When I was 15 years old, I went to stay with my great-aunt Hilda in Lenachee (actually, unincorporated lower Lenachee County) for a few weeks. On the first day, she explained that if I wanted to make a long-distance call, or take a shower over 5 minutes, or run the dishwasher or other appliances, or “anything that costs real money”, that I needed to check with her first. “Every time.” Her roof, her rules, so I did as she asked.

One afternoon, while we were playing canasta (Bolivian rules), she suddenly collapsed. I knew about the high costs of ambulances and hospital care — great-aunt Hilda had talked about it often when reading the evening edition of the Lenachee County Dispatch aloud, as was her custom — so I asked her if it would be okay to dial 911.

She didn’t answer — I think it might have been due to the unconsciousness — and I was an volunteer EMT trainee, so I knew I had to take charge. So I called a hospital’s accounting department and asked how much it would cost to get her treatment. I didn’t ignore great-aunt Hilda, of course — I put it on speakerphone while I did CPR. They said they couldn’t tell me, so I asked for an estimate. They said that would take a while to figure out. I said I’d call them back, and called two more hospitals.

It turns out the first one I had called — the one I’m sure 911 would have dispatched an ambulance to — offered an estimate over $20,000 higher than the second!

She didn’t survive — when I got the three quotes and called the ambulance, the EMT’s said I’d done as well as one can doing CPR alone when one has to keep stopping to navigate phone trees. But she’d passed some time before they arrived (maybe an hour or two). Still, I know that, had I called 911 and gotten her straight to that first hospital, she’d have been horrified upon waking up to learn I wasted $20K without consulting her.

It was an important lesson: When you don’t take the time to consider the high costs of things, bad things can happen. In saying “wait a second, don’t just send out the rescuers — I need to double-check these numbers”, Kristi Noem is doing God’s work.