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For You EMS Newbies…

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… Episode 76 is up on Confessions of An EMS Newbie.

Ron and I discuss, among other things, the fine art of pre-arrival ED notifications, and answer a few good listener questions along the way.

It's Confessions of An EMS Newbie, the only podcast rated by the Office for National Drug Control Policy as being riveting enough to make a pothead put down the Cheetos. You should, like, totally give it a listen, dude.

BANG! “Oh, Sh*t!”

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During Epic Hog Hunt 2011, Old NFO had a negligent discharge with his FN SCAR 17.

After we cleaned the crap out of our drawers, I told him, "You know this is getting blogged, right? Shall it appear on your blog, or mine, or TOTWTYTR's?

"I'll write it up," he assured me. "JUst give me some time to investigate, check with FN, and see how this might have happened."

Investigation complete, go read his post and learn the anatomy of a negligent discharge, and how you can avoid them with your own semiauto rifles.

I'm here to tell you, folks, a .308 going BOOM! into the ground when you don't expect it is enough to shake anybody, and the sick look on NFO's face (and everybody's, truth be told), was worth a lifetime of dry safety lectures.

It was only through NFO's assiduous adherence to the Four Rules that no one was hurt.

Chief Complaint of the Night

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Patient: “I play too many video games.”

AD: ” … ”

Patient: “And they make me itch.”

AD: “And?”

Patient: “And it kinda scared me.”

AD: “And?”

Patient: “And I think I need to go to the hospital to get checked out.”

AD (sighing): “Get in the ambulance.”

Patient: “Can I bring my video game?”

AD: ” … ”

As you may have surmised, his mental cheese was none-too-firmly affixed to the reality cracker.

Makes me glad to be an intrepid lifesaver, yessiree…

A Love Song For Kimberly

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In the wee hours of the morning on October 18, 1968, she was delivered by natural childbirth, a full three minutes before I. That, of course, made me her younger brother, a fact she never let me forget.

She was a beautiful baby, cherubic face and big blue eyes. Kim was the Gerber baby, and by contrast I was one of those little troll dolls with the wild hair. I came out bruised and misshapen, with club feet and one ear that sits higher than the other, and a head that will never be described as symmetrical.

I blame it on cramped confinement. Hey, when both twins weigh over seven pounds, living space is at a premium. You gotta fight for what you can get, and I took my first ass-kickings from her long before I was ever born.

My twin sister came out of the womb knowing how to fight.

 My older sisters loved her. She did what most newborns do, which was sleep 20 hours a day. She was the perfect baby to cuddle, the kind who nestles in your arms and settles in contentedly for hours, unmoving until your arm falls asleep. Then, when she'd finally wake, she'd gaze up at you trustingly, rarely crying, while you changed her diapers or gave her a bottle.

I, on the other hand, was a little different. I was a squirmer. I rarely slept for long, and I was prone to making unexpected vocalizations at the top of my lungs. Not exactly a crier, mind you, but a sudden fit of cooing and calisthenics when it's least expected can jangle your nerves as much as a crying baby. Kim was the quiet one, and I was the one that had no volume control from birth onward.

My sisters thought I was possessed.

Much is said of the supposed psychic link between twins, how alike they are in temperament and mannerisms, how even twins separated at birth and reunited many years later discover that, throughout their entire lives, their preferences and unconscious decisions mirrored one another. They drove the same types of cars. The had the same favorite colors. They married women that could be twins themselves. The gravitated to similar careers and hobbies. It's an uncanny bond.

Yeah well, maybe that shit is true for identical twins, but not fraternal ones. No two personalities could be more different, no two people less alike in temperament and mannerisms than me and my twin sister.

Still, there was something there. I remember countless times as a child when we'd break out singing the same song at the same time – a song only one of us liked. Or she'd start to speak, and I'd finish the sentence – even though the thought was completely foreign to me. But even though our personalities were so disparate, and as much as we diverged as we grew older, that link was always there. No matter what fictions you may conjure, no matter how you may veil yourself to the rest of your family, you cannot hide what you are from your twin.

There were times in my life when I treasured that. It can be fun sharing secrets no one else knows. And in other times, I wish we hadn't. The hate you direct at your twin burns you too.

**********

As is the case with most male-female sets of fraternal twins, the female is usually bigger and stronger. I weighed seven pounds, she weighed seven and change. She was always one size bigger as we grew up. When it came to wrestling matches, she always won.

She was not, however, faster. Every developmental milestone, she reached at an appropriate age, but I was months ahead of her every step of the way.

I walked unassisted at seven months. Kim didn't walk until she was well over a year old.

I was talking at a year, and speaking full sentences (at the top of my lungs, of course) by 18 months. Kim didn't talk at all until she was almost two, and she suffered from a speech impediment until we were well into grade school.

I was potty trained much earlier than she was. Then again, my parents might not have considered that a good thing the day I broke away from them and pooped in a display toilet at Sears. Kim never induced such embarrassment.

By the time we reached kindergarten, I had read the entire Encyclopedia Britannica, all 26 volumes. Kim was still struggling with the Jack and Jill Reader.

When we played tag, I was the kid you wanted on your side. I could outrun anyone. Kim, on the other hand, was the ringer when we played Red Rover. You'd dare not call her over to your side, because she'd break the link of kids twice her size, and you damned sure didn't try to break any link she had made if the other side called you. After a few instances of near-decapitation, I learned to avoid my sister's part of the line when the other side called, "Red Rover, Red Rover, let Kelly come over…"

It can't have been easy for her, being my sister. Faster, far more mobile… I had my pick of any toy in the box. Kim, on the other hand, learned to latch onto what few toys she could outrace me to, and hold on to them with grim determination. I never had to fight for what I wanted.

But my sister always did.

When we were toddlers, my mother heard a bloodcurdling screech from the living room and rushed into the room to catch me trying to bite my sister. She spanked my bottom soundly, and scolded me for doing such a mean thing. It wasn't until bath time that she discovered the livid bite marks on me that Kim had inflicted before she walked into the room.

It was a pattern to be repeated for the next fifteen years. I'd finally snap after weathering hours of torment, and Mom would walk into the room just in time to catch me retaliating.

“Oh, so you two wanna fight, huh?” she’d muse. “Well, I’ve got the cure for fighting. When you get done, you won’t wanna fight any more, believe you me!”

She’d then proceed to the hedge and gather three diabolical switches, test them for proper flexibility and tensile strength, and then hand one to each of us.

“Go ahead and fight,” she’d exhort us. “Work out all that aggression. And if you don’t fight, you get a whipping from me.”

Great, Mom, let's give the evil twin a weapon. Good parenting move.

I’d spend the next five minutes getting lashed by not one, but two psychotic females.

The only time Kim ever got a spanking for biting, she didn't have it coming. When we were still toddlers, Mom caught her holding me down, teeth bared over my back. Mom snatched her up and spanked her soundly before she could inflict the bite. Kim was indignant, insisting that she was not trying to bite me.

It was 1971, and The Youngbloods' "Smile On Your Brother, Everybody Get Together" was still popular on the radio. And that's all she was doing, smiling on her brother.

Me, Kim, and Paxton Quiggly, Jr., one of the best dogs EVAR.

 

Still as much as we fought, we looked out for each other. Or, more properly, she looked out for me. Beating my ass was her personal prerogative, but she'd suffer no one else to even try. For my part, I never had to defend Kim from anyone else. She was the toughest kid on the block anyway.

My mother bred and raised poodles when we were kids. Growing up, it always seemed we had a litter scampering around the house, and our brood bitch, Tiffany, liked to make her nest in the bathroom laundry hamper. So, until the puppies were weaned, Mom kept the laundry elsewhere, and Tiffany nursed her puppies in peace. It was understood by all the children that the puppies weren't to be disturbed, and that doing so could make them sick, not to mention result in punishment for the recalcitrant puppy-snuggler.

Well, when I say understood, I mean understood by all the older kids. Kim and I didn't count. After all, only one of us could walk and the other couldn't do much more than crawl. What harm could we do?

Turns out, quite a lot. Separately, we were just a pair of twenty pound toddlers, but together, we were a formidable forty-pound octopus that could, and did, get into most anything.

So when we decided that the puppies needed a bath, we brought them into the bathtub with us. And when we were through bathing, the most logical means of rinsing off the soap was, naturally, the toilet. So, eleven toy poodle puppies with their eyes barely open got a warm bath, followed by a communal swirlie in the toilet. The only thing that kept most of them from drowning was the volume of stuff we threw in there with them. Between the combs, hairbrushes, bath toys, dog toys and this funny big rubber bag with a long hose on it that Mom insisted we never play with, all but two of the puppies managed to find enough flotsam or jetsam to cling to keep from getting flushed.

Mmmm, corduroy. Helen Keller's favorite color.

When we were kids, no more than five or so, my parents went out of town for a week, leaving us in the care of our 18-year old sister. Sheri, like most 18-year-olds, was so self-absorbed that I doubt she even realized we were there. She spent the entire week with the phone surgically grafted to her ear while Kim and I were left to our own devices.

Normally, that would have been fine with us, but at some point, a five-year-old has to eat, and it became obvious to us that we'd starve before our sister would ever notice. Surely, our parents would come home to find our decomposing corpses on the floor in front of the refrigerator, with Sheri locked in her bedroom, still on the phone and idly wondering what that stench was.

So we learned to cook. I knew how to read the directions on a can of Campbell's soup, and Kim was strong enough to work the manual can opener, so we subsisted on a diet of vegetable beef soup, hardboiled eggs, and Kool Aid. Our parents came home to find Kim on her hands and knees on the floor in front of the stove, me standing on her back taking a saucepan full of hardboiled eggs off the burner.

For the life of me, I can't understand why they seemed more horrified than proud of our teamwork, a mystery only matched by how Sheri managed to survive their wrath.

My parents separated briefly when I was a kid. During that time, my mother took Kim and I to Oklahama to visit our aunt. On the long drive from Oklahoma City, Kim and I got bored with our coloring books, so we made a a sign that said "HELP, WE"RE BEING KIDNAPPED,"  and held it up to passing motorists. When stopped for gas just across the Oklahoma/Texas line, the station attendant stared suspiciously at our car, furtively picked up the phone, and dailed a number. It took him forever to fill our tank, check the oil and tire pressure, and clean the windshield. Heck, he may have even checked the belts and hoses, radiator level and washer fluid, too, while he stalled for time.

Before my Mom could pull back onto the highway, two Oklahoma DPS troopers roared up, and ordered her from the car at gunpoint. One trooper pulled us out of the car and sat us on the trunk while the other trooper questioned Mom some distance away. Judging from the death glares Mom was giving us, we both knew we were in hot water, so when the other trooper came over to us and said, "Son, this woman swears she is your mother, and all this is a big mistake," we said the only thing we could under the circumstances:

"Officer, I've never seen that woman before in my life. Please don't send us away with her, she'll kill us."

I wasn't exaggerating much, either. On the scale of Epic Syllable Whippings, that one went all the way to eleven.

**********

I made straight A's on my report card. Kim struggled for C's. I was the kid teachers bragged about. Kim was, well… the sister of that kid the treachers always bragged about.

My kindergarten teacher, Mrs. Dickens, used to tell all the new teachers of the little boy who'd read Louis L'Amour novels during naptime, rolling her eyes in faux exasperation, but it was clear she thought I was a rock star. All the teachers thought I was a rock star. Kim was the child you had to put in time out, because she'd bloodied another kid's nose when he tried to take her crayons.

In the fourth grade, the state put us through standardized tests to determine our reading comprehension level. Kim tested right where she ought to be – at fourth grade.

Except, nobody paid much attention to that, because her twin brother maxed out the test, with the reading level of a college junior.

In high school, I was the popular kid, the class clown liked by everyone. Kim was the street-tough hood feared by everyone. She was however, the undisputed Queen of the Smoking Area.

From the beginning, my sister was damned with the shame of low expectations. Nobody required much of her, and she was perceptive enough to be insulted by it. And she was happy to oblige them. If nothing was expected of her, nothing was what she'd give them.

Because fuck them, that's why. That was my sister.

My parents used to reward us for good grades; five dollars for every A on our report cards. After our school system switched from grades every nine weeks to grades every six weeks, it got rather expensive, and the reward dropped to three dollars. Later, it dropped to one dollar.

But after the fourth grade and that reading test, the rewards stopped coming altogether. Instead, they'd reward my sister for B's and C's; five dollars for an B, three dollars for a C. I got nothing at all.

I was outraged. My sister was the dummy, and here she was being rewarded for it, when I was clearly the better student. My mother tried to explain that I didn't need the incentive, but they felt that Kim did. It was a parenting failure that would have a ripple effect on me and my family for the rest of my life.

I don't mean to say that I divorced myself from my family in general and my twin sister in particular just because she got paid for mediocre grades while I got stiffed for excellent ones. It was more than that. But that event sowed the seeds in my mind that, in my family, mediocrity was the norm, and failure carried no shame.

And I'd be damned if I was going to settle for mediocre. Let the rest of the Grayson family be a bunch of fucking failures if they wanted to, but I was getting the hell out.

**********

Our fights were epic, if one-sided beatdowns can be considered epic. I was the good son who adhered to his parents' admonition that Boys Do Not Hit Girls. It was understood from childhood that men do not pick on the weak. Women were weaker than men, and for that reason, we should protect them and never, ever raise our hands to them.

Except that, Kim was never weak, and she adhered to the motto, "Hit first, and hit dirty." I took enough shots in the balls that it truly is a wonder that I was ever able to father a child. From the latter years of elementary school on, beatings were a daily occurrence. Gone was any sense of the bond between twins. She was an angry kid, and I was a convenient punching bag.

I took them for years, at first because I wasn't physically capable of whipping her, and for several years, simply because I still had qualms about hitting a girl. The epiphany came in junior high school, when we were playing Smear The Queer during recess.

(Yes, I know it's hurtful and insensitive, but kids are often hurtful and insensitive. We grow out of it.)

Anyhow, during this game of Kill The Man With The Ball, my sister was the only girl playing. She was playing far too rough for the boys present, and since she was my sister, I was elected to tell her to leave.

She beat me silly, to the point that the principal felt it best that I go home for the rest of the day and physically recuperate.

I took a lot of ribbing for that beatdown, until the day a month later when she administered a comparable whipping to Brian Puckett. In eighth grade, Bryan Puckett was 6'2" and 235 pounds, but that wasn't big enough. Apparently, Brian's parents had also taught him that Men Do Not Hit Women, and he paid the price for his chivalry.

That beating at least got me entrance into a fraternity of otherwise strapping young men who had gotten their asses soundly whipped by Kimberly Ann Grayson, but it also cemented my sister's reputation as Badass, First Class.

And then it hit me: she was more than my match, and not fighting back just invited more aggression. I'd long since become bigger, stronger and faster than she was. What I wasn't, was meaner, and if I wanted to discourage future beatings, I was going to have to be as ruthless as she was.

So I learned to fight back, and I modified my personal ethos: A man does not instigate violence against a woman, and he walks away from it if he can… but if flight is not an option, then he shows her that attacking a man is a man-sized job. Women need not apply.

And while this thought was germinating in my head, I started to watch how my sister fought. It occurred to me that those right haymakers that started in the vicinity of her left knee might be countered somehow.

Like, maybe… by ducking.

And when those knuckles whistled past my head, there would be a moment to get in three, maybe four quick blows of my own.

Or one really good one.

And that when I got in a few of those blows, her rage would just bubble over, and if I kept my head, I could just pick her apart while she flailed at me.

Sure enough, it worked. And on a March day in 1981, with a school bus full of kids (and, truth be told, the bus driver and several teachers) cheering me on, I finally got the better of my sister. She never landed a punch, and I discovered that I had more than enough strength in my arms and shoulders to drop her like a bag of wet cement. After the third or fourth time, she couldn't get up, and I delivered a kick just to make sure.

I left her there, bleeding and broken on the sidewalk, with all the kids jeering at her and calling her names, and told the teachers to call my parents to come bring her home, because I was taking the bus.

She never beat me up again. Somehow, victory didn't feel as good as I'd expected.

**********

It wasn't until I was grown that I ever wondered what had made my sister so angry. She was always a tough and stubborn kid, but shortly after we were ten, something changed in her that I was able to understand only in retrospect. It seemed that overnight, she became this sullen and withdrawn kid, one who would lash out with frightening violence at the slightest provocation. My sister was bitter and angry, and…

… no, angry doesn't even begin to describe it. Angry is what you get when someone cuts you off in traffic. Angry is what happens when the kid at the drive-through screws up your order, and you don't discover the error until you're ten miles down the road.

What my sister had was a seething hatred for everyone around her. None of us were spared. Most of the time, it lay just below the surface, but it was always there, ugly and feral. I tried my best to avoid fighting with her, because I feared that I'd have to kill her to keep her off of me.

"Float like a butterfly, sting like a bee" isn't much of a fight strategy when the other guy is swinging a machete at your head.

But it wasn't until I was grown that the truth came out. Kim had been molested, systematically and repeatedly, for years. And if she told, her abuser told her that he'd kill my older sister, and my parents, and make her watch before he killed her.

And once he knew he had her cowed, he ratcheted up the psychological torment, and convinced her that telling our parents wouldn't do any good, because they already knew. In fact, her whole family knew, and they didn't care. Of course, none of us knew, but that doesn't matter when you're a ten-year-old girl clinging desperately to sanity, and the only lifeline you can see is the one extended by your abuser.

To this day, I carry the shame of not putting a bullet in that twisted fucker's head and leaving his balls in his mouth. Not only did he steal my sister's innocence, but he stole my sister from me.

The one thing that kept me from doing so was the knowledge that killing him would only compound the hurt, and bring pain to others in our family. Perhaps that is what stayed my father's hand, as well. For that reason, I will not utter his name, but he knows what he did, and he knows that his punishment awaits.

If not in this life, then in Hell.

So by the time I finally had the answer, it was too late to do much of anything about it. Too late to feel much of anything about it, really. I was a grown man, and had long since mentally and emotionally divorced myself from my family.

That was a survival mechanism my sister never had.

And so, even though I finally knew why my sister would provoke my mother until I'd have to step between them to keep Mom from killing her, and why my father always seemed to take her side when we fought, and why Kim always seemed to get a pass for every insult and hurt she inflicted, the endless parade of shiftless characters she shacked up with, all the drugs they ignored and the jail time they pretended never happened…

… I was too distant to really care. Family news for me was just another Jerry Springer episode, and I'd long since changed the channel.

**********

I'd hear snippets of family news from time to time, always from third parties who were surprised that I even had a sister. I knew she'd been busted for drug possession. I got updates from the sheriff's deputies who worked the jail, and they looked out for her because she was Kelly's sister. I told them to never let her know that I knew she was in jail, much less that they even knew we were related.

I knew she had lost custody of her son. Chase is the spitting image of his mother, only with a dash of his uncle's sense of humor. He's sixteen now, almost a man himself. I haven't seen him since he was six.

I'd see Kim at holiday gatherings, and I'd put an interested mask on my face while everyone caught me up on family gossip, all the while mentally counting the minutes until I could leave. On one Christmas gathering, I took her boyfriend outside and told him I'd throw him off the balcony head first if he showed up staggering drunk at a family gathering ever again. Kim blamed me when he didn't come back inside.

The last time I talked to her for any length was almost ten years ago, after Mom died. Dad had fled to Oklahoma to live with my Uncle Sonny, while Kim allowed our half-brother, the son of our biological father, to live in the apartment behind Dad's house.

My father's house.

I couldn't believe the insult, and that fact that my father stood for it was all the proof I ever needed that he had become an old man. He was beaten, and he couldn't fight any more. All he could do was flee, and let the rest of them fight over what he had left. All he asked was that I find Kim, and retrieve his guns.

I found out Kim had pawned all of Daddy's guns, and I forced her to cough up the pawn tickets. She lied to me, and told me Daddy had given her his blessing, and when I called her on it, she defended herself by saying she'd do whatever it took to feed her son.

"So you'll fucking steal from your own family, rather than ask me for help?" I asked. "Do you really think I'd let my nephew starve? I'd have given you money, and never expected it back."

"I don't take charity!" she shot back.

"Riiiiiight. You're too proud to take a handout, but not too proud to steal your father's most prized possessions."

"He is not my father!" she spat. "Bob Magee is my father."

"Bob Magee is the guy who fucked another man's wife thirty-odd years ago. Norman Grayson is the man who raised you, fed you, clothed you, and took your side when you tried to drive the rest of us insane. Norman Grayson is your father, and you owe him better than this."

"Fuck you! Go to hell!"

"You know, you've been carrying that hatred since we were kids. I never knew what happened, and it hurt me too. Dad didn't know, either. But that was twenty years ago, Kim. It's time to let it go, and stop letting it dictate who you are."

"Fuck you, I AM over it! I'm WAY over it!

I won't repeat the rest of what she said, but it was obvious that the pain was still there, and still raw after all this time.

So I wiped the spittle from my face, told her sarcastically, "Yeah, anyone can see you're just the fuckin' picture of mental health," and drove away.

Because that's the kind of loving and supportive brother that I am.

**********

She finally kicked her drug habit, with addiction and drug abuse counseling from a faith-based charity called Rays of Sonshine. Their rehab center was located right across the street from AMR headquarters in Monroe, and I'd see my sister two or three times a week. Mostly we ignored each other, but after a few months, she'd wave whenever she saw me. I'd just pretend I hadn't seen her.

"You know that woman?" my partners would ask me curiously. "She seems to know you."

"Probably a case of mistaken identity," was all I'd reply. They got the message not to pry further.

When KatyBeth was born, I brought Dad in to see her. My brother Terry was out of touch, the only contact we'd had a broken, sobbing message I left on his answering machine in the hours before she was born. He didn't call back until a week later. The rest of my family was not invited. KatyBeth has never even met her Aunt Kim.

**********

Kim, with just a few of the people whose lives she touched.

Whatever you may say about faith, whether you believe or not believe in God, whether you believe in Him as a being, or attribute the good works of religion to the social support system of a network of believers, God healed my sister. Whether He did it in an act of grace, or the simple act of believing is what turned the tide for her, and the teachings of Christ to serve others is what finally helped her to see beyond her own pain, rather than some magical healing touch…

… it doesn't matter. Faith healed her pain when her family could not. She believed God was responsible, and she was paying Him back by serving others.

She lived in virtual poverty in an orphanage in Port Elizabeth, Eastern Cape, South Africa. She had no possessions other than a few personal effects, her only income a $200 monthly stipend from a charitable sponsor.

In recent months, she reached out to me through Facebook, and I accepted her friend request. We still didn't talk much, but I'll confess to stalking her page, and from the photos of her there, my sister seemed happier than she had been since we were kids. And just as clearly, she was loved.

My sister was not lonely in the end. It was about damned time.

I've joked for years that if I died tomorrow, that I'd be in the ground for three days before my family knew about it… and that was just the way I liked it. I have a miracle daughter, and even though Mary and I are no longer married, we still care about each other. I've got a beautiful girlfriend who loves me despite my flaws, and God knows I have plenty of them. I've got friends that are closer than any blood relative, and even though we may be separated by thousands of miles, all I need do is pick up the phone and they'll be here, no questions asked.

My only regret is that I never got to know the person my sister became, and most of my memories are of the person she no longer was.

I'm still not close with my family, and I likely never will be. I love them all, but I love them best at arm's distance, because the joy of hearing their good tidings is not worth all the family drama that comes with it. Now, with all the correspondence over the past week, I've heard enough family news to last another lifetime, and precious little of it welcome. I can't avoid it, though. Plans have to be made, social obligations have to be met.

It's said that funerals are for the living, and of that I have no doubt. I'd much rather skip out on the memorial service, although undoubtedly that would just confirm their opinion that I am still the arrogant asshole brother that thinks he's better than the rest of them.

And you know, maybe that's a valid opinion. I don't much care one way or the other. I just know that I don't want to be there, and that  that I don't need their presence to say goodbye to my sister, and I don't need to hear some preacher say the words to know that she is with God. 

I was at work when I got the news last Sunday. Perversely enough, my ex read it on my older sister's Facebook page, and called to see if I was okay. That was the first I'd heard of it.

"Yeah, I'll be all right," I told her, and I went to work that night as usual. And all night long, all I could think was, "She can't be dead, because I didn't feel a thing. We're twins. We're supposed to sense things like that."

Looks like that emotional distance thing has its price.

I've waited a week to feel something, and only now do the tears come as I type this. And I hope the rest of my family forgives me, but  I'm going to go down to the beach at Cameron in the morning, and watch the sun rise, and say goodbye to my sister alone. And I'm going to pray that she knew I loved her, and that I was proud of who she had become. Somehow, I suspect she does.

Twins know these things.

Schlemiel, Schlimazel, Hasenpfeffer Incorporated!

11 comments

Heading this morning to the land of Laverne DiFazio and Shirley Feeney, to speak at the Wisconsin EMS Conference.

While I'm there, I'll be enjoying good food and beer, and trying to understand people with funny accents.

Y'all watch the place, keep the toilet lid up in case the dog gets thirsty, and make yourselves at home. There's Shiner Bock in the fridge, and plenty of Ho Ho's, potted meat and pickled quail eggs in the pantry.

I'll turn on the free ice cream machine again when I get back.

To All of You Who Offered Condolences…

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on the death of my twin sister, I thank you.

Kim was a missionary in Port Elizabeth, South Africa, living and working at an orphanage and school there. Her friends told us that she had been swimming in the ocean near her home, and got caught by currents and drowned. Paramedics on scene were unable to resuscitate her.

I've been estranged from my family for a very long time, and Kim and I hadn't been close since we were children. But in recent years, I'd started to reconnect in some small way with my siblings, and through our older sister I learned that Kim had turned her life around, and devoted her life to God and improving the lives of countless children in South Africa. She was poor, she was uninsured, and she lived in virtual poverty, but she was happy.

And it looks like, in the last few years, she had found a way to make a difference. For that, I am thankful.

After we have time to get Kim's ashes shipped home and I have time to process all this, I'll write a post about my sister. We fought like demons and were bitter enemies for years, but there were good times, too.

I'd like to share some of them with you, to honor my sister.

Until then, thanks for your prayers and good wishes. They were very welcome.

 

 

We Don’t Need Just a Victory, We Need a Friggin’ Roman Triumph!

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I'm still in first place ( I think) in the 5.11 Tactical Adventure Blog contest, but there's nothing like piling on a few points to cement a victory.

Either go to the link Winter Wings on my blog, and Tweet it, or Facebook Like or Share it, or go here to 5.11's Facebook page and like the post yourself. Mine's the first comment in the queue.

Thanks!

Kimberly Ann Grayson, October 18, 1968 – January 22, 2012

62 comments

I remember the person you were, and for that reason, we were not close. No two twins were ever less alike, or fought more.

But I will always regret never knowing the person you became. You overcame your demons and helped many others overcome their own, and I'm sure there are many children in South Africa who were richer for having known you.

Rest now, sister. You've earned it.

Olfactory Vagaries

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Regular readers of my blog and book know that my nose has been on strike ever since the Great Chicken Gut Call of 1994.

For weeks or months at a time, I have no sense of smell. My sinuses can be perfectly clear, I’ll feel perfectly fine, but if you blindfolded me and held a rancid skunk directly under my nose, the most I’d be able to manage is a vague, acrid hint of… something.

Not enough to identify as an odor, at any rate.

Invariably, my sense of smell abandons me when it might be useful, like when I’m trying to detect the odor of ketones on a diabetic’s breath, or the odor of alcohol metabolites that might tell me if my combative patient from the car accident might be drunk, or suffering from a head injury, or simply an asshole.

During such times, I have to rely on my partner’s sense of smell to detect those subtle clues.

Since it has been largely gone for almost seventeen years, I don’t much miss it any more. Not being able to smell is simply part of the landscape.

But every now and then, my schnozz decides to start working again, just to remind me of all the stuff I no longer notice.

Like necrotic decubitus ulcers.

Or body odor.

Or Toxic Sock Syndrome.

Or crack cocaine.

Or weed.

Or cigarettes.

Or urine and feces.

All of which I have smelled in various combinations in the past 48 hours, as my rebellious nose punishes me for one little insult seventeen years ago, but being hyper acute to all the stuff I don’t want to smell.

If it’s all the same to you, Mr. Olfactory Center, you can go dormant again any time now.

Overheard On The Bolance

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Overheard in a phone conversation with Matt G.

Matt G.: “… so the chick doesn’t act drunk, and I couldn’t detect any alcohol metabolytes on her breath, but she looks like she could be a medalist in the Illicit Pharmaceutical Olympics, and she’s doing the twitchy meth dance…”

Ambulance Driver: “Well, you know ingestion is sort of passé as a means of alcohol intoxication among the kids these days…”

Matt: “Oh?

AD: “Sure. There’s nebulized vodka, vodka-soaked tampons, red wine enemas…”

Matt: “I wonder what red goes best in an enema? A hearty Cabernet Sauvignon, perhaps a port?”

AD: “The sommelier offers you a packet of KY and opens the clamp on the hose for you…”

Matt: “I’d imagine the whole cork-sniffing ritual would have to be altered a bit, too.”

AD: “Should the wine breathe for a few minutes before you stick the nozzle in your ass?”

Matt:“I wonder how one goes about tasting the vintage and signaling approval to the sommelier?”

AD: “I don’t know, but that’s about as far as I’m willing to take this mental exercise.”

I Made The Finals!

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Okay folks, you did your part to make Winter Wings one of the finalists in the 5.11 Tactical Outdoor Adventure Contest.

Now I need you to put me over the top to win the whole thing. Daddy needs a new pair of 5.11 tactical trainers!

Just click on the link to the post, and hit the Facebook SHARE button at the top of the post, or the TWEET THIS button at the bottom of the post.

Or hey, both would be nice too. If you have Google +, pimp it there, too.

You get me a few hundred Facebook shares in the next couple of days, and I'll have some more tasty, tasy free ice cream soon.

I promise!

If Tim Tebow Was a Paramedic

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Those of you who read Sean Eddy at Medic Madness are probably familiar with his Celebrity Medic series, in which he imagines what a celebrity or fictional character would be like as a paramedic. So, given the dramatic win last weekend and the upcoming divisional playoff game against the Patriots, Sean and Greg Friese have challenged us to imagine what it would be like if Broncos quarterback Tim Tebow were a paramedic. If you’d like to play along, consider this a meme. Drop us a link to your blog post in the comments.

Hey, Tim? Nice veins.

If Tim Tebow Was A Paramedic:

He’d have more code saves than any other medic in your system.

Of course, his detractors would point out that the reason is that Tim Tebow has more people die in his rig than any other medic in the system, because Tim Tebow struggles reading 12-lead EKG’s  and recognizing subtle patient presentations…

… but his fans would  counter with the fact that, once the patient is dead, Tim Tebow always seems to convert the patient to a perfusing rhythm on the first shock.

“Yeah, but that doesn’t happen until they’re dead!” his critics would retort.

“What does it matter as long as they go home neurologically intact?” his fans would crow. “A save is a save, baby!”

“Dude, the guy‘s a weak medic,” would come the counter argument. “He can’t read EKG’s, struggles with drug dosages, can’t remember the landmarks to do a needle decompression, breaks half a dozen teeth when he tries to intubate someone – “

“ –but gets the tube in when it really counts!” his fans would proclaim. “That’s what’s important, right?”

Puhleeze. The guy has killed more people than smallpox.”

“He’s saved more people than Billy Graham!”

“Grim Reaper!”

“Johnny Gage and Roy DeSoto!”

“Dude, you’re talking about the guy like he’s an elite medic. Elite medics know cardiology like Tom Bouthillet. Elite medics manage an airway like Ambulance Driver. Elite medics are cool under pressure like TOTWTYTR. Tebow couldn’t stand on a stepladder and kiss those guys’ asses.”

“Oh, yeah? Well, how many code saves did those guys have this month? None, baby! Woo hoo!”

“That’s because those guys don’t let their patients code. They manage the call, so they don’t have to do any heroics at the end!”

“ Tim Tebow rules!”

“Tim Tebow drools.”

“You just hate him because he’s guided by the hand o’ Gawd!”

“I hate him because he gets the credit for every save, when it wouldn’t have been possible without the uninterrupted chest compressions done by his partner, or the prompt call to 911 by the patient’s family, or for the contributions of half a dozen other people. Nobody gets a save all by themselves. Resuscitation is a team sport.”

“TIM TEBOW WAS THE BEST EMT-B THAT EVER LIVED!”

“Yeah, but now he’s a medic. Everybody in this system was an awesome EMT-B, or they wouldn’t even be here. This is the pros, baby, and your boy’s game doesn’t work here.”

“YOU TAKE THAT BACK!”

“Not gonna happen. Maybe your boy might make a decent – I mean just decent – medic with a lot of practice and a few years. But he ain’t there now, and he doesn’t even deserve to be mentioned in the same breath as Rogue Medic, or AD, or TOTWTYR, or Happy Medic. “

“HERETIC! GOD SEES YOU, UNBELIEVER!”

“Blow me.”

[fisticuffs ensue]

And while the argument raged around him, Tim Tebow would keep on running calls and doing his best for his patients, because he’s Tim Tebow, and he’s a good kid. He’d recognize that he’s got a gift for the heroic save, but he’d also be honest and admit that he’s still nowhere near the medic he should be.

And nobody would outwork him in getting there.

He’d be humble and self-effacing to his fans, always deflecting praise to his teammates (and God), and he’d be gracious to his critics. And he’d make some serious gaffes, but he’d keep on racking up saves.

And after each one, he’d Tebow.

Naturally.

 

 

For You EMS Types…

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… there's a pretty good discussion on spinal motion restriction with me, Kyle David Bates, Rogue Medic and Dr. Laurie Romig on the First Few Moments podcast.

 

Go check it out!

What Gun For a Girl, and the Combat Mindset

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It's a question debated ad nauseum on the gun blogs and shooter forums, and the answers are as varied as the individuals asking the question.

I recently had opportunity to answer the question myself, when an ex-girlfriend emailed me, asking for advice on purchasing a handgun. Seems she had acquired an unwelcome suitor -not quite the creepy stalker type, but ardent enough that his attentions became unwelcome, and started her thinking about self-defense.

"I wanna buy a gun," she told me. "Which one should I get?"

She might as well have asked me, "Do you still beat your wife?" or "Have you ever been caught masturbating in the closet?"

There's no right way to answer those questions.

I gave her the advice I give to most new shooters -male or female – with that question: Shoot a bunch of different pistols, and choose whichever one you like and shoot best, with the following three caveats:

  • 1. Snubnosed revolvers are for experienced shooters, not beginners.
  • 2. If anyone tries to steer you toward a specific type of gun to the exclusion of all others, ignore that person's advice and get away from the supposed "expert" as quickly as possible..
  • 3. Don't get anything less than a .380.

Turns out a co-worker had already taken her shooting, and she came away with a couple of impressions: she didn't like the .45 at all, and she much preferred the .22 she shot. After a little more talking, I learned that instruction by her coworker had been pretty much nonexistent; he had pretty much given her a polymer-framed .45, pointed her downrange, and told her to squeeze off a few rounds – one handed, no less. Unsurprisingly, she found the .45 very heavy to hold, and the recoil unpleasant.

Obviously, more shooting was needed, and instruction from someone other than her coworker. So, we made plans to take her to the range this weekend, after which we'd go to the gun show and let her pick out a gun. I'd bring up all my handguns, maybe rent a couple more, and we'd let her try everything from a .22 LR single action revolver to my 1911 in .45 ACP.

"Do you have something that has a hole in the muzzle that looks like a .45, but kicks like a .22?" she asked, jokingly. "I want the scariest gun possible."

To which I replied, of course, "You don't pull a gun to scare someone. You pull a gun to shoot someone. If you're not willing to pull the trigger, you might as well just give the mugger your gun and save him the trouble of taking it from you."

"Oh, I'm not going to shoot anybody. I don't think I could kill a person."

Whoa. Full stop.

If you haven't already done that mental self-assessment and unequivocally answered the question about where your particular line is drawn, under what circumstances you'd take a life, the answer to the question, "What gun should I buy?" can only be, "No gun at all."

"What if someone took your purse at knifepoint?" I asked her.

"I don't carry much in my purse anyway. He could have it."

"So you'd let him have your purse, with your driver's license, credit cards, house keys, everything?"

"Sure, all of that can be replaced. Lives can't."

"So it wouldn't bother you at all that someone who'd take your property by threat of violence, now knows your address and has access to your home? Not to mention everything he needs to steal your identity?"

"Uuuhhh…"

"What if he's pissed that your purse only has eight bucks in it, and forces you to drive him to the ATM for more? What then?"

"Yeah, but how likely is – "

"We're talking about a guy who has demonstrated that he is willing to kill you to get what he wants. What makes you so sure he wouldn't?"

"Okay, so I'd probably drive him to the ATM."

"And if he decided that he'd like to have your car, too? And that it'd be a lot less risky if he didn't leave any witnesses? Would you be willing to kill him then?"

"Wow, you really want to shoot someone, don't you?"

"I don't want to shoot anyone, but I'm willing to if necessary."

So you'd kill someone over your wallet? Over a few hundred bucks?"

"If I had to."

"I can't believe you'd shoot someone over a wallet."

"With a smile on my face and a song in my heart."

"I'm just not sure I could kill someone."

"Then rape is okay, as long as you can trust the guy not to kill you afterwards?"

"Now wait a minute, I didn't say that."

"Yes, you did. You're telling me that the threat of violence is acceptable to you, as long as overt violence is avoided. The problem is, you're not making that decision where the line is drawn. Your attacker is."

"I'd never really thought of it that way."

"Until you have, you don't need to carry a gun."

**********

In the end, we decided not to go to the range or the gun show. She's going to buy a Ruger .22/45 for plinking and target practice, and I'll take a day off in the near future and give her some instruction in gun safety and basic marksmanship. She'll keep the gun at home, and in the meantime she'll take a CHL course, and hold off buying a defensive firearm until she has decided for herself just where her line is drawn.

A Tale of Two Conferences

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Those of you who read my blog know that I speak at EMS conferences around the country. It's an enjoyable sideline and a nice way to supplement my income, but not something that I'll ever do frequently enough to make a living at. I make a fair bit of money doing it, but the real reason I do it is to have a chance to hang out with my EMS tribe a half-dozen or so times a year, decompressing, commiserating, sharing contacts and ideas, and consuming adult beverages after I'm done speaking for the day.

The honorarium I charge is not insignificant, but neither is it prohibitively expensive. I've refused to waive my honorarium when asked by bigger conferences who can well afford my fees, and been known to waive it altogether for small conferences struggling to build an attendance. I've even been taken on hunting trips in lieu of an honorarium, and would do so again in the future.

The point is, it's not about money. It's about professionalism and courtesy.

There is a large state EMS conference here in the south where I refuse to submit proposals any longer, simply because in five years, I never once got so much as a confirmation email for any proposal I submitted. I've been asked by EMS system administrators and even conference committee members from that state why I've never submitted a proposal to speak there, and told them, "I have, and five years ago I'd have spoken for free. But when you don't even get a confirmation email, much less a rejection letter, eventually people give up."

I skipped a year speaking at my own state EMS conference – where I speak for free every year – simply because the people I submitted proposals to lost them, and nobody ever bothered to check why they hadn't heard from me.

I've lectured at two similar conferences that I've thoroughly enjoyed, both held on the same weekend every year. Both had similar attendance – maybe five hundred people at most – and both are in states largely served by volunteer EMS. The attendees are great; warm and welcoming people passionate about their profession – or avocation, in the case of the volunteers – and thirsty for knowledge. I had a rollicking good time at both conferences.

I've given clinical presentations and keynote speeches at both conferences, to packed rooms, and I got excellent evaluations from both.

But one conference has a committee that is courteous, proactive, and stays in contact with its speakers, and the other has a faceless bunch who won't even answer your emails. One lets you know early on if your submission doesn't meet their needs, and the other, you find out you weren't selected when your colleagues get their speaker contracts, and you don't.

One conference pays you on-site, and the other, you have to hound for the money they agreed to pay you, and they finally get around to sending you a check a few months later.

One conference offered me a speaking engagement for 2012, which I turned down because I had already submitted proposals to the other conference held on that same date.

That's a mistake I won't make again, especially after multiple emails to the other conference went unanswered.

Here's a little tip for those of you who sit on your state's EMS conference committee, or are involved in booking speakers:

These national speakers you covet? If you want them to speak at your conference, be aware that there may be others vying for their services on that same date, and the one they choose will most likely be the one that treats them best, not necessarily the one that pays them the best. We're also busy people. We often have to juggle work schedules to come speak at your conference. None of us makes his living "doing the speaker circuit." And believe me – we talk and compare notes. We tell each other what conferences to submit to, and which ones to avoid.

Recently, several nationally known speakers just put another conference on their avoid list.

And to you folks in Nebraska, I'm sorry I won't make it to your conference in 2012, but I'll see you again in 2013. I'm looking foward to it.

Soul Callus

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0600, only a few minutes from shift change. It's been a long night, and we're finally getting around to washing the rig and completing station duties when the call comes in, "Cardiac arrest."

Betty Rubble's demeanor vacillates between excited and pissed off. That first part comes from the natural adrenaline rush that accompanies true emergency calls, where speed and skill really do matter. All rookies get that rush. The second part comes from the realization that we're going to get off shift late, yet again, and we wonder why it's always our truck that gets fucked with the late calls.

That second part, she gets from me.

"It's a 'woke up dead' call," I tell her tiredly, attempting to rein in some of that enthusiasm.

Or perhaps quash it, I can't really tell anymore.

She looks at me questioningly, and I explain. "It's 0600. Somebody just woke up and found their family member dead. Likely as not, they've been dead a while, and all we're going to do is pronounce it."

En route to the scene, the data temrinal flashes new call info, "Law enforcement officers on scene, CPR not in progress."

"See what I mean?" I tell her, pointing to the screen. "Cops aren't even doing CPR. Probably rigored up and everything. All we'll do is gather information and run an asystole strip for the coroner, maybe explain the situation to the family. We'll be done in ten minutes."

And as we pull up to the high rise, I see a body crumpled on the lawn, and crime scene tape being strung around the scene. Officers are staring up at an open fifth floor window, lighter than the others around it because this one is missing its screen. Relief floods me as I realize, "Oh great, it's a suicide. Crime scene – even less paperwork for us."

I say as much to Betty Rubble.

She looks at me questioningly, and I point my flashlight up to the open window. "Somebody took the Nestea plunge out their window. Cops aren't gonna want us in there contaminating their scene. We can clear from this as 'no patient found'. No paperwork at all."

Still, I think it prudent that I examine the body, at least, perhaps check a pulse. I tell Betty Rubble to stay outside the tape to limit scene contamination, and carefully approach the victim. From ten feet away, the misshapen body and livor mortis tell me he's far beyond resuscitation. I check a pulse, feel the coldness of his skin, and back away.

Outside the scene tape, the crew from the backup unit is chatting idly with Betty Rubble. Nearby, a cop's radio crackles, "Door was unlocked, found the suicide note on his bathroom counter."

"Wonder what it said?" muses the medic from our backup crew.

"I dunno," I speculate. "Maybe 'Goodbye, cruel world?' Or perhaps, 'If my calculations are correct, these wings should provide me with just enough lift to…'"

Everyone within earshot dissolves into fits of laughter, and I grin.

And then I look up to see the faces staring down at us from other windows, and my grin fades in a wash of shame.

And I ask myself what sort of example I'm setting for Betty Rubble, and the answer is all the more shaming.

"Come on," I say brusquely, "let's go before we catch another call."

On the way back to the station, I stare out the window and wonder when the hell I lost my humanity, and why I didn't miss it when it left.

A New Disease

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Fred Sanford Syndrome: clinical disorder characterized by the life-threatening complaints in the absence of any objective clinical findings. Sufferers of Fred Sanford    Syndrome (FSS) usually present with chest pain, often accompanied by a constellation of associated symptoms including respiratory distress, dizziness, anxiety, syncope, flatulence, incontinence, amnesia, seizures, speaking in tongues, headaches, blurred vision, loss of vision, aphasia, dysphasia, paranoia, combativeness, belligerence, and catatonia.

FSS is thought to be triggered by emotional distress, often resulting from verbal conflict with family members. The hallmark signs of FSS are dying declarations, although these dying declarations are easily distinguished from from the far more ominous "profound sense of impending doom" often reported by acute coronary syndrome sufferers, primarily by the volume and frequency of the declarations, and the presence of a receptive audience.

FSS is exclusively found in males, although many healthcare care providers note its similarities to Scarlett O'Hara Syndrome (SOS) found in females, and postulate that it may indeed be the same disease.

Given the frequency at which I see this disorder, I think it's time we added it to the ICD-10.

Or, given the total lack of objective clinical findings, perhaps the DSM V.

 

A Little Pimpage, Please

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The folks over at 5.11 Gear are holding an Outdoor Adventure Contest. Simply write a blog post detailing an outdoor adventure, and if you win, you get some cool outdoor schwag.

Rules and requirements are here.

I entered my post Winter Wings in the contest. I'd sure appreciate it if y'all would click on the link, read it if you haven't and leave a comment, and then click the Facebook LIKE button and pimp the hell out of it on Twitter.

Like it, tell your Facebook friends to like it, tweet and retweet the hell out of it, and ask your Tweeps to do the same. Heck, might as well pimp it on Google +, too. Every little Like, Tweet and +1 gets me closer to the finals.

Daddy needs a new pair of shoes 5.11 Tactical Trainers.

Thanks!

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If you like inspirational, gritty, underdog stories like Rocky or Rudy, rent this one.

Of course, since it is an underdog movie, it is a bit derivative of the aforementioned flicks, but it more than makes up for it with a good story, solid acting, and great MMA action. Nick Nolte puts in a good performance, and Joel Edgerton makes a likeable Everyman as the main character. You really want to root for the guy. I'll be looking for him in future movies.

I give it four out of five stars.

Complaint of the Night

24 comments

Fecal impaction.

Direct quote from the family member who called: “You won’t need your stretcher, just a pair of gloves and some KY.”

Uuuuhhh… no.

I don’t know what is more distressing; the fact that they called 911 because Grandpa has a big growler prairie-dogging his rectal sphincter, or that apparently, one of my colleagues cleared the impaction on scene last time, without transporting.

I think if Rule 1 of EMS is, “Thou shalt handle no one’s junk but your own,” then 1a ought to be, “The only cavity thou shalt insert one’s fingers into is the oral cavity.”


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