Square Pegs, Sadness, and Old Rock Stars

A voice is heard in Ramah,
weeping and great mourning,
Rachel weeping for her children
and refusing to be comforted,
because they are no more. 

                             - Matthew 2:18

I would like to be writing about something else as Christmas approaches. It should be a time of joy and quiet reflection, surrounded by those who love and care about you. Despite this, there are other things going on that are making this year's holidays more challenging. 

The Newtown, Connecticut mass shootings have been at the forefront of the national conscience for the last week. This event, even more than others of recent note, has shown the need for all us to step back, breathe deeply, try to make sense of the news flashes and rumor-mongering, and resist the urge to make snap judgments. 

I wrote at length earlier this year after the shootings in Aurora, Colorado. My feelings about the nature of these events remain unchanged. There are some things that spring to mind about this latest event that have to be said, however.

Newtown is to me but a momentary blip on a well-traversed road. Sandy Hook Elementary is but a mile or two from Interstate 84, part of a seemingly bucolic suburban/rural countryside between the New York state line and Hartford, scarcely noted and just as quickly forgotten while trying to get somewhere else. 

Perhaps one of the greatest lessons of Newtown - once and for all - is that it can happen here.

Several articles compared the Newtown shooting with the the biblical account of the Slaughter of the Innocents - in the time after the birth of the Christ child, King Herod ordering the death of all boys under 2 years of age, in hopes of catching the infant Jesus among the dead. 

This was not the first thing on my mind when contemplating these events. My thoughts were thrown back to two evenings before, when I tuned in the Concert for Hurricane Sandy Relief that was broadcast on seemingly every cable network. We were confronted with Roger Waters of Pink Floyd singing what is probably the toughest song of his masterpiece The Wall, with the assistance of Eddie Vedder of Pearl Jam.

Mr. Vedder's presence caused me to start interlacing the lyrics he was singing with one of his own band's more famous songs, topical to the events at hand - 

I have become comfortably numb...

Jeremy spoke in class today....

These were combining in my head with the lyric and haunting solo piano of an Elton John masterpiece from 1974. As a result, the soundtrack of my life this week has been in a decidedly minor key.

You've lived too long in silence, Mama said, remember Mama said, ticking, ticking..

Assuming that life can be compared to a movie, the quality of the script hopefully trumps the background music. Resolve on the part of the players to not allow these events to define us as a society, to rise above them, and join together with the President in saying "enough" - is but the tip of an iceberg of issues that seem to combine to create the atmosphere where such atrocities can occur. 

To be sure, we've had enough - but enough of what?

Guns - I believe that gun laws would likely not have prevented what happened in Newtown - the guns used were legally owned by a law-abiding citizen. Regardless of what the NRA had to say (and was there really any doubt about what they were going to say?), we as a country need to take a good hard look at both the practical and cultural aspects of guns in our society. 

There are legitimate arguments on both sides of the debate about whether or not to ban the sale of semi-automatic assault weapons. Efforts to close the so-called "gun show loophole" equate to the prohibition of gun sales between private individuals, which would effectively require a background check for any gun sale conducted within the boundaries of the law.

The NRA's initial suggestion of an armed presence in every school - something they're calling National School Shield - sounds more at the onset like a reactive posture that only addresses one component of what needs to be a comprehensive solution. As such, it landed in Connecticut with a decisive thud.

A best practice methodology - one that addresses technology, processes and people and leverages resources on a multi-disciplinary basis - is for me the best approach toward applying a solution that is both responsive in the short term and sustainable over the long haul. Those other disciplines are:

Mental Health - Newtown is yet another example this year of deadly actions taken by a subject - in this case 20 year old Adam Lanza - who had displayed very high intelligence accompanied by social isolation, combined with the means, financial or otherwise, to accomplish his ends. 

This is bringing additional public debate about the nature of the safety net that is supposed to be in place, in the form of community mental health services and crisis team response.

There are several excellent posts on a Washington Post blog that delve into many issues surrounding the mentally ill in America - from the lack of effective treatment options to the lack of understanding of certain disorders such as Asperger's Syndrome to the demonization and stigma surrounding those who are suffering.  

One writer took the novel approach of suggesting that the firearms industry should take an active role in funding mental health outreach programs. This made me think of Chris Rock's idea on how to reduce gun violence. 

Still another blogger saw a post written about her personal experiences as a parent of such a child, titled "I am Adam Lanza's Mother", go viral. She wrote an excellent follow-up in USA Today. This all sounds like a bizzaro version of an Erma Bombeck column.

I believe that there are many people, including myself, who share personality characteristics similar to the shooters at Western Psych, Aurora, and Newtown. I believe that the effects of social isolation, along with environmental factors and stimuli unique to our period in history, are contributing factors to a documented increase in children being diagnosed with what are known as Persuasive Developmental Disorders.  

Now imagine, if you can, being unable to effectively interact with anyone unfamiliar, instead retreating into an artificial environment of television, computers, and/or video games. Something happens, that world is threatened, and you cannot cope. Your attempts to secure help are met with misunderstanding, dismissal, or contempt. You drive yourself deeper into escapes from this reality, until circumstance backs you into a corner. A response from outside the acceptable boundaries of reality appears inevitable.

This was expanded upon by an anonymous writer, who submitted an essay to Newsweek/Daily Beast, which published it under the provocative headline I Was Adam Lanza. Now a more stable adult after years of therapy, the writer attempts to explain, from first person experience, how someone like Mr. Lanza may have been driven to his actions. This stuck out for me -

When your brain works more efficiently than everyone else's, that means it performs most mental tasks more efficiently than other people, including go crazy. Worse, because a smart person's brain is so good at running through hypotheses and rejecting them, it tends to come up with insanity that's more resistant to basic therapy, because the rationalizations are built to withstand the assault of a genius level intellect. When people say genius and insanity are close cousins, this is what they're talking about.

And when you're isolated from other people, your own mind - and its crazy ideas - becomes the only company you have.

I have no scientific basis for any of this, of course - just a feeling based on my own life - that there is a comfort in the speed and ease (mostly) of electronically produced results, and the illusion of control when dealing with the cool, arbitrary nature of ones and zeroes. It doesn't translate well when facing tragedies and choices in the real world. Paging Neo and Morpheus...

School Safety - Before we establish an independent, separate layer of armed security at the behest of a lobbying group that serves firearms manufacturers, let's look at what's in place so far, and how we as a community can enhance those efforts.

My experience with school safety and response planning, mostly in Colorado, centers on extensive use of the School Resource Officer (SRO) concept. According to a tutorial from the Center for Technology in Education at Johns Hopkins University, an SRO is best defined as - 

..a sworn law enforcement officer, assigned to a school on a long-term basis. The SRO is specifically trained in and performs three main functions, law enforcement officer; law related counselor; and law related educator. In addition the SRO works in collaboration with the school and the community as a resource.

That aptly describes the SRO's I worked with out west - not just an armed guard standing next to a metal detector, but someone who was invested in providing an active, responsive police presence not only to their assigned schools, but to the general community surrounding them. A component of the community public safety system, there to educate as much as to protect and serve.

This concept appears not to be as well embraced in Pennsylvania as it could be. A comprehensive article, published in 2000 by the National Center for Juvenile Justice - now headquartered in Pittsburgh - detailed what was then a grant-funded program to place SRO's in several schools across the commonwealth.

The article detailed the daily activities of North Fayette Township Police Officer John Bates, the SRO at West Allegheny High School, and the pilot SRO program initially funded by grants from the Pa. Commission on Crime and Delinquency.

The SRO program there is still in place and functioning well, according to now Sergeant Bates, who when contacted last week stated he was getting a lot of calls from nearby school districts about their program, which is now jointly funded by the township and the school district. 

As reported extensively in recent days, Quaker Valley schools employ an armed police officer as an SRO. Robert Wright appears to function as a district employee when on duty, even though he also works as a police officer in Sewickley. Whether Officer Wright can exercise police powers when he's wearing his QV hat is unclear, and is something I will explore further after those in charge return from their holiday breaks.

The National Association of School Resource Officers (NASRO), responding to the NRA's recent comments, stated that "only a fully-trained law enforcement officer should carry a firearm on school property. In addition, law enforcement officers assigned permanently to schools should receive specialized SRO training as soon as possible."

It sounds as if Quaker Valley is ahead of the curve on this issue, but I think that there's room for improvement in terms of providing a layer of protection, service, and response that is seamless between school and community. This means that the officer protecting the high school can also help to investigate and mitigate problems in the neighborhoods surrounding the school. Things like traffic and parking issues.... 

As much as I would like to talk about moving forward in the spirit of peace and love, the reports of continued violence continue to stream in. While I wrote this today, public safety brethren in the Rochester, New York were reeling from today's fire and ambush that killed 2 volunteer firefighters. One was also a police officer, the other a 9-1-1 Dispatcher.

Hope is a precarious emotional commodity, even at this time of the year. I remain faithful that we'll see our way through this. Hearts and minds are stirring - it will be messy, but we will get through it - together.  

We need to watch out for, and care for, one another. That collective action of our hearts and minds is greater than any gun, badge, doctor, or government agency, and is keeping with the true spirit of this season. 

The luminaria will probably be wet tonight, but they will still be lit.

I'll wish you the best possible holiday with a couple of 70's throwbacks, both involving old rock stars and some unlikely combinations of music and performers.

Here's to a blessed and peaceful Christmas, courtesy of Sonny and Cher and David Bowie and Bing Crosby.

And to all a good night.

Light-Up Night: The Shadow Fireworks

Wow, it's December already.

The Thanksgiving weekend came and went quietly and uneventfully. Leslie, Gianna and I were the beneficiaries of a neighbor's hospitality for holiday dinner. 

That's how it seems to go, what with working weekends and tending to avoid participating in Black Friday, otherwise known (at least to me) as the high holy day of The First Church of My Stuff. I saw at least one Internet meme over that weekend that brought this point home very clearly.

This past Friday evening I headed to the library to review some long-awaited research materials for an upcoming post, and encountered the traffic and crowds associated with Sewickley's annual light-up night. 

The library was bustling with activity associated with the event as well. Staff were setting up tables for kids to do a craft project. Sewickley Herald reporter Bobby Cherry was there as part of their coverage of the festivities.

When I left just before 6, I noticed crowds making their way into the event areas along Broad Street, via the closed section at the intersection with Thorn. There were clearly marked detour signs posted, along with dedicated signs for a detour around the celebration for those needing to access Heritage Valley Sewickley Hospital.

That's when I heard the helicopter. 

Thinking that it was perhaps more than coincidental that a helicopter could be circling the village at that time - perhaps a news chopper to add to the hype surrounding the festivities - I scanned the skies for a spotlight or other visual cue. Not finding any, I started scanning the airwaves, specifically the public safety and aviation bands, for some telltale activity.

Finding some, I headed across the river to find a STAT Medevac aircraft at the landing zone adjacent to Valley Ambulance headquarters, with Moon Township VFC standing by. An ambulance had just left with the flight crew, headed toward Sewickley in bridge traffic that was backed up almost to Coraopolis, and through the village detour to the hospital previously mentioned. It took roughly 10 minutes, with lights and sirens, for them to travel the roughly 1 1/2 miles to the hospital. 

As I wrote in February, the practice of flying patients out of Heritage Valley Sewickley is an infrequent, complex, and frankly perplexing exercise. This is taking into consideration the underlying reasons for using that mode of transportation (usually speed), the proximity of Sewickley to Pittsburgh, and the ready availability of ground transportation. 

After about 45 minutes, the flight crew was making their way back to the aircraft with their patient, and shortly afterward lifted off for a Pittsburgh hospital with what sounded like someone with a cardiac problem.

It's likely that the ambulance committed to that relay back and forth from the aircraft could have had the patient in Pittsburgh in considerably less time, and for a lot less money. Finding out how and why this happens is near impossible, what with privacy laws and stakeholders less than willing to speak to anyone about the underlying processes and politics of our so-called "non-profit" health care system. 

All one can do is try to be an educated health care consumer. 

This wasn't the only thing happening in Sewickley during light-up night. When the fireworks started, the numerous police officers deployed throughout the village were alerted to a report of a male seeking psychiatric evaluation who had run from the Heritage Valley Sewickley ER. A description was aired, and hospital security was seen in the area of Broad and Centennial assisting in the search. It's unknown if the man was ever located or turned back up. 

Sewickley Borough Manager Kevin Flannery, contacted today, dismissed the incident as more commonplace than it might actually seem to be. He estimated that 5 to 7 people run from the ER a year. This makes one wonder even more about another health care factor  relegated to the shadows, perhaps deliberately - the propensity of mental illness in our society, often exacerbated by substance abuse. 

My primary purpose for speaking with Mr. Flannery was to get a sense of the emergency planning contingencies in place for an event that draws a large amount of traffic and several thousand people to a few square blocks of shopping district. I was impressed with what I heard.

Mr. Flannery cited joint planning efforts by the Police Department, Cochran Hose Company, and his office to assure that emergency resources are able to quickly respond into the event area, and that people can be moved quickly from the areas if needed. He spoke about assuring a minimum 18-feet wide clearance to allow emergency vehicle ingress and egress to and from key entry and exit points to the event. Cochran Hose volunteers also assured that the fire station was fully staffed and ready.  

This was put to the test in recent years as well as this year, when a vehicle was reported to be on fire near the intersection of Blackburn Road and McCready Way. Firefighters found that the car had just overheated.

Other reports included some who had enjoyed perhaps a little too much holiday cheer. One woman wanted officers to find a friend that she had become separated from. One man was arrested near the borough building for public intoxication. 

And in the 'ignorance is bliss' department, several reports of loud pounding noises were made by borough residents..during the fireworks display.

Planning for these types of special events is often accomplished by emergency managers and local governments through the use of the National Incident Management System, or NIMS. There is specialized online training available through the FEMA NIMS website to address these events, defined by FEMA as "a nonroutine activity within a community that brings together a large number of people".

Mr. Flannery expressed satisfaction that the event was so well attended, but also stated that some merchants complained that foot traffic within their shops was less than expected, owing to how nice it was outside. I'm sure someone will get right on that problem for next year...

Mr. Flannery also expressed gratitude to Heritage Valley for allowing use of their parking garage during the event. He also stated that the pleasant conditions made walking from the parking lots at War Memorial Park more amenable to attendees.

As far as attendance at these types of events, Mr. Flannery also cited the annual Harvest Festival and Memorial Day observance as examples where their efforts in planning and communications have paid off.

I asked him about potential contingencies where attendance numbers would possibly require the use of overflow parking in more remote locations, with shuttle buses into the village. Mr. Flannery stated there are areas where such a contingency could be implemented if needed, but he also hoped that attendance would not get too far beyond the 7 to 9,000 that these events have been typically drawing in recent years.

That's a good perspective - not necessarily wanting too much of a good thing. Perhaps that's a message that all of us can identify with. 

May the holidays bring you joy and peace. 

Aurora Observations

                                                                          Karl Gehring - The Denver Post

A week ago this past Friday I was engaged in my normal routine of getting ready for work. This includes getting up at 4:30 AM. One part of this routine is taking a look at the news online. There really wasn't anything of significance on the local and national news sites I look at regularly.

It wasn't until I got in the car and turned on KDKA, and John Shumway teased about "complete coverage of the tragedy in Colorado coming up", that I knew something significant had happened. There were about 5 anxious minutes of driving, wondering about the where and what out there (my son lives in western Colorado), before the initial blurb was broadcast about yet another active shooter incident, this time in the large Denver suburb of Aurora. 

When I got to work, I got a couple of questions from co-workers about what I knew about the incident and the location involved. I'm somewhat familiar with the area, and have driven past the location of the incident on I-225 many times. I'm familiar with how public safety operations in the immediate area, and across metro Denver, are conducted. A former co-worker, who has been a dispatcher at the Aurora dispatch center for many years, was interviewed as part of the initial media coverage. 

Fortunately, none of the friends I have living in the metro Denver area were involved or anywhere near the scene of the shooting. Prayers have been going out for those impacted, including the responders.

Having had the time to take in some of the reporting and commentary over the last week, I've identified some points that seem to either connect or contrast with conditions or situations in the Pittsburgh area and in Pennsylvania.

1. The general public's understanding of this tragedy has been enhanced by comprehensive coverage in the Denver media, especially the availability of recorded radio traffic during the incident. KUSA-TV tied this audio in with some excellent interviews of the dispatchers involved, providing the public with a look at the human side of the job that doesn't get seen very often..or often enough.

The Denver media obtained the radio traffic either from the comprehensive hobbyist site radioreference.com or similar websites. This site also offers recorded archives to those who pay for memberships to support the site's operations.

There is streaming scanner audio available online for all of southwest Pennsylvania, through Radio Reference, other sites, or smartphone apps. There are also recordings of radio traffic from the Aurora shooting posted to YouTube. 

These recordings continue to drive reporting about the incident, including reports about the lack of ambulances at the scene in the initial minutes, resulting in many of the victims arriving at local ERs in the backs of police cruisers.

Also intriguing are some extraordinary attempts by prosecutors and the courts to lock down access to court records and involved officials. These attempts are being challenged by numerous media organizations. 

The use of these types of recordings by journalists is occurring more frequently for many recent critical incidents around the country. This would appear to be a potentially important resource for media outlets in Pennsylvania, since the official recordings are not considered open records here as they are in other states, including Colorado. I've written about this disparity previously. 

I haven't seen any major print or broadcast media outlet in our area post links to or utilize online scanner audio as part of their reporting. To try and ascertain the local media's awareness of this resource, or their policies regarding its use, I sent email inquiries to the Post-Gazette and Tribune-Review editorial departments, as well as the news desks of three Pittsburgh TV stations. None of these media outlets chose to reply. 

If we can say for the purposes of argument that accountability and transparency in government results in a better level of service provision for all citizens, then a lot of what's happening in Aurora in the aftermath of this tragedy should be something that citizens interested in reform here should be reviewing. This is particularly important when looking to expand and improve the availability of government documents and records to citizens and the news media. 

After all, it wasn't that long ago that the Pittsburgh area experienced its own mass shooting tragedy. How would a more comprehensive approach to reporting and information gathering by local media and others improve our community's understanding of what transpired? Is there a need for greater openness or access to public records? How can the public interest be competently served?

2. There seem to be some eerie similarities between the Aurora shooting suspect, James Holmes, and John Shick, the Western Psych shooter. Both appear to have been intelligent, excellent students with impressive credentials, from seemingly stable home environments and possessing ample financial resources.

It wasn't until this past Friday, when reports surfaced that Holmes was seeing a psychiatrist, that the Post-Gazette ventured a comparison between the two men, apparently becoming the first mainstream media to do so. 

There are some questions that come to mind about these two unfortunate individuals:

What are the social or other factors that contributed to the mindset that led to their actions?

Did the use or abuse of prescription medications or illegal substances possibly contribute to their isolation, or other problems that manifested themselves in their actions?  

How did two men that showed such promise in their academic life suffer such a descent into irrational and violent behavior? 

I hope that some investigation and answers will be forthcoming, and not just to satisfy the prurient interest of the TMZ or Smoking Gun crowd.

Can we as a society learn more about what is causing these people to act the way they did, and learn from it? I hope so...

                                                                                      facebook.com

3. As one would expect, this incident has generated lots of debate about gun laws and gun rights. I can see the point about the right to bear arms if one chooses to, but I have to wonder out loud how much arms a citizen needs to be able to bear to 'protect'  themselves, and how much involvement the government should have in the process of tracking the sale of such weapons. There has been much commentary online about the regulatory hypocrisy when it comes to guns - the attached photo is but one example.

What really concerns me is the lack of discussion about improving both community awareness of recognizing the signs of potentially dangerous behavior, and/or improving access to mental health and crisis intervention services, regardless of social or economic status. 

It almost seems as if trying to ratchet down gun laws further, regardless of the opposition, is an easy way out compared to taking a comprehensive look at ourselves. What is about our society that causes promising young people like this to go crazy? How do we do something about it?

We got a taste of this locally last week, when a Leetsdale man was charged with drug and weapons offenses after police discovered an apartment full of knives, chemicals used in explosives manufacture, and notebooks with some interesting entries that police claim may constitute malevolent intent.  

Some of the commenters to the above Patch story seemed not only defensive of the suspect, but hostile toward the police that investigated and took action. Leetsdale Police Chief James Santucci expressed surprise that someone with Zachary Clifton's alleged propensities could exist "under the radar".

Some would advocate turning up the range and sensitivity of that "radar", through legislation and enforcement activities designed to catch people before they act - a sort of pre-crime detection strategy.

As with any discussion about these kinds of issues, emphasis will need to be on improving awareness, assuring diligence in service provision, and protecting the individual liberties of law-abiding citizens. Despite all of the clamor and cries for justice and protection that seem to exist in the immediate aftermath of something like this, we must place trust in the checks and balances of a free society. 

We also need to help and care for each other. 

4. One of the hallmarks of that free society, especially in the digital age, is the diversity and seeming universality of information, including entertainment products. As the entertainment industry, specifically the film industry, is inexorably tied to this latest tragedy, I found and have remembered several links to information, opinion, and stories that may help understand these concepts further.

Film critic and American man of letters Roger Ebert wrote an excellent column for the New York Times shortly after the tragedy.

Controversial filmmaker and activist Michael Moore has been focused on the issue of guns in America since his Oscar-winning documentary Bowling for Columbinewas released. He also wrote a blog post after the Aurora incident, referencing the same salient points that he made nearly 10 years ago. He also provides a link where you can watch the whole film for free online. It's worth it.

Also check out The Lives of Others and Minority Report for an illustration of how we as a society can degrade the cause of freedom through fear, control, and intolerance.

There's lots to think about, probably more than we have time for every day. The important thing is not to be afraid. Easier said than done, but essential to maintaining our way of life, and our freedom in challenging times.

Enjoy your August.

Construction Creates Chopper Confusion, Communication Challenges

The greater Sewickley area, with the Hospital and its most recent medical helicopter landing zones indicated. (Bing Maps)

On a quiet Sunday afternoon last October, I was doing some household chores when the unmistakable hum of rotors overhead shook the house. I knew the sound – a light twin-engine helicopter, most frequently used locally for EMS purposes. Not having heard the fire department across the street responding anywhere, I turned on the scanner and jumped in the car.

What was happening should be a fairly routine occurrence for any community that has a hospital such as Heritage Valley Sewickley. Interfacility transfers from smaller hospitals to larger facilities with specialized capabilities make up the lion’s share of the air medical transport business in this region. A helicopter had been summoned to transport a patient from the Sewickley hospital to a specialty facility in Pittsburgh.

This is a more complicated process than in most communities; Sewickley is one of only two full-service hospitals in Allegheny County that is not served by a licensed heliport (the other is UPMC McKeesport). Typically, the use of this type of Landing Zone (LZ) requires a Police, Fire, and EMS response - scene safety and security issues need to be addressed, and an ambulance is needed to transport the helicopter crew to the hospital, and bring them and the patient back to the aircraft. 

The radio traffic revealed a lot. The helicopter was circling Quaker Valley High School’s stadium, but was telling its dispatcher that all they saw was an athletic event. They could not make radio contact with anyone on the ground. The helicopter’s dispatch directed them to the field at the Sewickley Valley YMCA, across Blackburn Road from the hospital. Upon my arrival there, families were playing soccer together, but nothing indicated that the field was to be used for emergency purposes.

I found the collected public safety resources of Sewickley Borough assembled at the Quaker Valley Middle School, awaiting an aircraft that never came. The STAT Medevac chopper elected to land at the Valley Ambulance Authority headquarters, across the river along Route 51 just south of the Sewickley Bridge.

Construction activity at the Middle School had just begun in earnest; I heard additional radio traffic that indicated that the Middle School, which apparently was the "regular" LZ for the hospital, was not going to be available for use because of the work going on. I chalked up the confusion to this logistical uncertainty, and figured that the powers that be would have it straightened out in short order.

However, two similar situations occurred during the third week of January. On the first occasion the helicopter elected to land at Valley Ambulance again. The following day, the landing occurred at Osborne Elementary School.  I thought it necessary to look into the situation a little further. What I found presented an opportunity to learn more, and perhaps identify some issues that may need to be looked into down the road.

Aerial view of Heritage Valley Sewickley, with the YMCA and its soccer field across Blackburn Road. 

(Google Maps)

When I lived in the area before 1995, helicopter landings for patients at what was then Sewickley Valley Hospital were relatively infrequent. When those landings did occur, the LZ of choice was the soccer field at the Sewickley Valley YMCA, as illustrated.

During 1993 and 1994, controversy ensued about the lack of a heliport at the hospital, along with issues related to noise and safety as it impacted residents of the neighborhoods surrounding both the hospital and the YMCA. I contributed my own opinion at the time, which was that if the hospital intended to fly people out of their facility, then they should work toward building a heliport on their campus.

I wondered why the YMCA was apparently no longer being considered for landings, and found two public servants willing to shed more light on the subject. Cochran Hose Company Chief Jeff Neff stated that the YMCA field has become "tighter" for landings due to the facility's expansion encroaching upon it, and the field's location against a wooded hillside. When the "Y" added a row of parking to its lot south of the field, the decision was made to use the Middle School field along Ohio River Boulevard as the "official" landing area. Sewickley YMCA Executive Director Trish Hooper did not respond to a request for comment.

Chief Neff also stated that he had received an e-mail from "someone on the medical side" indicating that until the work at the Middle School was complete, all landing zones for patients being flown out of the hospital will be established at Valley Ambulance's headquarters. This landing area is located between Route 51 and the railroad tracks, in a largely industrial area. Sewickley Borough Manager Kevin Flannery, who has been directly involved in the planning efforts to establish an acceptable designated landing area, confirmed Chief Neff's statements. When asked about any community concerns regarding more recent arrangements, Mr. Flannery stated that his office has not received any complaints in recent years.

Landing Zone at Valley Ambulance Authority headquarters along Route 51 in Moon Township.

Acceptance by the community is but one of a two-pronged approach to the problem of where to establish an area to land what is, for many areas, a critical means of accessing emergency care. According to Frederick V. Peterson Jr., Vice President for Emergency Management at the Hospital Council of Western Pennsylvania, the state has "strict licensure criteria" that govern exactly where and how a heliport is constructed, maintained, and monitored, including assuring that the landing area is "sized to accommodate the size of the aircraft that intend to use it". Mr. Peterson added that an unlicensed LZ designated by a hospital for patient transfers may only be permitted a certain number of landings before attracting some type of regulatory attention. 

As you would expect, the government has lots to say about heliports. The FAA has published detailed guides with recommendations on heliport design, and one of the nation's foremost authorities on fire safety and emergency preparedness has just issued updated standards for the nation's heliports, most of which are owned and/or operated by hospitals.

In Pennsylvania, evaluating and licensing heliports falls under the purview of PennDOT, and its Aviation Division. Spokesperson Erin Waters characterized her agency's approach to an unlicensed hospital LZ this way:

While we evaluate heliport situations on a case-by-case basis, in general, if the hospital's stated "intent" is that the designated site will be used approximately four times a year then no licensing action would be required. The municipality may have local zoning requirements that must be met as well for this "infrequent" use. Upon owners' request, we would be willing to review sites. We work to facilitate a cooperative relationship with aviation stakeholders.

The amount of use that LZs get in the Sewickley area would appear to fit that profile. When asked about any concerns that the Quaker Valley School District had regarding the use of their property for this purpose, Dr. Joseph Marrone, Director of Administrative Services, stated in an e-mail:

Safety which has been addressed by all concerned.  The other is disruption to the teaching and learning process.  The use of the fields is very infrequent, a few times a year.

Another factor to consider is the role that Heritage Valley Sewickley plays as the closest hospital with an Emergency Department to Pittsburgh International Airport. In the event of a Mass Casualty Incident (MCI) there, or anywhere proximal to the Sewickley area, how would the lack of a licensed heliport impact the hospital's ability to receive and/or manage patients? 

According to Knox T. Walk, EMS Manager for Allegheny County Emergency Services, the impact would be negligible. "No hospital destinations (specific to the severity of a patient's injuries) are written into the Airport MCI plan", Mr. Walk stated. This is designed to prevent any particular hospital or group of hospitals, i.e. trauma centers, from being inundated with victims it could not handle. Given the hospital's proximity to Pittsburgh and its trauma centers and other specialty facilities, Mr. Walk added that he thought it "doubtful" that helicopters would be used to transport patients from Sewickley Hospital in an MCI scenario.

Considering that it takes me about 20 minutes, absent rush hour traffic, to get into downtown Pittsburgh from Leetsdale, one can see very quickly the validity of Mr. Walk's assertions. In addition, our area is served by one of the county's largest and most competently run EMS agencies. The availability of rapid ground transport, combined with the direct traffic routes and drive time at emergency speeds, literally makes a helicopter trip from Sewickley into Pittsburgh more time-consuming in comparison.

With these factors in mind, why are any patients flown from our area hospital? This is where incident-specific circumstances and patient care issues begin to muddy the clearer waters we seem to have explored thus far.

It's been reported that some of these most recent helicopter trips involved the transport of pediatric patients or premature infants. The specialty centers that receive and treat these types of patients often send their own personnel and equipment with the helicopter to effect the patient transfer. These "specialty teams" help to assure that the patient receives specialized care at the earliest opportunity, and helps the referring hospital meet its obligations under federal law to effect the transfer with "qualified personnel and transportation equipment", which the referring hospital may not have or be able to spare.

In some cases, the hospital receiving the patient is the one that makes decisions on the mode of transport. This appears to be the case with one of the recent landings; according to Mr. Flannery, the staff at Heritage Valley Sewickley were not aware that a helicopter was being sent. In the early 90's, a medical helicopter with a Children's Hospital transport team responded for a child in distress at the Edgeworth Commons outpatient surgery center, landing in the parking lot with little or no prior notification to local Police, Fire, or EMS. Incidents such as this helped to create the emphasis on a coordinated, multi-disciplinary response to help assure proper coordination and protection of patients, responders, and community assets.

So where was the ball dropped here? As it is so often in many, if not most jurisdictions across the country, problems arise when essential communication pathways are under-utilized or ignored. Something as simple as the lack of a common radio frequency for contact between ground responders and the aircraft continues to hamper air medical responses, and diminishes their effectiveness when time to definitive care is a factor.

A change in the availability of an infrequently-used landing area - recognizing that change, identifying an alternate contingency, and communicating it to all stakeholders in advance of a pressing need - these are all things that I have encountered in my years in EMS, air medical, and public safety communications.

I would have preferred to obtain a greater perspective from what would appear by all aspects to be the key local stakeholder, but attempts to secure a statement from, or an interview with, a representative of Heritage Valley Sewickley were unsuccessful. J. Daniel Murphy, Vice President for Institutional Advancement, stated in an e-mail that he tried to obtain a statement for a week after my initial call, but didn't have any luck.

Mr. Murphy referred me to Mr. Flannery at Sewickley Borough, who seems to be the official most responsible for assuring that some form of communication took place across multiple jurisdictions, institutions, and disciplines. Multiple messages left for representatives of the region's air medical service providers,  STAT Medevac and Life Flight, also went unanswered.

It seems that we as citizens, and especially as health care consumers, are faced with an escalating risk-versus-benefit equation when it comes to managing the type of health care services we seek out, receive, and are able to reasonably afford. As these concerns continue into this presidential election year and beyond, it's my hope that we can have some assurance that the community's public safety net - and that includes hospitals and helicopters - will all be on the same page about what is needed, how to get it here safely, and how to make sure the community's risk profile is not impacted negatively by a lack of coordination or communication.

Be safe out there.

Farewell to Air Com

For just under a year, I worked at St. Mary's Hospital in Grand Junction as a Communications Specialist in their telephone office, known as "PBX" to those familiar with the hospital's operations.

The dedicated staff of that stuffy, windowless room, some of whom have been there for over 25 years, also took on the duties of receiving requests and coordinating the helicopter and fixed wing resources of what is now called St. Mary's CareFlight. The flight program, originally called Air Life, changed names when the hospital switched aircraft and maintenance vendors from Englewood-based Air Methods to Petroleum Helicopters Inc. (PHI). "St. Mary's Air Com" was the telephone and radio voice of the program.

One of the toughest calls I have ever had to make as a communications professional was to St. Mary's on February 28, 2001. I had to inform them that a helicopter had crashed in the Whitewater area, and knowing that their ship was out on a maintenance test flight at the time, could they check it's status? The voice on the radio repeatedly trying to reach CareFlight afterward, without success, still resonates with me. The program lost a pilot in the crash.

As of today, St. Mary's Air Com has gone silent. As Paul Shockley reports in today's Daily Sentinel, the hospital elected to outsource its communications needs to a communications center in Phoenix operated by PHI.

St. Mary's VP for PR Dan Prinster is quoted in the story as stating that the ability for PBX to answer CareFlight calls was somehow impacted by the operators being "barraged by a lot of other calls". Having been in the room for a year, I'd have to agree and disagree with that statement. The PBX workstations and job assignments were set up so that the operator handling CareFlight would typically be the last to answer other phone lines, and could take themselves out of the call distribution queue when a flight request was in process.

This being said, the hospital apparently could not justify setting up a separate communications center that could handle CareFlight and other hospital resources such as Security and Engineering. As a result, you have what happened today.

This practice has become somewhat of a trend in the air medical industry. Air Methods operates a communications center in Omaha, Nebraska that handles requests and aircraft coordination for numerous flight programs across the country. I was offered a position there in 2010, but turned it down. I wasn't ready to move yet, and got a local job offer that made more sense at the time.

This trend has affected air medical operations in my the area of my new home as well. Pittsburgh-based STAT Medevac, which started with one aircraft in 1985, now coordinates 17 aircraft across 4 states and Washington DC from one communications center here. Air Evac Lifeteam, which operates and coordinates nearly 100 aircraft from headquarters in Missouri, has a ship in East Liverpool, Ohio and 4 aircraft based across West Virginia.

Is this a good trend? I believe it depends on the nature of the flight program. Some hospital-based air medical programs have re-engineered their communication centers into "transfer centers" that can act as a one-call destination for outlying facilities needing to get a patient accepted by a physician, transported, and admitted to a facility capable of providing more specialized care. The flight program I worked for in the 80's and 90's is an example of this model.

As much as I feel for the "Comm Specs" at St. Mary's Air Com, I did not believe that their operation was sustainable in this operational climate. That's why I sought to attend a school that would certify me for more complex work with aircraft of all types, and left St. Mary's in pursuit of that.

Two years ago I was in San Jose for the annual conference of the leading trade group for the air medical industry. Ironically, October 19 marked the conclusion of this year's conference in St. Louis, and along with it the end of an all too short tenure for a small center and a dedicated group of communicators.

Best wishes to those impacted by the closing.

Have a good weekend ahead.

Responding to Change -Non-Profit Nastiness

As most of us realize at some point in our lives, change is the only thing that remains constant. As old and overused as that may sound, it is no less true.

People, and the groups and organizations that they affiliate with, respond to change in many different ways. I've been reading and collecting information about changes that are upon the Pittsburgh region, and how they've been responded to (or not) by those who stand to be impacted.

There's plenty of voices providing coverage out there, so I'll just limit myself to observations that (hopefully) haven't already been made elsewhere:

WYEP / WDUQ

As I write this, I'm listening to legendary WDUQ Jazz DJ and Pittsburgh Jazz Society founder Tony Mowod doing his last show before the format changes at about 11:00 PM.

There's been plenty of pleading, complaining, and yawning on the part of different Pittsburgh pundits and community leaders about the change. Links to it all are on the Save our WDUQ Facebook page.

There's also been talk about getting a new jazz radio station off the ground. As Tony said on his show tonight, "one door closes, another opens". I hope they can make it happen, and make it a sustainable venture. LPFM, anyone? Let's hope someone donates tower space on a nice, high hill somewhere.

Not much else to add that hasn't been said already. I'll miss you, Tony.

Highmark / WPAHS / UPMC

One thing I've learned from working in government, health care, and with volunteer non-profits is that "behaving like a business", which local health care giants Highmark and UPMC have recently been accused of, is kind of like accusing a person of eating when they're hungry.

My first wife Jan and I both worked for a hospital in the old Allegheny Health, Education and Research Foundation (AHERF) before it imploded under a mountain of debt in 1998 and was acquired by West Penn Hospital, becoming the West Penn Allegheny Health System (WPAHS).

25 years ago, Jan's father retired from West Penn Hospital as its Chief Financial Officer. He died in 1995, 3 months after I moved to Colorado. I would have loved to have asked him what he thought about AHERF's collapse and absorption by West Penn. Wayne was a very steady, intelligent person, and his insights would likely have been most valuable.

One thing that has been nearly palpable over those years has been the quiet acrimony between what is now UPMC, Highmark, and WPAHS. UPMC has helped to leverage its position in the market by offering its own insurance plan; now Highmark has seized an opportunity to help support an ailing but vital health care system, and perhaps optimize the efficiency and "surplus-ability" of both.

Many of the analysts and pundits that have commented on this have praised the opportunity for more competition in the health care marketplace, in an effort to keep costs and prices down. Still others have chided officials of both organizations for basically behaving like petulant schoolboys on the junior high school playground. For me, this is conduct unbecoming organizations that citizens depend upon to provide quality health services.

This is the way it's been in the Pittsburgh region for a long time, and it doesn't sound like there's a lot of room for improvement in this area. From what I've seen and heard, there may not be much chance of that unless people share their disdain with those who provide services, and insist upon displaying the same commitment to service first, and "surpluses" second.

Highmark/WPAHS and UPMC need to focus on not making things any harder for Pittsburgh area health care consumers than it already is.

Enjoy your Independence Day holiday.