Top 10 not-so-altruistic ways to improve EMS with a billion dollars

The Ambulance Driver imagines a glorious future, funded by his Powerball winnings, as our EMS dear and fearless leader

Wednesday’s Powerball jackpot is reported to be worth $1.3 billion, with a cash value of $800,000,000.

Wait. Let me say that again in my Dr. Evil pose and my sinister overlord laugh:

"One. Point. Three. Biiilllionnn. Dolllllaarss."

EMS1 Editor-In-Chief Greg Friese wrote a column about what EMS could do with $800 million dollars (last week's Powerball Jackpot). Predictably Greg played it straight. He’s a Boy Scout, the ceaselessly loyal, earnest, altruistic Patrick the Starfish of EMS. If Greg won the jackpot personally, he’d be the kind of guy that the money wouldn’t change.

Me, I’m not so incorruptible. Eight hundred million smackeroos would change me, big time. I’d probably lose my girlfriend, alienate all my friends and abandon all my greedy relatives, and make a big show of parking my hind parts on my operations manager’s desk and haughtily telling him precisely which acre of it he could kiss.

But only if he brushed his teeth thoroughly first. One’s mouth must be clean to kiss a billionaire’s butt. We have our standards, you know.

Yep, that much money would ruin me, but I’d console myself with the empty, meaningless relationships I’d have with dozens of supermodels, and the endless parade of sycophants telling me how great I am, while all the nurses I’ve clashed with chained to my throne, forced to peel my grapes and fan me with palm fronds.

And yes, the Princess Leia slave girl costume would be the required uniform.

But I’d be a benevolent overlord, and I’d give something back to EMS. So, when my legion of flying monkeys completes my quest for world domination, here’s what I’d buy for EMS with a half-billion (no way I’m giving it all to you lazy freeloaders) dollar budget:

10. Rocket-powered ambulance fleet
Every rig in the fleet fitted with snowplow bumpers and twin water-cooled .50 caliber machine guns. No more plodding behind the dude in the Prius yakking on his cell phone. We’d just lay a burst into his fuel tank, push him off the road, and leave him behind in a cloud of toxic rocket exhaust.

And I’d invest heavily in new siren technology, one that had multiple modes like "Wrath of God," or "There’s An Ice Cream Truck One Block Over."

9. Politicians
I’d buy lots and lots of politicians. And not just ordinary politicians, either. I’d buy only the good kind; the type that, once bought, stays bought. And once I had enough of them in my pocket, we’d reform this whole Medicare fee-for-transport reimbursement model.

8. Better perks
No more System Status Management. Every ambulance crew would have their own station, outfitted with comfortable furniture and amenities, covered parking, a wide-screen television with surround sound and a full cable package. Every station would have a Slushie machine and an espresso maker, and the deck out back would be equipped with a cigar humidor. Access to premium and pay-per-view channels would be a performance incentive. Every station would have a foosball table and a dartboard with the founder of system status management's likeness on it.

And if the public griped about long response times for frivolous 911 calls, I’d just quietly remind my hired politicians who funded their kid’s college education.

7. Better diagnostic technology
I’d underwrite the research and development of the LifePak 25, the first monitor with integrated Blu-ray player, video streaming, TiVo, and a deodorant mister for those homeless patients with Toxic Sock Syndrome. And each LifePak 25 would have an integrated, cordless Tricorder that docks into a port in the monitor. The Tricorder would be capable of wireless 24-lead ECG, CT scanning, and ultrasound, and would feature a new Malingerer Artifact Filter to identify people faking their symptoms.

6. Powered stretchers
And I don’t just mean powered loading systems and hydraulic lifting capability like Greg suggests. I mean powered stretchers. They’d be outfitted with a capacitor charged by friction generated from vehicle movement, and they’d deliver a powerful electric shock any time a patient lied to us.

"I’m allergic to all NSAIDs, and the only drug I can take is Dilaudid." ZAP.

"Honest, I was just standing on the street corner, minding my own business." ZAP.

"Man, I ain’t gonna lie to you. See, what had happen wuz…" ZAP. ZAP, ZAP, ZAP. ZAPZAPZAPZAP. [Activates LifePak 25 deodorant mister to neutralize the smell of singed hair]

5. Personality transplants for every triage nurse, ever
Not quite sure how it could be done, maybe with behavioral conditioning or microchips implanted in the brain, but I’m willing to throw money at the problem until it’s solved. And I’d surgically sever all extraocular muscles responsible for eye-rolling.

4. Better health for EMS crews
Greg had the right idea, but I’d take it one step further. I’d clone Jillian Michaels so that every EMT could have their very own personal trainer. Only she’d be nicer, because of the behavioral control technology we pioneered for triage nurses.

And yes, I know it’s sexist, and I should clone hunky male personal trainers for the female EMTs, but I don’t care. I’m a billionaire with his own cadre of sycophants, remember? I am immune to your indignation.

3. Ejection seats in every ambulance
Because let’s face it, some partners just have it coming.

2. Parable of the Five Monkeys for every EMS system
I’d employ the Parable of the Five Monkeys to every EMS system in the country, and I’d replace them with new monkeys who weren’t trapped by the organizational inertia forcing them to do things the way they had always done them.

1. Big, ostentatious statue of myself
In my 5-story high statue, honoring my accomplishments in making EMS a better profession, I’d look a lot like Bruce Campbell in "Army of Darkness," only I’d have a laryngoscope hand instead of a chainsaw hand, and the buxom woman at my feet would be my dream girl, Christina Hendricks.

And it would be glorious, I tell you. GLORIOUS.

About the author

Kelly Grayson, NREMT-P, CCEMT-P, is a critical care paramedic in Louisiana. He has spent the past 18 years as a field paramedic, critical care transport paramedic, field supervisor and educator. He is a former president of the Louisiana EMS Instructor Society and board member of the LA Association of Nationally Registered EMTs.

He is a frequent EMS conference speaker and contributor to various EMS training texts, and is the author of the popular blog A Day In the Life of an Ambulance Driver. The paperback version of Kelly's book is available at booksellers nationwide. You can follow him on Twitter (@AmboDriver) or Facebook (, or email him at Kelly is a member of the EMS1 Editorial Advisory Board.

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