I’m desperately trying to write the stirring narrative of how I, again, learned to be human next to a dying man on a bathroom floor.
However, my friends keep dragging me out of the wooly comfort of my “writing den.” They get me drunk and make me grateful for the people who are alive.
I have the best friends!
–maddog
Radio Silence?
It’s been a while, I know.
There’s been a bit going on with me, not the least of which is the "Arab Spring" and the resultant nervousness of the local regimes, especially about bloggers and social media.
When the revolutions started breaking out all over the place, many of the less-affected countries responded by either cracking down on dissent or trying to bypass it by throwing money at people. The wisdom or effectiveness of these measures will be determined by analysts, historians, sociologist and a whole team of people that are not simple paramedics like me.
What I got from all of this was a fright. I shut down and stopped posting so much. When I did, I was so paranoid about revealing who I really am that I often opted to post nothing and simply write it to myself in a big A4-sized ledger I bought at a local bookstore. I went backwards in tech, you could say.
There is still a strong crackdown on dissent over here and what I’ve been observing makes me realize how much we take for granted in America regarding freedom of expression, information access and our ability to say what we want in the public forum that is the Internet. Though those freedoms are being insidiously eroded by things like the Patriot Act, we can still, generally, say what we want and breathe easy.
Over here, someone got a death sentence for a tweet. Yeah. A goddam tweet.
Granted, most of the folks getting screwed by the government are local minorities and other disenfranchised groups. I know many westerners over here who feel they are above the scrutiny and reprimand that falls so heavy on the locals and, in many ways, they are right. It’s the westerners who keep the money flowing that keeps this whole region afloat. Combine that with the natural hospitality and enthusiastic friendliness towards visitors that is inherent with the culture here and it becomes easy to think you’re above the rules.
I have to think about this, though. It’s easy to forget that I’m not in a free country. I live in a community that looks like a San Diego suburb, I get CNN, ESPN and all the US cable channels on my satellite TV. My house voltage is 110v while the rest of the nation is 240v. In fact, as I write this, I’m listening to a US radio station piped over the (company provided) Internet, typing on my US-bought MacBook Air at a desk I bought at IKEA down the street. Later, I might pop out to the local branch of Fuddruckers for a burger. It’s easy to forget that I’m a stranger in a strange land.
So, I’m nervous. I’m nervous about revealing where I am, who I work for and what my name really is. I’ve gotten emails from folks looking for information about ‘medic jobs overseas and I always answer in generalities as I really don’t want to reveal where I am and who my employer is. Granted, I’m not likely to be beheaded or swept up in some arbitrary roundup but I will certainly lose my job and be sent back home. I don’t want that to happen. I like my job here and I certainly like my pay!
What has changed? Why am I breaking "radio silence?"
It’s a combination of me having a lot to say, my loss of connection with my readers and a better understanding of the rules of how we’re monitored over here. I’m coming around to the idea that, if I follow some simple guidelines, I can post, discuss, tweet and blog about my life over here without getting dragged away by the local version of the Gestapo.
Expect more from me. I’ve set a personal goal of no less than 3-4 post a week. I’ve got some stories to tell, I plan on continuing my "Lack of Affect" series (I’m working on "Self Confidence" right now) and I’m going to start a series on pre-hospital pharmacology. The blog’s about to get lively again.
The other thing is EMSToday. In the past, I’ve gone to the conference, registered as my own real self. While I was at the FirstRespondersNetwork booth last year, I had my conference badge (with my name and company affiliation) hidden as I was manning the booth as "maddogmedic." This year will be different. I’m going to register as an EMS blogger. I’ll be "maddogmedic" and folks will see my face. I may still hide my badge from time to time but I think it’s time to come into my own as my online self.
With that notion in mind, I’m going to blog and write with less fear. I’ll still try to be circumspect about where I live, who I work for and, of course, identities of my coworkers and patients but I’m ready to start telling the stories of all the cool stuff that happens to me every day. I live a really interesting life (even to me) and I think it’s worth sharing.
I’m ready.
–maddog
Handcuffs
A slow night shift and gorgeous winter weather finds me outside in the ambulance bay taking in the night air when a small pickup truck comes screeching into the ER entrance, urgently beeping its horn. This is quite common. The locals here often will just throw a sick, injured or dead person in the back of the car and drive to the hospital rather than call for an ambulance. There’s always a desperate urgency, even when the chief complaint is dizziness. I arrive at the truck at the same time as the ER staff. They’ve responded to the notification bell we have for just this sort of thing.
Across the back seat of the pickup is a man who’s not breathing and has no detectable pulse. Time to go to work! In the confusion of extracting the patient from the backseat of the small pickup and the family members wailing and interfering, it’s passed that he was stabbed.
That’s odd. I find no blood. I’d expect a stabbing victim to have a bit of blood in his clothes. He’s completely dry and, as we slide him onto the bright yellow backboard, he leaves no telltale streaks of red. He’s also not as “floppy” as I would expect someone who just died. My brain records this and many more things as we do our work but the screaming family (and complete lack of security) are plenty of distraction.
As we roll the stretcher into the better-lit doorway of the ER, I see his face is swollen and covered with a pattern of burst blood vessels. I’m still looking for a wound or some sort of injury. My brain is already thinking asphyxiation but it’s also on the “trauma” mode of thinking and, for the life of me, I can’t find any obvious injury. As I do chest compression, the cartilage of his sternum and ribs does its dutiful crackling and his ribs are in fine shape. It seems he wasn’t crushed.
In the resuscitation room, I have to hip-check a screaming man (the patient’s brother) who’s getting in our way. We cut off the patient’s clothes, looking for a wound, injury, anything.
That’s when I start to notice things:
Head, Eyes, Ears, Nose, Throat (HEENT): Face is swollen with a pattern of bulging eyes and burst capillaries indicative of asphyxiation but no bruising or trauma around his neck. The vertebra of his neck are normal and his larynx is normal-shaped. His jaw is stiff and difficult to open. No blood in the mouth, eyes or ears. A few scratches and bruises on his face and forehead.
Chest/Abdomen: All the bones are intact (except for where my chest compressions separated a few) but he’s got some minor cuts and scrapes on his back and a strange pattern of bruising all over his abdomen: a repeated mark across his belly that looks like a fresh bruise. He’s also got what we call dependent lividity. That’s where the blood has settled to the lower tissues of the body. It looks like a big purple bruise without the swelling and usually occurs a few hours after death.
Extremities: All the bones are intact but his joints are a bit stiff. I notice his wrists. There are dark red rings around his wrists. Like a bruise that stayed dark red. No swelling, no purpling. The ring is single on one side and double on the other side of his wrists.
Handcuffs
Around his ankles is a pattern of similar bruising (red, not blue or yellow) but they’re like hash-marks spreading from his ankle to the bottom of his calves.
Then I see it in my mind:
He’s seated in a chair with his ankles tied to the chair legs and his hands cuffed behind his back. They beat his stomach over and over again. It’s painful. It fills his gut with nausea and waves of pain and knocks the breath out of his lungs. He tries to get away but his hands are tightly bound, straining against the metal of the handcuffs, making a deep impression in each of his wrists.
Then comes the plastic bag. It goes over his head, tied off but not too tight around his neck. He tries to suck in air but the plastic closes off his nose and mouth. As he gets hungry for air, he tries to kick his feet and thrash around. The chair digs into his back. Again he can’t move his wrists but his legs are strong and they thrash against the restraints (probably zip-ties) around his ankles and they chafe and cut against his skin. The strain of trying to breathe bursts the small blood vessels in his face and makes the soft tissues swell. He keeps struggling, using up his remaining oxygen to the expected result.
I’m stunned. My stomach starts to flip. We’ve stopped attempts to resuscitate. Before I can get properly sick, I’m distracted by the frantic family member who worked his way into the resuscitation room. He goes ape-shit and starts attacking the staff.
Where the hell is security?
I spin, block his blows on a nurse and shove him into a corner. He backs off but he’s in obvious grief. He’s very agitated and wants to get close to the patient. I’m in full-on fight mode: strong stance, on the balls of my feet and my guard is up. I’m not going to let him get near anyone in scrubs. At the same time, I’m being ripped apart inside. This guy is in the painful grip of grief and I’m going to have to put hands on him to protect my staff (Where the f**k is security?). What kind of person am I that I would add to his pain? What the hell am I doing? Why the hell am I here, in this place?
Finally a lummox in a uniform arrives, followed by his comical companions to take the burden from me.
I walk out of the resuscitation room and the story comes out of the arriving horde of family. Two days ago, the family gets a call from the victim that he is suddenly going camping in the desert with some friends. Camping in the desert is common this time of year so they don’t seem to think it’s too odd but it does seem abrupt. At two o’clock this morning, their doorbell rings. When they finally open the door, they find a bundle on the front steps that turns out to be their dead father/brother.
It keeps coming back to me, though: handcuffs.
I ask a few of my local colleagues about how easily one can get handcuffs. We can buy them just about anywhere in the USA. Over here, they’re not at all common. Pretty much, the only people who have handcuffs are cops and the government.
They dumped him on the family doorstep. They could have disappeared him into the desert but they dumped him on the family doorstep!
I wade through the crowd of wailing, veiled women and sobbing men in the hallway. As I approach the nurses’s station, I see smirks and eye-rolling on the faces of some of the staff who were not involved in the resuscitation room.
“Jesus! Why does there have to be so much drama?” Asks one of them. There’s a few nods of agreement and a lot more eye rolling.
I’m going to throw up! I have to get the f**k away from these people! What the hell is wrong with people? Is it somehow “cool” to be jaded and dispassionate? I’m thinking to myself that if I woke up to a doorbell at 2 am to find my father tortured, murdered and dumped on my doorstep (probably by my own government), I’d be making a lot more noise than all of the family in the hallway and the parking lot combined! How can these nurses be so glib? When did compassion become a bad thing?
handcuffs
I’m angry. No, I’m furious! I’m out the door and I go to the furthest corner of the parking lot. I have to be away from people. If anyone comes near me, my anger will lash out. I feel like a boiling kettle full of bile, fire and despair. Bring on the SARS, MRSA, drug-resistant TB and global warming! This species doesn’t deserve to live anymore! What the hell is wrong with us?
I’m angry at the people who would do this to another human. I’m angry at the organization that would call for it and find it worthwhile. I’m angry at myself for hurting that poor, grieving man. I’m angry at the medical “caregivers” who would wipe their asses with someone’s grief and then shove it in my face like a joke. I’m angry at the broken, backwards place where I live. I’m angry at my own nation that does the same thing but conveniently exports it outside their own borders. I’m angry. It’s burning in me still.
It’s a lower flame now, though. I have unlimited gratitude for my family and my friends upon whom I can rely. One friend in particular dropped everything and gave up a chunk of time to help me turn my head around.
Thank you. Forever thank you.
I’m still going to be messed up by this for a while but I will get better. I know this. I’ve been beat down like this before and I know what to do, I know how to apply “first aid” to this pain. Another thing I’m thankful for is the ICISF. Saved my life more than once.
I’m also going to keep writing here. I need this.
–maddog
On 9-11…
There is a lot more to the attacks on 11 September 2001 than the FDNY and the world trade center. I watched the Pentagon burn from the Potomac river and, later, felt cheated when NONE of the EMTs and Paramedics who suffered and died in the WTC collapse were included in the traveling "9-11 memorial."
I’m not fully ready to discuss my thoughts fully in the public forum. I’m still sorting out my own feelings and reconciling them with the notion that I am a kind, forgiving and accepting man. I don’t condone any killing but I find myself more enraged by my fellow Americans’ reactions and responses to the attacks (and, yes, there were more attacks than in New York City) than to the act of terrorism itself.
In the past I’ve avoided writing about "9-11." I’m still sorting things out. I wasn’t in New York City. I didn’t work for FDNY. However, I WAS at a "Ground Zero."
Still Processing…..
–maddog
This actually happened…
It’s a typical workday for Saggy and I. It’s quiet for both the ambulance and for the rest of the Emergency Room. Saggy’s playing a fishing game on his iPad and I’m reading Dashiell Hammett’s The Thin Man on my e-reader.
At this point, before the "action" starts, I have to take a moment to talk about my new partner, Saggy.
Of course "Saggy" is a made-up name. Saggy does not describe him in a physical, mental or moral sense. It’s just a convenient nonsense name that serves to remind me of who he is in a context that only I know.
Here’s the rundown on Saggy:
- He’s a local.
- He’s unfailingly generous.
- He gets just as excited about our job as I do.
- He’s a bit of a technology geek like me.
- He’s not satisfied with how much he knows or how good he is at what he does.
- He’s a really good ‘medic! I’d ride any ambulance, anywhere any time with him.
- We treat each other like family. I’m a lucky man.
On to the action!
I’m deep in the debauchery, detective drama and 1930s-era sexiness of my book and Saggy is catching sharks on his iPad. "The bell" goes off. One bell means we have an ambulance call. Readers from countries that have mature, established Emergency Medical Systems may not understand that we have nothing like a real Emergency Medical Dispatch system here. The local logic is, since the deployment of ambulances is a fleet operations (the deployment of vehicles) issue, a contracted fleet manager (with the requisite fleet training) is the first person to take the call when someone hits the emergency number. His only job seems to be to get the address.
Fortunately for our patients, we have an extension of the emergency phone in the ER. Often we can get a good idea of what the caller is calling about and be a bit prepared. This time we’re not so lucky. The caller had given his address and hung up after saying he needed an ambulance.
The only other info that Saggy and I can get is that the caller said he has a fever and then we’re off. The call is in an apartment housing complex for students of what most places would call a "vocational school." It’s more like a dorm building than an apartment and the median age of the residents is around 22. All male, of course.
In our service, our ambulances have a driver. I italicized that word to emphasize the scope of his skills. He drives the ambulance. That’s all. (more on that later) As such, one of us has to ride in the back of the ambulance going to every call. I’m a kind man and have had my share of "windshield time." I hop in the back before Saggy can object and we’re rolling.
The apartment is a few floors up and we don’t know a dang thing about what’s really going on. I load up the stretcher with everything. We go into the lobby equipped to handle a heart attack, allergic reaction, meningitis (he did say "fever"), overdose and just about anything else.
We arrive ready for the apocalypse.
Saggy gets to the apartment door before me and he stands in front of the doorknob and knocks. I know that I now work in a country with an inherent abhorrence of personal violence but I still cringe and slide out of the fatal funnel. Somehow being in a sketchy apartment building makes me plot exits and plan my escape.
All this paranoia is for naught. After a few knocks, the door is opened by an 18 year old local who is standing bright-eyed and talking to us clear and coherent. Saggy talks to him in Arabic right away. This gives me the chance to look at the "patient" and check out his surroundings. The room is overly warm; no evidence of drugs; single occupant; no long-term nesting signs (non-issue furniture, art, posters, etc.). In short: everything looks normal.
Saggy’s pretty empathic and his body language is showing a lot of compassion for this guy while he’s making agreeing noises at our "patient’s" explanations. I interrupt:
"Malum, Inglezi? (Do you understand English?)" I say.
"Yes" he replies in English.
"Ma’sh’Allah!" I say with a smile. It means, literally, "You demonstrate the greatness of God!" Or, figuratively, "Awesome, Dude!" depending on your context. Then we all switch to English.
I ask him to tell me why he called for an ambulance. He says, "I’m studying at the [local training center]. I told the school doctor that I had a fever and was too sick to study. He refused to give me tomorrow off so I called you."
We have a name for this condition: Man-flu.
Saggy and I have developed a form of subtle eye-slide towards each other (without moving the head) that says more than I could ever type. We did this at exactly this moment. Both of us had entered the elevator on the way up, preparing ourselves to work a full-on code (worst-case scenario, right?). We both think the same way. We would rather be surprised that our patient was fine than be surprised that he’s dead. To be that fired-up after a hang-up call and find this d-bag has tried to use us as an excuse to get out of school is what we call, "Pissing-off the paramedics!"
However, Saggy and I are professional and we take the time to check this guy out. He’s slightly warm, young, homesick and not about to die in the next hour (or even the next 24, if he can stay off the highways). Understandably, our gear stays on the cot and our patient sits in a proper chair for his "taxi" ride to the hospital in our ambulance. His English is so simple that Saggy and I can converse in slangy American English (Saggy went to college in the USA) without being understood by our patient. He relates to me that our patient just left home, less than a week ago, to come to school and is feeling VERY homesick.
En route to the hospital, I call the ER and let them know we’re coming and with what. The charge nurse is a Lebanese man who has a great sense of humor.
"Hassan? This is maddog on the ambulance. We are en-route with a level one "man-flu" patient, exacerbated by homesickness. We will be transporting our patient immediately to waiting room one. Do you copy?"
I hear his chuckle over the phone earpiece as he thanks me. Our patient doesn’t understand my inflection or choice of slang but he seems impressed by my serious face when I give my report. He dutifully follows Saggy to the waiting room when we arrive at the hospital.
Right away, Saggy and I restock "the Bus" and immediately dive in to the ER to help with a flurry of old patients who have: heart failure, respiratory distress, diabetic emergency and other things that can kill them right away. The homesick child/man-flu patient is quickly pushed from our minds.
A little while later our "Man-flu" patient barges in. He has an exchange with Saggy that’s too fast for me to follow and then heads back towards the waiting room. I look at Saggy with a question on my face. With a chuckle (He’s really good at that!), he tells me that our patient wanted to be seen first because he had important things to do. I drop my head down, mouth open, eyebrows up saying, "AND!!!" without words. Saggy chuckles again (He is really good at that!) and said, "I told him that if he wants to be seen sooner, he has to try to die."
"Like the rest of our patients tonight?"
"Yes, like the rest of our patients tonight." With a smirk (another thing he’s good at).
"And so?…"I ask.
Saggy gives a full-body shrug that is unique to this part of the world, conveying resignation, acceptance and absolution all at once, "And so he left."
–maddog
On Compassion and Screaming Children
I had an interesting experience the other day.
While sitting in my corner of the (mostly quiet) ER where I work, I watched a family rush by my little cubby towards the nurse’s station, carrying a limp, naked child, face down.
That’s the sort of thing that will get me to stop playing Half-Life 2 immediately and go to work (Saved game be damned!).
It turns out this 18-month old toddler had accidentally tipped over a curious bottle causing a quantity of sulphuric acid to spill down his back and the back of his legs. An angry red topography of burned and twisted skin presented itself on this child’s back with clothing fibers and some of the chemical still visible on the worst of his burns.
At first, my job is to restrain this screaming, frightened child while the nursing staff and my ‘medic partner pour quantities of sterile water over his burns to wash away the acid. We find we don’t have enough bottles of sterile water on hand to do the job properly and the decision is made to move the child to a decontamination shower. I already have the most control over the squirming, screaming kid so I gather him up, careful not to touch his burns, and carry him to the shower.
On the way he gets a jab of morphine into his leg muscle. Probably a combination of that and the warmer water of the shower calms him down a bit. Up to this point he is such a whirlwind of pain and fear-induced screaming that his mother and father have fled the treatment area and the rest of the Emergency Department has fallen into an awed silence.
My entire attention has been taken up with restraining this child without breaking anything. This is not an easy task as he is a strong little Arab boy and I can feel the softness of his joints and bend of his long bones as he violently tries to escape this torture we’re inflicting upon him. A few times, despite my best efforts, I feel a wet crackle in his joints and feel his humerus bend beyond what an adult’s ever could.
Here’s the "interesting" bit: I don’t care.
I don’t mean to say that I’m not concerned that this child is injured, that he is in pain and that it’s my job to help alleviate his injury and suffering. I’m making a lot of effort to keep from touching his burns and to move my grip in response to his struggles so he doesn’t dislocate a shoulder or twist his little bones.
What I mean to say is that the pain and distress that we are causing him as we treat his injury does not bother me. I don’t find myself distressed in the same way I am when I see needless violence, or some stranger abusing a child. The entire time I’m wrangling this kid so he can be subjected to this painful and necessary treatment, I’m murmuring something along the lines of, "Ok, buddy. I know, little man. It hurts, I know. It’s a bad deal, little buddy. Ok, little man." or something like that. Clearly, some part of my mind recognizes that what we are doing to this child is horrible, frightening and painful. What surprises me is that I’m not upset.
Later, in the shower, I stood for 15 minutes, holding this child under the water as I got soaked and my back became more and more sore with the awkward angle I had to hold him due to his burns. I have to give mad props to my partner, Saggy (he’ll never read this). As soon as I said something about my back, he put both of his hands in exactly the right spot in my lumbar and braced me there with his own body, taking the pressure off my back, for the full 15 minutes. The next person that tells me that all Arabs are lazy is going to get punched in the face.
It was only later, after I had cleaned up, dried off and had a chance to think about that patient that my thoughts turned to how odd my reaction seemed to be. I was not upset. Is this one of the early signs of burnout? I always told myself that as soon as I stop caring, I’m out. I’ll sign on as a forecastleman on a sailing cruiser, change my name and never treat another patient again.
I wrote about this later in my journal:
I never want to hurt a child or scare or distress him. However, I can forcibly hold a toddler spread-eagled while cold water is being poured down the acid burns on his back. While doing that, I don’t feel distressed as he screams and struggles. It is almost as if I’ve become heartless to that distress because this treatment must be performed, no matter how distressing it is now, in order to avoid/reduce greater and longer-lasting pain.
After the incident, when I examine my feelings, I don’t find myself distressed by this any further. Is it because I don’t know the child? Would I feel so nonchalant if the patient was one of my nieces or my nephew? I imagine I’d be upset at their injury but would not hold back on the appropriate treatment to avoid distressing the child or myself. In short: I’d do the same thing. I just might feel a bit more shitty about it.
I know that I often must inflict pain on my patient in order to help her(or him). With adults, there is an understanding. They know a bit of how this works and can bear up in order to get the treatment they need. I can also talk and reason with an adult more than a child. I can warn them and apologize in advance. I can say things like, "This is going to hurt but I have to do it. Do your best to stay still."
Children don’t have that understanding. Communicating and reasoning with them is much more difficult if at all possible, depending on their age. They get scared and distressed even when we are not causing them physical pain. I know a few adults who are very much bothered by this. They can’t bear to upset children and see them in pain. I don’t enjoy pain in others, especially children, but I can see when it is a necessary evil and it seems to have no effect on me.
What am I getting at? I guess I’m afraid that I’m losing what I consider to be the most valuable personal component of my practice as a Paramedic: my compassion.
Then again, when I think about it, there’s a difference between being compassionate and being empathic. I can be empathic with the pain of this child and get upset, feel a small part of his distress inside myself and let it tear me up. On the other hand, if I’m truly compassionate then I put what’s right for my patient ahead of my own overwrought feelings of empathy and do the hard job of pinning down a child so we can effectively torture him for his own good. It may suck now, but the compassionate thing to do is treat his burns the right way and not let that treatment be inhibited by my own threshold of child distress.
I come away from this experience feeling that I’ve passed some sort of compassion test. It’s one thing to be feel what my patient is feeling and to empathize with him or her. If that empathy, if my own upset at their pain and discomfort, gets in the way of effective treatment, then I have taken the coward’s path and allowed my own personal feelings to get in the way of ultimately compassionate care.
Then again: Does it make me a good ‘medic that I’ll torture a child for their own good?
The next day seemed to be "Bring your kid to the Emergency Department" day. I made no less than 8 funny faces from inflated purple nitrile gloves for bright-eyed, barefoot kids running around the place.
Still thinking about it…
–maddog
‘Nother update:
Got home from Spain to find my interwebz were knocked out and no practical solution available. We just recently got our home internet back online but I have no internet access at work. When I’m not in the ER or in the ambulance, I’m spending much of my time refurbishing a 48-year old sailboat I use for fun around here.
Still alive but covered in a fine dust of barnacles and fiberglass.
–maddog
Nightmare
I had a horrible dream. I dreamed that Herself had died.
It wasn’t one of those epic dreams where she dies, the music swells and the camera closes in on my anguished face.
This dream was perfectly real. There we were in bed. I’m falling into the wooly comfort of sleep, thinking of nothing but the oblivion that comes with a well-earned oblivious nap. Then I suddenly notice that Herself is no longer breathing.
I grab her hip. It’s the part of her that is the most accessible. I give that hip a hearty shake, enough to wake any sleeping person. She flops under my efforts like a collection of meat and bone.
Ominous!
Somehow, in an instant, I’ve pulled her off the bed onto the floor. The phone is off the hook, emergency number dialed and I’m shouting instructions to the dispatcher as I pound on her chest and blow my own air into her cheeks and lungs.
There’s an ambulance (staffed with those I know and trust), a ride to the hospital (I’m directing drug & defibrillation efforts from my position as the one who is keeping up chest compressions), the transfer to the ER staff and then the painful, inevitable declaration of death.
I’m still in my pajamas, knees to my chest, back to the bulk of the nurse’s station, staring at the complication of equipment, people, wires and drugs that can’t possibly be a real person.
Everyone is doing everything. Yet, somehow, someone "Calls it" and the time of death is noted on a paper somewhere.
Somehow, all of the worst things I’ve ever seen/done/been a part of has happened to me.
I’m sweating as I wake up. I find myself alarmed to be in the same position and condition as when this dream started. The noise of our AC keeps me from hearing Herself’s breathing.
My hands find her femoral artery (pounding away) and feel the rise and fall of her ribs as she breathes (regular and normal).
Just a dream, maddog, just a dream.
In my coffee – hour after waking, I think of this dream. In my job, I meet people who live this horror. As the ‘medic, I experience these events with a certain amount of dispassion. Am I being told?
Compassion!
–maddog
By the way…
I’ve been going on and on in various places about professionalism.
This guy hits the nail on the head (he usually does, that’s why he’s a regular read of mine).
Kelly Grayson refers to this article on EMSWorld.com.
When I first read Ms. Loscar’s article, I though some sort of Philip K. Dick-style mind-stealing had happened. She was writing, much more eloquently, what I’ve been thinking for a long time! Tracey Loscar is smart, prescient, and articulate. If you read her article and don’t feel compelled to do something to improve yourself, you’re likely part of the 75%.
I’ve been harping on professionalism in blog posts and in magazine contributions. Have I been missing the forest for the trees by delving into the particulars and details of how to behave like a professional? Maybe. I know, in my mind, what a professional paramedic is. I’ve met her before. You all have. Any of you, reading this blog, whether EMS providers or just fans (Hi, mom!) know what a professional in anything is because you can remember meeting him or her. She was perfect at what she did. She made it look natural and easy and elevated your opinion of her entire profession and industry.
I could be talking about a paramedic, wait staff at a restaurant, a tax accountant or a "customer service representative" at the mobile phone store. The fact is that we all, regardless of our profession and experience, have encountered someone who is a quintessential professional. Perhaps we’ve left that encounter thinking, "Why can’t everyone be like that?"
Have you ever left those encounters thinking, "How can I be like that?"
–maddog
Update:
Events in my country of residence have made me VERY nervous about posting to my blog. Many regional governments have reacted to the Arab Spring with fear, intimidation and increased efforts of control.
If you’ve been following me on Twitter, you’ll know I’m currently on vacation in Spain. It’s one of my favorite countries. Mostly because the wine is good, they know what to do with a pig and, having lived here for 4 years as a kid, I’ve got enough language to get around.
I’ve taken steps to help protect my blogger-self when I return to the Middle East. Inshallah, there will be more blog traffic from me. I have many ideas and such committed to paper (a nice medium that is, in our modern world, quite impractical to monitor). I’ll be continuing the series on professional behaviors I call "Lack of Affect." I’m also considering a periodical discussion of EMS drugs, one by one. Pharmacology has always been my weakest area. Perhaps I can bootstrap myself into a better practice by researching and writing a few things about drugs.
I haven’t been completely idle, though. I have had the honor of being included among some of the most interesting and compelling members of the EMS community. Together, we have put out a quarterly e-magazine, free of advertisements, focused on the EMS industry. Interventions has released its 4th issue, aimed at EMS supervisors, and it can be found by clicking on these words you’ve just read. If you’re interested in reading any of our back-issues, they can be found by clicking on these words right here.
¡Hasta luego!
–maddog (¿perroloco?)
