Of God and Geography

by Steven P. Velasquez, MICP, NREMTP
Aug. 22, 2011

Sometimes the EMS calls we go on serve to remind us of how fortunate we are, if we're wise enough to understand the messages, hidden and not. 

One sunny afternoon I was detailed to a critical care transport truck with Bob (Bro) Casey, an MICN or Mobile Intensive Care Nurse.  For those of you not in the EMS field, that is someone who is both a paramedic and a registered nurse.  Working with Bob was always great because he was so smart, so cool and so unshakable that you knew no matter what happened, things would be ok.

We were dispatched to a home in New Brunswick, NJ for a child with difficulty breathing.  As we approached the scene, only a few short blocks from Robert Wood Johnson University Hospital, who also has a renowned children's hospital, we saw a single police car parked in front of the address.  We called on scene when the front door sprang open and a police officer darted out of the house with a limp baby in his arms.  He was performing chest compressions (CPR).  We grabbed the baby and got into the truck and went to work.  I radioed our dispatch center, “Med –Rescue 4 Urgent!”  No reply.  “Med-Rescue 4 Urgent Traffic!”  I heard field units asking the dispatch center for our last known location as they knew we were in trouble.  Coordinating another unit to assist didn't happen.  The police officer drove our truck and we did our best to resuscitate the baby. 

After dropping him off at the emergency department, we went out and cleaned our truck up and completed our paperwork (a form of documentation using an ink-charged writing implement with hand-written symbols on a carbon based material known as paper, derived from trees before electronic charting).

I thought for a moment that even with the grave circumstances this baby faced, how absolutely fortunate they were, even if reduced to the factor of geography alone.  This family spoke no English, were of Mexican or Central-American descent, I’m assuming were un or under-employed, uninsured and had little more than the roof over their head in the category of assets.  Yet, this very sick baby survived the event and received the best possible care one could ask for, despite their inability to pay for it.

The event caused me to contemplate my fortune in this world.  Born of a mother from Puerto Rico and a father from Peru, my life and future could have had many possible outcomes.   Had my father not trekked to the US in the early 1960s and met my mother, I might exist by another name, another set of circumstances and in a foreign land without access to everything people, even those without means, have here.  My father came here with his minimal life savings and approximately a 6^th grade education by American standards.  He worked over thirty years as a laborer in a textile mill in Passaic and married my mother, a bookkeeper. 

"It's going to be ok baby.
You're here."

‘Twas a twist of fate and perhaps the hand of God that brought my father here, introduced him to my mother and gave them their humble start in a small apartment in the City of Passaic and later a house in Rutherford where I grew up and was educated.  Like this little angel, I have benefited so greatly to be born and raised here in the greatest of nations known through the history of man.  I know not what my life would have been like had I been raised elsewhere.  I am relatively certain this baby would not have survived elsewhere.

For parents that chose to live here despite adversity and enormous risks.  For a land of opportunity -- for all. For the best health-care system anywhere on Earth, we're both thankful for God and geography.

"When Amateur's Attack..." - Well, not really. How about when they get caught on camera?

Please click on the link below.  Watch it in its entirety, then read the article below. 

Original video was shot by Jerry McCrea of "The Star Ledger".


http://videos.nj.com/star-ledger/2011/08/boonton_emergency_responder_i.html 

A recent shooting of two people in Boonton, NJ as they walked with their three year-old son has left this Morris County town, and its emergency responders, reeling.  The event triggered the obligatory news coverage including the video linked above above.  


A fellow paramedic called my attention to the video he posted on his Facebook page.  He was deeply disturbed by the video.  There were already over 25 pretty angry responses insulting, shaming and blaming the EMT for perhaps a bit more than she could possibly be responsible for.  There were insults to her speech patterns, calls to remove her certification, eliminate her from the field and some other unsavory comments too. Typical responses from a group of otherwise honorable people who are tired of being misrepresented in the media and on TV - especially by (clearing my throat) "one of our own."


I understood where everyone was coming from as the video delivers yet another (as if we needed it) black eye to the emergency medical services as the casual observer can easily assume she is an accurate representation of EMS as a whole, and we're all cut from the same fabric as this young, amateur provider.  


After careful examination of the video, and being as disgusted with it as they were, there was something else glaring at me and it came from the father side of my equation more-so than my paramedic side.  My reply to the group is included below.

"I'm with all the veteran and experienced providers here, but am also looking at the part that screams out here -- she's a baby. She's 21 and rides in a low-volume, suburban system. Her admissions were not those of a veteran EMS professional with years of service and dozens of traumatic experiences in her toolbox. She's a kid. A kid who saw something frightening and possibly life-changing for her. As a father of a 21 year-old, I often have to look past or forgive the un / under-developed thoughts of my daughter. I run into the circumstance where I can be "right" or I can be a good and patient father. I try for the latter.

To pin all the woes of volunteerism, a poor education system, lack of oversight and standards, the battle between paid and unpaid and the unsolvable problem of male pattern baldness on the unrefined words of a little girl, I think, may be just a bit extreme.

Sure it was painful to watch and listen to. She should have deferred to someone else with either the experience or the authority to make a representative statement. She probably didn't know what to do, shit or go blind when a camera and mic appeared before her. She lacked the equanimity that a cadre of speech-writers and a room full of teleprompters offer our president (Sorry Shaq, I couldn't help it. You know I'm teasing!)

She's not the worst representative of an incident I've seen on screen. One only has to go back to late December 2010 when the NYC Mayor, Michael Bloomberg (not a 21 year-old) made an ass of himself criticizing and slapping the very EMS professionals that endured the insurmountable task of responding to the blizzard of all blizzards.

As stated, what she said was wrong in so many ways and embarrassing in even more ways, maybe I'm the one who's wrong here, but guys, she's a kid. Nothing more."

I suppose my point is this.  If you're new to the biz, are not a designated PIO (Public Information Officer), have no experience with media relations, don't fall into the trap of opening your yap.  "No comment." or "Please direct your questions to..." work just fine.

To my veteran brothers and sisters I'll summon a Chinese proverb; 'Do not remove a fly from your friend's head with a hatchet.'   This EMT, if she remains in the field, is going to have to live her life as being "that girl."  The one who fell apart, abandoned a patient, made unqualified statements about the presence or absence of life of the patient etc...  Her life, like all of ours, is not summed up in one moment in time.  Her life, like ours, should be judged on nothing less than its' entirety.

What say you?

The Question Is - 'Why Do I Want To Be A Paramedic?'

By Devin Kerins, B.A., MICP
Aug. 13, 2011

So you passed your EMT class, found an ambulance to climb aboard and are now contemplating taking the plunge into the next phase of EMS?  Or perhaps you're a 'seasoned pro'  EMT who is wondering if you should advance your career?  Either way, you're probably wondering when the time is right.  It's a huge commitment in time, with great responsibilities and even greater personal reward, but whether or not the time is right is never an automatic 'yes.'  So let's start by examining the most important patient of all -- you! 

The first question you need to ask yourself is "Why did I want to be a paramedic?  We all have our own reasons for getting into EMS.  Some get into it out of a genuine altruistic desire to help people. Some get into it because it's a great stepping stone to a career as a nurse or physician.  If you're like me, you got into it because you get to drive a flashy truck, scoff at major traffic laws, and chicks dig the uniform.  Okay, well that isn't entirely true.  But I did want to help people and did want to go to medical school -- we'll just gloss over the fact that I failed organic chemistry miserably.  But ask yourself, why do you want to be a paramedic?  Do you want to do it because of a need to do more for your patients?  Do you want to do it because it is a logical progression in career?  Do you want to do it because the pay is better and you want to provide for your family?  Whatever your reason, hold onto it, because it will be your driving motivation through the arduous medic program.  Just make sure your reasons for wanting to be a medic are strong and rational enough to push you through the next two thousand hours of school and clinical time.

Next you need to question yourself and see "How much experience do I really have?" Is the ink still dryin on your EMT card?  If so, now might not be the right time for you.  Sure, you can find a paramedic program who will gladly accept you and take your money, but that doesn't necessarily mean it's the right thing to do.  As Groucho Marx said, "I wouldn't want to be part of any club who would have me as a member" -- it shouldn't be that easy.  Give yourself some time to learn the basics first.  Experience some stressful situations and see how you react.  Watch someone die and see how it affects you (Please note: I am in no way advocating you do anything to hasten that one along).  No one in EMS has ever seen it all and done it all, but you can see a lot and do a lot, and it's important to see and do as much as possible to know how you'll react in stressfull situations.  Remember, as stressful as you think being an EMT is, there isn't much you can do to kill a patient -- short of running them over with the ambulance or tossing them down a flight or two of staris.  As a paramedic, you truly hold someone's life in your hands.  If you think that's dramatic, give a read through all of the various medications and procedures paramedics carry and can perform and see how easily at least half of those could terminate someone's existence.

Finally, ask yourself "what kind of student am I?"  If you just barely eeked by in EMT school because you never opened your book or human resources policies prevented the school from failing you out, now is definitely not the time for you.  If you can't remember what kind of student you were because it has been so long since you were in a formal education setting, now might be the time for you but I'd recommend doing some research on better studying techniques.  If you have a thirst for knowledge, and a realistic appreciateion of how much of your life has to be devoted to passing your class, then this is the right time for you.  Paramedic school requires a lot of studying.  You owe it to yourself and your future patients to make it your top priority for the next two years to study you trade and hone your skills.

Once you've done the above soul-searching, look at your current situation in life tnd see if you can devote the time you'll need to school.  If the answer is a resounding 'no', do not force yourself.  Wait for you situation to change, and try to learn as much as possible from the paramedics around you in the meantime.  If the answer is a 'maybe' it might shock you to read me say "go ahead and do it!"  Unless you absolutely, positively cannot do it at this particular moment, I strongly encourage you to go for it if there is a chance.  If not, something in life will inevitably come along to derail your motivation train.  There will always be money problems, there will always be family problems, but you need to push through if you think there is a chance.  Otherwise, you'll watch you opportunity waltz right by.

This blog isn't meant to discourage anyone from being a paramedic.  It is to set you up with some manageable expectations.  Paramedic school isn't brain surgery, but it isn't a walk in the park.  It can be a lot of information to process, but it's not organic chemistry (who doesn't love call-back jokes?).  But above all else, paramedic school requires a major commitment of you.  Make sure that you are ready to fulfill that commitment with the very essence of your being.  Peoples' lives really do depend upon you now, and you need to takle that seriously. 

Having said all that, good luck with your decision.  And regardless of whether or not you decide to go on to paramedic school, be the best EMT you can possibly be!

Devin Kerins is a 17 year veteran of emergency services in New Jersey.  He has been a paramedic for the past 8 of those.  He is also a career emergency manager, serving as the Planning Section Chief for a regional incident management team.  He has parlayed his love of the job, eye for detail, and sarcastic humor into writing.  His books of EMS anecdotes "EMS: The Job of Your Life" and "EMS 2: The Life of Your Job are cult classics among EMT's and paramedics around the country.  His novels "Aim High" and "Lotto Fever" are also available online. 



 

Harley Therapy - "The Summer Wind" and Riders Errant

by Steven P. Velasquez
Aug. 8, 2011

This past weekend I found myself in an unfamiliar position. My calendar was clear; no work, no teaching, no family obligations. One daughter, Nicolette (15) was in Phoenix, AZ with her mother at a fine arts festival and my youngest, Brianna (4) was with her mother in Boston, MA for a weekend getaway. As always, there was plenty of opportunity to pick up shifts at one of my employers but, like a recovering addict at a bar, I said no and removed myself from the situation. My calendar was clear but my mind was not. It was time for some Harley therapy.

In my traditional form, I mounted Rocinante, my trusty steed, and headed in a direction dictated solely by happenstance. That direction was south and this rider errant, "the Medic of La Mancha," was off on yet another two-wheeled adventure.

I packed what I could fit in my saddlebags; some books, my laptop, my camera equipment and even some clothes and toiletries.

About 75 miles into the trip, I left the Garden State Parkway (no real reason why) and entered the town of Smithville, NJ which, according to the welcome sign, has been here since 1637!  I felt like I had gone through a window in time.  You'll see why shortly. It's an absolutely gorgeous day with temps climbing into the 80's.  I traveled down Route 9 and visited a local Wawa. While outside the store enjoying an enormous Granny Smith apple, my mind began to wonder; how is it possible this is the same Route 9 that runs through the Newark and Jersey City areas? Route 9, home of hot sheet motels, heroin and homicides is also home to the summer's scent of salt water, the sound of seagull's and steeples tall (on churches that is).

Seagull's weren't the only crooners on this day. A brown Mercury is parked before me with its windows down and the stereo blaring. The sounds, strangely not annoying, were familiar, but of an era not mine. "Old Blue Eyes" (Frank Sinatra) is belting out "The Summer Wind" and the driver, an older man, is seated seemingly transfixed, waxing nostalgic, probably of summer's gone by.

A pickup truck parks and a man with a weathered face and a distinct southern twang sees me looking at a map. Unsolicited he asks where I’m headed. “No idea,” I replied. “Cape May Ferry perhaps?" He offers me directions, south on 9 till I get to a country club, then go right on Jimmy Lee’s till you see the Parkway. "How polite" I thought. I asked where he’s from. He replies; “Texas.” I asked what brings a man from Texas to New Jersey? “My wife" he said. Jokingly I counter, “Are you still mad at her?” He didn’t smile. He drew a breath and replied; “She’s passed.” YOU IDIOT! I thought to myself  as I seemingly shrank to the size of an action figure. (I actually envisioned my mortified mother whacking me about the head repeatedly with her chancleta (slipper)) He seemed to forgive my gaffe and stared intently at my bike. By my estimates, his stare was 10% admiration and 90% nostalgia as he pleasantly relived his own riding history.

Today, he works as a boat mechanic and remains in NJ because of his family and grandchildren. His mind however, still lives upon his Indian motorcycle traveling across six states decades ago. He readily regaled me with some of his favorite encounters. I could tell as he spoke he was no longer here and, as if I were a ghost, he didn't even see me standing before him. I wasn't offended. He was "in the zone."  I fully understand that phenomena. Because, like a young fool, I often try to explain it to others. But, like trying to describe what a banana split tastes like to a blind person, it's something one can only appreciate after living, tasting and feeling it. It is an experience reserved for people like us, the rider's errant.

I Just Love Distracted People!

By Steven P. Velasquez
August 1, 2011

I'm sitting here in the Livingston Diner trying to calm my nerves before going into work tonight.  My coordination betrays me as I've survived yet another, if not "near-death" then at the very least "near maim" experiences.

It's a beautiful summer day with temps in the 80's, a brilliant sun and perfect traffic patterns as I trek northward to the land of the affluent, Livingston, NJ.  While motoring along on "Rocinante" (my trusty iron steed made by Harley Davidson), following traffic laws, wearing protective gear, sober and well-rested, I signaled that I was moving into the right lane.  A quick glance at the mirror and a brief look over one's shoulder is usually enough to verify the coast is clear and you can proceed safely.  I did however; mention this is New Jersey where motorists tend to violate not only motor vehicle laws, but often the laws of physics too.  The most common law being broken is the one where "matter cannot occupy the same space."  In the instant that my eyes returned to the forward position, a car appeared suddenly on my right causing me, on my already leaning bike, to tap the brake, upright and quickly scan for options on my left - of which there were now none.  A shiny white BMW saw my mild gesture to the right and obsessively blasted her accelerator to immediately occupy my now partially vacant spot.

Both brakes are now engaged, my deft (no, not left!) foot quickly down-shifting, the engine roaring, my pupils dilating whilst every sphincter of my tense body constricts preparing for the seemingly inevitable!  I was close enough to manually unlock her door if I had to.  Fortunately, I was able to avoid dire consequences and a trip to visit Dr. Jellyfinger and the broken bone team at my local trauma center, with only the beads of sweat on my forehead.  Whew!

Me before ending up under your car

At the next stop-light, I pulled up alongside the privileged beauty (she was gorgous I'll admit) and took advantage of her open window.  I mustered the most menacing face I could make and yelled "I have three beautiful daughters!"  (I know, real bad-ass right?  I'm considering auditioning for "Sons Of Anarchy").  "What?" she replied as she put down the cell-phone and lowered the radio.  "I said I have three beautiful daughters!  Your aggressive driving is going to kill someone!  I want you to know who's life you're taking!"  I guess it now registered in her distracted, little mind that I was a lunatic and perhaps dangerous.  She began rolling her window up and looking to get away from me. "Dumb bitch" I thought aloud.

I often get to see not just the carnage caused by people like her, but the shattered people that cause the problem in the first place as they're overrun with remorse and pain often bellowing out "I'm sorry!" or perseverating "I didn't see him, I didn't see him..."  How hard is it to just avoid the circumstance in the first place?  Is it really so hard to drive attentively? Share the road?  Think before you act?  All of these, to me, seem much easier, but then again, I have a stable career because of such behavior.  I'd just really rather remain a patient care provider vs. a patient. 

Alright, the tremors are gone.  Check has arrived.  I'm off to work.  Please drive safely and watch for motorcyclists.