That's how we do it where I'm from...

Everyone was so very nice at my W-EMT class. There were 13 of us there. 5 were from one county EMS system, 2 were from another professional EMS system, another pair was from a volunteer system, one was a medical student who worked Search and Rescue and Ski Patrol, one was an instructor of EMT's and one was a corpman from a sniper unit in Iraq, newly home. Then there was me.

There are a lot of stories I suppose. Where to start.

(Begin at the beginning and when you get to the end stop....)

To begin with, I had set up to rent a small utility vehicle. I ended up with a huge (not my pick, by the way, they couldn't find the keys to the car I was supposed to have...) Chrysler SUV with less than 10 miles on it. It was huge and nice, but huge and not really what I was used to.

The first night when I got there I was so amazed that I hadn't gotten lost on the way I didn't believe I was in the right place. I entered the lodge and asked if this was the lodge. The poor folks in the building at the time were students themselves and not really sure of my question. Eventually we all got on the same page and thankfully they helped me with my luggage. They asked me about the car...

The next day we started class. We started with lecture and then moved into practical simulations with moulage on patients to simulate injuries. The first one was a fall with a laceration and rib fracture. I was a rescue worker on that one (as opposed to a patient). This time a had a partner and she was much more experienced than I. It was kind of a sink or swim thing as I was a bit rusty on my assessment, so I had to explain to her that I was not a moron, just out of practice.

The next exercise I was the patient. I was a Gun Shot Wound (GSW) victim who was "guppy breathing" on the ground. Apparently my blood pressure was through the roof, which I have decided to attribute to guppy breathing on the ground for nearly ten minutes. Oh, and the altitude.

Then we had our first big simulation. I was a worker, but not a lead. When we got to our simulated rock climbing accident, one guy was hanging from a rope bleeding arterial from his femur and the other had suffered a severe head trauma and was on the ground unconscious and vomiting. I was helping with the puking kid. We back boarded him and cut his shirt open. I began respiration, but that meant I couldn't really breath into the mask (the guy wasn't really dead...) and then I noticed I was all by myself. The others were all working on the other guy. Meanwhile the second simulation had started and that set of patients were screaming bloody murder. This poor guy on the board must have been freezing (he had his shirt cut off and I was blowing on him...) Actually he was laughing because the other team's girl screaming didn't exactly sound like she was in pain so much as well, um, not in pain, and also instead of blowing away from him, I sort of (and I didn't mean to) kept blowing across his nipple until I figured it out and stopped. Then he "died." So we kind of declared him and went to work on our other guy (all together... no rest for the dead.)

That night I went to the grocery store I found first in town. Apparently it was designed by a schizophrenic. It had three or four (or more) different sections, none of which corresponded to the normal distribution of a grocery store. I needed a dramamine after I left for the disorientation. then I came back all set to make BLATS (Bacon, Lettuce, Avocado, Tomato Sandwiches...) but the bigger group invited me to have dinner with them. It was pretty good. then I tried to read over fifty pages before I went to bed.

The next day we did more simulations. We talked about spine stabilization and how to carry people. I hid under a truck to prove the point that I could think of interesting and challenging scenarios. I was also a combative patient with a broken clavicle. That evening I went into town again, though this time a couple guys came with me so I wasn't by myself.

The next day we had big simulations again. This time I was the patient. I had a dislocated shoulder and pretty ugly, contaminated hand evulsion of sorts. Also I was supposed to be having an Acute Stress Reaction. Further, I was told to give everyone else Acute Stress Reactions until someone fixed my shoulder. Meanwhile the other patient was impaled on a helicopter blade. The stripped him down and poor guy was suffering from real hypothermia before we were done. When I was "healed" I went to help with that case. By then I had pretty much ticked everyone off with my crying, screaming and carrying on... But the fact that I actually fell firmly on my but during the whole escapade mollified many.

That night we drove into town to go to Walmart. I didn't go in, I used the time to talk on the phone where I had service. But it was nice to get out.

The next day we learned about snakes, bites and helicopters. We all went out that night to a Mexican restaurant that put Parmesan in everything... I think that is weird. One of the guys kept asking about daylight savings. I explained that it was moved back, by an act of congress. He didn't believe me. He said, "We'll you're from the south..." Like we are some foreign country. Oh no, he didn't!

On Sunday I was his patient with constipation. First he asked if I could be pregnant. I told him it was possible. Then he asked me about birth control and then asked me about my sexual activity. I was really getting tired of this jerk.
We took the test and during the wait on the simulation I snuck in and checked my (and several others) scores just so I could enjoy te sim without stressing the test. I passed, so did all the people I enjoyed time with...

Then we ran the last sim. The jerk was my patient, a hiker caught in a flash flood with hypothermia and a broken pelvis. So I did what I needed to, I cut him out of his wet clothes (exposing him to the 35 degree weather in nothing but wet underwear) and bound up his pelvis in such a way that apparently pinched several important parts. Then we packaged him and carried him the half mile out. When he complained to me about his treatment later, I smiled and answered, "That's how we do it in the south."

Was that wrong?

Seriously, the class was a blast. Like summer camp for grown-ups and
I wish it had been a week longer. On the way home I called my crush at work to make sure my classes were covered the next day. He mistook me for a girl he had met the weekend before, but been to drunk to catch her name before he gave her his number. It was a rather odd conversation. Until I knew the details as to why, just this morning, I didn't know why hew was so strange on the phone... Now I do...

Tomorrow I really do go back to my work outs. I imagine I will be seriously sore. So to put it off I am cooking winter soup, chili, and chicken noodle soup for school tomorrow, just because.

Also I still have this issue on my mind which makes me feel crazy. I'll have to see how it works out. Hopefully I am not as crazy as I think. We'll see.

Worlds Colliding

Sometimes it seems like I live in several very separate worlds and they occasionally are at extreme odds with each other.

I have my life in education, medicine, caretaking, church and of course camp and they are very different places inhabited by very different people. All of these worlds are very important to me. They make up so much of who I am in my entire world...

Being here with these awesome people who are rescue workers, fire fighters, ski patrol, EMT's, Paramedics, Instructors, Research fellows, PA's, Truck Drivers, and lots of other things as well, fathers, husbands, friends, family, deacons, local city councilmen, and chefs it is so clear to me that the kind of people who do what we do are so very diverse and yet in so many ways so very similar. These are good people. Their education, religion, background and interests are so different, but we are all here to learn the same thing, how to help others who are a long way from help.

It's late, I'm tired and I imagine that is why I am finding myself rather philosophical...

I look up at this very clear, very cold, very beautiful night sky, the same one I sit in the amphitheater and look up at late at night in the warm summer nights of camp and see the same stars. The world is so very small, in a good way, I think. It feels very safe and warm... Even with all these different worlds colliding...

Death by Acronym!

This wilderness EMT thing is awesome. Seriously. Awesome. I am having a blast.

Just one thing.

Acronyms.

There is an Acronym for everything in the medical world.

TBI = Traumatic Brain Injury

ICP = Inter Cranial Pressure

MOI = Mechanism of Injury

FOOSH = Fall Onto Out Stretched Hands

There is also FOAM, BEAM, STOPEATS, and quite a few more. They are starting to make me a bit crazy IYKWIM... If you know what I mean!

Anyway.

I'm learning lots. The people here are from such diverse backgrounds, though I am from the farthest away. Most of these are at least Northerners, all are Westerners. They are very welcoming, and not condescending or belittling at all. I knew that was unlikely, but still, who knew for sure...

Today I got to be a severe trauma patient for a massive rescue simulation. I Dislocated my shoulder and tore my hand up in a huge Helicopter Crash. I was suffering additionally from severe ASR (Acute Stress Reaction) until they "reduced" my injury in field. Sufficed to say, when I am supposed to have AMS (Altered Mental Status) from stress I can be pretty DIC (Disoriented, Irritated and Combative.) The poor EMT assigned to me was really pressed to be sure.

Well.

TTFN!

What was I thinking?

Cold Feet have set in.

Going over this list of "supplies" for my wilderness EMT class has got me panicking like a long tailed cat in a room full of rocking chairs. Everyone else seems to think this is very funny. That is not really comforting.

There is a part of me that figures I'll be OK and that it won't be so bad. Then there is the pigtail side of me that is screaming about choking, failing, falling and making a fool of myself.

How ridiculous is this?

Granted at this point I have spent more on equipment and gear than the cost of the course and my plane ticket.

Helmet, head-lamp, water-bottles, captain's chairs, power bars, socks, boots, synthetic apparel, gloves, hats, bedding, and all kinds of other little things...

What was I thinking?

I am going to be fine. I am going to have a great time. This is going to be OK. My fears will seem silly in hindsight...

Isn't it funny that someone who has been through as much as I have can still be as big a coward as I am?

If I were king of the forest....!

Seriously.

The Scarlet Ibis

One of the stories my students read each semester is "The Scarlet Ibis." It's an interesting story about a boy and his brother, Doodle, who has some unnamed handicap that makes walking difficult. The older brother pushes his younger brother to be able to move, get along and eventually walk. In the process of teaching his brother to run, his brother finally succumbs to the inevitable that the doctor had been warning about and dies. It is an interesting story and tends to cause a lot of reaction from students.

As an adult I find the story interesting because I can see that it is not the older boy's fault his brother died. Granted the older brother was not always nice, pushed his brother too hard sometimes, and was occasionally cruel. Most siblings do those things. In this case there were factors beyond both boys' control that neither understood. The older brother may have made a mistake in his actions, but what occurred was in no way proportionate to that mistake. Life is like that a lot I think. Mistakes and consequences out of proportion, in both directions.

Last year (2005) at summer camp I had a run in with another staffer. Up to that point we had been rather close. I thought of him as one of "my boys." We were rough housing (not uncommon) and I broke the locking mechanism on a strap that he used to keep his pocket knife attached to his belt. The locking mechanism wasn't the only thing that snapped. Only now, over a year later is there anything resembling a comfortable friendship between the two of us again. I've never understood why. He's never told me and I don't think I can ask. The reaction was not proportionate to what occurred. I suffered a lot of guilt over the whole mess, and there were a lot of uncomfortable incidents at camp during the off season because of it.

Five years ago a good friend that I trusted compiled a list of 50 things she hated about me and I came across it one day when I was doing some housekeeping. This happened two days after she announced that, while she had volunteered and we had already made plans accordingly because of it, she was not moving to Georgia with me. This ended up costing me $1000 in moving costs because I had originally planned on her being with me during the move. When I saw the list I was beyond furious, beyond hurt and beyond betrayed. Yet I never told her, never yelled at her (which with my temper is saying something) and just let it go. We even stayed in touch. She continued to act like she thought of me as a good, close friend. Several years later I let her come visit me and she even came to camp. I introduced her to the man she later married (he was a good new friend of mine that I met just after moving here) and let her live with Nana and I for the 13 months before their wedding. I sang in the wedding. Now she works for me helping to care for Nana (She lost her last job to budget cuts right after she got married.) My original reaction to the situation five years ago was not anywhere near proportion to what she had done. People who know most of the story have commented on it to this day. Because of the fact that I didn't loose my temper back then, I have the help I desperately need with Nana now (and she's gown up a lot since that whole mess, otherwise she wouldn't be caring for Nana). By the same token she once asked me why we aren't the same kind of close friends that we were all those years ago when we were roommates the first time. I've never had the heart to explain it to her. Mostly I just stammered something about people changing over time and so friendships do. The few times we have argued since she moved here I tend to get angrier than the situation calls for though... Makes you think...

This past summer I put a good friend in a really awkward situation, though he says I didn't. Then I made a bad judgment call because I was really upset about that situation and let some other friends make some bad decisions that I should have/could have/ would have normally stopped. They also seem to feel it was not that big a deal. In terms of repercussions none of it was, in that nothing happened in the long term. I'm still good friends with the one and the others and everyone is healthy, happy and whole... So, no big right? Again, I'm not sure that the mistakes and the repercussions were in proportion.

The students and I talked today about decisions we make as young people and the repercussions that occur. A fifteen year old has sex and gets pregnant. She is now a parent which is a major repercussion for a common mistake of youth, nothing happened to her sister when she did the same thing. Yet another fifteen year old makes big mistake and gets drunk, but nothing happens, no one gets hurt and they go on with their lives mostly unaffected. Two people try Cocaine; one dies and the other just gets a buzz and is fine the next day. People drive all the time way over tired or over emotional, and sometimes they cause massive accidents and drunk people manage to get home with out killing anyone. My students had lots of examples personal and general about how the repercussions in life are rarely equal to the mistakes.

To a certain degree I guess some of this is what I was talking about yesterday when I talked about assumptions. We tend to assume that if we made the mistake before and nothing happened, we can make it again. We tend to assume that if nothing happens when we make a mistake that we got away with it, no harm no foul and that there is no damage. It is more than the issue of assumptions, however. Sometimes we make a minor mistake (though a mistake none the less) and the damage is massive. We never make that mistake again, hopefully, but we suffer for something that should not have been such a big deal. Sometimes we make a major mistake and nothing happens, but we continue to suffer because we know how close to ruin we came.

The Scarlet Ibis is a great story for that reason. I learn so much about my students each time we read it. I think they learn a lot too about themselves and the reality of life, mistakes, consequences and responsibility. Some times when I teach it, it is just a good class lesson, some days, like today, it is rather cathartic actually.

It was a nice surprise.

This is why I teach English. Somehow I don't think this is an experience I could have in a math class.

If you are interested the story is "The Scarlet Ibis" by James Hurst, I believe you can find it online. Let me know what you think.

That's several philosophic waxings in several days. Tomorrow (unless there is a really good reason otherwise) I plan to write something hysterical about nothing important.

82

My dearest friend Beathechemist had a run in with a senior citizen yesterday that echoes my life so much. Check her story on the Spitting Eyes. This is the flip side of Nana's "I'll flake away to nothing!" rant I get everytime I try to push her to take a shower more than once a week.

One time I was treating a patient (as an EMT intern in the ER) from a nursing home. Her skin was so dry that as I helped her out of her clothes and rolled her over onto a clean bed so much dry skin flew up in the air around us that I coughed, gagged and sneezed all at once. You couldn't see through the stuff!

Speaking of old. Today is Nana's 82nd birthday. To celebrate we are going to a doctor appointment and then dinner at a friend's. This morning as I woke her up with singing (Happy Birthday to you) she clapped and said, "Today is my lucky day because I get to live with my Sister Sandy!" (She often calls me sister.) So I started my morning in tears. The good kind, for all that they still mess up my mascara.

Nana has seen so much. Done so much. Loved so much. She really is a special lady. Everyone thinks so. Really, everyone. She has already gotten cards and flowers and calls. She said to me last night as I made our dinner that she didn't want me to get her a present, that the party was enough. That's the thing about Nana. To her everything is a treasure, a gift and a joy. I bring home vanilla icecream as a surprise one day and you'd think I gave her diamonds. I take her to see a school play and you'd think I got her Radio City Music Hall tickets. I am humbled by how easy it is to make her smile, to make her happy. She provides her own joy.

Honestly, each morning I hold my breath for just a moment when I wake her, until she opens her eyes, smiles at me and says (every blessed morning!) "Is it really 5:30 already?" (One of these days I'm gonna get her up at 2:00AM just so I can say, "No, go back to bed, just checking your reflexes!). Yesterday morning she was particularly peaceful and I paused. Obviously I will miss her when she is gone. But in her case, she's had such a good life, I want her to simply go to sleep one night and pass peacefully into paradise. She deserves that. By the same token even though I know she's tired and might even like to lay her burden down I have become so jealous of this time I have with her. I want as much as I can have. There would be such a hole with out her in my days... I paused afraid to wake her up and afraid to let her sleep. Isn't that strange?

I think I will get her butterfly balloons that I saw at Kroger for her birthday. Let me tell you about Nana and butterflies.

Eight years ago, I called her in Kansas and said, "Nana, you goose! Answer your phone!" She called back and left this message on my machine. "I'm not a goose! I'm a butterfly!"

I've never forgotten that. She is a butterfly, a beautiful, colorful butterfly!

Happy Birthday, Nana. May God continue to bless you as richly as you bless those around you with your joy, your laughter and your wide eyed innocence. I love you.