Research

I’m on the 40 minute flight from Phoenix to Vegas for two back-to-back conferences any reader of this blog better already know about. As usual, the drama is already starting with rumors, innuendo, on-stage battles between presentations, the ever-elusive hunt for the next *-gate, and the always popular feats of strength. But I’m not going to talk about that. Drama is one of those nebulous concepts slightly more elusive than porn; sure, you know it when you see it, but unlike porn you have a hard time noticing when you’re in it. Let’s be honest, we’ve all been in the middle of more than a little drama in our lives. The problem with drama is that it doesn’t benefit anyone except the press, and maybe some sadistic bystanders. It certainly doesn’t benefit those involved. Drama raises emotions, lowers reason, and devastates credibility. It’s hard to take someone seriously when they get all “woe is me” on you. I remember one of the more dramatic incidents I responded to in an ambulance. A woman ran over a child outside of a school. She more just bumped the kid with a couple ton car than any actual running-over, and while serious, it was clear the kid was going to be okay. The woman? A friggin’ mess. Hysterical screaming, ranting, and full-body-rending spasms that completely distracted everyone from the kid on the ground who needed medical attention. That drama reduced the care the kid received, at least until we showed up, ended up requiring a second ambulance for the woman (not the cheapest mode of transport in the world), and did nothing but make a serious incident even worse. Another rescue drama was one of the more heart-wrenching calls I ever responded to, with a far worse outcome. I was responding on a mountain rescue call for someone lost in an avalanche. His hiking partner was a total freak-job, evading the truth (out of guilt) and recruiting his college friends to engage in their own private search (big no no). At one point I remember flying up a snow-covered trail, closed due to avalanche danger, in a Jeep driven by a park ranger with an even less-developed sense of self preservation than I have to help the Sheriff’s Officers remove the individual. In the end, the victim wasn’t in the avalanche and probably died of exposure a mile or so away before the first rescuer showed up. The drama of the survivor and his changing stories did nothing more than pull valuable resources from where they needed to be, and destroyed his credibility. To this day I’m convinced his ego killed his partner. Sure, these are extreme examples, but in each case those involved lost credibility and respect while distracting both bystanders and those there to fix the problems from the real issues. In a less-extreme example I’m still embarrassed for some of my own attempts for an Academy Award for Best Victim in a Drama for a couple of bad breakups in college. I let the drama take over, and to this day my friends still occasionally remind me of those antics when I need to be put in my place. Leave the drama for entertainment. When another industry engages in it, all it does is hurt the credibility of those directly involved, and anyone associated with them. It’s hard, but we need to sometimes divest ourselves of emotions and let the facts and events play themselves out. Share:

If you read this, you know why. Arriving Tuesday, departing Monday. Probably at Hotel Paris since I didn’t get my stuff together in time. Share:

Dentist: You shouldn’t feel any pain. Me: Great. Dentist: Now close your eyes to keep the debris out. Me: What? Ah, yet another one of those painful maintenance tasks. The follow up instructions tell me no alcohol tonight, and no drinking from a straw. Which sucks, because that totally blows my usual Thursday night routine. Share:

As I may have mentioned, we moved into a new home about 3 weeks ago. This isn’t the first home I’ve owned, so either things have changed since I bought my last house, or it’s different when you buy a new build. According to our postal carrier, we’ve been getting mail here since long before we moved in. Technically before we knew our physical address (we just had a lot number). What kind of mail you ask? SPAM SPAM SPAM SPAM SPAM SPAM SPAM wonderful SPAM Landscapers. Blinds. Water treatment. Closets. Garage organization. You name it, we got it. Now most of that you get pretty much anywhere, but there’s one kind of snail-mail SPAM that’s really pissing me off. Mortgage stuff. A lot of it. Mostly predatory “mortgage insurance”. “What happens if you or your wife lose your ability to work?” garbage. My favorites are the “mortgage cancellation” programs. “You are not taking advantage of your mortgage cancellation program, contact us immediately”. Cancel my mortgage? Works for me, You gonna pay? What’s annoying is that all of these “services” know who my lender is, and the amount of my mortgage. I figure either my lender probably sold us out, or maybe it’s a subscription service from a credit service. Either way, I figure there must be enough idiots out there for this stuff to work. Snail mail, while cheap, isn’t nearly as cheap as email, and this stuff has to show some kind of returns. Sigh. Where there’s prey, there’s predators. Share:

As I’ve mentioned before, I’ve been doing martial arts for a while; most of my life if you count high school wrestling. I recently switched from Traditional Taekwon-Do to Karate after moving to Phoenix. One of the things I love about martial arts is how many lessons on life you can draw from it. I had another one of “those” experiences Tuesday night. Where I train is more than just a Karate dojo- there are three training floors with a bunch of different instructors from different arts; each a real instructor in their art, not just some dude with a black belt in one style, and 3 random classes under his belt in 8 others. A couple weeks ago they started a Mixed Martial Arts program (MMA). Yep, we’re talking Ultimate Fighting Champion! While I like to delude myself into thinking I’m too pretty to fight full contact at the ripe old age of 36, you can attend the class without going to the nose-bursting extreme. The combination of switching styles and playing with MMA really highlights something about most martial arts. While one goal of sparring is supposed to be a way to simulate a potential real-life fight, most arts end up constrained by whatever rules they decide on for sparring and tournament competition. Problem is that none of those rules exist in the real world. In TKD you can’t grab or throw, so there are a lot of high kicks and multiple kicks. In Karate you can do basic grabs and throws, so I quickly learned to pull that leg back in darn quick. But in Karate certain kinds of techniques don’t score, even though they could do some damage if they connected. For example, there’s something called a hook kick; I’ve noticed in Karate that the version taught is not a version you’d ever use for real- it’s totally worthless outside a tournament. Because of the rules, most tournament matches are won and lost off a few basic techniques, so that’s what you spend most of your time on in class. It’s the same for pretty much everything- boxers don’t have to worry about takedowns or kicks. Wrestlers don’t have to worry about getting kneed in the face. No one has to worry about getting kicked in the nads or fighting more than one person at a time. As one of my instructors in Colorado puts it, “any martial art is only as realistic as the last time it was used in combat”. In nearly every martial art I’ve trained in, the rules for sparring and tournaments have a dramatic influence over the techniques a student learns. Even MMA has rules, and being more of a sport than a specific martial art those rules define how people train, and how you train defines how you will react- be it in the ring or on the street. Now most of us don’t get into all that many street fights anymore, but this is one of those analogies that easily extends. For example, how many of you, in your day to day job, expect your customers to behave according to the arbitrary rules of your business and become upset when they act differently? A customer/client/john might ask you for something simple outside your normal process, and even if it’s easy, even if it’s beneficial to both of you, even if it doesn’t violate policy, your instinct will be to say no. Why? Because you don’t think you can do it. You’ve allowed arbitrary rules to define your capabilities. As Rob Tobin, another master instructor (and great friend who died long before his time) once said while we were doing some business together, “don’t make it hard for people to give you money”. And the worst culprit? Compliance, but I’m not going to talk about that here. As a martial artist I constantly strive to train according to the rules without letting them limit my capabilities. To be honest, it’s a lot easier to do on the training floor than in my professional and personal lives. Keep it real. Share:

We’re in the new house and I just fired the Roomba off for the first time. This house is a lot bigger than our last one, and the Roomba was basically roaming the entire first floor. It’s been running for about 40 minutes now. Within seconds of walking downstairs (I’m working upstairs) it turned, grimaced, and headed straight for my feet. Considering the floorspace involved, the statistical odds of this happening are low. Very low. And that’s not counting the grimace. We have a lot of tile, and the Scooba is sitting in the garage, waiting for some floor scrubbing action. But I’m worried they’ll team up. I’m even more worried the Scooba will convert its cleaning fluid into a deadly nerve agent. Share:

I’ve been pretty quiet for a couple weeks since we were getting ready for the new house, moving into the new house, and dealing with all the fun new house issues. The good news is the house is incredible- it’s been amazing to design and build this thing almost from scratch. Nearly everything is exactly the way we want it; it will be a long time before we have to do any kind of upgrading. The community is even better, and one of the main reasons we picked this area. Our neighbors came over this weekend to introduce their kids (to our cats, since we don’t have kids) and they brought cookies. Cookies! How often does that happen anymore? The bad news is the builder (Toll Brothers) doesn’t quite understand that customer service is still important after someone buys their product and moves in. We had a number of things identified on our last walkthroughs that weren’t completed. Eventually, our construction manager just stopped answering his phone or returning calls. We’re now on warranty, and I’ve submitted our issues, but we’ll see how well they respond. When I mentioned my exasperation with construction to our neighbors they gave us a knowing grin. Our experiences aren’t unique, and once Toll Brothers gets you into the house their responsiveness drops significantly. It’s too bad; our build experience was great, but last week they drove me to drink. And not in the nice way where I give them my keys. I took almost 2 weeks off work to get the house ready to go, and literally lost days of my vacation waiting around for imaginary service calls. They wasted my time for no good reason than they didn’t have the honesty to tell me they wouldn’t do the work, or would get to it later. That bothers me. A lot. I won’t bore most of you with the details, but a blog is a good place to record certain experiences for posterity, and it’s the only public outlet I have to express my dissatisfaction with my home provider. Build experience good. Post-build experience bad. Hopefully it will change, and maybe someone out there will be better prepared when they make the new home plunge. For the record, from what I hear, no builder is any better. Share:

I was one shit hot paramedic. All you had to do was ask me. I was smart; no question about that. So smart that I was accepted to paramedic school (p-school) due to some really high test scores, despite being a year or so short of the required amount of field experience. I started school when I was 21, basically the earliest you can drive an ambulance in Colorado due to insurance requirements, and was one cocky 22 year old by the time I graduated and went on the job. I think I graduated number 2 from my class- on test scores at least. Since most of the men reading this have probably been 22 by now, and most of the women have had to deal with 22 year old guys, you can probably see where this story is going. (spoiler) For those of you that want to skip to the end, the short version is that brains and ego alone can’t ever compensate for real experience. Oh yeah, and Soylent Green is people. And Snape killed Dumbledor. And Tony Soprano got whacked. They said like 3 times that it all just goes black, and it went black; seems pretty darn obvious. (/spoiler) So there I was: 22 years old, filled with my own confidence, and ready to change the face of emergency medicine. A few months after graduating p-school I started my first full time paramedic job working for a company called Foothills Ambulance out of Golden, Colorado. Foothills wasn’t what you’d call a very professional organization. Our headquarters was basically a condemned shack with a few bunks and enough parking space outside for a couple ambulances. I’m not kidding about the condemned part- the only reason it wasn’t to down was because the fire inspector knew better than to stick his head inside the door. The working conditions weren’t much better. We were expected to work at least 60+ hours a week and weren’t paid overtime. Illegally. The owner made it clear that if we ratted her out she’d drop everyone to minimum wage and 40 hours a week. Heck, one time the drain cracked, dumping water and refuse into the crawl space below the small kitchen, and we only noticed when the smell finally started freaking people out. Management’s answer? Buy some lye and make one of us crawl in there ourselves and spread it around. Why did we put up with this? Foothills was one of the only companies in the area (nearly everyplace was a private company, not a municipal department) that would let every rig run 911 calls. Nearly everyplace else required years on transfer cars running back and forth between nursing homes before you gained enough seniority to use those lights and sirens. As far as I know, these days all that’s left of Foothills are a few t-shirts buried in rag piles. Even our noble “headquarters” is probably long gone. I managed to get a job there thanks to my roommate who was working for them as an EMT. I was totally psyched- there I was, fresh out of school, and I’d be running real emergency calls. So psyched I managed to sleep through my alarm the first day and showed up 40 minutes late for orientation. Not the best start, and it probably didn’t get better. Most places start you off as a third-rider/candidate working under a senior medic called a Field Training Officer. You spend a few weeks learning your way around, the department’s protocols, and having your skills evaluated. (Except Jersey City- when I worked there it was 3 shifts and you were on your own; getting lost with lights and sirens running is always tons of fun). I started to learn pretty quickly that my lack of experience was a bit of a liability. I was far from polished, but good enough I probably wouldn’t kill anyone. Actually, as a medic you really have to screw up to kill someone directly- it’s more along the lines of not effectively preventing them from expiring that’s the problem. Eventually I muddled through the program and was handed the keys to my very own ambulance, with my very own EMT partner. A really cute one. With red hair. I’d like to blame the next part on her for distracting me, but alas, it was my own stupid ego. The day started slow; I think we maybe just did a transfer or two. After dark we finally got our first call. I was excited. I was pumped. My very first call as a solo paramedic on a paid ambulance (I was also volunteering somewhere else at the time). We were dispatched to a local trailer park, one of the nice ones, for an elderly patient with altered mental status. This can mean pretty much anything from a drunk to a room-temperature body (you’re not real responsive at room temperature, unless the room is 98.6 degrees). More often than not, at that time and with that kind of call, it’s some sort of medical issue. We rolled up and I let my partner lead. We often let the lesser-trained EMTs run calls as training experiences. Personally, I was trying to show off to a cute girl. We walked up the stairs into the trailer and were met by a neighbor, also an older woman, who showed us to her friend sitting in the living room, not very responsive. Up to now all was good in ambulance-land. It didn’t last. There are a lot of things that can make someone act weird. This patient was staring off into space, and wasn’t very cooperative. She’d fight everything we’d try to do. Sure, it could be a head injury, drug interaction, hypothermia, or dozens of other medical problems, but in this case the odds were strongly in favor of hypoglycemia- low blood sugar. Mostly because she was diabetic. And might not have eaten recently, according to her friend. Here’s where things went wrong. For some reason

Over the holiday weekend my wife were walking across a big mall parking lot as we made our way from dinner to the only bar in our area carrying the big UFC fight. (Way more fun to watch than boxing anymore). It was about 6:30 pm. We live in Phoenix, and it isn’t called the Valley for the Sun for nothing. It doesn’t really get dark until well after 8 unless there’s some sort of eclipse or massive asteroid headed for a world-ending collision. As we were walking we both noticed a parked car with its engine running. The conversation went kind of like this: Me: “I wonder why that car’s running without anyone driving it?” Wife: “Maybe they have a dog or some…” ..pause as we glimpse naked (probably) teenagers moving around.. Me: “Woah” Wife: “Stop looking!” Me: “Wow. I mean it’s not like parking behind a building or anything!” Wife (while laughing): “Stop looking!!” Me: “Wow. Now why couldn’t I ever talk someone into doing that with me?” Wife (still laughing): “Seriously, why can’t you stop looking! Leave them alone.” … Wife: “You think they know they’re parked in front of Babies R’ Us?” Me: ..guffaw.. That guy is destined for marketing or PR; no one else can talk someone into doing that in a car in the middle of a busy parking lot, in the middle of the day, with nothing more than barely-tinted windows to block the view. Share:

By the time I pulled back into the parking lot after lunch at home, I knew something was wrong. The first sign was the ambulance racing out towards the hospital with full lights and sirens. The second sign was catching a glimpse of the crowd of guests on the bridge slowly walking back in the direction of the pool. You can’t see the pool from the parking lot, but it was obvious it had been cleared. While we would empty the pool every couple of weeks on a lost child search, the combination of an empty pool and ambulance didn’t bode well. But accidents happen, this wasn’t the first ambulance we’d called, and as I exited my car and started towards the entrance I was more excited than anything else; wanting to know what I missed. It was only when I saw the faces of my coworkers and the guests as I walked in that I realized something terrible had happened. A kid died in our pool. Every now and then we have moments in our lives where disparate events coalesce into a coherent inspiration. Recently, I’ve been thinking a lot about my life in emergency services. A month ago I had to take an EMT refresher class to transfer my certification from Colorado to Arizona. Two weeks ago I gave a presentation on “The Firefighter’s Guide to Risk Management”, where I played off my past as a rescue worker to talk about Enterprise Risk Management concepts. Last week I finished reading “Playing for Real: Stories from Rocky Mountain Rescue”, an excellent book by Mark Scott-Nash, a friend from Rocky Mountain Rescue. Those three events made me realize how incredibly lucky I’ve been to have some amazing opportunities and experiences. For nearly 20 years now I’ve bounced around nearly every rescue job in the books- some paid, some volunteer, all professional. I’ve driven fire trucks, worked the ambulance in the inner city, flown on helicopters, patrolled one of the top ski resorts in the US, responded to Katrina, started IVs while hanging off cliff faces, SCUBA dived for bodies, and spent thousands of hours training for nearly any possible crisis. All of these adventures started in high school with my first non-fast-food job. Graydon pool is a mix between a man-made lake and municipal pool located in the New York suburb of Ridgewood, New Jersey. About 100 yards on each side in a vaguely rectangular shape, its sandy bottom is surrounded by an artificial beach. Originally a small pond, it was later excavated to its current size and massive filtration systems added. Visibility is still a pond-like few feet and we’d regularly row around in a small boat to drop chlorine tablets and other chemicals to keep it sanitary. A long buoy line snakes through the middle dividing the 0-4 foot deep shallow end from the 13+ foot deep end, equipped with a high dive, two concrete resting platforms, and a small lap area. During summers Graydon is the social center for Ridgewood. On a sunny day about a dozen lifeguards perched on 7 foot stands would watch over hundreds of swimmers of all ages. I was 17 when I started working there as a lifeguard and couldn’t imagine a better job. The pay was good ($35 a day my first year), the nightly parties better (thanks to a mix of high school and college-age staff), and at times I felt more like a professional volleyball player than a public servant. I can’t remember exactly when the drowning occurred, but think it was either in 1988 or 1989. Graydon was often the host for youth groups from other towns looking for a change from the traditional lap pool. I think the group that day was from Patterson, a low-income town whose school was featured in the film Stand by Me. While I was out at lunch a group of kids jumped off the main platform in the deep end, and started swimming about 30 yards towards the concrete T-shaped dock that held the olympic-height low and high diving boards. Once they hit the other side, they realized one of their friends hadn’t made it and quickly notified the guard at the diving area. I’m bad with names, and this was nearly 20 years ago, so while I remember what she looked like I can’t remember my coworker’s name. She was one of the few employees over 21 (that’s the kind of thing a 17 year old remembers) and on summer break from college. She immediately blew three short blasts on her whistle- the emergency signal for a rescue- and dove into the pool. Off-duty lifeguards would swarm over the area as everyone in stands would start clearing the entire pool. When enough guards hit the water in that area, we’d switch from a spot search to a more organized sweep that I later realized resembles an avalanche search. Side by side, the lifeguards would tread water in a line, dive to the 13-foot bottom, swim forward a few strokes, and start all over again. If we didn’t have a search area, or enough time passed, we’d grab SCUBA tanks, lay a few search lines, and start a dive search. Not that any of us were even certified to dive. But based on what others later told me the search never got to that point. Another female guard, in the next stand over, jumped in to assist and they quickly located the boy. Piecing the story together, he’d quietly slipped under the water without a struggle while swimming across with his friends. The two female guards found him very quickly and started mouth to mouth while swimming him to shore for CPR and to transfer him to the ambulance for a short trip to the Valley Hospital Emergency Room. That boy, high school at the oldest, never came back. The two guards were emotionally devastated and the death was a pall over the entire staff. Initially there was a suspicion that his heart stopped