t-day and stuff

Sorry for the delay in posting. Been crazy busy…

Just got back from medic class. Spinal trauma. Whoo Dog!

The lecture for medic class last Wednesday went well (according to my fellow students and the instructor who sat in on it), though I wasn’t really happy with it as I was a bit rough in a couple spots. Doc Shazam (see Mr. Hassle’s Long Underpants link at the right) suggested that maybe I should farm out some of the trauma part due to my lack of experience in that area. If such a person existed around here who was willing to do it, I am sure they would have been asked already. Doc, I have been to lectures aimed at medical students and MDs (both at Hopkins and NIH) and I likely have an understanding of the types of lectures you attended (and continue to attend) to learn your craft. Pre-hospital care teaching, at least where I live, is VERY, VERY different (sadly). Most of our lectures stick with the state outline for the class (the state effectively mandates what they teach) and re-cover what was in the text point-by-point. I tried to do you proud (for example, I talked some about the “sweat spot” in terms of CO2 and O2 concentration and the adverse effects that can come from hyperventilating our brain damaged patients), and the fact of the matter was that I did a better job on that lecture than the alternative (his claim, not mine, though I believe him). Is that sad? Maybe. There is considerable “cognitive diversity” among the students in my class (and providers in the field), an unbelievable amount compared to a class of 1st year medical students. Maybe the modal teaching style in EMS is what it is because of this. In any event, I did much more than give them an “outline” lecture, and I am certain I did not misinform them while I tried to make an interesting and and important contribution to their understanding of the brain and field management of head and brain trauma.

T-Day itself and surrounding days were good, though my wife and son were wicked sick with hand, foot and mouth. It hit them harder than me and they were both miserable for a while, and any of you with a significant other and kids knows how that pain can be spread around so that EVERYONE feels it, sick or no.

Ambulance calls I remember (with the students gone, I took a lot of call):

90’s female – Possible Transient Ischemic Attack (ministroke). Memorable to me fore two reasons. First, she went from not being able to talk or move her right arm and leg to doing fine on the Cincinnati Stroke Scale within 20 minutes. Second, the third sentence out of her mouth when she could talk again was “BASTE THE TURKEY”. I’m not kidding.

80’s male – Respiratory distress secondary to cardiac event (at least that’s what I think it was…) Walked in to see a patient that makes you go, “OK folks, TIME TO GET GOING”. His pulse ox was 82 ON his home oxygen. We did not stay long.

Male with injuries from a fight. Both eyes swelling shut, split upper and lower lips, typical deal EXCEPT for the neck pain and “Buzzing” in all four extremities. Caught my attention, that's for sure. Collar wouldn’t fit around his neck (think of a VERY short neck the width of which is equal to the thickest part of a basketball) so we used the rolled up towel trick for head and neck stabilization. Board, blocks, and trip to the hospital (took help from the firefighters to lift this guy into the rig). I never did see the size of the guy who whacked our patient, but he must have been HUGE.

70’s female with unilateral weakness and “I’ve fallen and can’t get up” syndrome. Memorable as when I told her what her blood pressure was she said, and I quote, “it must be up because I have my hand on your leg”. And that, ladies and gentlemen, is the most action I got all weekend.

Why I'll be doing class prep Wednesday...

Lecture in Medic class tonight was burns. Interesting enough, but mostly a repeat of what I learned in EMT class and PHTLS class.

At work my students are gone as of tomorrow afternoon, but I'll be doing class prep. Why? Because a couple of weeks ago the instructors of my medic class approached me and asked "hey [dj], did you know the state tells us to ask experts in a field to teach a lecture when appropriate"? I, being the ever bright one, say "Oh, that's cool". I really didn't see the next part coming, and I admit that makes me a little slow. The next question, as you likely guessed, was whether I would be willing to teach a 3.5 hour lecture (the section on head and brain trauma). I am not an expert on the head nor brain, though lasted I checked I have at least one of each (get your mind out of the gutter as it is already crowed with mine). Nor trauma. I am an expert on some types of cognition, which, in the end, is admittedly driven by the brain. They figure my background puts me in a better position to lecture on this topic than them (despite the fact my pre-hospital care experience is shy of a year). This is what we call an "Empirical Question". I hope the data are consistent with their original hypothesis, because it is easily falsifiable.

I am a bit tweaked about this, but also excited. I lecture most days for my job and I am very good at it in the setting I am in (yeah, yeah, I know, sounds bad, but it is true based on evaluations from my students and my peers- Professor of the year and all...). What makes me nervous is that the medic class is a MUCH more diverse group of people (in terms of age, education level, intelligence, coming to class prepared, etc.). Not only that, but the stakes are different. If someone in a class on human cognition doesn't want to learn the difference between declarative and procedural memory, it is no skin off my back. On the other hand, the folks I am talking to Wednesday night will be making life-or-death decisions based on this material (and depending upon where I crash my car, it could literally be skin off my back!). Different ball game.

I'll let you know how it goes.

DJ
Who, while not a Super Freak, is very willing to dance with his kids to with some Rick James pounding in the background (poor parenting, to be sure, BUT IT IS SUPER FREAKY!)

Sunday, Grumpy Sunday

Grumpy mood producers:

1) Hand, foot and mouth disease. No, really. I have a mild case, my daughter is overwhelmed with it (her throat looks like it was hit by a shotgun full of birdshot).

2) Lack of common courtesy. I just finished an hour and 40 minutes of reviewing statistics for about 20 of my stats students. On a Sunday afternoon. At their request. Not one "thanks Dr. J!". Really.

3) People sucking up my time for no good reason. I spent two hours today working on letter to the chair of a department (which has to be cc’d to the Dean) who wrote a letter to the Dean complaining that I denied a junior faculty member from his department the opportunity to teach in the program I run because I am an autocratic dictator. Did the chair call me first to get my side? Nope. Is there any truth to the allegations in the letter? No, and I am sure that everyone will see it my way when the facts come out (the course was NOT ready for prime time). But, BECAUSE the letter was sent, I have to spend my time defending making a correct decision based on quality data. That’s right, I DID THE RIGHT THING AND I HAVE TO DO MORE WORK BECAUSE OF OTHER PEOPLE’S DYSFUNCTION.

I am going home to serve myself a safe but effective dose of EtOH, and if anyone comments that I am hypocritical to slam on students for drinking unsafely while I use EtOH as an anxiety reducer, I am going to give them a paper cut. Better yet, I am going to give you a BIG kiss and you too can share in hand, foot and mouth disease.

DJ
(Frankie Says RELAX)

If you are going to complain

I occasionally bitch about students. This is an anti-bitch.

I am writing a recommendation for a student. This woman is a NCAA Division 1 athlete. She is not good enough to play at a Tennessee or U-Conn. She is good enough to be competitive at the D1 level.

Her cumulative GPA is a 3.5. She is NOT an under-water basket weaving major. She got an A- in the second semester of Organic Chemistry (while conditioning, practicing and playing her sport!), and has A's or B's in some of the toughest classes on campus. She will be graduating after 8 semesters (4 years) of college (she takes a full load on semesters she is “in season”).

These are NEVER the kids who complain about not having enough time. These are the kids who turn in their assignments EARLY because they have an away game. These are the kids who I sometimes ignore because I am spending time in disciplinary boards with kids on the opposite side of the spectrum.

College students CAN manage their time, have multiple interests, and excel academically. Some amaze me with a maturity I did not have when I was their age (alas, I may not have it now :-) ).

Wanted by the NJ State Police

Your favorite college professor who moonlights as an EMT at $0.00/hr was in Newark, NY this week on work related travel. If you ever get the chance to check out the Newark area of NJ, well, DON'T :-).

The meetings I was attending were at a Marriott which is VERY close to the airport. This is good if you need to fly people in from various places, meet, sleep, meet, and fly out of town. That's just what we did.

Wednesday morning I decided to go for a walk around the hotel to get some exercise. As the hotel is surrounded by highways, etc., I just repeated laps around the grounds, staying on the perimeter. On my second lap I noticed a tall building jutting into the sky with a disc shaped top. It sure looked like an air-traffic control tower, but for some reason I assumed it couldn't be based on how close it was to the hotel.

Each lap I made I looked closer at the building, very curious. Soon I hear the "whump, whump, whump" of helicopter blades. Hmmm, I wonder what a police helicopter is doing around here. It gets closer. Well, they must be looking for someone - Maybe I better step up my pace in case I am in danger. The helicopter follows me for a complete lap of the hotel (probably 8 minutes). I begin to realize, of course, that I must have looked odd repeatedly checking out a federal aviation control tower. I must not have looked too scary as they final left me to my walk and ground units did not come to ask me what was up.

NJ is now free of the dangerous DJ.

I Wonder Why

Why did a smart, sweet, funny 60 y/o start smoking when she was young, vivacious and outwardly beautiful?

Why did a quadruple bypass over 10 years ago fail to get her to stop?

Why does she smile at me, showing an incredible inner-beauty via her flirtation and sense of humor, even while it is evident that she cannot catch her breath, that her lungs are full of fluid, and that her own behavior has caused her current predicament?

Why is it that I know I will be back to her house one day for a full arrest and that I will cry when I get home that night?

Wollongong Bound

Been busy this week setting up information sessions for students interested in going to Wollongong, Australia with me (and my family) for Feb-Jun of 2006. I am very pleased to have been selected to get to take this trip and will write more soon. For now, http://www.uow.edu.au

No EMS calls this week. I'm on tonight from 1800-0600, so we'll see...

PHTLS

Sorry for the delayed report on the PHTLS class - I am swamped at work and tired...

The 16 hours of class this weekend (Pre-Hospital Trauma Life Support) were well worth the energy. Most lecture sections were taught by M.D.s from the nearest Level II trauma center (the one we go to with anyone meeting state trauma criteria). In fact, one is a MD by day and volunteer paramedic at night. Cool!

The lectures were, for the most part, superb (the worst one was still good). The best part, however, was the hands on experience. Unlike my basic EMT class, these practical stations were aimed at teaching us how to handle multi-system traumas in very practical situations (as opposed to following the state skill sheets verbatim). Scenarios included rapid extrication, unsafe scenes, difficult to maintain airway, limited equipment, pediatric immobilization, etc. Excellent experience and I recommend the class to any EMS personnel interested in serving their trauma victims better. One thing that was very clear at the end of the course was that if your BLS skills are not up to speed ALS procedures are not going to help you.

Medic class last night was soft-tissue and musculoskeletal injuries. Seems the exam from last week wounded some people (the range, before they added points to everyone’s score, was from 53 to 95). You need a 75% average at the end of each module to continue in the course, and the module exam makes up 75% of this (the other 25% comes from the quizes). My understanding is that you are allowed to re-take one module exam during the course and a few people just used up theirs.

Couple of EMS calls over the weekend but nothing to phone home about (one severe headache and one whooping cough).

It started snowing yesterday and ice is on the roads for the first time this season – I used to call this season late-fall / early winter, but now I call it Trauma season…

PHTLS

I will be spending 8-5 both days this weekend taking a Prehospital Trauma Life Support course. While this isn't part of my medic class curriculum, it looks very interesting and everyone I have spoken to about it makes it sound very useful in the field.

Between my job, the medic class and my ambulance shifts, my wife has been holding down the fort at home FAR more than her fair share. When I am out providing medical services to the community they will owe HER and my kids as much as me.

I'll check in Monday to let anyone interested know how the PHTLS course went.

Sample E-Mail

Here is an example (name removed to protect the young) of the type of e-mail that drives me INSANE:

Professor [DJ]-
My name is [], and I am a first year student planning to major in []. I am currently in [] 150, and I was hoping to taking [] 255 next semester. Unfortunately, I saw last night that all the space in your class has been taken. I was wondering whether it would be at all possible to get a spot in your class because I am incredibly interested in [] and your class sounds very interesting. I have heard from many student that you are a very good teacher, which is probably why your class is full. I am sure you have already received many emails asking for spots in your classes, so I am sorry to add one more. However, [] is my passion and I would like to take as many [] classes as possible before I graduate.
Please let me know if a position in your class will be available.
Thank you very much,
[]

Here is what I wrote:
Hi [],

The department is meeting on Tuesday to discuss enrollments. I will know much more then.

Prof. [dj]


Here is what I THOUGHT:

I have trouble getting words on paper sometimes (as you've likely noticed reading my blog), but despite a deficit in phoneme-to-grapheme conversion (and back again) I can STILL see the grammatical errors in the e-mail... Some of the sophomores on the waitlist could not get into the class last year. How are they going to feel if I let this person in? How would THIS person feel if when she were a junior a first-year was let in ahead of her because the first-year REALLY wants into the course?


This is not an institutional problem that is easily fixed. Enrollments in different majors vary year-to-year based on a number of variables outside of an institution's control (e.g., poli-sci enrollments go up whenever there is a war). If an institution kept enough faculty on hand to ALWAYS be able to serve EVERYONE who wanted something, we would be grossly over-staffed as an institution and tuition would be even MORE than it is now (total costs here are now a $38k/year or so - how much higher can it go?).

Patience... I need to learn patience...

The frazzled DJ

Test Night + "I'LL DO ANYTHING!"

Medic class tonight entailed our first exam (covering Modules I and II). I got to class at 1825 (class starts at 1830), only to see many people working away. I then remembered that the instructors said we could come at 1800 to get an early jump on the exam. Given the exam was 100 questions, and class is 3.5 hours, I figured I'd be fine.

40 minutes later I turned in my exam and the instructor graded it right there. Here are the answers to the questions I missed:

1) washing hands.
2) elicit a good history.
3) Cullens', Late.
4) flaccidity.
5) intima.


The first two were bad questions in my not so humble opinion (e.g., is washing hands "Body Substance Isolation"? I think not. Infection control, yes, but BSI?). The last three were things I just didn't know. I went into the exam fairly cold as I have been SUPER busy at work and my wife was having a tough day so I came home early to help out. I wasn't that worried as I figured the real issue is what I know, not what I can cram in the two days before the exam. My strategy so far has been to go to class very prepared and it has served me well.

On another front, the students at my school are registering for spring classes. My 200-level class is full at 18 and has 20 on the waitlist. I am really not sure what to do with the e-mails from people telling me that they'll do whatever it takes to get into my class (hard to keep your mind out of the gutter, but please try). It cracks me up when people start to argue that they should be in the class because "they really want to take it". Hmm, what do you think the other folks are there for? Free koolaid and a bucket of chicken? The music? My dancing (I do dance around, but there is no music)? It's an elective. EVERYONE who signed up wants to take it, and the fact that you think you are special does not entitle you to jump to the front of the line (unless you have a suitcase full of cash, for then we can chat...).

I voted yesterday and I'll save the political venting for those blogs oriented that way...

DJ

Did the Dog Leave the Iron On?

I just got back from Medic class. Bleeding and shock tonight and our first major exam on Wed.

On the way back in town I stopped by the station to see who is on with me tonight (I take the 0000-0600 EMT shift the nights I have medic class) and hear the following on the scanner:

" fire monitors, # XX road, the *&$*% residence, dog house on fire. The dog house is not attached to the residence"

I clean the wax out of my ears as their tones drop. I listen closer this time because I KNOW this fire department did not just get called out for a dog house fire.

They did.

But that isn't the good part.

Five minutes after the first alert the following is broadcast for all to hear:

" fire monitors, manpower needed at the scene, # XX road, the *&$*% residence, dog house on fire. That's for fire monitors, manpower needed at the scene for a dog house fire".

Now, bless the heart of the dispatcher who did all of this without laughing. I was almost on the floor. The questions don't end, but the first in my mind were:

1) How did the dog get his/her house on fire?
2) How many firefighters does it take to put out a dog house fire when it is a stand alone structure?
3) Does the dog have replacement cost insurance and has it inventoried its dog toys recently?

Inquiring minds want to know.