A Work in Progress

Christmas was lovely; we did all of the traditional things. Including, Chinese food on Christmas Eve, earning the right to get downstairs on Christmas morning, a stocking for the pets, lasagna, cranberry blush, completely overwhelming the children, and baking cookies, of course. One of my favorite things from Santa this year (among others) is a set of silver spoons that belonged to my great-grandparents. They’re engraved with the initials of their last name (also my middle name) and once I polished them up, they’re shiny and beautiful. Seems a bit silly, I mean, they are just spoons, but it's nice to have something special from that side of the family. But, don’t think that spoons are a sad choice for a favorite gift. It’s not like I chose to highlight the spoons out of an array of unusually mundane gifts, having to think to myself: “Well, what can I say was my favorite? The empty box, the spoons, the pack of lined paper, the sock, or the extension cord.” I received normal t...

Oh, how I’ve missed you these last few weeks. You; the curer of many ills, the bringer of needed energy, the generator of dreams, the decision-maker. Don’t get me wrong, naps are great now and then, but are no substitute for long, uninterrupted bouts of sleep. Many times I’ve found myself warm and cuddly wrapped in blankets, only to be brought out of sleep abruptly, unbidden. Alarm clock #1 shouts at me, alarm clock #2 tells me to get up, while I shout expletives at both of them. It seemed that this semester, it was only on the bright, sunny mornings that I didn’t have to get up early, causing sleep to elude me again. No matter, I have made up for it over the last few days. It’s been awesome! It’s all been very relaxing until I realize that I haven’t bought half of the Christmas presents that I need to. Yikes! Come to think of it, I still haven’t done that. Oh well, I’m easily distracted when it comes to these sorts of things…look! something shiny! I have also finally posted the first...

I survived my first day at work as a cleared ALS provider. It was a little weird, but felt great. We had 6 calls in 12 hours, two were BLS. I had my first ‘superstat’ which means that it’s a critical patient that needs to be transferred ASAP. It’s pretty much the only time we get to go lights and sirens in the private ambo service. Our patient was having severe chest pain and was on several drip medications. Once we got her packaged and loaded it only took us 4 min to get to the receiving hospital. In that time the patient gained 1.5 cm of ST elevation in lead 1. We took her straight into a cardiac cath lab where they discovered she had nearly 100% occlusion of the left main, wow! (basically, the patient was having "the big one" (a bad heart attack) and was within minutes of being beyond help.) Everything happened so quickly that the patient wasn’t even registered at the hospital before her cath was underway. When we went back out to the ambulance we were accosted by her dau...

Landing gear down, heat is off, 365 off, door off…wait. Aviation is so fascinating to me, yet I don’t understand it one bit. I feel accomplished just operating my headset and flipping the radio channel switches. Looking in the cockpit, I have no idea what all those gauges, switches, and pedals are for, but I’m glad somebody does. Yesterday I rode the helicopter again. We had two calls, neither of which I would have fathomed calling the helicopter for, but okay. The first was for a guy who fell in the bathroom, and the other was for a kid who had a little too much fun sledding, caught some air, and landed on his back. He was great, totally calm, adorable, and not even complaining that he was uncomfortable. “Can you squeeze my fingers?” “Okay.” (squeezes weakly) “Squeeze them as hard as you can.” (incredulously) “As hard as I can?” (as if to say: “Are you sure, because I don’t want to hurt you with my super-human strength.”) “Yeah” “Well, okay” (squeezes hard) “Ooh, That’s great! You’r...

Being on an ALS chase car is interesting and sometimes frustrating. We’d get a call, and then be cancelled on the way, another one, and be cancelled on scene. Get another call (but don’t get your hopes up) as we’re cancelled again. While we’re en route I’m thinking about treatment plans and drug dosages for the supposed condition, and then…well, nevermind. Chase cars are fun too, we got to meet different BLS crews and ride in some wacky ambulances. We had a patient; 9 months pregnant with contractions 3 minutes apart, and we were in probably the tiniest ambulance I had ever seen. I had to put my feet up on the seat just to switch places with my preceptor. Starting an IV was hard enough, thank God she didn’t start having the baby, I don’t know where we would have put it. We also had a diabetic, dehydration, CHF, and oh yeah, a moped accident involving kids 5, 2, and 20 months. How could three children be on a moped on a blustery winter day? Well, it involves a little neglec...

Yesterday my parents came down and we had a very Baltimorean day. We visited the American Dime Museum which features ‘memorabilia of the exotic and novelty acts of old” such as a mummified giant, shrunken heads, paintings done by monkeys, a two headed cow, a sea monster from the patapsco river and much, much more. (deciding what is real and what's not exactly real is up to you and half the fun!) It's called the 'dime' museum because these novelties were serious entertainment back in the day, and cost a dime to see. Unfortunately, the museum be closing at the end of the month. I suggest you go see this piece of American history while you still can (it’s worth every dime.) Afterwards, I was glad that we stumbled upon the mayor’s Christmas parade going down 36th street or “The Avenue”; it was great. The marching bands were playing Christmas carols, the drum corps were awesome, and Santa was there too! I enjoyed it immensely in spite of myself. We had dinner in Hampden a...

For two nights last week, I was in the city on what I think is the 3rd busiest medic. We were pretty busy and I couldn’t hear the radio at all from the back, so we’d be returning to the station and all of a sudden, we’re going to a mystery location, lights and sirens, like “surprise! we have a call!” Whatever, I like surprises. The calls I went on the first night sounded better as they were dispatched rather than what they actually were. For example, “Shot in the eye with a BB gun.” On the way out of the station, everyone was taunting: “You’ll shoot your eye out!” Little did they know, it wasn’t actually in the eye, but on the eye, therefore making it not so interesting. Also: “Pedestrian struck by vehicle.” True, she was hit by a car, but with no blood, no deformity, no crepitus, strong distal pulses, and no LOC PTA, in other words, very lucky. The second night, I almost missed CHF, forgot charcoal existed, and missed 2 IVs, but, I got to give charcoal (gross!), morphine, and nitro. I...

I started out Monday morning so early that sleeping in until 7 the next day sounded awesome. As I was driving along to this far away clinical, the sun was coming up, the road signs became keystone shaped, and all I could think was “why are there so many people driving at this unholy hour?” It was like a mini road trip except too short to stop and eat, too early or too late to do something impulsive and fun, and I was by myself. The clinical itself was pretty good. The ‘white cloud’ gods didn’t realize I was there until about 10 am, so I got to run a few calls before they stopped coming in completely. I was on an ALS chase car, hospital based system. Upgrading to ALS is nice as the patient is usually already packaged, and histories, allergies, and med lists are already obtained, sweet! We had an asthma attack and a guy who ate a whole bottle of vicodin. The preceptors there are pretty cool as they really do sit back and let you go at it, intervening only if you’re about to kill the pati...

I received my first application for a real job, yikes! This whole real life thing is beginning to freak me out. So far, this is the only company that interests me. To get the job I have to (finish school, get my registry paramedic) apply, take tests etc. Then, if I get it, I have to find a place to live, get reciprocity, probably get a new car, ride 20 shifts before I get cut loose, and oh yeah, this is over 400 miles from home. Don’t tell anyone, but I’m scared. I got cleared at work, yay! (not a fake job per se, but...) Last week, I spent 12 hours of clinical time doing BLS calls, (not that they can’t be useful in some way…wait. what am I saying?) One was a call for a stroke. “Awesome!” says I, anticipating a good ALS call to salvage the day. 5 seconds after we arrived, it became clear that it was not a stroke, heart attack, dismemberment, asthma attack, or fainting; but actually absolutely nothing. Medic: What’s going on that makes you think you’re having a stro...

That (with an open mouthed stare) about sums up my emotions concerning the few patients that I saw during my observation rotation at the premier trauma center in the country. I was told that they often inadvertently have ‘theme nights.’ The night I was there, the theme definitely would have been: Faces. I will spare you from the gory details by using medical terms and other big words. Patient #1: His cerebrum came in contact with a small lead projectile, forcing it to leave the skull permanently. Patient #2: Patient’s frontal lobe was herniating into the orbits. I’ll leave that one to the imagination. Patient #3: Prisoner was stabbed with a bucket handle resulting in a tension pneumothorax. Patient #4: Patient’s face came in contact with a human fist at a high velocity. Patient #5: Defenestrated herself from the second story of a burning building, resulting in the avulsion of the lower 2/3 of her face. If all of these patients had actually only been one ...

Ah, the Harry Potter franchise. I love it. The latest installment in cinema form came out yesterday. I really liked this ‘cliff notes’ version of the book. Granted, I could go on for days about what was missing or changed. And, I believe that people who have not read the books will be pretty lost by the end, it’s book readers movie. I do think that the producers underestimate the attention span of Potter fans. We can follow a scene with more than six lines in it. We can be entertained by scenes without extra dragon time. I love the story for the story; the action is just a bonus. In general: the world cup is short, the challenges have the best effects yet, Rita is hilarious, the acting is better than ever, the Yule Ball is a consummate representation of teen angst, and “He-who-must-not-be-named” is deliciously creepy.

Wednesday was a work day. I got paid mostly to read Harry Potter and JEMS, sweet! We only ran three calls, and one of those was BLS anyway, requiring more muscles than brain cells. The other two calls were pretty good. I felt slightly less retarded running them today as opposed to my last shift. Yesterday I ran with a critical care transport team. My first call was a guy who had a lung transplant last month, and it wasn’t going well. We took him from his bed in ICU to get a lung biopsy. That was pretty cool. First and foremost, I got to wear a lead apron; that was pretty hardcore (and heavy!) Then they used a bronchoscope to go down his ET tube and into his lungs, where we could see the sutures from his lung transplant. After taking some pictures and performing lavage (which consisted of them injecting saline into his lungs and sucking it back out) they stuck a smaller tube in that went deeper than the scope. This tube had a little claw-type thing on it that open up and grabbed some lu...

After an uneventful weekend, aside from getting to hang out with my niece and nephews, today I returned to the illustrious city. If it hadn’t been for said relatives, the weekend may have been a complete loss. Yes, I did have a helicopter shift. We did get to fly to another hangar for maintenance. Other than that, I did some homework, got pretty far into my ‘remind me what happened’ reading of Harry Potter 4, and even watched an entire football game. That should show you how bored I was. A visiting boy scout troop broke up the monotony of the day, a bit. But, back to today. Because I have been one of the lucky few to not be assigned a city preceptor yet, I’ll be borrowing everyone else’s. I rode today with a supervisor truck which was pretty cool. Basically we rode around and squirreled calls that sounded interesting. I was reminded of how much I enjoyed my city shifts last year. We had a heroin overdose who ‘got distracted’ on the way to rehab, a fender bender, twins ready to be born...

Wednesday I had my first shift in a neighboring Maryland county. It was really nice. We had two chest pains in a row and later in the day we had a cardiac arrest in a nursing home. It wasn’t dispatched as such so we brought in the traditional ‘baggage.’ As we went down the hall, all of the employees simply looked at us and then pointed in the general direction of the room. Every single employee, not excitedly, but quietly pointed. We were almost to the room when I thought to myself, we should have brought the monitor. We found the patient conveniently placed right behind the room door with CPR in progress. He should have been suctioned probably 10 minutes before we got there, but alas. We took over, I put him on the monitor and my preceptor went for the tube. I was initially jealous of his position (it was merely more convenient in that ridiculous space in which we had to work for him to attempt the tube) but my jealousy quickly dissipated when what looked to be an easy tub...

I had my first helicopter ride-along yesterday. Leading up to yesterday, it looked likely that I would have to be tied to the helicopter in order for me to go, à la “What about Bob?” Luckily for me, I was just settling in when we got our first call around 7:10. This way, I had little time for second thoughts, as before I knew it, I had grabbed my camera, clamored into my seat, adjusted my headset, and became airborne. “Wow!” and “Ahh!” were the words overriding conscious thought. The view was amazing! I figured I might as well enjoy the ride, as I was kind of committed at that point. No one is more surprised than I am that I enjoyed it immensely. Especially as I classify a simple elevator ride as the moment I was most scared in my life. Before 9:30 we had run two calls. The first was an ejection from a vehicle. The patient was basically okay and extremely lucky. The second one was a motorcyclist v. deer. This patient had an obvious facial fracture (I may even go as far as calling it a...

On Friday I had another clinical at the cath lab. This was pretty good. The nurse I was paired with was a little scary at times. But she was a good preceptor and let me do everything. I got my 1st IV (attempt and success) in 5 months which was pretty exciting. I think I was just as nervous starting that one as I was when starting my first one ever. It had been almost too long. I figured that out when I realized that my hands were shaking slightly when I’d finished. That night I went to a Halloween party at my friends house. I went as a crazy cat lady, which consisted of wearing pajamas, putting my hair in haphazard curlers, and safety pinning numerous stuffed cats to my clothes. I tied for best costume with Andy, who kind of cheated because he looks so creepily like napoleon dynamite, it didn’t take much to complete his costume. Last night I was kidnapped by CJ and Ewing. They made me ride in the car blindfolded to go to a mysterious location. They even had me walk into a store like th...

I have been officially offered and accepted a job. It should be cool. I had a clinical for school with the same company and the unit I was on only got three jobs in 12 hours. Let me tell you, there’s nothing like putting in clinical time with a company you are about work for. It’s a little more difficult as all you can think is “In about a week, I could be getting paid for this!” Oh, well. On Friday I had my required physical and lift test. I had to go back to the same creepy clinic where I got my drug test. Every room I went into seemed to be a storage/exam room with stacks of miscellaneous boxes marked with ‘to be filed’ ‘pregnancy tests’ ‘private patient information’ ‘we’re not sure what this is’ and ‘looks important.’ For the lift test I had to lift a 60 pound box onto a shelf a little higher than my waist 10 times, put that same box on a shelf almost as tall as me, then walk around the room with the box (my new best friend) and walk up stairs with it. Of course, I had to be on my...

This morning started with an interesting phone call. It didn’t come up as anyone in my phone book which usually stops me from picking it up. But I looked at the number and it was local from my hometown so I decided to answer. Me: “Hello?” Other end: “Hi, this is officer ____from the Maryland State Police.” My brain: “Holy crap! What did we do?” My heart: “I'm going to start racing now!” Me: “Hi…” Other end: “I’m your preceptor for your MSP aviation ride-alongs.” My brain: “Whew!…wait…Holy crap!” My heart: “I'm going to keep racing!” Me: “Great!” Needless to say I’ve worked out the details of my first cough-helicopter-ahem ride. (don’t tell my parents I’ll be riding a helicopter, and definitely don’t tell me.) I won’t disclose the date yet. But as I’m riding on the trooper in my hometown, it will be hard for my parents to not notice me come home and then go missing for 12 hours. Today I discovered that my trucks' gas gauge is broken. I watched with horror as the g...

I’ve applied for a job. Yes, a job, me. Hard to believe, I know, but a little petty cash never hurt anyone. I’ll be working for a private ambo transport service (snore!) but I only have to work 12 hours every two weeks, so it’s not so bad. I’ve learned so far that the pre-hire process is really annoying. My last job interview was about 5 years ago and for that job; I applied, was interviewed on the spot, my label maker name tag was printed out, and two days later I was happily greeting customers at my first real job. If only it were that easy for this job. I applied and was interviewed the next day (which was nice, giving me less time to back out of it.) Then I’m told they need a pre-hire drug test, a copy of my passport, a picture of me in a zebra costume, a valid blockbuster video card, a physical, and various other things. Now, about this ‘pre-hire drug test.’ Luckily I read the paper that said that* I had to get it within 48 hours of my interview, or they would make me watch my fav...

Yesterday marked the class’ second sojourn to the cadaver lab. Wow, I really forgot how much fun this is! The weather is turning great here (high of 78 today, ooh that makes me all warm and fuzzy inside). Yesterday I was trying to gauge what to wear by looking at the people outside. The first person I saw was wearing capris and a sleeveless shirt. The person right behind her was wearing jeans and a jacket; both looking quite content. How am I supposed to decide what to wear when I see that?! I ended up wearing my scrubs with a sleeveless shirt underneath. We entered the lab and all the memories of last time came rushing back to me. First, the fact that we have to wear a gown, shoe covers, surgical cap, gloves and the optional face mask. Second, the presence of two dead bodies. Well, it’s not so much that I forgot that, just that I forgot how unpleasant it is until you can get acclimated to the cadaver lab environment. We got right into it, reviewing airways, intubation, and the like....

Had my first clinical of the semester yesterday. I was riding with a critical care transport unit. My first call was ‘in house’ moving a patient from the ICU to the angio lab. This was pretty cool, as I got to watch the angiography on his brain. (very generally angiography is when they put radioactive ‘ink’ in the bloodstream and x-ray it to identify problems with your vascular system) I was hoping that the bleed would be really obvious but it turned out to be this tiny little thing that was unnoticeable to anyone normal. My other call of the day was bad yet good; the circumstances tragic, the outcome unknown. (I’ll be watching the paper for the next few days.) For a full account you can rent my diary, but the price has gone up. Yet, somehow I got front row seats to a cut-down IV, chest tube insertion, needle decompression, and later a central line insertion. Even better, I understood nearly every aspect of the patients treatment, including drug therapy. Although I did little to nothin...

Oh, to be learning about heart blocks and types of shock! Sitting outside, armed with calipers and a thick packet of EKG strips, analyzing them until I went blind…those were the days! Gone are the times of intubation races, putting 18 gauges in my friends’ arms, memorizing assessment sheets, drip calculations…alas… Now, I’m stuck at my desk reading about peak load staffing, cream skimming, and economics of scale. What exactly is a public utility model, anyway? I’ve been trying to get ahead in my homework before clinicals officially begin for me next week. Unfortunately, I find some of the work…well, er, not engaging. Yeah, that’s nice. Classes are interesting, amazingly so, but that doesn’t necessarily transfer into homework. But in fact, (don’t tell the management students) I’ve actually learned stuff! And, enjoyed it! Other than that I’ve reacquainted myself with late-night, met a frog, found a kitten, worked the system, and ‘donated blood.’

After learning today of the president’s remarks concerning New Orleans, I decided to do a little research and break my rule of avoiding news. After a little googling, I discovered too much for comfort. It's truly overwhelming. The people affected are on my mind, and I hope that our government can sort this thing out and help in the return to normalcy.

Went kayaking today on the Chesapeake, launching from my roommates house on the bay. We went out for about three hours. I’d kayaked the area before, but this was kopapas first salt water experience. On the way back to the house we thought it would be an easier paddle but somehow it turned out that the waves were doing more harm for us than good. At one point it seemed I had been paddling for 10 straight minutes and hadn’t actually gotten anywhere. But riding the waves or, wakes, rather as there were many large boats enjoying Labor day, was good fun. It was a bit harder to get into my Zen kayaking mode because I had to pay attention to the waves, jet skis, Ewing, jellyfish, excessive sea vegetation, and the relatively constant threat of capsize. The day has rekindled my interest in going surf kayaking. Although I think I would fail spectacularly at it, I’d like to give it a try. As for school, all is going well. Then again, I’ve only had one day’s worth of classes so fa...

The room is back in order with a few additions and a few deletions. Most noticeable addition: kopapa, who just barely doesn’t fit completely under the bed, but I think it’s standable. Yesterday was yet another day when I question why we live on the 3rd floor. (other days include, move-out, the other move-in, and the day we bought the TV.) It’s good to wonder ‘why the top floor?’ to roommates when we’re half way up the stairs with a million pound television, having narrowly escaped death after it threatened to crush us for the 50th time. The day before yesterday I received my official NREMT-I patch, card, and certificate, two of which are currently displayed in my room. I have a few more days to veg before school starts. I’m not sure what I’m going to do with this time. Maybe review ACLS, as our test is coming up, but I doubt it. Maybe reacquaint myself with the ‘gargantuan book of death’ (paramedic textbook), but I doubt it. Maybe I’ll go downtown and take the CRT exam,...

Imagine my excitement, mere hours after my last post and 5 comments, unprecedented! Hours later, even more! Unfortunately, these comments needed editing by me. For those posted by actual people, thanks! Glad you like it, keep reading. As for the others; not so sure about the picking up girls thing, definitely not on the market for HD dish TV, and antioxidants are great, but thanks anyway. As a result of this 'comment spam' I've added word verification to the comments. Apparently this stops non-humans from commenting on the blog. Sorry that this is a pain, but hopefully it will rid me of fake comments.

Although I think that I deserve to be declared officially sane; instead of a stamp, I'll be receiving my official NREMT-I patch very soon! I was looking through my old posts back when national registry and I first met and I found where I declared: “NREMT exams are designed not to test your knowledge of paramedicine, but you're overall mental health.” So true. Luckily, I won't have to pass their tests again for another 9 months! And after that, I'll only have to deal with them every two or three years for the rest of my working life...wait, I'll never be rid of them! That horrifying thought aside, today their website says the best thing it's ever said: "Currently registered with the NREMT*." I'll be back at school on Saturday in the greatest apartment ever to enjoy, a dryer, netflix, rice Krispie treats, a dishwasher, Johnny movies, and great friends (oh yeah, learning and all that too). As for now, I'm going to shoot arrows and enjoy this lo...

Well, that's all I have to say really. I must have gotten the pre-test superstition ritual right this time (and it's the 13th). Now I know I have to drive clockwise around campus three times while thinking hard about what I want, and magically, a door will open filled with IO stopcocks, IV bags, a lifepack 12, trauma dressings, retractable needles, and everything else I could possible need to pass the test. Wait. I'm getting mixed up with harry potter. Either way, it's over! So, can I burn my registry sheets now? Yeah, I'll make s'mores, yum!

Since last I wrote...not much has happened. I turned 22, kayaked until my arms fell off (makes you wonder how I’m typing this right now), studied, ate ice cream for lunch, met a hamster, remembered why I hate summer then remembered why I love summer, and posted more pictures on my photobucket account. Yesterday I learned river respect by riding down my first (what you could call) real river. Up until now I've done open water and a class I river. This river had sections of class II which were really fun and challenging. It was an amazing experience. It was the first time when I could really feel the power of the river; I learned quickly how to read the water and chose a good line. I got a great feeling of accomplishment when I could look back at what we just came through, and say “that was awesome!” Kopapa (my kayak) and I had only a few moments of thinking “we’re in a tight spot!” But, as Dori says: “Just keep paddling, paddling, paddling, paddling...” or something like that. It wa...

I have added LAS and Europe pictures to my photobucket account. Feel free to peruse them at your leisure and enjoy! http://photobucket.com/albums/y148/resqellie/

So, apparently my wanton rule-breaking was found to be acceptable by national registry. Now, the ‘N/A’ has been replaced with the most fantastic word: ‘passed.’ (and there was much rejoicing) At least that much of the ‘I’ test can be declared a success and officially over. Hopefully I will be retesting (again) the practical sometime in the next 3 weeks. Until then, I’ll be…oh, I just can’t say it! Okay, studying. There. A horrifying word for the month of July, but nonetheless, a necessary one.

No, this is not because I hit ‘refresh’ 1000 times in a row. I guess it’s because sometimes people other than my mom look at my blog. How touching. No really, I think I could be crying…oh wait, there’s just a piece of glass in my eye! (kidding, kidding) oh well, maybe for 2005 hits. Instead of crying I’ll throw a party in cyberspace. You’re invited. Just come to my blog resqellie.blogspot.com and well, that’s basically it. Whoo-hoo! party! Gifts are permitted, I’m registered. I especially want that potato slicer/peeler, cotton candy maker, and double boiler (the uses for these items are endless!) Well, thanks for the hits, but not so hard next time!

My boys of the summer. One is 16 the other like, 10. One quite busy saving the wizarding world, the other quite busy inventing candy with Johnny Depp. Charlie and the Chocolate Factory: one of the most insane movies I’ve ever enjoyed. I was telling my brother; not crazy like Fellini, crazy like taking Roald Dahl, Tim Burton, and Johnny Depp, mixing them all together and making a children’s movie out of it. Throw in some identical oompa-loompas, Christopher Lee, tooth paste caps, and dentistry, and you’ve got a classic! Many have called it creepy, and they’re totally right. The Half-Blood Prince: great. Best one since Prisoner of Azkaban, I think. I’ll say no more, I’m not a spoiler! Don’t worry, my t-shirt that says NERD really big is already ordered and in the mail. At least I didn’t dress up like my favorite character and camp out for 19 hours at our local Borders. Now, that’s nerdy. I just calmly walked into my store of choice and picked it up. I didn’t e...

I’ve put a few retroactively dated updates. The phones at my house have been out for the last few days so I couldn’t update (stupid dial-up!) until now. Enjoy!

Wow, for an organization I am desperate to be a part of, I am sure making it difficult. For about a month now my classmates’ written results have been available online, and mine has said “N/A.” Now, that doesn’t look good no matter the reason. Well, I figured out what exactly this means. I received a letter the other day stating that I had wrongfully written throughout the test booklet. I broke the rules. They even sent me a copy of them, just in case I forgot…again. So, as a result of my illiteracy, I get to write a letter stating why I was so ignorant and blithely ignored the rules. Until the investigation of this ‘irregularity’ is over, my results will stay in testing purgatory. I mean, seriously! This is ridiculous! I don’t really want to be part of an organization with such idiotic rules. Becoming an ‘I’ used to mean a lot to me. Now it just means beating the registry. I’m moving to England where things are logical (except for the whole driving on the left thing). A p...

A rude awakening today. My parents and I arrived last night and Jon called me this morning. I didn't want to believe him. Pretty freaky considering I was there a week ago. All I can say is that London and it's people are in my thoughts today.

I don’t want to bore you too much in one sitting. So, I broke it up to give the illusion of shortness. Let’s see…I left off with a tall tower. Our next day in Paris we started at the Orsay, an impressionist museum. We saw some great Monets, Van Goghs and Whistlers Mother. In the afternoon we visited Versailles. I found this place to be…excessive. Although, I can get behind the idea of having yourself painted more beautiful and fit than you really are. We returned to the city and went to Sacré Cœur. This beautiful church was built in the 1800s although you wouldn’t believe it. It looks more like a modern mosque from the outside, and has beautiful ‘modern’ mosaics inside. We strolled through this area for a few hours, got a crêpe (yum!) and people watched, a classis Parisian pastime. The next day we tackled the largest museum in the world, the Louvre. We spent the morning seeking out the ‘big three,’ the Mona Lisa, Vénus de Milo and Winged Victory. All relatively easy to spot...

I would like to provide you with a quick(ish) review of the rest of my vacation. I’m assuming, of course, that you care. Either way, here goes. Let’s see…I left off with some old stones. We took our free day in London to go to the National Gallery, fantastic, again. We also stopped at the Natural History Museum. This is a beautiful museum. One of our tour guides said that if she were queen she would live at this museum (keeping most of the stuffed animals) and wear the crown jewels at all times, all of them, even in the bath…especially in the bath. The next day we drove to Canterbury and enjoyed their beautiful cathedral and charming town. We took a ferry over to France, then drove 4 hours to Paris. It was about now that I realized I don’t speak any French and it had been a long time since I’d been in a truly foreign country. Our first day we had a bus tour of Paris. We got our first proper view of the Eiffel Tower which bigger than I imagined, but I’ll get to that later. We ...

I'll apologize in advance for my spelling and the length of this entry. And, for the record, I knew there was more to see than London. (the outskirts have ambulances too!) We have been to several places outside of London. After my last entry we visited Westminster Abbey so that we could catch up with all of our friends: Chaucer, Darwin, Newton, Oliver Cromwell, and some kings and queens. Now, unless you’re very unorthodox, you’re sitting down already, but Mom, Dad, and I flew the eye. Unbelievable, yes. (well, only if you really know us, actually) It’s quite a feat, believe me. This was awesome to say the least, ‘Flying’ above London at about 500 feet. Then we visited the British Museum. This is a vast and frustrating place. They have 5 million objects to see, and we had about 2 hours to do it. Impossible. But, we saw the Rosetta Stone, The Marbles ‘acquired’ from the Parthenon in Greece, a statue from Easter Island, plus a ton of other stuff. We also visited Shakespeare’s birthpla...

Just as I left you. We are here after one of the longest days of my life. There could have been 10 rapid response units outside our window last night and I would have slept through it. Half of the battle was over when we survived getting to our layover in the smallest plane I had ever been on (I think it was produced by Matchbox). Our hotel is lovely except for the minor a/c problem (actually it's not a problem, it just doesn't exist). But, we can have a full English for breakfast, included! (hurrah, as they say.) Today we had a nice bus tour of the city and visited St. Paul's cathedral built by Sir Christopher Wren exactly 295 years ago (after the 'great' fire of London destroyed the city of London in 1666). Turns out that I didn't remember a thing about this place from out last trip. We also saw the building that served as the backdrop for Gringotts Bank in Harry Potter. Our tour guide today was hilarious and told us to 'chillax' a combo of chill and r...

Here are a few left over things from London and an update on the rest of my summer. I have fixed my questionable spelling and grammar in the London entries. Now you sticklers can breathe easier (mom). Hey, mannequin and souvenir are hard to spell! In London, they call a cardiac arrest a ‘suspended.’ They never clarified to me if this meant functioning has suspended or if the patient was ‘suspended’ between heaven and wherever. Paramedics in certain areas carry a set of large and unhandy keys for unlocking exclusive gated communities. Every paramedic in London is issued their own paramedic bag. They can take it to and from work, the grocery store, library, or pool. They are responsible for its contents and also get to organize it in any way they want, pretty cool. For the next two weeks I’ll be on vacation. I’ll paraphrase a conversation I had this morning: “Where are you going?” “Um. London and Paris.” “Weren’t you just there?” “Er, Sort of……yes.” The original plan was for my ...

There is nothing a good cup of tea and some gratuitous violence can't fix. I drove home this morning feeling better purely because it was a new day. I got back, made some tea and decided to sit and watch one of my favorites, Kill Bill. From the first punch I felt better, what a satisfying movie! I decided (well, faced actually) that there's nothing I can do about registry and I'm going to have to use this as a learning opportunity. Maybe (once I pass) I'll join the registry's governing body and change all of their moronic policies. (I think that a stamp on your forehead the reads "Loser" is preferable to retaking the whole test.) I must take this space to apologize to my fantastic friends for being a bit 'down in the mouth' yesterday and not feeling too festive. You all did great! I'll see you on the 15th for Charlie and Harry!

Yeah, I'm down for the count. And the day started out so nicely. Wait, no it didn't. The 5 o'clock hour and I rarely meet, and never under good terms. It was nice to see everybody today and help to calm their nerves by sharing my NREMT practical experience. I was (and always have been) dead confident in the skills for this test. I had no reason to think that I wouldn't pass one station, again. In fact, failing today completely caught me by surprise. I'm fairly certain that I uttered some unfriendly words under my breath in front of the registry rep. I didn't really care. I feel hurt, let down by my supposed confidence. I also feel let down by the national registry and its ability to "assess the knowledge and skills necessary for competent practice." It's so helpful when they refuse to tell you why you fail a specific station. That really aids in the learning process. In failing this station today I am not alone. In failing to this extent, I am alon...

"I want a good clean fight!" Ah, we meet again national registry practical, for the last time! I hope your conscience is clear, trauma assessment! In all of the excitement of leaving for London , I cleverly neglected to inform you kind readers of my national registry practical/written exams. What a fun task this test is! I liked the practical so much that I decided to take the trauma assessment station again, I just can't get enough! Long and boring story short I failed the trauma and have to take it again tomorrow. But that was the only one! The story of my classes' practical is a long and sad one. Our practical was originally scheduled for the middle of May. Then, something retarded happened (it is a mystery that will go down in history) and the practical was cancelled the night before. (gasp! horror! shock!) I'm fairly certain that a few members of my class had to be resuscitated before deciding to stay up late and maybe have a few drinks. Fast forward to the ...

Well, almost. I'm here at school, a logical rest stop between Newark and home. We arrived yesterday around 7:00 here time (midnight our time). Getting back was a trial at times. It started out with our airline weighing our carry-on bags and saying that they couldn't be more than 6kg. We were kind of freaked out about this; I knew mine was way more than that. I was carrying a grocery bag with orange kit-kats in it (yes, for you) so I decided to throw stuff from my bookbag into that bag. Working the system, I guess, but they didn't care. This was so ridiculous because you could have bought a million kilos worth of stuff at the duty free shop. I guess that my extra few kg didn't affect the plane too much. Maybe they should weigh each passenger as well. Or, put a huge scale on the runway to measure before planes take off. Then they can stop the plane and announce that they can't go until they jettison some cargo, guilting you into throwing your duty-free vodka, souvenir...

Our last official day in London was just as fantastic as the others. We visited the LAS museum located in Ilford. This is probably about 10 miles away as the crow flies, but in London it takes about an hour to travel it. We ended up in an ambulance station with a section dedicated to the 'museum.' They have old British ambulances parked outside. Inside they have stuff everywhere. There was a section with ancient training devices including the mask of a woman who we know as "Anne" (the CPR mannequin). Interesting story that I never knew before: In the late 1890s, this young woman was pulled from the river Seine in Paris. It was assumed that she committed suicide and because she was unknown, a death mask was made of her face. The story was romanticized throughout Europe and years later Asmund Laerdal decided to use the death mask to produce a resuscitation mannequin in order for more people to learn live-saving skills. And, the rest is history; we all use Laerdal produc...

Quick note on yesterday's activities. I rode out in Wimbledon with a First Response Unit. We had a fun day. The best call was for a diabetic with a blood sugar of 1.7 (gasp! horror!). Pretty bad yes, but we gave glucagon while waiting for the transporting unit to arrive. Glucagon, you ask? Their EMTs can give glucagon. In fact, speaking of gasps and horror. The guy I was riding with was shocked at the lack of skill out EMT-Bs have. Really couldn't believe it, I had to slap him around a bit; he just glazed over when I told him we couldn't give any drugs with needles (save epi), do 12 leads, do 3 leads (for that matter), check glucose levels, manage intraortic balloon pumps, or perform thoracotomies, and I agree, it's just terrible! Practically skilless, our EMTs. I need to get a more powerful job and get EMTs some fun skills. We also got to see the All England Lawn Tennis Club Wimbledon (that must be said with a posh English accent). This is where the Wimbledon champions...

Combined update tonight of yesterday and today. This may be kind of long and boring, but... Yesterday we visited what is basically a haz-mat team that is comprised of personnel from LAS, the fire brigade, and the metropolitan police. They call it CBRN (chemical, biological, radiological, and nuclear). They took us out on the Thames on the LFB (London fire brigade) boat. This was awesome; we went all the way up (or down, depending) to Tower Bridge. I felt very touristy, taking a million pictures, but it was something that very few people get to experience. After this we visited the EXPO, the explosives office. London is the only city in the UK that has a civilian bomb team. They respond to any suspicious thing and neutralize or minimize it. They have a museum of sorts filled with explosive devices; military, commercial, or homemade. All of these had been found in London which is pretty amazing. It was a little freaky when the guy was holding a hand grenade (with his index finger in the ...

We started today visiting the LAS press office. Got a feel for what they do pretty quickly: deal with the press, make up ad campaigns. These campaigns are extremely clever and deal with issues that the providers see out in the field. The national health system started this a few years ago with posters concerning house numbers and the difficulty in finding houses. The catch phrases were "999 where are you" and "Is your number up?" a hilarious play on words. The LAS has done a few since then. One concerns abuse toward ambulance personnel. This "No excuse" poster features and actual LAS paramedic who was assaulted while on the job. Another features a London taxi cab and a London ambulance. It reads "Only one of these is a taxi service." Hilarious! These posters mostly improved employee moral rather than discouraged Londoners from calling 999 needlessly. Their current one is advertising their free bystander CPR training. It has an actual cardiac arre...

Today we attended the HEMS governance day. This is a day once a month where HEMS docs and paramedics get together to do QI on calls and their system in general. This was set in a building that was very modernly decorated. The lecture hall we were in was completely green, I mean green. From carpet to ceiling, crayola green, with the exception of 10 completely random red chairs. They started out reviewing articles from various medical journals, and then reviewed several cases that HEMS took where the patient died (overviewing what happened to the patient, what care was given, and what could have been better). The calls involved a hanging, car v. pedestrian, car v. cyclist, and a 'one under' (someone under a train). After this they reviewed two calls from start to finish, from the 999 call, dispatch and response, right down to the data recording. Then for lunch Jon and I ate at the café there (completely red) and split a lemonade shandy. This is a drink half lemonade and half beer...

"We'll just pop 'round to the 'ospital and get you looked over, love, a'right?" Today we visited an LAS training center and met an upcoming class of EMT-3s. I should take this time to explain the certification levels here in the UK. There are three levels of EMT in London only. EMT-1 is BLS capable, can administer oxygen therapy, and use an automatic defibrillator (AED). EMT-2 is an interim EMT-3 (for 12 months). EMT-3s can do everything a 1 can plus a few interesting skills. They are 3 lead and 12 lead capable. They can recognize ST elevation and basic heart rhythms. They can also administer nitroglycerin, aspirin, glucagon, entonox (nitrous oxide, believe it!), adrenaline (epi), parasetamol (pain reliever/fever reducer for children), and glucose paste. These drugs are all given subcutaneously, orally, or IM. Paramedics have a whole host of other drugs they can administer very similar to our drug scheme. They also perform decompression, intubation, and variou...

We started today with a nice chat with the senior clinical advisor (or, assistant medical director, if you will). He was quite fascinated with the intricate idiocy that American EMS can sometimes resemble. He had a hard time getting his head around the fact that there is no national system, only national curricula. Their system is so simplistic (and smart) here now, (it became really organized in 2000) that it’s hard to believe that the US doesn’t operate in the same way. It was nice to have an opportunity to talk to him and further learn about their system. Their national registry is called the British Paramedic Association and the Health Professions Council is who registers qualified paramedics. Once you have an HPC number, you can take it anywhere in the UK and get a job as a paramedic. We also learned that it would be almost ridiculously easy to transfer national registry to here. (probably easier than transferring to Virginia (but don’t tell my parents)). I’ve also learned that I ...

Today we hung out at the central ambulance control (CAC) or dispatch and listened in on 999 calls. Some pretty cool stuff, a cardiac arrest, a lightning strike, lots of little trauma, and various medical calls, all not requiring real care. They're dispatch system is very similar to ours. We met a doctor who runs with the physician response unit. This is a very clever idea where a doc responds to lower priority calls and diagnoses and treats people without the need for ambulance. My Briticism of the day is the phrase 'went wobbly' which means fainted. We also hung out the HEMS or helicopter EMS desk and figured out how they decide which calls they go on. That consists of a paramedic and doc who respond to trauma only, land in places like Piccadilly Circus, and render care like thoracostomy tubes and chest cracking (apparently with good outcomes). That would be cool to witness. The helicopter says Virgin on it, but that is mostly for advertising purposes. They pay £450,000 pe...

Here's another micro update. I'm here at Waterloo, the LAS HQ. I've been riding another rapid response unit tonight, mostly north of the river in the heart of London. We've had some good calls: a cardiac arrest, a stabbing, and various other drunk-related incidents. I learned that English AEDs speak to you in British accents (useless fact). I know I look quite fetching in my LAS ballistic vest (stab vest) and I feel pretty damn cool too (haha). Some of the most fun of the night has been racing past Buckingham Palace (waking up the Queen), Trafalgar square, and St. Paul's, hanging out in Soho, and watching the sun rise over Waterloo Bridge. The sun rises quite early here, by 4:00 it is already bright. I also got to go fetch a patient off of the top floor of a double decker bus (first time on one of the busses here). I also got to go in an exclusive London club near Piccadilly Circus (a guy had been assaulted and cut in the face) so, another life goal fulfilled. (I ho...

Two posts in one day; well, sort of. It still counts as the same day if you never go to bed, right? This update is free. I'm here at the Oval Ambulance Station utilizing their computer. I've been doing a night shift with a 'Rapid Response Unit.' I'm with a paramedic and we respond to category 'A' calls or priority '1' as we say in the states. It's been awesome and I feel great even though it's almost 6 am here. I'm all hyped up on caffeine at the moment. Maybe I'll go straight to Portobello road from here. We've had a lot of calls, (17) and I got to draw up 'Daizamuls' aka Diazepam. Pretty cool. I've learned a lot about LAS and England in general. All different, but the same. Just with British accents and phrases like 'When did the poly start?' 'Shock box' and 'Sharp Scratch.' The people here are awesome, I can still barely believe it. They were worried I'd be bored because we've mostly ...

Welcome to the most expensive and fast blog update ever! I'm here in London with Jon, things are going great! Living at a hostel is a new experience for me, but this one is really nice (as are our roommates). We arrived on Wednesday around 10, checked in, and found the closest pub for a pint. Expensive here, but Jon has learned that Guinness from the tap rocks his world. Yesterday we visited a station of the London Fire Brigade. We saw all of their equipment, and it was so cool, even my squirrel tail went up! Then, we found our way to LAS headquarters and met with the kind people who have planned this for us. There is much in store, and just thinking of it makes me giggle. Tonight we are doing a night shift until 7am. That should be interesting. The LAS people have treated us extremely well, gave us a nice LAS pen, disposable camera, and other goodies. They also drove us around to see the sights in one of their haz-mat units. Being on the 'wrong' side made me a little nervo...