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A Tiny Little Haiku about My Experience with Rape...

April 2nd, 2013 (08:17 pm)

In the very last minutes of last March, almost two days ago, I made a brash decision to publicly post an accounting of my personal experience with sexual assault. I didn't seek the counsel of my friends before doing so, and I didn't really consider that there could be any consequences. For a giddy moment or two, I wanted to shout it out to the world! Discussing it felt very freeing and refreshing! The thing I realized afterward is this: When I communicated something honest, heartfelt, and true, it actually relieved the stress and anxiety that had been building in me. A certain background noise of emotional discomfort had been accumulating with every news piece that covered the issue of rape and sexual violence. It was tough for me to constantly hear about an occurrence that resonated with my past. And what I found harder still was that it felt as though there was an oath of silence surrounding that painful event.

So, especially if you read the sort of harrowing, and rather graphic, last post, I want you to know how glad I am that I wrote it. I want to say that I already have more peace than I had before. And I hope that I will enjoy more genuine discourse about this subject with the men and women in my life. We might only be fixing me, but wouldn't be amazing if we could fix the world?

A poem came to me, almost like a dream. It showed up in the seconds before I fell asleep last night night. I usually never try to preserve those little passing thoughts at the edge of sleep. But last night I did, and recorded it in the moments before my eyes closed. As the title of this post promises, here follows my little haiku:

I could not scream then,
and now, there is no need to,
though I am able.

blogtastic_dee [userpic]

My Personal Experience of Rape....

March 31st, 2013 (11:55 pm)

In the future, when I think back upon the news and media of 2012 and 2013, there's a word I'm going to recall having heard a lot of, "RAPE." The instances are too many for me to hyperlink to now, but a short list might highlight: Tosh O., Military Rapes, Rape Jokes, Legitimate Rape, Rape Easy, Steubenville, Sandusky, and Rape Culture. There are far too many other instances to attempt a more inclusive roll call of rape references. It's wearying to hear such a charged word repeated so many times! I often feel as though I've been on an emotional treadmill, when in fact all that I have done is listen to NPR. But I have come to feel as though the worst part of this cultural phenomenon is that often we're not discussing rape in any meaningful way. We don't grow personally from these assaultive news stories and true discourse rarely occurs. I want to really talk. I want to honestly speak. I'd like you to be able to ask me about my rape and I'd like to say something substantive. If we're going the suffer the discomfort of this subject, let's actually accomplish something for our trouble!

I've given several days of thought as to whether I would broach this rather charged and unpleasant content on a public and online journal. I first wrote a version of this short essay in March of 2007. At the time, it was heavily locked and only available to about four or five readers. It's now in the last few minutes of March 2013. March is Women's History Month. While a rape experience is not the exclusive domain of a female, it does disproportionately impact women. And we often bear the shame of this in quiet. My contribution to this last gasp of March is to share my experience with having been raped.
My aim making it public now isn't to garner sympathy or disturb anybody. There's no pressure to read any of what follows, or to reply. My intention is to just open an opportunity in myself to claim an experience that's sometimes easier to ignore. If I can open an exchange of thoughts, then it's an added benefit.
Graphic / Trigger / NSFW / OversharingCollapse )

blogtastic_dee [userpic]

Ten observations about my moonlighting job...

March 20th, 2012 (02:17 am)
current location: dorm room at work
current song: Stereophonics 'I'm alright' (You have to go there to come back.)

For over a year and half, I’ve led a secret professional life. My primary source of employment, and my heart’s true calling, is in the emergency services field as a 911 responder. And that’s clearly no secret! I’ll tell anybody who stands still long enough to listen about my beloved vocation as a paramedic. However, I’ve been afraid to be honest about my other employment (especially when at my main job in EMS) for almost two years. I was concerned for my workplace relationships in the occasionally conservative world of first response. There’s a dominant culture of strength, invincibility, and (sometimes) machismo that I find less hospitable when it comes to discussing certain personal matters. And my side job definitely treads upon the personal.  

My clandestine moonlighting job is at an abortion provider. Several of my respected colleagues and dear friends are Pro-Life. We are at a point in history where meaningful dialogue on the subject of abortion, from opposing perspectives, appears increasingly impossible. When one side believes that the other is supporting a massive slaughter of millions of innocent lives, and the other side feels that over half the population could be deprived of the basic rights to manage their body’s functions, it’s fairly difficult to find a common ground. Knowing that this ideological chasm exists caused me to avoid the issue of my ‘other’ job when talking with casual friends and co-workers. Close friends were sworn to secrecy. I answered evasively when asked by co-workers after my days, supposedly off work.

So far, I’ve been happy with my duplicitous compromise. My employment in the provision of abortion services is not a long-term goal. Happy and harmonious work-place relationships (in the field that IS my professional destination) are very important to me. A few white lies or sins of omission are small prices to pay for smooth sailing when on the ambulance, or when hanging out with my first responding friends. It strikes me now that my delicate balance isn’t fair to the thousands of women who have trusted me to take care of them when things were at their worst. This year we are heading to polls, and we are perhaps making decisions that will fundamentally change what it means to be an American girl or woman. Many of us are making these important votes without a genuine understanding of the role that abortion plays in women’s lives. I don’t expect any woman to discuss her own abortion in a public, or semi-public, setting. If merely requesting birth control pills brands one a ‘slut,’ I shudder to imagine the risk of censure posed by admitting to having had an abortion. Yet if I can’t even be brave enough to discuss my very involvement in the abortion services industry, I certainly can’t expect the people in my life to understand what these publically silent women might be experiencing, or who they are. And how can we understand how important it is to our society, if we barely know of its reality?

I’d like to share some of my observations with anybody who would care to read this missive. In offering my thoughts to you, I’m not promoting myself as an expert. I’m not even a paramedic when I go to work in the abortion clinic. I fill an extremely entry level role in the clinic hierarchy. There, I am only a technician who secures the intravenous line (that the doctor later employs for medicine and fluid administration). I check vital signs and support the patient’s recovery. And, most importantly, I offer my ear to listen, my shoulder to cry on, and my arms to hug. The drastic professional demotion has been a source of some consternation to me. I have thought of leaving at times. I’ll truly say that the patients, and my lovely co-workers, are my only reasons for staying. I feel very protective of them. Even in California, we are not living in easy times to have an abortion, or to provide one. I am a paramedic working outside her chosen purview, in a capacity that she’s ambivalent about: a flawed narrator at best.

When I began working in the clinic setting, I held a similar impression of who has abortions, and why they do, to the one promoted by the popular media culture. And how could I think anything else? Nobody discusses having had this experience. I thought that a very small percentage of young women, who found themselves pregnant without a good partner or enough money, made this tearful choice. As a Feminist, I considered myself above the judgment of how promiscuous they might have been. My understanding has grown tremendously during my time working in women’s medicine. Here are some things that I have noticed. None of these are exaggerated in order to put forth any political agenda that I may have. There was no research done in the writing of this. Any inaccuracies noted are my misunderstandings alone. This is not informational, but more observational. The motive of posting this essay is to undo the disservice women, and society, are done by everybody’s silence (including my own) on this sensitive subject.

  1. Abortion is one of the most common surgical procedures performed in America. If you know three or four women, you probably know somebody who has had one. I’ve heard it’s exceeded only by cataract surgeries (because the eyes are counted individually).
  2. Women of all ages, ethnic groups, and religious backgrounds have abortions. I’ve cared for grandmothers who believed their fertile days were over, as well as twelve year old girls (who were barely aware of how they had landed in such a situation). It’s been my observation that it often matters not if a woman’s culture, religion or family proscribes abortion: if a woman does not wish to be pregnant, she will go to great lengths and risks to end it. I believe that it’s a profound survival instinct that pushes a woman to do something she may feel is immoral, if she sees it as in the interest of her life (or her children’s lives).
  3. Mothers are a lot of who have abortions. The welfare of their children is nearly always paramount, and they will make great sacrifices to preserve their children’s happiness and health. Many mothers that I’ve seen in the clinic setting express great sadness, since they do love their children and babies. In some situations, the abortion may be perceived as a huge personal sacrifice made to promote the lives of their family members and offspring.
  4. Some women are pressured by circumstance or people into their decision. This is a very painful truth for me. It’s extremely tragic to discuss this procedure with a person who does not appear to want it on any meaningful level. I always offer these women more time to think and plenty of ‘outs’ prior to the operating room. As a health care provider, I can only cede to their stated wishes.
  5. There are rape and incest victims who seek abortions. This is not simply a myth created by the Pro-Choice proponents to validate something awful with something else even more horrible. There are women that I’ve spoken to who feel re-victimized by every second that passes with a pregnancy that was forced upon them through brutality, chemicals, or coercion. I do feel, after speaking to these women, that it would be no less than actual torture to mandate them to carry such pregnancies to term. I’m not being at all hyperbolic. ‘Torture’ IS the accurate term for such a legislative act.
  6. Unfortunately, there are also women who do view abortion as method of birth control. They are the extremely, extremely small minority and much exaggerated by popular media. While there is much that can be done to manage the intense discomfort of an abortion, few would describe it as a comfortable event. Also, most of the patients that I’ve met feel the sting of society’s judgment very sharply and take great pains not to repeat the experience. This is not something that people rush toward. It’s been shared with me by a person who had sought repeated procedures that Medi-Cal would cover an abortion procedure more easily than the inconvenience and difficulty of continuous birth control. The women who have this experience are not even remotely the large group made out to be by the media, in my observation.
  7. Some abortions are medically recommended. Not all miscarriages naturally pass from the womb. Some pregnancies would place the mother’s life in grave danger. It stands to reason that a fetus (incapable of independent life) would not be well-served by the loss of a mother’s life. Anybody who suggests otherwise does so without the support of any medical substantiation whatsoever. I’ve met enough of patients seeking our services at the urgent referral of their primary care provider to say that they are a significant group that deserves consideration.
  8. Not all women are emotionally traumatized by the (admittedly difficult) experience of ending a pregnancy. There’s some conventional wisdom that suggests women are permanently scarred by having had an abortion. While there are women who have found themselves with a deep and lasting sadness, it’s needlessly fear-mongering to suggest that this is the most common post-abortion experience. I’ve found the process of actually working with women in that environment to ultimately be redemptive. Most of the women do heal and find a way through their loss. There’s been clear research from the United Kingdom that supports that.
  9. Nobody actually likes abortion. When Pro-Life extremists refer to Pro-Choice lobbyists as being ‘Pro-Abortion,’ they’re referencing something that doesn’t even exist. It’s inaccurate and cruel. Though there are for-profit providers of abortion services, everybody could accept a world in which abortion was not needed or desired. When abortion makes some stem cell research possible, the scientists and their procurement specialists are not happy. It’s just the reality of the situation. Abortion is not a desired outcome. It occurs when something did not go according to the best laid plans of the woman having it. To judge the woman at that terrible crossroad is insane. If you truly long for a world without abortion, there are better ways to diminish its need. Education, easy access to birth control and social policies supportive of unintended parenthood will all go much farther than hostility.
  10. There are really protesters in front of some clinics. And, yes, it’s a terribly awkward feeling to walk past them on your way to or from work. Most of them have been moderately civil to me. I have always been so as well, and I’ve looked over their proffered literature. Unfortunately, I’ve not yet encountered an anti-abortion tract that is medically accurate. Again, I find the distance too great to bridge when seeking a true exchange of thoughts between our ‘sides.’ There’s been a rare protester that has addressed me, or a patient, in a verbally abusive manner. I’ve not yet been scared. Yet, in such moments it’s crossed my mind why some people would be.

These are the late evening and early morning thoughts of a sometimes misplaced paramedic who is simply trying to have an ethical mark in this crazy, polarized world. I hope that some people read them. I hope that we are not too far gone, as a society, to have real and adult discussions about truths that are all too real. I’m honored that trust has been placed with me to care for some of the bravest and saddest women that I’ve ever met. I long to live in a world that also cares for them.

blogtastic_dee [userpic]

In a Room full of Love....

May 5th, 2010 (03:48 pm)

current location: home couch
current mood: thankful
current song: soft radio

Standing at the front of the church, I was surrounded not only by the kind faces of the congregation in their pews. I was also encircled by my own memories and thoughts. It often strikes me that even the most intense moments of communion leave some private core of a person quite alone. 'Self-conscious' is a term often bandied about. But when are we ever not conscious of our very own 'Self-hood?' 

I felt so shy and bashful to find myself far from the back pew (where I imagined that I hid in anonymity) facing the entire parish. My embarrassment sharply intensified as my beloved friend, M., stood proudly in the middle aisle snapping pictures. And, in a moment of combined vanity and shame, I hoped that I looked good, immediately before regretting that I was considering my appearance at such a time.

Physically, I felt the stray drops of water that ran in rivulets down my head, onto my shoulders and chest. They were not so many, or as cold, as I imagined so the sensation was not unpleasant. Actively pleasant was the imprint of the pastor's warm and loving hand upon my head. My skin seemed marked by the joy of having been so blessed and I wanted to lean into his comforting mass.

My strongest feeling, though, was a searing stab of grief that seemed to tear at my midsection. For, even enveloped by a palpable wave of love, I still saw flashes of the most desperate solitude and misery. As my ears heard the intonations of the pastor, and the approving murmurs of his flock, my mind heard a small cracked voice. It was softer than the brush of moth wings. In my heart, I was in the ambulance, holding the tiny dry hand of an old woman who would surely die. In church, I shed the tears that had been pressing at the back of my throat since I met the old woman. These were the tears that had threatened my vision as I tried to start an impossible intravenous line, that might deliver life-saving hydration. Tears that I swallowed so that I managed to see my needle and pierce her only once. Even that small discomfort was one that I wish she was spared. How much can a person endure, before they can endure no more? Suffering that can be absorbed is far greater than most people can imagine. The old woman's neglect was staggering. She had been trapped without food or water for days. She was weak, emaciated and confined, without grooming, for weeks. Flinching in fear at every abrupt noise or movement, she still tried to tell me something, in her broken voice. I heard only the sound of wrinkling tissue paper, so thin the vocalization was.

In that happy warm church, the contrast devastated me. Clean, well-loved, well-fed (some might say to excess), I was pained that her last months had not been so. As much as the juxtaposition made me raw with sadness (and a sharp guilt for my spieces), I tried not to avoid the truth of it, or to forget her. In being grateful for my own blessings, I will try to honor a very tiny, very brave old woman... now gone. 

blogtastic_dee [userpic]

"They would miss us if we didn't come."

January 5th, 2010 (12:39 pm)

current location: Work
current mood: contemplative
current song: Sinead O'Connor - Make Me a Channel of Your Peace

I've recently been attending church. The pleasure this experience gives me has been a genuine surprise. I met the pastor through a chance encounter in my neighborhood and I wanted to hear him speak. However, the church was having a rash of guest speakers around then, so I didn't hear one of his sermons right off. That was a blessing, since the sweetness of the church community grew on me in the weeks when I waited to hear the sermon that I initially came in for.

At first, my attendance was a sort of exercise in detachment. Not every aspect of every sermon can possibly resonate with each parishioner. And I don't consider myself a Christian, exactly. I didn't know quite how integrate my regular my involvement in a Christian church with my very broad belief structure. Honestly, I don't know if what I believe could even be described as anything as stable as a structure. It's definitely not that I'm lacking in strong morals. It's just that my actual beliefs lack firm boundaries delineating what can't be included in them. I wondered if I was an impostor. And then I wondered if my life truly needed another commitment. Suffering from what Chinese and Buddhists have described as monkey mind, I equivocated internally about what I was even doing in a church. So, I tried hiding in a back corner of the sanctuary and simply worked on sitting up straight during the service. (This turned out to be a worthwhile endeavor, since I have very poor posture when seated.)

I've been loosely connected to some form of organized religion for much of my life. I was raised a Bahá'í and I'm proud to have that as a foundation for my world view. While many of my young chums had never been outside of their family's church, I had been to worship with Buddhists, Hindus, and Baptists. I had a modicum of familiarity with the prophets of major world religions. Bahá'í children are taught to understand and embrace other religions. Unfortunately, as I aged, my relationship with the beloved faith of my youth changed. It's not a unique challenge to the spiritual experience, but my personal path met a juncture where it seemed to depart from religious clarity. I felt that I might be a spiritual wanderer. I began to describe myself as a Freelance Monotheist when asked. (I wish that I could remember who first coined that term.) I visited a wonderful aunt at the ashram where she lived and tried to chant. I was in a Catholic choir for a year or two, and I enjoyed my Methodist grandmother's sermons.

In truth, I no longer knew if I was a monotheist at all. Working as a paramedic, I saw certain things that cast doubt on the concept of a sentient and omnipotent Entity paying active attention to us all. I retained a sense that we each hold some spark of Divinity. Though it was perhaps more of a wish than a firmly held belief. I sometimes found it difficut to be near a person who was dying and to not feel that something energetic had transpired. Hopes aside, I realized my only real interest in matters of the spirit rested in just trying personally to be a good human being. The remainder, I decided, was of no consequence. Theology no longer required rejection or embrace from me. How can it matter what I believe, or who I have signed up with, when there is so much loss and destruction in the world? In a manner, medicine provided me with the only truth that I needed: Just to try to be good, to try to be there for those who suffer, and to try not to make the planet much worse. Those things didn't replace religious experience or become my religion. They became so important that they superceded the requirement for any other directions. Who needs absolutes, beliefs, and ideas? In a cynical moment, one could find those to be the stuff of wars and conflict.

I didn't experience a watershed moment sitting in the little church, minding my posture, where I realized the truth of a divine Being. And I didn't see Jesus with a plan laid out for my life. I looked about and I found really amazing people who also wanted to be good human beings. I was pleased to discover that the regular pastor is a gifted orator who is kind to his parishioners. Both of the pastors expressed a very strong commitment to social justice and the causes that matter the most to me. More and more, I sat in my pew and I wanted to feel connected with a group of good people to whom kindness matters. I developed a visual, perhaps a selfish one, of me in the center of a web. The web was comprised of my connections to the people, and the values, in the sanctuary around me. After church I spoke to a lovely young couple who had also recently started attending services. I asked them how they liked this particular church. The wife remarked to me that they had felt after their first visit as though they would be missed if they didn't return. And that's something really beautiful, a group of people who would notice your absence. Is that what we all need?

I still don't know what I am. I don't know if I'm an impostor in a house of worship. I don't completely understand the faith experience, as I have heard it described. I do know love. I know how precious service is and I hope that prayers count for something, even if they're just a private expression of intention.My favorite Christian prayer, the Prayer of Saint Francis...Collapse )

blogtastic_dee [userpic]

Stoicism and its Untimely Demise

December 1st, 2009 (04:32 am)

current location: Work
current mood: contemplative
current song: News channel

I feel a bit hypocritical marking this loss with any grief, as I am not a Stoic in any real sense. I am extremely emotive, with my joys and sadnesses being both deeply felt and frequently shared. If there is any person who is not contributing to a widespread culture of self containment and reserve, that person would be me. However, I have an ingrained respect for, and understanding of, a stoic personality type. Some of my family's social heritage is in German and Norwegian Lutheranism. Though my Teutonic ancestors were not professed followers of the philosophical creator of Stoicism, Zeno of Citium, they definitely held similar views about life: The supposedly negative emotions of desire, fear, pleasure and pain should be avoided and the more positive ones of will, caution and joy are the goals to be pursued. (Though I do suspect that some North-Western European people from my family's history would even argue temperance with that risky 'joy' emotion!) There are a number of other cultural groups that also subscribe to these practices. Famously, the Japanese are said to be patient and unemotional in the face of both success and adversity. Each group has its own advantages, and I would never promote one over another. I can only make observations about that which is familiar to me through experience.

It shouldn't come as any great surprise to me, in my modern, multicultural Californian life, that we are a long way from ancient Greek philosophers and Germanic tribes in terms of how we see the world today. Stoicism seems to be on its way out. Yet, it increasingly seems to me that there is a place and a time in the world that is well-suited for a stoic mind-set. And that is at and during 911 calls. Generationally, the patients we have with the most stoic characteristics are older. Many are veterans from the second World War or Korea. Some can recount the Great Depression's horrors firsthand, and they know how to view our most recent recession in a broader perspective, not born of hysteria. Tom Brokaw popularized them by describing these folks as the 'Greatest Generation' and writing a book about them. I am opposed to describing an entire generation as superior to any other, but I share his admiration of their calm strength in the face of adversity and loss. Having few grandparents, and only one within a reasonable drive, I meet this greatest of generations primarily through my job as a 911 paramedic. I meet them as their bodies, independence and memories weaken and fade. Like many, I am often impressed with the personal dignity shown by my older patients as the process of aging inflicts indignity after indignity upon their lives. Professionally, they may infuriate me with their frequent denial of pain complaints and recalcitrance about sharing medical history:

Paramedic Dee: "So, your wife tells me that you have been having chest pain?"
Mr. Greatest Gen.-er: "Well, no, not really. I'm fine. I told her not to call."
Dee: "Would you tell me a bit about your medical history?"
Gen.-er: "My doctor says that I have some heart problems, but I'm fine."
Dee: "May I check you out, sir?"
Gen.-er: (unfailingly polite, but now prickly) "Yes, but I'm fine."

While that personality type involves a certain number of medical risk factors, such as holding in emotions and not seeking treatment, it's a method of behaving that I can't help but look up to. I suppose these respected patients that I see today remind me of the beloved elders in my early life. I think many of my co-workers also have a similar idealization of the 'strong and silent' type of patient. Perhaps they too recall a quiet relative from their youth, with eyes that have seen more than their pursed mouth could ever share. I think this contributes to our occasional preference for relating to these dispassionate individuals.

When they're not frustrating me while I am trying obtaining medical pain assessments, I deeply appreciate patients who bravely suffer serious injuries and cooperate with my requests. It's difficult to extricate any seriously disabled patient from a crumpled vehicle. It's significantly more so to rescue the hysterical victim. More and more frequently, I notice that younger patients, of all cultural and ethnic backgrounds, do not prize sobriety and reserve as they face their trials. When we are being uncharitable, we first responding professionals refer to such expressive sufferers as 'whiners' the moment they are out of earshot.

In a perfect world, people could be brave when afflicted, yet also honest when they are in pain or harmed. It is human nature to swing between extremes and I think many of today's middle-aged people felt scarred when their parents told them things like, 'real men don't cry' and they vowed to validate their own children whenever possible. Feelings are valid, but I would argue that there are ways of sharing them that aren't. When it's a particularly bad flu season, as it is this year, I begin to miss my 'tough old birds' as we respond to and transport healthy, albeit genuinely scared, adults with routine cold and flu symptoms. There's no one single way to be and human society will always travel a long road towards finding a happy medium. In a media-dominated and fear-mongering time of history, how can we not all be a bit more anxious and requiring of care? I just hope that we can learn some things from that 'Greatest Generation' while they're still around to learn from.

blogtastic_dee [userpic]


November 15th, 2009 (01:03 am)

current location: Work
current mood: thankful
current song: I Don't Want to Know About Evil - John Martyn

A semi-constant concern, and an endless source of fodder for workplace discussion, is the question of who ones partner is on any given shift. I have had the position of working at agencies without set shift bids, so it's often possible for me to have a different partner for every day that I work in a month. It's hard for my non-EMS chums to understand why this relationship is so crucially important. I'll typically explain, "Well, we do live together for twenty four hours." And that's usually clear enough. But it goes much further than that alone. It's more than just sharing three meal-times, sleeping in adjoining rooms, and both needing to be within one hundred feet of an ambulance at all given hours. The shared, and intense, nature of emergency response work makes for a closeness that is not always found in day to day non-uniformed life.

An interesting aspect of the relationship between a first responder and their partner is that it requires an absolute trust in some very important matters. Sometimes the warm camaraderie that exists between crew members enhances the overall dynamic. However, in many cases, partners need to actively find a way to make hundreds of hours of working (and living) together go smoothly. And this rapport must exist even if these shift mates herald from wildly divergent backgrounds, or hold opposing moral values. Fitting a strong professional respect into alignment with a certain degree of personal disdain is a feat of denial, or the mark of an emotionally sophisticated person.

In a way, moving from the role of an Emergency Medical Technician, functioning with a more basic scope of medical practice, has made me more vulnerable at work. When I segued into a Paramedic's set of responsibilities, I found it much more difficult to concentrate on as many separate things. The clinical care for my patient became very engrossing for me. While the EMT is constantly reminded to manage the scene and also to ensure the safety of his or her crew, the paramedic often develops tunnel-vision. The medic also holds the heavy weight of responsibility for the team's welfare, but he or she is often distracted by the very real concern of the patient's welfare. As the our old adage goes, "Paramedics save people. EMTs save Paramedics." When I was an urban medic (working in a neighborhood that wrestled with crime and poor response times from police), I remember responding to medical aid calls and failing to notice very real scene safety threats. I have been pulled out of a house by an observant EMT more than once. It wouldn't be hyperbolic to say that I owe my very life to at least one partner from my past.

Sometimes I think to myself about a partner, "Trust him with your life, and your patient's. But just don't trust him." And that becomes the odd sort of disconnect, or compartmentalization, that is part of my job. I have seen the necessary closeness between partners hurt and confuse the significant others of EMTs. How does one share an experience with a shift mate that could not even spoken of with a loved one? How can somebody, that a medic might even avoid in the outside world, become their most important relationship for twenty four hours? I have come to feel that a sort of separate-ness or division is a character trait in many successful EMTs. Many of us have the 'self' that goes home to make love, put a child to bed, or to cook meals. Yet it is not the same 'self' that races to an automobile accident, jokes about tragic deaths, or witnesses profound poverty that that cannot be assuaged.

I worked yesterday with a partner that I have come to really adore, but who is my polar opposite ideologically on most defining personal issues. We have worked together for almost four years and we know each other very well by now. He perfectly compliments my patient oriented approach to compassionate medicine with a strong grasp of scene control. His management of an emergent environment is a source of inspiration to me. And, over time, we have even shared more private thoughts and feelings. Yet we are both passionately and diametrically opposed in our belief structures. We have had discussions in the past over key issues that left us both genuinely upset. Some three years later, I am just happy to know that I am on shift with a good partner who could give me that all-important tap on the shoulder when he sees a risk that I failed to notice.

blogtastic_dee [userpic]

Evil Socialist Healthcare Reform...

August 5th, 2009 (12:18 pm)

current location: work
current mood: discontent
current song: Fox News

If you're here visiting, or a Johnny-come-lately, here's a little about me: I am a relatively liberal paramedic working in a very conservative rural geographic region in Northern California. (Yes, there are Conservatives in California, too.) In general, this experience is positive. In tough news weeks, I might downgrade my impression from 'positive' to just 'not harrowing.' However, I would consider the culture clash overall to be healthful and the debates to be spirited. As you might imagine, the recent drama of healthcare reform has been shaking things up in the crew's quarters over coffee.

The most frequent complaint lobbed at the Obama Administration by my co-workers, and the conservative media at large, is that we are risking becoming a socialist society. This particular prophesy is not one that troubles me greatly, since I have traveled a little and I do not find more socialist governmental systems to be grossly inferior to the United States governmental system. Unfortunately, I am not a student of political science and I could not say which method of administration is the best way to manage a country. However, I can conclusively state that North Western European countries are not worse places to live overall. Or, at the very least, life isn't so dire over there as to warrant the constant warnings about the terrors of rampant Socialism. As I say, I am a Liberal. So you can take what I say with a pinch of salt, if you're not.

Anyways, as I was listening to NPR recently (I have to keep my liberal bias informed somehow.), the issue of Congressional recess prior to healthcare reform voting came up. And as I tooled down the road, I thought, "Well, goodness gracious, of course it's easy for them to carry on about the dangers of Socialism, they already live like well-off Europeans." They enjoy generous vacations, pay and healthcare. I'm not the first person to think this, and I don't mean to have sour grapes. I just wish we were a tad more egalitarian about these things.

Feel free to chime in if you agree or disagree. I'm off to watch some Fox News with my co-workers.

blogtastic_dee [userpic]

Book Meme...

June 16th, 2009 (02:27 pm)

current location: Work
current mood: thoughtful
current song: BBC News (Somewhat liberal crew today!)

Instructions: Don’t take too long to think about this. List fifteen books that you’ve read that will always stick with you. List the first fifteen that you can recall in no more than 15 minutes.

1.) The Handmaid's Tale by Margaret Atwood
2.) Wild Swans by Jung Chang
3.) Love in the Time of Cholera by Gabriel Garcia Marquez
4.) Woman: An Intimate Geography by Natalie Angier
5.) Beggars in Spain by Nancy Kress
6.) Pastwatch: the Redemption of Christopher Colombus by Orson Scott Card
7.) The Secret History by Donna Tart
8.) The Reluctant Fundamentalist by Mohsin Hamid
9.) Housekeeping by Marilyn Robinson
10.) Motherless Brooklyn by Jonathan Letham
11.) Complications: A Surgeon's Notes on an Imperfect Science by Atul Gawande
12.) The Mambo Kings Play Songs of Love by Oscar Hijuelos
13.) Operating Instructions: A Memoir of my Son's First Year of Life by Anne Lamott
14.) Me Talk Pretty One Day by David Sedaris
15.) Buddhism Without Beliefs by Stephen Batchelor

blogtastic_dee [userpic]

When a Friend Dies...

May 12th, 2009 (09:56 pm)

current location: chair
current mood: sad
current song: None

I lost a childhood chum recently. This week has been the week where I cope with the loss. I was in a different country during her memorial service and I am pained to have missed that celebration of her impressive life. It's been a lot harder for me than I expected it to be. I have been reading some of the things that she wrote and looking at her lovely pictures online. In a way, I am getting to know parts of her better in her death than I knew when she was alive. In her life, she was somebody that I knew best when we were very young. It had been a few years since I had last seen her in person. I avidly read and occasionally commented on her online postings. (Not because I am a devoted or constant friend, but because they were so entertaining, clever and surprising.) Her writing was (is) rarely beautiful. She had a unique gift for language and thought. She was also Queen of the Random and Unexpected. I could never anticipate what she would next post, but it was always a delight or something to make a person think deeply. Unfortunately, I was not a part of her current life in any real-time sense. I wish very much that I had been. I have enough love for all of the people that I know, and have known. It's just that I barely have enough time for even a few of the people who are close to me in a geographic sense.
I feel a bit guilty sensing her departure so acutely. What right do I have to miss her, when she was already not close to me in a daily way? And I feel selfish telling her loved ones that I, too, am sad that she is no longer on this plane of existence with us. The greatest loss must be in the lives of the people that she was currently close to. I also feel a bit mad; being so grief stricken over an event, death, that is a part of my weekly or monthly routine. Professionally, we medics become sort of death and grieving experts. I, of all people, should be able to understand that it is inevitable. I should know that the hugs, the witty postings, the cups of coffee, and glasses of wine are all gifts. I do know that death claims the young as well as the old. Still, it is a great and heartbreaking shock to me that this beloved figure of my youth is one that I will not see again in this life.
I went to a rural school where the grades were jumbled together a bit, due to small class sizes. The blessing of small schools is that age based discrimination is a luxury that can't be afforded. So, though she was closer in age to my younger brother, she was often kind enough to have me over in her home. Her family was a bit more cohesive than mine was able to be at the time. The evenings in their home were a great source of comfort and solace to me. I wish that I could remember more of the details. Reading what her other friends say about her brings certain parts of my past times with her into laser sharp focus. Of course, I won't have the chance to play 'remember when...' games with her anytime soon. So all that I have of her are my imperfect memories from a difficult time in my own life. I don't know why that hurts so badly. My heart and mind keep screaming at me, "NOT ENOUGH!" I want there to be more still, for there to have been more. And I want everything that there was there to be something that I can easily recall.
Lacking more, I look through her photos. I see her intelligent, and achingly beautiful, face staring out from photographs taken across the world and I think, "Oh, I recognize her!" I see the lovely shining girl that I knew inside of the radiant woman that she became. I read the things that people write about her. A lot of references to light come up. I think, "Yes, she always was full of brilliance, of course people describe her that way." I remember that she was blunt and honest. I remember that she was funny! She often used her humor to cheer up other people. I remember that she was giving. Even in an egalitarian and wonderful school, I was not the most popular kid. My face was spotty, I was poor, even by the standards of the area. And clothes hand-washed on a wood stove often become a sort of dingy gray, with their original colors quite irretrievable. Though we had to spend time at school, at lunch and P.E. together, the fish sticks at dinner and the late night talks were things that kept me going. I admire her greatly. I respect the things that she accomplished. I am proud to have ever known her. She inspires me to make something of the writing that I so love to do. I am grateful to have the chance to try to get to know her a bit more now. Most people who die do not leave behind so large a group of loved ones and so great a body of writings. It's a rare gift I have that I can seek these resources out now.
I guess most grieving is selfish in one way or another. It's selfish to miss a person that (I believe) can only be found as Goodness or in a Good Place now. And it's selfish to feel that a part of your own self has also died, when you feel that it was living inside of another person. But, such self centered thoughts cannot be avoided at such a time. I feel that a great big light and life is not here right now. And I very much wish that she still was! I want to read her wonderful, and often strange, new postings a few times every week. I want to see new travel photos from her latest adventure. And I very much wish that I could still see her in the person again! My eyes won't stop watering. NOT ENOUGH! There just wasn't. When something, or somebody, is so good, you just don't want it to end. The adventure just shouldn't stop. In my heart, I feel that it still goes on somewhere. I just want to to be where I can still see it.
Goodbye, goodbye!! I miss you. You touched me more than I knew, or told you. A thousand thanks. And a thousand more to your family. I wish that you didn't have to go so soon.

blogtastic_dee [userpic]

Anticipated Outcomes...

March 28th, 2009 (11:23 am)
current location: Work recliner
current song: Sadly, the basketball game...

A lot of my job is absorbed with trying to adapt to and react to unanticipated outcomes. That's a very important skill for the EMS professional because the human body is an incredibly dynamic creation to nurture and protect. Even presuming that the information a paramedic receives is accurate, it is impossible to consistently and correctly predict how your patient's physical condition will progress. When a person takes into consideration that our patients and their families rarely offer completely truthful (or even coherent) narratives, it's obvious that being prepared for anything is a definite credit to the emergency care provider. Of course adaptability is also an asset in everyday life, which frequently does not go according to plan.

Sadly, the outcomes that can most easily be foreseen in life often revolve around matters of the heart and mind, sometimes more so than those of the flesh. I am not one of those who scorns psychology as a non-science. Behavior can be every bit as predictable as physiology. So many times I have wheeled our gurney into our designated psychiatric receiving hospital and thought, as I did so, "This won't be the last time that I take this patient here." There are times when I see a person who is developing, or trying to manage, a chronic pain condition in the course of my work. I'm an optimist in my own life, but it's all too easy to imagine the drug dependency that may be nascent in such a patient. My hopeful spirit cringes when we start to have frequent calls to that person's house for fabricated maladies, and when I see the ever-mounting pile of pill bottles (all from different doctors). Work has made me a professional pessimist, or at the very least, it's made me a realist.

I had a recent 'could-have-seen-that-coming' moment in a family that we respond to with some frequency. They are a genuinely good hearted group, but they've suffered more than their share of misadventure. Both parents have fought with drug addiction, but neither could yet be declared victors in that battle. They have a lovely young daughter, around fifteen years of age and a younger son. We are typically activated when the mother has had a seizure. She is not always compliant in her medication regimen, and she has a seizure disorder. I remember the last time I went to their home, months ago, thinking that the erratic parenting was sure to result in the daughter developing inappropriate relationships with men. She is a beautiful girl, friendly and smart. Her Mexican culture is one that has not always had a very strong prohibition against men dating girls (who have not yet crossed the threshold to eighteen years). On a night not too long ago, I saw my concerns realized. It was quite late in the night. As we examined the mother for injuries and a healthy blood sugar after her seizure, I saw a man who looked to be in his twenties holding and reassuring the daughter of our patient. In the family home. Very late in the evening. I sighed heavily and whispered sharply to one of the volunteer firefighters who had responded with us to the call, "Who is that man?" He could hear the exasperation, even in my hushed voice, and responded only, "I know... I know." I could tell that the twenty something man cared for his too-young girlfriend, in his way. His familiarity and body language with her indicated a physical side to their relationship. He was tender as he comforted her. (No matter how many times a person has seen it, a tonic clonic seizure is a scary thing to witness.) And the family seemed to acknowledge his role in her life. He might help around the house, which could make his company valuable. That said, the whole matter breaks my heart. I gave the daughter a little chat about school, which she attends infrequently.

I know that I'm just some terribly aged old medic that sometimes looks after her mom, at least in her eyes. How can a few words (kindly meant) on a late night ever share all that I want to tell her? What I want to tell her is that she doesn't need to offer up her body in order to experience love. I want to tell her that school is an investment in herself. I wish that she would believe that there's a lot of love out there that is free from sex. And that the love that comes with sex is a heck of a lot better when the girl having it is older. I know that even if we had the time for me to tell her all of these things, they would all be just words, anyways. What is the fantasy of healthy love if there is no consistent love at home at all? I know it's probably like telling a hungry person to hold out for an organic, sustainably-produced meal that may or may not come, especially if there's less healthy food right at hand. Because love is a very real human need.

As we left the family's house, I whispered again to my firefighter buddy, "I wish that I could take that little girl and watch after her." He murmured back to me, "My wife and I have wanted to, as well..." I sadly patted his shoulder and walked towards the ambulance. I know that that the young daughter may be pregnant and permanently out of high school by the time her mother has the next grand mal seizure. How do I know that? I'm a professional realist.

blogtastic_dee [userpic]

Thanks, traballenguas!

March 10th, 2009 (10:33 am)
current location: Work
current song: Blue October - Hate Me

I needed something amusing. Though this is also a little sad...

Fight the Man!

blogtastic_dee [userpic]

Not so Much of a Badass, after all...

March 5th, 2009 (06:27 pm)

current location: Home office
current mood: hopeful
current song: Grounds for Divorce - Elbow

This is a little difficult to admit in the profession that has made a point of distilling, packaging and marketing hero worship. I am at the right place, wearing the right uniform, and I even know some of the lingo. Can't I be just a bit of a hero? Unfortunately, I'm really not such a badass. Now, I never particularly thought that I was, so this is not a stunning revelation born from a single moment of self doubt and misery.

However, there were a few moments here and there in which I felt the gentle breeze of medical competence soothing my furrowed brow, moments where I felt that I might one day be a confident healthcare practitioner. I still hope to feel that way, and it might be a sign of rationality that I am don't. A field emergency care provider is the great generalist and it is hard to know enough about every possible emergent medical condition in order to always have the correct differential diagnosis. We have some protocols and a relatively short training to guide our treatments, but we all want to be more than protocol automatons. Without disintegrating into cowboy medicine (where a medic alters or ignores protocol in order to treat by their own whims, whether they're correct or not), I do want to be a sophisticated and intelligent medical professional. Perhaps it's just honest to admit that I really sometimes don't have a clue? Maybe the short training to be a paramedic required in the the States just isn't up to the challenge? Or could it be that I would be sharper if I attended mores classes and conferences?

My problem is not that I have embraced the conception of valor promoted by my peers. I don't think that I would be a more awesome medic were I in possession of a mega-sized red pick-up truck and a vanity license plate that proclaimed my profession. Though I have been tempted at various points to adopt some variation of the Star of Life or a Caduceus tattoo to signify my devotion to medicine, I am sure that the want of a medical tattoo is not responsible for my lackings. I would like to be stronger and more fit physically, but my womanly Earth Mother physique doesn't detract from high quality job performance. A 'six-pack' of abdominal muscles and the ability to run ten miles would increase my life span, and not that of my patients. No, I don't think that my non-conformity with the idealized image celebrated by the media (and some of my co-workers) is what makes me weak.

Honestly, exposure to learning environments, as the one imparting the information, is very, very difficult. I learned fairly quickly that fifteen or more edgy young men under the age of twenty five is not a group of the population that I can easily assert dominance over. Having tried, I know now that I don't particularly care to, either. Let a person, with the desire to do so, file away their rough edges and hone their attributes. The ability and wish to guide that particularly willful class of students is a gift that I do not currently have in my grasp. Since I discovered that, I have been putting my efforts into mentoring experiences. I took my preceptor class with the hope of being a co-preceptor at work. The experienced preceptors that I am on shift with have been generous enough to share their interns and their calls with me. While I was, at first, thrilled with the joy of having a single eager and receptive student at the ready, I have grown more intimidated by the enormous skill, experience, and emotional wisdom required to precept. Increasingly, I am grateful to only fill in as a secondary preceptor.

There are a lot of adages that apply to how I feel right now. It's been said that when a person begins a journey they 'don't know what they don't know.' And, as they progress, they begin to 'know what they don't know.' Though the latter condition has the traveler better informed, it's a more sobering step. Having briefly tasted the responsibility of mentoring, I now recognize how awesome a role it is to fill in a student's life. I see how delicate the balance of scolding and encouragement is in the creation of a safe, but instructive, learning environment. Paramedicine, by itself, is a very serious burden and honor. The stakes are supremely high and, in some instances, the room for error is nonexistent or minimal. As another axiom states, "If you're not scared, you're not paying attention."

The sole responsibility for a patient's life during transport, while it's something I'm always aware of, has grown increasingly comfortable. I can only hope that more years of medical practice will gradually allow the weight of mentoring to become a manageable one. I intend to seek a second job in a higher call volume area. Though my current transport times and the acuity of my calls allows for excellent experience, I would enjoy a high number of individual calls. Finally, it must be admitted that I am not a twenty year medic, though several of my partners are. That doesn't make for comfortable comparison, I'm sure.

There you have it: I've realized I'm not a badass, hardcore medic. Just give me another sixteen or seventeen years. I'm on my way!

blogtastic_dee [userpic]

Epilepsy is Dancing...

February 19th, 2009 (04:13 pm)

current location: Work
current mood: curious
current song: Epilepsy is Dancing - Antony and the Johnsons

That is the title of a beautiful and disturbing (or beautifully disturbing) song by Antony & The Johnsons. Maybe you can watch its music video and let me know what you think when you hear the song and see the video? And let me know if you know anything more about this song and its content.

I have a higher than average exposure to epileptic people, as a result of my job. It's my impression that most epileptics have an unfavorable impression of their syndrome and an even worse relationship with the meds needed to control the disorder. Cruelly, the most common family of drugs prescribed involve lethargy and tiredness as side effects. It's very difficult for a person to pass through life with a needed damper on his or her energy level. As a result, the patient's compliance with such medications is on the low side. It doesn't help that the medications have an inherently narrow therapeutic index. The older epilepsy sufferers I meet have a great deal of shame associated with it, and many of them have gone to elaborate lengths to keep their health condition private. Many of them can recall having been teased by the kids in school, for something that they can't even help. (Not that school children are famed for their kindness and sensitivity.) Most of the younger patients I have encountered accept it with a bit less self-reproach. It's pretty commonly understood that epilepsy is a neurological state. To those of us in health care, it's completely devoid of emotional attachment. It's one of the many reasons that our pagers tone us out, but we approach such calls without any particular dread or anticipation.

Some ancient cultures imbued sufferers of neurological and chemical conditions with mystical or divine qualities. Many of the online reviewers of that song described 'Epilepsy is Dancing' as a very personal song. I don't know if Antony Hegarty relates to that song in his own life. I wonder if the beauty of that song and video is an attempt to recapture a positive sort of magical thinking about epilepsy. I also wonder if some people saw that video as insensitive. I personally was confused somewhat by the content. However, my stronger reaction has been one of appreciation for the beauty of the song and its accompanying video.

I'm curious what you think.

blogtastic_dee [userpic]

Economic Downturn...

February 19th, 2009 (01:08 pm)

current location: Work
current mood: tired
current song: UHF radio tones

I am more weary than I can say of this economic crisis that we hear constantly about. Every time I turn my beloved NPR on in the car on my way to work it seems the majority of the morning report is consumed with the most recent batch of bad news. I'm not insensitive to the misery implied by these dispatches. I know that every new story about the total number of homes foreclosed represents so many individual tragedies. And for every genuine tragedy, there are thousands more bad judgment calls. I have nothing but compassion for these people living the headlines, but I really don't want to hear, or read, about it anymore.

I have been living in this ordeal for over a year. I made a series of catastrophically awful decisions around real estate and personal finances. I lost an imaginary several hundred thousand dollars. What I lost in the concrete realm has been a house, twenty thousand dollars (or so), two or three hundred points off of my credit score and much of my mental well being. It's sad, but it's not remarkable. And it's not interesting enough to be newsworthy, at least not anymore. I am merely one of the vast unwise and over-extended throng. I have usually been somebody who considers herself to be part of the solution, at least in theory. I recycle. I purchase used items (previously by choice, now by necessity). I try to use kind words that create positive interpersonal environments. I make a lot of mistakes, but not often as big as my last few doozies. It is with no small amount of shame that I admit to now being part of the problem. Like most of the people in my situation, I genuinely believed that the home I tackled would ultimately grow in value. My disastrous plans took place across the backdrop of the insecurity and unhappiness of a divorce. That couldn't have improved my thought processes. I could barely make my mortgage and I don't know how I thought I would ever complete home improvements or even basic repairs. When the reality set in that I had bitten off far, far too much, I worsened my lot by maxing out credit cards in a last ditch remodel designed to make my home resale ready. Enter the recession (or whatever it is these days). We all know the rest of the story.

I live in the California Bay Area and I work in the Central Valley. Every day at work I see more and more of this nightmare. I leave in my five hundred dollar Craig's List Special car and listen to the sadness on the radio. I drive East and see ever more empty homes with shoddy front yards. What really gets to me is the homes and their inhabitants when I run calls. When one enters a home physically, a barrier to intimacy is broken. Passing by houses from the outside, it's possible to think judgmental thoughts. When a person sees the tangled mess of weeds and the battered vehicles in front of a house, but not the inhabitants, it's easier to look for the personal reassurances that come with harsh censure. It's better to think that individual weakness and greed, rather than lay-offs and interest rate increases, causes such havoc. After crossing the threshold of a front door and speaking to the family living within, the reasons cease to be so simple. Our ambulance transports take a while, so I get to hear quite a lot about my patients' sad stories. The town where I practice is a Bay Area commuter outpost. It's been hit especially hard. In the heyday, huge homes were selling at steep prices with extravagant luxuries. They now sit unoccupied as bizarre reminders of the former suburban glory of our town. The homes not empty are now too full or too empty. It being Winter, we will often find a beautiful three thousand square foot model home with the whole family living exclusively in the living room and kitchen area. In order to conserve heat, the other areas of the home will have linens curtaining them off. The marble and granite counter tops matter not one bit to families when they're chilly. The other common finding is a single family home with as many as three or four families crowded into it. And, on the way to the hospital, it's inevitable that the missing jobs and health insurance come up in conversation.

Am I burned out on the economy? You bet! If you've read this post, you may be tired of the sad discussion as well. I suppose I will continue to listen to NPR and the BBC. I do want to remain moderately well informed about my world. If I want to remain employed, I will still have to keep going into my patients' devastated homes. And since it's my own life, I do need to keep dealing with my own financial wreckage. All I can say is that if we get together socially, let's talk about music or the arts. If you have friends in financial crisis, try not to judge. The chances are pretty strong that your friends can give you blow by blow accountings of their misdeeds and errors. Give your broke and over-burdened friends some hugs. Lend them some good books about something other than economy. And hang in there, yourself!

blogtastic_dee [userpic]

Irreverent humor!

February 7th, 2009 (01:25 pm)

current location: Work
current mood: amused
current song: *darned Country music they like in the Central Valley*

Thanks, serendipitygirl! This was hysterical. I posted it at work as reference!

blogtastic_dee [userpic]

A Break for Humor...

January 28th, 2009 (09:33 pm)
Tags: , , ,

current location: Home
current mood: amused
current song: Bob Dylan

After the last depressing post, I thought that I would add some levity. This was borrowed with affection from my wonderful FList:

Many people work side by side with space aliens who look human - but you can spot these visitors by looking for certain tip-offs.

Experts have listed 10 signs to watch for:

1. Weird or mismatched clothes. “Often aliens don’t fully understand the different styles, so they wear combinations that are in bad taste, such as checked pants with a striped shirt or a tuxedo jacket with blue jeans or sneakers,” noted Brad Steiger, a renowned UFO investigator and author.

2. Strange diet or unusual eating habits. Aliens might eat french fries with a spoon or gobble down large amounts of pills, the experts say.

3. Bizarre sense of humor. Aliens who don’t understand earthly humor may laugh during a serious company training film or tell jokes that no one understands, said Steiger.

4. Takes frequent sick days. An alien mightneed extra time off to “rejuvenate its energy,” said Dr. Thomas Easton, a theoretical biologist and futurist.

5. Keeps a hand-written or online diary. “Aliens are constantly gathering information,” Steiger said.

6. Misuses everyday items. “An alien may use white-out to paint its nails,” said Steiger.

7. Constant questions about customs of co-workers. Aliens who are trying to learn about our Earth culture may ask questions that seem to be stupid, Dr. Easton said. “For example, a co-worker may ask why so many Americans picnic on the Fourth of July,” noted Steiger.

8. Secretive about personal life-style and home. “An alien won’t discuss domestic details or talk about what it does at night or on weekends,” said Steiger.

9. Frequently talks to himself. “A space alien may not be used to speaking as we do, so an alien may practice speaking when it thinks it’s alone,” Steiger noted.

10. Displays a change of mood or physical reaction when near high-tech hardware. “An alien may experience a mood change when a microwave is turned on,” said Steiger.

The experts pointed out that a co-worker would have to display most if not all of these traits before you can positively identify him or her as a space alien.

Have you ever discovered one?

ARE YOU ONE????????????

blogtastic_dee [userpic]

Entitled to be Insensitive...

January 28th, 2009 (05:44 pm)

current location: Home
current mood: contemplative
current song: Niyaz - Nihan

The famously dark sense of humor possessed by EMSers is somewhat of a point of professional pride. On this matter, I cannot claim to be an exception. I have often horrified my loved ones by cackling with chums, who also work in the field, about matters that should be ideally treated with great delicacy. I have learned that these conversations cause the least concern if they take place out of earshot from non First Responders. It's not uncommon for us to peek over our shoulders in restaurants prior to delightedly recounting the sweeping extent of a trauma patient's injuries. To see us interacting, it might not be difficult to imagine that we are sharing a turn of good fortune, rather than a tragic event that likely brought about irrevocable change in our patient's life.

Most of us have a line that our joking will not cross, usually based on personal experience or private fears. I would say that a common taboo for EMS related dark humor is child abuse and the unexpected death of a baby or child. I think that this is because these calls are relatively rare (in proportion to our over-all call volume) and they represent the greatest fear of field workers. This isn't to say that babies and children completely escape our morbid humor. However, when they are featured, it is typically in the context of being completely extreme and preposterous. The subject becomes safer the farther away from the probable realm that it is. I believe the most common joke involves some take on the hypothetical busload of hemophiliac schoolchildren. In jesting, the bus is crashed into by anything from trucks carrying razor blades to passenger jets.

My own off limit jokes are usually based on gender, orientation and race. I have seen too many friends who are gay, transgender or of color harmed by unkind remarks. Humor at their expense is just not that funny to me. When a population seems particularly harangued or disenfranchised it doesn't seem fair to kick at them some more. Other medics have their own off-limit areas. I worked with a medic who had suffered a terrible vehicular crash that claimed two close members of her family. For her, unsafe driving and humor about vehicular collisions were strictly verboten. To the population at large, it's not exactly clear why intoxicated driving might make a good subject for a laugh. It makes sense only as a defensive strategy to handle the tragic losses incurred by such behavior. Other First Responders draw their lines at sexual assault or suicide. It's basically whatever pushes the 'not-funny' button on a person. One doesn't need to work too many shifts with a partner in order to gain some sense of their boundaries. Depending on an EMT's personal fortitude and their partner's cruelty, their lines of conversational demarcation will either be respected or trampled at will, and often.

I suppose that I must give my partners the impression that I am particularly sturdy (or some of my partners are rather cruel) since there is a fair amount of workplace jesting that targets my liberal sensitivities. Despite the twinges the I experience when I hear groups that I care about disparaged, I also understand that the humor is a form of a pressure relief valve. My own personal ethics demand that I don't sit idly by and laugh at jokes that I consider wrong or inappropriate. I will usually explain why what I am hearing could be very hurtful if overheard. I also feel that there is quite enough negativity in the world and that one should give careful thought before adding to it. While I do speak up with my concerns, I don't let our differences damage valuable workplace friendships. I try to put the comments of my co-workers in the context of their behavior on calls.

I'm not an apologist for discriminatory EMTs. Yet it is sometimes difficult to integrate what a person sees in 911 services with a cheerful or positive world view. The most common statement that I've heard from co-workers is, "I'm not racist, I hate everybody equally." Of course there are variations on that statement involving 'sexist' or 'homophobic.' Insert whatever form of discrimination that is currently being discussed and that sentence works. While 911 work will expose a First Responder to rare triumphs of human nature and impressive acts of great courage, more often than not he or she will be disgusted by the stunning idiocy and incompetence of the 911 activator. More common than the brave mom nursing her cancer stricken child with tenderness is the methamphetamine addled mother who infrequently feeds her child, and has apparently never heard of a pediatrician. For many people in our line of work, the cynicism and bleak jokes are just a coping mechanism. Perhaps it's less healthy than journaling, yoga or art therapy. I would suppose that it's preferable to drinking, though it can supplement the after work drinks very well. 

I guess the insensitivity is considered a privilege and a consequence of functioning as society's garbage collector. In many ways, we are the last stop when a person breaks their contract with societal norms. We understand that the separation is often not an intentional one. A mentally unbalanced senior who has stopped grooming and has begun hoarding is not usually doing so strategically. We know that drugs exact a heavy toll and that succumbing to their destruction doesn't necessarily denote moral weakness. With several drugs, falling victim to their influence only means that there was an initial exposure coupled with continuing availability. First Responders are familiar with the connection between poor parenting and harrowing childhoods.

The understanding of why things break doesn't make their clean up any easier, in my experience. If a person is not careful to avoid it, they will find that their stony facade develops fissures and that their heart can break a little on every call. When my co-worker from last night remarks that forced sterilization might not really be such a bad idea and that it has just had the wrong champions to promote it, I know that he's just getting out the mortar and repairing last night's cracks. I see his terrible bravado over coffee is a way of dealing with the call that he isn't discussing directly. Instead of describing the pile of small children cuddled like puppies on the living room floor of the parents' one bedroom house, my partner sarcastically debates the merits of eugenics. I don't remind him of the steam clouds that the children's breath formed over their heads in the unheated home at three in the morning. I, instead, will hit his arm and tell him that he's sick in the head. We don't have to tell our other co-workers that we whispered our assessment of the father, hoping that the mother would be waking the kids for school in just four hours. If we scratch the flea bite that the mere ten minutes on scene before transport earned us, we'll laugh it off and say, "Man that place was a mess! Tell them to meet you outside if you respond to 123 on Such-and-such Street." We both know that the lean little bodies of the kids have more bites. If we see those children in town at the market, we will recognize their perennially grey clothing and the rivulets washing their faces makes in the dust on their necks. We know that particular family isn't badly off enough for Social Services and that they will keep maintaining as best as they can. We anticipate them continuing to call us for the illnesses that the General Practitioner, that they don't have, isn't treating.

I'm not sure that anybody has really ever earned the right to be insensitive. Who can ever be entitled to add to the sadness and pain of life? Even the noblest of service doesn't buy a dispensation for disrespect. However, it's easy to understand why some First Responders (and sometimes I'm one) say things that sound so unkind. Being compassionate is likely to wear down the armor that he or she took such care to put on in the morning.

blogtastic_dee [userpic]

And now for something happier....

December 7th, 2008 (08:13 pm)

current location: Work
current mood: okay
current song: Damn football game...

A friend's sister is researching alternative fuel vehicles and consumer choice. Fill this survey out to help her! It's interesting and will make you think about your own purchasing decisions.

blogtastic_dee [userpic]

(no subject)

December 7th, 2008 (08:05 pm)

current location: Work
current mood: sad
current song: Football game in other room

There is a news story that has been ongoing in a community that neighbors the one that I work in. Given its close proximity, it is somewhat more haunting than if it had taken place across the country somewhere. One of my shift partners routinely stations an ambulance (that he works on for another agency) in that exact neighborhood, sometimes in front of that very sports club. Other people are acquainted with the parents who have children attending school with the other kids. However, I think that I would find that piece of news chilling, no matter where it took place.

How is it possible for such evil to exist? Torture for its own sake is a crime that I cannot understand. I have thought upon this a great deal more than I would like to, because it is an equation that I simply cannot solve or set to rights. I keep wondering how the three adults who tormented this young man could be going about their days, creatively planning ways to misuse him. Would they be sitting at their desk at work thinking, "While beating Kyle with a bat has its merits, perhaps we should heat the bat first so as to simultaneously burn and bruise..."? What turn of events in life could cause a family (comprised of perhaps two moderately functional adults and some kids), to welcome another adult and child into their family apparently for the express purpose of that other child being the designated recipient of their cruelty? I would argue that there is no way that the family was well or healthy at the outset, however it appears that they were not so violent with the other children. Was there a sense of 'other-ness' that justified that atrocity to them? Was it a form racism or ethnic violence?

As sick as the whole sordid nightmare is, I wish that I could understand what in humans makes such occurrences possible. How could hundreds (thousands?) of Germans in the first half of last century (many of whom were likely fine family and community members) horribly abuse Jewish prisoners in concentration camps? I would like to have an honest answer from the adults who harmed that boy to the question, "Why did you do it?" What makes slavery and torture actions that we, as a species, are capable of?

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