Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

An EMS Giant is lost – Well-known educator Mike Smith dies at age 61



The EMS community lost one of its contemporaries early this morning. Mike Smith, chair of the Tacoma Community College EMS program and a well-known EMS speaker, died of an apparent heart attack.[1]


In EMS, we seem to die of things that as if they should be easily prevented. MVCs (Motor Vehicle Collisions) while not wearing a seat belt and heart attacks.

Why do I start writing about the death of Mike Smith by mentioning this? Because I think that is one thing he would want us to learn from his death at the ripe young age of 61.

We deal with death much more frequently than most other people, and yet we seem to be trying to get there faster than most other people.

Too many of us drink too much – and I do mean alcohol. Many of us drive while drunk and are able to get a free pass from the police, because we are the good guys. You didn’t kill anyone this time, so try harder next time. This is preventable.

Too many of us drive recklessly, even without the assistance of alcohol. The most common cause of LODD (Line Of Duty Death) is either heart attack or MVC, but how many of us regularly wear seat belts?

Mike Smith appears to have died of a heart attack.

What might Mike Smith use as lessons from this?

I barely knew him. I knew him well enough to say, Hi to him at EMS conferences.

I think that he would focus on preventing the pain that is inevitable from his death.

According to sources, Mike was transported by EMS from his home to a local hospital where he succumbed to a myocardial infarction.[1]


He might point out how painful this must have been for EMS, since he probably taught everyone who showed up.

He was a big guy, so maybe he had students press down on his chest in class to see that two inches is not going to do much on a big guy. But he would have been alive for that lesson.

How does EMS deal with the bad outcome, even if there was no way for EMS to change the outcome? This might be a class best taught by Shakespeare.

He is survived by his wife Sylvia and two grown children, as well as a new granddaughter.[1]


He might point out how much the patient would prefer to be around to see his children prosper and his grandchild grow up. How many things would he have told them, if he knew that he had so little time left?

Maybe the biggest lesson would be about taking better care of ourselves. We take care of other people, but we often do not take care of ourselves.

He was blunt and not afraid to share his thoughts and opinions with anyone. He was idealistic and filled with a zest for EMS and patient care. He loved people, and could be the best friend in the world or a formidable opponent if he thought you were unjust. Having grown up in Chicago, he would not back down from a fight when he was right.[2]


Are my comments too blunt?

Unlike his friend Jim Page, his death may not have been a tragedy of a lack of a defibrillator, but a tragedy of a big heart that did not beat long enough.

I have been trying to get rid of my EMS weight. I have lost about 20 pounds in the last five months, but I would like to lose another 30. Last night at work, I was the smallest person in the room at work, and I am not small.

I want to see my family grow old and become more successful. I want to make it beyond 61, 71, or even 81 – and with my brain still working. Exercise helps prevent stroke, too.[3]

It is painful for me to run, so I use a machine, then I walk for a while. I keep increasing the time. Eventually, I hope to be able to run, but even if I cannot, I can get good heart exercise from walking briskly. A few hours at about 140 beats per minute is over 75% of my calculated maximum heart rate and more than is recommended by the CDC (Centers for Disease Control and Prevention). This is prevention, the part that alternative medicine propagandists pretend that real doctors do not recommend.

10 minutes at a time is fine
We know 150 minutes each week sounds like a lot of time, but you don’t have to do it all at once. Not only is it best to spread your activity out during the week, but you can break it up into smaller chunks of time during the day. As long as you’re doing your activity at a moderate or vigorous effort for at least 10 minutes at a time.

Give it a try
Try going for a 10-minute brisk walk, 3 times a day, 5 days a week. This will give you a total of 150 minutes of moderate-intensity activity.[4]


It isn’t about me, or even Mike – it is about you and your family – even especially if you consider your family to be EMS – the people who would have to deal with treating you.

What is more important to you than your family, whoever your family may be?


Image replaced 17:10. Thank you to 9-ECHO-1. I had the wrong Mike Smith. I am not good at facial recognition and did not notice the differences. My apologies to everyone I upset with my error.


[1] An EMS Giant is lost – Well-known educator Mike Smith dies at age 61
Art Hsieh

[2] Passing of an EMS Icon – Mike Smith, who died unexpectedly at age 61, was a well-known EMS educator and writer
A.J. Heightman, MPA, EMT-P
Letter by John Sinclair, Fire Chief, Emergency Manager, Kittitas Valley Fire Rescue, Ellensburg, WA
Monday, October 14, 2013

[3] Association of physical activity level and stroke outcomes in men and women: a meta-analysis.
Diep L, Kwagyan J, Kurantsin-Mills J, Weir R, Jayam-Trouth A.
J Womens Health (Larchmt). 2010 Oct;19(10):1815-22. doi: 10.1089/jwh.2009.1708. Review.
PMID: 20929415 [PubMed – indexed for MEDLINE]

Free Full Text from PubMed Central.

Although it is unclear how PA plays a protective role against stroke, results of this study suggest long-term benefits. Future research to examine the impact of PA on the pathophysiological mechanism of stroke will be desirable. Some studies37–41 have suggested that impact of PA on reducing the risk of stroke mortality could be explained by deceleration of the atherosclerotic process, amelioration of endothelial dysfunction, structural modification of the arteries, enhancement of myocardial electric stability, or attenuation of hypercoagulability.


[4] How much physical activity do adults need?
CDC (Centers for Disease Control and Prevention)
Physical Activity for Everyone
CDC page of recommendations.



  1. The picture is of Mike Smith, just retired director of Durham County (NC) EMS. As of this afternoon he is alive and well.

  2. I was a student of mike smith! TCC class of 2006-2007. I am absolutely in shock right now! This man made me who I am today. NO ONE! and i mean NO ONE influenced my life like mike! I could go sit in his office for hours on end and talk about life! The best part about mike was that he was a better person then he was a paramedic, instructor, speaker! these words do not do mike justice. His impact on this world will never be matched!

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