Wednesday, April 28, 2010

My Father Was An Ambulance Chaser - Part 3 April 2010


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.  

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.

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
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
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.

    The boys.


    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!

    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
     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.


    (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.

    Thursday, April 15, 2010

    Mexican Cell Phone Debacle - UPDATE April 2010


    This whole cell phone fiasco has made the news daily,
    in some way or another.

    The government has staunchly held firm;
    register your cell phone or risk having your service canceled
    on April 10th.  
    No ifs ands or buts!

    Ok, now make that the 16th.
    No ifs ands or buts!
    There are 83.5 million cell phones in Mexico.

     The registration system is swamped.
    Cell phone providers have stacks
    and stacks of completed forms
    that have not been processed.
    They are reportedly working as hard as humanly possible.

    There are 3 ways to register - no ID required!
    1.  Send text message yourself, easy, direct, should be foolproof.
    2.  Register online on government web page.
    3.  Go to cell phone outlet shops and they will do it for you.
    No problem, right?

    The Mexico City news is reporting today that:
    Are you ready? 

    Mexican TV from DF reports that 5 million cells phones have 
    been registered in the name of Felipe Calderón 
    and 4 million have been registered in the name of Carlos Slim. 

    That would be Felipe Calderón - President of Mexico
    Carlos Slim - President/Owner of TelCel,
    and the planet's richest man.

    Tuesday, April 13, 2010

    Retirement - Mexican Trailrunner Style April 2010

    What do you think of when you see this?

    This is what I'm thinking:
    • EEK, scorpions!
    • Life on social security
    • Ah, the simple life
    • What happened to my 401K!!!
    • Wow, I must be really hard-up for a blog post
    What are you thinking?

    Thursday, April 8, 2010

    Things That Make You Go Hmmmmm. . . April 2010

    WHO KNEW . . .

    . . . 9/11 could inspire this much fun.

    Sunday, April 4, 2010

    Behold The Jacaranda April 2010

    My favorite COLOR.
    There is even a special name for this shade of purple.
    Perhaps it has to do with the time of the year,
    or maybe it's just the exact right name for this color.
    Do you know what it is?

    The Jacaranda (ha ca ráhn da) in all it's glory
    can make you hit the brakes and cause a rear-end collision.
    Or trip over a cobblestone and fall flat on your face.
    Be advised, it's a very dangerous tree!

    It astonishes and surprises the unsuspecting
    as they round a bend in the road.

    It blends in well with the landscape.

    It can even inspire graffiti!


    It fills the senses with it's breathtaking color.

     It makes an agreeable neighbor too.


    It's spent petals carpet the cobblestones.

    HAPPY EASTER 2010!