Had another one of those real world experiences today that was just begging for a blog post. A couple hours ago I was driving down the highway on my way to my physical therapy appointment when I saw a rollover car accident on the side of the road near an on-ramp. There were a bunch of bystanders, but the first police officer was just pulling up and there was no fire or ambulance in sight.
There is some good news and some bad news if you get in an accident by that particular on-ramp. The good news is it’s right down the road from the Mayo clinic. The bad news is a lot of doctors drive on and off that ramp at any given moment.
Very few of them work in the emergency department.
I first became an EMT in 1990, went on to become a full-time paramedic, and have dabbled in everything from ski patrol to mountain rescue to HAZMAT over the years. I’m still an EMT, although not doing much with it since moving to Phoenix. If I’d knocked someone up when I got certified they’d be getting ready for college right about now. That is, to be honest, a little scary.
Since no responders were on scene yet I identified myself and asked if they needed help. The other bystanders, including the first doctor, stepped back (she was calling the patient’s parents). The patient was looking okay, but not great, crying and complaining about neck and head pain. She did not remember the accident.
The next bit went like this:
DAD (Dumb Ass Doctor): Here, let’s put this under her head [holding rolled-up jacket] Me: Sir, we don’t want to do that. DAD: I’m a doctor. It’s fine, she was walking around [Note, most patients who scramble out of their overturned car through the missing windshield wander around a little bit until someone sits them down.] Me: What kind of doctor? DAD: Anesthesiologist. Trauma anesthesiologist. It’s fine. [Note, that means he puts trauma patients to sleep in an operating room so a surgeon can fix them.] Me: Sir, we have a patient complaining of head and neck pain with a loss of consciousness; you do NOT want to manipulate her head. DAD: I’m a doctor [inserts pillow, as patient cries out from the pain]. Gee [other doc’s name] don’t you remember that emergency training and the chain of command? Me: You’re the doctor, can you gossip with your friends and stand over there now while I make sure she can still move?
For the record, I’ve never met an ER doctor in the world that will clear a patient’s c-spine in the field with that mechanism (a rollover) and pain on touch and movement. I would never pretend to be able to anesthetize a patient, but this bozo, like many doctors, thinks he’s fully capable of directing field treatment completely outside his experience.
Here’s the thing;as professionals we train hard at becoming experts in a particular domain. This doesn’t make us experts in adjacent domains. For example, I may be a security expert, but despite some broad knowledge I’ve specialized in certain areas, like information-centric security. If, for example, you needed me to read your IDS logs or deploy your UTM I’d send you to someone with practical network security knowledge.
When doing risk assessments or practical, on-the-ground security, make sure you engage the right domain experts before you break something. You may have kung-fu, but that doesn’t mean you aren’t a total freaking idiot.
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