Skipping School

I just found out about this blog because someone posted a link to an article by this young woman.

http://skipping-school.com/

I love it.
She sounds so much... like us.

Plus, she's a decent writer.

Time for a change

Been considering this for a while.

This blog started out as one thing, and has somehow morphed into something else.

It is time to separate things out a little.  Even while noticing how very connected they are.

For now, I'll leave this here, for anyone who wants to read back through the archives- including myself.

Most of the fencing-related and teaching-related stuff will appear on our new collaborative blog, The Swordmaster's Grimoire.

The EMS stuff will be on my new, actually-an-EMS-Blog blog, The Lonely EMT.

So whichever of those you are interested in, now you know where to go.

I don't know yet if I'll end up continuing this blog or not. There might be some things that don't really belong on either of the other two, but I don't know yet.  I'll know if and when it happens.  I kind of expect that it will.

Alcohol Related

Had a talk with some of our students this morning.

It went basically like this:

College is an interesting time in your lives.

It's a time to get away from your parents, from your family of origin, and start to make your own way in the world.

It's a time to learn many new things, to make new friends and connections that will last a lifetime.

And it's a time to make mistakes, and do stupid things. Some of which you'll look back on, years from now, and wonder why you did.

Please don't let one of those "stupid things" be drinking yourself TO DEATH.

Two local college students (different colleges, and as far as I know completely unrelated circumstances) died this past weekend.

Official reports say the deaths are "alcohol related."

I don't know what that means, exactly.

Except it means it was a total waste. A tragic loss for the families that was brought on by the choices made by the individuals.

I can't help but notice the frequency of calls for ambulances because of someone drinking him or herself into a stupor.

And every time I hear that, or see that, I always wonder about the families. I wonder if the parents realize that they are paying through the nose for their kid to get an education, and what they are getting is stupid drunk. Not just ordinary drunk. But enough that they need a trip to the ER.

I did a lot of stupid things when I was younger.

I imbibed my fair share, or perhaps a few peoples' fair shares, of alcohol.

But never have I done so in such away as to need emergency medical care, or even close.

Seems to happen all the time now, in some places.

The cause of this stupid behavior- I started to be politically correct, and say "unfortunate," but let's face it, it's stupid- could be argued at length, and I'm sure there are a variety of contributory issues.

I don't really care what the cause is.

I care about the results.

Lives wasted.

So please.

Whoever you are.

Wherever you are.

Don't do this to yourself.

Just don't.

It's an ugly, ugly way to go.

Ambulance Driver's blog post today

I almost never do this, but I have to, this time.

Go read this post, entitled "On Teaching, Mentoring and Stewardship"

Talk about the perfect crossover between my two worlds, of teaching and EMS.

AD really gets what it's about.

I'm envious of anyone who has been or will be precepted by him.

Split Personality?

Feeling like I have a split personality these days.

On the one hand, I'm researching and working on writing my fencing master's thesis. That's a lot of reading. And a lot of writing. Teaching classes, and otherwise focusing and refocusing on the whole fencing thing. Writing for the new blog. Working on my own training. It's good.

On the other hand, I'm excited about going to EMS Today. Enthusiastic about the opportunity to learn some stuff, get some decent training, and network. Making preparations for applying to the local ambulance company, where I've wanted to work since my first ride along. Looking forward to getting more into the whole EMS thing once I get my youngest a little older, so I can work long hours without feeling like I'm being negligent.

Seems like two totally separate things, pulling me in different directions.

But it isn't.
Not really.

There is a lot of overlap.

One big area of overlap is something I've been thinking about a lot lately.
It's more than just "customer service."

Something fencing and EMS have in common in a HUGE way is the necessity to be able to create rapport. To connect with the student/patient in a very personal, immediate way, without distracting from the technical things you must also be able to do.

Knowing how to get my student to focus where I want him/her to focus, and to stay connected with me, is a HUGE help in being able to help my patient focus where he/she needs to focus, whether it's on something like his/her breathing rate, or something- anything- other than what is happening around him/her in a crisis.

Being able to give a technical lesson, and perform the skills I need to perform, while giving constant verbal and non-verbal feedback to my student, is a huge help in being able to treat my patient AND keep communicating.

Knowing how to use my voice to keep my student focused is very much like using my voice to calm my patient.

Maybe my personality isn't as split as I thought.

Worth a thousand words?

When I first joined the fire service, one of the things I did on scene was to take pictures.

Some of these were used on the fire company website.

Some have been used for fire investigation.

Some have been used for training.

As I became trained to do more things on scene, my ability to take pictures decreased because I was simply too busy doing other things that needed to be done, to be available to take pictures.

Back when I took a lot of pictures, I was always careful about what kinds of pictures I took. I never took a picture of a patient. Didn't take pictures of things that might cause any patient or homeowner embarrassment or grief. Any pictures that I took that showed identifying information such as license plates, I didn't publish.

Recently, the fire company, in a fit of I-don't-know-what announced a new policy regarding taking pictures.

I found this a little amusing, considering no one had taken any pictures on scene for quite some time, even though there is a company camera in one of the apparatus for just that purpose.

The policy, as I remember it (there has been no written version) is that no one is to take any pictures on any scene. Pictures are only to be taken at training, or for the purposes of a fire investigation. This is a policy recommended by "the company lawyer" for liability reasons.

Whatever.

So a couple of weeks after the announcement of the new policy, there we were, at an accident scene, and one of the assistant chiefs was taking pictures with his cell phone. He then asked if the company camera was available, and asked someone to use it to take pictures.

That's interesting.

Seems to be in direct violation of the company policy.

But this scene was unusual, and in my personal opinion, pictures of it would be very helpful for training purposes-and, for the most part, that is what I have always thought scene pictures were most useful FOR, so that they could be looked at later, and information gained that wasn't necessarily noticed at the time. So I heartily support the idea of pictures of this particular incident- it was unique.

At the next training, when we did a post-incident analysis of the event, the pictures taken on scene were shown. As they needed to be. And there was a big notice written on the white board in the training room, saying that these pictures were to be seen inside the fire company ONLY, not to be shared with the public. A reminder of the new policy, or at least related to it in some way, considering that it isn't, exactly, in accordance with that as-yet-unwritten policy, which didn't mention anything about sharing or not sharing pictures, but I digress...

A sensible consideration, a reminder not to be spreading the images around far and wide, if there has been a decision by the company not to do so.

Fast forward a while.

Imagine my surprise, to find out, by chance, that those very same pictures were sent to someone, who shared them with a large number of people outside the fire company.

Okay. So maybe I wasn't that surprised.

And, for the record, I think the people who saw the pictures SHOULD have seen them. That's not the issue.

The point is that it seems to me to be counterproductive to have the officers announce a new policy, not to put it into writing, and then to violate that policy themselves almost immediately, not only by taking pictures, but by sharing them around town. What was this policy about, exactly? Is it, or is it not, company policy? Is it policy for some, but not for others? Or what?

At the very least, I think the "policy" should be reconsidered- but I thought that the moment it was announced.

I have the same problem with a "no pictures" policy that I have with parts of HIPAA. Neither takes into consideration how VERY useful information can be in training.

That I am limited in how much information I can find out about a patient after they leave our care, means that I have no feedback on the care I provided. If I don't know how effective I am or am not, how can I improve the quality of the care I provide?

If we can't share pictures of unusual situations- the condition of a vehicle, the location of a patient, etc- with other EMTs in the company who weren't at an incident, how can we share what we have learned from any new experience? How can we use it to train and practice for future events?

Any thoughts on this? Does your agency have a "no pictures" policy? Do you think they should?

I know that there are places where there have been issues with people being stupid about sharing photographs that they shouldn't have shared, but I don't think prohibiting pictures at all is the solution.

EMS Today

I applied for a scholarship to EMS Today, thinking I'd never get it, and never be able to afford to go.

The application info said they would start notifying people on Feb 1st, which came and went, not a word.

I assumed I hadn't gotten it, no surprise, and pretty much stopped thinking about it.

Some of the folks who are going were tweeting about it and posting about it, and knowing I wouldn't be able to go, I passed over those comments, with a feeling of sadness for myself, while being happy for them.

It's not like I have nothing else to do. I'm pretty busy, and have plenty to keep me occupied.

It's not like I can't work on continuing my education in other ways, like the variety of books I've been reading lately.

And it's not like I can't still read EMS blogs, and learn from them.

But still.

EMS Today.

The premiere EMS conference, incredible opportunities all in one place, people I'd love to meet in person, educational sessions galore, and the whole exhibit hall. And it's not that far away.

Worth ever penny, it would be, no question.

I just don't have the pennies. :-(

A couple of days ago, we were getting ready to go out dancing, when I checked my e-mail just before leaving.

And there was an e-mail, with the subject heading "EMS Today scholarship."

I assumed it would begin with something like "Thank you for applying, but with so many qualified applicants, it was difficult to decide who to give a scholarship to. Unfortunately, it wasn't you."

It didn't.

It said "Congratulations! After careful review of your scholarship application for EMS Today, you have been selected to receive a Gold 3-day passport to this year’s conference!"

!!!

I think I screamed.

I'm not a screaming person, in general.

Suddenly, I'm scrambling to choose which sessions I want to take (all of them! Aaahhhh!), I'm looking for a hotel room somewhere near the convention center, and I can barely contain my excitement at actually being able to GO!

I'd like to thank JEMS for making the whole event possible, and for making it possible for me to go.

I'd like to thank all the EMS bloggers for inspiring, educating, and entertaining me. I'm very much looking forward to meeting some of you!

I'm sure I'll have a lot more to say once I'm there, and when I'm back home again.

Sure of it

My daughter has lived with us EMTs a few years now, and is reaching the age where she can take the class and join us. She has been riding with the rescue for the last year and a half, and has been very helpful there, fetching and carrying, etc. Now that she is getting ready to become certified herself, she has started paying more attention to the patient care.

We typically use the time on the way to the scene to go over our plans on arrival, and to remind ourselves of any pertinent information we may have about a patient's medical conditions, or any special needs. If appropriate, we review any intervention we might need, etc. Sometimes, we are close to the scene and don't have a lot of time. Sometimes, there isn't anything in particular that we need to review.

The other day, we were on our way to a reported accident with no injuries, expected to be a sign-off. The proverbial "wants to be checked out." It happened that the call was on the far end of town, so we would have a longer drive than usual. Plenty of time to go over whatever we wanted to go over, but little that we really needed to review for that particular situation. Basics. Scene safety. BSI.

But because my daughter was with us, and had been talking about starting her EMT class, I decided to go over trauma assessment. From the beginning. By the numbers. In addition to scene safety and BSI, mechanism of injury, number of patients, need for resources, spinal stabilization, general impression, level of consciousness and etc, on down the line. An excellent exercise, one found around the house every day. Literally, at our house, but I digress...

We arrived on scene to what turned out to be a two car accident.

We all know how accurate dispatch can be.

But true to what we had been told, there were no real injuries, just a little redness from an airbag. No problem. It's all good. Just hanging out, waiting for the wrecker. A relatively pleasant call, albeit in unpleasant weather.

Ever have one of those days where suddenly, everything changes?

Yeah.

Not far up the road, a sudden collision (is there any other kind?).

Bad.

Real bad.

As in "What is that in the road? How did it get there? It doesn't look like anything I've ever seen before. Oh, shit. That must be a car."

We hustled.

Called for more resources.

Major trauma.

Good thing trauma assessment was so fresh in our minds.

I had never seen a car in that condition before. It was literally ripped apart.

I was sure there would be fatalities.

There weren't.

It was nothing short of a miracle.

Great teamwork all around.

Patients extricated and packaged in an unbelievably short amount of time.

And my daughter?

An impeccable job, staging gear and assisting us.

Kept her head in a very stressful situation.

She's going to be a great EMT.

I'm sure of it.

On a Roll

Went over to the Fire Academy last week to return a book to the library.
The librarian- who is the best librarian I've ever met- pointed me towards some books that she just got in, from another library that closed.
I found several that looked interesting, but only brought one of them home, since my reading time is somewhat limited.
Turns out that the one I brought home was of enough interest that I started looking to buy a copy.
Ended up also ordering the other two I had looked at, and some others I found online. I'm on a roll.

Here's the thing.
The fire department I'm in offers no EMS training at all. None. I think they think they do, but they don't know enough about training to realize that what they are doing isn't training, at all.
A prime example occurred just this week.
The scheduled training was for the EMS Director to give a presentation on cold weather emergencies. He has no training to teach, at all. (I could write a whole post about that.) His "presentations" are last minute rambling about some subject, with little to no preparation.
But if that isn't bad enough, what actually happened is that he didn't show up.
He handed on old EMT textbook to another person, who also has no training to teach, and told him to "cover this."
So that person read from the old textbook.
And that is what happens when they even attempt to provide training. Often, it just gets canceled.

For a long time, I felt some sympathy for both of these people, who are being asked and expected to do something for which they have no training, and less skill. They do "the best they can." But the longer this goes on, the more I realize that it is their responsibility to step up and say "I do not have the training or ability to do this; let's bring in someone who does." And they don't. I don't know whether they are embarrassed to admit they can't do it, or whether they don't realize they can't. Either way, it's bad.

And this isn't good enough. Not even close.
So after three or four years of this, now that I have SOME experience, as little as it is, rather than NO experience, I'm doing the only thing I can reasonably do.
I'm finding training opportunities elsewhere, as much as I can, and I'm organizing training for myself and the other EMTs, without relying on the fire company to do so. I have years of teaching experience, and training people is what I do. Shifting those abilities over to include EMS is inevitable, although I didn't intend to be forced to do so this early. I won't be attempting to teach new skills; that is beyond what I can claim to be able to do. But I can run drills, and I can go through scenarios, and we all can learn a lot from a wide variety of sources.

Why am I mentioning this?
These books I've started accumulating are mostly EMS education books.
Some, clearly designed to be used as such, and others, perhaps written more for sharing experiences, rather than outright teaching, but they can also be used to great benefit.

As I read through them, I'll share here what I find interesting and/or educational.
It might be medical information that I didn't know.
Or it might be about teaching, itself, more than about EMS, in particular.

I would also welcome recommendations for resources other people have found useful, both on the EMS front, and about teaching.

Things They Don't Know

The general public doesn't know a whole lot about medicine, for the most part. They don't need to, and often, they don't want to. I've lost track of the number of patients I've seen who are on medications that they do not know the reasons for. Lost track of the people I've talked to who don't understand their own medical conditions and/or who misinterpret doctors' instructions.

I am frequently amazed by the fact that most people don't know, and don't want to know, how to do CPR. Appalled by the nearby retirement community where the resident council REFUSES to allow an AED on the premises, because they are afraid of being resuscitated. What about any visitors?


And so it goes, on down to the number of times I've heard dispatch say the patient is "unresponsive," which is, apparently, the only way laypeople know how to describe someone who has any sort of altered level of consciousness.

Today, I was glad.

Got a call for an unresponsive elderly patient. On a day when I knew I'd be first on scene alone, my usual cohort being out of the country, and neither of us ever knowing if anyone else will show up at all. Such is the life of a volunteer EMT in my department. We have automatic ALS backup, which is a damned good thing, but it is not uncommon for us to go to a call and get no one else before the ambulance gets there.

All the way there, what ran through my mind was "please let this be 'bystander's unresponsive'."

It was.

I was delighted to talk with the patient. I've never been so happy to hear someone's voice.

Rules

I used to think that all the world's problems would be solved if people would just follow one rule. I've had to revise that a bit. Two rules. If everyone followed these two rules, everything would work out just fine.

1. Don't be an asshole.
2. Don't be an idiot.


With the following corollaries:

1. Tell the truth.
2. Keep your word.
3. Take responsibility for your actions.

Add in a fair amount of "learn from your mistakes" and I think pretty much everything is covered.

Only a volunteer?

I have been a volunteer for a variety of different organizations over the years. Some large, some small. Some, I've been in charge of, and others, just one tiny part. Some have been run well, and others, not so well.

It is interesting to consider them all, and look at what problems they share.

Almost universal is this:
1. The majority of the work is done by a small group of people.

I think this can be perfectly fine, as long as everyone is clear that this is happening, AND there are built in positions in the organization for those who want to have small roles. The people who want to belong, but don't want to do much, should be in the small roles, and those who are there to work should be in the larger roles, and be the ones making most of the decisions.
Oddly, that seems rarely to be the case.
More often, there is much complaining and power play bullshit from the ones who don't actually want to work, while the ones who do the work, keep on working.
They have their excuses, for sure. Chief among which are "not everyone has the time" and "we're only volunteers."

Yeah. Well. If you don't have the time, don't volunteer. Or if you do volunteer, take your time (and other) limitations into account, and volunteer for things you actually can and will do. Seems that would be much more satisfying for you, as well as more functional for everyone.

And for what it's worth, being a volunteer does not mean that you aren't accountable for what you do, or that your standards should be any lower than a professional. It just means you don't get paid. It SHOULD mean that you do this for the love of doing it, or because you believe it worthwhile and important, both of which should create HIGHER standards.

Which brings me to the next nearly universal thing:
2. Those who do most of the work do it for personal reasons, not for recognition or for glory.

For one thing, there is little of either to go around. Those who just want the perks end up doing only those things that are publicly visible and/or recognized, and doing only enough to get that recognition, leaving the bulk of the real work to those who are content behind the scenes. Since that is by far most of the work, this is part of what leads to the first universal situation, of most of the work being done by a few people.

3. It can be hard to "fire" someone who is a volunteer.

This becomes an issue when you have someone in a position that requires certain things to be done that they simply don't do. Especially in a small organization, where there may not be anyone else willing or able to do that job, this can kill the organization in a hurry. Also, in a small organization, it is likely that everyone is at least acquainted, if not friends, and that makes it even more difficult to ask someone to step down, or leave, because of the emotional trauma involved, and because people generally don't want to hurt someone else's feelings. At least they don't want to do so face-to-face or in any way where they have to take responsibility for it.

Instead, they give them "time to work things out" and make excuses for why the person is not doing their job. Second chances, and third. Extensions on deadlines. Anything to avoid confrontation. Anything to avoid being "disliked." And usually, anything to keep the status quo. (Also see #6 and #7, below.)

Thing is, if the work needs to be done, it needs to be done. Someone eventually has to step up and change the situation, one way or another, or the organization will not be effective, if it survives at all.

4. An organization is only as good as its... organization.

If no one knows what is going on, or what needs to be done, or what has been done, things are not going to work very well. There must be good record keeping, and there must be good planning. Long and short term. The more open the records and planning process are, the better. Keeping people in the dark rarely leads to good.

Which leads to the next issue:

5. Any organization that does not trust its people will not be able to recruit or retain good people, and will not be able to function effectively.

The leaders of an organization must lead by example, must be worthy of trust, and must create and maintain an environment that fosters trust. This is true of all organizations, and especially true of volunteers. This includes open and accessible records and other information, and it includes not tolerating anyone who demonstrates that they can't be trusted to do what they say they will do. Building trust is a skill that not everyone has. Learn it, and earn it.

6. Politics should be left to politicians, but it isn't.

This is another thing that will lead to no good. Office politics. Cronyism. Cliques. Plain old bullshit. Any time decisions are made for reasons other than effectiveness, the results will be less than stellar. Whether it's outright favoritism keeping people in positions they are not qualified for, or simply don't do, or whether it's keeping qualified people out of a position because they aren't the buddy of the person in charge, the result is the same. Poor performance, and poor management of resources.

Where this becomes even more of a problem in volunteer organizations than in others is when there is little outside oversight. When people are not held accountable to any particular standards, they can get away with keeping their buddies happy rather than getting the job done, because no one outside the organization knows that is what is happening. Nor would they generally care.

Also, this leads to exceptions in the category of "firing" a volunteer. Instead of getting rid of people who aren't doing their jobs, often, a dysfunctional organization focuses on getting rid of people the "in group" does not like, regardless of qualifications or job performance.

Last, for today, but not least:
7. People HATE change.

Organizations that do not change, that do not grow, that do not continually work to improve themselves, will become less and less effective, until they ultimately fail.
People often seem to prefer this to actual change.
The status quo bias: an irrational preference for the way things are, rather than changing.
Been around at least as long as Shakespeare.


For those of you who know me, you might find it interesting that most of these observations come originally from organizations I worked with over ten years ago, rather than directly from any I'm involved with now. But if the shoe fits...

Family

I've been thinking about family lately.
In the past couple of weeks, an aunt and uncle of mine have died. I didn't know either of them well. I had met them both, but the last time I saw either one was years ago.

When I was growing up, both of my parents, for some reason that I've never known, stopped having anything to do with their families. We visited a lot when I was very young, but after I was around 6 or 7, we stopped. It may have been because we moved further away, and travel was expensive, but I don't recall them keeping in touch in other ways, either. They both reconnected with their families after I was grown, but that didn't really do me any good.

What this meant for me is that I grew up knowing I had a whole bunch of cousins (Around 35 of them? I'm not even sure.), but I didn't get to know any of them. Some of them, I knew their names, but some of them, not even that. When I was 17, I met a couple of them, but didn't stay in touch. And when I was in my twenties, I visited some who lived near where I was then, but again, didn't keep in touch. Keeping in touch was somewhat difficult then.

It isn't now.

A few days ago, I suddenly realized that it is likely that at least some of my cousins are on facebook. Not knowing their names, or who is and is not there, I didn't know how to find them. I mentioned that to my Dad, who happened to talk to one of them that day, and she said that yes, she is on facebook, and is friended with several other cousins.

Find one... you find them all, eventually.

So I did.
I sent friend requests to the nine cousins I found. So far, five have responded.

It is a little overwhelming. In a good way.

I don't know what it feels like, really, to have cousins. I remember a little from when I was 6 years old, but since then, have rarely had that opportunity to be with people who are extended family. I'm having to learn what that feels like, and so far, it feels pretty good. There is a sense of belonging, even though these people are, for the most part, strangers to me, really. I'd like to change that- the "strangers" part, anyway.

Another reason I've been thinking about family is that we've had some EMS calls lately that have been more stressful than average. A full arrest, who should have been able to be saved if any are. We had every advantage. We were right on top of that "cardiac chain of survival." Early activation of EMS, early CPR, early defibrillation... or there would have been had she had a shockable rhythm. She didn't. We were called for difficulty breathing, she arrested as we came in the door, and went right to asystole. It was very sad. I still think about her family.
We've had other calls that were serious, too, load and go, don't mess around, this person is SICK. A string of critical calls.

One of the recent ones provided me with a reminder of why I do this.

It was a diabetic issue.
Unresponsive, blood glucose the lowest I've ever seen. Barely hanging on, with his family right there worrying.
But the magic of D50 wins again.
As he woke up, and saw his wife standing near his head, he smiled the brightest, most beautiful smile I have ever seen.

And that, right there, that moment, is what it's all about.
Being able to help people have that moment, to see their family, to smile at each other again.

I nearly wept.

Family.

Don't take them for granted. Enjoy every moment together that you get.

And there it was

In early Spring, the winds change gradually, a hint of warmth one day, rain the next. Sun for a few hours, then a chill breeze. The leaves start to show, and then it snows. It's hard to know when Spring actually begins, when it's here to stay.

The same with summer. Warm Spring days and cool nights gradually shift to a little drier, a little warmer. More and more leaves, flowers, insects, until one day we wonder how the summer flew by so fast. It's impossible to set a date, a time, for when we knew it was really here.


Not so, Winter.

I woke up this morning, and there it was.

I don't care what the calendar says.

The frost on the windshield, the freeze-killed plants, said all that needed to be said.

A harbinger of times to come

This blog started out with a long list of things I wanted to write about, thoughts I wanted to share.

I discovered not too long after I started that the most interesting things to write about, and to read, are the more personal ones, and that the more personal things are often too much to share. A dilemma.


That said...

I meet a lot of people in this tiny town. Often, when they are having a difficult time of some kind. Sometimes, I RE-meet them on those stressful days. People I've known for years, but not well, suddenly thrown in together as they face a difficult event, and I do my best to help ameliorate it.

Sometimes it's great. We reconnect, and I walk away feeling like I was able to be some help to them.

But sometimes, it's a harbinger of times to come, when things will not end well.

A while back we had a call for an older man who had fallen. He wasn't hurt. Just needed a hand up.
This was a patient I had seen before. The last time, at his house when his wife was ill.

I had not heard at the time, but she passed away shortly after that.

So this time, at his house, she was not there.
It was heart wrenching to see how much he has changed in so short a time. His caregiver said simply "He is dying of a broken heart."

It will likely not be long before we are no longer called to that address.

That is the reality of this job.
We do the best we can to help, and then comes a time when we can do no more.

When I was younger, I had very little contact, very little realization of death. My grandparents died when I was fairly young, but I did not know them well, so it didn't have much effect on me. I knew one or two people in my first three decades who died in accidents. I was, I guess, fortunate in this.

Now, I am closer to Death. My own, as I grow older, and other people's as my calling brings me to their doors. It is nearly every day that I recognize a name in the obituaries. A patient. The mother of a friend. Someone I went to high school with. The woman down the road.

It is an interesting thing, this specter called "Death."
Everyone's final act, if rarely their goal.

The Big One

I wear a pager on my hip. Much of the time, I leave my pager "open," that is to say, so I can hear calls for other fire departments in the county, not just my own. I do this partly because I'm as curious as the next person, but also because I know a lot of people in the fire service now, and whenever there is a call, it is likely friends of mine who are putting themselves in danger.

Whenever there is an emergency that requires either firefighters or emergency medical services, the information that tells them where they are needed is preceded by tones on the pager. Listen to these tones often enough and you begin to recognize them before the dispatcher says anything. There is a department near here that has a tone that is distinctive, and is used when they need to alert off-duty personnel that they may be needed. My family calls this the "shit hitting the fan tone."

Whenever we hear that tone, we stop and pay attention. Likewise, whenever any area department is called to a structure fire. Often, when it is a real emergency, or even when it's clearly not, someone will suggest that it's "the big one."

It's sort of an emergency services in-joke. Most of the "big ones" out here in the middle of nowhere aren't really big. Big for us, or for our neighbor departments, maybe. But not much compared to a lot of other places. Some departments, a cat in a tree might be their "big one." And that's not a complaint, at all.

The thing is, whenever anyone says that, there is an underlying suggestion that it COULD actually be "The Big One." Anything can happen. Anywhere. You just never know.

I can't help but think about what must have gone through the heads of all the FDNY responders on 9/11.

It's the big one.

The REALLY Big One, no joke.

That thing, that specter in the back of everyone's minds, this is really it.

And yet, as big as it was, each individual firefighter, each EMT, each person, what they needed to do, their job, was quite simple. One thing at a time. The same as always. Set up water supply. Pull hoses. Make entry. Search and rescue. Triage. Patient care.

And that's what they did. In impossible circumstances, a situation so beyond the ordinary that there is no way to train for it. They went to work, did their jobs, and were there to help people they had never met.

Only the world came down around them.

I will never forget the moment I saw the first tower begin to fall. Slow motion. Looking exactly like one of those planned demolitions of the old casinos in Las Vegas that there are documentaries about.

Except.

Except.

My mind froze the moment I realized.

There are people in there.

People who had simply gone to work as usual that morning.
People who could not possibly escape, and who likely had time to realize that.
People with families. Husbands. Wives. Sons and daughters.

And heartbreakingly, sadder than sad, those who had gone to rescue them.

People often say that a firefighter is "willing to die for others." That they "rush into burning buildings."

Like hell.

No sane person is "willing to die."
No sane person rushes in without considering the circumstances, the risk/benefit ratio.

They may choose to take a calculated risk.
And they may underestimate the risk, for whatever reason.

No one knew what the risks were that day.
No one could imagine them.

They can, now.

Since that day, I have met people who were there. People who have stories to tell, about how they were able to survive when others didn't make it. Stories they don't often tell. It isn't about them.

It's about those who can no longer tell their stories.

We lost a lot of good people that day.

Let their sacrifice inspire you to make a difference in the world. We're left with a lot of catching up to do, to do all the good they might have.

Do something in their memory today.

EVERY day.

Three years

As of today, there have been 1040 residential fire fatalities this year, compiled by the US Fire Administration's Quick Response Program. This list is compiled from the media, meaning that there are undoubtedly fatalities that aren't on the list because they didn't make the newspaper. You can see the list here.


Three years ago today, our house burned.
Last year, I posted a description of the events of the day.

Today, we still have not gone through all the boxes of stuff that was packed up by the cleaning company, but we have gone through a lot of them. We have donated, given away, and thrown away a lot of it. While not down to the level we hope to eventually reach, we have far less "stuff" in our house now, and that's a good thing.

As of last month, when my daughter joined, we now have three of the four of us in the fire service. While I had been interested in the fire service for most of my life, and my oldest had some interest before our fire, there is no escaping that the fire was quite... motivational.

It is the beginning of the school year, of the academic semester at local colleges, and this means that a lot of people are going to spend their days in large buildings with crowded conditions, and a lot are going to be living in dorms, also often crowded, or at least, high occupancy.

Take fire safety seriously.
While the most common causes of residential fires may be unattended cooking or that all-too-famous "carelessly discarded cigarette," causes that might be avoidable, they do not all begin that way. Sometimes, there is no warning.

What happens is this: an emergency, by its nature, happens suddenly. You don't have time to think, to decide, to make rational choices. You may be in an unfamiliar building. You may be asleep. There is no way to know.

Make your plans NOW, before things go wrong. Practice them.
You may want to make changes in your house. More smoke detectors. Fire extinguishers. Escape ladders. Furniture arranged so that windows are accessible. Less clutter. Care with the placement and loading of outlets or extension cords. Appliances unplugged when not in use.

If it feels like you are so prepared that no matter what happens, escape will be easy, so you don't need to worry about it- that would be great!

I guarantee you that you do not want to suddenly find yourself inside a burning building, with no protective gear, holding an empty fire extinguisher, facing a fire that is growing exponentially, hoping that your children and pets are already outside. You do not want to hear the fire destroy everything it reaches, or see your house full of smoke down almost to the floor. You don't want to stand in your yard, waiting for help to arrive, wondering if you will have anything left, or where you will go, what you will do. You don't want to hear the firefighters with a chainsaw on your roof.

Trust me on that.

Paying it Forward

In the past few years, I've had some financially difficult times. More than once, online friends- sometimes people I barely know- have come forward to help me out right when I needed it most. A miraculous save. Appreciated far more than I could ever express to them.

I have an opportunity to pay some of that forward, and I'm asking anyone reading this to consider helping, too.

One of the blogs I read is written by a fellow EMT-B who goes by the name of Epijunky.

Contrary to the sound of her name, she's more than a trauma junky, for sure. Her heart is in great patient care, whether it's an emergency or a transfer, and she expresses it with soul and wit, even when she's sometimes a little crispy around the edges. She often brings tears to my eyes, and she reminds me why it is that I do this.

Since I started reading her blog, she has more than once mentioned wanting to be a paramedic, and recently, she passed the entrance exam to be accepted to the school near her. She was worried about the exam, but those of us who have gotten to "know" her online had no doubts at all.

Then the bad news hit, and she was going to have to call it quits for financial reasons.

Fortunately for all her future patients, one of her blogfriends has put together a donation account on paypal so everyone who cares about her and/or thinks she would make a great paramedic, can chip in a little to help make it happen. It only takes a little from each person to help her out a whole lot.

So I'm asking you to consider it. Go on over to Bernice's blog and look for the donation button.

I know how hard it is to need help. And I know it's even harder to ask for it. I know Epi would never ask for herself, so I'm joining the group of people asking on her behalf.

And Epi, if you read this... I also know how hard it is to accept help. Just do it. It's not really for you, it's for all the people you will be able to help. They need you.

Don't leave me

I learned something today.

I recently took a class at the state Fire Academy, certifying me as a Fire and Life Safety Educator. This is a subject very near and dear to my heart, for a variety of reasons.

I am working on organizing a class in the Fall for middle school aged kids, and will undoubtedly write about that here off and on. As part of my preparation for that class, I have been researching a variety of fire safety issues, including what is taught to what ages- and what is not.

One of the things that is fascinating about fire safety is that even people who know better, often don't act on what they know. For example, one might think that firefighters are the most safe people, as far as making sure there are not hazards in their house, that they have enough detection devices, and that they practice what they preach.

Not necessarily so.

At our house, we are pretty paranoid about it, having had a serious fire. We have more smoke detectors than you can shake a stick at, of various types. We have Carbon Monoxide detectors. We have escape plans and fire drills, and talk about it all incessantly.

Even so.
There are a variety of things we could do to make our house safer, that we somehow don't manage to get done.
And if WE don't, as paranoid as we are, I can only imagine what other people do- and don't do.

I read some statistics yesterday that said that according to the National Fire Protection Association (NFPA):

Fire is the third leading cause of accidental deaths. Residential occupancies account for most fire fatalities and most of these deaths occur at night during the sleeping hours. 1.5 million Americans are injured by fire each year. It is estimated that each household will experience three (usually unreported) fires per decade and two fires serious enough to report to a fire department per lifetime.

This means that most people, at some point in their lives, will have a fire.

The most common cause of home fires is unattended cooking. Food left on the stove while the person leaves the room to do something else.

I've been guilty of this. If the heat is turned down low, I know the food won't burn, and there isn't anything near the burner that might catch fire, then what's the danger?

Well.

This evening, I was cooking pasta. Boiling water, basically. What's dangerous about that?

When I turned the burner on, it lit as usual. A few seconds later, for some unknown reason, the fire went out- but the gas was still on!! If I had left the room, I would not have known this happened. And if the gas had built up, and found an ignition source...

Have any of you ever seen a building that has had a gas explosion? Probably some of the folks reading this have. Hopefully, most of you have not, and never will. Let's just say that being inside that building would be a most unpleasant experience.

I'm cured, that's for sure. I will NEVER leave the room with the stove burners on again. I strongly encourage you to do likewise.

How much?

We're almost to the end of the semester. Soon it will be time for the evaluations again. I can't wait!

We did a couple of things a little differently this semester, so it will be interesting to see what, if anything, that changes in the reviews we get.

The main things I've been thinking about:

How much does someone need to know in order to be able to do the things they need to do?
How much intellectual understanding is necessary, and why?
How does the progression of the class change, depending on the goal of the class?
What level of precision is reasonable to expect in 12 weeks, and how is that affected by whether or not the student will be continuing?


The university PE classes have always been sort of the "odd man out" in our overall program. These people will almost all NOT be continuing students. They take one class, for a semester, get their credit, and move on. They aren't really dedicated to the sword, and most of them don't want to put in the effort such dedication would require. They want to pass the class, maybe. They want to be able to say they "fenced in college."

For the most part, that's fine. In the fire service, this class would be at the "awareness level." Learn enough about it that you can recognize it, know what it is, and know who to call for additional help, but no real training to deal directly with the situation. These students will have seen a little fencing, learned a little about it, tried it on for a day or two (like a level A hazmat suit) to see how it feels, but they aren't likely to ever need to use it.

We show them a lot of things, but don't expect much, if any, technical precision in any of it. Enough that they aren't an immediate danger to themselves or others, but not enough that they can perform any of the techniques at anything close to what they would need to defend themselves. We simply don't have the time to do that, nor do they have the interest, most of them, to sustain that level of training.

Our introductory class elsewhere has a slightly different purpose. It is designed to give the student enough exposure that they can decide whether or not this is something they are interested in enough to continue. It is also designed to support and be preparation for the continuing classes that follow it.

What this means is that we require a higher level of precision, right from the start. We introduce things more slowly, giving more time to work on each skill before moving to the next. If we didn't do that, we'd have people slogging through a bunch of uncoordinated movements, none of which would build towards the goal of learning to fence. We still need to have things move along relatively rapidly, in order to reach that goal of helping people decide whether this is for them. It is a different balance of information/precision than the PE classes.

Once a student finishes the introductory class, and chooses to continue, indicating that they have made a commitment to fencing, the continuing classes move at a MUCH slower pace than any of the introductory classes. NOW, we're trying to gain skill. This requires much repetition, and time to integrate each skill. There is no point to moving ahead more quickly, since the results would be counterproductive.

Back to the classes this past semester and my questions.

How much does a PE student need to understand, in order to do what they need to do?

That has to start with an agreement of what they need to be able to do, and the answer is... not much.

What I would like the class to be able to do:

1. Not hurt anyone.
2. Have some semblance of moving without undue distress, and without falling over.
3. Try a few things with the blade that suggest the skills of fencing.
4. Have fun doing it.
5. Gain an appreciation of what is involved in being able to do this at a high level of skill.


Some of these are easy to evaluate, others take some consideration.

The first one- not hurting anyone - is easy to evaluate.

The second one takes some decisions about what that means. At what level will I make corrections, and what will I "let slide"?

As we introduce each skill, we give a lot of feedback, both to the group as a whole (because they all make similar mistakes) and to each student (to point out to them specific things they need to focus on). We describe and demonstrate each skill, facilitate practicing it, and keep reminding them of the details. Most students, after some practice, will begin to incorporate the skill, and begin to self-correct. But not all of them. Some will, even at the end of the semester, still make fundamental errors, things we have pointed out and corrected over and over and over, either unwilling or unable to make any changes.

In the PE classes, as long as they aren't dangerous, we don't care. We don't have the time to continue to give individual corrections to someone who is not invested enough to make changes. At that point, people who are making an effort- and that is easy to see- will continue to get as much individual feedback as we can provide. Those who are phoning it in can do whatever they do, as long as it's not a safety issue. They will get reminders, but they will be broad concepts, not specific details, since they can't process any details for skills they aren't even beginning to do.

In the other intro classes, we continue to try to give a lot of feedback, to a point. Some students will clearly not be making an effort- but they also usually stop showing up to class. In these classes, they aren't concerned about a grade, so if they decide they aren't interested, they just quit. Anyone who still shows up is making at least that much effort, and almost all of the time, will be making improvement in each class. Those who are not- and there are usually one or two- are probably there because their parents make them go. We'll give them some reminders in each class, but if they don't respond, then they just don't.

Once we are past the intro level classes, we give individualized feedback for all students, as much as we can, with the expectation that they will focus on the feedback and make corrections.

When I was a student, rather than teaching, I was hugely impressed by the Master's skill at being able to give individual feedback to every student, at exactly the level they needed in order to work on exactly what they needed to work on. Turns out that although it certainly takes effort and energy, it isn't hard to do, with a body of knowledge that has a clear progression of skills.

The third class goal- trying a few things. That's simple. We do that.
And the fourth, have some fun, that's pretty clear, too.

But the fifth one... gaining an appreciation of what is involved. I'm not sure we ever really meet that goal. Some appreciation, sure. Real appreciation- I don't think it's possible at this level because there is no frame of reference. I need to think about that one some.

This semester, one of the things we did differently has to do with how much theoretical knowledge we presented in the PE classes. We skipped some stuff we have introduced in all the previous semesters, information that is critical to understand if you really want to learn to fence. It was an experiment. It felt... awkward. Odd. Incomplete. But that is probably because I have ALWAYS had that included, whether in a class I've taken, or one I've taught. Force of habit, or of expectations. My question became whether the CLASS missed that material, or if only I did.

The answer surprised me somewhat.

Looking at their level of understanding, compared to previous years, they clearly understand way less. We didn't teach it to them.

But looking at their level of physical performance... it was the same, and in some cases, slightly better. Granted, "slightly better" is probably a score of 5% rather than 4%. They don't have any real skill to speak of, so there is not a lot to compare. The important thing is that their skill level was NOT worse. This suggests- but does not prove- that the information we omitted was not necessary at this level.

I suspect that their level of enjoyment of the class is unchanged. They can't miss what they don't know exists. I will be interested to see if we get any clues from the evaluations about the overall level of enjoyment of the class, compared to previous semesters.

It might be worth continuing this experiment. Do they actually enjoy the class more, and feel like they have gotten more out of it, if we don't clutter their brains with too much theory? Do they WANT to understand more (quite possible), but need to understand less? Is it more important for them to experience the scientific nature of the way everything works together, theoretically, or is it more important that they make some broad movement attempts, and feel how that feels?

They answer, of course, is yes. Or no. Or it depends. All of the above, and none of it.

It's ALL important, and necessary, for someone who wants to be able to fence at a high level of skill- and why would anyone want to do it any other way?

But it is, perhaps, not all important for a PE class.

I need a larger sample size to begin to evaluate this.
And I need to get past my own biases and preferences and intellectual overattachments, too.

I mean, really. Look at this overly long vomitosis of wordiness. I overanalyze everything.

Maybe, just maybe, NONE of the theory, none of the explanation, is really important, in the grand scheme of things.