Wednesday, May 26

Is The Problem Really Based On The Number of Phone Calls?

In my capacity as our institution’s faculty representative to the NCAA (the governing body of college athletics in the U.S.) I administer a coaching certification exam to our coaches and assistant coaches. Coaches need this certification in order to go on the road and recruit athletes. The exam is based on this huge manual that is full of rules concerning college athletics (the manual is a 3 meg download at Information in the manual includes things like:

--Begin Quote from Page 89 of the NCAA 2003-2004 Division I Manual --
13.02.12 Telephone Calls. Facsimiles and other electronically transmitted correspondence shall not be considered telephone calls. Prearranged electronically transmitted correspondence (i.e., the time and method for such correspondence had been designated in advance) between an authorized institutional staff member and one or more prospects and any electronic correspondence sent by “instant messenger” or similar means shall be considered a telephone call. The use of a pager to contact a prospect is considered a telephone call….
--End Quote from Page 89 of the NCAA 2003-2004 Division I Manual --

You can image what test questions look like (this is purely fictional – I would not divulge a real test question):

Jimmy is a recruit in both baseball and track. In the month of April he is sent an e-mail on Monday, a text page on Tuesday, and a FAX on Saturday. How many official phone calls has Jimmy had?

A) 0
B) 1
C) 2
D) 3

Given events in the news this last year, one wonders if these are the questions this exam should be concerned with. For example, maybe a better question would be:

Based on: (
In order to lure Jimmy to your program, you’d offer him:

A) The same things a non-athlete would be offered (campus tour, sit in on a class, meet with a faculty member, etc.)
B) Sex
C) Drugs
D) B and C.

Based on: (
In order to ensure your basketball players maximize their classroom experiences you should:

A) Have them take a normal course load in terms of type and number of courses.
B) Have them take a course “taught” by an assistant coach of their own team.
C) Have them take a course in basketball with a final exam consisting of twenty questions, one of which is “How many points is a three-point basket worth”?
D) B and C.

I like college athletics. Some of my most motivated and achieving students have been varsity athletes, and I can not imagine a college or university without an active athletic department. Colorado and Georgia are not alone in setting up a system where student-athletes are more athlete than student and the academic side gets laughed at (yes, yes, I realize this does not apply to all Buffalo and Bulldog athletes or programs).

Is there a problem with college athletics? I personally think so, and not just because someone who is supposed to be in college for an education gets an “A” for knowing that there are two halves in a whole game. I think the root of the problem is that we have moved from the ideal of college athletics being about college students who also get to compete at a high level athletically. I am worried we have moved to a system where college athletics:
1) Serves as a huge semi-pro system for the NFL and NBA that is cost-free (to the leagues) and where the cast-offs (the vast majority who come to play) have no career and no education. Let the NFL and NBA pay for their subordinate systems like baseball and hockey. People like Maurice Clarett (who clearly did not go to Ohio State for an education) would be better off with such a system and someone who wanted an education AND to play football could have had his slot.
2) Line the pockets of a few schools that run systems with control of $$$ as the top priority (do you REALLY think we don’t have a playoff system in DI-A college football because of concern about student welfare?)
3) Line the pockets of the TV networks and the corporations who advertise on them.

Do I think colleges should be prohibited from doing any of the above? No. I like the free market just fine, thanks. I do think, however, that colleges have the RIGHT to not do the above, and that people who run them should consider if the current system is in the best interests of the students (both those who compete and those who don’t). Reform will not come from the NCAA and cannot be solved on a school-by-school basis. University presidents, with the support of trustees (herein lies the weak link in the chain), will need to band together if anything is going to be done.

Could I do better? Not and keep a job as a college president. What needs to be done is so simple, but so radical and incongruous with what alums and society wants that it won’t happen. Just two simple rules would have a drastic effect on the problem. The goal would be to have STUDENTS playing sports vs. having athletes who have to go to class. The rules:

1) Require each TEAM at an institution to have incoming players with a median SAT and high-school GPA that is equal to, or great than, that of the rest of the incoming class. In addition, each team would be required, on a semester-by-semester basis, to maintain a median GPA and credit-hours earned that is equal to, or greater than, that of the rest of the student body. Change the number of games played and hours per week allowed for practice to allow the above to happen.

2) Do not allow any televised coverage of collegiate athletic contests (including bowl games). College athletics SHOULD cost the intuition money. Anything that costs money will be controllable by the administration. Anything that makes money will have a mind of its own. I grew up in Iowa. The top paid public employees in that state are coaches at Iowa State and Iowa. Not the governor. Not the college presidents. Not the scientists at the UI or ISU who perform life changing research. Coaches. What does this tell us?

WHAT? You mean I can’t see my team in action on Saturday? That’s right. So maybe you’ll support your local minor-league team. These guys put athletics first and are not taking slots away from students who want to learn. Yes, it would mean a lot of us would have to learn to do things differently (instead of hoping the Iowa Hawkeyes will be televised on a crisp fall Saturday I’d have to either go to a live game in my area or find a minor league team for which to cheer)

Why won’t this happen? We have decided that our principles are worth less than money. Any other answer comes back to this issue. CASH. Winning produces happy alums. Happy alums watch games on TV (indirectly providing TV revenue), buy team branded gear, buy tickets, and, most importantly, give money to the school.

Sunday, May 23

Glad I Missed It

My last 4+ shifts have seen no calls. I'd complain about the lack of action but given what happened to our neighbors this week I am glad. Our "corps next door" ran a horrific call that I am sure they are all still thinking about. An 18 year old driver going too fast on a hilly road came over a rise to see a car stopped behind a school bus with its flashers on. Driver could not stop and, in order to avoid the stopped car, swerved to the right. He hit an 8 year old girl as she was exiting the bus (the bus driver slammed the door closed on the two kids exiting behind her or it may have been worse). They were going to call for a helicopter but she was too unstable and was pronounced at our local hospital.

No drugs, no alcohol. Just too fast. Today's paper mentioned the driver is facing felony charges. That's a lot of changed lives for one moment of "fun".

Given Clark's latest blog entry ( and the above I have found myself being a little more cautious on the road these days.

Thursday, May 20

Done (I Hope)

State written final was tonight. Overall I think I did well but will know for sure in four to six weeks (YECH!).

One question I was confused about went something like this:

Child patient riding a bike and hit by a car.  Initial assessment shows no life threatening injuries and rapid trauma assessment shows deformed right arm and deformed right leg.

Two answer choices that were even considerable were:

     PMS both extremities, take time to splint each extremity separately, board, load.

     Fix both extremities to body, move to long board, load and go.

I picked the second choice and everyone else I spoke with, including the course instructor, went with the first choice.  My rationale was this:

1) Our state pediatric trauma protocol says that kid + bike + car = major trauma.  BY DEFINITION.  Also, by same protocol, two or more long bone fractures, BY DEFINITION, is major trauma.
2) Our state pediatric trauma protocol has a grayed box that states, and I am doing this from memory, something on the order of: Do not spend time on the scene doing the following assessments/treatments.  It then goes on to list stuff that comes before, and is more important than, splinting.

What drives me nuts is the "no life threatening injuries found".  Does that MEAN there are no life threatening injuries or that I didn't find them?  One major problem with major trauma is internal bleeding.  My understanding from the book is that kids show external signs of shock LATE and by the time they have decompensated you have screwed the pooch (ok, ok, there may be a better term for this, but it is late...).  SO, I figured you get them in the rig and on the way to definitive treatment ASAP.  The body and long board ARE splints, just not the best splints.  Of course, if there ISN'T internal bleeding, fine, stay and play. But isn't the point of BLS trauma protocals to admint that in the field we can't always know what is wrong?

Anyway, overall is was fine and I'm glad it is over.

Tuesday, May 18

Map Reading

Been busy with family, work and EMS stuff. State written exam is Thursday night. I haven't really studied for it yet, but have taken several practice NREMT exams from a book I bought. I've been scoring right around 90%, and assuming the state test is anything like these I am not worried about passing (which is 70%). I know our state protocals very well so any state specific stuff should only help me.

Just got back from a call that was interesting for non medical reasons:

Control: "XXXX ambulance monitors, 2 car MVA on Route ZZ". Hits our tones. Repeats: "XXXX ambulance monitors, 2 car MVA on Route ZZ".

Now, at this point I'm out the door driving to the station when it occurs to me that it might help to know WHERE on Rt. ZZ the accident is, or, even, whether it is North or South of town.

Medic 6: "Medic 6 to control"
Control: "Control's on Medic 6"
Medic 6: "I'm responding to the station. Do you know where on Rt. ZZ the MVA is?"
Control: "Affirmative Medic 6. Police state the MVA is on S. Main in ----ville".

Route ZZ goes through a lot of villages around here, and often has a street name in each place. In ----ville, S. Main is in one county (which we do not serve) and N. Main is in our county (E and W main split the village in half, we take the north side, a different corps takes the south).

Our Chief: "Control, are you sure this call is in our county"?
Control: "You are covered by static".

While our chief tries to figure out if it is our call, we are flying down the road toward the MVA. We are within sight of the accident, which is clearly across the county line, when we are called off. It is property damage only AND it is in the wrong county. We go check everyone out anyway, but our chief, who arrived on the second rig, was a little grumpy with control once he got a hold of them. Personally, I don't let 200 yards get me too wired up, but it is true that there was no mistaking that this call belonged to someone else AND that a quick look at the map would have told control this. Everyone has bad days, and today control and our chief must have both gotten up on the wrong side of the bed. For some reason it only put me in a good mood (maybe because I got the boost from the call, got to drive fast, and everyone was OK).

Saturday, May 15

You're HOW old?

Two calls last night. Both EtOH related. Neither a college student.

First call comes in as "woman down". We arrive downtown, which is FULL of students and others celebrating the weekend, to find what appears to be a late 40's early 50's woman sitting on the sidewalk surrounded by college age individuals, all with smirks on their faces. She had "a glass of wine" to drink. She last ate two days ago (trying to fit into a new dress for graduation?). I predict it was more than one glass, but it was hard to tell. She was alert and oriented times three, did not fall or hit her head, and did NOT want to go to the hospital. Her daughter and son claimed she was in fine shape to make this decision, that they would look after her, and our EMT decided to let her go. The only difficulty she had in giving us information was her age. She knew the date she was born, but she did not know how old she was. Note that this was not due to an acute cognitive deficit, as the problem is that she is so used to saying "39" that she really didn't know :-).

Second call comes in as "underage intoxicated female". Local dance club has teen night which is alcohol free. However, this 15 YO female was not free of alcohol. TRASHED. Transported, managed to have her puke before and after the ride but not in our rig, and met her father at the hospital. My guess is that her hangover will be punishment enough but it won't be all she gets.

So, while I predicted we'd have some EtOH calls this weekend, I did NOT expect them to come from the 15 and 56 year olds.

Friday, May 14

Seeing Pepper Everywhere

My meetings this week finished up well. I managed to get a sinus infection following a cold which has knocked me out over the last couple of days.

Things were quiet around town this week as most of the students headed home and the seniors went away for senior week. Things are starting to pick up, however, as seniors, friends and family prepare for graduation this weekend. Today's sighting of private jets, Porsche Cayennes and a Rolls confirmed that something is going on. Our county is one of the poorest in the state. Today I saw TWO Cayennes at one intersection. This is only the third time I've seen one in person, and you can bet they were not being driven by anyone local.

Lot's of ambulance shifts this weekend so maybe I'll catch a call to write about...

Tuesday, May 11

Out of Shape

13.5 hours of meetings today. Really. Every year at the end of the spring semester the faculty get together to talk about the "core curriculum". There are five "university professors" that oversee the different components of the core, and since I'll be one starting in July I figured I better go to today's meetings even though my sabbatical gave me a free out.

At one point (after lunch when I REALLY needed a nap) I was chewing on two pens at once and drooled on my shoes. I had future leader written all over me...

Things I had managed to forget in my absence:

1) Let X equal the number of words required to convey concept Y. Given this, a member of a humanities department will take somewhere between 9X and 12X words to convey Y. When finished, a department mate will start in with "What I think Bob is trying to say is...."

2) Consider thing Z. Whatever Z is, someone from the social sciences will remind you that Z is a western (or male, heterosexual, 20th century, etc.) construct and that to REALLY understand what Z is about you need to call it Q and consider it from a different perspective.

3) If you want a scientist to change how something is done you better either make the new way easier OR have data demonstrating that the new way is better.

Back again tomorrow starting at 0730 for small group discussions on future directions. I predict everyone agrees right off the bat and we'll be done by 0800. Or not.

I'm on call for the amulance from 2400-0600. PLEASE - NO CALLS!

Saturday, May 8

Almost there...

Took the state practical today.

Trauma: MVA - two car / motorcycle w/ ejection. Flail segement in chest and femur fracture.

Medical: Bee sting with anaphalaxis.

Other stations: long board, airways & suction, AED, BVM.

I was super nervous but am now qualifed to take the state exam on the 20th.

About to head out to dine with the wife in celebration of mother's day.

Friday, May 7

Done (sort of)

Written final in my EMT class last night. The look on the faces around me ranged from relief to fear to joy. I did fine (87%), though my mind was elsewhere. The evaluations for the class are over. One last meeting tonight to practice for the state practical Sat., then a couple of week wait for the state written. I am sure my wife won't know what to do having me around some evenings.

We've come so far, yet yesterday's call taught me I am not yet prepared to deal with the human side of working some types of calls. I can't stop thinking about the patient and her family.

Thursday, May 6

Tough Morning

Tones went off this morning at 0430. I wasn't on the board so listened to be sure it wasn't an MVA or something else that needed our second rig and started to fall back asleep. No response from our corps and control re-alerts. I figure people are just slow due to the time, but I roll out of bed and start heading down just in case I'm needed. Our rig calls out of service when I'm about half way to the station. Deciding that I'm already awake I continue down to check out the board for today. After putting my name on the board for a couple of slots next week I start to leave the station. Just as our rig is returning another call comes in. I expect the ambulance to drive on by but it stops. The driver tells me he has to leave to go pick up his son from college and hopes that I can drive for him. No problem. We are off for just another difficulty breathing call.

It wasn't just another difficulty breathing call. The patient was in a small room at the top of some very steep and narrow stairs. Cyanotic. Maybe a V on the AVPU scale, but safer to call her a P. We have a paramedic, an AEMT-CC, two EMTs, a CFR, a “significant other” (someone who helps out on calls but has no certification and me. I figure this lady is in great hands. She was. Great hands were not enough this morning. She coded on us as she was being taken down the stairs. Most of you reading know the drill: ET tube, epi, more epi, some opiate antagonist (she had a bag of meds the size of a suitcase and there were several opiate pain relievers in there), bagging, chest compressions, etc. The ED doc called it almost right away. As far as we can tell she threw a clot (she had knee surgery two weeks ago) and it turned out the lights for her.

I am still a little shaken. She went so fast, and the call came in just like so many others. We have difficulty breathing calls where the person really just needs a vaporizer and some rest, I had already gotten complacent regarding DB calls. No more.

I feel for the patients family as she was talking to them before we got there. They must be in shock.

Somehow I need to get this out of my mind and study for tonight’s test. I’m not really in the mood.

Wednesday, May 5

Mentioning Honors (NOT Honorable Mention)

LT defended her thesis today. Her presentation went very well and she handled the questions like a pro. It was an easy call for the department to award her high honors (not all of the defenses went so well). I of course smiled when my colleagues congratulated me on a job well done as I knew it was just luck of the draw. I think I helped her less than any other student I’ve had go through my lab as she didn’t really need “help” as much as occasional guidance. You really can’t know a student will be that good until you have already have them working with you so it isn’t like you did something special. Sometimes you get to have a true collaboration and this was one of those times.

What a pleasure to work with a student who is talented, motivated, kind and grounded. Working with undergraduate students like LT is the reason I wanted to be at a smaller institution. Days like today remind me why I got drawn to science as a student and why I wanted to get into academia to give back to a new generation of students what my professors gave me. LT is one of those kids who will make a fine adult and make society a better place. Today I was feeling honored to have had the chance to work with her.

Next fall will start another cycle (next year I have at least four people working on senior theses in my lab – NOOOOOOOOOOOOO :-) ).

Written final in my EMT class tomorrow night. 200+ questions - yeach. When things are all over I'll have a converstation with the instructor about the idea of random sampling...

Tuesday, May 4

Saying No and Feeling Bad

My son had his first t-ball practice tonight. Between basketball, soccer and t-ball, there is a strong need for coaches. I volunteered to coach basketball and wanted no part in soccer or t-ball. I picked the ambulance corps as my main way to give back to my community, and right now I put enough hours into this effort that I am sure I am doing my share. I had convinced myself that I could be guilt free in not helping out with t-ball and soccer.

For basketball and soccer people who signed up were contacted ahead of time and told who was coaching their child’s team, when and where activities would be held, what equipment was mandatory and what was optional, etc. For t-ball, we were told to be somewhere on Tuesday at 1800. Nothing about clothing, equipment or who the coaches were (never mind which team our son would be on). When we showed up, the organizer asked for some volunteers to coach the four t-ball teams. Not to help coach. To coach. This guy was asking people, with no forewarning, to step up on the spot and volunteer their time for two nights a week over the next several weeks. In fact, I heard later that people who expressed interest in coaching weeks ago were told he wasn’t ready to deal with coaches yet and they’d work it out the first day. This placed me in an awkward situation. There I was, an able bodied human (and, based on the number of eye-movements made my way, it made a difference that I was male). After the first three coaches volunteered there was a LONG wait. There were several mothers and myself. They didn’t know I was waiting for my wife, who was headed for a board meeting of the nursery school (more volunteering), to drop off our two-year old so I could care for her and then take both kids home. Or that I have EMT class on Thursday and couldn’t coach then. Or that once the class is over I’ll be giving away HOURS of my time each week so that if they call 911 someone will be there. All they know is that a 6’2” 30 something male, who though he could lose some weight seems semi-athletic, is standing there not stepping up to the plate. What an awful feeling. However, I was proud. I did NOT volunteer for this. It is someone else’s turn. And if I AM going to volunteer for something, it isn’t going to be something so poorly organized that they don’t think to ask for coaches until 60 seconds before the season starts.

That all said, I wish I could say I didn’t feel guilty.

Monday, May 3

Finals Week

It is finals week. Usually this means I would be seeing a lot of students in my office, proctoring some exams, and avoiding grading tests to no avail. However, this semester, this week my experience will be more like my students'.

Tonight: 125 question exam on the last 1/4th of the class. I went in feeling a bit underprepared and felt the exam was much better written (and more difficult) than previous exams. I ended up doing well (94% and high score) but I should have known the ones I missed (that is, they were fair questions and I just didn't know the answers).

Wednesday: My honors student defends her thesis in front of the department. While this is really her time to shine, I get anxious too as in a way I am on trial up there with herl (that is, if she does well it reflects well on me and if she bombs it means I did not properly prepare her).

Thursday: Final written exam for the EMT class. The instructor keeps changing his mind between 225 and 250 questions. Either way that is a LOT of quesitons. I have a lot of studying to do for this.

Saturday: State practical exam.

I'm getting a little tweaked, and while I can sympathize with my students a bit more, I have to confess that most of the stress associated with exams is self-induced and fully under my control. I have to fight hard not to get compulsive about the academic material. I HATE missing questions and this is just nuts and I need to relax a bit.

I'm drinking a beer and going to bed.

Saturday, May 1


Thursday I had a fair amount to do and left my pager at home so I would not be tempted to go on any calls. I was in my office talking to a student about research opportunities for the summer. We were almost done when he slapped at his waist. Given he rides with the ambulance (in fact he is one of the student coordinators) I took this as a clue that he had his pager set to vibrate and that we had a call. When I asked if he was going he explained that he had class but that he knew the board was a little light (this is the last week of classes and finals start Monday) and that I should head down if I wanted. Down I went.

Call came in as a 93 y/o female with injuries from a fall. When we entered the apartment we see a 90+ woman sitting on the floor, next to her bed, looking a tad white but AOx3. She is complaining of pain in her left hip. Pain? My hip hurts just THINKING about what her’s looked like. I could see the head of her femur, dislocated from the hip joint, jutting out at an odd angle. This lady was tough! We gingerly collared and boarded her and got her to the hospital ASAP (we were BLS). Our patient had been stuck on the floor for over 3 hours.

When we asked the patient questions about her medical history she reported being fit at a fiddle. No Hx of: cardiac issues, hypertension, orthopedic problems, etc. Stunning that one can live to be over 90 with no health issues what so ever. With a little extra prodding, however, she did mention that she had been in the hospital in the last month. What for? TO HAVE SCREWS PUT IN HER LEFT HIP. Gee, you think that is pertinent?

I’m off to a 9-4 EMT class (ambulance operations, extrication, etc.). The end is in sight!