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Wednesday, October 15, 2014

An EMS Instructor's Opus

by Steven P. Velasquez, NREMTP

Of all the courses I teach, I am probably most proud of teaching The Difficult Airway Course; EMSTM. (DAC).

There are many reasons for this sense of pride, not the least of which is how a student can immediately put these assessment techniques to work, immediately begin practicing airway management more safely and based upon best evidence, can begin driving better outcomes for patients.


Mark Bober NREMTP, Difficult Airway Course; EMS Instructor
and Clinical Manager - JFK EMS
 
Less than a week ago, our team took the DAC to J.F.K. Medical Center's EMS Department in Edison, N.J. The audience included everything from the newest paramedics in search of good information (and perhaps a couple of CEU's) to seasoned practitioners, flight paramedics and critical care transport nurses.

I personally have a near panic attack every time I get in front of a group of people and this group particularly because I directly work with many of them. I prefer the relative anonymity of being the "visiting team" where no one knows me, but that's just me.

Occasionally, someone pulls me aside weeks, months or years after they have taken one of my classes and they regale me with a story where some valuable nugget I shared or seed I once planted, emerges during a patient encounter and they say "thank you" for helping them - help someone else. There is no bigger reward in the life of an educator.

Richard Dreyfus playing the roll of Glenn Holland, a frustrated
composer who finds fulfillment as a high school music teacher
in "Mr. Holland's Opus".
Now I am no "Mr. Holland" and this may not amount to my "Opus," but I am as moved as Richard Dreyfus' character was in the award winning 1995 box office hit, by a few text messages I received today.

A young lady sent me a message describing a patient she encountered today. She detailed how the patient presented, highlighted the abnormalities that would certainly prove challenging if the patient decompensated, and ultimately told of how what she learned a few short days ago, changed her approach to said patient today. Her name will be left out, but the messages were as follows (my replies  have been omitted as they are not important):


"Just took a 450lb patient to the hospital.. In respiratory distress with a sat that started at 65% hellooo difficult airway class"
 
"todays job was such a great case.. granted i think the EMT thought i was crazy and thought i just kept talking to myself…. when really i was just thinking about plans in my head .. of the what if this happens."
 
"i swear when i walked in and saw this guy…….. first thing i said was….. can i bag him with a bvm… no… ok he's not getting a paralytic…. nor do i want to intubate him… failed 3:3:2. not a good cric can't landmark…. i was like this could get difficult."
 
"before the difficult airway class… i would have just walked in the doorway and shit my pants….. at least today….. i shit my pants and then went through the algorithms lol"

And there you have it folks, taking the DAC may not eliminate the biological stress responses one has when faced with a challenging patient, but at least you'll have evidence-based algorithms to follow as you make better decisions and reduce the possibility of harming patients.

Now go clean up and register for the next Difficult Airway Course; EMS!



Wednesday, September 10, 2014

The Invisible Patron

Steven P. Velasquez, NREMTP

 

A tired paramedic completed his night shift and greeted the beautiful summer morning with a smile -- and strong coffee. His unit was close to the home of his seven year-old daughter who lives with her mommy. He called the mother to see if they were busy. If not, perhaps he could spend the day with his munchkin. She agreed and they chose a venue somewhere between their locations, a diner with a retro 50's theme and customers to match. The place was busy, jammed, filled with what looked like a casting call for Ron Howards' 1985 movie "Cocoon." Walking through the door, a delicate ear could hear a gentle and homogenous hum, an alliance of sound, a mix of atherosclerosis and Elvis filling the air (and apparently rendering the tired paramedic invisible).
 
 
Tired as he was, and eager to read the book under his left arm, he moved to the rear of the diner and aimed his large body toward one of the last remaining seats, a booth. Standing before him -- and looking right through him it seemed -- the waitress gestured to a family that had just arrived by the front door across the restaurant. "Family of three?" she called, "I have a booth right here."

With a now furrowed brow, the tired paramedic looked at the waitress standing directly before him with her arms furiously flailing toward the family by the door. "Are you giving this booth away?" he pointed and asked. "They are a family of three" she sniffed, as she sidestepped him to allow the family's passage. "So is mine!" he said so other tables could hear, but no one cared. He felt slighted though his family had not yet arrived. He felt like an invisible patron but was too tired to make a commotion. He returned to the front of the restaurant and sat -alone- at a table for four, spread his books and notepad and began to read, though he was distracted by the stares and whispers of the "visible" patrons, seemingly upset at the view of a table for four only 1/4th occupied -- and during a busy time. Even the exciting vibes of Bobby Days' "Rockin' Robin" were no match for the judgment and scoffs of the elderly - the visible.

Finally, the paramedics' little girl ran through the door and leapt directly into his arms. Hugs and kisses followed and so did a simmering of the collective tempers of the white-haired, table jurors.
 
His family ordered breakfast and made light conversation, a necessity, as there are many reasons why Mommy and Daddy cannot live together anymore. They traded niceties.
 
A man in a booth against the wall seemed to be panting, clutching his chest and telling his wife he had tightness across his chest and down his left arm. Instinctively, the invisible patron rose from his chair and went to the man's aid. His daughter's mom ran out to the vehicle to get whatever equipment was in his duty bag from the night before. He introduced himself. He offered his name and said; "I'm a paramedic. I'll stay with you until help arrives. Tell me what's bothering you."
 
The man in the booth was warm and profusely sweaty. He clutched his chest and rubbed his left arm and hand. His pulses were palpable and of a normal rate. The invisible patron called his local dispatch center, identified himself as one of their paramedics -off duty- and requested paramedics to the diner for a man having chest pains. This act put the wheels in motion for the local agencies as they would now send police, a local basic life support ambulance  with EMT's (Emergency Medical Technicians) and a regional mobile intensive care unit with paramedics who have advanced education, skills and tools.
 
The police and an EMS unit from Munchfaster Township arrived and entered the crowded diner; a tight and narrow squeeze eased only by "Please Mr. Postman"; a Motown great by The Marvelettes. The Munchfaster EMT's took the patient to their ambulance and sped away. The paramedic unit never arrived as they were coming from a great distance. The invisible patron returned to his seat and re-joined his family (of three), but not before a round of "thank you('s)", "good thing you were here('s)" and "great job('s)!" erupted from the elderly table jurors.

The paramedic, I suppose, through his perceived act of kindness had finally joined the ranks of the visible.
 
Quite Visible
 
 

Wednesday, August 13, 2014

The "Sad Lightning" of Robin Williams

by Steven P. Velasquez
August 13, 2014


Little B and I visited my parents today. My mother uses me for two things usually, to create and transport grandchildren to her home, and to fix all the technical issues in said home. Today I had to re-direct her Facebook account to her new email address and connect a DVD player to her new HD TV. Her fascination with her oldest son faded many years ago and has transformed to a relationship of utility.

Abuela, a septuagenarian from Puerto Rico, sat in her rocker, gently rocking to and fro, while Little B watched "Mama Mia" on the newly connected DVD player. The afternoon air filled with conversation about current events, a custom born of retirements' boredom. The sadness of the passing of actor Robin Williams dominated the conversation and was only temporarily sidelined to allow for discussion of yesterday's passing of actress, Lauren Bacall.

Robin Williams as Dr. Hunter
"Patch" Adams

Abuela asked me if I had ever heard of or read the Spanish poem "Reir Llorando" by Juan de Dios Pesa. My reply, of course, was "no," as I have never immersed myself into anything other than English literature. She began reciting phrases from this poem, as if fresh in her memory. Who knew these were thoughts unveiled from the mind of a 13 year old, now 78?

She began to explain how she felt the words of this poem from her childhood, applied directly to the modern day "Garrid," Robin Williams.



Curious, I hit Google and found a version of the poem and nearly sprained my brain reading it. The poem is written in a very formal, Castilian version of Spanish
which really eludes my grasp. We made our best attempt to translate it and make it meaningful. I must admit, I was quite impressed with how much of it I did, in fact, understand. Its' beauty - exposed, its power - felt deep in my gut, and I found myself awkwardly (and rarely) agreeing with my mother completely. This poem was the story of Robin Williams - to a fault.

The link to the Spanish version is listed above. I also searched for a translation to English and found this in a Yahoo Answers forum. Ironically, it was only posted yesterday by "Carmenzmb" and she too agreed this was Robin's story.

**Note - Garrid (Sp) and Garrik (Eng) are interchangeable**


To Laugh While Crying (Reir Llorando)

Watching Garrik – an actor from England -
the people would say applauding:
“You are the funniest one on earth
and the happiest one…”
And the comedian would laugh.


Victims of melancholy, the highest lords,
during their darkest and heaviest nights
would go see the king of actors
and change their melancholy into roars of laughter.

Once, before a famous doctor, came a man with eyes so somber:
“I suffer – he said -, an illness so horrible
as this paleness of my face”

“Nothing holds any enchantment or attractiveness;
I don’t care about my name or my fate
I die living an eternal melancholy
and my only hope is that of death”.

- Travel and distract yourself
- I’ve traveled so much!

- Search for readings
- I’ve read so much!

- Have a woman love you
- But I am loved

- Get a title
- I was born a noble

- Might you be poor?
- I have riches

- Do you like compliments?
- I hear so many!

- What do you have as a family?
- My sadness

- Do you go to the cemeteries?
- Often, very often.

- Of your current life, do you have witnesses?
- Yes, but I don’t let them impose their burdens;
I call the dead my friends;
I call the living my executioners.

- It leaves me – added the doctor – perplexed
your illness and I must not scare you;

Take today this advice as a prescription
only watching Garrik can you be cured.

-Garrik?

-Yes, Garrik… The most indolent
and austere society anxiously seeks him;
everyone who sees him, dies of laughter;
he has an amazing artistic grace.

- And me? Will he make me laugh?
-Ah, yes, I swear it;
he and no one but him; but… what disturbs you?

-So – said the patient – I won’t be cured;
I am Garrik! Change my prescription.

How many are there who, tired of life,
ill with pain, dead with tedium,
make others laugh as the suicidal actor,
without finding a remedy for their illness?

Oh! How often do we cry while laughing!
Nobody should trust the merriment of laughter,
because in those beings devoured by pain,
the soul groans while the face laughs!

If faith dies, if calm flees,
if our feet only step on thistles,
the tempest of the soul hurls to our face,
a sad lightning: a smile.

The carnival of the world is such a trickster,
that life is but a short masquerade;
here we learn to laugh with tears
and also to cry with laughter.

Dear Robin, I did not know you, but I grew with you in my life. You entertained my family and I with laughter to the point of tears. 


Thank you for your art and your life's work. 

May God keep you forever more.

Saturday, July 26, 2014

Bringing Home Rebecca


 
by Steven Velasquez

 

This morning, New Jersey's Police, Fire and EMS agencies were called into respectful action for the third time in as many weeks, to bring another young, deceased, member of service home.
 
Flight Paramedic Rebecca Serkey's remains arrived at JFK International Airport early this morning to make her final journey home, following a fatal MEDEVAC helicopter crash July 17, 2014 near Newkirk, New Mexico.
 
Rebecca (29) was a NJ Mobile Intensive Care Paramedic with Holy Name Hospital MICU in Teaneck and University Hospital EMS in Newark before following her dream and moving to New Mexico, to work with TriState CareFlight. Rebecca had also worked as an EMT for Holy Name Hospital, Teaneck, Ridgefield Ambulance Corps. and others.
 
Today she was brought home surrounded by those who loved, worked with and respected her. Numerous EMS agencies including:
  • Montclair
  • Ridgefield
  • Teaneck
  • University Hospital
  • Jersey City Medical Center
  • Holy Name Hospital
 
Area police and fire departments, the Fourth Watch Motorcycle Club's mother chapter, the Knight's Of Life, and a large cadre of police motorcycle units including:
  • Fort Lee
  • East Rutherford
  • Cedar Grove
  • North Haledon
  • North Arlington
  • Essex Fells
  • Clarkstown, NY
 
Photo Credit: Dave Brierty and Lee Ruiz
Fourth Watch MC

 
The motor units provided an impressive and valuable escort (and some much needed safety).
 
The somber parade departed JFK, and due to traffic conditions on the Van Wyck Expressway, took a circuitous, but at least moving, route through Brooklyn. We crossed over the Verrazano, traversed Staten Island, then went over the Goethals Bridge before returning to NJ and making the final leg of the journey, up the NJ Turnpike into Fort Lee, where final services will take place Sunday, July 27, 2014.
 
Photo Credit: Dave Brierty and Lee Ruiz
Fourth Watch MC
 
 Rebecca, may you rest peacefully and may God comfort your family. Till we meet again.



Saturday, June 14, 2014

Transitions

by Steven P. Velasquez
June 14, 2014

My family, over the recent past, has been encountering (sometimes enduring) what seems to be an unprecedented amount of change, of transitions. From anticipated change like the long-awaited arrival of Spring, to special occasions that no matter how well documented, highlighted or punctuated they are on one's calendar, always feel like a surprise!


Nazareth Area H.S.
Class of 2014
A few weeks ago, we finally began to encounter temps over 50 degrees Fahrenheit. The days are longer and one's warm-weather wardrobe re-emerges from storage boxes beneath their beds. This week, my first born daughter Nicolette, graduated high school (so proud). Next week, she will blow out 18 candles, be eligible to vote, to serve in the military, to make her own decisions (I pray she makes good ones). A month from today, she'll leave her mother's nest, spread her wings and begin attending Liberty University in Virginia, about half-way between her parents (NJ & PA) and her oldest sister Samantha and grandmother Pat in Savannah, GA.




Happy Birthday Abuelo
 


A few weeks ago, my father Americo blew out candle-lit pancakes at IHOP, one of his favorite restaurants and guilty pleasures, for the 78th time. Happy Birthday Daddy.







Last week, we paid a surprise visit to the elders with my youngest, Little B, in tow. This is always a welcome event by my parents as they love their granddaughters more than life and air and the sun combined. One of their complaints in their new home in Toms River is the silence, the sound of time passing and their arteries hardening. They miss getting in the car and going places. They miss the sound of their children playing out in the street, as Mountain Way in Rutherford was more like a sports arena than a street corner during my childhood. Perhaps they even miss refereeing another fight between my sister Diane and I. Odd I know, but it was the activity, I suspect, that reminded them they were alive - and young - and vibrant.

It was late when I decided to scoop them up and take them out. They usually oppose my impulsiveness with their long, choreographed list of:
  •  How late it is 
  •  How tired they are
  •  Or how little money we have
That night they offered a gentle "Okay, where are we going?" I was surprised to say the least. I was going to pack the mini-van tight with three generations of Velasquez family and take them to where one is always reminded - that they're alive - and young - and vibrant.



Abuelo & Abuela on the boardwalk
Point Pleasant, NJ

 


Our destination was one deeply embedded in my family's DNA; a place my parents had brought me to since before I could walk. Our love for this location was reinforced with frequent visits during my youth, changes and transitions. Following this tradition, I have taken all my daughters there since before they could walk. Their love for this location was reinforced with frequent visits during their youth, changes and transitions too.
 
We watched with smiles ear to ear as Little B, Josh and Kimmie flew through the night, upward, downward, sideways and up again on the roller coaster. We chuckled as they smashed into each other on the bumper cars. I watched my aging parents illuminate, like proud, veteran candles.
 


Little B and Kimmie team up against 16 year-old Josh
Point Pleasant Beach, NJ


My father then leaned over to me and asked quietly;
"Have we ever come here before?"
 
I immediately covered my mouth with my hands and attempted to swallow my tears. My father has been showing signs of change and transition in the form of forgetfulness and cognitive impairment. This however really shook me. I had prayed memories like this would remain till the end, reminders of being alive - and young - and vibrant.
 
Remember Daddy, remember...
 


2006 Abuelo hold his youngest granddaughter
Little B

Saturday, May 3, 2014

Rain, Rain, Go Away, Rain Took Me Back - To An Earlier Day

May 1, 2014
by Steven P. Velasquez, MICP


Credit: www.nycareaweather.com
A soaking rainfall introduced us to the month of May this year. Most of New Jersey got between 5 to 5 1/2" of rainfall over twenty-four hours. The normally miserable morning commute worsened exponentially as roads were impassible, routines were disrupted and tempers flared.

My commute from the Keyport area of Monmouth County to Newark was one of them, but this guy ain't complaining, as my detours drove me into a chance meeting with a real-life "Ambulance Driver."

I abandoned the Garden State Parkway in search of perhaps longer, but at least moving, roadways. I traveled into Union County, past one of their submerged county parks, entered Kenilworth and out of sheer frustration, planted myself in a booth by a window to study Tranexamic Acid, eat some grub and spectate while my commuter cohorts sat paralyzed in their coffins trying to reach their daily grind.

The Kenilworth Diner was the perfect perch to sip coffee, read literature and listen to the locals discuss daily issues from their Medicare coverage (or lack thereof), to the bunions on their feet or the local propagandist tying the heavy rain to the certainty of global warming.

Who Owns That CPR Van?

http://cprtrainingnj.comMy work vehicle is a very distinguished, wrapped mini-van that promotes our CPR Training Center at Newark Beth Israel Medical Center. Sometimes mistaken for a local taxi service (I was once parked, texting, when my doors suddenly opened and several, Central Americans began to enter the vehicle asking for transportation. Quite the scare!)

A very tall man entered the diner, obviously known to everyone but me and begins querying out loud;
"Who owns that CPR Van? If I was still working, I'd flatten all his tires."
Not willing to "engage crazy" I remained silent. The locals and propagandists apparently knew him well and understood his sub-reference. Apparently, he was a retired undertaker and saw my business as a threat to his former business (if we're saving lives, he's out of business). Ahh! Gotcha. I continued with my research into TXA.

Several minutes later, he began asking everyone in the diner who's vehicle it was. The two doctors in the booth behind me sold me out. "It's his we think." He bellied up to the table and introduced himself to me. I invited him to sit down, and politely he began to explain who he was and inquire as to who I was and what my CPR mobile was all about.

George (I don't have his permission, so I won't use his real name) worked for two funeral homes in Irvington, NJ about 50 or so years ago. He told me stories that proudly began with the sentence; "Back when I was an ambulance driver" (mentally, I cringed in the booth with both hands over my ears like a kid in a classroom full of screeching chalkboards) and went on to explain how emergency transportation, in his day, was a rapid ride in a comfortable, but very fast Cadillac Ambulance. "We had absolutely no medical training" he laughed out loud as he waxed nostalgic. "On occasion" he said, "we'd give the patients 5.2 liters of Oxygen" when directed to do so by the physicians. I could tell he no longer saw me across the table, but the many patients he'd seen, and good times had, over his time; and I understood that look well. I knew not to interrupt it (never disconnect a man prematurely - from the Matrix).

What Is Past Is Prologue

Of  the many fascinating things George mentioned, I found his problems and complaints of the period eerily similar to ours today. Of them were feelings of futility from a limited scope of practice, frustration over not enough education to be of help, and ironically - fear of competition by who else?? Volunteers!

He explained the funeral homes he worked for used to earn $30.00 / trip for a pickup. $35 at night and an extra $2.50 for him personally if he had to respond from home. "Then came those rescue squads." The dawn of volunteer first aid squads had arrived and with it (these are his words, not mine) bored house wives who often couldn't lift or do the work required. "Sometimes they'd come over and ask us if we'd come help them lift. I told them go get a job!"

His laughter really picked up as he told a story of how the ambulance drivers used to bypass the ER and bring the patients right to their beds on the floors. "It was truly door to door, bedside service back then." He told of how one time, a patient had died in transit on the stretcher before him. He leaned into the window to tell the driver; "He's dead. I got nothin'" His driver instructed him to follow his lead. When they arrived in the ER, the driver placed his hand beneath the sheet to mimic movement of the patient so the ER staff wouldn't A: Turn them away and B: They wouldn't get hung up forever waiting for the medical examiner's office to come make a pronouncement of death. They bypassed the ER, avoided the M.E., and took the stiff right to their comfortable bed upstairs! "Let them handle it!" He laughed out loud.

Before you light your torches and grab your pitch forks, I'm not laughing at the anti-volunterism, the misogynistic tone, the questionably criminal deposit of the dead in a hospital or whatever your imagination is conjuring, so chillax! I find humor in hearing some of the same sentiments of today - from the septuagenarian at my table! It was a delicious view into a window of the past through George's eyes - and words.

Farewell Ambulance Driver

George seemed to snap out of his daydream, his eyes fixed on the boulevard before him. He turned his head to me, looked down at my pile of documents and excused himself. "I'd better let you get back to your work. Sorry to have been so long." He rose to his 6'3" height, smiled, turned and left.

I doubt I'll look upon his countenance again. But I'm glad today for the rain, the traffic, the detours and the look into the past, of the field I love so much today. I'm sure he'd disagree, but understanding how processes work, I realize I / we cannot have what we do today if it was not for the "Ambulance Drivers" of yesterday. I feel blessed to have met George.






Friday, March 7, 2014

Of Birds, Bread and Little B

by Steven P. Velasquez
March 3, 2014

This past weekend, my daughter's mother gave us a complimentary pair of tickets to a NJ Devil's hockey game. I'm sure I don't need to embarrass myself by offering gruesome details of financially difficult times, we all have them, some worse than others.

Anyhow, for a family that tries to make small things count, since small things are often all they've got, Little B and I tried to make the best of it - on a budget. So, instead of the overpriced foods of the arena, we were going to pack stuff from home and have us a Newark-style picnic. We prepared cold cut sandwiches on Portuguese rolls, wrapped them in foil and headed to the Pru (the Prudential Center Arena). She was bouncing with enthusiasm as she has blossomed into a devout Devil's fan, and she was spending quality time with her favorite father.

When we arrived in Newark and found parking. We walked to the Pru at a rapid pace (it was really cold and my head was chock full of flashbacks from working EMS in those very streets).

Once we arrived, it dawned upon me that we were probably not going to make it inside with home-prepared food on our person. Some cop-wanna-be, homeland security zealot would certainly mistake the foil-wrapped sandwich in my pocket for a hand grenade instead of a ham & cheese with mayo. So, we had to implement Plan-B (no pun intended).

We stood across the street and had a sidewalk picnic. We joked and ate and watched our exhaled breath dissipate before us into another family memory. I've discovered in life these precious memories serve as their own currency and don't require large capital investment.

Little B suddenly began crying and buried her face in my chest. "What the hell just happened?" I wondered. I tilted her head upward, reassured her and asked what was wrong. She, gasping for her breath, exclaimed; "I don't like the bread." She felt guilty because she thought I'd be upset at her for wasting food. "She's conscious of this even at the tender age of seven?" I questioned.

I reassured her that it was perfectly okay to eat the meat and spare the bread. And then I showed her how we can make use of her perceived waste. I explained how birds are in perpetual states of hunting for food and that we could break the bread up, toss some on the ground, and surely some would appear.

"But I don't see any birds Daddy." It's okay, Breezy (my pet name for her), believe me, they see us. We scattered a small amount and 1 or 2 began circling overhead. I explained to her how they were communicating with others and more would surely arrive. Within moments, we were surrounded by seagulls, cawing and squawking. She lit up with excitement as she enthusiastically tore and tossed more bread.

I explained that this was a lesson in leadership for when she gets older. Quizzically, she asked how so? "Behold" I said, "if you throw the bread fast and hard (like a manager with a new idea) they'll startle and scatter out of fear. If you promote your message gently and slowly, you'll build curiosity among a few - which later will attract a larger organization." She may not have perfectly grasped the vocabulary, but she indicated she understood the principle.

She tore and tossed, and tore and tossed until she had run out - and the gulls flew away.



Lil' B feeding the gulls at the Pru - March 2014

Thursday, February 13, 2014

I Pressed On - The Medic of La Mancha's account of the Blizzard Of 2010



by Steven P. Velasquez
Feb 13, 2014


Originally outlined (but not finished) in January 2011, I never actually put the finishing touches on this little gem. Today I'm sitting, quietly composing its' final draft, in the Yellow Rose Diner in Keyport, NJ, as we get clobbered with yet another of the endless snowstorms of 2014. I reached back into my archives and thought you might appreciate another of the Medic of La Mancha's not-so heroic tales.

A decade has passed since I last heard so many friends and co-workers speak with such granular detail about somewhere they were, something they saw -- or something they endured.  Two 110-story office towers had collapsed in lower Manhattan after being struck by fuel laden jet-liners in a terrorist attack.  Another plane flew directly into the Pentagon and a fourth dove into a field in Shanksville, PA after a valiant struggle between unarmed passengers and the blood-thirsty animals aboard. America, and freedom-loving people everywhere, were dealt a crippling blow that brought society to a standstill and galvanized a people united – albeit temporarily. 


"Never Forget September 11, 2001"
An "Interfaith Memorial" was held in Sayreville, NJ's

Waterfront Park just days after the terrorist attacks


Though far less dramatic by comparison, the end of December 2010 brought 18 to 32 inches of frozen precipitation followed by 60+ mph wind gusts to the Northeast U.S.  Initial reports said we might see a little, but probably more out toward eastern Long Island.  We brushed it off as a remote possibility as the forecasters seemed ambivalent about it, so why cause a public stir?  Within hours, the forecasts had become dire.   We were suddenly advised that a nor’easter was headed our way and packing a punch.  

Sunday afternoon, I spent the day preparing my plow truck, blower and hand-tools to go recoup at least some of two-thousand plus dollars I had just sunk into the rear end repairs to my truck.  Not to mention the five-hundred dollar TV repair, the Christmas expenses and my past-due school tuition.  This storm, I thought, should put me in much better financial circumstances than I was about to end 2010 with – I thought.


Facebook again served as a powerful advertising tool as I broadcast to friends and followers that I was available for hire to rid them of their snow-induced woes.  I went out Sunday afternoon and began making my first passes during the first 2"- 4” of snowfall.  My truck and machinery were performing well and as the snow continued to pile up, so did my appetite for the possible windfall profit I was in position to earn.  




I swung by the house to clear out some parking spots for my family and neighbors which surely would earn me my “most favorite neighbor” status that I enjoyed with each snowfall.  One of my supervisors from work called and asked if I would travel down to his mother’s house near Long Branch to help her. “Of course” I replied  “No problem.”  I figured I’d take care of her property then a few of her neighbors would see me and ask (or beg) me to do theirs.  It was about to be a great night!  

Friday, January 17, 2014

Squared Away

by Steven P. Velasquez
January, 16, 2014


We responded for a report of an unconscious person and when we arrived, were updated this would be for a pronouncement of death. Pretty routine event, and with (it would appear) greater frequency during the holiday season.

"Meah" we shrugged, "at least this will be an easy chart" and bring us about a half-hour closer to shift change.

He laid in bed upright in the cold, dimly lit room. Without getting into grizzly detail, it was a safe assumption his passing was recent by his presentation. Unlike so many other DOA's we respond to, his home was impeccably clean, disturbingly clean even. I poked around looking for anything we could include in our patient care report like his medications etc...


A police officer was at my side when we opened his cabinets (sometimes this requires more bravery than one might imagine). The sight in the cabinets now punctuated the pristine apartment we were scouring through. Like the Campbell's Soup Army, each can seemingly stood at attention with it's eyes (label) forward. "This is weird" I thought, "this guy must have O.C.D. or something."


The apartment had modest furniture, absolutely zero clutter, no foul odors, nothing. An open closet finally clued me in to this man's background. His suit jackets were hung to the left, dress shirts hung in the middle, buttoned top to bottom, pressed and facing in one direction, and slacks, geometrically perfect, pressed and hanging to the right. Beneath the clothing a shoe rack, polished, symmetrical and ordered by type (dress, casual, athletic).

"This man is a Marine" I said. The officer replied; "How do you know?" I shined my flashlight in the clutter-free closet and said; "Look." We turned to each other and simultaneously said "squared away." The officer informed me he too was a Marine.

 
 
 
As our search continued, I finally discovered the two pieces of framed wall art in the apartment. Proudly displayed above his TV was a certificate indicating when he joined the United States Marine Corps. The year was 1954. I looked up, squinted and calculated, the president was Dwight D. Eisenhower. The young police officer seemed impressed at my grasp of history. The second piece was evidence of this man's completion of his service to our country, his honorable discharge.

There was a somber tone in the apartment as I revealed my findings to my partner, a U.S. Army veteran and the second police officer. We performed what we came to do and turned over the scene to the police.
 
My suspicion was that this man had never left the United States Marine Corps despite his age and discharge. He reminded me of the immortal words of Gunnery Sergeant Hartman in Stanley Kubrick's 1987 blockbuster hit, "Full Metal Jacket."
 
"Today, you people are no longer maggots. Today, you are Marines. You're part of a brotherhood. From now on until the day you die, wherever you are, every Marine is your brother."
 
 
 
 
Judging by this man's appearance and household, I believe he died as he lived, and he lived as he was taught - six decades ago - Squared Away.
 
 
To all those have served, are serving or will serve in the future, on behalf of my family, and from the bottom of my heart, a sincere Thank You. Semper Fidelis.