My Award

So this happened back in September of 2007, but since I wasn't keeping up with my Blog at the time, I'll share now.

For the awards period of June 2006 - May 2007, I was awarded EMT-Intermediate of the Year for the State of Oregon. Here's an excerpt from the letter my Ops Chief sent to the state recommending me for the award:

"Jeramy has always been a good employee, however over the last year he has been exceptional... [He] contributes on a regular basis towards in-services, continuing education, and assisting with the EMT-Basic class at Clatsop Community College. He balances his time between work, school, and family life very well..."

So the letter goes on, but the State of Oregon Health Division found it appropriate to bestow this award upon me at the EMS Awards Banquet in Bend. Several awards are handed out every year including Medals of Valor, Meritous Servous, and Unit Citations to name a few. My wife and father (also a Seaside volunteer lieutenant) were also in attendance at the banquet and what a wonderful thing it was to share with them. I am so very proud and humbled.

Commercial Structure Fire

I responded with my fire department to a commercial fire at the Seaside Outlet Mall earlier this month. Check out the department's website for the full story and a photo gallery.

www.seasidefire.com

My Care Home Frustration

My partner and I took a call today at one of our assisted living facilities. We have 6 in our county, 8 in our total response area, and multiple adult foster care homes which are outside of the normal assisted living community. We were sent for low blood pressure, which happens quite frequently and is most often attributed to the med-aids' inability to take an accurate blood pressure. The staff tells me that they found the resident in his bathroom pale, sweaty, weak, and with a very low blood pressure.

My first impression of the patient as he's sitting in his wheelchair is that he has great skin signs and is alert and competent. My partner gets a quick set of vitals, after which I ask the staff "so what's his pressure normally?" I don't know was the immediate answer. I then ask the staff "what's his history?" I don't know, he's only been here four days and we don't know anything about him. Now, I should mention the patient is extremely hard of hearing and I have to communicate by pen and paper. He keeps saying he's been sick, but is non specific and the staff has no idea what he's referring to. His medical paperwork has no information regarding a previous history. At this point I realize I won't be getting anything from the staff or the facility, even though there are three med-aids in the room at this point all with the same blank I don't know expression.

So I take Mr. So-and-so to the hospital and turn him over to the ER nurse who asks me a multitude of questions that I wasn't able to answer because I couldn't get answers from the care staff. It should also be said that I'm on great terms with the ER nurses and they understand my frustrations and don't hold this against me.

It occurs to me that it's these care takers' jobs to know what their patient's conditions are. It's there job to know a medical history and their recent activities. It's there job to be able to give me an answer other than I don't know. Granted the resident was new to the facility... by 4 days. I might be able to forgive this after his first day, but after 4 days I would assume the staff had a clue regarding the patient's medical conditions and history. Given this, I know I wouldn't want my grandmother taken care of by these people.

This is just one more irritating example of the incompetence inherent in the assisted living system.

My Anticipation

As I posted a little earlier, I'm a big Star Trek fan. So when it was announced that a new Trek movie was in production with JJ Abrams in charge, I damn near had a Klingon kitten. So I watched the teaser trailer and felt indifferent. Abrams has already talked about approaching this as a reboot of the franchise and the theme of the trailer illustrates that. But, I circled Christmas day on my calender as the theatrical release date and began the countdown.

However, I find out yesterday that the release has been pushed back to May of 2009. Initially upset (I'll have to white out my calender) I then did some investigating. I find out that Paramount pushed the release back to make it a summer blockbuster contender and avoid holiday competition. My gut reaction was "what kind of BS is this?" What kind of holiday competition is a Trek movie concerned about? And the fact this is supposed to be a blockbuster contender? This just rubs me the wrong way. I feel like the movie is being marketed as a money maker, and not a true addition to the franchise.

I'm anticipating the movie, but the more I find out about it, the more apprehensive I get.

My Partner

As the Paramedic on my ambulance, I work with an EMT-Basic partner. The interesting this is, my partner is somebody I went to high school with, and he's dating the daughter of my supervisor who happens to be my best friend (the supervisor, not the daughter). He's a cool enough guy, we get along because we're both that early 20's demographic who are into computers and technology. We know all the same people, we have a lot of the same complaints, and we share a lot of similar interests.

The reason we get along so well as friends is also the reason we fail to get along as partners. He doesn't respect me as his Senior. He respects me as a Paramedic, but not as the Senior tech in charge of the crew. We never argue or have problems on scene, in front of patients or the firemen, but it's when we're in the ambulance or at the station that it starts. Some might say that we're just two guys poking fun at each other, but there has to be a basic level of respect and I don't see that.

I talked to my supervisor about it and she sees that same thing. She knows my partner respects me as a Medic, but that he thinks of me more as a buddy than a boss. It hasn't caused any major problems yet and I can't see that it will. He'll never contradict me on scene or undermine my authority as the Medic--and if he does it'll be that last thing he does as my partner.

I've talked to my partner about it and his common response is "you have sand in your vagina?" My supervisor understands that nature of the problem and is working on getting partners switched around. Not just for my benefit, there's other crew problems on my shift, I just hate to be someone that's causing waves.

My Review (of The Good That Men Do)

I'm a big Star Trek fan. Not the costume wearing, convention going, Klingon speaking fan--but the other kind of big fan. My favorite, out of all the series, was Star Trek Enterprise, taking place 100 years prior to Captain Kirk. It lasted for four short seasons (arguably the first two being the best) and had a horrible series finale. The Good That Men Do is an attempt to appease Enterprise fans by rewriting a bit of canon to give a more fitting end to the series and my favorite character, that of Trip Tucker. I picked up the book first without knowing a thing about it--really by just looking at it's cover. I think the cover art is fantastic and that the title embodies what Star Trek is all about, the goodness of man, the self sacrifice, and heroism.

First of all, you have to understand the book is written for a Star Trek fan, with lots of technical jargon and references to the overall Enterprise story line. However, there is still a lot of exposition concerning events of the fourth season of Enterprise that lead directly up to the book. Often times, these passages read more like an episode synopsis than a fluid narrative and it can be quite annoying. Some of the analogies made throughout the book are a bit too Trekish as well.

For fans of the show, the story does not disappoint. It's right up there with most of the other over-the-top Trek story lines, specifically reminding me of Unification from TNG. The Good is an enjoyable read if all you're looking for is something entertaining. There is nothing cerebral here and most of the time, if you put too much thought into the story, you start to find holes--not plot holes but story holes that just don't always add up.

My biggest complaint about the book is that the ending does nothing to tie up the Enterprise franchise. It instead opens a door to the possibility of another franchise with the character of Trip Tucker as the star. Star Trek is plagued by so many literary franchises anyways that this isn't really the best of ideas. I got the feeling after reading the final chapter that I was being set up for a sequel, just like watching a bad movie.

As a Trek fan though, I couldn't have asked for more from the story. It was exactly what I was looking for; a more heroic fate for my favorite character.

My...

By the way, I'm fully aware that I'm ripping off the title of my posts from Scrubs, but I love that show. I know it sounds funny, but I've developed a lot about my personal relationship with patients from this show.

My Last Year

I started this blog almost a year ago really with one purpose: to write about the personal and professional impact of my brother-in-law's death on me. And while I still won't share the story of what happened or the days that followed, I'd like to talk about how the year has been.

My brother-in-law Ryan chose to end his life last February. Ryan and I went to high school together and shared a lot of the same interests--computers, Star Trek, hobby games, and other nerdy stuff. Ryan would often joke that we were friends before my wife and I got together. I spoke at Ryan's memorial and commented on how Ryan and I didn't have to try to be brothers, that it just happened for us. I think about my friend and miss him every day.

Meghan was incredibly close to Ryan, the closest I'd ever seen a brother and sister. His loss was devastating to my wife. I had never seen Meghan in such a dark and lonely place. She went to counseling and adjusted aspects of her lifestyle. She's had a turbulent year and I've tried to support her the best that I know how.

I responded to the 911 call with the fire department and saw Ryan. Following that day, I questioned whether or not to stay involved with EMS and the fire service. I took two weeks off of work and my paramedic internship to be with my wife and family. I spoke with friends at the fire department who shared similar experiences. I wondered if my life had changed forever. I returned to work and I remember the first 911 call I responded to and the panic attack that ensued. I worried about my ability to continue working as an EMT.

Meghan and I have put up with a very tough year. I think that I've accepted Ryan's passing more completely than my wife has. I have a firm belief that Meghan and I will see Ryan again, but I have only a few years of memories with Ryan and my wife has a whole lifetime. I can't count the number of times that Meghan has cried herself to sleep. We've tried to make a lot of positive changes this year, including buying a house and getting two dogs. We've attempted to move forward, but not to forget. I've become so much closer to Meghan's family because of all of this.

The pain of Ryan's passing has lessened, but it's not gone. I've learned to disassociate how Ryan died with the fact the he's gone, and that's made it easier for me, allowed me to continue working. I took Ryan to Portland by ambulance a few years ago for an appendicitis, and I still have a picture of him on the gurney on my cell phone. I look at that quite often to remind myself of the friend I've lost. Ryan's reasons and motivations are his own, I won't have the answers in this life and I have some comfort in understanding that. It's just a year later, my wife and I still miss our friend.

My First Lesson

As a new paramedic, I feel pretty fortunate. My company has a tendency to put new medics into the field with little field training time and this is apparent in the quality of the paramedics that work for us. I had a month of FTO time before I was put on my own, which was more than most and very welcomed. I finished my field internship in July of last year, which means that from July until when I tested in August, then received my certifications in September, I hadn't practiced as a medic. I needed the field time with a senior medic to re familiarize myself with the skill set. I started in October as the senior tech on the ambulance; we staff an ALS transported ambulance with one paramedic (the senior tech) and an EMT-Basic (the junior tech).

My first call as a paramedic was a gunshot wound to the chest. Now, I live in a small community with virtually no violent crime and virtually no firearm related accidents. As an EMT, when you hear of a gunshot wound you immediately get pumped up; you're thinking about blood, guts, and carnage, which is what our EMT training was all about. As the paramedic, the guy ultimately responsible for the patient and your crew, I was thinking about our safety and trying to put together a treatment plan.

But I was nervous. This was my first call and up until this point, the only gunshot wound I'd ever been to was a through-and-through to someone's leg. I'd never dealt with anything this potentially life threatening on my own before and I was a little scared.

The first arriving sheriff's deputy advised us by radio that this was a confirmed GSW to the chest, but that it was a hunting accident and safe for us to approach the scene. The patient was in the back of an SUV, having been brought down from the woods by friends, and was not in good shape when I approached him. He was hurt, but he was conscious.

So I started communicating my plan right away to my partner, the firemen, and the sheriff's deputies. I then went back to the ambulance to give a preliminary radio report to the hospital and activate the trauma team. It was at this time that I learned possibly my most important lesson (so far) about being a paramedic. When I returned to the patient to see the progress made in moving him from the SUV to the ambulance, nothing had been done. So I communicated by plan again, which at this point was simply get him on a backboard and into my ambulance.

Still nothing happened; the firemen seemed to have their own idea about what to do. So I communicated my plan again, punctuated by a "now!" It was no that the fire chief turned to me, told me to calm down, and that they were working on it. Now, if there is one sure fire way to piss me off, it's to tell me to "calm down," and the sheriff's deputy saw it. He turned to me and said, "I know. I'll take care of it." And he did. Within the next two minutes, the patient was on the board, in the ambulance, and we were transporting.

It was a short trip, less than 10 minutes, and I had my hands full starting IVs, getting him onto the heart monitor, oxygen, and checking for other injuries. We arrived at the hospital, turned over the patient to the trauma team, and then I went to go have a conversation with the fire chief. He started immediately apologizing and said "I thought your partner was the paramedic." In other words, he thought my EMT partner was the one in charge and had told his firemen to listen to my partner, not me.

So now, whatever call I'm on, I always start with, "hello, my name's Jeramy and I'll be the paramedic taking care of you." And you know what, I've never had a problem of mistaken patient care responsibility since.

My Review (of Pour Your Heart into It)

So I recieved a few books and some Barnes & Noble gift certificates for Christmas and one of the books I just finished has been on my want list for a while, Pour Your Heart into It: How Starbucks Built a Company One Cup at a Time. I'll start by saying that I love Starbucks. No matter where I'm at, if I want a good cup of coffee, I can go into a Starbucks and order a cup that tastes the same as the Starbucks back at home. One of my biggest problems when I'm out of town at a class or conference is not being able to find a good cup of coffee. I love the Starbucks experience as a whole; the feel of the stores, the friendliness of the baristas, and that taste of the coffee. All of my Starbucks beliefs have been reaffirmed.

Pour Your Heart into It is written by Starbucks CEO Howard Schultz and he tells the story of how Starbucks as we know it today was created. The book is a mix of Starbucks history, personal biography, business phylosophy, and management self-help. Schultz does a wonderful job of conveying his love of coffee and his company, his drive to build an employee and customer centered company, and his personal ideas about the kind of business he wants to run. Every chapter of the book balances parts of the Starbucks story with Schultz's business philosophies and management advice. Overall, the highest points of the book are when Schultz is passionatley describing how he was struggling to build Starbucks into a national company. The low points of the book would be when his advice segments would run a little long.

I picked up the book because I wanted to learn about the history of Starbucks and I came out the other end educated and enraptured in the Starbucks experience. This is in no way a book about how to run a successful company, the notes are paragraphs that Schultz includes are more about highlighting or illustrating a point in the story than acting as a teaching point on their own. You have to have a little patience when reading the book as some of it reads like an essay (a little reminiscent of my time reading A Perfect Thing), but I worked through the slow points because of how much I love Starbucks. If you're a Starbucks fan, this is such a great story that teaches you so much about the cup of coffee in your hand.