Ordinarily I save "In other news" for the end of a post, but the World Beard and Moustache Championships just can't wait. Some pictures are worth more than a thousand words! Only 591 days and counting until the 2011 installment. http://www.worldbeardchampionships.com/
I paid a quick visit to Hanover this past weekend for a belated celebration of Ellen's birthday. In addition to getting to spend altogether too-scarce time with Ellen, I also got to see a number of undergrad and grad student friends. The temperature dipped below freezing at night, which was a clear sign that fall has arrived. On the plus side, this made for stunning foliage on the lengthy drive to and from New Hampshire.
Paramedic school continues to go well. It's hard to believe I'm more than 10% of the way done already. The program is becoming increasingly rigorous (we took three exams today and more are on the immediate horizon), but I'm loving every minute of it. In addition, I was hired by a local ambulance company last week to do part-time standby and shift work. This is a great opportunity to keep up my skills and gain some experience working alongside veteran paramedics, so I'm pretty excited. New-hire training begins on Thursday and I'm heading back to the operating room tomorrow to continue with intubation clinicals. It's going to be a good week!
Congratulations to the Yankees for clinching the AL East and to the Giants and Jets for starting the season 3-0!
About Me
- Robert
- I'm a 2009 graduate of Dartmouth College who loves Jesus, my wife and all things Northeast.
Tuesday, September 29, 2009
Monday, September 21, 2009
Last day of summer
Despite my most fervent efforts to forestall it, the last day of summer has arrived. It's not that I don't like fall--it boasts the baseball playoffs, football season and the U.S. Chess League--but I like summer better. Above and beyond the aforementioned autumnal advantages, though, this fall brings considerable reason for excitement. Not the least of which is ELLEN'S BIRTHDAY TOMORROW!!
As hard as it is to believe, I'm 10% of the way through my paramedic class. It has exceeded my expectations thus far, for classroom, lab and clinical components alike. I have a number of clinicals coming up; in addition to my return to the operating room and rescheduled trip to the morgue (last week's trip got canceled because there were no autopsies scheduled), we begin Emergency Department rotations in a few weeks. We're concluding pathophysiology and immunology with tomorrow's exam, and Patient Assessment starts on Thursday. After that will be pharmacology, respiratory and cardiology, which will take us most of the way to Christmas.
Chess also continues to go well. I won the Daniel R. Acker Grand Prix tournament on Saturday with a score of 3.5 / 4. It was a small but strong tournament, with no titled players but five people rated Class A or higher. The tournament organizer even graciously posted two announcements on the Buffalo chess blog welcoming me to the area. Here's my Round 2 win over Class A player Glenn Westcott:
1. d4 d5 2. c4 c6 3. cxd5 cxd5 4. Nc3 Nc6 5. Nf3 Nf6 6. Bf4 Qb6 7. Na4 Qa5+ 8. Bd2 Qc7 9. Rc1 Bf5 10. Ne5 e6 11. e3 Bd6 12. Nxc6 bxc6 13. Bb5
13. ... cxb5 14. Rxc7 Bxc7 15. Nc5 0-0 16. 0-0 Bd6 17. Qe2 a6 18. Rc1 Rfc8 19. f3 h6 20. Qe1 Bc7 21. Ba5 Bxa5 22. Qxa5 Nd7 23. g4 Bg6 24. Rc3 Nb8 25. Qb6 b4 26. Qxb4 Nc6 27. Qa4 Kh7 28. Nxa6 Ne7 29. Rxc8 Rxc8 30. Nc5 Nc6 31. Qa6 Rc7 Black resigns.
I'm also beginning to settle into "WNY" life in other ways, most notably an apparent resolution to my search for a church home. More on this soon.
As hard as it is to believe, I'm 10% of the way through my paramedic class. It has exceeded my expectations thus far, for classroom, lab and clinical components alike. I have a number of clinicals coming up; in addition to my return to the operating room and rescheduled trip to the morgue (last week's trip got canceled because there were no autopsies scheduled), we begin Emergency Department rotations in a few weeks. We're concluding pathophysiology and immunology with tomorrow's exam, and Patient Assessment starts on Thursday. After that will be pharmacology, respiratory and cardiology, which will take us most of the way to Christmas.
Chess also continues to go well. I won the Daniel R. Acker Grand Prix tournament on Saturday with a score of 3.5 / 4. It was a small but strong tournament, with no titled players but five people rated Class A or higher. The tournament organizer even graciously posted two announcements on the Buffalo chess blog welcoming me to the area. Here's my Round 2 win over Class A player Glenn Westcott:
1. d4 d5 2. c4 c6 3. cxd5 cxd5 4. Nc3 Nc6 5. Nf3 Nf6 6. Bf4 Qb6 7. Na4 Qa5+ 8. Bd2 Qc7 9. Rc1 Bf5 10. Ne5 e6 11. e3 Bd6 12. Nxc6 bxc6 13. Bb5
13. ... cxb5 14. Rxc7 Bxc7 15. Nc5 0-0 16. 0-0 Bd6 17. Qe2 a6 18. Rc1 Rfc8 19. f3 h6 20. Qe1 Bc7 21. Ba5 Bxa5 22. Qxa5 Nd7 23. g4 Bg6 24. Rc3 Nb8 25. Qb6 b4 26. Qxb4 Nc6 27. Qa4 Kh7 28. Nxa6 Ne7 29. Rxc8 Rxc8 30. Nc5 Nc6 31. Qa6 Rc7 Black resigns.
I'm also beginning to settle into "WNY" life in other ways, most notably an apparent resolution to my search for a church home. More on this soon.
Tuesday, September 15, 2009
Clinicals begin
The clinical component of my paramedic course began last week with a trip to the operating room for hands-on advanced airway experience. Anytime a patient is placed under general anesthesia, he cannot breathe for himself and must have the anesthesiologist do it for him. Hence, once the patient is unconscious, a thin plastic tube is placed in the airway and connected to a ventilator. This ensures that the patient receives adequate oxygen as well as sufficient anesthesia gases to maintain a deep level of sedation. It's rare for prehospital care providers to have a ventilator on hand, but the intubation procedure is the same in the OR as at the side of the road, which makes this an effective method of skills practice.
It was something of a slow day at the OR when I went, at least in terms of cases requiring general anesthesia. There were a number of surgeries being performed under local or regional anesthesia, but since those procedures don't require the patient to be intubated, they didn't do me much good. I wound up attending two surgeries and performed one intubation. Unfortunately, the requirement is that I perform four intubations (one of which must be a laryngeal mask airway placement), so I'm heading back at the end of the month to finish up.
Tomorrow I'm headed to the county morgue to observe two autopsies. I don't need to participate at all, just watch the medical examiner at work. The goal is to give us a better sense of topographical anatomy (i.e., where everything is in the body), which will be beneficial as general knowledge but especially for our understanding of trauma calls. In the evening I'll be attending a meeting of the local Regional Emergency Medical Advisory Committee (REMAC). This is a board of physicians and other experts who approve protocols for use by EMS providers. I'm looking forward to glimpsing the process by which our protocols and procedures are decided upon and modified. And I'm sure it'll smell better than the morgue.
In other news, I made my Western New York chess debut on Saturday, winning the Jenifer Woods Memorial Grand Prix with a score of 3.5 / 4. The tournament was rather top-heavy, with two of the eleven players holding the title of FIDE Master. I managed to defeat both masters before a last-round draw with one of the Duke Chess Team's recent alumna. The tournament was hosted by the Rochester Chess Center, which is an excellent venue for playing chess. It boasts the elusive combination of a well-equipped facility and a low-key, friendly atmosphere and staff. If only it weren't an hour and a half away!
It was something of a slow day at the OR when I went, at least in terms of cases requiring general anesthesia. There were a number of surgeries being performed under local or regional anesthesia, but since those procedures don't require the patient to be intubated, they didn't do me much good. I wound up attending two surgeries and performed one intubation. Unfortunately, the requirement is that I perform four intubations (one of which must be a laryngeal mask airway placement), so I'm heading back at the end of the month to finish up.
Tomorrow I'm headed to the county morgue to observe two autopsies. I don't need to participate at all, just watch the medical examiner at work. The goal is to give us a better sense of topographical anatomy (i.e., where everything is in the body), which will be beneficial as general knowledge but especially for our understanding of trauma calls. In the evening I'll be attending a meeting of the local Regional Emergency Medical Advisory Committee (REMAC). This is a board of physicians and other experts who approve protocols for use by EMS providers. I'm looking forward to glimpsing the process by which our protocols and procedures are decided upon and modified. And I'm sure it'll smell better than the morgue.
In other news, I made my Western New York chess debut on Saturday, winning the Jenifer Woods Memorial Grand Prix with a score of 3.5 / 4. The tournament was rather top-heavy, with two of the eleven players holding the title of FIDE Master. I managed to defeat both masters before a last-round draw with one of the Duke Chess Team's recent alumna. The tournament was hosted by the Rochester Chess Center, which is an excellent venue for playing chess. It boasts the elusive combination of a well-equipped facility and a low-key, friendly atmosphere and staff. If only it weren't an hour and a half away!
Monday, September 7, 2009
Doing double duty
In honor of Labor Day, I wanted to highlight an article from Thursday's New York Times entitled "Firefighters Become Medics to the Poor." Imprecisely titled and haphazardly organized, the article nevertheless touches upon several of the major issues confronting EMS and the fire service today.
The article, which follows the Washington, D.C. Fire Department's Engine Company 10, boasts a title that suggests firefighters have not always been called upon to provide emergency medical care. In reality, Engine Company 10 is staffed and equipped for both fire and medical calls. The shift in the proportion between EMS and fire calls is a fascinating and complex issue unto itself, as is the reaction of the emergency services community to this phenomenon.
The issue at the center of the article is excellently presented: First responders are increasingly called upon to act as primary care physicians. Unfortunately the author doesn't pursue this question in any depth. What does it say about society when poor people choose to call 911 instead of going to see a doctor? Is it selfishness, an abuse of the emergency response system? Or is there a broader social statement when millions of people cannot afford to see a physician but desperately need medical treatment of some kind?
Prehospital emergency care rarely comes cheap to the patient (for more on reducing the costs associated with ambulance treatment, see my earlier post on the subject). Calling for an ambulance instead of making an appointment with a physician will not fend off a bill. The bottom line may even be more expensive with an ambulance ride since often this results in a trip to the emergency department and opens up an entirely new front of charges.
There are some people who take advantage of the 911 system, it is true. But these individuals are much rarer than those who simply see an ambulance as their only means to medical care. This may stem from inadequate or nonexistent health insurance or from some other obstacle. Whatever the case, the American health care infrastructure is in a state of crisis. No one should ever have to call an ambulance because they have no other access to health care. But as long as they do, EMS will be there.
The article, which follows the Washington, D.C. Fire Department's Engine Company 10, boasts a title that suggests firefighters have not always been called upon to provide emergency medical care. In reality, Engine Company 10 is staffed and equipped for both fire and medical calls. The shift in the proportion between EMS and fire calls is a fascinating and complex issue unto itself, as is the reaction of the emergency services community to this phenomenon.
The issue at the center of the article is excellently presented: First responders are increasingly called upon to act as primary care physicians. Unfortunately the author doesn't pursue this question in any depth. What does it say about society when poor people choose to call 911 instead of going to see a doctor? Is it selfishness, an abuse of the emergency response system? Or is there a broader social statement when millions of people cannot afford to see a physician but desperately need medical treatment of some kind?
Prehospital emergency care rarely comes cheap to the patient (for more on reducing the costs associated with ambulance treatment, see my earlier post on the subject). Calling for an ambulance instead of making an appointment with a physician will not fend off a bill. The bottom line may even be more expensive with an ambulance ride since often this results in a trip to the emergency department and opens up an entirely new front of charges.
There are some people who take advantage of the 911 system, it is true. But these individuals are much rarer than those who simply see an ambulance as their only means to medical care. This may stem from inadequate or nonexistent health insurance or from some other obstacle. Whatever the case, the American health care infrastructure is in a state of crisis. No one should ever have to call an ambulance because they have no other access to health care. But as long as they do, EMS will be there.
Thursday, September 3, 2009
Sad news from the fire service
The Buffalo Fire Department suffered two line-of-duty deaths last week. Lt. Charles McCarthy and Firefighter Jonathan Croom were killed last Monday when the first floor of a burning building collapsed, trapping them in the basement. Investigators have not determined what caused the fire.
Lt. McCarthy entered the building after bystanders reported hearing voices from inside calling for help. When the floor collapsed, Lt. McCarthy radioed for help and Firefighter Croom went in to rescue him. Unfortunately he too fell through the floor and additional efforts to reach the men were unsuccessful. After the fire was extinguished, investigators concluded that there was no one in the building besides the deceased firefighters. It was not immediately clear if there had been someone trapped inside who had managed to escape, but authorities later determined that the voices the bystanders reported hearing came from an unrelated argument taking place on the street in front of the store.
Emergency services personnel are above all public servants, and Lt. McCarthy and Firefighter Croom served with distinction and honor. These men exhibited a depth of commitment and steel of resolve to the public welfare that sets the bar for every emergency services worker. The next time you meet a firefighter, thank him in memory of these two fallen heroes.
Lt. McCarthy entered the building after bystanders reported hearing voices from inside calling for help. When the floor collapsed, Lt. McCarthy radioed for help and Firefighter Croom went in to rescue him. Unfortunately he too fell through the floor and additional efforts to reach the men were unsuccessful. After the fire was extinguished, investigators concluded that there was no one in the building besides the deceased firefighters. It was not immediately clear if there had been someone trapped inside who had managed to escape, but authorities later determined that the voices the bystanders reported hearing came from an unrelated argument taking place on the street in front of the store.
Emergency services personnel are above all public servants, and Lt. McCarthy and Firefighter Croom served with distinction and honor. These men exhibited a depth of commitment and steel of resolve to the public welfare that sets the bar for every emergency services worker. The next time you meet a firefighter, thank him in memory of these two fallen heroes.
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