"...and so we commend their bodies to the deep."

First Coastie death in the US occupation of Iraq.

Fair winds and following seas to you, DC3 Brukenthal. Our service is too tiny to lose any of our brothers and sisters. My thoughts are to your wife and child to be.

I'm going to go kick something repeatedly and curse a lot now.......

--maddog

Watch out! We're breeding!!!!

Seadoc got some great news today and I found the coincidence interesting. I don't usually put personal information in this blog but, about the same time Doc found out he and his wife are going to have a baby, I found out I shall be adopting newborn twin girls in July or August.

Now I can staff my own ambulance!!! Woo hoo!

"Daddy, can we intubate the dog today?"

"Daddy, can we start an IV on mommy?"

Daddy, can we put a traction splint on the cat again?...Pleeeeeeeeezzz?"

This is going to be a blast!

--maddog

Trackbacks.....Help?

Ok. Haloscan has updated my free comments feature to allow me to have trackbacks. I also see them on other blogs and I'd like to refer to a couple entries. So far, I have not been able to figure out how to use it and the help pages at Haloscan have been less than useful.

Can anyone explain to me how to trackback to another article? I presume the process is the same to link to mine. I appreciate the help.

--maddog

Duty tonight. Sleeping in.

Not much going on so far. Someone found a bunch of old navy pencil flares. I think they're called MK79 personal distress flares, if my memory serves right. Of course I was called to check 'em out. I explained how they worked and how hight they were expected to fly. I also explained the inherent hazards of the flares and the proper way of firing them off. This got all the boys super excited about the flares.

I sternly admonished everyone for playing with dangerous flares....and then shot one off. WOO HOO!

After a couple we had to quickly police up the brass and take to obviously throwing the football around as the cops were cruising by.

Fun fun!

Now I've discovered that someone has contrived to connect a couple X-Boxes and a couple televisions. They're playing 2 on 2 HALO and I'm not one to miss the fun!!

w00t!

--maddog

Broke a thousand! 1003 hits since Jan 1st, 2004!

w00t!

Thanks for the visits all!

--maddog

Medical Blogging and Politics.

Ok, no sooner do I post about not wanting to talk politics then I hear all kinds of cranky, crabby bitter postings about what other bloggers are saying!!! Come on, people! Act your age!

Here we go!! Apparently Medicmom has some opinions about the NAACP among other things. Her website has many links to the issues she feels is important.

Clarke has responded to her post with his own feelings and reaction. Now things are getting silly because others are sounding off on their blogs with their opinions and almost boycotting the members with whom they don't agree.

C'mon, you meatheads. Tolerance is the key thing here. Stop getting your feathers all ruffled and have the patience to allow someone to feel however they feel. Our blogging community, bound by the commonality of emergency medicine, is very small yet diverse. We are the place where tolerance and acceptance should flourish.

Don't tout the 1st amendment to me. The first amendment says GOVERNMENT shall not infringe out right of free speech:

"Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the government for a redress of grievances."

There's nothing in there about your "right" to act like a crybaby whenever someone expresses an opinion with which you don't agree.

Sheeesh! NOW you know why I don't do politics in my blog.

"grumble grumble.....crybabies.....grumble grumble......No sense of camraderie.....grumble grumble..."

Hey, read the Damn thing, already!
The Constitution of the United States of America
The bill of Rights

Oh yeah. This isn't a bad start either:
The Declaration of Independence

Just because I listed the Declaration of Independence, does that mean I have to pull Random Acts of Reality from my blogroll? The author is British, you know!

"Sigh!"

--maddog

Ain't been writing much. Sorry. Argh! School, work, family, house (selling), house (buying) sickness (flu then cold) have been distracting me from what I WANT to do. I have too many things that I NEED to do! Dangit!

For example: I am taking both organic chemistry and an advanced Spanish class. I like them both. I have been spending a lot of time working on the homework for the Spanish class and not a lot on the homework for the Chemistry class. Result? I'm doing well in Español and not so good in Organic Chem. The problem is: Spanish is NOT a required class to continue in my major next semester.

¡Es una lastima que no haya seis mas horas por dia! ¿No?

I apologize to all of you readers for being so quiet lately. I have no excuse. I use a wonderful program that allows me to write on my laptop and then post to my blog with a click of a button. I just need to remember to open the thing and write!

I suppose one of the things that's keeping me from posting so much is the fact that I feel that whatever I write needs to be more EMS related than my thoughts and feelings (see previous post). In any case, I shall endeavor to do more and find more to say.

As always, Feel free to leave a comment by clicking the link below or send me an email. I'd be glad to talk to you. At the very least it will give me motivation to POST!!!!

--maddog

Audience Driven Blogging, the answers.

OY! Where have I been? Sorry for the slowdown in posts. Not much going on EMS-wise but a LOT going on in the personal life and at school.

In my last entry, I asked you to tell me what you wanted to know. I'd like to address some of those questions:

This question is from Jason:

Q: "I check here frequently - but you don't update frequently enough!!!  I'd like to see more about your Coast Guard days - being a rescue/recovery diver, that type of stuff kind of interests me."

A: Well, I don't update much because I have been keeping this blog related to my experiences in EMS, Paramedic school, or fire department (through which I currently practice EMS as an EMT-B).

As to my Coast Guard experience, I was never a rescue diver. I was a shipboard rescue swimmer which meant if someone fell overboard, I'd be one of the people that might dive into the water (with a harness and line attached) and grab the poor sot. There's a lot more experiences I had in the Coast Guard but I think I'll let them come out as they become relevant to my current experiences or by request from my darling readers. Thanks, Jason.

From Clarke:

Q: "Just write about you- all of you, not just the fire dept you."

A: That's the thing. When I started this blog, I spent some time reading other people's blogs. Many were just rantings or stream of consciousness writing about people's personal lives. I don't think my inner thoughts and feelings are particularly interesting to read and the details of my personal life are not to scintillating either, "Woke up, Cornflakes for breakfast again, Drove to school in bad traffic....blah blah blah." I DO think my experiences in becoming a Paramedic are somewhat more interesting and the process gives me a more focused theme upon which to write.

The other side of that is, though I am quite outgoing, there are many areas of my life and self about which I am intensely private. My family and friends have not chosen to write this blog nor did i consult them about it. Therefore, I respect their privacy and don't write much about them unless it is relevant to the theme in question.

So, I shall write about the "Fire Department" me, The "Undergraduate Student" me (especially since clinicals start in the fall), and the "Getting mad about poor patient care" me. Don't expect to see politics, socially contentious issues or religion. Unless they relate to my experience in EMS, I find they are outside the scope of my subject.

I will give a few details about me, though:

I am 6'4" tall (2 meters for you metrics)
I weigh 235 lbs (about 105 kg)
I run marathons
I enjoy Shakespeare tremendously
I LOVE good beer
My nose has been broken 4 times
I work out every day and am still pear-shaped (It's the beer)
I wear glasses
I have an 11 year old dog that adores me
I have a 10 year old cat that kills everything
I speak Spanish
I love German cars
I am passionate about the Constitution of the United States of America
I love sailing
I box for fun (don't compete anymore)
I am disgusted by the fact that more people voted on "American Idol" than voted in the last presidential election
I do not have a television.

That should do it for now!

From Drew

Q: "As far as your content goes, just stick to what you have been doing. It's important that people know that EMS is not always lights and sirens. People have this weird delusion that EMS is glamourous and heroic. While that may be "sometiems" it's mostly dull and uneventful."

A: Thanks, man. That's what I'm finding this blog to be. It started as a description of my experiences and is becoming a medium where I can share my own feelings as well. This is greatly helped by knowing that people are reading and hearing their opinions and thoughts too.

From MedicMom

Q: " I don't think it would hurt write more things about yourself. You should be able to do that without revealing too much. People generally want to know a little about the author of the blog that they are reading."

A: Looking back, I see things about myself coming out in my writing. I suppose I could be a bit more open in reference to my topic. I just hate the idea of talking about "me" all the time. That's so easy to do and it's BORING to read.

Q: "Your tagline says, "This is my journey (late in life) to become a paramedic". I am curious to know how old or young  you are (approximate will do if you don't want to tell) and what was the one thing that made you decide to take this career path? We know it isn't the money. HAHA!"

A: I turned 33 a week ago. I suppose that's not TOO old but it's a bit late to quit one's job, be a full time undergraduate student (Can you say "mortgage?" OW!), and THEN start a new career (I graduate in 2006).

As to the "thing" that made me want to be a paramedic: it was a collection of things. I've had flashes of "brilliance" and "great ideas" that have led me into jobs before and they all have turned out to be unsatisfying. This decision to become a paramedic is more of a well thought out, complete realization that EMS what I am "made" to do and what I want to do. Let me recap:

I NEVER panic.
I NEVER get grossed out
I love helping sick and hurt people.
I am a walking font of compassion.
I LOVE the challenge of solving complex problems.
I'm fascinated by medicine outside the hospital.
I hate the 9-5, cubicle routine (see Office Space)
I am a total adrenaline junkie

It makes too much sense to ignore. I have been on this path for over a year now and the passion to do so has not diminished at all. The idea of being "called" to something is what we usually associate with clergy and crusaders. I really believe I have found my calling.

Q: "Where did the name maddog come from?"

A: It comes from my days on active duty in the Coast Guard back in the early 1990's. While I'd like to say that it comes from me being recognized as a total badass and that the nickname is a badge of respect bestowed upon my by my peers I'm afraid that's not quite the case. At the time, I was very enthusiastic, upbeat, high energy and always looking for ways to get into something. I would frequently be the one telling jokes, singing and saying "ARRRR!" as we fought 25 foot seas in -15 degree weather in a 21 foot boat in Alaska. Many of my supervisors and shipmates found this attitude to be somewhat exasperating and took to using the word "goddam" before my name. As cursing is generally discouraged around officers and members of the public we serve, my shipmates reversed the word and took to wryly calling me "maddog." Needless to say, it stuck.

Q: " What methods do you use to calm/comfort anxious/afraid patients"

A: I use a variety of methods depending on the patient and the situation. My time working in sales has taught me a lot about how people respond to different attitudes. Some patients are comforted in the presence of confidence, some like to have a lot of smiles. I generally stay cool, move with confidence and keep my voice down. I make a LOT of eye contact, I smile a lot if it works and will occasionally use distraction to keep a patient occupied. I'll ask questions, get their mind focused on something else, that sort of thing. If a patient responds well to being touched, a reassuring hand on the head or shoulder does a lot. Generally, I let my natural compassion come through, try to connect to the person who is my patient and perform my job calmly and with an air of competence. That's what I would like if I were a patient.

I hope that satisfies your thirst for knowledge. I will always answer questions from my readers. Thank you all very much for reading and commenting. I'll try to post more often.

--maddog

Entry topics:

MedicMom has put out an entry about audience-driven blogging. Now, I have been pretty strict about keeping this blog within the limits of my EMS experience and my process of becoming a paramedic. I'm not too keen on putting in personal information and this blog has given me a great way to review my EMS calls and self-critique.

That said, I have noticed my hitcount and comment frequency drop off rather dramatically recently. I'm wondering if my audience is becoming bored with me. I suppose I can't have amazingly exciting calls EVERY week but I do try to be faithful with my experiences and my perspectives on them.

This is the question I put out:

Does anyone want to know more or is there anything my small audience wishes me to blog upon?

Please comment on this post (I check them frequently) or you can privately email me and I'll do my best. If I choose not to answer a particular question, I shall explain myself in my blog.

Thanks for reading.

--maddog

There was another call on my last shift. I haven't had the time to write about it and I really don't have the time now. But here we go:

I slept in at the station that night. I found myself to be hyper-alert to every noise from the dispatch radio that is piped over the PA system in the bunkroom. As to the bunkroom, I found a decent bunk that, combined with my sleeping bag and orthopedic pillow, allowed me to sleep nicely, once I got past the dispatch calls.

The bell woke me at 6:35am. Three single bells spaced out so that I realized it was not a 3 bell call for our truck but a single bell call for our ambulance. Old Coast Guard training took over and I was in my boots, pants and at the ambulance before I was awake.

But I didn't have a driver.

Figuring that D was slow in getting up, I went and got the run sheet and found out the call was for a woman who was diabetic and had CHF. She was breathing normally and had no pain. She merely called because she ran out of her medicine two weeks ago.

Ok, I futz around for about 30 seconds getting myself together, still no driver. I then realized that I had not figured out where D slept and was preparing to go into the darkened bunkroom and find his somnolent self. Fortunately, a volunteer who had come in early this morning had seen me wandering around stupidly, and had gone in and gotten him.

D comes out in his underwear, puts on his bunker pants and we roll. He doesn't fully wake up until we arrive on scene.

I read the address and refer to the map. Into the infamous apartment complex we go. I follow the map for access which leads us on a long foot trek to the apartment building far from the road. We get there to discover a shorter sidewalk not on our map that leads to an adjacent road. The patient greets us at door. She insists that she walk 150 yards and up about 2 flights of stairs to get to the ambulance. She insists on getting in the ambulance herself. She complains about having to go into the hospital on the stretcher and will only do so when I explain to her how much our stretcher costs. (Figure THAT one out!!!)

Fortunately for us, the ER is EMPTY and we get her a bed right away. At this point, all I can think of is coffee.

Admitting nurse asks me if she's crazy. Apparently they got from dispatch that it was a diabetic emergency and she's surprised at her evidently good condition. I give vitals and describe the patient's perfect lucidity. I also relate to the nurse the story the patient told me of how her doctor (cardiologist) couldn't reach her because her teenage daughter is always on the phone talking to "boys." Eyebrows shoot up on on the nurses face.

"You got kids?" I ask.

"Four." She says with those pursed lips and raised eyebrow. I'd hate to be on her bad side!

We share a private smile and wink. She heads back into the patient's room with a totally different attitude.

Horrible but strong coffee greets me back at the firehouse and I think that sleeping in isn't too bad. I might even do it again.

--maddog

Just as I was getting my head around going to bed, D and Ch decided they wanted to take the ambulance on the air to go cruise around. I'm not one to miss a call so I go along. D is driving and Ch gets in the front. I ask if I can and she tells me she's senior so I have to ride in the back.

"Sigh!" I'm about 13 years older than her, been an EMT longer and my only reason for being there last night was to ride the ambulance but she's been at the firehouse longer so she's "senior."

Well, going on the air means they go driving to the nearby university which is out of our area, and cruise around. D's recently-ex-girlfriend is working at one of the gates and he goes looking for her. What an ass! As I spend time with D, I'm coming to realize that he's NEVER WRONG, he hates to be one-upped by anyone on anything and he's extremely vocal about his opinions. The Mac Medic's wrote an entry about "hackers and crackers" and how it relates to EMS. In all aspects of his life, I think D is certainly a "cracker." He always complains without offering solutions. He never looks at anything as a solvable problem and he's intellectually lazy. Oh, yeah, because of his confrontational attitude and never being wrong, you can't effectively tell him to shut up.

"Sigh!"

While we were out cruising around, we got a call from another unit that came upon an MVA in our area. We head out and find one car on the road, the other down the embankment in the grass. The two people from the car on the road are up and walking. I head to the car on the grass to find a male hispanic talking on his phone. No major deformities to the car and the airbags have not deployed. A firefighter from another station accompanies me to the car and tells me the guy has refused transport. Fine, I still want to at least talk to him.

"Hey! Get off the phone!" yells the Firefighter to the guy in the car.

"I got it, man. Thanks." I say to the Firefighter. He shrugs.

I squat down to get to eye level with the guy. He's speaks English with an accent and he's more intent on calling his insurance company than with talking to me. I try to ask him some questions in English and he keeps saying "I'm fine." I try a different tack.

"¿Hablas Español?" I ask him.
(Do you speak Spanish?)

"Sí."
(Yes.)

"Bien. No estoy policia. Es necesario que tú contestes mí preguntas. ¿Me intiendes?"
(Good. I'm not the police. It's necessary that you answer my questions. Understand?)

"Sí."

"¿Usaste el cinturon de seguridad?"
(Were you wearing your seatbelt?)

"Sí."

"¿Te duele a tu cabeza?"
(Does your head hurt?)

"No."

"¿Te duele a tu cuerpo?"
(Do you hurt in your body?)

"No."

"¿Porque hay sangre a tu boca?"
(Why is there blood on your mouth?)

"Mordí mí labio."
(I bit my lip.)

He's alert and orienting to me as I ask questions. I can certainly smell booze but it's not too powerful on his breath. It smells like old booze in his sweat.

"¿Te duele a otras lugares a tu cuerpo?"
(Do you hurt in other places in your body?"

"No."

He's on the phone now. I ask for his license and get it. I fill out my sheet, he signs the refusal and I split. In the ambulance, Ch is getting information from the couple who were in the other car for their refusal forms. They both look fine. sitting comfortably upright on the bench of the ambulance. I watch their heads as they turn to look at me in the side door. Good movement. I go around back to get in and watch their head movement again as I open the door. Full range of motion in the other direction with no wincing or guarding. Good. I get in the back and introduce myself to them.

"Hi, my name is ****** and I'm going to ask you a few questions while my partner's filling out the paperwork, Ok?"

Nods all around

I look at the woman, "Did you hit your head?"

"No." same question and answer from her husband.

"Do either of you hurt anywhere?"

"No."

"Ok, now I have to ask you silly questions but it's important that you answer, Ok?" Nods again. I look at the woman. "What's the date?" She smiles.

"Heh....Uh, it's April the second?" Giggles.

"Thanks." I turn to the husband, "Where are you, Sir?"

He smiles big, "In an ambulance on *************** Avenue."

"Thanks, guys!" I say and head out to collect our gear from the roadside. While I'm stowing the bags, Ch asks me, "Is the other driver going to the hospital?"

"He's Hispanic, from out of town and smells like booze. He's going to jail tonight." I say wryly. Ch laughs. I don't. I'm sure if he was white he'd be going home tonight with a citation for reckless driving or something innocuous.

We stop by the firehouse near the University so Ch can chat with the pajama-ed college boy firefighters for a while. We're all sociable and I get friendly flack for checking out their new ambulance. Maddog's squirrelling the ambulance! I shrug.

Late back to our firehouse. I stage my gear for a quick get up and go. Then sleep......

--maddog

I'm not sure about the big night. Our truck just left on a cover assignment. No ambulance calls so far tonight. I'm here for the night, though. This lack of action is making me sleepy.

We'll see.

--maddog

Big night?

I'm gearing up to pull an all-nighter at the firehouse. Due to most of our people being called up to active duty, going on spring break or having their reserve drill weekends, we're short staffed. Even though I'm just a lowly Senior Ambulance Technician, I'm going to sleep in tonight.

Promises to be hella-fun.

It's rainy and cold. If my experience driving home this afternoon was any indication, we're going to get another extrication tonight.

You'll hear it here first!

--maddog