Mexican Trailrunner: April 2010

Wednesday, April 28, 2010

TYING UP LOOSE ENDS

Armed with a diploma from the Stanford University Hospital
Paramedic Program,

documentation from Highland Hospital in Oakland that I had passed

my hospital rotations, documentation from Southern Marin Fire that I had treated the required number of ALS (Advanced Life Support) patients appropriately,

as well as a folder full of certifications:

BLS (Basic Life Support), BTLS (Basic Trauma Life Support),

PHTLS (Pre Hospital Trauma Life Support),

ACLS (Advanced Cardiac Life Support), and

PALS (Pediatric Advanced Life Support) — I was still a very

long way from being employed. Visa was beginning to send
thank you cards.

Now, California wanted to know about me.

Did I have a record? No.
Did I do drugs, no - please leave urine sample as proof.

California DMV (Department of Motor Vehicles)

wanted to know if I had any driving infractions. No.

How about drunk driving? No.

Well then, you must come by the nearest DMV, pick up your

ambulance driving manual and study it for your exam.

But before you take the exam, we want a full physical

by OUR doctors. . .not yours.

I passed the physical exam, passed the ambulance drivers

exam, and was awarded a license to drive ambulances

in the state of California for 2 years - renewable.

WHEW!

I was STILL not employable.

California required all paramedics to pass

the aptly named, 4 hour, BARE (Bay Area Regional Exam)

before you could work on any ambulance

in the state as a paramedic.

The nearest and closest exam was to be held in

Sacramento in 2 months.

More studying, more stress.
I passed

and was blessed by the state of

California to start job hunting.

My first choice was San Mateo County, they had an international
airport and 2 little ones, a long coastline, mountains. urban centers,
freeways, and a brand-new company

that had designed and purchased a fleet of new ambulances

and equipped them with all the latest high-tech

sophisticated bells and whistles.

We even had TVs between the captain chairs in the cab!

Each ambulance was stuffed with all the latest medical equipment.

And they paid well too - woo hoo!

More hoops to jump through.

San Mateo County perused my paperwork,

Baystar (my potential employer) gave me

oral interviews, written testing, skills scenarios, orientations,

CHP (California Highway Patrol) ambulance

drivers ed and testing,

and assigned me to a crew for an ALS

5-call evaluation.

Passed.

There is nothing in all of this training and testing that can

prepare a new paramedic for their first day on the job!
With every crackle of the radio; my heart rate soared,
I perspired profusely, and turned a whiter shade of pale.

There were 9 hospitals in San Mateo County,

I couldn't find any of them.
I lived 2 counties away and was not familiar with SM.
My partners quizzed me between calls.
Ok, we're at the intersection of blah blah and blah blah,
what's the closest receiving hospital and
how will you get there?
Umm. . .
I memorized map routes, I asked fire to
direct me, I asked PD for an escort,
I found the hospitals on the first try — most of the time.

Meantime, I memorized the county protocols

(CHECK THEM OUT!)

until I could recite them in my sleep.

I started on the night car because I had no seniority

and worked 4 consecutive days of 12 hour shifts from 6pm to 6am.
Working twelve hour shifts required living in the ambulance the whole time
on street corners and in parking lots,
or wherever we felt safe. Remember, we carry morphine.
I had an hour and a half commute on each end as well.

I was a mess.

My first call as a wet-behind-the-ears medic was for an

elderly woman, short of breath, in San Mateo, at 3:30 AM.

She scared the life out of me.

We found her in the foyer of her apartment building

breathing to beat the band, with a lengthy medical history,

and terrifyingly at the end of her rope.

My partner and I assessed her,

her lungs were full of fluid and she was moving almost no air.

We put her on high-flow oxygen by mask, established an IV,

sprayed Nitroglycerin under her tongue,

gave her a IV diuretic, made her as comfortable as possible on our gurney,

and I climbed in back with her as my partner slid behind the wheel

for a Code 3 return to the nearest ER.

She made it — and so did I.

At the time, Baystar had 12 hour and 24 hour shifts for medics to work.

My favorite was the 24 hour shift because we worked only 10 days a month.

Part time job, full time pay.

My kind of career.

Eventually I accumulated enough seniority to bid for the 24 hour car
in East Palo Alto.
I arrived for shift change at 7 am

and got off at 7 am the following day.
The rotation went like this: On, Off, On, Off, On, Off, On, 4 Off.
Those 4 days off were heaven.

We were free to do as we pleased between calls as long as we

were available and could be on scene of a call anywhere in our zone within
the 8 minute county-mandated response time.

Life on a 24 hour paramedic shift:

Again, this cartoon is the brilliant work of the funniest paramedic

in the business - Steve Berry

I Am Not An Ambulance Driver

Ok, enough background, you get the picture.
Now for the fun stuff. Stay tuned for:

EMS stories - as the sirens wail
Real 911 calls
Defibrillating on the reef
The death of a partner
Novel ways to kill time between calls
'Bending' the rules. . .shhhhhhh.
An accidental needle stick
Partners - the good, bad, and the scary Larrys
Ambulances crash too
System Status Management - get the gun
Getto medicine - get in and get out
Politics
Fire guys - gotta love 'em, even married one
Getting shot at
Stop eating and driving - we can't get the salsa out of the radios
Getting a clue

Saturday, April 24, 2010

Curds and Whey in Los Potrerillos April 2010

Over the mountains, and behind my village of Jocotepec,

lies a tiny dusty village of 5000 enterprising souls

called Los Potrerillos.

There are millions of these little towns in Mexico,

most never grace the maps.

Main St.

Looks like there's not much going on here,

but wait, there's something going on everywhere!

One must dig.

Like every pueblo, there's a pretty little church.

And like every little pueblo, there's a bullring.

Horses, mules, and burros are the main mode of

transportation in this pueblo, every family owns

one or more, but alas, only a quarter of the families

own a car. My kind of town!

And a pretty plaza.

If it looks a bit uninhabited,

that is because it was hot and at least half of

the townspeople are in the US working.

But my story doesn't end here.

Remember I said you have to dig?

That's where the stories are,

under the surface — some deeper than others.

I knew there was a family here,

making queso fresco (fresh cheese) for 3 generations.

I went to find them.

Instantly, a group of men materialized, one of which was fluent

in English and lives in California, but is home to tend

to his mother who is preparing to pass.

My timing was perfect.

Come in! !Pasale, Señora!

We will be making cheese in 30 minutes.

We pushed in through the dark grocery, then the house,

into the kitchen of

Sr. Ramon de la Torre del Toro

and la Sra. Delia Martinez del Toro.

My self-appointed English speaking host

was Delia's cousin Sr. Heriberto Martinez.

Yes, everyone in Los Potrerillos is related,

descendants of the original 15 families,

having begun their ancestries in the

Hacienda of the same name in the 1600s.

Heriberto.

The boys.

And

The star of the show, Ramon, and the cheese making

equipment that has been used for 45 years.

They could not have been more hospitable!

Or, maybe it was the cervezas. . .

Here we go. . .

While particles of dried cow intestines soak

in a vat of milk encouraging coagulation,

Ramon prepares the cheesecloth bag.

Then the fresh milk is ladled into the bag

and the curds are collected.

The bag is massaged and squeezed to release every drop of milk.

Until the bag is full.

The curds are pressed into molds and left

to sit for about 10 minutes.

I was presented a sampling.

It was incredibly good!

So, from this. . .

to this. . .

about an hour.

Not counting the cervezas, razzing, and laughing.

If you live locally and would like to visit Ramon and Delia

and pick up some cheese,

just drive to the plaza and park, walk through

the plaza one block and make a left.

You will find them mid block, right side,
(Independencia #10)

and they will be delighted to meet you.

Alternatively, ask anyone where

you can find them.

The smaller wheels of cheese are 40 pesos

or about $3.25 US.

The larger blocks (shown) are 100 pesos and are 1 kilo.

About 8 bucks.

You won't be disappointed!

I left amid copious adioses and

que le vaya biens (have a nice day),

and accepted Heriberto's invitation

to return with my friends so he can take us

on his horses into the mountains for

a fine fiesta.

I can't wait!

The HAPPY COWS

of Los Potrerillos!

More?

Ok, just 1 more. . .I can't help myself.

AND. . .my all time favorite one!

Monday, April 19, 2010

Paul Embleton and The Brave Foundation April 2010

Ever since I moved to Mexico and started

working with Cruz Roja Chapala,

I've been trying to get an

Advanced Life Support ambulance

in service here at the lake.

We have terrific sophisticated medical

centers in Guadalajara,

but they are an hour away and

that hour can be life-threatening for some patients.

We have had some near-successes

and we have had some significant

improvements.
But for the most part,

we have not been successful

in getting an ALS ambulance up

and running.

For all the same reasons the world over:

money and politics.

While watching CNN one night last year,

I saw a piece on a Washington state

firefighter/paramedic who was up for

CNN Hero of the Year.

Before Larry King had signed off

I had already emailed Paul Embleton.

How could he be so successful

where I have failed so miserably!

Paul has built fire stations, created an

aquatic ambulance for transporting

patients across Lake Atitlán,

and set up a slew of training centers

across Guatemala.

Not to mention organizing and transporting

fleets of donated ambulances, firetrucks,

and other assorted vehicles from Washington

to Guatemala.

REMOTE Guatemala!

I went to Lago Atitlán, Guatemala,

to meet up with Paul and find out.

Paul's current project was building a
clinic/firehouse/ambulance center in the
tiny village of San Juan La Laguna,
so one morning I caught a panga from Panajachel to
San Juan to meet him.

No surprise he was a nice guy.
He had some good advice and I came back
re-energized and with a new attitude.

Meet Paul. . .

. . .and see what he's been so busy doing.

BRAVE FOUNDATION

(Don't miss the videos!)

Paul's Blog

Recycled medical and/or fire equipment gladly
accepted by Cruz Roja and BRAVE.
Email me if you have donations
and we can work out the details.