My dad could still be alive, but he's not

https://www.jenn.site/my-dad-could-still-be-alive-but-hes-not/

by DustinEchoes • 8 months ago

456 290 8 months ago

rectang2• 8 months ago

This story reminds me of how the high schoolers on the Korean ferry MV Sewol obeyed the instructions to stay in their rooms.

davidw2• 8 months ago

I don't have this one in my memory but... high schoolers? I'm not going to look that up.

neom• 8 months ago

There are a few docs out there on it, extremely extremely extremely insane/sad situation. https://www.youtube.com/watch?v=5_A8dq2fA5o

prmph4• 8 months ago

Also the Grenfell tower fire

nrhrjrjrjtntbt4• 8 months ago

Just read about it on Wikipedia. Straight up murder. This isn't "you shouldn't follow instructions" but more "dont get murdered".

They 2x overloaded cargo, made it loose, captain abandons ship while staying in place order remains.

kingstnap• 8 months ago

Yeah this is really way out there. The crew and captian straight up murdered those passengers. There was literally no reason to tell the students to stay put there were even rescue boats available.

hcknwscommenter• 8 months ago

Something similar happened to a friend of mine. In San Francisco. I just sort of assumed it was just bad luck. Bad things happen occasionally even in good systems. But maybe that assumption is wrong? Is this a thing? Are ambulances just unreliable?

sitharus• 8 months ago

It Depends. It's going to depend on your location, how your health system works, and a bunch of luck.

Even in the most well-resourced system if your high-priority call comes in just after a bunch of other high-priority calls you may not get an ambulance in time as everyone's already helping someone else. Also in our current economic system there's a whole bunch of pressures that mean we can't base our medical care availability on the worst case, so sometimes people don't get the care they need due to lack of staff.

However I do think in a good system dispatchers would have visibility to know if an ambulance can be dispatched or retasked and how long it will take to get there. You can't make good recommendations without the information to do so.

zahlman2• 8 months ago

FWIW, I also live in Toronto and been in an ambulance a fair few times (generally for false alarms that were still worth checking out); I can't recall it ever taking that long for an ambulance to arrive, even reporting less severe symptoms.

chzblck• 8 months ago

I'm really sorry about your dad.

I bet he's proud of you for writing and sharing this to help others.

ugh123• 8 months ago

my dad is dead, because his family members were too naive to know that the thing they were instructed to do by the state was a false thing.

We're told a lot of things by "officials" not because it's correct, but because it holds the least legal liability for official parties involved, especially anything involving healthcare. These officials also sometimes include doctors, who work to protect themselves and the system first, and then patients.

vkou3• 8 months ago

We're also told to do a lot of things by officials because it's correct most of the time, but with the benefit of 20/20 hindsight, generally correct advice can turn out to be dead wrong for you.

Sometimes doing what you're told is the right thing. Sometimes, not doing what you're told is the right thing. Sometimes, you're told to do the intuitive thing, and it's wrong. Sometimes, you're told to do the unintuitive thing, and it's wrong. It's hard to tell the difference between those situations, even when you're not stressed.

userbinator• 8 months ago

Perhaps 2020 hindsight, even.

2muchcoffeeman• 8 months ago

This is very conspiratorial thinking.

Do you really think that in a high stress situation you’re going to make the best decisions?

Do you really think health workers are all concerned about legalities first?

Not moving a patient unless you explicitly know how is probably right the vast majority of the time. Sometimes that’s wrong, but how are you going to get the entire public to understand what the right situation is?

It’s so easy looking at a single case in hindsight. May we all have the ability to make the right choices all the time.

_drimzy• 8 months ago

Do you really think that in a high stress situation you’re going to make the best decisions?

I mean that statement could be used to excuse any mistake in any project/system ever made, and is mostly a cop out. Yes, the system is definitely designed to minimize legal risk for the health-workers/hospitals. A system is only as good as what it's' design objectives are, and if "save a life at all cost" was the objective the system might as well look entirely different.

wk_end2• 8 months ago

It's not that health workers are always thinking about legality; it's that they're following policies either written by people thinking about legality or re-written by people in response to legality, i.e. they got sued and changed the policy in light of that.

somenameforme• 8 months ago

Do you really think health workers are all concerned about legalities first?

100%. Legal issues are a huge deal in healthcare. This is a snippet from a study [1] on the topic, just to get an idea of the scale (which I think most do not realize at all):

---

Each year during the study period, 7.4% of all physicians had a malpractice claim, with 1.6% having a claim leading to a payment (i.e., 78% of all claims did not result in payments to claimants). The proportion of physicians facing a claim each year ranged from 19.1% in neurosurgery, 18.9% in thoracic–cardiovascular surgery, and 15.3% in general surgery to 5.2% in family medicine, 3.1% in pediatrics, and 2.6% in psychiatry. The mean indemnity payment was $274,887, and the median was $111,749. Mean payments ranged from $117,832 for dermatology to $520,923 for pediatrics. It was estimated that by the age of 65 years, 75% of physicians in low-risk specialties had faced a malpractice claim, as compared with 99% of physicians in high-risk specialties.

---

I can give a very specific example of how legal issues play directly into behavior, and how it leads to antibiotic over-prescription. Antibiotics are obviously useless against viral infections but many, if not most, doctors will habitually describe them for viral infections anyhow. Why? Because a viral infection tends to leave your body more susceptible to bacterial infections. For instance a flu (viral) can very rarely lead to pneumonia (bacterial). And that person who then gets very sick from pneumonia can sue for malpractice. It's not malpractice because in the average case antibiotic prescription is not, at all, justified by the cost:benefit, but doctors do it anyhow to try to protect themselves from lawsuits.

There have been studies demonstratively showing this as well, in that doctors who live in areas with less rampant malpractice lawsuits are less likely to prescribe antibiotics unless deemed necessary. Or if you have a friend/family in medicine you can simply ask them about this - it's not some fringe thing.

[1] https://web.archive.org/web/20250628065433/https://www.nejm....

energy123• 8 months ago

Incompetence and laziness among doctors is a big cause. As a professional you've probably worked with many colleagues you thought were bad. Well there are doctors like that too. Many of them. And unlike in tech, they don't get let go if they're bad. They stay around and keep "treating" patients.

nrhrjrjrjtntbt4• 8 months ago

I was thinking this the other day about GP. If I work in tech I work in a team and we pair. Why doesnt this happen with doctors. Why is everything all on one mind to get wrong or right. Yes there is a team of doctors sometimes but they communicate via emails async and you visit one then the next and so on. I guess I know the answer. Money.

photon_lines3• 8 months ago

This is 100% true, especially in Canada. I've had multiple encounters with doctors who were not fit for their positions and should not have been working as doctors. One of them nearly killed my mom, and another one was suspended due to malpractice and performing research fraud, but was given her license back and is back to work at the moment. Yes she is fully licensed and back to working as a regular MD in Canada: https://en.wikipedia.org/wiki/Sophie_Jamal

moomoo112• 8 months ago

Yep. I had a misdiagnosis because of a dumbfuck doctor and I’m eternally grateful for the Cleveland Clinic doctor who fixed me up.

Fuck that bad doctor, it’s not like they’re some Holy Paladin. He had no remorse either and didn’t really pay much attention to me.

I hope AI puts as many doctors out of work as possible so that only the best, like my CC doctor, remain.

zahlman2• 8 months ago

Okay, but we're also specifically told to wait for ambulances because they can administer certain forms of care within the vehicle, right?

grogenaut4• 8 months ago

Like most things, it gets pretty complicated. I went through 200 hours of training (EMT) which essentially helps me sort into what makes me go safe, go fast to a medic en route or a hospital, and go fast to a hospital (where a paramedic can't help much or at all). The goal of all Emergency medical personnel is to get people to definitive care (not EMS).

Asking a lay person to know what a BLS (non-EMT fire & police), EMT (Ambulance), Parmedic, or MSO can take care of, or even what the differences are, is, I don't think, super useful. The red vehicle shows up and takes you to care.

In the case of MCI, EMTs can a) give aspirin or nitro (rx), b) have an AED and lots of CPR training but have to stop the vehicle to give effective compressions, c) a radio and the ability to meet up with Paramedics.

Paramedics have more complex treatments (drugs) and EKGs, but it's still 2 folks in a truck, not a hospital. They can do amazing things.

But as the joke goes, sometimes the best treatment is High Volume Diesel Therapy (burn rubber).

kelnos3• 8 months ago

It kind of depends. EMTs are able to do some things, paramedics are able to do more things, and the hospital itself can do even more things.

I live about 6 minutes from the closest ER. If an ambulance can get to me in, say, 3 minutes, it's still not clear if it's better for me to get myself to the ER on my own. Maybe I get an ambulance with EMTs who aren't trained/authorized to do what needs to be done for me. Maybe I really need to be at the hospital within 8 minutes or I'm going to die, and waiting for an ambulance just isn't going to cut it.

But I think, statistically, people should usually prefer to wait for the ambulance. It's just that specific circumstances can make that the wrong move, but most people won't know when that's the case.

godelski2• 8 months ago

  > We're told a lot of things by "officials" not because it's correct

Often these rules are in place because they are statistically correct.

What needs to be understood is that no rule can be so well written that there are no exceptions. Rules are guides. Understanding this we can understand why certain guidelines are created, because they are likely the right response 9/10 times. This is especially important when dealing with high stress and low information settings.

BUT being statistically correct does not mean correct. For example, if the operator had information about the ETA of the ambulance (we don't know this!) then the correct answer would have been to tell them to not wait. But if the operator had no information, then the correct decision is to say to wait.

The world is full of edge cases. This is a major contributor to Moravec's paradox and why bureaucracies often feel like they are doing idiotic things. Because you are likely working in a much more information rich environment than the robot was designed for or the bureaucratic rules were. The lesson here is to learn that our great advantage as humans is to be flexible. To trust in people. To train them properly but also empower them to make judgement calls. It won't work out all the time, but doing this tends to beat the statistical rate. The reason simply comes down to "boots on the ground" knowledge. You can't predict every situation and there's too many edge cases. So trust in the people you're already putting trust into and recognize that in the real world there's more information to formulate decisions. You can't rule from a spreadsheet no more than you can hike up a mountain with only a map. The map is important, but it isn't enough.

kelnos3• 8 months ago

This was exactly what I was thinking (though less eruditely) when I was reading the blog post. In this particular case, waiting for the ambulance led to a worse outcome, but I would not be surprised that, statistically, a you're better off waiting for the ambulance than trying to get to the hospital via other means.

But unfortunately:

if the operator had information about the ETA of the ambulance (we don't know this!) then the correct answer would have been to tell them to not wait. But if the operator had no information, then the correct decision is to say to wait.

I expect the operator just is not allowed to give advice like that, even if they did have information on ambulance ETA. There could be liability if someone is advised to drive to the hospital, and something bad happens. Even if that bad thing would have happened regardless. I think that's a bad reason to do the situation-dependent incorrect thing, but that's unfortunately how the world works sometimes.

vondur2• 8 months ago

This is horrible. What is going on in Toronto that ambulances take 30 minutes to respond?

ch2026• 8 months ago

I’d assume it’s there’s X ambulances and Y calls and occasionally Y>X.

The bigger issue is the dispatcher not being aware of overloaded status nor conveying that information to the caller.

croes4• 8 months ago

There are also things like accidents or traffic jams

starkparker• 8 months ago

https://www.cbc.ca/news/canada/toronto/toronto-paramedic-sta...

Last year, Toronto paramedics reported that in 2023 there were 1,200 occasions where no ambulances were available to respond to an emergency call. That was up from only 29 occasions in 2019.
CUPE Local 416, the union representing 1,400 paramedics working in Toronto, has also reported high instances of burnout in recent years.

canucker20164• 8 months ago

There were several reports during the pandemic about lack of ambulance service in Toronto:

- 2022 - https://www.blogto.com/city/2022/01/toronto-ran-out-ambulanc...

- 2023 - https://www.blogto.com/city/2023/10/paramedics-raise-alarm-c...

from the 2025 Program Summary for Toronto Paramedic Services, https://www.toronto.ca/wp-content/uploads/2025/04/8d5d-2025-...:

- Page 3

- Avg 90th Percentile response times have gone from 12 minutes in 2019 & 2020 to 14.5 mins in 2024 and almost 15 minutes as a 2025 target: (12.1, 12.1, 13.0, 14.2, 14.0, 14.5, 14.8)

- staffing is up more than 50% in that time, while number of patient transports is up just 10% during that same timeframe

- Page 4

- scary graphic - graph concerning Daily Hours with < 10% available ambulances

- 2019-2020 - Daily Average - 0 hours, 43 minutes

- 2021 - Daily Average - 2 hours, 29 minutes

- 2022 - Daily Average - 5 hours, 57 minutes

- 2023 - Daily Average - 4 hours, 33 minutes

- 2024 - Daily Average - 4 hours, 9 minutes

torton2• 8 months ago

TL;DR chronic underfunding of the system, here's one example article:

https://www.cbc.ca/news/canada/toronto/ambulance-response-ti...

The federal government shifts the responsibility to the provinces, the provinces in turn try to download as much as possible onto the cities. There's not enough money for everything on every level of the government.

This also reflects on 911/dispatch systems, where there indeed might not be easy visibility of when an ambulance might be available, and even then it could be preempted by a higher priority call -- although a heart attack has to be close to the top of the list.

There are also occasional weather events, like the storm two days ago, that cause a surge in demand (>300 crashes reported and many of them needed attending to).

vkou3• 8 months ago

The federal government shifts the responsibility to the provinces

It's not a 'shift'. Healthcare has always largely been in the hands of the provinces.

The federal government funds research, distributes money from have regions to have not regions, and sets federal standards, but the actual spending of money and provision of services is in the hands of provincial authorities.

trnglina• 8 months ago

Healthcare is one of the exclusive powers of the provinces, as laid out in the constitution. There are things the federal government can do, such as provide money, but provincial leaders complaining about lack of federal involvement do so in bad faith; they would certainly complain louder if the federal government overstepped their bounds. It's worth pointing out that taxation and borrowing are also constitutionally protected powers of the province.

Insanity• 8 months ago

Toronto healthcare generally is quite below the bar. When I moved here 5 years ago, I was told that hospitals are short staffed, ambulances have significant delays, and when you do finally get care you are rushed through the system.

Fortunately I only had one encounter with a situation requiring ambulance (and subsequent hospital visit). Ambulance arrived in about 10 minutes, triaging before seeing a medical professional took hours. There were no rooms so I was kept in a hospital bed in the hallway along with other patients but with some monitoring.

Now to be fair - this was during Covid which understandably put pressure on medical resourcing.

xyzzy_plugh• 8 months ago

Healthcare funding is managed provincially and the Ontario government has been poorly managing the system, pretty consistently, for over a decade. Some would argue decades, but things do seem to be steadily declining post Covid, as they were pre-Covid. Over the last few years, several ERs have been experiencing intermittent closures, and at least one was closed permanently, due to staff shortage.

What's worse is that the closures are poorly communicated. I know of at least two people who, within the last couple of years, went to an ER only to find it closed.

With respect to Toronto, and more specifically ambulance services, they are jointly funded by the province and the city, but I understand that provincial funding is more significant.

All parties recognize things are not functioning well, and various attempts at increasing spending have been made, but any effort will take significant time before results are visible. I'm not particularly optimistic, and the current provincial government's track record here is dismal. Their policy is to be tight-fisted.

pas4• 8 months ago

like in many places people live too scattered (higher density would provide more healthcare facilities closer to people), service costs are enormous, and productivity is abysmal

klipklop• 8 months ago

Massive population growth, without adding a meaningful amount of new healthcare workers?

moralestapia3• 8 months ago

family members were too naive to know that the thing they were instructed to do by the state was a false thing

Would be interesting to see everyone who jumped in here yesterday [1] to comment on this one as well.

1: https://news.ycombinator.com/item?id=45889297

CamperBob2• 8 months ago

What terrifies me personally is that people with 2-digit IQs are apparently being employed in virology labs. That's the kind of realization that could undermine anyone's confidence in government.

Marsymars• 8 months ago

I don't know that there really exist any jobs where someone with a 99-IQ who's hard-working and dedicated to getting through the hiring process would never get hired.

And really, if your critical virology lab procedures depend on having a double-digit IQ as a floor... you're probably hooped anyway the next time your 120-IQ employee is having a bad day where they slept poorly and are distracted by family problems.

komali2• 8 months ago

The problem with Canada and the USA is that there's no educated ideology primed to capture the inherent distrust people have of systems that used to work and now don't, such as government authority.

People should absolutely question authority basically all of the time. Authority should be justifying its competence to tell you what you should be doing with every decision it hands down. But there's nobody on the other side of the AM radio hosts to say "yeah the flip flop on COVID masks was weird but it's probably not because billionaires are putting tracking devices in the masks and more because the CDC just didn't understand the issue correctly yet. Here's some studies on the effectiveness of mask wearing in slowing the spread of disease, seems smart to wear one just in case?"

Instead you have neoliberal America, politicians on every side of the aisle saying "no matter who we are, at least always trust us," and the only vent from that is alt right and conspiracy theorist podcasters.

moralestapia3• 8 months ago

Authority should be justifying its competence to tell you what you should be doing with every decision it hands down.

1,000%

unnamed76ri• 8 months ago

I’ve been reading Influence by Robert Cialdini and just finished a disturbing section about how we are wired to obey an authority figure even when it causes harm. In this instance, the 911 dispatcher was the authority figure. Sad story.

gryfft3• 8 months ago

See also the Milgram Experiment.

croes4• 8 months ago

Doesn’t fit here because you don’t know if obeying or ignoring causes the harm.

croes4• 8 months ago

In such cases how do you in advance what causes harm? Waiting for the ambulance or driving yourself? People died also because they didn’t wait for an ambulance.

rogerrogerr2• 8 months ago

(Not GP): Heart attacks and strokes are the two things where I will always load family members into the car and get to the hospital as quickly as practicable. Time is brain, and time is heart. I’d call 911 on the way and have them notify the hospital what’s going on.

I figure that if I’m a 10 minute drive from the hospital, it’s highly unlikely that lights and sirens will get to me and then to the hospital quicker than I can do only the second leg. If they want to meet me halfway, fine - but if they aren’t there, I’m not waiting.

Everything else? Sure, we can wait for the ambulance. I can control bleeding or whatever and you’ll live through some pain without lasting side effects. But if there isn’t blood going to an organ, we are gonna get that fixed ASAP.

nrhrjrjrjtntbt4• 8 months ago

Causes harm is the hard thing to know. In the London Grenfell fire the dispatchers said stay in the appartment. This is correct advice, except when some dodgy supply chain middleman puts effectively what amounts to gunpowder up all the external walls.

analog8374• 8 months ago

It's like we're wired to trust what we're told over what we see.

The one doing the telling is the confident man on tv and the people around us.

What's funny is, 9 out of 10 people are totally credulous. They'll swallow any foolish thing as long as a authority says it. That last guy is a skeptic. BUT if everybody around him AND the authority are saying the thing, then he believes it. Because that's reasonable, right?

jimmydddd• 8 months ago

During the 9/11 attacks in NYC, the folks in the second tower were instructed to stay in the building after a plane struck the first building. Also good advice until a second plane struck.

burntoutgray• 8 months ago

From the caller's perspective the dispatcher is the authority figure. But that person is just at the bottom of a pyramid. The supervisor, the section manager all the way to the CEO and shareholders.

croes4• 8 months ago

my dad is dead, because his family members were too naive to know that the thing they were instructed to do by the state was a false thing.

Hindsight is 20/20. There are also cases where people died because they didn’t wait for the ambulance. So without proper statistics that‘s a dangerous conclusion.

captainkrtek11• 8 months ago

My condolences, very sorry for your loss.

I work as an EMT (911) and resourcing is certainly a problem. In my small city, our response time is around 5 minutes, and if we need to upgrade to get paramedics, that’s maybe another 5-10.

However, if we are out on a call, out of service, or the neighboring city is on a call, now the next closest unit is 15+ minutes away.. sometimes there can just be bad luck in that nearby units are already out on multiple calls that came in around the same time, making the next closest response much further.

for a heart attack or unstable angina, the most an EMT will do (for our protocols) is recognize the likely heart attack, call for paramedics to perform an EKG to confirm the MI, administer 4 baby aspirin to be chewed and/or nitro (rx only), and monitor closely in case it becomes a cardiac arrest. If medics are far away we will probably head immediately to a hospital with a catheterization lab, or rendezvous with medics for them to takeover transport.

The few goals though:

- recognition (it could also be something equally bad/worse like an aortic aneurysm).

- aspirin to break any clots, assist administering nitro if prescribed.

- getting to a cath lab.

prmph4• 8 months ago

Is it recommended to take or give aspirin ASAP before the EMTs arrive? If so, I wonder if the dad took it.

pugio4• 8 months ago

Assuming no sensitivities/allergies, give 300mg chewed for faster absorption immediately. Normally (where I am) the dispatcher will tell you to do that on the phone.

captainkrtek11• 8 months ago

Yes you could (assuming no allergies or gi bleeds) and just inform the incoming EMTs

laszlojamf3• 8 months ago

Apparently it's no longer recommended, since it could also be an aortic rupture, and aspirin would make it worse. https://www.health.harvard.edu/heart-health/should-i-take-an...

amluto• 8 months ago

Does this mean that someone having a likely heart attack should have someone drive them to an ER in advance of paramedics arriving?

captainkrtek11• 8 months ago

I’d say no if it were my family, and I know the response times in my area, but the story in the blog is a nightmare scenario.

People can go from heart attack to cardiac arrest quickly, and you don’t want to then tell medics you’re on the freeway and now need to do CPR.

See: https://m.youtube.com/watch?v=mxUqHwHbNtk&t=1520s

Around the 11 minute mark this man went into cardiac arrest, a moment prior was still talking.

frenchman_in_ny• 8 months ago

I'm coming at this as someone who had an MI at a relatively young age:

For the goals -- and this may differ between EMT / paramedic & protocols -- but I would really wish that there was a blood draw done in the field. Before they bring you to the cath lab with a suspected MI, the ER is likely going to draw blood to get troponin levels at a 2-hour interval. You could save some time & heart muscle by getting a blood sample (containing initial levels) in the field.

captainkrtek11• 8 months ago

Certainly protocol dependent, and likely more in the paramedic realm.

DrewADesign• 8 months ago

Maybe paramedics, but basic EMTs don’t even start IVs where I am— It’s the sort of thing you can get certified to do in a few weeks and pays about as much as entry-level fast food work. Phlebotomy is a lot more nuanced afaik.

ryanjshaw2• 8 months ago

Possibly a dumb question, but wouldn’t the other thing you do be to carry the guy out on a stretcher? It seems like her dad was able to get into the car but that last bit where he got out at the hospital and walked was just too much. Or do you think the stretcher would make zero difference?

captainkrtek11• 8 months ago

Yes! These patients are critical and we would not let them ambulate themselves to the ambulance, we would insist on loading them and moving them ourselves to limit exertion. Extra exertion could tip them into cardiac arrest.

jakebasile• 8 months ago

If the author sees this, I'm sorry for your loss.

Losing family is hard, but losing them suddenly makes it harder. Losing them suddenly because of poor advice or (in)action of people who are supposed to help is yet more difficult. I know from experience.

It does get easier to deal with, in time.

mrcwinn• 8 months ago

There's another scenario where someone heads to the hospital and get stuck at a red light or behind and accident or you're speeding and kill someone. It's just hard to know sometimes which path to pick when you don't have a guaranteed outcome on either one.

In any case, I'm sorry for your loss. My dad died too due to a heart attack, except he was alone.

gryfft3• 8 months ago

This just doesn't seem like it takes probability into account. Getting someone to the hospital fast is almost always going to be better than waiting, and moving someone isn't usually inherently damaging if they don't have a spinal injury. In the context of a heart attack, it seems indisputable to me that it is better to drive if you have a safe and sober driver available.

bensonn2• 8 months ago

It isn't all about getting somebody TO the hospital but getting them INTO the hospital/ED/ER. EMS in an ambulance who are alerting a hospital of an MI enroute will get their attention, a walk-in will have to wait unless there are obvious signs.

Calling 911 will normally get LEO on scene that know CPR and can do radio communications. A lot of dispatchers are EMDs (emergency medical dispatchers) that can start helping immediately. You may have off duty EMTs nearby that are scanning the radio. Finding a fixed target it much easier than finding a moving target (white car headed towards hospital), you are on your own if you get stuck in traffic. Statistically, 911/EMS is the best outcome. I agree with another commenter, exceptions do exist.

the_jeremy• 8 months ago

Thanks to this I looked where my nearest ER is and found that it's 7 minutes away, so I can't imagine calling an ambulance for my wife unless I was worried about her spine. (I don't think she can lift me so the reverse isn't true.)

michaelhoney• 8 months ago

I'm sorry this happened to you/Jenn.

I lost my brother to a heart attack aged 50, but he died immediately. In the end it was very quick, but he had warning signs for years. Look after yourselves, people.

riffraff• 8 months ago

Let me add one thing: high blood pressure is both very bad and sometimes has no clear tell signs, and cake people doing sedentary work like IT folks it's very common. Get tested regularly.

pugio4• 8 months ago

I can speak to this. I recently joined a community first responder association (I've always wanted to know what to do in case of a medical emergency) and was shocked to hear the members' horror stories of how long it can take an ambulance to arrive. Like the author, I grew up with the narrative "in trouble, call the ambulance, they'll scream through the streets to get to you in moments".

That might still be true where I grew up, in the US, but that's certainly not a guarantee in Melbourne, where I now live. On joining the local volunteer organization, I went from thinking "oh this will be a useful bonus for the community" to "wow, we can literally be essential". Since our org is composed of people living within the community, average response time to ANY call is <5 minutes (lower for cardiac arrest, when people really move). Sometimes one of us is right next door.

We can't do everything an ambulance paramedic can, but we can give aspirin, GTN, oxygen, CPR, and defibrillation. We can also usually navigate/bypass the usual triage system to get the ambulance priority upgraded to Code 1 (highest priority, lights + sirens, etc.) If for some reason the ambulance is far away (it backs up all the time), we can go in the patient's car with them to the hospital, with our gear, in case of further issues in transit.

I tell everyone now to always call us first (since our dispatcher will also call the ambulance) but while I feel more confident in how I'd handle an emergency, I feel less safe overall, with the system's faults and failings more exposed, and the illusion of security stripped away.

My condolences to the author.

In terms of updating - consider whether The System is really working. If not, what can you do yourself (or within your larger network) to better prepare...

gobins• 8 months ago

Wow melbourne is getting that bad! Does your org have a name?

softgrow2• 8 months ago

Sounds like Hatzolah Melbourne, https://hatzolah.org.au since 1994

Since 1998, in Melbourne for anything that might need a defibrillator a fire engine is sent at the same time as the ambulance (EMR Emergency Medical Response Program). https://www.mja.com.au/journal/2002/177/6/cardiac-arrests-tr... Medical Journal of Australia article. There is also GoodSAM https://www.ambulance.vic.gov.au/goodsam/ for individual helpers

scorpioxy6• 8 months ago

Oh yes. Quite bad and I don't know if things are getting slightly better than "bad" or the media is tired of reporting about it.

Up until a year or so ago, an appointment at a GP would take weeks of waiting. Specialist appointments were 1+ years waiting time. This is somewhat better now with the establishment of critical-care clinics operating after hours. This is from personal experience.

The emergency rooms often had waiting time of 12+ hours(or more). I know someone who has been waiting on a procedure at the public hospital for 6+ years. Another has a child waiting for an appointment with an estimated wait time of 3+ years. All non-urgent but a wait list in the years is no longer a wait list to me, it's a system that is not fit for purpose.

Initially all of this was attributed to the pandemic and the harsh lockdowns in Victoria. But a few years out, it seems difficult to still do that. When asked, our government just re-states that they've invested in this and that and then deflect. Recently, due to the horrible state finances, the healthcare system was being downsized with services cut and the bloodshed continues. This is without talking about the systemic issues and incompetence I've seen.

The funny thing is that outsiders think that public health care means free. It's really not. We pay for it on top of our income tax(1-2% on top, more if you're above a certain threshold) and it is not cheap. It wouldn't be so bad if it was working like you'd expect but paying for a non-functional system is....I don't know what to say.

anotherevan• 8 months ago

Would that first responder association be Good Sam?

https://www.goodsamapp.org/oz

I've been thinking of joining that.

pabs3• 8 months ago

The emergency service number should be calling the closest first responders, not the other way around...

rich_sasha2• 8 months ago

My cousin's 3yo daughter stopped breathing one night, woke up struggling for breath, turning blue. They called the ambulance. Dispatcher said, 3 hr wait, and pretty please get off the phone, as there's a queue of callers.

She started breathing again after a few minutes and seems fine, but they left the UK not long after that.

pfannkuchen2• 8 months ago

The dispatcher must not have understood right? This is like evil levels of incompetence otherwise, because the system can’t possibly be designed to do that right? So the dispatcher must have been in the wrong, but to make the dispatcher not completely evil we have to make her merely stupid and/or careless. That’s terrifying. Where did they go to if you don’t mind me asking?

verelo• 8 months ago

That’s wild. I fell off my garage roof almost 2 weeks back. My wife called the ambulance, they arrived within 20 minutes. We are in rural Ontario, 30 minutes from the nearest hospital, on a dirt road that is privately owned and maintained. I expected over an hour.

I plan to make a trip in to the ambulance hall and fire hall this week and say thanks. I am ok, fractured vertebrae, but honestly i just am so grateful for the public service they provide.

tetris11• 8 months ago

London, last year - 90 minute wait for an ambulance to the hospital 10 minutes away.

We called an Uber

moomoo112• 8 months ago

First of all, my condolences to the author.

I resonate with your thoughts about USA response times. We lived in a middle class suburb with mostly immigrants. When I was 10 my mom slipped in the bathtub and was knocked out. I dialed 911 crying and within 2 minutes a cop had arrived and only a few minutes later the fire truck first response had arrived. They helped my mom out and she was fine afterwards.

It was so crazy for 10 yo me. I thought my mom was gone.

I am so sorry for what the author and his family had to endure.

pfannkuchen2• 8 months ago

On the ambulance delay time. Have people perchance started calling ambulances for less and less serious matters over time? Thus increasing the calls per capita. I could kind of see that given what I’ve heard about 911, but then again maybe not. Also I feel like 50 years ago people would have been more worried about having some enforcement action taken against them for wasting the 911 line’s time on something inappropriate? Not sure if that enforcement ever actually happened, though.

Spooky23• 8 months ago

Yes, but cities design for that. Urban paid departments have a 7 minute response time or less.

My mom lived in the country, and the sheriff there started a paramedic service and trained deputies as EMTs. It made a huge difference as the paramedics arrive first in most cases.

stickfigure2• 8 months ago

That response time is better than where I live, in the country about an hour north of Oakland. Paramedics are about 30m away. We're a volunteer district and I'm a volunteer, but when I get paged it takes a few minutes for me to get dressed, 5m to get to the station, a few minutes to get the engine started, and ? mins to get to the incident. Realistically, the minimum response time is 15m.

Sounds like you keep medbags at home and respond directly to the incident in personally owned vehicles? That's a neat idea. Does everyone have a medbag?

pugio4• 8 months ago

Yes that's right. We have a pretty extensive kit we keep in our car at all times. There's also a mobile app for alerts, navigation, and writing down vital signs and patient care records, and a radio for direct contact to dispatch and other responders.

evanelias• 8 months ago

Even in the US, response times can really vary. As an extreme example, in Jersey City (population ~300k) there were a bunch of incidents a couple years ago where residents called 911 in an emergency and no one answered.

burnt-resistor• 8 months ago

E911 (location information sharing) also doesn't work consistently.

The advantages of coming in an ambulance are traffic priority, priority attention in the ER, and medical triaging and coordination. The disadvantages in the US can be extremely expensive to some people if they don't have the correct insurance and inconsistent timeliness.

The advantage of coming in a private vehicle are speed (usually), but at the disadvantage of having to get past ER gatekeepers and lack of information and preparedness. It is probably wise if possible to have a third person in the vehicle call the ER at the destination hospital to let them know what generally should be expected.

Another issue is that it's inherently risky to live more than 30 minutes driving distance from a major city hospital. To do so basically necessitates a life flight which is extremely expensive and not necessarily quick either.

The for-profit, gotcha capitalism monopolization of hospitals and medical services by private equity also results in worse, deadlier patient outcomes, hospital closures, and more expenses. Medicare for all (m4a) isn't a fix because of the Medicare Advantage scam, the medigap scam, the part D scam, and the lack of long-term care, skilled nursing, dental, vision/glasses, mental healthcare, and hearing aid coverage that doesn't provide true comprehensive single-payer healthcare at a sane cost per patient and with better outcomes.

gpt5• 8 months ago

Melbourne has an excellent ambulance response time (defined from the moment 000 call is received to when the first ambulance resource arrives on scene):

* Average Code 1 response time: 12 minutes 47 seconds

* Code 1 responses within 15 minutes: 77.2%

* Number of Code 1 first responses: 12,375

This places Melbourne among the faster councils in the state, and well ahead of the statewide average response time.

Source: The Victorian Parliamentary Budget Office’s 2025 report: https://static.pbo.vic.gov.au/files/PBO_Ambulance-funding-an...

kelnos3• 8 months ago

Perhaps my understanding here is lacking, but that doesn't sound good at all. Feels like if someone has some sort of cardiac event, or, worse, isn't breathing, by the time the ambulance gets there, they'll be dead, with too much brain death for any resuscitation effort to be worth it.

apimade• 8 months ago

I live in Merri-bek. 50%. 3km north of Melbourne CBD.

I can drive to an ED within 3-5 minutes.

This report doesn’t make me feel good.

johnisgood2• 8 months ago

how long it can take an ambulance to arrive

When everything is far apart, or you live away from a city, that is definitely true. This is one of the cons of living outside the city. There are many perks, but this one is a con for me for sure. Especially because I have MS and I do not drive nor have a car.

mathgeek• 8 months ago

Although we're a world away from each other, thank you for what you do. I greatly appreciate it.

weddpros4• 8 months ago

My sincere condolences to the author. Wishing you strength and peace.

I once saw a man have a heart attack on the beach, less than a 5 minutes drive from a fire-station and rescue team. A helicopter arrived after 45 minutes, and the man was deceased already. That was in Martinique, french Caribbean.

There's a need for an app to let patients track the ambulance. It's been possible for 10+ years, as seen with Uber. It seems existing products have focused on tracking only for the purpose of managing a fleet, missing the focus on patients needs.

selcuka• 8 months ago

There's a need for an app to let patients track the ambulance

I don't want to blame anyone, but I'm pretty sure that kind of visibility is not desired.

weddpros4• 8 months ago

Not desired by whom? I think transparency is desired by citizens/customers. Do you think there are (good) reasons why obscurity is preferred?

stinkbeetle2• 8 months ago

my dad is dead, because his family members were too naive to know that the thing they were instructed to do by the state was a false thing.

The primary goal of the state is to ensure the power of the state is perpetuated. It's really the only goal of the state, anything it does good for its people is a side effect in its pursuit of maintaining power.

The government doesn't care about you, doesn't care about your health, your children's education, your safety, your house, your job, anything else about you except in as far as they provide conditions for people sufficient to avoid large scale civil unrest and threat of government losing authority. If individuals get crushed in the machine, nobody gives a shit, least of all the government.

This is the reason vigilantism is viewed so harshly by the state and tends to attract much more attention and harsher punishment than a crime that was not motivated by justice. Not because the outcome for a victim of vigilantism is any different, but because the act threatens to undermine the authority of the state in application of justice.

The biggest perpetrators of atrocities and injustice, war, murder, theft, genocide, death and suffering through negligence and incompetence, has been the state and agents of the state. Everybody should be critical of everything the government, politicians, bureaucrats, "experts" tell you at all times. Consider they can and do lie and cover-up as easily as a person drinks water, consider motivations, and explore outcomes and alternatives and consider what is best for you, your family, your community, your society. Use your common sense, don't prejudice your ideas with what gets repeated about things. Develop plans accordingly, or at least spend a little time to think about these things.

This is not "conspiratorial". The actual conspiracy theory would that those in government are conspiring to actually help the people foremost. Anybody who puts forward that kind of crazed unfounded conspiracy theory had better come up with air-tight evidence, otherwise they'd just be peddling far-something ultra-something disinformation.

roncesvalles2• 8 months ago

The primary goal of the state is to ensure the power of the state is perpetuated.

Well, that makes sense considering failure of the state is a very, very bad situation.

stinkbeetle2• 8 months ago

That's not why it makes sense. And it's not even true, the failure of Pol Pot's communist state was best for the greater good, the failure of the Nazi state was a good thing. The failure of the Islamic State was great too (not always necessarily true for everybody who have hitched their wagons or bet their fortune on the success of the state of course, but for most people).

Whether the success or failure of the state is good or bad for people is irrelevant to the goal of the state, as I said. You can and do have states that are better or worse for the people, all share the goal of the perpetuation of the power of the state.

moralestapia3• 8 months ago

[flagged]

beyondCritics• 8 months ago

It is terrible to lose a relative in young age. But at least 80% percent of all heart diseases are known to be fully avoidable. The risk factors are known for ages and as matter of fact every adult is fully responsible to care for his own health. The right thing to do, is to watch out for a healthy diet.

samdoesnothing2• 8 months ago

Such a tragedy, and I'm really not surprised it happened in Canada. Our healthcare system here is utter garbage and there isn't really any political will to do anything about it because "it's better than the Americans at least" (it's not). I don't buy that it's underfunded either, it's just sorely mismanaged and nobody wants to build or grow. Even a child could tell you if you increase the population of a country by 10% in ten years, you also need to grow its infrastructure by at least that amount - but our political class are idiots and haven't even considered it. After all it's not "green" to build more hospitals. And thus we get situations like this where there literally aren't enough ambulances to handle the load.

I'm sorry if I'm ranting under a post about a father's passing, but tragedies like this are so avoidable that it practically sends me into a rage. This person should still be alive, she should still have her father. Fuck sakes.

canucker20164• 8 months ago

Not 10% population increase in ten years, it was 10% population increase in 3 years. (An increase in immigration rate of 4x over those three years compared to the previous 20 years - makes the USA's southern border influx look minor in comparison)

And the population increase wasn't spread evenly across the country...

samdoesnothing2• 8 months ago

jfc

canucker20164• 8 months ago

I was wrong about the size of the increase - after checking the numbers again, the increase seems to be about 80-100% increase in immigration since the pandemic started (an exception is the first year of the pandemic where it dropped below previous year levels).

dnlzro• 8 months ago

What makes you draw that connection between climate policy and a lack of new hospital/healthcare construction projects?

Magi6042• 8 months ago

This is a very tragic story and my heart goes out to the family. It's one I've seen a few times now and hear about on a very regular basis from my coworkers.

I am a Canadian Paramedic (EMR soon to be PCP in a few months, roughly equivalent to EMT and AEMT respectively). Some things strike out at me:

- Here in BC our calltakers can advise patients on some treatments. I'm sure if that were to happen here, they would have advised the family to administer some ASA (Aspirin) to the patient which would have bought valuable time until professional care could be reached. Even if it was found to be contraindicated, the fact it was not mentioned in the blog post stands out to me.

- I'm not familiar with the geography of Toronto or its normal traffic patterns, but it's surprising that a single ambulance was not 30 minutes from the patient driving lights and sirens at that time of night (shortly after dinner).

- Fire crews here in BC are dispatched to severe medical incidents (like heart attacks) and most of the time can even beat ambulance crews to a scene. They would have been able to provide CPR if needed, possibly even ASA or Nitro depending on their scope. So again it's surprising that there's no mention of them. Perhaps they aren't dispatched to medical calls in Toronto?

- Lastly it's surprising that the calltaker had no visibility on where the dispatched crews were at. At the very least they could have radioed the crew to get an ETA. I guess I just take it for granted that over here we are tracked as soon as we sign in to our vehicle (it's a safety thing especially in some of our more rural/remote stations). If the ambulance was just about to reach the patient right before the family decided to go to the hospital on their own, things might have turned out differently.

Also since I'm assuming that a large percentage of HN readers are older males who are at risk of a heart attack (due to factors like working desk jobs and not keeping up with fitness as much), read up on the signs and symptoms of a heart attack and keep a bottle of aspirin at the ready. Bodies are complicated and weird and you never know.

fsckboy2• 8 months ago

Fire crews here in BC are dispatched to severe medical incidents (like heart attacks) and most of the time can even beat ambulance crews to a scene

according to the blog post, the father was talking (said "be careful" about a left hand turn) and apparently ambulatory (collapsed on his way into the hospital), so perhaps it wasn't yet considered a severe medical incident yet.

in the post she was told by her mother that father was in the hospital and she could visit him in the morning. This was at 11:30pm, hours after the arrival at the hospital which was within an hour "after dinner"

seems to me the father's condition was not known to be that severe, and well after the "late" arrival at the hospital he was thought to be in good condition. (tho always possible the hospital staff was not keeping the mother informed)

Magi6042• 8 months ago

So I don't know exactly how Toronto operates their ambulance service, but unless the family gave some bad details, the calltaker should have gleaned that they were likely dealing with a case of cardiac-related chest pain, and that's right at the top of the list of severe emergencies, regardless of how far along it has progressed, at least over here anyways.

I should add I feel a little queasy about dissecting this blog post for details. It seems more like a cathartic exercise for the author rather than some breakdown review of how the incident went, so it seems like some details were left out on purpose.

grogenaut4• 8 months ago

At least in my area, King County area, a call of severe chest pain would immediately get units rolling code (lights+sirens) for CHEST PAIN. Pulse point, which works in our area, would also start paging BLS certified people in the neighborhood who have the app.

When I've called 911, the dispatchers grilled me going right down the list of signs and symptoms and did an excellent triage job.

I'm a volunteer EMT / FF at a pretty rural station, and the thing that slows us down the most is traffic if we're coming from behind the accident, and distance. As the sibling / gp said, the dispatchers know where we are via gps at almost all times and usually tell the RP (Reporting Party) when we're close so someone can go out and flag us down.

I don't mean to be argumentative, just provide what I know working as a volly FF/EMT for a year. As others have said, this is tragic.

tensor• 8 months ago

Yes they send fire here in Toronto too. They frequently beat the ambulance. And yes they prioritize heart issue above all else too.

markus_zhang• 8 months ago

I’m so sad to see this. For anyone who reads this, get a day, learn CPR, and buy that machine if your parents or whoever has history of heart issues. The machine doesn’t fix every kind of heart diseases but the trainer told me it decreases the possibility of death from a heart attack greatly. I recall that the possibility is lowered by 50% if you do CPR and 80% with the machine.

It is not hard to use the machine as it has clear instructions. They probably expect you to still be able to read when in panic.

girishso• 8 months ago

Which machine? Defibrillator or EKG?

infinet• 8 months ago

GP likely means defibrillator. EKG along won't save life and it requires training to read EKG. An AED has a built-in smart EKG that can identify shockable fibrillation. There is also automatic CPR machine that can do chest compression. However manual CPR is still light years better than no CPR.

jopsen• 8 months ago

This was the first heart attack.

Sometimes lightening strikes, you have bad luck. And there is no guarantee that getting to the hospital faster would changes the outcome.

But taking the car is decidedly a decent option of the hospital is only 15 mins away.

manyturtles• 8 months ago

Alas the data doesn't agree: "Bystander-initiated CPR may increase [survival] odds to 10%"

From: https://www.npr.org/sections/health-shots/2023/05/29/1177914...

Referenced underlying study: https://pubmed.ncbi.nlm.nih.gov/20123673/

Absolutely worth training for and administering, but far from 100% success.

grogenaut4• 8 months ago

yet it can help. no direct counter stats to your stats but different data: https://www.mediconefoundation.org/whyandhowtohelp/ https://newsroom.uw.edu/news-releases/study-spotlights-cardi...

getting compressions going and getting an AED onboard is the focus of this program. that means getting people and responders trained on CPR + AED.

twodave2• 8 months ago

I feel this, but in reverse. My son could be dead, but he’s not. He was born on the floor of a trailer park apartment, not breathing. His birth mother’s partner called 911, who dispatched an ambulance. All rescue units for his zone were already busy. An ambulance returning from the nearby hospital to another zone heard the call over the radio and happened to be passing by. The hospital was expecting a DOA, but the paramedics (HEROES) managed to get him breathing again on the way. He’s 11 now, and he is the source of all kinds of trouble and joy. Our home would be very different without him.

mlrtime• 8 months ago

Amazing story, Thank you!

jredwards• 8 months ago

I cannot even imagine the horror and the relief. I imagine if I were those paramedics, getting a card or a picture from that kid would make my whole year.

jll292• 8 months ago

Ex-paramedic here. Happy to here your son is fine.

But either you mistold the story, or the paramedics made a mistake: ambulances are not supposed to transport a dead person - the paramedics are first to resuscitate and stabilize the patient, and only then initiate transportation.

(I understand you may not care, because the outcome of their action incidentally was one you like.)

IAmBroom• 8 months ago

You are assuming things twodave didn't say.

He didn't say the baby wasn't breathing when they picked him up. He said the hospital was expecting a DOA - presumably because of the news along the way, before they resuscitated the baby.

twodave2• 8 months ago

There is probably some nuance that I am just not aware of. As the adoptive parents it is difficult to get the full account, since we weren't present until a few hours later.

From what I was told, he was born with the umbilical cord wrapped around his throat, and just kind of "fell out" while his birth mother was walking from the bathroom to the living room. I know that part is true, at least, because we saw the apartment floor the next day...

I think probably the paramedics were able to detect some faint vitals upon arrival. Since the birth mother and her partner weren't super reliable or coherent, we weren't really able to piece it all together until we tracked down the two young men who helped save our son's life that night.

deburo• 8 months ago

This must have happened within seconds otherwise he must have been breathing almost imperceptibly, right? Otherwise how could his brain still survive?

mdavidn• 8 months ago

Infants don't breathe before birth either. A beating heart would provide umbilical circulation for a few fleeting minutes.

captainkrtek11• 8 months ago

When the baby passes through the birth canal, the pressure forces any fluids (ideally) out of the baby's lungs, then the contact with air, the temperature drop, and other physiological changes trigger the first breath/inspiration. However, the baby is still attached via umbilical cord to the placenta, and is still receiving good oxygenated blood from mom until the placenta detaches, then the pulse of the cord stops (this can take minutes). But yeah, an apneic baby is a very time sensitive emergency.

hitensethiya• 8 months ago

Really sorry for you man! May his soul rest in peace.

MarkusAllen• 8 months ago

test

anonymousiam• 8 months ago

The post mentions Toronto, so I'm going to assume that the publicly funded Canadian health care system bears some responsibility for the sad outcome.

drgo• 8 months ago

Yes. If emergency services were run by a private company, like airlines for example, they will never ever be 30 minutes late!

pas4• 8 months ago

that's not exactly fair, air travel is very well optimized for safety and costs, not for availability and latency (and cost in public systems)

sklargh• 8 months ago

First, I want to offer my condolences to the author. I lost my father suddenly at a similar age—it's terrible. Sending positive energy. Former Firefighter-EMT here — I did this a long time ago in a rural setting). Now to the practical matter. I want to offer some frameworks for thinking about this in rural or exurban transport situations. This is not risk-free or even optimal, and can put you in worse position, but it's worth considering seriously if you suspect you may have a very long or delayed transport time to the hospital.

Before anything else, ask yourself two things:

Would this person possibly benefit from (A) an automatic external defibrillator (AED) or (B) Narcan[1]?

Can the person safely get into a car and be driven to the hospital?

If the answer to 1A or 1B is YES: Don't drive. Call 911, clearly state "cardiac arrest," or "overdose" give your exact location, and start effective CPR if required. A police officer with an AED will likely arrive quickly. Getting the location right is critical—this is life-saving information.

If 1A/1B don't apply and you can answer YES to question 2: You have some thinking to do. I suggest doing it now, in advance, whenever you move—think through how you'd handle massive bleeding, heart attack, or stroke symptoms.

It's worth briefly considering emergency scenarios and the risks you're willing to accept. Ambulances or fire engines sometimes can't reach you quickly: logistical issues, mechanical failures, dispatcher problems, insufficient volunteers. In rural settings during a cardiac event, waiting thirty minutes for basic EMS care—followed by a 30-60 minute hospital transport when you have alternative transportation—may not be your best choice. Even in a volunteer live-in program with career-grade response times, I found it could take 20-30 minutes to reach people at the edge of our territory. That's not counting the 2-3 minutes to get us awake and out the door at the station, plus another 2-3 for dispatch.

My household is minutes from two decent suburban EDs (we're lucky). Certain situations would lead us to skip 911 and drive straight to the ED: massive hemorrhage or an obvious heart attack when another adult is present to drive. This requires nuance. Time saved by skipping the ambulance can easily be lost to an incompetent admissions screener. You need to use the magic words: "heart attack," "chest pain," "think I am going to die." If you're having a stroke, you may not be able to drive at all (and you shouldn't). You'll also need to choose the right hospital—challenging in the moment, potentially impossible if you're impaired. The wrong hospital can be as lethal as waiting for an excessively delayed ambulance. In large cities with saturated EDs, this strategy often doesn't work: too many false alarms and just overall volume mean you won't skip the line.

I have direct experience managing and assessing these issues. You may not—consider getting meaningful first aid training. It helps.

The general rule: If you're confident in your department and know a nearby fire station generally has a paramedic-engine or paramedic-staffed ambulance with reasonable response times, wait for it - paramedics can do a lot for you on the way to the hospital and most critically get you to the best facility for care. You could crash your car or deteriorate en route to the point where you can't drive. But if you're fifteen to twenty minutes in and don't hear sirens (admittedly, not all departments use sirens properly), it's time to consider leaving—and how you're going to do it.

[1] Regarding Narcan: I won't engage in broader discussion about police possibly asking about circumstances requiring it—that's your business. IANAL. But many cops and almost all ambulances carry it, and the person will be alive after they administer it.

grogenaut4• 8 months ago

Excellent summary!

johnisgood2• 8 months ago

It depends on where you are, obviously.

Here nor the ambulances nor the cops carry Narcan. We do not have opioid overdoses around here.

blobbers9• 8 months ago

My condolences.

Did the ambulance ever show up to your house?

lhh• 8 months ago

Very sad, for more reasons than one. For pretty much everyone, heart disease is totally preventable now. If you’re over 30, get your ApoB checked (non HDL cholesterol is a proxy), and if it’s high, get a calcium scan on your heart. If you score above zero, get your ApoB down as low as possible (which will probably require drugs - diet barely moves the needle on this for most people). Low ApoB -> no heart disease.

Source: Peter Attia

Xunie• 8 months ago

Someone, please, for the love of all that is holy: Set up a website with information on how to reach emergency services from x to y country. People are literally dying here.

I once tried to call an ambulance on an active suicide attempt in the United States (while I myself was in Europe).

Problem 1: What number should I call? My country's national emergency line could not help and had no direct communication with ANY emergency services in the USA. Unable to find the phone number for EMS in the USA, I called the local police department which was answering their regular phone line at that time.

Problem 2: This requires long distance calling and local police departments do not accept collect calls.

Problem 3: Police receptionist was hesitant to connect me to dispatch but did so anyways.

Problem 4: I am now easily 10-20 minutes into making an emergency phone call and I haven't even talked to anyone able to help me.

Problem 5: Ambulance took another 10-15 minutes to even show up.

I explicitly stated "they just took pills, they have no neurological symptoms right now, do not leave immediately."

Problem 6: Ambulance left after a simple "it's a prank call" given at the front door.

Not much later, this person started showing severe neurological symptoms. I repeated the call, told them they were now actively dying and needed help. Luckily an ambulance came and helped this person, but it was an incredibly close call.

protocolture4• 8 months ago

i don't understand why the common narrative that i was told, that we were all told growing up, is that one should wait for an ambulance

My wife had a seizure a few years ago, and the first response team clocked in under 5 minutes (close to 3 by my count but I wasnt paying a lot of attention). Then 2 more ambulances arrived <5 more minutes. There was straight up an emergency services gathering at my front door.

The emergency response team is an SUV rather than a full ambulance, with 2 trained paramedics and as much kit as they can fit in. They are faster, because they don't do patient transport, and can arrive ahead of patient transport vehicles. See issues with "ramping" and so forth.

Anyway, this is really an issue of local government policy. Just vote/spay/neuter/tar/feather your politicians.

DustinEchoes• 8 months ago

What country was this?

protocolture4• 8 months ago

Australia.

antman• 8 months ago

I have the opposite story. Friend collapses in front of the house. I pick him up and rush him to the hospital, he is a geek and we had spent great amount of time going over his rare genetic condition that randomly causes internal bleedings from his organs. No ambulance available but no traffic also, we arrive soon at the hospital. Only to wait for 1hr or more because he didn't look bad, since internal bleeding doesn't look bad, and his arrival time (or cause) had not been registered on the system since we came by car.

After we were finally admitted in the actual room the doctor said his ematocrit was lower than a dead person’s, but fortunately he was saved that time.

noduerme2• 8 months ago

It's not moloch. It's all health systems, even ones that are religiously oriented. Triage and logistics and having enough trained people working all hours to handle all cases of life threatening situations... it's a bug in all systems.

Nothing is scarier than the moment you realize you're in the hands of the medical establishment. Whatever that looks like, wherever you are. Ever tried to rush a mechanic to fix your car? Ever tried to argue with a gate agent at the airport about rebooking a cancelled flight? Now imagine doing that while your heart is failing and 10,000 other people are also trying to get their attention.

If you want to blame anything, blame the fact that our society has failed to produce sufficient numbers of people trained or willing to help in emergency situations. And the people who sacrifice their lives to doing it are heros, the finest of us. The difference between individual societies and governments is quite small in the long run.

Aurornis• 8 months ago

It's not moloch. It's all health systems, even ones that are religiously oriented.

The moloch reference is a shibboleth for the rationalist community. It’s not an actual religious reference. There’s another reference to “updating” further down which is another rationalist term meaning “updating your priors”.

endtime• 8 months ago

Specifically: https://slatestarcodex.com/2014/07/30/meditations-on-moloch/

noduerme2• 8 months ago

Huh. This gets complicated. I wasn't making an appeal to religion... my perception was that "moloch" was understood by non-religious socialist-leaning people to mean the god of money or capitalism (which seems to comport with what you're saying). But it has a separate meaning as a vengeful deity from the bronze age that demands sacrifice and which is used as an example in Abrahamicreligions for why you shouldn't worship other deities. I was pointing out that the alternative to a "moloch" health care system would be a "religious" one - by which I guess I meant a Judeo/Christian/Islamic one, but it serves a few separate meanings, like, one which isn't at its core capitalistic, or one which doesn't sacrifice children.

All I was trying to say was that the organizing ideology of such a system (healthcare) doesn't matter as much as having enough people committed to and working within the system. A capitalist version may work better than a communist one, e.g. at developing new approaches to disease, or serving more people in more tailored ways, as long as the incentive structure exists to bring enough people into the workforce so that each practitioner is not overwhelmed.

TL;DR I was playing along with the "moloch" reference, although clearly it means different things to different people.

efitz• 8 months ago

This is not a criticism of the author of the article; I can feel their frustration and the pain of their loss but I don’t have anything to say that can ameliorate that.

I’m coming up on 60 years old. The mindset that many people have now seems to be to wait for someone from the government to help them- whether it’s ambulance, police, health care, food assistance, college, whatever.

Back in the 80s when I was coming of age the mindset among the people around me was different. The mindset of many people today seems more “I’m helpless”.

The government has never been good at anything; it doesn’t have the right organizational incentives and doesn’t give the right personal incentives to employees. I’m not criticizing government employees; there are individuals that do a great job, and from time to time I am delighted with an interaction, but mostly it’s just lots of waiting for mediocre service.

I don’t know how to change a widespread mindset of helplessness, but I suspect that it involves changing laws to remove all the obstacles that government and lawsuits have put in place to helping yourself and helping others.

buyx• 8 months ago

My grandfather died at a hospital in South Africa in 1997 after experiencing chest pain. Apparently, he went to reception, and they told him and my uncle to take a lift/elevator up to the ward, and he died in the lift. I was told afterward that it's a no-no to exert oneself during a heart attack. No idea if that's true or not.

Anyway, not second guessing OP, just putting it out there.

onlypassingthru• 8 months ago

The state has an incentive to encourage callers to wait for trained emergency drivers. Nobody wants mom in a panic and flying through red lights at the intersections. Or worse, my former teacher drove himself to the ER while in the midst of a heart attack rather than wait for an ambulance. He didn't survive the attack but made it to the hospital without incident.

edit, to add this old gem: "I want to die peacefully in my sleep, like my grandfather. Not screaming and yelling like the passengers in his car."

NiloCK• 8 months ago

Absolute sympathy for the author.

My own story of heavy industrialized medical process goes the other way. My daughter could be dead, but she isn't. At birth, she presented with some abnormalities around her stomach. Not good. We lived in a somewhat remote location where the hospital's capacities were modest. Really not good.

Within 8 or 10 hours of birth, she and I were aboard the smallest plane I've ever been on, with a pilot, and neonatal specialist nurse and respiratory therapist (all had arrived on the plane). Daughter was in an incubator and I couldn't touch her.

Five or six hours later we were in one of the largest children's hospitals in Canada. Another hour or two and a probable diagnosis was sussed out, and a plan made for a surgical exploration / opportunistic fix.

I'm at an age where there are real professionals who register to me as children, and in the pre-op meeting, this is how the anesthesiologist struck me. He was even wearing a Star Wars t-shirt. I didn't mind either the age or the t-shirt, but it was jarring because it situated me somehow as a more responsible participant in the whole situation - a grown-up. Failing to tell him to use the force will proably be the esprit d'escalier that follows to my grave. (I mean, don't turn off the targeting computer, but use the force too.)

Anyway. Another six or seven hours - the worst of my life by far - and finally the good news emerges. Seven years ago now.

There were probably close to 100 people directly involved in providing care to her that day, and I couldn't imagine the number for indirect involvement.

To be honest, all of it was the first experience of gratitude in my life.

---

We are all burned daily by the rough edges of our approximating policies and norms - life's outrageous slings and arrows.

I'd spent a lifetime being too smart and too aloof to be impressed with anything. Suddenly the most important thing to have ever happened to me went sideways, and put me completely at the mercy of the great machine. It really came through for me. It's a good time to be alive.

---

aside: People will have lots of reasonable principled and pragmatic objections to $MEGACORP laundering image via $OUTREACH_EFFORT, but I'll also take the moment to say that Ronald McDonald House is the real deal. Lifesaver. Extraordinary reach to provide a sense of "new-normalcy"

utterly snide and unnecessary dig: The weakest meal (although not bad by any means) that I had at McDonald House came from Microsoft. Hard for a tech company to compete with groups named "3rd Street Grandma's Club" in terms of banger comfort food. Thanks for the pizza, MS.

bensonn2• 8 months ago

I won't call clickbait on this as it is a personal site and the headline is accurate. I saw another article recently with the same issues.

He is dead from a heart attack. If dispatch, EMS, hospitals, etc. didn't exist doesn't mean he would be alive. They didn't kill him, they failed to save him.

The other article I saw was how the hospital "killed" a drowning victim. Water was never mentioned.

There are many failures in our systems. There will always be exceptions to rules. It is a heart-breaking story but at the same time it is impressive. Maybe the system failed on this call but the fact that their is a system with this many resources is amazing. Hit 3 digits on the phone and LEO, EMS, Fire are all alerted 24/7 us pretty impressive to me.

MattRix• 8 months ago

I’ve gotta say I’m almost impressed at how callous this response to the story is.

monadgonad• 8 months ago

I won't call clickbait on this

But you are going to imply it by bringing it up at all.

They didn't kill him, they failed to save him.

The post does not say otherwise.

Please give this, of all topics, the respect it deserves, respond to the article as it is actually written, and don't use this, of all things, as an opportunity to get on your high horse about some other article you have problems with.

sohrob• 8 months ago

The emergency response system is broken in many areas. I once dialed 911 in Los Angeles seeking help for a motorist and was put on hold for 8 minutes. A lot can happen in that time.

aarroyoc• 8 months ago

So sorry for your loss. Some months ago I was very angry to found out that a person was dead for a bike injury that can be easily solved but he had to wait for almost 50 minutes for the ambulance. Not because he was far away, but because he was in between two regions and the 112 was discussing who should send the ambulance. In fact, they initially send one and later told the driver to go back while in the highway. He's dead just because he happened to have the accident near the border of two regions of the same country, each one with its own public health system.

Link (Spanish): https://www.elespanol.com/alicante/vega-baja/20251028/hijo-c...

DeathArrow• 8 months ago

I can't help but feel that this tragedy is closely related to the the direction Canadian politics and society is heading. This should never have happened.

Sprocklem• 8 months ago

What direction is that?

didgetmaster• 8 months ago

Communities across the world have a dilemma. How to have enough emergency responders available without breaking the budget. They tend to staff just enough to handle a normal workload plus a little extra. A major event can overwhelm them.

If you have an emergency when no one else has one, you can get a quick response. If there happens to be three other emergencies in your area at the same time, then the response time may be very slow.

zitsarethecure• 8 months ago

Sorry for your loss, but this experience is not universal in Toronto. I was visiting my (sick) older brother about a year ago when he woke me up calling out about chest pain. I called an ambulance and they were there within about 10 minutes and saved his life, for which me and my family are so very grateful. Had he been visiting me here in Ohio when he had his heart attack, the results may not have been as good.

https://fox8.com/news/i-team/i-team-more-people-waiting-30-m...

philipwhiuk• 8 months ago

Not having visiblity on how far the ambulances are away is wild.

Surac• 8 months ago

My condolence to you. I live in Germany and had to call the ambulance on different occasions. Ambulance driver later told us to never wait for them to always try to get to ER ourself

jll292• 8 months ago

First of all, Jenn, I'm very sorry about your father's passing.

The scheduler gave your family the correct instruction to wait for the ambulance car to arrive.

There is something called the "rescue chain", which begins with first aiders (standers by) who are expected to take first action, then hand over to paramedics upon their arrival, who in turn provide professional emergency care and transport the patient - once stable - to a hospital, again handing over the patient to an ER/stationary care.

Instead of "just waiting", next of kin are normally advised to start resuscitation procedures according to the algorithm recommended by the Red Cross or CHA

* https://en.wikipedia.org/wiki/Cardiopulmonary_resuscitation

* https://www.redcross.org/take-a-class/cpr/performing-cpr/cpr...

* https://www.mayoclinic.org/first-aid/first-aid-cpr/basics/ar...

All kind of bad things can happen when transporting a critically ill person in a private car, notably accidents caused by a shaking, stressed and overwhelmed driver (e.g. a relative) ignoring traffic lights actual traffic and sometimes buildings. Ambulances have medication onboard as well as qualified staff, and they are only supposed to live once a patient is deemed stable.

In case an ambulance is very far away, the scheduler can also be asked to send a volunteer semi-professional or professional aider e.g. a medic living in the neighborhood or a Red Cross paramedic volunteer, to walk over and bridge the time.

Once, one of my co-workers died in the office (in Switzerland), which was right next to a hospital, despite two dedicated colleagues calling for help and administering CPR/first aid (I was at home in the shower when it happened). It can happen that all cars are somewhere else, or all emergency medical staff is already dealing with emergencies. In this case, the ambulance arrived after more than 40 minutes, which triggered a routine investigation by the attorney general.

To all readers: in case you have never taken a First Aid course, now it is the time to register for one. They are typically offered free of charge, and you may regret one day not to follow this advice now in case you are thrown into a situation such as standing next to a loved one of yours who collapses.

encoderer• 8 months ago

I was floored when watching the recent documentary about the Grenfell fire that residents who called 911 were told to stay put and if they needed to evacuate a fireman will come.

These poor people, inside an inferno, losing their last chance to escape, because they listened to the official state policy. An animal knows to run from a burning barn but here we are, trained to ignore that instinct.

KETpXDDzR• 8 months ago

I can highly recommend looking to response times for you locality. For me it's Denver and I'm shocked that they didn't meet any of their goals: https://www.denvergov.org/files/assets/public/v/2/auditor/do...

tsoukase• 8 months ago

It cannot be taken for granted that arriving at the hospital alive, he would stay alive. A massive heart infarct or other fatal incident (aortic rupture, lung embolism) must be ruled out through an autopsy which is strongly indicated, if not taken.

Such a sudden death usually is predated by alarming symptoms like minor chest pains in the past few days or by a history, like heavy smoking, uncontrolled hypertension/diabetes or a covered anxiety/stress

An ambulance is for emergencies but unfortunately only effective for hour-long ones, not minute-long. For the latter self transport might work in a life or death situation.

rufus_foreman• 8 months ago

Where I live, it's common for them to not answer when you call 911.

They were out trying to steal my neighbor's car, and my girlfriend called 911, and no one would answer.

She went and banged on the neighbor's door and told them someone was trying to steal their car, she walked right past the car thieves to do this, which was more than I would do, because I was scared of getting shot.

The car thieves noticed and moved down the block to steal someone else's car. My girlfriend stayed on the line, but yeah, 911 never answered.

You live somewhere where the ambulance is too slow when you call 911, be grateful. Here, they just don't answer. You deal with whatever it is personally.

911 never answered. They were busy with something else I guess.

For the woke/progressives among you, I agree, this was not as bad as the crime wave of the late 1980's and early 1990's. I was there for that crime wave. It was fucking epic. This was not as bad as that, so we're all good.

This is fine.

My dad could still be alive, but he's not

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