An old ambulance driver answered his last call inSan Diego this year, and 300 people made sure they were there to wish him well. His family was there, Life-Saver. And so was hisEMS family. Mostly, they were his former employees.
Robert Hartson was a former U.S. Army medic who, with Juanita, his high school sweetheart and spouse of 62 years, co-founded Hartson'sƒa tight little, medically oriented ambulance service that earned national respect for its commitment to its people and the public. I was lucky enough to be a Hartson ambulance driver, EMT and, eventually, the company's first paramedic. I joined them in 1971, when my firstEMS manager couldn't give me a week off to get married. ˙Not enough seniority,Ó he said. Silly man.
I wish I could count all the sensible ideas this column has described as a result of Bob Hartson's life, either directly or indirectly. There were a lot. One was the use of airline-sized pillows on ambulance cots. If you inserted the pillow sideways, you had about 18 inches of unused pillowcase, which you could tuck under the head end of the mattress to keep the pillow on the cot. When you took a patient outdoors, you could use the surplus pillowcase to shield their eyes and face from bad weatherƒor even just sunlight. Another idea was the ˙two-blanket rule,Ó which said if either crew member was wearing a jacket, there should be a second blanket on the cot. ˙Non-stop decelerationÓ was a driving practice of modulating your foot pressure on the brake pedal so smoothly, no one in the ambulance could feel it come to a stop.
Speaking of stopping, we were expected to come to a complete stop before we broke an intersection, so we could make eye contact with opposing drivers (and minimize the energy of a potential collision). Violating that rule in a Hartson ambulance was a terminal offense, and there were no second chances. Folding the end of a roll of tape when you put it away, that was another one. We viewed patients as customers and ˙managed by wandering aroundÓ years before those perspectives were published by the people they made famous.
Then there was pre-alert dispatchingƒinitiating the movement of a crew toward a call as soon as its nature and location became knownƒwhile a caller was still on the line. That usually required two people to answer an emergency line. A phone operator would interview the caller while a radio operator alerted a crew to head ˙south on ThirdÓ (or somewhere). But it recognized ˙time to bedsideÓ as the only honest measure of response time. (Lots of big systems still don't get that, but Hartson knew it made perfect sense to patients and their families.)
Hartson understood something else, too: that people are valuable, their safety matters, and how you treat them affects the way they treat others. If Hartson hired you, part of your employment packet included a menu. You checked off the foods you liked or didn't like for lunch. Then, around 1100 hours on your duty days, a station wagon would meet you someplace and deliver your lunch and something to drink. The idea: Noon is a busy time in every system. Crews get hungry at noon, and they're nicer to people when they aren't hungry.
In 1982, after surviving a battle with lymphatic cancer, Hartson decided to retire. When he inquired about jobs for his crews, the most logical buyer didn't qualify. Hartson sold the company to a pair of employees instead, along with two additional investors. They formed MedTrans, and eventually won 9-1-1 contracts in several states, using names like MedStar and Baystar. In the early 1990s, a Canadian firm purchased AMR and MedTrans, and folded the MedTrans organization into AMR. They were betting theClinton health-care plan would be adopted, and were positioning themselves as a nationalEMS provider. It was a good idea, but the plan never materialized.
Hartson had another notion: that no manager was smart enough to manage. ˙The best I can do,Ó he said, ˙is to surround myself with good people, and then make it easy for them to do their jobs.Ó That's called empowerment, another term coined by a famous author in the early 1990s. More than anything else, it requires a leader to serve.
But his best idea was that when you're fussy enough to hire people who are naturally nice, they'll probably have a lot in common. And if they do, they'll probably love each other. That we did, and we still do.
We still love you, too, Bob. Happy Trails.
Thom Dick has been involved in EMS for 36 years, 23 of them as a full-time EMT and paramedic in San Diego County. He's currently the quality care coordinator for Platte Valley Ambulance, a hospital-based 9-1-1 system in Brighton, Colo.