tag:blogger.com,1999:blog-62934502024-03-14T21:49:22.951+03:00MaddogMedicThe life and times of a come-lately paramedic.--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.comBlogger356125tag:blogger.com,1999:blog-6293450.post-88103847895678799292011-04-26T19:41:00.000+03:002011-04-26T19:41:29.651+03:00MOVED!<div dir="ltr" style="text-align: left;" trbidi="on">My blog lives <a href="http://www.maddogmedic.com/">HERE</a> now. <br />
<br />
Check it out!<br />
<br />
<em>--maddog </em><br />
<br />
<a href="http://www.maddogmedic.com/">http://www.maddogmedic.com/</a></div>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com3tag:blogger.com,1999:blog-6293450.post-12211623464570153442011-04-26T02:14:00.002+03:002011-04-26T02:46:02.835+03:00Hero?<div dir="ltr" style="text-align: left;" trbidi="on"><br />
I wrote a letter to a friend of mine who's a writer, a fellow Coastie and, oddly, has the EXACT same birthday as me! I wrote it out as freely as my pen would flow and then went back to proofread. As I read it, I realized I had an amazing blog post here!. I was speaking to him (in ink) with an honesty and freedom I haven't used in a LONG time in this blog.<br />
<br />
I will excerpt:<br />
<br />
<div style="text-indent: 20pt;"><br />
"<em>My life continues to be a series of sublime moments that awe me without fail"</em> <br />
</div><br />
Yes, that's true but here's the blog-worthy part:<br />
<br />
<div style="text-indent: 20pt;"><br />
<em>"You wrote in your letter that you haven't ever found the place where you can say, 'Therein lies the boogeyman!' Well, I think I have found him. This boogeyman lives in the most uncomfortable place. He's right here *</em>Taps Sternum*<em>. <br />
<br />
I told myself that I was coming to this land without any prejudice, preconception or bias. I truly came here with my heart open to every person I meet but, DAMN!, It snuck up on me!. </em><em>If I walk down the mall in Washington, DC and someone is looking right at me and they track me with their eyes and head as I pass, My first reaction is going to be, "</em>OH HELL, It's on!!!" <em>and to get ready for a running fight.</em></div><div style="text-indent: 40pt;"><em> <br />
This is the most obvious example of how wrong my notions are over here. I'm tall, white and odd-looking. This is a society that, truly, abhors personal violence. I'm more likely to be killed by a meteor than to get into a fight with an Arab. <br />
<br />
I had been going around this place in a state of high alert, ready to 'throw down' and get busy. Then, one day, I was at a shopping center and I was tired of this hard-look, closed-face 'eyeballing' I was getting at every turn.<br />
<br />
I had been here long enough to learn the basics of greeting and salutation. My predilection to languages allows me to speak Arabic with an almost perfect regional accent. So, here is a young Arab guy in his traditional dress with prayer beads in his hand. He's looking HARD at the big, fat, white, American me!<br />
<br />
I lock eyes with him. <br />
<br />
I see he has no weapons (training will never die).<br />
<br />
I tilt my head and dip my chin in a gesture I've learned as both welcoming and courteous. I say, 'Salaam Aleikum (Peace be upon you).' But my hands are free (that damn training!). <br />
<br />
The BIGGEST smile EVER explodes across his face and he enthusiastically says, 'Wa Aleikum A Salaaam (and upon you, Peace!)!' He throws his arms wide in a gesture that is, at the same time, welcoming and disarming. What a charming young man!<br />
<br />
Now, it's broken English, MTV-references, and a crowd of young Arabs who are eager to show off how much English they have learned from the internet and TV. I received no less than seven invitations to dinner and later get text messages inviting me to coffee, weddings, etc.. It's handshakes, back-slapping, smiles and enthusiastic affection. The EXACT opposite of what I feared.<br />
<br />
All of the fear of foreign people, backwards societies and unfathomable religions had been clouding my view of the truth I had written to you before, my friend:<br />
<br />
People are just people. <br />
<br />
The boogeyman was in <b>me</b>. I'm sure each of those young Arab men saw the boogeyman on my face as I returned their 'hard stares' and I've since learned to put a pleasant smile on my face out in public. Once I stopped being afraid of the boogeyman (or, stopped being afraid of people I don't understand) I find I move though this country like an honored prince. <br />
<br />
However, I'm white, tall, American and <b>MALE</b>. Only the King (peace be upon him) has it better than me. <br />
<br />
Yes, Racism. It's alive and well here. I have found that, along with suppressing the 'boogeyman' in me, I've had to suppress the 'Outraged Defender of the Weak' hero that lives in the very front of my conscious. There are not enough numbers in my mind to count the times I've had to stop myself from punching the **** out of someone. There are many times in my work here when I have to engage in the uncomfortable exercise of suspending my compassion. <br />
<br />
That has been, for me, the hardest part of moving here. <br />
<br />
Life is cheap here. I see so many preventable deaths that are attributed to the 'Will of God.' Is it appropriate that, just because someone is from Bangladesh, he should be a laborer and treated as chattel? Is it 'The will of God' that the Indonesian housemaid you've hired should also have sex with the man of the house because she is, in essence, a slave? <br />
<br />
Slavery was only made 'illegal' here in the late 60's. Enforcement?<br />
<br />
I'm still trying to reconcile those wonderful, generous, welcoming young men (who later helped me buy a mobile phone) with the notion that any one of them would willingly rape an Indonesian housemaid because they thought that's what Indonesian housemaids are for. ... Or that ANYONE could think that another human being existed to be raped. <br />
<br />
The 'boogeyman' isn't always immediately recognizable as the 'bad guy.' My strong desire to go punch the life out of those ********* and to 'Defend the oppressed' has to be held in check. The boogeyman wants to go a-prowlin', kicking ass and saving people exactly as we learned in all the comic books and TV shows of our youth. <br />
<br />
The problem is that all of those 'hero' stories relied upon a moral, rightful and same-thinking society there to receive the rescued victims of our heroism. There are not a lot of comic stories about how Batman helped that gang-rape victim have the strength to continue to go to therapy. I've not read a comic about Superman helping the teenage son of a woman who was attacked deal with his own anger and sense of helplessness. Nope. That's, somehow, not heroic. We western (read: American) 'heroes' think we can swoop in, fix the problem, receive accolades and leave. Obviously this notion has guided our foreign policy over many administrations. <br />
<br />
I have suffered the hard lesson that I cannot be a hero here. In the USA, I could activate a victim-advocacy system when I encountered child, elder, spousal or other abuse. I often was able to do positive good because I saw that clues that someone was a victim and our society had mechanisms in place to help. <br />
<br />
Not here. That's not easy to deal with as a paramedic. <br />
<br />
Even more difficult is the situation I encounter where the victim is so ignorant of their life station that they are not even aware that they are being victimized. It's just how their life is. <br />
<br />
I had a 13 to 16-year-old actively giving birth the other day. She had no F*****g idea what was going on. She's probably lived in a tent her whole life. Once he found out the baby was a boy and healthy, the 18-year-old father gave not a F**k about anything else. Meanwhile, I was busy keeping 'Mom' from bleeding to death and helping her deliver the placenta. <br />
<br />
I'm not the hero there. I'm just the guy who helps make sure that mom and baby live until tomorrow. What they do with the rest of their lives (or what is done TO them) is not my purview. That's the part that runs up against my notions of 'hero.' That's the part that hurts the most. <br />
<br />
'Well, what the heck am I doing here?' I ask myself. 'What is my role here?'<br />
<br />
Again and again I have encountered other medical practitioners (nurses, doctors and others) who were clearly hired based upon what they can show on paper vs. what they can DO when the poop hits the air mover. Perhaps I need to feel I'm positively contributing to my workplace an our 'unit mission' (props to my Coastie audience). In the context of what and how I do my job, I often find(to my own horror) that <b>I'm </b>the most competent, trained or willfully assertive member of the resuscitation team. <br />
<br />
There's my niche!! That's where I fit in!<br />
<br />
I have learned to gently guide, direct and supportively 'push' the other medical personnel in my sphere to practice medicine in a way that is focused on the patient more than covering their own (or their manager's) butt. I work with a bunch of smart, driven, caring practitioners. However, I think I'm the only one who's not afraid to say, 'Let's do what we have to do!!' and that's the most important thing I do every day. <br />
<br />
Somehow I'm in exactly the right place. </em><br />
</div><br />
I'm not a hero. I'm not going to pull a comic-book-style rescue on anyone. I think the important thing is that I'm not afraid to give that little 'push' for my patient. Have I grown old enough to realize that the best work I can do here is by stepping back? <br />
<br />
I hope so. <br />
<br />
<em>--maddog</em><br />
<br />
<em> </em><br />
<em><br />
Halfway through the letter, I had to refill my pen. I'm going to bed with ink stains on my hands. Does that make me a writer?</em><br />
</div>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com4tag:blogger.com,1999:blog-6293450.post-77898525865582431652011-04-21T08:24:00.001+03:002011-04-21T10:06:30.300+03:00Moving<div dir="ltr" style="text-align: left;" trbidi="on">In a few <s>weeks</s> days, I'll be moving over to the <a href="http://blogs.firstrespondersnetwork.tv/">First Responders Network</a>. These guys are awesome. Met 'em at the EMSToday conference in Baltimore this year.<br />
<br />
Look for me soon at http://www.maddogmedic.com<br />
<br />
w00t! My own domain! I'm turning into a grownup!<br />
<br />
Stay tuned!<br />
<br />
--maddog</div>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com1tag:blogger.com,1999:blog-6293450.post-68114761894178471752011-03-16T20:48:00.000+03:002011-03-16T20:48:55.304+03:00Where we're headed?<div dir="ltr" style="text-align: left;" trbidi="on"><a href="http://firstrespondersnetwork.tv/wmrandomward-a-man-i-just-became-inspired-by/">This Guy</a> gives me hope for my profession. <br />
<br />
With folks like him riding ambulances and being members of our community, we will improve. <br />
<br />
<em>--maddog</em></div>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-72966444880516289082011-03-16T07:14:00.000+03:002011-03-16T07:29:38.977+03:00Murderer.<p><br />Jolly and I are on night shift at the main clinic when we get a call for a security guard who's collapsed at a facility about 45 minutes away. <br /><br />We roll. <br /><br />On the way, we're advised that the patient has been loaded into a security vehicle and they are racing to rendezvous with us. We meet on the dusty shoulder of a desert highway. A panic-eyed security guard opens the back door of the SUV and I see our patient. <br /><br />He's blue. It's been at least 20 minutes since we got the call. <br /><br />That's not so good. <br /><br />BVM, good air movement. I holler over my shoulder to Jolly. He slides in and we quickly transfer our patient to the ambulance. No pulse, no respirations. <br /><br />Load and go, pump and blow!<br /><br />The drivers hired by our company for the ambulances are not medical personnel. They are local employees who are sliding towards retirement. They have NO training in emergency vehicle operations and no concept of what it's like to be in the <em>back</em> of an ambulance. They also drive like locals. <br /><br />Our particular driver has been infected by the urgent panic of our patient's colleagues. He goes screaming down the highway, around corners and over speed-bumps in such a way that Jolly and I can barely keep up CPR, much less attach a monitor, intubate or start an IV. <br /><br />Chaos. <br /><br />Jolly is alternating between chest compressions and bracing himself against the movement of the ambulance. I'm doing my best to manage the airway with basic adjuncts while screaming "Schweiah, Shcweiah, F*****g Schweiah, already!!!" Over my shoulder. ("Schweiah" means "Slow") The panic makes the driver deaf. <br /><br />*Sigh*<br /><br />At the ER, we work the code with the rest of the staff, most of whom were my students in an ACLS class I had taught 3 days before. <br /><br />Asystole on the monitor. <br /><br />Tubed with a 7.0. Bilateral 16s, wide open. Enough Epi to make a sloth break a 4-minute mile. <br /><br />We call it after about 30 minutes of working. We went that long mostly for the benefit of the patient's coworkers who were looming outside the door. <br /><br />51 years old. This was only the second time he's ever seen a doctor. Also the last. His previous visit was 7 years ago and it ended with a prescription for cholesterol and blood pressure meds that he never filled. <br /><br />We did our best but there's always that let down. Maybe it's the adrenaline wearing off, maybe it's the obvious grief on the faces of his friends. <br /><br />It's late. I clean up and hurry over to the commissary next door to grab a missed dinner before they close. <br /><br />The Indian guy at the checkout looks at my name tag. He pronounces my last name carefully. <br /><br />"Do you know what your name means in my language?"<br /><br />I shake my head. I'm really tired. <br /><br />He wears a big grin. "Murderer!"<br /><br />Great. Just great!<br /></p><p><br /><em>--maddog</em><br /></p>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com2tag:blogger.com,1999:blog-6293450.post-40950279879768747502011-03-11T19:19:00.000+03:002011-03-11T19:19:32.665+03:00Pretty Lucky Guy Part II<div dir="ltr" style="text-align: left;" trbidi="on">After about 26 hours of ground and air travel, I'm safe and sound in my little desert Kingdom. I got through Bahrain with no delays. Even drove right over the Pearl roundabout and spied some flags and banners. Not much going on. While things are showing as busy and dangerous on the news, none of the much-covered unreast reaches this far into the unpopulated wastes where I live. Occasionally a camel may protest by blocking traffic for a while but otherwise things are quiet. <br />
<br />
I'm a pretty lucky guy. <br />
<br />
On my way out the security gate to go to work this evening, the young security guard brightens up when he sees me. <br />
<br />
"Hello my friend!" He says with a big grin. He looks vaguely familiar but I go through so many gates and see so many security guards that it's hard to keep them all straight. I figure he's just being super-friendly as many locals are here. It's really quite charming. <br />
<br />
"Do you remember me? You helped me!" He says, reaching out his hand to shake mine. <br />
<br />
BING! It hits. It's the <a href="http://maddogmedic.blogspot.com/2010/07/pretty-lucky-guy.html">pretty lucky guy</a> I treated a few months ago. I shake his hand warmly as he grins and smiles. <br />
<br />
"Ali! How are you my friend?" I'm a little surprised and delighted to see him. <br />
<br />
"I am fine, Al Hamdulillah (thanks be to God)! Thank you so much, my friend!" And he is. He's got few scars on his forehead from the accident but he's up and walking around with no pain. Back on the job and happy to be there. <br />
<br />
And grateful. <br />
<br />
Cool!<br />
<br />
<em>--maddog</em></div>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com1tag:blogger.com,1999:blog-6293450.post-12196509604441456812011-03-08T05:44:00.002+03:002011-03-08T17:38:02.539+03:00"Home again, Home again, Jiggedy-Jig..."<div dir="ltr" style="text-align: left;" trbidi="on"><br />
A spinner takes a mass of wool and makes it come together into an organized yarn of useful thread. A knitter binds that thread into a useful garment that fends off the cold. <br />
<br />
Tonight, I'm hip-to-hip with my father in the kitchen of my parents' house. We're cleaning up after an awesome dinner my mom put together. I can think of <b>no</b> better way to spend my last night in the USA after my awesome experience at the EMSToday Conference and the amazing meetups provided by <a href="http://www.zoll.com/">Zoll</a>, <a href="http://chroniclesofems.com/">Chronicles of EMS</a> and <a href="http://firstrespondersnetwork.tv/">First Responder Network TV</a>. <br />
<br />
Mom put on a fantastic feast and Dad & I are doing are doing our duty to clean up the aftermath. We be talkin'... We talk about politics. We talk about race. We talk about women and, ultimately, we talk about music. We both love the blues and the popular music that has evolved out of the blues. He likes Bonnie Raitt and Eric Clapton. Me? I like 'em too, but I do see the DIRECT connection between the blues and Led Zepplin, the Black Keys, or, even, the Beatles. <br />
<br />
"<i>Sheesh, maddog! When are you going to talk about EMS? We didn't sign up for some discussion on popular music in the USA and the UK in the 20th century!"</i><br />
<br />
Well, here's where it folds together: <br />
<br />
Robert Plant and Jimmy Page didn't set out to be one of the greatest bands of the 20th century. They originally just got together to listen to some old recordings of American blues artists that were pressed onto vinyl and shipped to the UK. From this collaboration came the awesomeness that was (and still is) Led Zepplin. (If you ever doubt that connection, please listen to the Levee Song, Dazed and Confused, I Can't Quit You, Baby and just about everything else they've done --- wikipedia link <a href="http://en.wikipedia.org/wiki/Led_Zeppelin">HERE</a>)<br />
<br />
After meeting many of my blogging professional colleagues this week (and a poet!), I'm beginning to realize that none of us set out on our own personal journey to be <i>superstars</i>. We just became 'medics to fill a need in our community or to advance our careers or to keep us busy or to follow our fate-given calling. Whatever the reason, we came to here, now. We are paramedics. We are internet users. We are attuned to convenient, prescient and useful collaboration. <br />
<br />
And, as such, we are bloggers. Somehow, doing that (blogging), we become better medics. As bloggers, we gain different insight into our day-to-day work. Thus, as medics, we become better bloggers. We know we are not alone. <br />
<br />
We all take all these disparate threads of our experiences, con-ed, seminars, advice of colleagues, websites and medical journals and we try to spin and weave something that resembles a competent practice that, under the right circumstances, can save a life or two. That's all we ask for. <br />
<br />
But, wow, we often feel like we are the<i> only</i> ones holding back the tide of death and misery. How many times have each of us felt alone? I do it all the time. Every time that loneliness has cut me deep, my fingers dance on the keyboard. I tell you (the collective 'you') about it and that, in itself, fends off the lonely. <br />
<br />
Thank you all for reminding me that I am<b> not</b> alone. <br />
<br />
I say to the rest of you out there: <b>You are not alone! </b><br />
<br />
Ask the question! <br />
<br />
Vent your rage! <br />
<br />
Share your funny! <br />
<br />
Say It! Ask it! Do it! <br />
<br />
<i>"...Do. Or do not. There is no try. ..." </i><br />
<br />
I used to tell my students, "<i>Go forth. Do great things.</i>" I can think of <i>no</i> better advice to my newly (re)discovered community of blogging EMS providers. <br />
<br />
I thank you all from the very bottom of my living, breathing and creative soul. <br />
<br />
<i>--maddog</i></div>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com1tag:blogger.com,1999:blog-6293450.post-66985247447127585132011-03-07T06:45:00.000+03:002011-03-07T06:45:17.377+03:00Recent Keyword Activity<div dir="ltr" style="text-align: left;" trbidi="on"><br />
Apparently some folks in Canada have been getting to my blog by putting the following into their Google search:<br />
<br />
"bedoin peeing in sand"<br />
<br />
Will the madness ever stop?<br />
<br />
<i>--maddog</i></div>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com1tag:blogger.com,1999:blog-6293450.post-90476643671297668522011-03-06T18:30:00.001+03:002011-03-06T18:30:36.874+03:00So much to write about.<p><br />Wow! What an amazing time I had at the 2011 EMSToday conference. I learned a lot, met some amazing people and have been re-energized to make this blog fly. <br /></p><p><br />There's so much to write on but I've got 90 minutes until hotel checkout and too much knocking around in my head. I'll be with family for the next day or so then I have about 24 hours of plane and car travel to get me back to my tiny desert town. <br /></p><p><br />I want to write about the people I met and the impact of social media on blogging. I've seen a DRAMATIC change over the last 2-3 years. I want to discuss that. <br /></p><p><br />The recent protests in the Middle East merit mention considering where I live and work. <br /></p><p><br />Give me a few days to get all these thoughts organized and I'll be pushing out some posts over the next few days. <br /></p><p><br /><em>--maddog</em><br /></p>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-50816594653638787642011-03-03T19:11:00.000+03:002011-03-03T19:17:01.214+03:00Boat? What Boat?<p><br />While at the EMS Today conference in Baltimore, I popped by the EMS blogger party hosted by Zoll. (Thanks, Charlotte!).<br /><br />What an amazing time. What an amazing group of people! I met some of the brightest, sincerest and funniest bloggers out there. I realized that my recent inactivity and general decline of blogging has led me to miss the boat. Social media, facebook, twitter and the increased interconnectedness that we get from that has transformed EMS blogging. <br /><br />I started it as a diary of sorts of my times and efforts becoming and then working as a paramedic. Now, these amazing professionals share information, teach each other, engage in collaborative learning that would not have been possible 10 years ago and would have been unusual 5 years ago.<br /><br />I feel like I took a long nap and then woke up to find my house full of the smartest, most motivated people I've ever met and they're all clamoring to do cool stuff. <br /><br />People like <a href="http://ems12lead.com/">Tom Bouthillet</a>, the <a href="http://happymedic.com/">Happy Medic</a> and so many others were there last night and I have to say to all of you, thanks. You have made me feel welcome again into this growing community of blogging EMS providers and I'm really glad to be back. You have inspired me. <br /><br /><em>--maddog</em><br /></p>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com3tag:blogger.com,1999:blog-6293450.post-43098979937715160072011-03-01T22:17:00.001+03:002011-03-03T19:19:38.234+03:00Growing Pains<div dir="ltr" style="text-align: left;" trbidi="on">Howdy, all.<br />
<br />
As you can see, I've updated my blog template from the same one I was using since 2004. UGH!<br />
<br />
Unfortunately, my old comments program, Echo, failed to make it across so I have to now start using the Blogger comments and have lost all of my archived ones.<br />
<br />
Furthermore, I was using Blogroll for my links bar. They've now gone defunct and I failed to backup my links. If I've linked to you in the past, please send me an <a href="mailto:maddogmedic@gmail.com">email</a> or comment and I'll restore the links manually.<br />
<br />
Oh, if you're in Baltimore, come by and see me and other bloggers on Thursday night! Click <a href="http://maddogmedic.blogspot.com/2011/03/baltimore-ems-blogmeet-2011-is-on.html">Here.</a><br />
<br />
<i>--maddog</i></div>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-61408171793982579132011-03-01T02:43:00.001+03:002011-03-01T02:49:57.601+03:00Baltimore EMS Blogmeet 2011 is ON!<div dir="ltr" style="text-align: left;" trbidi="on">Howdy, Kids!<br />
<br />
I've traveled 8,000 miles to be at the 2011 <a href="http://emstoday.com/">EMS Today</a> conference and I'm keen to meetup with some other bloggers! <br />
<br />
WHEN: Thursday, March 3rd, 2011 from 6pm until about 7:45<br />
WHERE: <a href="http://www.prattstreetalehouse.com/">Pratt Street Alehouse,</a> at 206 West Pratt St., Baltimore (right across the street from the Convention Center)<br />
WHO: EMS Bloggers and all of our thousands of screaming groupies!<br />
WHY: Why the heck not? At least you can come chastize me for not posting as often as I used to.<br />
<br />
Afterwards, I'll be heading out to the JEMS Meetup at <a href="http://connect.jems.com/events/event/listByLocation?location=Uno+Chicago+Grill+-+Harborplace+Pratt+Street+Pavilion">UNO's Chicago Grill</a>. The details are <a href="http://connect.jems.com/events/the-meetup-at-ems-today-1">here</a>. The JEMS Meetup promises to be pretty big and I'd like to have one just for bloggers beforehand. Come out to one of them, come out to both! WOOHOO! <br />
<br />
In keeping with previous blogmeets, I'll be wearing a hat to be recognizable. This year's selection is below:<br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://lh3.googleusercontent.com/-4TihjE0yyA0/TWwydb6dP8I/AAAAAAAACQU/C8Uahq7duGs/s1600/Photo+on+2011-02-28+at+18.26.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://lh3.googleusercontent.com/-4TihjE0yyA0/TWwydb6dP8I/AAAAAAAACQU/C8Uahq7duGs/s320/Photo+on+2011-02-28+at+18.26.jpg" width="320" /></a></div><br />
See you all there! Comment below or <a href="mailto:maddogmedic@gmail.com">email</a> me as needed. <br />
<i><br />
</i><br />
<i>--maddog</i></div>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-16346605793585881062011-02-11T07:24:00.001+03:002011-02-11T07:24:00.396+03:00CommuteOn the bus from a remote clinic to home after night shift. <br /><br />Sunrise on a desert landscape out the bus window while listening to the Drive By Truckers. <br /><br />Nice. <br /><br /><i>-maddog</i>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-69731087967761233052011-01-17T22:25:00.000+03:002011-01-17T22:29:07.870+03:00Bawlmer, here I come!<p><br />Soooooooo....<br /><br />I'm going to the<a href="http://www.emstoday.com/"> 2011 EMS Today</a> conference in Baltimore, MD.<br /><br />I've<a href="http://maddogmedic.blogspot.com/2009/03/blogmeet-its-on.html"> previously done a "blogmeet</a>" however, I'll likely not be wearing the same hat. <br /><br />Who's game this year?<br /><br /><a href="mailto:maddogmedic@gmail.com">Email</a> or comment. Let's do this! Bloggers of the (EMS) world: UNITE! (to eat, drink and tell stories!). <br /><br /><em>--maddog</em><br /></p>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-72560904888911870562011-01-10T08:20:00.001+03:002011-01-10T08:20:09.293+03:00Tidying up.<p><br />I've been making a few changes to my blog and there are more to come. Sorry for the boring "housekeeping." I've gone through and edited a few posts to make my blog just a tiny bit more anonymous. It might just be paranoia but I'd rather be on the safe side. <br /><br />In the next week or so, I'll be making some more cosmetic changes and updating some broken links. I'm still using the same Blogger template I started with in January 2004!! Wow! I'll be looking for a newer, more functional layout that still has the same clean style. <br /><br />Why all this recent activity? Well, I've "unplugged" from the biggest time-waster of all time: Facebook! Man! That thing just drained all the creative energy out of me. I'd sit down to just, "see what my friends are up to" and the next thing I know, 2 hours have passed! I'd look back and see that I had done NOTHING substantive; I hadn't had any meaningful communication with anyone, I hadn't written anything worthwhile and hadn't done a single productive thing! <br /><br />That thing is like a drug! I had to put that mess down and walk away! <br /><br />*Yawn!* Yes, I know. That was boring. More exciting posts are on the way. I promise. <br /><br /><em>--maddog</em><br /></p>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-10374746098963738752011-01-05T14:26:00.002+03:002011-01-10T08:08:56.766+03:00Life in the Kingdom Part 2 of ?Well, here's a bit of news that may affect yours truly. It appears that the Ministry of Interior intends to try to regulate all online publishing via "licensing." <br />
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Hmmm... You know, I'm squirrelly enough about getting "found out" that this is just the thing to put me into hiding. <br />
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Never fear, dear reader, I'll soldier on and post post POST! <br />
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This bit of news does open a door into another discussion. There is NO free press here. In fact, it's kind of funny, coming from the United States where, basically, the press can say ANYTHING they want to. Here, it's not so much. A lot of what I read in the local English language press, aside from grammatical and translation errors, is full of unsubstantiated facts, opinion of the author (or editor) presented as fact and a clear sense of "talking around" an issue. <br />
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I'm not media-savvy enough to discuss the issue at length but when I read the local press, I'm always left with a sense that there's an actual story looming behind the print and somehow it isn't allowed to come though. I wonder if readers here take the news for fact or if they have developed a refined ability to read between the lines. There's much that has been said about the Bedouin ability to perceive much more than what is on the surface. Does that apply to reading the news as well? I wonder. I don't have the answers. It's yet another thing to ask my hosts, colleagues and Arab friends. <br />
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For my own sake, I'll have to carefully navigate the next few months of my blogging. I know other bloggers here in the Kingdom who do not blog under a nom de plume. I wonder what it'll be like for them. <br />
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Strange times in a strange land. <br />
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<i>--maddog</i>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-43739185286149823452011-01-04T13:37:00.001+03:002011-01-10T08:07:48.383+03:00Life in the Kingdom Part 1 of ?I see that I've just kept going on (albeit slowly) blogging about my work and antics as a paramedic as if there was no change in my life at all.<br />
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But there has been. For those of you who only occasionally visit here, I've moved to the Middle East and taken a job over here as a paramedic in a small clinic in the middle of the desert (Really!). I've posted a few things about working here and some of the differences but it's mostly been in the context of a particular call. Of course there's entries like <a href="http://maddogmedic.blogspot.com/2010/10/car-vs-camel.html">this one</a> that make it obvious that I'm not in the USA anymore. <br />
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My call volume is considerably less than in the USA and, honestly, I'm not as fresh-faced and filled with wonder as I used to be. These may be reasons I'm not as frequent in posting. I'm still here and I'm still having a blast. There are times when It feels less noteworthy. <br />
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I'm going to try to change that. At least I'm going to try to post more about EMS and, specifically, about my particular experiences over here in the desert. I've got a pretty cool thing going on here and, honestly, it's worth sharing. <br />
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Over the next few weeks, I'll be posting 2-3 times per week describing the peculiar, different and outright bizarre aspects of my life here in the Kingdom from my perspective as a paramedic. I'll discuss how the EMS system is structured differently, how we practice medicine differently (and the same) and how my attitudes towards, death, suffering and human treatment have shifted to adapt to my life here. It's pretty odd. <br />
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Please feel free to hit the comments or email me if you have any questions or if you're curious about my life over here. <br />
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More soon (I promise this time)<br />
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<i>--maddog</i>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-81939857734359035522010-10-08T17:37:00.003+03:002011-01-10T08:06:55.551+03:00Car Vs. Camel!Jolly and I are working this warm desert night when we get called for a car accident about 30 km south of our location. I let Jolly take the front seat and I hop in the back of the ambulance. From the dispatch information we receive en route we figure it's a single-car accident with two victims. Injuries unknown. I know this stretch of desert road pretty well. It's straight as an arrow and completely unlit. I drive it from time to time to work at a remote clinic about 140 km away. On the way to the scene, I find myself wondering what would cause someone to go off the road on such a straight length of highway. Well, I decide, I'll just have to see when I get there. <br />
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It's moonless and dark when we arrive. No streetlights and no other light source for a few kilometers in each direction. This is the middle of the desert, you know. We park as close as we can but the car is up a 2 meter embankment, about 20 meters off the roadway. Jolly goes ahead to check it out. Anticipating trauma, I grab two backboards, collars, and the usual. Jolly hollers at me to not bother. <br />
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This is going to be good. I scramble up the rocky embankment and join Jolly at the scene. Jolly is a local so he's doing all the talking with the local police and security personnel who have arrived before us. This frees me to check out the car. We have a Toyota Camry resting upright on its chassis. The front and the rear are completely smashed, there's not an intact piece of glass in the whole car and the sheet metal of the roof looks like it was ripped off with a giant can opener. No sign of the roof anywhere nearby. <br />
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There are no tracks leading to the car either. Just an impact print about 8 meters behind it, then blank sand then another impact crater a few meters back. End over end roll. Up a 2-meter embankment. Wow. <br />
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The driver (I assume he was) is completely wrapped around the center console. Yes, completely, like 270 degrees of twist. His head is so badly deformed that it's clear we're not rescuing him. Even assuming we can cut him out of the car. The nearest rescue squad is at least 45 minutes away. The passenger is lying next to the car and I get that the responding police had pulled him out of the front seat. He, too, has a badly deformed cranial cavity (skull). Even though there's no brains leaking out, both of these guys have what we call "injuries incompatible with life." No, they weren't wearing seatbelts. <br />
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Jolly and I proceed to search the surrounding desert. We surmise that the car bounced end over end and, without a roof, we worry there may be someone lying out in the sand having been thrown from the car. We work our way back along the estimated path of the car. From the bits, pieces and imprints in the sand we figure this car was going pretty fast. About 100 meters back, we find the gouges in the shoulder that shows us where the car went off the road. To have traveled 100 meters, bouncing end over end, that car must have been going pretty dang fast when it left the road. <br />
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100 meters further down the road, we see another police car with its lights on. There's a dark mass on the road in front of it. As Jolly and I work our way down the roadway, the smell hits us. I've not smelled anything so nasty and vile in my life. It's the smell of an eviscerated camel. We find the roof of the car. Most of it is still in the camel. A quick look tells us the story: Our two friends were speeding down the road when, out of nowhere, there's a camel in their headlights. They hit the thing full speed. I estimate they were doing at least 200kmh. This is not unusual in this country and specifically in this part of the country. <br />
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The front of the car snaps off all four of the camel's legs and the camel's body hits the roofline of the car. It rips the metal off the roof and impacts with both occupants' heads, killing them instantly, I'm sure. Bounce, flip, the camel goes over the car leaving the Camry to swerve a bit, travel a few more meters, hit the shoulder and begin it's aforementioned end-over-end flip dance to finally rest another 150-200 meters further on. It's an impressive display of physics, biology and plain stupid. <br />
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Jolly and I are shaking our heads as we get back in the ambulance and head home, leaving all three bodies for the police to deal with. <br />
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And, Oh! The smell! <br />
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<i>--maddog</i>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-86166854044151844172010-08-30T01:43:00.000+03:002010-08-30T01:44:13.609+03:00Night shift is a b***h!<p><br />Car vs. Camel. (Well, I think we can ALL figure that one out!)<br /></p><p><br />Bedouin babies! <br /></p><p><br />USA vs. KSA: Who gets the patient????<br /></p><p><br />Stay tuned!!<br /></p><p><br /><em>-maddog</em><br /></p>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-39936863059248635172010-07-31T06:40:00.001+03:002010-07-31T06:40:44.803+03:00Pretty Lucky Guy<div>His name is Ali and, according to the ER doctor, he's a pretty lucky guy. I have to agree. <br><br>We got called to an accident down the road. About 20 minutes later, we arrive at a crest in the road, made notable in the moonless night by the collection of cars and police lights. <br><br>About 30 to 50 meters off the road away is a bashed up compact car resting in the rocky sand. Our patient is the driver and he's secured to a backboard in a Red Crescent Society ambulance. <br><br>Here's a wierd bit: since the patient is an employee of my parent company the Red Crescent Ambulance waited on scene for about 10 to 15 minutes for us to arrive and take the patient to our company hospital which happens to be a few kilometers from their base. <br><br>Oh well. That's how thing are done over here. <br><br>The Red Crescent ambulances around here are staffed and equipped at a very basic level. Some have the ability to start IVs, administer glucose checks and give nebulizer treatments but that's about as advanced as they get. The Red Crescent guys had secured my patient to a backboard but hadn't secured his head, applied a cervical collar, conducted any examination or even taken vitals. They pulled their stretcher out as we approached with ours and I had to wade through the typical crowd of well-meaning but dangerous bystanders grabbing, pulling and trying to "help."<br><br>The Red Crescent guys don't speak English and my Arabic is not much more advanced beyond "Yes, no, thanks, hello," and "Where do you have pain?" but I immediately see that they want to lift the patient off their backboard and onto ours. I use a little pantomime, make eye contact, smile and then grab each of their hands and out them where they should be for a proper logroll. They get it right away and we do it by the numbers. It's neat to see that common training show up even across such wide gaps in culture and geography. </div><div><br class="webkit-block-placeholder"></div><div>In short order, we get Ali transferred to my backboard and cot. I quickly move him into the ambulance so the nurse and I have room to work without being crowded by the bystanders, onlookers, police and anyone else. The nurse I'm working with this night, a strong-willed, unflappable and solidly competent Jordanian woman, makes the call to take this patient to our company clinic in the nearby city instead of our tiny "camp" clinic. I think she realizes that there is an emergency physician on duty at the city clinic and only a general practitioner on call at our "camp" clinic. </div><div><br></div><div>I do my assessment en-route and find that he's got a painful left hip but no shortening or rotation of the leg. This would indicate a break in the thigh or dislocation or break in the hip where it meets the pelvis. His thighs are pain-free when I push on them and his pelvis is stable. All the rest of him is fine. No signs of head trauma, lungs are good and clear, extremities are intact and give good pulses and motor/sensory response. All his vitals are fine. The only thing is this hip pain and the fact that he doesn't remember a big chunk of the accident. I wrap a folded sheet around the upper part of his thighs and tighten it like a band. This produces immediate relief from his pain. Other than an IV and monitoring, that's about all I can do for the guy until we get to the hospital. </div><div><br></div><div>From what Ali tells us, he went off the road, not wearing a seatbelt, and rolled "many, many times." During all this rolling he said he "went out the window" and landed in the sand. So, we're looking at the unbelted driver of a car involved in a multiple rollover with ejection. All he's got is a painful hip and a few cuts on his hand and thigh. </div><div><br></div><div>Yep, he's a pretty lucky guy. </div><div><br></div><div><i>--maddog</i></div> <br>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-43918880106323771652010-07-20T02:06:00.001+03:002010-07-20T02:06:43.222+03:00These hands<p><br />There are times when I look down and see my hands. Yes. Of course. We all see our own hands all the time, but there are times when I <em>see</em> them. <br /></p><p><br />My fingers are pretty long. Sometimes I think they're too long to be "manly."<br /></p><p><br />My fingernails grow too fast. I want short, unobtrusive nails that don't look shiny or pretty. However, they just grow that way (and fast!). <br /></p><p><br /><em>"Clip...clip...clip...,clipclipclip"</em><br /></p><p><br />Herself tells me that my hands are big and strong and make her feel safe. When she's not there: I don't see that. <br /></p><p><br />What I see is my hands being wrong for what I <em>want</em> them to be. <br /></p><p><br />I want my hands to be strong, <strong>every</strong> time. I want my hands to do the perfect thing, <strong>every</strong> time. I want my hands to be absolutely and perfectly "right on" <strong>every</strong> moment they touch someone. <br /></p><p><br />Every time I touch a patient, I question that. It doesn't matter how well I do my job. It doesn't matter how well (or poorly) my patient ends up. I will always look at my hands as if they belong to someone else.<br /></p><p><br />This is the worm of doubt. <br /></p><p><br />How did I do that?<br /></p><p><br />Did I do that right?<br /></p><p><br />Are these my hands?<br /></p><p><br /><em>--maddog</em><br /></p>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-24989694835919693772010-07-10T01:14:00.001+03:002010-07-10T01:17:02.732+03:00"And so I reach out my hand, and he grabs it"<p><br /><a href="http://pdxemt.blogspot.com">This guy </a>is a 'medic. And <a href="http://pdxemt.blogspot.com/2010/07/throat.html">this post</a> is a clear indication that he's a GOOD medic.<br /></p><p><br />"What's a good medic?" You ask?<br /></p><p><br />Well, that answer is complex, nuanced and full of opinion. I ain't ready to fight that battle in the blogsphere yet.<br /></p><p><br />However:<br /></p><p><br />All of us paramedics get the same training, to a point. We all have to pass the same (or similar) test to be blessed as a paramedic. There are folks who will argue the contrary but, please, for the sake of my posting, let's assume my statement is true. I'm sure I'll get a bajillion comments when I finally do post on what makes a <em>"good 'medic"</em> but today, I want to talk about <em>one</em> thing that makes <a href="http://pdxemt.blogspot.com/" title=" ">this guy</a> a "good medic."<br /></p><p><br />Some of the best in our profession don't try to be doctors. We don't try to be nurses. We recognize that this is what we do and we put effort into doing it better and into improving the efforts of those who come after us. There's a lot to be said for being a paramedic. There's a bit more to be said for being a <em>good</em> paramedic. There are <em>volumes</em> to be told for being a great paramedic.<br /></p><p><br />What is "that thing?" What is the one thing (if we can condense it down that much) that makes the difference between a paramedic and a "good" or, even, "great" paramedic?"<br /></p><p><br />The short answer for<strong><em> </em></strong>me is, "I don't know."<br /></p><p><br />But I do know what I've seen in the paramedics, EMTs, Firefighters, Cops and public servants that I've met in my job.<br /></p><p><br />We <strong><em>care.<br /><br /></em></strong><br /><br />When we do our job, no matter how busy our county/system/service/company is, we treat one patient at a time.<br /></p><p><br />When we have the privilege to treat them, they are the ONLY patient we've ever seen and ever will. It's the zen, hokagare, samurai way, or whatever you choose to call it, but it's what paramedics do. We are called upon to <em>consistently</em> deliver the compassion, care and individual feeling that makes that difference. Everyone who needs a paramedic becomes a member of our family. Some of us want to do well. Some of us are just tired of the dying and killing and some of us, honestly, want to really, REALLY, help.<br /></p><p><br />When the public (yes, you!) see us. You are at your worst. That only challenges us, further, to be at our <em>best</em>.<br /></p><p><br />Nobody is a 'medic for the money.<br /></p><p><br />Nobody is a 'medic for the groupies.<br /></p><p><br />We do it <em>(and keep doing it)</em> because we care.<br /></p><p><br /><a href="http://pdxemt.blogspot.com/" title=" ">This guy?</a> I hope someone like him comes to my house when I have to make "the call."<br /></p><p><br /><em>--maddog</em><br /></p>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-43288455686444043712010-07-08T14:05:00.001+03:002011-01-10T08:05:29.202+03:00Resistance is Futile!Let's talk a little about combative patients:<br />
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A combative patient is one that fights treatment or control. This can happen for a variety of reasons. When we talk about combative patients in EMS, typically, we're talking about folks who have a brain injury or are hypoxic (brain's starving for oxygen) and they start flailing about. You see, when the brain's in trouble, i.e. starved for oxygen, the body kind of goes into "freak out" mode and starts lashing around in an attempt to somehow correct its oxygen starved state. When you're the paramedic in a small box that's moving down the bumpy road at high speed with said combative patient, this is what is sarcastically referred to as, "fun."<br />
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Now, there are patients that are combative because of a physical injury. Then there are patients who are combative due to a chemical insult (too much booze, pills, or whatever they ingested, snorted or shot up) and then there are patients who are combative just because they're ornery! Yep. The injured a**hole. Now, technically, we shouldn't refer to these patients as "combative." That term is usually reserved for folks who do not possess the ability to make an informed mental decision and we've got to fight 'em for their own good. The very reasons they are in such a combative state also usually alters their mental faculties so that they can't give or withhold their permission for treatment. That's when we get "implied consent." and proceed to do the things necessary (we hope) to save their lives, etc.. <br />
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Now, let's go back to the <a href="http://dictionary.reference.com/browse/ornery">ornery</a> ones: <br />
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Some folks are just a pain in the butt. They get themselves all banged up, cut up, sick or otherwise in a bad way. Not enough to alter their mental state, mind you, but enough so that someone calls for a paramedic and they actually need some treatment. But they get stubborn and it's a constant argument to get them to let us do the simplest things. For example, I had a patient a while back who had an unfortunate meeting with his lawnmower. This 80-year old gentleman got tired of waiting for, "them darn kids" to show up and cut his grass that he went out, sandals and all, to do it himself. Well, needless to say, the mower somehow rolled back and he's a bit stubbier on his left foot than his right as a result. <br />
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We arrive, find him bleeding a bit, uncomfortable, furious, ornery and in full possession of his mental faculties. No, he doesn't want us to take him to the hospital. No, he won't let us bandage his foot. No, we can't start an IV and hook up the monitor. Who cares how many cardiac medications he takes, "I ain't goin!" All the while he's swatting at my partner and I when we get close, waving his arms around and being a pain. <br />
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In the time It took his wife, daughter, my partner and I to convince him to let us treat and transport him, I could have driven him back and forth to the hospital 4 or 5 times. Yes, I could have taken a refusal from him but I would have been back later when he finally gorks out! This happens more often than I'd like in the USA. <br />
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Now I'm over here in the Kingdom and there are a lot of differences. I don't see as many drunk, high or chemically altered patients as I did in the USA. I know they exist in the Kingdom but not where I practice, I guess. I also expected a lot more distrust and even open hostility to my white face and lack of Arabic language skill from many of my patients. However, that's just not so. <br />
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The men who have fallen under my care seem to be in one of two states: Dramatic flailing, wailing and hollering over the tragedy and pain or completely limp as if they had swooned. Usually, if they're in the first state, they quickly swoon with a melodramatic sigh as soon as a medical person shows up. I'm always so surprised at how uncomplainingly they put up with any of my treatments. A patient may cry out at an IV stick, sure, but he usually doesn't pull back, strike out or otherwise act "ornery." It seems to me that, once medical help is perceived to be on scene, the patient just gives all into Allah's hands and sighs all the way to the hospital. After fighting ornery, bloody lawn-mowing 80-year olds, It's a nice change!<br />
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I haven't had any Arabic women patients. Usually, they are brought in by their husbands to the ER directly. I'm sure if I ever do have an encounter with a female patient over here, It'll be seriously blog-worthy!<br />
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<i>--maddog</i>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-30254698493089578672010-06-23T21:01:00.004+03:002011-01-10T08:04:57.369+03:00Surfing the Chaos.<div><span class="Apple-style-span" style="font-size: small;"><br />
</span><br />
<span class="Apple-style-span" style="font-size: small;">We get called for a motor vehicle accident (MVA) a few kilometers away on the nearby desert highway. Though we are a company EMS service that exists to provide medical care to our own facilities, we are often called upon to help out the general public. No problem. I like the work. <br />
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My Arab partner, AJ, and I both hop on the responding ambulance since it was reported there were multiple patients. AJ gets in the back and I ride up front. Neither of us is driving. Over here, the ambulance drivers are, typically, company workers from other departments who are nearing retirement. They have no medical training, limited usage of English and, other than getting the cot in and out of the unit, aren't very useful to a paramedic on-scene. </span><br />
<span class="Apple-style-span" style="font-size: small;"></span> <span class="Apple-style-span" style="font-size: small;"><br />
</span> <span class="Apple-style-span" style="font-size: small;">We arrive at the place where two ribbons of asphalt meet in a "T" in the middle of the rocky waste of the desert. A small pickup truck carrying two young men went barreling into the intersection without considering the large lorry that had stopped to make the turn</span><span class="Apple-style-span" style="font-size: small;">. That is typical of how men drive over here. Just go fast!! The rest is in God's hands!</span><br />
<span class="Apple-style-span" style="font-size: small;"><br />
</span> <span class="Apple-style-span" style="font-size: small;">By the time we arrive, there are at least fifty men all standing around the accident scene, looking, talking to the victims, pulling them out of the car; It's chaos. The front of the pickup is trashed. The driver is sitting in the front seat looking dazed. There's a nice star on the windshield over the steering wheel. Ok, Got it.</span><br />
<span class="Apple-style-span" style="font-size: small;"></span><span class="Apple-style-span" style="font-size: small;"><br />
</span> <span class="Apple-style-span" style="font-size: small;">The passenger is lying on his back next to the truck. AJ and I can tell that he got out himself and laid down. He's pretty bloody from what looks like a busted nose but it's hard to tell what else. More on that in a bit. AJ and I have to physically push people out of the way to get to our patients. There's no concept of "stand back, the paramedics are here" in this country.</span><br />
<span class="Apple-style-span" style="font-size: small;"></span><span class="Apple-style-span" style="font-size: small;"><br />
</span> <span class="Apple-style-span" style="font-size: small;">The driver is swiveling his head back and forth and talking to people. I figure he's been there for about 20 minutes before we arrived, he can wait 5 more. (yes, It takes us that long to get there sometimes). I quickly decide to help AJ package the passenger. <br />
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Now. My USA readers must understand some key differences here: there is NO rescue squad, no fire engine blocking traffic, no reliable and competent rescue techs briskly deconstructing the wreckage to allow us easy access to the patient. Also, there is no concept of "get out of the way and let the paramedics do their job" either. Everyone who shows up either wants to get close and look or feels they can contribute by grabbing the nearest thing and pulling, pushing, hollering and getting in the way. I get more than a few angry looks as I use my 230 lbs to shove people out of the way between the patient and me. <br />
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Oh, police? Yes, the police are there. Probably the ENTIRE shift has come to the scene and </span> <span class="Apple-style-span" style="font-size: small;">parked their cars everywhere. Only about half of them have</span><span class="Apple-style-span" style="font-size: small;"> put their lights on. Are they controlling the crowd? No. They are a part of the crowd: equally shoving, pushing, jostling for a look and so on. <br />
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Like I said: Chaos. <br />
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Back to AJ and I with the passenger: AJ is chattering in Arabic with the patient. I do a rapid trauma assessment and find blood everywhere. Is the patient bleeding everywhere? No. He's wearing a </span> <a href="http://en.wikipedia.org/wiki/Thobe"><span class="Apple-style-span" style="font-size: small;">Thawb</span></a><span class="Apple-style-span" style="font-size: small;">. A </span><a href="http://en.wikipedia.org/wiki/Thobe"><span class="Apple-style-span" style="font-size: small;">Thawb (or Thobe)</span></a><span class="Apple-style-span" style="font-size: small;"> is a long, white garment that is traditional with Arab men. Imagine a white dress shirt that goes all the way to the ankles. They come in many colors but the most common is white and they're almost always made out of finely woven cotton. Which makes them an </span><i><span class="Apple-style-span" style="font-size: small;">excellent</span></i><span class="Apple-style-span" style="font-size: small;"> blood sponge. I'm serious. Get a nick on your wrist and before you know it, your entire sleeve will be red and drippy. <br />
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This guy's got a bloody nose, a busted lip and a cut on his elbow. It's making him look like an extra from </span> <i><a href="http://www.imdb.com/title/tt0365748/"><span class="Apple-style-span" style="font-size: small;">Shaun of the Dead</span></a></i><span class="Apple-style-span" style="font-size: small;">. Talk about challenges to patient assessment! Awesome!<br />
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AJ and I quickly get this guy collared, boarded and loaded in the ambulance. Now, there's two patients and we're basically the only available ambulance for about 150km. We move the patient from the stretcher to the bench-seat and secure him with the seatbelts. He's maintaining his own airway, able to answer my questions and, since we have no other choice, is left in the ambulance while AJ and I go get the driver. <br />
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Yeah, I know. I'm sure some of you who are EMTs and paramedics are shaking your heads and thinking, "Abandoned your patient?" or "The driver should not have been left. He should have been boarded and collared too!" <br />
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Yeah, I know, I know, I </span> <i><span class="Apple-style-span" style="font-size: small;">know!!!</span></i><span class="Apple-style-span" style="font-size: small;"> I was thinking the same thing! I had just arrived from the USA and had not yet grown accustomed to being completely unsupported. Yeah, we had about 50 bystanders but they were all medically useless. Even if I had additional resources to call upon, even the most basic of them would have taken 30 -90 minutes to arrive. If a Mass Casualty Incident is one which the number of patients exceeds the capacity of the local EMS to handle, then this was an MCI. <br />
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And that's how we do it over here. <br />
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So, back to the driver: AJ and I again have to wade through the crowd to get to this guy. Collar on, lay him down onto the board. Slide board onto cot. Re-assess ABCs and we head for the ambulance. The crowd is getting so pushy and curious that we need some isolation to work. We get to the ambulance and I'm astounded to see it </span> <i><span class="Apple-style-span" style="font-size: small;">full!! </span></i><span class="Apple-style-span" style="font-size: small;">There are about 5-7 Arabs in the ambulance. They're all talking to the passenger, kissing him, touching his head, one or two are weeping and one or two have a look of morbid curiosity on their faces. <br />
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Now, I've learned that my size and strange appearance (bald, beardless, big and, dare I say it?, burly) scares most of the Arab men I've met. I use this to my advantage. Out comes the "Sarge" voice and, even though I'm hollering in English, they get the message and clear out of the ambulance pretty quick as I go charging in. <br />
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We get the driver into the ambulance and divide our efforts. The passenger speaks a little English. He's mine. AJ discovers that the driver is asking the same questions over and over again and, though he denies losing consciousness, can't remember why he's there or how the heck he got into an ambulance. Both these guys are boarded, collared and can only look at the ceiling of our ambulance but they can hear each other. The driver is worried about the passenger. He keeps asking where he is and reaching out to touch him. The passenger keeps repeating that he's okay over and over again. <br />
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Yep! Driver's got him some head trauma! <br />
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Neither of these patients were in a hurry to die so, AJ and I didn't have too much of a challenge managing them medically. Our biggest challenge was physics. The driver of our ambulance (remember him?) has gotten so excited by all the drama, blood and people that he's driving the ambulance as if he were being chased by the devil. In all my years of having to deal with over-enthusiastic volunteer firefighter drivers, I've never encountered a ride as chaotic, bumpy, swervy and generally crazy as this!! Even in 35-foot (10 meter) seas in the Bering Sea, I had an easier time. <br />
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Keep in mind that, even though each of our patients presented with signs of pretty serious injuries, our treatment plan was constantly being adjusted and re-evaluated based upon priority, safety and the vagaries of the situation. If chaos is a sea, we do our best to surf the swells and keep from capsizing. Really!<br />
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Somehow, we managed to start a couple IVs, get some vitals, assess the patients, immobilize and bandage some injuries. <br />
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We survived the trip to the hospital which was chosen, not on the nature of the patient's injuries and the closeness of the facility but, as it works over here, by the employer of the patient. More on that later. In fact, my whole experience in a non-company hospital (we have our own) was so surreal and interesting that I think it deserves its own post with its own ruminations. <br />
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Suffice it to say that it was an eye-opening welcome to the world of EMS in the Kingdom. <br />
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My thoughts at the end of the call? "This is going to be a blast!"</span><br />
<span class="Apple-style-span" style="font-size: small;"><br />
</span> <i><span class="Apple-style-span" style="font-size: small;">--maddog</span></i></div>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0tag:blogger.com,1999:blog-6293450.post-80601550353850260632010-05-07T19:32:00.000+03:002010-05-07T19:32:29.379+03:00Holy crap! I'm back!I went on a short trip to India. Kolkata is INTENSE. <br />
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In the mean time: my laptop died, my home computer died and I got assigned to a remote area clinic even <em>deeper</em> in the desert. <br />
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At this Remote Area Clinic (RAC), I've had very limited computer access. The only computers available at work are the ones in the general emergency room and the attending doctor is is VERY nosy. I've stopped him a few times from reading over my shoulder. More on that later. <br />
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Well, now we finally have an office for the paramedics where I can blog in privacy. I have a few days off in about a week. Herself and I are discussing a drive to The Big City to get a replacement laptop. There's an Apple-authorized reseller and I need to see what the price difference is 'tween them and the USA. <br />
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Ok. I've actually had some calls and such. I'll be posting about that and paramedic life in the Middle East soon! I promise!<br />
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<em>--maddog</em>--maddoghttp://www.blogger.com/profile/08904887053919966765noreply@blogger.com0