“The Paramedic Heretic” – a First-Person Account of PSA's Flight #182 Tragedy

PSA Flight #182 - The Day That Broke the Heart of a City

When Patrick McDonald began rescue training in the 1970s, he was among the first paramedics in the nation, filled with the zeal to save lives in ways not imagined even a decade before. More than 20,000 911 calls later however, pride in his profession has eroded.

So he turned to his three-decades of note-taking to scribe an imminently readable, jaw-dropping assessment of the power struggles within the cloistered world of rescue – a battle that sometimes has fatal consequences. He also defines what he calls the “Immutable Laws” that reign supreme in the business of saving lives.

McDonald, having experienced the trenches of rescue for more than 30 years, offers story after story in which rules and policy corrupt paramedic efficiency. He details some success stories, but reveals dozens of cases where the consequences of protocol short-circuit rescue efforts. In one fascinating case the author himself nearly lost his medical license because he authorized a non-EMS helicopter to fly out critically injured Girl Scouts in a Palm Springs bus tragedy – until the famous Sonny Bono (who had been on the disaster scene) saved the day.

“The Pedigree of a Paramedic Heretic: Immutable Laws and Ethical Illusions” reveals that time after time, saving lives is not rescue priority. Instead, following policies, ensuring team safety and avoiding lawsuits all trump patients’ lives. “Heretic” also points out numerous medical myths, such as ambulance sirens saving lives (they don’t); the “Golden Hour” of patient care (one doctor’s silly fantasy); and the futility, in many cases, of CPR. Some of the biggest problem areas, McDonald writes, are mistakes made in prescriptions; wholly unnecessary surgeries and flawed medical records.

That paramedics remain mute in the presence of incompetent or criminal physicians, for fear of losing their jobs, is a maddening reality. Saving lives, in the end, has become far more about capitalism and power struggles, than heroism.

Author K. Patrick McDonald knows of what he writes. He was appointed the first EMS supervisor for San Diego city and created one of the country’s first Special Trauma & Rescue teams.

Patrick McDonald, a graduate of University of California, San Diego School of Medicine original advanced field medicine program, co-wrote the National Pool & Waterpark Lifeguard Training Manual. He has served as a consultant to the U.S. Secret Service and Super Bowl XLIX in Phoenix.