{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://marmia.aviaryplatform.com/iiif/p843r0rn8w/manifest","type":"Manifest","label":{"en":["Howard Champion 3, circa 1988"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/053/original/cropped-marmia-logo-copy1.png?1586173104","metadata":[{"label":{"en":["Source Metadata URI"]},"value":{"en":["https://marmia.libraryhost.com/repositories/2/archival_objects/15135"]}},{"label":{"en":["Date"]},"value":{"en":["circa 1988 (Creation)"]}},{"label":{"en":["Description"]},"value":{"en":["Be advised that this video may contain sensitive, triggering, and offensive language and content. (Content warning)","Digitized with funding provided by the Council on Library and Information Resources' \"Digitizing Hidden Special Collections and Archives: Amplifying Unheard Voices\" grant program. (Funding note)","Raw footage of an interview with Dr. Howard Champion, director of the MedStar shock-trauma unit at the Washington Hospital Center. (Scope and Content Note)"]}},{"label":{"en":["Format"]},"value":{"en":["1 U-matic"]}},{"label":{"en":["Identifier"]},"value":{"en":["WJZ-UNKN-070-002 (Identifier)"]}},{"label":{"en":["Series Title"]},"value":{"en":["Unidentified Footage"]}}],"summary":{"en":["Be advised that this video may contain sensitive, triggering, and offensive language and content.","Digitized with funding provided by the Council on Library and Information Resources' \"Digitizing Hidden Special Collections and Archives: Amplifying Unheard Voices\" grant program.","Raw footage of an interview with Dr. Howard Champion, director of the MedStar shock-trauma unit at the Washington Hospital Center."]},"provider":[{"id":"https://marmia.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["MARMIA"]},"homepage":[{"id":"https://marmia.aviaryplatform.com/","type":"Text","label":{"en":["MARMIA"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/053/original/cropped-marmia-logo-copy1.png?1586173104","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/267/656/small/open-uri20250314-1605153-5ts23f_1741980301.jpg?1741980302","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656","type":"Canvas","label":{"en":["Media File 1 of 2 - open-uri20250314-1605153-5ts23f.mp4"]},"duration":1376.383,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/267/656/small/open-uri20250314-1605153-5ts23f_1741980301.jpg?1741980302","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/content/1","type":"AnnotationPage","items":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-marmia.s3.wasabisys.com/collection_resource_files/resource_files/000/267/656/original/open-uri20250314-1605153-5ts23f.mp4?1741980300","type":"Video","format":"video/mp4","duration":1376.383,"width":640,"height":360},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656","metadata":[]}]}],"annotations":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503","type":"AnnotationPage","label":{"en":["AUTO_TRINT_WJZ-UNKN-070-002_FFV1.ia.mp4 [Transcript]"]},"items":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e My understanding was Kenny's trauma score was 14. Tell me what a trauma score is very briefly.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=9.36,14.7"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/2","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Trauma score is just a way we have of combining the vital signs so that we've got some one number which will give us an idea of whether the person's got a significant risk of dying or not. It has to be combined with other things for the purpose of identifying all of the patients at risk of dying, but it can be helpful. and some studies in San Francisco by Maurice Anco. indicated that it was helpful in an urban environment to identify people at risk of dying.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=16.43,49.54"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/3","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e So how serious were Kenny's injuries?","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=51.989,54.07"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/4","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, in the inner city, we get the patients pretty quickly. I mean, the average time between injury and arrival is less than 30 minutes in the middle of a city here. And so he didn't arrive on the brink of death. You know, given another 15 minutes or half an hour, he would have been in much worse shape. As it was, he came in with a lot of injuries, and he had fairly. prompt surgical treatment. The team was there waiting for him. There was no delay in appropriate operation. He was in the operating room within a few minutes and he required the blood vessels that were bleeding to be sewn up and that was all done. And a few weeks later, he left hospital.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=54.889,100.25"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/5","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e And could there have been a different outcome and a different outcome?","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=102.18,105.9"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/6","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, if there had been any delay in mobilizing the surgical team or the ability to open an operating room to get him in there, or any delay in x-ray or blood transfusion capabilities, these could all mitigate against his survival. It's quite possible for somebody with this set of injuries to die because they don't get into the operating room quick enough, and if you've got a hole in a major blood That's all. uh... the treatment is unequivocally to have somebody operate on that and uh... and close the hole uh... and if that's not done uh... then there's a very high chance of dying","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=107.1,150.16"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/7","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e What about some who pays for all this?","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=152.72,154.74"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/8","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, that's a very good question. If we don't do something about the reimbursement for injury care, it's going to be set back considerably in the next few years. Hospitals are being squeezed in their ability to provide free care. This hospital provides $12 to $15 million worth of unreimbursed care a year. And I don't know how long it can tolerate that. The bill for Kenny was... over $45,000, $45,761.35. He's not going to pay for that. The District of Columbia medical charities have to date made a contribution of $70 per day, which would amount to a little over $1,000 to his care. So. If we were to rely on that resource, then we would still have an outstanding bill of close to $45,000. DC Medicaid might come forward to reimburse the hospital for the care, but they pay $4,810 per discharge, irrespective of whether the patient has been in hospital one day or one year. So the maximum that one is likely to get from that resource for Kenny's bill is still going to leave an outstanding bill of close to $41,000. us. And there is basically very little chance of the care that he received, either from the hospital or from the physicians, of being reimbursed. Now multiply this many, many times over in urban environments all over the country, and you've got a huge problem. In some parts of the country, the patient is subject to a wallet biopsy. which is aimed at making sure that they've got insurance before care is instituted. Basically, it would have been possible in some parts of the country for a patient with this set of injuries to be transferred to a county hospital or the local hospital that cares for those patients that have no ability to pay. In doing so, one might uh... transgress the ability to save a patient's life like this There is a window of opportunity for this individual patient of 30 minutes or two hours, whatever it is, and assessment of his ability to pay plus transfer to another institution transgresses that capability, then the patient can die or be permanently disabled and even more cost to society as a result of not being able to pay.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=156.72,348.36"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/9","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e I mean trauma centers are the only place I've been where they don't ask for all of their information. It's treat now and deal with the rest later.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=349.14,356.56"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/10","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e That's right. I mean, in most parts of the country, the hospital that is designated a trauma center has got a specific commitment.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=357.82,366.66"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/11","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e Hang on. What the hell was that? My tape ran out. I mean, we were talking about how trauma centers are the one place that you should walk in. I guess the question is, you said how are they going to survive it, but if we want trauma care to spread, I mean hospitals aren't going to be in the mood for this too long.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=369.909,388.12"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/12","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Right, yeah, I mean, I think the system of reimbursing hospitals is getting more and more difficult for them. The hospitals are not being able to operate on the same margin of profitability that they used to, and thus their ability to provide free care is significantly reduced. One group of patients. uh... which clearly have significant demands because they can often come in very very sick uh... the patients with severe injuries and they can require a considerable uh... amount of a hospital's resources at at great cost uh... it's been estimated that a trauma center would lose at least five million dollars a year in an urban environment uh... in many communities there are attempts to reimburse hospitals for. care of indigent injured. But in many, there are not. In some communities, no hospitals want to be a trauma center, because there is a large number of indigent in the community, and the government has not seriously recognized the need to provide some financial resources for the hospital's expenditure of personnel and facility resources. I mean, they can't. uh... be a mismatch like this for much longer","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=388.34,474.07"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/13","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e But at the same time, what you hear from people is we can't let that hospital be a trauma center because they're going to steal patients from us and we won't be ours to make money and we need all these people. And again, it comes back to this contradiction.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=475.25,487.85"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/14","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, it depends where you are. Another group of patients will pay quite well. The automobile accident is the main source of. the United States and many communities require some form of insurance for automobiles and so if you live in a suburban or rural community then the chances of injury or trauma as a disease paying because it brings a lot of people to the emergency department and it brings a number of injured people who require admission who are insured to the is fairly good. I mean in Orange County it pays to be a trauma center. uh... in uh... suburban in the suburbs of washington d.c. it pays to be a trauma center and there is a lot of competition for trauma centers in affluent suburbs the main impetus for uh... urban trauma centers uh... is uh... the uh... fact that it is uh... important to teaching programs and it's important to the ego of an urban teaching hospital to be trauma center i know that at our hospital here we have both populations we see a lot of penetrating injury that i'm sure doesn't pay uh... they come from nearby 14th Street, they are indigent and they don't pay. We also get transferred in a number of patients with severe blunt injury from automobiles and they by and large do pay. And so we have some sort of balance at this hospital with regard to the overall ability of this patient population to pay. But nevertheless, if the DRG system, which is being used to pay for medical treatment, care was to be implemented for injury and its full force were to be felt, it would not be possible for trauma centers to survive economically.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=488.6,627.32"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/15","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e What do you think the federal government should do about this?","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=628.37,630.87"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/16","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, I think they need to do something, and they need to do something fairly soon. I think injury is a huge disease problem in this country. It robs this country of a significant productive population. And it needs to do something to document the extent of the disease, to move in terms of prevention, and to ensure that injured patients who are at risk of dying. receive the medical care that their injuries demand and that this is not based on a wallet biopsy at the entrance to the emergency department. Something needs to be done. We've got a national scandal in terms of not being able to provide adequate care for this population. Now, the Department of Transportation, which is... One agency that's had a long-standing interest in injury has moved towards injury prevention with regard to trying to stimulate an interest in seatbelts. Congressman Layman has been a leader on Capitol Hill in terms of mobilizing some financial resources to start the Center for Injury Control, which is located in Atlanta now. And that will, I hope, help coordinate research in injury and begin to document the scope and nature of the disease. We just don't know where it ends or starts.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=633.06,732.98"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/17","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e In the meantime, politics is always slow, and I think, what is it that you think people watching at home need to know to make their own lives safer?","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=733.15,743.53"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/18","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e They need to know whether their community has a system for treating patients with severe injuries. Do they have a trauma system in their community? And if they haven't got a trauma system, then they can be pretty much assured that one in five persons who die from injury in their community is a preventable death. wherever this has been studied. in the United States in the past ten years, that number is the one that comes forward. One in five. Now that could be your son, that could be your daughter, it could be your wife. And one day it possibly will be. Unfortunately it will come very quickly and if you haven't created the system before then it's too late.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=745.89,800.74"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/19","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e I mean, we talked to you.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=801.71,802.69"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/20","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e All right, okay.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=804.75,805.55"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/21","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e What do you say to the parents of these people? We've talked to you, we've been out to preventable injuries and deaths. And they think they went someplace and got great care and everybody said we're doing everything we can and then the person died and they find out later about trauma centers and they go, oh my God. Well, it's just. Say to those people.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=806.61,827.44"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/22","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, it's too late. They should have thought about it beforehand. I mean, injury is not a disease that just affects somebody else. It's very likely to affect your family sooner or later. And it is time for them to do something in their community to make sure that they've got access to appropriate care. Now, trauma care is very, very expensive to provide. And you need a lot of facility resources, and you need some skilled personnel resources. So. The most effective way of setting up a trauma system is to develop an institutional commitment at one hospital to provide care for a certain population and to make sure that the other hospitals and doctors send all those patients to that one hospital. So you need, basically, a trauma center in the community or a relationship between that community and the nearest available trauma center. and if that's not available you have can't even start. You need to have your pre-hospital people trained to recognize the type of patient that should be in a trauma center. Not all patients need to be there, just a small percentage of them, seven to ten percent. You need to train the doctors to provide quick care that can save somebody's life while they're getting to definitive care. The American College of Surgeons Advanced Trauma Life Support Course is the vehicle by which this can be provided. to a community. The hospitals must develop a relationship so that the hospital with a commitment to care is able to and willing to receive the patients with multiple severe injuries. In that hospital, there must be a commitment from individuals and from the hospital administration so that the resources are always available for this group of patients. And then skills begin to build, and the number of preventable deaths goes down very rapidly. and the actual survival begins to improve after that. We find that we can reduce the number of preventable deaths to less than 5% by creating a trauma system in a community. And after that, as the severely injured are concentrated into fewer and fewer hospitals, the skills of the team improve. And the cutting edge of survival begins to march forward, and you actually get people being saved and returned to productive life, which five years ago... would not have been possible in that community.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=827.83,977.56"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/23","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e And we don't have that who's accountable.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=978.54,980.6"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/24","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, everybody is to some respect, the society is accountable because they ignore it, the politicians because they will refuse, sorry, the politicians are accountable. Council.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=981.75,994.71"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/25","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e Okay, tell me again. Who's accountable?","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=995.27,996.21"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/26","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Society is because they ignore it as an issue and will allow the medical care to be finally honed in the direction of heart transplants or something else which might be available for a minute segment of the population and yet allow this huge disease problem to march on unrecognized and unchecked. uh... the politicians are responsible because they will not allow this to become an issue they will not do anything about it because the people who suffer as a result of a lack of uh... of a system to provide the care are uh... are often permanently disabled or dead and therefore uh... they willfully ignore the issue even when it's been brought to them and provided in graphic numeric format or with photographs They will just ignore it because it's not a constituency. problem that they can get some benefit from as a result of responding to it. In addition, there's competition between hospitals and between physicians that will often mitigate against an appropriate solution in a community. In my opinion, it's time for some leadership at the federal level. Senator Cranston, Kennedy and Gore have got a bill which they have just put before the Senate. which would attempt to address some of these issues. They would provide for hospital coverage for indigent care. There is a number of, I've lost my train of thought on this thing. Oh.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=996.96,1101.25"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/27","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e Okay.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=1101.28,1101.28"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/28","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, we only have about two and a half more layers on this one.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=1105.02,1107.48"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/29","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 3:\u003c/strong\u003e I mean, do you ever get angry and frustrated about all this? We've known how to do this for 20 goddamn years!","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=1109.21,1114.59"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/30","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e I get incredibly frustrated. I've spent 10 years in the city trying to attract some attention to it. And I get a little spark of interest just before election time, and then it vanishes. The thing that upsets me most is to have some of the people that we train go out to the suburbs and to provide care based on the financial forces that are at play in their medical practice building. They will take care of a young girl involved in an automobile accident. uh... and she will eventually be shipped into us say six weeks later with irreparable sequelae in her lungs uh... from inadequate initial care and uh... a seventeen-year-old will be dead uh... as a result of uh... inadequate care because of various uh... forces at play uh... uh... in their need to build their medical practices relate to their communities and that sort of thing. It's very, very distressing. to see preventable deaths that occur every year.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=1115.69,1194.04"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/31","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e I mean, I just think that the medical community has to be held accountable at some point.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=1195.96,1199.48"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/32","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 2:\u003c/strong\u003e Well, the health care community does. It's partially the medical community. But in injury, I mean, I use the analogy that if you're going to have open heart surgery, you will have time to pick a hospital and a doctor that's got a reasonable chance of success in your operation under most circumstances, whether you have a private physician or not. One way or another, the medical health care system will somehow get you into a hospital that does cardiac catheterization or open heart surgery. If you're going in there electively, you will check whether this guy has had any patients that lived recently, whether he's done this operation in the past five years, etc. The medical and health care community seems to rally around somebody with a heart attack and put them. in the element in the system which is best capable of caring for them that's not so with injury yet you can be severely injured with multiple injuries with twenty times the chance of dying from open heart surgery and yet the ambulance system will take you to an emergency room that they know uh... has not got the capabilities at three o'clock on a sunday morning providing your care they will allow this to happen to you. uh... you can go into a hospital there and a doctor because he's on night call there will uh... or is in need of patients will initiate the care when he has not seen a multiple injured patient or who has not operated on a liver for instance in the past five years he will instigate care that he hasn't got the experience because of financial incentives which are either from himself or from the hospital who would not like you to ship that patient out. your statistical chance of survival begins to decrease substantially because of these forces. I mean, someday it should be possible.","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=1200.59,1324.5"},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/33","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"\u003cstrong\u003eSpeaker 1:\u003c/strong\u003e I'm sorry. That's tape. Yeah. That's tape. Got it. And that was for-","format":"text/plain"},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656#t=1325.16,1327.9"}]},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503","type":"AnnotationPage","label":{"en":["English [Transcript]"]},"items":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267656/transcript/77503/annotation/34","type":"Annotation","motivation":"subtitling","body":{"type":"TextualBody","value":"https://d9jk7wjtjpu5g.cloudfront.net/file_transcripts/associated_files/000/077/503/original/trint_WJZ-UNKN-070-002_FFV1_transcript.vtt?1742308209","format":"text/vtt","language":"en"},"target":"https://d9jk7wjtjpu5g.cloudfront.net/file_transcripts/associated_files/000/077/503/original/trint_WJZ-UNKN-070-002_FFV1_transcript.vtt?1742308209"}]}]},{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267657","type":"Canvas","label":{"en":["Media File 2 of 2 - open-uri20250314-1605153-i0m2u6.mp4"]},"duration":1376.383,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/267/657/small/open-uri20250314-1605153-i0m2u6_1741980382.jpg?1741980383","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267657/content/1","type":"AnnotationPage","items":[{"id":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267657/content/2/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-marmia.s3.wasabisys.com/collection_resource_files/resource_files/000/267/657/original/open-uri20250314-1605153-i0m2u6.mp4?1741980381","type":"Video","format":"video/mp4","duration":1376.383,"width":640,"height":360},"target":"https://marmia.aviaryplatform.com/collections/948/collection_resources/144800/file/267657","metadata":[]}]}],"annotations":[]}]}