11,000 miles

My car hit the 11,000 mile mark over the weekend. I bought it in August with more than 122,000 miles on it, and thirty weeks later it has consistently proven itself sturdy and reliable. With all the negative press Toyota has been receiving lately, I'm relieved that my car is as dependable as ever. Despite the fact that I haven't made the drive to or from New Hampshire in nearly three months, I nevertheless average fifty miles of driving per day. And with spring break trips to NH and MA looming, I bet that number will be climbing.

Not long ago, I received a letter from the community college inviting me to join Phi Theta Kappa, which is the two-year college version of Phi Beta Kappa. Evidently I qualified based on my high marks in my paramedic classes. It was flattering to be recognized in that way, but I am declining induction into the society. This feather seems unlikely to outweigh the Ivy League degree already in my cap. There is no point in paying a fee for an honor that I cannot utilize.

Lastly, my external checklist for verifying the arrival of spring is almost complete. The vernal equinox is past, Daylight Savings Time has begun and Opening Day is nearly here. All that remains is for leaves to reappear on the trees. I don't care how warm it gets; bare branches and springtime cannot coexist.

Spring break begins

Yesterday was the end of the International Trauma Life Support module, in which a month's worth of study and lab practice culminated in a 118-question written exam and a trauma "Megacode." We now enter spring break, after which we return for a month of internal medicine lectures. When we get back, we head to the lab for Advanced Cardiac Life Support and then start practicing for our exit megacodes. The end is in sight, which is both exciting and a little scary.

I'm leaving tomorrow to spend spring break with Ellen in New Hampshire. We leased an apartment in which to live once we're married; I'm looking forward to seeing it in person. And of course my excitement about seeing Ellen should go without saying (but I'll say it anyway!). Ellen has work and classes to occupy her during the day, so I'm hoping to have ample time to visit with some old friends as well.

April Fool's Day isn't until tomorrow, but the community college spring break begins today, so I had to get in my practical joking early. Last week in the English tutoring lab, we had a long discussion about the proper way to cite a title using APA format if the title itself ended with a punctuation mark like a question mark or exclamation point. The APA style book does not address that situation, so I decided to take matters into my own hands.

In the tradition of K. Jason Sitewell , I fabricated the following email and handed it to the director of the lab, telling her that I had emailed the APA and this was their reply:

"Hello,

Thank you for your recent inquiry. Indeed, several others have pointed out this ambiguity in the APA guidelines. In the situation you mentioned, the two punctuation marks cancel each other out. It is proper to omit both the punctuation mark in the title and the period following the title.

Regards,
Irma Kidder"

She bit. Fifteen minutes later she came into the lab with the MLA style book to compare the APA's "answer" to other takes on the subject. I played it straight, and she soon left to forward the email to the psychology professor whose assignment had prompted the question in the first place. At this point I revealed the jest, eliciting a shriek of delight.

A full plate

Phase I of my field internship is flying by. I passed the one-third point on Tuesday and I'll be nearly three quarters done by the time spring break starts next week. My preceptor is incredibly knowledgeable and I've learned a ton so far. The call volume has been fairly low, but the patients have been pretty sick, so I've gotten to practice a number of my skills. Also, I checked with the clinical coordinator, and he said that the seventy five hour requirement is a minimum only. We're free to ride as much as our schedules and our preceptors' permit. My plan is to ride as much as feasible; when else am I going to have this opportunity?

Updating a previous item, a slot opened up on the crew for Friday's Sabres-Senators game, so I'll get to work it after all (my original shift bid had been denied). I'm also covering half a shift on the ambulance on Saturday evening and providing standby coverage for a high school hockey tournament on Monday. With field internship shifts on Thursday, Sunday and Tuesday, I'll be spending the next six days/nights on the ambulance. I'm half-seriously considering just moving into the parking lot at headquarters (which has been done before). I already keep a clean uniform and pillow in the car . . .

In other news, California is unveiling its newest money-saving venture: Early release for prisoners. If I didn't know better, I'd suspect an early April Fools prank. Notwithstanding its $20+ billion budget deficit, CA has a 70% recidivism rate. How on earth will spending less time rehabilitating inmates make that better?

Weekend roundup

The NCAA first round games were played in Buffalo on Friday, and I provided EMS standby coverage for the first half of the day. There were relatively few calls, which allowed my partner and me to watch most of the games. We saw West Virginia destroy Morgan State and a battle between Clemson and Missouri that was close until the final few minutes. There are four HSBC events remaining in March--three Sabres games and a wrestling event--and I'm hoping to work at least one of the hockey games.

Ellen came to visit this weekend, and it was wonderful to see her. It had been far too long since our last visit. The weather cooperated, thankfully, and gave us two beautiful days before relapsing into rain the day she left. I'm heading out to NH next week for the ECC spring break, so it won't be nearly as long before our next time together.

The United States and Russia have moved forward toward a new nuclear arms treaty. The most recent treaty, 1991's Strategic Arms Reduction Treaty, expired at the end of last year. One of my personal heroes, publisher and humanitarian Norman Cousins, was a lifelong antiproliferation activist. (He was also my great-uncle.) The upcoming treaty, which is expected to be signed next month, will represent continued progress toward a goal that was not realized in Norman's lifetime.

March Madness

I just finished filling out my bracket for the NCAA March Madness basketball tournament. Admittedly I'm a few hours late, but I didn't alter my picks based on the results of today's early games. Don't believe me? Just look how far I had Notre Dame advancing (Sweet Sixteen). Just for kicks, I compared my bracket to that filled out by President Obama; we agree on twenty three of the thirty two first-round games and have three of the same Final Four picks. As for the tournament champion, I see Kentucky winning it all. Not only are they a powerhouse, they have DeMarcus Cousins. You have to root for a team like that.

Speaking of March Madness, I'm providing standby EMS coverage at HSBC Arena tomorrow for the first round of games in the Eastern Region side of the bracket. Hopefully I'll be able to watch a good chunk of the action when my other duties don't call me away. And after I get home from that, I'll be mere hours away from seeing Ellen! Add to that a weather forecast calling for highs in the 60s and you have a recipe for an amazing weekend.

I haven't been playing much chess recently. Between class, clinical and work, there just hasn't been time. I have, however, been playing correspondence chess via email. After four of six games, my score is 4/4. My two remaining games are veritable battles--and uphill struggles both--but I'm thoroughly enjoying getting to play. It's not the same as over the board chess, but it's fun all the same!

In other news, The New York Times has a nice piece on Rudyard Kipling's Vermont home. Not only did I not realize he lived in Vermont for a time, I didn't know that he introduced tennis and downhill skiing to the state too. That, and he wrote a little bit.

Happy St. Patrick's Day

I realized too late this morning that I don't have a shred of green on me. That's a risky practice on St. Patrick's Day and all the more embarassing for an alumnus of the Big Green. Then again, I'm going straight from the tutoring lab to my geriatrics clinical, and there is no green on the clinical uniform. Maybe I'll spill some lime Jell-o on myself.

I'm looking forward to the geriatrics clinical. We aren't expected to do much in the way of procedures, since the clinical site is an assisted living facility with a small skilled-nursing wing; emergency medical care is not the primary institutional focus. Still, we can practice interacting with elderly patients and working through the unique challenges presented by patients in that demographic, especially those with hearing, vision and memory impairments.

In other (and far more exciting) news, Ellen is coming to visit on Friday! The weather has taken a timely turn for the better, too, so all systems are go for a fantastic weekend.

Field internship begins

My 255+ hour field internship began yesterday with a relatively low-key fourteen-hour shift. We took two 911 calls and a "take-home" transfer, where the patient goes home rather than to another medical facility. My preceptor allowed me to actively participate in patient care; I operated the cardiac monitor, administered medication and drew blood, among other things. There's plenty to do before I'm ready to take to the streets as a full-fledged paramedic, but it's exciting to have my field internship underway.

In the classroom, International Trauma Life Support is moving along at a healthy clip. We've been spending a lot of time in the lab, which has been great, with days of classroom lectures interspersed to keep things interesting (though the opposite is often true). A number of the skills are holdovers from the EMT-Basic curriculum with one or two advanced procedures appended. Others, such as intubation of the trauma patient and needle chest decompression, are paramedic-only skills.

Between class, clinical and work, I've seen an unfortunate decline in my reading time. I finished The Adventures of Tom Sawyer a week and a half ago, and even though The Adventures of Huckleberry Finn is not significantly longer, I've yet to make much of a dent in it. Hoping to play some serious catch-up over spring break . . .

In other news, the Internet Movie Database reports that a movie version of Tom Clancy's 1993 novel Without Remorse. No confirmed word yet on who will play protagonist John Kelly / John Clark.

Special events

The ambulance company I work for has a policy that only its part-time employees are eligible to cover events at HSBC Arena. When I first started, I was roundly advised to take full advantage of that policy. Talk about excellent advice. On Tuesday, I got to see the Billy Joel / Elton John "Face to Face" concert, and the next day I watched the Sabres defeat the Dallas Stars. There was work to do also--we treated patients with chief complaints ranging from cuts to difficulty breathing--but I was able to see the majority of both main events. My next shift will be on Friday for the first round games of the NCAA March Madness basketball tournament.

I spent this morning at a clinical in the Electrophysiology / Cath Lab at the county medical center. It reminded me of the stroke unit clinical I attended last month, albeit focused on the heart instead of the brain. Both labs can place stents in patients, for instance, although I didn't get to see a cardiac stent procedure today. As I was leaving, the staff exhorted me to bring any heart attack patients I might have to them instead of to a competing facility. There are multiple hospitals in the area that can place cardiac stents, so I suppose you have to drum up business anyway you can.

Updating a previous item, the Texas nurse being charged with a felony for reporting an incompetent doctor was acquitted on all charges. The trial lasted four days; the jury deliberation lasted one hour. I'm surprised it took even that long.

Getting ready for the home stretch

I spent the bulk of this past weekend doing clinical rotations in the emergency department. Of all my clinical rotations thus far, the ED continues to be my favorite. The other locations have been instructive as well, but the ED gives us the most opportunities to practice the widest range of skills. It's also beneficial to see the course of a patient's treatment after the ambulance crew departs, at which point EMS personnel consider a call complete. After all, EMS workers--and really all healthcare providers--are ultimately in the people business.

My field internship begins on Sunday, assuming the necessary paperwork is processed by that time. This was one of the highlights for me, going into the program, and I am eager and motivated to tackle it head on. The first component of the field internship involves me primarily observing my paramedic preceptor and assisting as directed; the second and longer component entails me functioning as the primary paramedic on the call.

As I mentioned earlier, I am trying to clear up my clinical schedule as much as possible for the spring and summer months in order to better accomodate the field internship. As a result, though, March is jam-packed. In the next ten days, I have five days of class, five clinicals, three tutoring shifts, two field internship shifts and two EMS standby coverage events. Once that is behind me, though, Ellen will be here for a visit!

In other news, The New York Times reported today on a Massachusetts study that linked regular, moderate alcohol consumption to a decreased likelihood of obesity. It's an interesting but unconvincing read, seeing as its measure for obesity is the Body Mass Index, which is currently in a dead heat with Nielsen ratings for the title of Most Meaningless Statistic.

Chasing the sunset to Cleveland

Yesterday had been a fairly slow day on the ambulance until an ALS transfer to Cleveland popped up. My partner and I were happy to go, and the only other available crew wasn't dying to make the journey, so we embarked on the three hour trip to the Cleveland Clinic. I'd never been to Ohio before, but I was armed with a GPS and determined to avoid the debacle of my last long-distance transport. About an hour into the trip, I was surprised to see how much light remained, considering how late in the afternoon it was. At the same time I realized that the sun had been setting extremely slowly. Finally I put together the pieces and realized that we were heading west as the sun went down. Chasing the sunset, as it were.

All went well with the transport; traffic was light and we arrived precisely on schedule. Not even Cleveland's crummy roads or the Clinic's bizarre policy of not accepting any patients through the main entrance could get in the way. The return trip was equally smooth, with my partner doing most of the driving on the eastward leg. We got back to headquarters about an hour after the scheduled end of our shift, but I had napped briefly on the way home, so I didn't mind.

This will likely be my last ambulance shift for a few weeks, since I'm trying to pack in the rest of my Clinical III rotations before spring break, but I'm keeping active with standby coverage. I'll be working at the Billy Joel / Elton John concert on Tuesday and then at the Sabres-Stars hockey game on Wednesday. Should be a good week!

In defense of nurses

During a recent ambulance assignment, my partner made an offhanded comment that I found deeply interesting. He was telling me about his son, who is currently working full-time as an EMT but who would like to go back to school and "become a male nurse." My question is, since when was "male nurse" a distinct profession? He'd already told me this was his son, so why the qualifier?

Sexism lies at the root of this phenomenon. I have heard the phrase "male nurse" before, in a variety of settings, and almost always it is uttered with a hint of a sneer. Underlying this derision is the belief that nursing is intrinsically "woman's work." (Whatever that is.) We don't speak of "female bus drivers" or "female lawyers," and it is disturbing to hear nursing treated differently.

Nursing is a demanding profession that constitutes a vital component of the healthcare infrastructure. Often, the relationship between nurses and EMS workers is one of cats-and-dogs antagonism, but we're all on the same side in the end. Speaking disparagingly about nursing and associating denigrating work with females is a compound insult that reflects poorly on those who espouse it. I didn't say anything to my partner at the time, but now I wish I had. Ignorance and sexism unconfronted will not themselves dissolve.

Hockey, hockey, hockey

I worked my first HSBC Arena standby shift yesterday, spending sixteen hours covering the "Super Sunday" hockey games. Super Sunday, I learned, is the culmination of the playoffs for all of the high school and club hockey teams in the area. Eight championship games, one after the next, make for an exciting day. It was especially fun to watch some of the games from the Zamboni entrance, which was closer to the action than I'd ever been before.

Speaking of hockey, Team USA's overtime loss to Canada in the gold-medal game was a heartbreaking end to a remarkable run. Still, the American players and coaches exceeded all expectations and have a great deal of which to be proud. Goalie (and Buffalo Sabre) Ryan Miller's selection as tournament MVP speaks volumes to the high level of play Team USA displayed game in and game out.

Whether it's high school hockey or the single-elimination Olympic playoffs, defeat is heartbreaking. But Team Russia head coach Vyacheslav Bykov seems to want to break more than that. He said of his players, who lost 7-3 to Canada in the Olympic quarterfinals, "Let's put up a bunch of guillotines and gallows. We have 35 people on the hockey team. Let’s go to Red Square and dispatch with them all.”