Feb. 24, 2023 Dr. Leonard Cobb’s program to send firefighters with cardiac equipment on serious calls was called radical.
By Elise Takahama Source The Seattle Times (TNS) Distributed by Tribune Content Agency, LLC.
Feb. 24—It’s difficult to pinpoint how Dr. Leonard Cobb came up with the idea to train firefighters in emergency medical care, but friends and family believe one particular afternoon more than 60 years ago played a role.
Cobb and his wife, Else, had stopped at a market in Seattle’s Madrona neighborhood for a frozen snack when they noticed a man slumped over in a nearby car.
When Cobb opened the car door to check on him, the man sagged to the ground.
Cobb stayed with the man while his wife rushed to a nearby fire station for help. A firefighter hurried over to bring oxygen, but there wasn’t much else he could do until the man was taken to the hospital, Else Cobb, 88, remembers.
“It was an incident where Leonard felt the fireman could have done more if he had known what to do,” his wife said this week.
In the following decades, Cobb devoted his career to researching cardiac care and developing Medic One, one of the country’s first efforts to deliver emergency medical care to patients before they arrived at the hospital. He was 96 when he died in his home at the Terraces of Skyline last week, surrounded by family.
The former Harborview Medical Center doctor was born in St. Paul, Minnesota, in 1926, eventually earning undergraduate and medical degrees at the University of Minnesota.
In the late 1950s, Cobb moved to Seattle to practice cardiology at the University of Washington — where he eventually met his future wife, Else Snoep at the time.
Their first date, a UW football game, was the first time she had seen the sport.
“I’m a Dutch girl, and I grew up with soccer,” she said. “I told him that maybe he should take someone else because I wouldn’t know what was going on. He said, ‘I’ll explain it all to you.'”
Cobb was already passionate about improving areas of cardiology in the 1960s, but was particularly determined to find faster ways to get care to patients outside the hospital, said Dr. Michael Sayre, current medical director of the Seattle Fire Department and its Medic One program, which now responds to about 550 calls a year.
At the time, the idea of firefighters providing serious medical care was “pretty radical,” Sayre said.
Paramedics didn’t exist then, and extensive medical training wasn’t required for many ambulance crews. Ambulances were stocked with bandages and oxygen, but little else, he said.
Cobb wasn’t alone in his thinking. Because new research and technology on emergency medicine was emerging from Europe in the late 1960s — particularly the use of mobile defibrillators — several physicians in the United States were also brainstorming ways to speed up care in life-or-death situations.
Cobb knew there weren’t enough doctors and nurses to deploy to every emergency medical call, Sayre said, but firefighters were already well dispersed throughout the city and could get places quickly.
He teamed up with Seattle’s fire chief, Gordon Vickery, to map out a pilot training program for firefighters and secure federal grant funding. In 1970, the city launched its initial version of the program, which trained firefighters and equipped “aid cars” for the first time with portable electrocardiogram units that read heart activity, pacemakers, resuscitators and defibrillators, in addition to standard first-aid equipment, according to The Seattle Times archives.
The program planned to dispatch the mobile unit — which initially consisted of two firefighters and a doctor — to heart-attack calls if the patient could be reached within five minutes, The Times reported.
About a year later, follow-up coverage reported Medic One had already responded to more than 600 calls, including to 16 patients who were revived after being found “clinically dead,” Cobb said in an interview at the time. Popularity of the program was growing and things were going smoothly.
Then, in late 1970, federal cutbacks whittled down the program’s grant and nearly put Medic One out of business. But Cobb and Vickery organized a fundraising drive — which yielded an “extraordinary response,” archives say.
“The community stepped up,” Sayre said, referencing bake sales and door-to-door efforts. “They needed to raise about $100,000 and they raised $200,000.”
The Seattle Fire Department eventually incorporated Medic One into its system for good. The idea has popped up in other parts of the country since then — but all of Washington’s Medic One and EMS systems are modeled after Cobb’s initial program, Sayre added.
In 1972, Cobb’s and Vickery’s Medic Two, which aimed to also train community members in CPR, came along. To date, more than a million members of the public have gone through the program, according to the Seattle Fire Department.
“We continue to see how important that is,” Sayre said. “People who get CPR started by a member of the public are twice as likely to survive. … It has to happen quickly, or it’s impossible for your heart to restart.”
He continued, “Now, millions of people learn this skill in high school. But that was a novel idea in Seattle at the time.”
In 2008, Cobb also helped introduce the city’s Resuscitation Academy, which trains EMTs to further improve outcomes for cardiac arrest patients.
Former colleagues remember Cobb as a hands-on leader with a relentless work ethic and constant desire to improve his programs, Sayre said. He even continued working on research up until two years ago, according to John Cobb, his younger son.
“He was forever writing papers on hospital medical care,” Else Cobb added. “Forever looking for better outcomes.”
Now, Seattle is “renowned for one of the finest EMS systems in the country,” according to the volunteer-led National EMS Museum, which documents the history of emergency medical response in the U.S.
Sayre, who knew Cobb for nearly 20 years, said he’ll never forget his mentor’s humility.
“That really made him a great leader,” he said.
But outside of medicine, Cobb’s top priority was his family.
Son John Cobb, 58, especially has fond memories spending summers at their cabin on the Oregon coast, playing bocce ball on the beach and crabbing on the Nehalem River.
When Cobb died, he opted to end his life through Washington state’s Death with Dignity Act, which allows terminally ill adults to request lethal doses of medication.
“His mind was all there, but unfortunately, his body was giving out,” John Cobb said. “He had lost his eyesight. He couldn’t walk. For him, he knew it wasn’t the type of life he wanted to live any longer.”
The day before Cobb died, he spent time with his family and longtime Medic One friends. The next morning was peaceful, his son said.
“In his last minutes, his grandson read one of the poems that had been written for him [by a family member],” John Cobb said. “Those were the last words he heard as he fell asleep. It was a wonderful moment.”
Cobb is survived by his two sons, Eric and John; his wife, Else; and five grandchildren, Alex, Pate, Lindsay, Miles and Owen.
A public memorial ceremony, organized by the Seattle Fire Department and UW Medicine, is in the works. His family has asked that contributions in his memory be made to the Medic One Foundation at 11747 N.E. First St., Unit #310, Bellevue, WA, 98005.