Sunday, February 22, 2009

A world so small, a heart so large

A few days into the EMT-B class, our instructor suggested that we get a scanner so we could listen in on medical reports, and learn from them. We get relatively few calls out here in the middle of nowhere, so we need to learn from as many sources as we can. Listening in to the radio reports, and especially the flight medics, we could hear how they give the reports, what interventions they have done, and a variety of other details not readily available elsewhere.

One of the first things we learned is that the flight medics are fantastic. They give their reports by the book, head to toe, easy to understand and follow. A good model for us, to hear that pattern over and over, the rhythm and flow of the report giving us a mental template to use in acquiring the information to give our own patient reports.

Another thing we learned early on is that we can recognize the voices of most of the ambulance personnel, so we know who is going on the call. This does a couple of things. One is to give us further information about each of them, their ability to be focused and calm, the clarity and completeness of the information they provide, adding to the level of trust we have in them when we work together. It also lets us know who to worry about, sometimes, depending on the situation they are going into- or on the road conditions.

We also hear a much wider variety of situations than we've gone to ourselves.

We have gotten into the habit of turning the scanner on when we hear someone get toned out for something that sounds like an interesting EMS call. We run through the call either in our heads, or sometimes, if we're both listening, with each other. Does the location of the call give us any information? Is this somewhere they have been before? What would you do first? What should we be concerned about, with that mechanism of injury? We'll visualize and/or verbalize the assessment we would do if we were on scene. It's decent practice for us, and more than once, we've ended up with a similar call relatively soon after hearing one on the scanner.

So last week, when we heard a call for someone who fell from a tree, we turned the scanner on, and followed the incident as long as we could.

My first thought was that I was glad that I didn't know anyone that age who lived in that location.

I was concerned for the patient. It didn't sound good. They called for a helicopter before arriving on scene, to get the flight team going and ready to fly. Called in an engine to set up a landing zone nearby. This is a common precautionary measure, but this time, it sounded like it might be necessary. There are so many injuries possible with a fall.

We don't get a lot of detail on the scanner unless we pick up a flight medic; since the radio system was upgraded a few months ago, the local ambulances give their reports on a frequency we can no longer pick up. This time, it turned out that the helicopter couldn't fly due to bad weather, so they had to transport by ground. Once they were loaded to go, we didn't get any further information over the radio. All we knew was that the suspected injuries were serious.

As we turned off the scanner, our thoughts and hearts were with the patient, hoping things would go well and he would be okay.

They didn't.
He wasn't.

Usually, we never know how EMS calls turn out. Privacy laws prevent us getting further information, unless we happen to know the patient personally, and hear things through friends or family directly.

The thing is, I don't actually know where every person I know around town lives.
And I definitely don't know where they all work, or where they might be at any given time of day.

Turns out that this patient was someone I know.
The husband of a woman I've known for many years.
A prominent figure in the local activist community.

I found out the next morning that he did not survive.
He leaves behind his wife and their four daughters. Three of whom I've watched grow up, and the youngest of whom I remember when she was born.

My daughter and I attended his wake today. There was an outpouring of community support which was nice to see, but it's a bit sad that it takes something like this to bring everyone together.

As it always is, it was a reminder that none of us know how long we have left. That death comes suddenly and surprisingly. That no one is prepared, but everyone somehow goes on.

In an odd way, I feel like I was there when it happened. I wasn't; I was only listening in on the radio, hearing just enough to know someone was in trouble, but not enough to know who, or to suspect how it might affect me personally. I wish I had been, if only to be able to give my friend some understanding of what happened and how. She is struggling to make sense of something that makes little sense.

Today, she was surrounded by love, by friends and community, by an outpouring of grief to hold her close, to hold her up while she mourns. She greeted everyone who came in, with a hug and a smile, and not a few tears. It must have been difficult, even while affirming the man she knows her husband to have been.

His burial is tomorrow.
Most of the people who were there today will fade back into the background.
My friend will somehow go on, having lost her partner, her love, the kind and gentle man she has spent most of her life with.
She will raise their daughters to remember him with love, and to honor his memory by continuing to work for the causes so near to his heart.
How she will do this, I don't know. Just that she will.
My heart goes out to her.

For Ellen, I wish comfort and grace, hope and love, family and faith.
For Peter, I wish the peace he has worked so hard towards.


Thursday, February 5, 2009


It's the beginning of a new semester, which always brings with it new observations on the process of learning.

We have a method for how we teach, but are always learning more about people, about learning, and especially about difficulties learning, so we're constantly refining what we do.

There will never be a "perfect" method that will work with every person in every situation, because people are all different. They key is to remain flexible, and observant, and to approach every difficulty from as many different directions as is necessary.

If I told every student everything I know about fencing in their first week... or month... or even year... they would not be able to understand most of it because they don't yet have the context. This means that sometimes students ask questions that I can't answer, not because I don't know the answer, but because they aren't ready to hear it yet. There is a series of perceptual shifts that have to happen first, and those take time.

I ran up against one of those myself recently, where I was trying to explain my thinking to the master, who was looking at the subject from such a different place that we could not reach a clear understanding on either side, and had to agree to discuss this again later on. Some of that is a language difficulty, trying to put into words feelings and concepts that are non-verbal. But some is that we are in different places still.

I recently had an experience in a class that helped me to understand not what the master was trying to say, but why it was that I couldn't seem to phrase my thoughts or questions in ways that helped us reach an understanding.

We were working on something new in a class of mostly relatively new students. It required coordinating hand and foot in a way they mostly had not had to do before, so it was very challenging. I needed to break the movement down into smaller pieces, so that they could begin to follow the new pattern. It went fairly well and there was great progress between the beginning and end of the class.

At the end of the exercise, as I usually do, I asked if there were any questions.

One of the newest students, a highly intelligent young boy, had several questions.

One of his questions went something like this: "Is this so that you can go faster, and does it lead to special moves?"


I had to ask him to clarify his question.

We addressed the "faster" part first, it being the simpler concept.
No, it has nothing to do with going "faster."

I believe he had gotten this impression because we were now coordinating one hand movement with each foot movement, rather than one hand movement for every two foot movements, and to his mind, that meant it was possible to make twice as many blade movements as before, in the same amount of time.

The trouble with that is that blade movements, and therefore hand movements, are not restricted by foot movement at all when you fence. We chose to coordinate the two in this practice session in order to facilitate coordinating movements AT ALL, but in bouting, blade movements are coordinated with your opponent's actions, not with your own feet. After all, it is your opponent who is attacking you, not your feet- unless you have far more serious problems than a fencing bout.

This was clue number one.

Then we addressed the next part of his question. Does this move "lead to special moves"?

Again, I was somewhat mystified by the question.

I asked him what he meant by "special moves."

He said something about how obviously, there are certain special moves that you don't do very often, you sort of keep them in reserve, so that your opponent won't expect them. Maybe a secret move that your opponent doesn't know about, and wouldn't be able to defend against. And he wanted to know if this new thing we had been working on was the beginning of such a move. A "botta secreta." (He didn't use that term, but that's what he meant. Google it if you aren't familiar with it.)

This was clue number two.

I had to think for a minute to figure out how to answer him.
The answer is both simple and complex, depending on where you are in your understanding of not only fencing, but all combat.

I told him that we'd have to discuss it again when he has learned more, but the simple answer is that no, there are no "special moves."

I continued thinking about this long afterwards.

What I realized is that this was a perfect example of the difference in focus between a beginner, and someone who is more knowledgeable and more practiced.

A beginner has a narrow, internal focus. He is still learning to control his own body, his own movements, and has no real understanding of the possibility, let alone the ability, to control another person's actions.

What this often translates to is a beginner's assumption that each action in fencing is decided on, planned, or otherwise thought out by the fencer with no actual connection to what the opponent is doing, other than maybe waiting to see what the opponent does and then trying to somehow counter that action. So, a fencer might plan some secret special attack to use at some previously decided on moment in the bout, in order to gain the advantage and win. He would keep this special attack in reserve until the chosen moment, and not use it any other time. Hence, the "specialness" of it.

This same internal focus lends itself to the belief that all coordination is of your own movements- your hand with your feet, your blade actions with your movements forwards and back.

There is no understanding that whatever actions you take are inextricably linked to your opponent, two ends of the same thread, tied together like a figure-eight follow through knot.

There is no understanding that your opponent's actions are controlled by your actions, your cues, your communication and misdirection. That you almost literally tell him what to do, so that you are prepared for it and can easily take advantage. That you do not "beat" your opponent so much as you set the stage for him to be his own undoing.

Beginners are very yang in how they look at combat.
Action, strength, speed, force, trickery.
They don't yet see the possibility of diversion, deflection, reflection, invitation, illusion.

I could go on.
There is also the mind/body separation of beginners (and I'm using that term in a very broad sense... one can be a "beginner" for a very long time!), in this culture of intense priority given to academic, intellectual thinking, and the resultant devaluing of all things physical. People who are still stuck in an intellectual appraisal mode want things to add up, match up, and "make sense" in ways that are easily counted and/or verbalized. It ain't necessarily so.

But my point in relating this story is to show how it was that I had this realization, with this student's series of questions, of how it feels to have someone ask a question from such a different frame of reference as to almost be speaking an entirely different language.

He would not have been able to understand much outside himself at that moment. He has not yet progressed to a place where he can SEE outside himself in this. It would have been much like trying to explain the ocean to a desert dweller, colors to a blind man, or algebra to my dog.

But what was most interesting to me was that his question, which made perfect sense to him, from his perspective, made so little sense to me at first, from my perspective, that I had to stop, go back, figure out his perspective, and then re-examine the question to even know what he was asking.

I suspect something quite similar happened in my recent discussion with the master, the one where we never came to an understanding.
Maybe he DID understand what I was trying to say, but is at such a different conceptual place that he couldn't answer anything in a way that I would have been able to get to at all- and trying to answer it from my perspective, which he no longer holds, was meaningless and just plain silly.

It probably didn't help that I'm somewhat in between perspectives on that particular thing, and part of my questioning was to try to make that leap from one to the other. Didn't get there. Yet. But it feels close. I can't explain it in words... and still seem to need to rely on them to try to explain. My guess is that it won't need explaining when I get it. We'll both know.

I'm close.
Very close.
I can't explain it... but I can feel it.