Administration and Leadership, Columns

Life’s Gifts Bring EMS Mission into Focus

Issue 12 and Volume 40.

I find the holiday season a great time to reflect on the gifts I received throughout the year. My favorite was the gift of life that occurred on Sept. 23, when my beautiful, ever-smiling new granddaughter Harper Anne Heightman was born. She smiles with pure innocence in an unpredictable world.

Our jobs in EMS require us to be highly educated and motivated to respond to all patients. Our jobs in EMS require us to be highly educated and motivated to respond to all patients.


My newest granddaughter, Harper Anne. She reminds me that our jobs in EMS require us to be highly educated and motivated to respond to all patients regardless of their age, physical condition or mental status. Photos A.J. Heightman

I got to see her for the first time after a series of back-to-back trips. But I thought about her every day, anticipating what she would look and feel like when I got to hold her.

Watching her smile, stretch and grow by the second reminds me why our jobs in EMS require us to be highly educated and motivated to respond to all patients regardless of their age, physical condition or mental status.

In Harper’s case, she’s too young to communicate verbally, so we have to be able to interpret her needs and respond to them.

My thoughts about her innocence, susceptibility to aspects of her changing environment and dependence on her parents to nurture and protect her from harm as she grows actually energized and helped me prepare for some of my recent lectures, because many of the topics I was presenting were difficult social and psychological topics, including why EMS, fire, ED and law enforcement personnel often don’t get along and why many emergency personnel are so stressed, suffer from PTSD, have contemplated suicide and are committing suicide.


In rural Okoboji, Iowa, I met and lectured to a group of first responders and EMTs from predominantly volunteer EMS services who attended the University of Okoboji conference because of their hunger for new information. I then drove two hours though Iowa and part of South Dakota to get to Sioux Falls airport to travel to Greensboro, N.C., for the North Carolina Emergency Medicine Today Conference.

I was excited to speak at this conference because it was where JEMS founding publisher Jim Page had served as the state’s first EMS director, and where a politically motivated governor fired him for his refusal to allow illiterate EMT students to be read the EMT exam.

Jim believed it was critical for EMTs and paramedics to be able to read to properly assess and care for patients. But the governor caved to political pressure and found it in his best interest to oust Jim in favor of potential voters. The story has a happy ending, as the experience inspired Jim to buy Paramedics International magazine and turn it into JEMS, a publication he and his team could use to present important information and right the wrongs in EMS. The other happy ending is that North Carolina has become one of the most progressive EMS breeding grounds in America with some of the most innovative programs and leaders.

I had the opportunity to interact with the 45-member staff of the North Carolina Office of EMS (NC OEMS), one of the most sincere, progressive and energized EMS offices in the country, motivated by goals and tasks— not politics. You can tell a state treats EMS as a high priority when it has a staff of 45 hard-working members vs. 10–12 paper-pushing bureaucrats.

High-energy EMS Chief Regina Godette-Crawford and Assistant Chief Tom Mitchell run the NC OEMS in an incident command mode, rapidly assessing and addressing the needs for EMS in the state. They aren’t stagnant like EMS leaders in some states, questioning whether something is a “change in the scope of practice” for their personnel. They change with the times, see the future and work hard to change their state’s laws to accommodate the needs of the patient and the personnel who serve them.

I also got a chance to meet and hear the vision of the new secretary of the N.C. Department of Health and Human Services (DHHS), Rick Brajer. He was there to present a session on his respect and vision for EMS.

As Secretary Brajer addressed North Carolina EMS leaders and responders for the first time, I sat with Bill Atkinson, a leader of NC EMS innovations for decades and a person who was also mentored by Jim Page. Bill and I both commented on how much Brajer reminded us of Jim Page, which is hard for anyone to do!

As a person who has worked in a state EMS capacity, I found Secretary Brajor’s words to be sincere and from the heart, and came away comfortable (and encouraged) that his actions will match his words. He’s a forward-looking and ethically centered leader who brings a deep sense of stewardship and a heart for service to the citizens of North Carolina.

More importantly, he gets EMS and is committed to making sure the NC EMS system is, as he commented in his speech, “redesigned to keep pace with the changing need of its citizens and responders.”

Brajer comes to DHHS after two decades of serving in leadership roles in the healthcare and medical technology industries. His roles have ranged from being a change leader in public and private equity environments to being an entrepreneurial leader at a venture capital-backed company.

From 1990 to 2002, Brajer was executive officer of Becton Dickinson and Company, and served as president of the company’s diagnostics sector. From 2003 to 2013, he served as the CEO and director of LipoScience Inc., a personalized diagnostics company that established a new clinical standard of care in cardiovascular management. Just before accepting the role of secretary of DHHS, Brajer served as CEO and director of ProNerve Inc., a monitoring company providing services to healthcare facilities and professionals in the U.S.

Governor Pat McCrory picked a real winner for the secretary of DHHS. Brajer brings strengths in change leadership, shaping of strategies, the ability to attract and develop talent, and put systems and a culture in the state that will drive execution. It will be exciting to watch North Carolina EMS programs change, grow and adapt to the demands of the rapidly changing healthcare environment.

During my visit, I also addressed the annual reunion of graduates from Western Carolina University’s (WCU) Emergency Medical Care (EMC) Program, the first baccalaureate EMC program in the nation. WCU’s EMC program is accredited by the Commission on Accreditation of Allied Health Education Programs through the Committee on Accreditation of Educational Programs for the EMS Professions.

The program is one of only 14 institutions in the nation offering a bachelor’s degree in EMC. Its students concentrate in one of two areas: 1) health management, which prepares graduates for leadership roles in healthcare, EMS administration positions, and graduate school; or 2) science, which prepares graduates for medical school, physician assistant programs, dental school, physical therapy programs and graduate school.

The program has a rich history of quality instruction in emergency medicine and their graduates pursue careers as paramedics, educators, physicians, physician assistants, researchers and EMS administrators. They’re the leaders of tomorrow and it was refreshing to see their pride in the profession of EMS and hear their desire to improve it, similar to Jim Page’s mission in life.

I knew I was in a progressive state because soon after I completed a difficult keynote on critical stress and suicides in EMS, and emphasized the need for all personnel to have access to employee assistance programs and management support, I was met in the convention center hallway by two North Carolina EMS service leaders who had already called their county administrators to make sure their personnel not only had access to mental health and counseling resources, but would be encouraged to utilize them in the future.


As I jetted to Seattle that night to meet baby Harper for the first time, I reflected on how refreshing it had been to present important information to such appreciative and receptive audiences. Quite often, I find conference attendees who are required to be there and instead of learning something new, they seem to dare the instructors to teach them something they didn’t know or, sadly, didn’t really believe or want to know.

Best wishes for a safe and happy holiday season. Be nice to your patients and, more importantly, be nice to each other in this demanding and stressful occupation we’re all involved in.

Learn more from A.J. Heightman at the EMS Today Conference & Expo, Feb. 25–27, in Baltimore, Md.

More on Leadership & Professionalism from