Geeks, Packagers, Pitchmen, EMS and You: Part IV


Community Leader Emeritus
It’s one thing to have designed a procedure that can raise the dead. It means nothing, however, unless the people who are best able to use it are able to use it with ease. Once that hurdle is overcome you’re still left with the necessity of making sure what you produced, the “product”, gets used. The word must get out and the product must get into the marketplace because that's how things work, otherwise, the breakthrough goes nowhere.

In the case of external cardiac defibrillation and CPR for that matter, the end users -- in this case the physicians -- had to be more than convinced; they had to be converted. Enter the Pitchmen!

Remember, the experimental development of external cardiac compression, and CPR, was happening out of sight, where only a few, select people got to visualize its potential. This was happening during a time when medicine was barely in its infancy when it came to the use of (what we would call today) high-technology in medical procedures.

Doctors were still working out of private offices and making house calls. Though there were about 6,000 hospitals in the U.S., only some few in the University setting were geared for innovation and experimentation. Teams like Kouwenhoven’s were affiliated with major institutions and no matter how important their breakthroughs, it still took time and an incredible amount of effort to get the ideas across to the larger population of practicing physicians.

Tom Corbin would never have gotten as far as he had were it not for the fact that the various incarnations of the external defibrillator that he was developing were being sold to teaching institutions.

But Tom was in a Catch 22; in order for the machines to get sold he had to make massive improvements, and In order to get the input he needed to make those improvements, he had to have machines out there in use.

This was not charity work, it was business. Levinthal, the parent company, began to balk at investing in development without sales. By his own admission, Tom Corbin was not the guy to do the selling. His co-worker at Levinthal, Elliott Farnsworth, was the man with the charm! He also had a good eye for identifying what the customer wanted.

Together they bought out their interest in the medical equipment manufacturing arm of the company that Tom had developed and formed Corbin-Farnsworth. It was then that these innovation really began to take off.

Together, in more than one way, they had to “create” a market. When new developments happened, few doctors knew about them. Continuing education was not part of the culture of medicine at the time. Rather than depending on the doctors to seek out opportunities to learn about new developments, Farnsworth had to schedule demonstration after demonstration and bring the technology TO them.

Though non-medically credentialed, they had to first demonstrate to and then train physicians on the use of their equipment; Tom’s responsibility was for the Steak; it was Farnsworth who provided the Sizzle!

At first, opportunities for the kind of exposure you would need to bring other hospitals on board were extremely limited. They were based on factors like having the right patient at the right time with the right condition and a doctor with the proper curiosity AND the willingness to invite other physicians to observe; basically, a crapshoot.

Without burdening you with the details of early attempts at gaining momentum in sales and development, let’s allow this part of the conversation to go to the dogs!

Much of the experimentation around internal and external defibrillation and CPR was done on dogs in laboratories; not necessarily in the hospital setting. Using those experiences as a baseline, the equipment was refined enough to present to other hospitals for sale.

The best way to introduce the largest amount of practitioners to the miracles available through use of these machines was to schedule “demonstrations”. The backing by one doctor in the hospital was not enough to justify such expenditures. Many people, both medical and financial had to get behind the adoption of these new technologies.

Farnsworth, who loved to dress up in scrubs for the demos, scheduled time in regional hospitals where doctor/specialists and other key people from the surrounding areas were recruited and invited to watch and learn.

In each demonstration, a dog was placed on an operating table, sedated, externally shocked into defibrillation (with its resulting apnea and pulselessness), given CPR for a number of minutes, externally shocked back to life, and taken off the table.

Can you imagine the draws dropping when the dog wagged its tail as if nothing had happened?

There’s no record of who first inquired, “Can we do it again?” but before most sessions were over, the poor pups would have had many near-death experiences and a number of doctors would have had their own experience of being Dr. Frankenstein and animating the dead through electricity!

You could call this the hub of an approach used to introduce, educate and sell prospective clients on a new technology. Within a few years, Farnsworth had developed a nationwide sales team who taught the medical profession the use of external defibrillation, and CPR, to reclaim life.

And of course, there were mishaps. In one instance, the acquisition of a dog for the demo got flummoxed. A local anesthesiologist took on the responsibility and got a dog less than half the size of the one’s they usually use and with far more hair. Without torturing you with the details, let’s just say the demo was a failure, but I don’t think the dog got the worst of it. The anesthesiologist had to figure out how to tell his wife and kids the family had made a very vital contribution to science!

The scene I’m trying to paint for you is a brief portrait of the not-often-thought-about aspects of getting technological innovations out to the people. It’s as much a sales job as anything. A good case in point is CPR. It took a powerful advocate to bring it to the public.

The Father of Cardiopulmonary Resuscitation is most often identified as Dr. Peter Safar. Today, he’s credited for getting the word out. Yes, I know you thought it was Johnny and Roy, but the truth is, they heard it from him! In his Obituary, it says:

Dr. Safar was the driving force behind both cardiopulmonary resuscitation and critical care medicine. He developed this country's first intensive care unit and paramedic ambulance service, and was nominated three times for the Nobel Prize in medicine.

In life, everyone stands on the shoulders of the people that preceded them; both the little people and the giants who created the tools and environment that allowed them to succeed. Dr. Safar was well aware of this:

He also demonstrated that CPR worked and pushed for its widespread use. Modest about his own accomplishments, Dr. Safar routinely named people who played key roles in his work.

In the case of Corbin and Farnsworth, their audience was limited to what we call today the “Early Adopters” the ones who first get a glimpse of the vision, way before the general public gets a chance to gain from the innovation. Their impact on the broader scale was limited.

What Dr. Safar did was popularize the ideas and concepts and new technology. He further created a demand, but this time, by educating anyone who'd listen. Remember, for all intents and purposes, CPR and external cardiac defibrillation go hand-in-hand. Once the people were made aware that sudden death might be retractable, and there were tools available to combat it, they wanted access; from the Chief Surgeon to Joe and Jane on the street.

Through Dr. Safar, the “idea” of advanced intervention took hold. Everyone was included in making it work. To facilitate a paradigm shift, from “Load and Go” to “Stand and Deliver” took public buy-in, and Safar spearheaded the effort. It spread across the U.S. and then the world.

In the words of Tore Laerdal, son of Asmund Laerdal with whom Safar developed the CPR-trainers’ friend Resusci-Anne:

He was absolutely passionate about the need to involve the first link in the chain of survival, to train the masses with some very simple but efficient lifesaving techniques.

When I tell people I was one of the first paramedics in the country and that was in the 1970’s, they can’t conceive that EMS as we know it has only been around that long! You could say it came from nowhere but in reality, it took lifetimes of dedication and the willingness to speak up again and again by people like these to create the union between medicine, technology, the common people and you.

NEXT: The Conclusion