Maybe I'm old and grumpy...

I got an e-mail this week that I still haven’t responded to as my initial reaction is to send off something nasty. As background, I gave a test in a relatively large class. This week I went over the test, question by question, during regularly scheduled class time. If I were to do this individually for each person in the class, it would take up three weeks of working solely on this from 8am to 5pm, five days a week.

Here is the e-mail:
“Dear Prof. (DJ),
My name is (some name), I am currently taking (some class). I was unable to attend the review session today as I had to complete a group project for my (some other class). I was wondering if it would be possible if we could arrange a time to meet so that I could see my exam. I was very upset when I recieved my grade because I put many hours into studying for the exam. I never missed a class and I found your lectures to be very interesting. I was hoping you could possibly tell me where I went wrong as far as preparing for the exam. I am very worried about my final grade in the course. If you could get back to me and let me know a time that is convient for you that would be great.”

Why does this chap my lips? First of all, “many hours”? If you expect to do well on “hours” vs. “days”, we’ve got a problem. But the kicker is that this person made a decision to not come to class the day we covered the exam. (S)he was not sick. Their mother didn’t die. No, this person missed class because (s)he decided to do work (s)he had should be doing outside of class. I do not have a problem with an adult making a decision to trade one obligation for another. All of us have to do it from time-to-time, but we pay the consequence. My problem is someone asking me to spend another hour of my time because (s)he was busy during scheduled class time. Growl.

Please keep track of the fact I’m bitching about a very small subset of students. Most are wonderful. I just submitted a scholarship application for a varsity athlete who has maintained a 3.89 GPA (on a 4.00 scale) taking real classes. This guy is a captain of his team. This is the kind of person who if he misses class he apologizes! So he misses class for a regularly scheduled game and says he’s sorry, while the person above misses class because (s)he is behind the 8-ball in another class, and asks me to repeat the class!

Super-Pup, Clinical and Ride stuff, Exam.

Travis the super-dog came home today. For those wondering, he is a 12 year-old Cardigan Welsh Corgi. He is still paralyzed below the “waist” (if you knew travis this term would make you laugh), but has control of his bowels and bladder. Imagine holding up the back end of your dog while he does his business – For my wife and I this is not something we have to imagine any more... He was VERY happy to get home. While I hope he recovers enough function to walk, as long as he is happy and not in pain I’m ok with things. Again, thanks for your well wishes. It is funny how it makes you feel better to have people you don't even know chime in. I really do appreciate it.

I had another round of clinical time Saturday night. The doc on duty is taking a stats class, so I taught him some stats and he let me shadow him around. He is a good teacher and I had a fine time. There were, however, no real stories to tell. I did get to see one of the patients from the night before (a psych patient). I just heard tonight that Sunday made it three nights in a row for her. You think she needs to be admitted somewhere?

Sunday I rode with my “preceptor” for the first time. He is about my age and has two kids as well. He has been a paramedic for a long time and is very street savvy. I was there from 0800 to 1800 and we only had three calls. The whole agency was slow for some reason (they usually do 60 to 80 calls a day). We did a BLS transport from a hospital to a nursing home, a chest pain and a difficulty breathing.

The only interesting thing about the transport was the facility we returned the patient to. NICE. May I live in such a nice place when the time comes.

The chest pain call was the real deal. Sub-sternal chest pain that started while he was shoveling snow. The pt was 51 and had no cardiac history. While we were with him his pain began to radiate to his back and down his left arm. He looked “bad”. Lots of oxygen, two nitros and two baby aspirin. At the hospital I got to see the 12-lead ECG including some S-T elevation. I also got to see them give the clot-busting drugs. Cool (I’m a cheap date).

The difficulty breathing call was a good one as well. Patient had pitting edema in her lower extremities. Lung sounds were diminished but not noisy. She had been sick recently. When we got her on the monitor she was in A-fib. My preceptor asked me to start the IV and I got it! Not much for those of you who do it all the time, but I was quite pleased. Her mental status started out a bit fuzzy but cleared up with the oxygen. We transported her without incident.

Tonight was our respiratory and cardiac emergency module exam. Big deal in theory as rumor has it that many people get kicked out of the course at this point. Given how similar the exam was to some pratice questions we’ve had, I can’t see how anyone failed it. I got a 97% (it was out of 126 questions, including reading and interpreting 23 ECG strips). I don’t know how others did, but nobody had that “look” when you know people are getting hammered.

We’re on to other “medical” calls. Endocrine, gastrointestinal, altered mental status, etc. If it were not for the ride-time and clinical time, the end would be in sight.

Thanks for reading.

DJ

Don't Ask, Don't Tell

Forgot to relay a story from last night. During a lull I'm hanging with the nurses in the nurses' station (who wouldn't :-) ) and one of them starts in on a dilemma she is having. Seems her 18 y/o daughter is in college and has taken a job at a rather famous restaurant known for its chicken wings and waitresses who wear t-shirts with owls on them (nudge, nudge, wink, wink). The dilemma was whether her husband should be told this news.

I have a daughter. While I really hope she makes different choices, if she were to decide to work at Hooters I'm not sure I'd want to know about it.

My Day Ended Well

Whew what a day.

8:20 class, bunch of crap, 11:20 exam for 160+ people, more crap, sneak home to play with my daughter while my wife picks up our son from school, back to work to post the grades of the exam, off to a party where I couldn’t drink as I had clinical time latter, attempt to sound semi-intelligent in speaking with the Dean of the Faculty at the party as he asked me questions about the program I run, then home to change and off to clinical time.

I arrived at the Emergency Department to see people everywhere. Every bed full and people stashed in various halls and spaces. Before I can really introduce myself and say why I am there a Physicians Assistant I know sends me into a room to get an initial set of vitals on a patient. In the three hours I was there I personally worked with:

20 y/o male with severe ankle sprain from a basketball injury.
3 y/o male with seasonal allergies.
7 y/o female with injury to her ear from her dad cleaning it too rigorously.
14 y/o female with medial right knee pain from basketball injury.
22 y/o female with pelvis pain radiating to her right flank.
29 y/o female with abdominal pain radiating to her left flank.
63 y/o female having a panic attack.



That’s all I remember.

I’m now home. I expected a bunch of pissy e-mails from the exam today (with 160+ people, 16 of them are in the bottom 10 percent and they are NOT used to it). Instead I get ONE e-mail, and here it is (I sent a congrats e-mail to those who scored 90 and above):

“Dear Prof. **********,
Thank you so much for congratulating me on my grade and for everything this semester. I truly cannot tell you how much I loved your class and how much I am going to miss having you as a professor. Your class was always something I looked forward to, and it was always the highlight of my conversation whenever anyone asked me how school was going. Thank you for making it such an enjoyable experience, and I look forward to being in more of your classes in the years to come.

Sincerely,
*******”

And that, dear reader, makes my day (believe me, the pissy ones will come, but for tonight I don't care). I’m off to bed.

DJ

EMS posts coming (I hope)…

Travis the super dog is still at the Vet’s (as expected). He is now a "1" on a scale that goes from 0 (no function what-so-ever) to 4. The Vet hopes he will get a lot more function back over the next week or so. Thanks for your well wishes via comments and e-mail. He’s “just” a dog, but he’s our dog and we love him.

Work has been wicked busy but should slow some after tomorrow (tonight a project raps up with a presentation by my students to a board of directors and tomorrow is the exam in a team-taught class I’m in, ending my section).

Our respiratory emergency and cardiac exam has been moved to this coming Monday. Between now and then I have 8 hours of clinical (emergency room) time and 10 hours of ride time scheduled, so I should have some more EMS related posts coming up.

What could I have done with $2,500?

I can think of a lot of ways to spend $2,500. Lots. Some responsible, others not.

No matter. I have been sick as a dog, so to speak, and woke up tired and cranky. Wife goes to feed Travis the super dog, and calls me down to look at him. Paralyzed from the "waist" down. Poor pup.

So, to the doc. Basically three options:

1) Kill him.
2) Treat him with meds and hope he gets better.
3) Send him to the Doggy surgeon.

Option 3 costs $2,500! For a $&(#*&(*&$ dog! A dog! But the vet claims this gives him the best prognosis.

He is family. And though it hurt$, we can afford it (it just zeros out any disposable spending we can do for the year).

I'm still cranky, but I think we are doing the right thing.

ACLS

Advanced Cardiac Life Support (ACLS) is an American Heart Association course that was sandwiched into the middle of my medic class. The teaching of this section was farmed out, and it has been a mess. We took the written and practical (“mega code”) exam tonight to see who would earn their ACLS card. The test was based on a book we were never given. Our didactic time was spent with our local EMS protocols and drugs while the test we took included drugs and therapies, many of them for the hospital setting, that we did not cover in class. Do not ask me how I passed, as I was sure I failed it (passing was an 85 – I got a 92). I was the only one out of 18 people to pass. The test was unfair and/or the teaching was horrible.

I’m looking forward to getting our regular instructors back (even though that means we have our module exam for respiratory and cardiac coming up).

Couple pictures...

When you want to grill out, you want to grill out...


Travis the super-dog asleep in the kids' play tent.

10 minutes of free time and I type this...

I’m waiting on a student for a meeting and will try to write as much as I can until she gets here (if I start doing any “real” work she’ll appear immediately…).

Medic class is going OK. We had a cardiac quiz on Monday which caught some people asleep at the wheel (7 out of 19 of us failed it). I made a couple of idiotic mistakes (there were 25 questions so each mistake was painful) and just didn’t know the answer to one question (they said to pharmacology on the quiz, but there was, and it was for a drug paramedics can push but we can’t…) and snagged an 88 (the oppsessive in me can’t take the <90 ). Given the 7 failures, I need to be less worried about my 88 and more concerned with thanking my lucky stars. Last night was our first night for an ACLS course which is outsourced to different instructors. Topics included mega codes, dropping tubes, rhythm recognition and pharmacology. Overall a fun night, but we went from 1830 to 2220, making it a long day.

A student I have known for four years (she was a student in a first-year seminar I taught) just found out she got into a Ph.D. program in which she was really interested. She is someone who does not look as good on paper as she really is, making crafting her letter a real challenge. I am very pleased she got in as she’ll do very well and will enjoy it (these are not always correlated).

My EMS agency has a “points” program where each call or shift you take is rewarded with “points” which can be redeemed for EMS gear and clothing. I put “points” in quotes as, in the end, the math isn’t so hard: You get a $0.50 credit for each call, standby, training or shift you complete. It was a busy year for us, and I went on almost 25% of the calls we ran last year! Between calls, shifts, etc., I have about $240 to spend on EMS gear. I like shopping when it won’t cost me cash out of pocket (clearly, it DID cost me…).


Student is here – got to jet…

DJ

I'm calling with regard to my son...

Every now and then an administrator tells me a story that kills me. I heard one such story last week...

One of our students interviewed for but did not get an internship at major business (you'd recognize the name).

The kid's mother calls the company and explains to them that they should really give her son an internship because [insert all the things all of our mothers think about us here]. His mother calls the director of resources! Can you imagine getting that phone call? Can you imagine not laughing on the phone as the mother is saying you should hire her smart, independent, son?

There are too many kids who are 20 years old and have never had something disappointing happen where mom and dad did not come to the rescue. CRAP happens. Usually, but not always, for a reason. If you don't let your kids figure this out when they are 7 (or 10, 15 or 17), they are going to have a TOUGH time when 25 comes around.

EtOH with the boys.

The last two medic classes have ended up with me drinking beer with the instructors. They are both really nice guys, and usually have a cast of firefighters with them who are fun to interact with. Given I tend to not drink with my students, it is a bit akward to consume with my instructors, but it was their idea and who am I to say no?

Work has been super busy in a bad way. I am feeling like I can't do everything as well as I'd like. In know, welcome to adulthood...

I have not been going on many EMS calls lately. The students have filled the board and I took my name off so I could concentrate on the clinical and ride time for my class. I am still waiting for that to start, but it should be soon, and I am sure it will provide a lot of stories.

The student conduct board is still going full tilt dealing with academic dishonesty cases from the fall. My lord.

I'm off to bed. I appreciate those of you who stop by for a read and am sorry things have been so slow. Things will pick up when my ride time starts...

DJ