TRIBUTE TO ALAN MAC MAHON By Dr C Robertson Alan was part of the best part of my life and I mean the best part because he gave me the gift of doing medicine outdoors. I remember my first night on call for METRO and there was a mountain call on the trail around Karbonkelberg. I went out and spent the night out with the patient. The next morning he called me not believing that a doctor had done that but I suppose he found us an extension of himself in doing the things that he couldn’t on the mountain and in the water. To most of us Dr Alan Mac Mahon, or Dr Mac as he was affectionately known, was immortal, he taught us never to give up and only acknowledge death with difficulty and so for us this tribute is difficult to make. Alan hated us making a fuss about him and so if he could see us all here today he would probably be mumbling something! He shied away from emotion and the mushy stuff but today we celebrate our deep respect and love for a man who touched us all and if we shed a tear, its unashamedly in the joy of having been part of his life and his mission to benefit humanity. Alan was a ‘mensch’, a true human being, a pragmatist, a visionary and a father not only of Modern EMS in South Arica but to each one of us who he touched over a lifetime of service to our city, province and country. I think most of us experienced his prickly exterior and were the target of a few choice expletives critical of our imperfection at emergency incidents but I was privileged to know a far deeper compassionate and caring man who was deeply concerned about the patients we serve and how to improve the care they received. He taught us the ethic of patient first and the power of building health systems and in so doing he touched millions of lives of people who would never get to know him and who owe him a huge debt. He was an excellent communicator, concise and clear, often in short four letter words necessary to the emergency situation. Smoke and mirrors was not his game, he was bluntly frank and openly honest. He was a pragmatist, sharp, with a mind for absolute detail and he deferred to common wisdom and sense rather than wait for the long gotten evidence. Every document he authored whether policy or otherwise was well thought through in every aspect. He applied the same detailed approach to EMS systems. Geoff Bettison remembers that when he designed a vehicle he knew exactly where each item of equipment should be and heaven help you if you moved it or it wasn’t on his plan! His vision for EMS is legend and if you think that he conceived our EMS System forty years ago and began the long journey of making it happen its an incredible story. I remember walking into METRO (which stands for Medical Emergency Transport and Rescue Organization) Control in 1992 and witnessing the first vehicle tracking solution which he was piloting, evidence of his appetite for innovation despite his typical scepticism and suspicion of technology. He started his EMS journey in 1973 while he was a Medicine Registrar at Tygerberg Hospital by innovating the A Medic (Tygerberg) and B Medic (Groote Schuur) response cars and his passion, enthusiasm and commitment eventually led to him being appointed by the Province to manage the ambulance services as a Medical Specialist and to my surprise he shared with me that he was never the ‘Director’ or ‘Manager’ of EMS and had led EMS his entire career in his capacity as a specialist until he moved into the hospital department in 1992. In 1975 he was party to importing the first ‘Jaws of Life’ into South Africa with Bob Muir at Milnerton Fire Department, tired of struggling for hours with a hacksaw to free patients trapped in motor vehicle accidents. His recognition of the key necessity of such equipment and skills to patient care eventually led to the establishment of the METRO Rescue Squad in 1979. METRO RESCUE became a household brand and if you were out after dark on the Cape flats you would hear the locals saying ‘hier kom die METRO’ evidence of Alan’s impact in those communities. METRO RESCUE branched in many directions including mountain rescue, industrial rescue, diving rescue and others but Alan had an acute sensitivity to height (and flying, legend has it that all National EMS meetings had to be held in Cape Town so he didn’t have to fly) and the rescue medics had great fun teasing him about not getting close to the edge or abseiling down a rope. Despite not being fond of water he had the vision to create a rescue diving unit and it must have given him great satisfaction to see us rescue three live patients from the Miroshga in 2012. The METRO Rescue Squad can recount endless tales of missions and rescues each with personal anecdotes of Alans adventures and the very close bonds he developed under austere conditions particularly in the eighties when providing emergency care was openly life threatening. He never withdrew from the duty to respond and resorted to wearing a crash helmet as if in some way to minimize the threat to his personal safety. He had incredible courage! His innovation included the Emergency Services Centre or ESC in 1976 which created incident command for major incidents and managed the flow of outpatients into Cape Town hospitals through the TransMETRO System. He also created an independent radio communication system across the whole Cape Province which still exists today and he often fondly acknowledged the contribution and support of people like Mr Lennox who survives today well into his nineties! In 1978 he established the first ambulance training college in Cape Town and his efforts saw the Cape Province lead the country in pre-hospital medical education with the graduation of the first advanced life support ‘Ambumedics’ in 1982. He was later instrumental in the Professional Registration for Ambulance personnel and served on the first Professional Board for Emergency Care personnel of the HPCSA. He was published on Disaster and Mass Casualty Medicine and his plans for aircraft, bus and train accidents live on in our system. He was a consultant to the Koeberg Nuclear power station and the emergency preparedness for a nuclear event and until very recently was involved in the preparation of a late phase plan in the event of reactor meltdown. Alan was an opportunist, a characteristic he passed on to us! In 1983 he convinced the Executive of the Cape Province, the equivalent of the current Provincial Government, to buy a Cessna Citation Jet Aircraft to the value of R3million for the Red Cross Air Mercy Service thereby cementing a relationship that has endured to the present to the benefit of the most sick and injured all over the Province and beyond. I remember when a local helicopter provider complained that there was unfair competition in favour of the Red Cross Air Mercy Service and I was summoned by the Standing Committee on Public Accounts. Alan was working in the Premiers office and I phoned him for advice. He went off and dug around in the Provincial Archives eventually producing the original Executive Minute that justified the investment in the service and we together produced a reply that eventually resulted in the extension of the service by another helicopter! He believed in the philosophy of asking for forgiveness rather than permission but I don’t recall he ever needed to! At the same time the Provincial Government were running a poorly thought through marketing campaign, the ‘Ears’ Campaign, which was supposed to communicate that the needs of the public were being heard. The campaign crumbled and Alan jumped on the opportunity to corner the R3million for EMS which we agreed to invest in a replacement for our rescue crane, Rescue 6, which would otherwise never have been replaced. His ability to pounce, his conviction to the cause and his timing always persuaded the treasury and he nurtured those relationships with the purely selfless motive of improving the services we delivered. He was constantly out on the street, responding to emergencies, teaching, guiding, commanding ….. cussing! I remember as a Varsity Student seeing his Range Rover rushing all over town, but in his selfless 365 commitment he confided to us that he had missed out on a huge chunk of his family life and his counsel changed the way that we balanced our lives for which we owe him, Jean, Candy and Justine a debt of gratitude. He made up some of the ground later with his grandchildren and the joy and fulfilment his trips overseas and down the east coast gave him were apparent every time he apologetically came to ask for leave. His journey with EMS was often a challenging one, Boet Coetzee the Cape Town Ambulance Chief once chased him out of his office, told him that there was no need for oxygen on ambulances, there was enough in the air we breathe! But he persevered and eventually earned their respect and friendship! If the measure of 21st Century leadership is about the diversity of a personal network or being able to anticipate change and see around corners or to have the courage to abandon the past, take risks and innovate, then he was a great leader. His influence on the diligence of ambulance personnel was legend and Wayne Smithsonian Frank tells the story when during his elective he was part of an ambulance crew that suddenly slowed down on the way to an accident. He asked them why they were slowing down and they said they could see Dr Mac Mahons lights coming up behind them and that if they got there before him they got into trouble and if they got there after him he would scold them for sleeping, so they had to arrive at the same time! His presence on the streets undoubtedly had a marked effect on motivation and on the quality of care. He pioneered many things not only in EMS but in the Health Department and the 24 hour Community Health Centres were his innovation to provide immediate access to acute care in the thinly distributed hospital system. He designed the Planned Patient Transport System which he proudly called HealthNET or Health Non Emergency Transport which benefits thousands of rural patients every year. The contributions he made are too numerous to mention here. He was the recipient of many awards including that of Paul Harris Fellow and a State Presidents Award but all he really sought was the satisfaction of a working health system that paid patients the respect and dignity of care deserved. He was genuinely humble. When he finally decided to retire I offered him a working home at EMS where he stayed. He was willing counsel, good company for coffee and a constant conscience. He would often walk into my office and preface the conversation by saying ‘you don’t have to listen to me but ….’ and then launch into a half hour conversation on something in EMS or the Department close to his heart! I miss the conversations we had over endless cups of coffee and the confidence he displayed in us as extensions to the system he loved so much. I know he loved you all and that you were all in some way part of the joy of his amazing service. Out of respect for Alan I never took the MEDIC 1 Call sign and it’s a source of great personal satisfaction that the call sign goes with him, I hope St. Peter’s got his ambulances in order otherwise heaven is going to be hell for a while! There can only ever be one Medic 1 and I can still hear him now in his gruff serious expectant tone, ‘Metro Control, Medic 1, Come in please’! Good-Bye Dr Mac!
Posted on: Sat, 05 Jul 2014 19:30:45 +0000