As last week's meeting on emergency response dragged into its fifth hour, the audience thinned out.
So did the participants. Three no-shows for the last hour of the workshop between county commissioners, fire district commissioners and chiefs and EMS administrators were particularly conspicuous by their absence.
The three, county commissioners Fred Coyle and Tom Henning and EMS medical director Dr. Robert Tober, range from skeptical in Henning's case to adamantly opposed in Tober's, to the concept being discussed in the meeting's final stretch - giving fire districts in Naples, Marco Island and North Naples control of EMS operations inside their boundaries.
Their departure did not go unnoticed by proponents of what is being billed as The Concept.
"Note with interest who's sitting at the table and who is not," North Naples Fire Commissioner Chris Lombardo said. "I am just stunned that we are missing county commissioners. I find it very hard not to be offended and I'm just appalled at the lack of respect."
County Commissioner Georgia Hiller, who frequently finds herself at odds with Coyle, chimed in.
"I'm offended that Commissioner Coyle is not here. I'm offended that Commissioner Henning is not here. We're talking about life and death. We're talking about the most important service we provide as a county and our two commissioners are gone. What is it? Excuse me. Lunch? Boating? Who knows what?"
All three men said they left because of prior commitments, not because of disinterest in the subject or lack of respect. But they also said they found little reason to believe they'd be persuaded into endorsing The Concept, no matter what transpired in the meeting's latter stage.
Henning had to pick up his son on an early release day from school and had activities planned with him after that. Coyle had scheduled meetings with a constituent then with the Freedom Memorial committee in the afternoon. Tober said he was due to work at the hospital at 1 p.m. but stayed at the meeting until that time, causing him to be late for his shift.
"I had scheduled my day based on a meeting that was supposed to end at 12 o'clock," Coyle said. "These are important meetings to me. People expect me to be there."
Since the meeting all three have had a chance to watch on video what happened after they left. Henning says it's too early to endorse The Concept.
"We just got that information that day. There's a lot of questions that need to be answered," he said. Making sure county EMS employees who would go to work under the fire departments are treated fairly tops his list of concerns.
Tober struggles to contain his disdain for The Concept, which would pare back the EMS service he works with and leave it to tend to the less-affluent parts of the county. While he was at the meeting for part of The Concept discussion, taking up a spot in the rear of the room because he said it was too cold at the stakeholders' table, he held his tongue. "I didn't see any opportunity to come out of my corner," he said.
Tober's "corner" in the fight between EMS and the fire service is his position that having too many paramedics with advanced training is actually counterproductive to public safety. Such paramedics handle dangerous drugs and in inexperienced hands those drugs can be deadly.
Coupling a lower number of advanced paramedics with an increased number of those trained in basic life support is more effective, because those with advanced training stay sharp as they employ their skills more often, Tober believes.
His position was bolstered during the meeting when Jim Fogarty, director of the model EMS system in King County, Washington, noted during a video presentation that his department has one advanced paramedic for every 76,000 people. In Collier County, the number stands at about one per 7,600. But Tober's view is in direct opposition to that taken by fire chiefs in Naples, North Naples and Marco Island, who argued that more advanced paramedics with the authority to use the entire range of drugs and techniques they've learned better serve the public.