Synthesis

SIGNIFICANT UPDATE:
Had breakthrough moment on how to fit the story together. Currently gathering visual media to accompany narrative. Failed to articulate this in the presentation.

Narrative:
While my experiences gained have been fantastic, they were never perfect. There were plenty of things along the way that I felt uneasy with and wanted to make changes in. I had the opportunity to start small - my ski patrol department's training program was lacking back in 2021 and their equipment was outdated and disorganized in complicated packs, which in my opinion led to a few bad outcomes on first aid calls. People died. I initiated a project to rebuild the equipment packs, updating and standardizing kits for streamlined learning by new patrollers and minimizing human factors on calls, while taking care to maintain sufficient redundancy and coverage of our ski area (go figure, kit organization: a fundamental value drilled into me through basic training in the army). I was then given the opportunity to take a trainer course and later rebuilt the yearly training. From what I can see, both of these systemic changes have been successful.

From my experiences as a paramedic, especially in rural interior BC, I had the opportunity to not only interact with underserved populations, but ones that also are completely out of sight and out of mind of most policy makers (who are located in urban centres). Our prehospital healthcare system is horrifically underfunded and understaffed, and DOES NOT adequately cover the majority of our province with a standard of care sufficient for a developed nation. In many instances we were called to drive hours away to cover another rural community with a slightly larger population, to have someone die a potentially preventable death on the same block as our ambulance station because our province is not allocating enough resources to keep both areas staffed. We are not doing our due diligence for rural communities, and especially for our Indigenous communities. Even in major urban centres, where as we know healthcare problems for underserved populations are very visible, we have a severe primary care shortage that has come from poor oversight and planning in the provincial healthcare sector.

In the military, complacency has become a systemic plague that infects the minds of the keen volunteers who join expecting to train, learn, and protect peace, human rights, and democracy. Poor morale among leaders due to poor equipment (a lack of investment by the federal government) starts a vicious cycle where we can't run quality training because equipment is poor, we can't retain quality troops because training is poor, we can't maintain morale because we have such poor effectiveness due to lack of talent and training, and over time that has generated systemic complacency where nothing useful gets done - which puts Canadians and global human rights at risk.

What I have realized, is that on top of the medicine, which is my primary interest by far, I have a burning desire to make systemic changes. The cognitive dissonance associated with dedicating your life to healthcare but not addressing the biggest opportunities to improve outcomes is mind-boggling, and I can't sit with it. I have been able to make the changes I want in my ski patrol job. I learned that I am capable of these things. But the scope of those changes are too small. It has been great, but I feel more strongly about serving the underserved or those in the most danger, as in prehospital/austere/military medicine, rather than rich skiers out for a day on the snow (*they also deserve due care as well*). I know I can see these issues, and I cannot be complacent. We need wellness promotion through holistic primary care for all and a well staffed and trained emergency healthcare system. We need investment into a small but capable armed forces to protect human rights worldwide.

Interacting with these larger systems has shown me: "rank" matters - for better or worse. Changes in prehospital care systems come not from paramedics (those that do the job), but rather exclusively from doctors, healthcare administrators, and politicians. Nobody cares what you think unless you have M.D., PhD, or Hon. somewhere in your title. In the military, if you're not an officer, you best not have an opinion. If I am to make these systemic changes, I must first undertake this dual journey of maximizing my clinical abilities and knowledge, along with my credibility as a policy maker (an artificial title), in order to both operate as effectively as I can within the current systems - where I believe a high degree of participation is ethically and mentally necessary for me (I will always be someone who needs to be hands on when an emergency arises in front of me, I've always been drawn to the risky and exciting) - as well as subvert the systems by climbing their ranks such that I can impose equitable and effective systemic changes.