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Who I am.  A “brief” aside

I became jaded and hard because of my experiences.  The general whining of so many who had no idea really what a bad day was all about.  I was hard on new hires, and students because what we did mattered and because I was hard on myself.  It wasn’t just a title, to be a paramedic.  It was a responsibility.  A responsibility to a scared mother who thrust her dying child into your arms at 0230 your first day on the trucks.  You don’t get to call timeout. You may not be able to ask for help.  You have to know, even with all that fear gripping your soul.  You have to push it aside and react, you have to do.  You’ve got to know. 

So I was hard in a controlled setting.  Where I could help you if you floundered.  Where you weren’t alone.  I was exacting and my standards were high.  I never expected perfection, just progress.  If you started with me the phrase I wanted to hear initially was, “I don’t know”.  Far better to admit a weakness than try to lie your way through it and find out you are responsible for a tragic turn of events.  Yet ego drove so many people.  They had to be right, or at least not wrong.  This hard exacting nature burned me; no it blew up in my face.

This part of my story has never been told en masse.  Some of it can be verified if you google it,  but for now I will hold off on that. It will follow in the next entry. I don’t know if it would be better if you researched it before reading my side or after.  I leave it up to you when the time comes.   Your choice.

I was tasked with precepting a student,  A Paramedic student from a neighboring Fire Department.  I was reluctant.  I had seen the change in quality of the new breed, it was entitled, self serving and egocentric.  When I was asked if I would take on a student I flatly said, “no”. To which my EMS Captain responded, “please, it would mean a lot to us”.  I said, “fine but know I don’t want to do this”. I asked that the student at least be a Firefighter if one was available.  This was done in the hopes I would get someone who would be able to perform in the environment I created for my students.  This was the beginning of my end.  

My student was late by 15 minutes his first day.  I said as much after he walked in the door, in a less than soothing manner.  We proceeded to get him settled in it was explained he was to be an active member of the crew just like at his station.  We went out and started working on the truck. I was at the second busiest station in the city so it wasn’t long before we had an Emergency response.  I am going to explain a few moments of interaction so if you’re confused at any point please ask.

  I believed in the, “see one, do one, teach one” plan of teaching.  We picked up the patient and on the way to the hospital I gave a radio report so they would know what was coming.  After the report I told the student “When you’re done with you’re report you’re done.  If you have to say anything at the end of it finish it with;  Do you have any questions”.  I followed that with why, “A lot of people say at the end of their report; do you have any questions or orders?  You don’t know who is on the other side of that radio”.  It is important to understand that only a Physician can give a Paramedic orders in the State of New Mexico.  Not a Nurse, or another medic but a Doctor,  “For all you know it could be a janitor who answers the radio and he may mean well by saying something he shouldn’t.  So do not do this while you are with me, if you do I will crucify you upside down on the back of my Rescue”.  

I advised the student not to give me all his reports at once.  After every call you have to do a run report.  As a student you are expected to complete one and have your preceptor go over it with you.  I told him, “If you give me all your reports at once and they are shit I am going to give them all back and make you rewrite them all.  Better to give me one or two and we can go over it together”.  We went on another call, abdominal pain.  On the way to the hospital we were talking about patient treatment options.  No people we don’t need to get the Doctor to tell us what to do.  We have protocols/guidelines to work with.  If we get in a bind we can call a Doctor absolutely but our hands are not held.  This is why its insulting to call an EMT or Paramedic an Ambulance driver.  

My student would not mention giving the patient pain medication.  This is not that unusual as some services are stricter than others but ours was fairly liberal.. if we felt a patient required intervention for pain we were allowed to administer it as needed.  So I asked, “what about pain meds?”  He didn’t think you could give them.  According to his protocols at his department you couldn’t. He was working with me and under our protocols.  I went to the same school he did for his Paramedic instruction. Before leaving to my internship I was given a copy of the service protocols so I would be familiar with them prior to arriving. Either he was not given the information or he didn’t study it.  Either way I was bothered and it was obvious. 

We got back to the station and he went to write his report.  Afterwards he came out and handed me eight reports  Eight.  Not one or two, eight.  I went through them and lo and behold, they were all shit. So he had to go rewrite them. All of them.  We were busy painting the station so I told him to hurry up with the charts so he could help.  Pressure in a controlled safe setting.  He never did come and help.  He gave me all the charts and they had to be touched up which he was not happy about but such is life. He made a sub par dinner, seemed to be fishing for accolades afterwards. They were not warranted.  At the end of the night, I went of over his deficiencies and strengths. I tried to give him a pep talk.  I told him it would get better as he learned more.  That we all went through the frustrations of our own internship.  He would be fine.

I am sure there were more moments but hose are the clearest and I am trying to be fair in my explanation.  We got off our 48 hour shift and I was at home when the phone rang.  I twas my student telling me he was having schedule troubles and asked if he could adjust his internship.  I told him, “ Do what you have to do to take care of yourself, as long as you get your hours I do not care, its up to you”.  he never showed back up, his schedule wasn’t going to work with our shift schedule. 

A few weeks later I received a phone call from my Union President, something was up.  I had a meeting with the Chief of the Department my first duty day.  He didn’t know what it was about but I should be prepared,I asked,  “prepared for what though?” he didn’t know.  Since this was supposed to be informal no Union representation was going to be present.   When I walked into the meeting; it wasn’t a meeting it was a God damned board of inquiry.  The Chief of the Department, the Deputy Chief, the EMS Chief and my Battalion Chief.  My student wrote a letter complaining about his treatment under my tutelage.

It was a four page letter describing in detail the events of our 48 hour shift.  The brass lay into me about how embarrassing it was for the Department, how could I do such a thing.  My reply, “What does it say”.  At which point I was given the opportunity to read it.  The accuracy of the letter was astonishing.  My vernacular to the word.  I cuss a lot people.  I figure sometimes to make it stick it has to be hard and dirty to be remembered.  He got it all, the chart rewrites, the threat of Crucifixion.  The words of my EMS Chief “ the thing is Josh I can hear you say all these things”.  This is an interesting point to remember for later.  Its also important to note that I did not deny that I said any of what was written.  I admitted to it.  I did explain the context of it but I owned my actions.  I stood tall and was unapologetic. 

I left the meeting feeling deflated and betrayed.  He didn’t tell me anything, no confrontation, he seemed grateful for our time together.  I always tell anyone I work with for the first time that if i do anything to offend you please say something because if you don’t say anything then I cant fix it.  I finished my shift feeling dejected.  A few days later while at my part time job I received a phone call from a fellow Firefighter.  She said she was questioned by the Chief Officers about a patient transport that her and I had shortly after my meeting.

I asked her to tell me which call.  She described the call and I remembered it well.  a patient with altered mental status, sudden onset, couldn’t speak or communicate in any way except grunts her eyes wide open and wild.  Recent history of some kind of surgery I think.  Otherwise no history of anything pertinent.  I remember my differentials were: Stroke, overdose, or psych.  I remember a pushy friend trying to ply her web MD wisdom on us which was curtly shut down.  If you call 911, answer their questions provide any information they need. Unless your opinion will have an effect on the outcome of the patient hold your opinions to yourself. You called them, they have training, have some faith.  

The transport was uneventful.. We had a student from a different program riding with us that day.  No big deal.  We dropped the patient off at the appropriate hospital and gave report.  A Doctor I knew came in and assessed her and did a cursory rule out of a stroke.  So psych or OD it was.  

I walked into another meeting same players but a different tone.  The Chief of the Department said something to affect of, “We got you now, a patient complained this time”.  Anyone who has an altered mental status is not a reliable witness,  so any complaint would be invalid plus there were witnesses.  I figured it was the friend that complained. Since I was given the heads up I knew what they were talking about and I took a different attitude.  One I am known for, smart-ass.  I quipped “She was altered, shes not a reliable witness”. 

He blew his top and screamed “Get the fuck out of my office!’  I obliged.  My Battalion Chief came out and asked why I had an attitude.  I told him I was tired of this bullshit and I questioned how he could allow this to happen.  Allow me to be railroaded with a bullshit complaint.  I was told the patient perceived that I was being hostile to her.  He asked me to tone down my attitude and come back in so I could hear their concerns.  

I went back into the office and was told the patient said I screamed at her. In her face.  Over and over again, that I did not listen to her concerns.  I blew up “What concerns!? She couldn’t talk!” I advised that this was bullshit and asked where my union representation was.  This put an end to the meeting.  The Union got involved, as they should have in the beginning, but we didn’t know what was happening and honestly I try to be a good soldier.  I take my beatings if I deserve them and I don’t complain about my mistakes. After it was all said and done I received a written counseling that would expire in 6 months time.  Then it hit me.

The student.   We had a student in the back of the Rescue with me.  I called the College the student attended and asked to talk to their field placement coordinator.  I asked, “ has anyone contacted you from the Fire Department asking to speak with the student assigned to Rescue 1 on xx day?”  The coordinator sounded a bit puzzled and said, “no, no one had called”. I asked, “did the student have any issues with her crew that you know of”.  Again the coordinator replied ,”No. she said she had a great time actually”.  I thanked her and advised her to call the department immediately if there were any issues.  So there it was.

The Department knew they had a third party witness to the events that happened in the back of the truck that call.  My partner who called me stated that she didn’t hear anything but she was driving.  They took the time to interview the complainant and my partner but not someone who would have actually witnessed my actions.  I am many things but I am very proud of my patient care and I strive to do my best for them. Always.  I may get complaints from bystanders but never had I gotten one from the patient.  

Some time went by and I found out that the patient who complained that day was the Chiefs neighbor.  How the two got together in the first place I don’t know.  I don’t know if her friend encouraged her to go to the Chief.  Maybe she was upset she was taken to the hospital she was taken to, or maybe she was upset about the unit she was placed.  It was the secure unit in the hospital for those who have psych issues.  

I also found out that the paramedic student that never came back; his Uncle came into a fire station.  He was a retired Firefighter from the City.  he told the station Captain, a man I trust that he helped his nephew write the letter.  See he was a Chief, but before he retired he got busted back down to Firefighter.  

Almost done with this entry, bear with me.  There are a few things I want to point out. I do my best to not lie.  I own my words and actions even if there are negative consequences.  I found out that honesty for the most part really is the best policy in life.  I could have reduced the chances of being in this situation.  If I wasn’t so hard maybe?  I hate to even say that. Its served me well, 17 years in Emergency Services and my brief stint in the Army and I’m still here.  I was trained by hard, driven and exacting me; professionals and masters of their craft. Yet, maybe.  Maybe I shouldn’t have used so much harsh language.  Maybe I should have followed up more, ensuring the student felt, safe? 

Initially I felt vindicated though.  I learned a valuable lesson though.  The administration doesn’t care what it has to do to be right.  No amount of common sense or reasoning can make a difference if their mind is made up.  

More to follow

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Who I am. Part II

So after working security for a bit I got the idea to become a Police Officer.  I call this “The time when I was sick”, to facilitate this I went and signed up for my first EMT class.  I figured it would be good to know how to patch someone up in an Emergency.  Back then the New Mexico State Police required an Associates degree before applying.  Not like now, a GED is all anyone needs.  

I started volunteering in my off time with a local Volunteer Fire Department.  This led me to get bit by the fire bug.  So i continued my training and after a few years volunteering I got picked up by a professional/paid Fire Department.  This was the beginning of what would mold me and make me the man I was going to be.  Or so I thought.

There was a lot of good that came from the fire service.  I made great friends,discovered brothers, sisters. Bonds that will only break in death and even then they may endure. I found out that I really was brave.  That I could face horrible things.  Many horrible things.   I continued to grow in my craft.  Took more classes, went to more training.  All to make myself more capable. 

I traveled because of my profession.  I went to Antarctica.  Yup, usually the one continent that people have a hard time with.  It paid for all my training, all my education.  There was another price though.  Much more expensive than anything monetary.

After getting back from Antarctica I got a job with a municipality, a suburb of Albuquerque.  The third largest city in the State of New Mexico.  It started off great.  I fought fire regularly, (my last department was slow, trained like no one else but slow in actual experience). I came to the realization we were an EMS Department that was Fire and Rescue capable. Even though we fought fire they were generally small ones.  A saying around the job was, “when I’m having fun you’re having the worst day of your life”  So true. 

We had one good fire, a great one.  Legitimate.  I performed well. As was expected.  I neglected to tell the “yellow tape story”.  So this is why I pushed to learn all I could about the job.  The Fire side, EMS, Rescue, any and all aspects of my profession.

I was at a fire when I was a volunteer.  I was only there to assist the Department if anyone became injured.  To help during rehab operations, (changing out oxygen bottles, getting water, checking vitals for the Firefighters).  During this fire in a little community North of my home town of Espanola I became frustrated because it felt like I wasn’t dong enough.  The guys were doing fine, didn’t need any medical attention. Just helped them with water and bottle swaps.  The Emergency services equivalent of the HS football towel boy.

I didn’t have the training to go into the hot zone.  Past the proverbial “Yellow tape”.  You see scenes are broken into the Hot zone; where the action is actually taking place. The warm zone” close to the action but out of harms way for the most part.  The cold zone; an area apart from any kind of emergency work, the safest zone on a scene.  

During that fire I vowed that I would never again be stopped by “yellow tape”. I would get all the certifications that I could to become capable of walking onto any scene and being useful.  I did.  There was not a scene I couldn’t respond to before it was all over. 

Shortly after getting hired onto the job outside Albuquerque I got a part time job working for New Mexico's only Level 1 Trauma Center.  Almost everyone in Emergency Services has two jobs.  I was able to get into a specialized unit in the hospital.  Again to further my abilities.  I worked for the Pediatrics Emergency Department.  Also the only one in New Mexico.  After getting settled in at my new Fire department, they sent me to Paramedic school. A year later I had obtained my Paramedic license.  

This was the best and worst thing that could have ever happened to me.  Lets get something straight. Ambulance drivers exist still.  Anyone affiliated with the job will pin their ears back after reading that.  It’s an insult to EMS professionals to be called that.  I say that because if all you do is show up get on the truck and do the minimum then no matter how much education you have you are an Ambulance driver.  Just like in Nursing, sometimes a nurse is just a bed pan changer. 

I shouldered a lot of responsibility as a Paramedic with an aggressive set of protocols.  A Paramedic who was trusted to make the right decision, even if it pushed the envelope. Just a little bit.  So I was burning at both ends.  The Fire Department showed me the awful reality of that 911 call you may have heard on the news.  The mother crying for help because her baby was not breathing.  Well I would would get off shift and go to work and be part of the team you’d see on TV that would receive the baby that wasn’t breathing and do our best to continue the attempt of life saving.  Honestly, more of than not we failed. 

I didn’t want to be an ambulance driver.  I wanted to be capable. I wanted to strive to be the best. So I tackled Pediatrics, the one call everyone fears.  A handful of Paramedics obtained the kind of experience I did, and I worked with all of them.  Even in the field it would bring relief if there was a sick child and I showed up on scene.  The funny thing is the only difference between me and the other medics on that pediatric scene that felt that way was that I just shit my pants in a more discreet way.  

I did this for 4 years.  I gained a good reputation from my peers and from the physicians who oversaw our care in the field, and the ER/Trauma team that also became part of my extended family.  I also became insufferable when it came to watching any stupid ass ER/EMS/Fire Department show.  They ALWAYS screw the littlest things up and it drives me nuts.  

More to follow

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Who I am

    Who I am is unimportant.  I guess you could argue what I am is even less so.  I am going to attempt to identify myself in the hopes you can develop a picture of who is trying to communicate with you.  This is just a description of how I view myself but as is the case with everyone; I am more.  

     I am first and foremost an American.  I am a Christian  I am a father.  I am a husband.  I am a New Mexican.  I am Hispanic.  I am a veteran.  I am a caregiver.  I am a healer.  I am a leader.  I am not ashamed of any of the above.  There is much more and as I write I hope to discover new things about myself which may help you understand who and why I am me and the message I am trying to share. 

     Now I am not very good at some of the things listed above.  I would say I’m not a very good Christian. I don’t go to church, but I truly believe in the message of Christ.  It speaks to my soul as I am perfect at one thing.  I am perfectly flawed.  Hopefully I will be a good father but only time will tell. I can do better as  husband, though we can all improve in our relationships with loved ones.  I am proud of my heritage and where my ancestors come from and where it brought me.  I have served my country, state and community in may different roles.  I am grateful I never saw combat but I have seen may horrible things.  

     I was raised by extended family and a single mother.  My biological father was not in the picture for long and my step father, well he gave me my sister and then after a time he was not in the picture.  My mother is from small town America.  A tiny little town in the North Central part of New Mexico.  She was and is one of my only constants since my birth.  Her and my late Great Aunt Ruth.  These two women were always by my side or behind me in everything I did.  No one else in my life has that distinction.  My mother is a public high school teacher.  My family is probably one of the only conservative families in all of North Central New Mexico.  

     For the most part I was brought up in a single wide trailer in another small town in Northern New Mexico.  The City of Española.  It used to be a small city, now its just small.  Small, sad, and broken.  Drugs have taken it and there is no hope the grip will weaken any time soon.  It is considered one of the most violent and dangerous places in New Mexico.  People from Albuquerque, which was ranked as one of the top ten most dangerous cities in the country are afraid of us.  We are Norteños.  People of the North, maybe we were Georges inspiration?  

     I always had clothes on my back, food in my belly.  Walls, roof and some form of climate control. Clean water and electricity.  At the age of six I became a big brother to a pain in the ass sister.  Then and now, amazing how some things don’t change.  Though amazing how we wouldn’t want it to.  I was a band geek and a football player.  My mother recognized the need for education and with the help of my grandparents, and only because of their assistance was I able to attend a small private school in town.  My mom made about five thousand too much to qualify for assistance and at one point it was only that and a ditch that separated us from public housing.  

    My mother was one of the old guard.  Family first no mater what.  She put her life on hold after divorcing my step father.  The split was due to constant domestic abuse culminating in me striking my step father because I truly believed (and still do) that he was going to punch my mother after knocking her to the ground.  She was responsible for her end of the situation that escalated to that moment but what else is a boy supposed to do but protect his mother when he is able.  

     I said only two people had been there my entire life.  My grandparents who were such a force in my life when I was younger faded into the grey mist of dementia.  My grandmother did, my grandfather went down with the ship.  An undying loyalty to her no matter how bad she got.  I was accused of theft by my grandmother to the point I couldn’t visit.  Which was awkward as at the time our trailer was on their property. 

     I enlisted into the United States Army at the age of 17.  I became a Cavalry Scout.  This was a defining moment in my maturation.  I will not lie, I drank the Kool-aid.  Ill explain that later. I was discharged honorably after my service.  I did my job, served my time and that was that.  No combat, thank God.  My mother says it changed me for the worst.  I think without the change I wouldn’t be where I am now.  

     After getting out like many veterans I struggled in finding any work, let alone any that gave me any satisfaction.  I moved back to New Mexico, the city of Santa Fe where I finally got a job working security.  Unbeknownst to me in the civilian world there was no need for the skills I obtained in the Army.  Shocking. I know.  I struggled to pay rent, my car was a hand me down from my mother.  A 1984 Delta 88 Oldsmobile.  Last of the boats, not what a young man pictures himself in after a triumphant return from the military.  Maybe not triumphant.  The security gig was good for a while.  I got to fight regularly.  I enjoyed that. 

More to follow.