would push people out of the industry who might otherwise be great developers? Would this system, that is ostensibly designed to protect customers, actually result in a better level of service?

toomuchtodo 8y ago

Northwestern Medicine in the Chicago suburbs has a mobile stroke unit; if there’s evidence you’re having a stroke, they’ll send the stroke unit along with the ambulance and will perform a CT scan in the ambulance to determine what type of stroke you’re having and administer interventions while you’re en route to the ER. http://westmobilestrokeunit.nm.org/ http://westmobilestrokeunit.nm.org/

sxg 8y ago
The Cleveland Clinic has the same system. https://my.clevelandclinic.org/health/treatments/17242-mobile-stroke-unit https://my.clevelandclinic.org/health/treatments/17242-mobil...
- toomuchtodo 8y ago
  Fantastic to hear. My mother passed due to a subarachnoid hemorrhage (the more difficult type of stroke to treat), so I follow advances in stroke detection and treatment closely.
mikec3010 8y ago
I wonder why ambulances don't have mobile x-ray systems? I realize the radiation would have to be managed, but it seems like a great application of technology to perform the imaging and send it digitally while eh route.
- deleted 8y ago
  [deleted]
- sxg 8y ago
  There aren't many cases where having an X-ray done a little faster would be massively helpful. Emergency department physicians and trauma surgeons can read an X-ray for acute trauma in a matter of seconds, and doing the X-ray itself doesn't take more than a few seconds either. It's hard to think of a pathology that would show up on X-ray but not through the patient's presentation or physical exam. Going off memory, I can't think of a situation where an X-ray would be the crossroads that determines what I do next for the patient. Also, an X-ray done in a moving ambulance is probably going to be of fairly low quality. In most cases, they'd just have to redo it in the hospital. The mobile CT scanner is also not super helpful for much other than determining whether a potential stroke patient has a grossly hemorrhagic stroke. In that one case, it is beneficial, but I don't think mobile CT scanners are used for much else.

jackhack 8y ago

Awe inspiring is correct! My grandmother was born in 1888. In her lifetime, she saw the first automobile, the first airplane (propeller-driven, followed by jet aircraft!), radio, "talkies" (movies with soundtracks), television (black & white, then colour!), stereo records, indoor plumbing and electrical service, electronic computers, rockets, artificial satellites, the moon landing, refrigeration(!), vaccinations and antibiotics(!), the internet, and on and on. She lived through two world wars, and the aftermath, losing brothers and friends as a result. There were joys and horrors to be sure. She remembered seeing the first car (which she called "a noisy piece of junk"), and the first time she spotted an airplane, and her first electric appliances (refrigerator and clothes washer). For a thousand years prior, life had changed but only incrementally -- someone from the year 900 could still recognize life in 1400. However, in this short 100 year span during her lifetime, from 1890 to 1990, the transformation of civilization was so thorough and amazing that it is difficult to appreciate civilization's quantum jump. What a profound change! Just stop and imagine this for a moment: a world without automobiles, where all travel is by horse/carriage, or train, or boat, or foot. No antibiotics. The milkman delivered (unpasteurized milk to the front porch) and the ice man delivered a block of ice every few days. There was no telephone -- a telegraph was the "text message" of the day and the radio was as close to instant information as one could get. There was no telephone. Photographic news could take weeks/months to travel across a country or an ocean, and the only way to cross the oceans was a boat with cloth sales or a steam boiler and a commitment of months. So to think of the transition from a time where a little scratch could lead to an infection that kills you, or an injury to a limb means chopping it off and hoping one lives, a scientific (lack of) understanding illuminated only briefly by Phineas Gage's tamper-rod-through-the-frontal-lobe injury to a time where surgeons can cut abnormal things out of your brain and you go home in a couple days functioning normally is just astounding. We live in a time of miracles. There is no other way to say it.

tomjakubowski 8y ago
> someone from the year 900 could still recognize life in 1400. Where?
- TomK32 8y ago

Waterluvian 8y ago

Emergency services are so underrated. In minutes I can have medical experts, fire rescuers, or even a small army at my door. And there's parts of the world where this is simply not a thing. We take it for granted.