Life in Manch Vegas

Moving Day

noreply@blogger.com (Anonymous) — Thu, 10 Sep 2015 10:02:00 +0000

This blog is moving.

Actually, moving day was yesterday. I had a long hiatus that I hadn't planned on. And I did some thinking. Basically, what I realized was that I needed to change my writing venue. If I wanted to start again I had to do it in another place with a different focus and a different intent.

My new place to post at is here.

I look forward to reading your commentary there. And thanks for reading what I've written over the past 10 years. I really, truly appreciate it.

The Blast of Winter

noreply@blogger.com (Anonymous) — Tue, 03 Feb 2015 15:51:00 +0000

It is incredibly cold outside.

Over the past week this part of the world has had considerable snow. I believe the totals in the New England area vary between 36 and 40 inches since last Tuesday. Not only has it been incredibly cold and snowy but there have been periods of high winds as well.

If you think about it, there has been very little snow this winter until now. And the predictions have been consistent that this is supposed to be a high quantity winter as far as the snow is concerned. I would say that the weather over the past week has more than made up for any shortfalls that there would be.

As I sit writing this I am at work. Waiting for the phone to ring. Expecting nothing more than a busy day when all is said and done. And I don't feel especially well; I am tired and I'm dealing with some mild to moderate nausea. The only thing I can think is causing the nausea is the possibility that I picked up a stomach bug from my grand-daughter. She has been sick since Sunday. I am hoping, however, that she is starting to come around and feel better. At the moment she is either with her father or well enough to have gone to school. I don't know which.

There are some things that are better than winter. Actually there are many things that are better than winter. Like summer. And warm days. And the feel of the sun on your face in the morning. Also, there is nothing like a good glass of lemonade on ice when it is hot. Or a cookout. Or being in the stands at a baseball game. These are all good things.

I miss the summer, especially when the weather is a cold as it is now. I do know, however, that spring will come first. The best part is that pitchers and catchers report in a little over 2 weeks.

The Oral Station

noreply@blogger.com (Anonymous) — Tue, 20 Jan 2015 15:18:00 +0000

I imagine that some people, when they read the title of this post, will maybe have unsavory thoughts cross their mind. If you do, shame on you. But I will admit that the title can be somewhat misleading.

The past two Sundays I've worked as an ALS skills evaluator at different testing sites. Both are always well-run, and the group of cadre that work as evaluators are a dedicated bunch of people. Not to mention interesting and always somewhat dysfunctional. This exam is skills - based as opposed to written; there is one of those as well, and as exams go it is among the most challenging exam I had ever taken. All things being equal, however, the skills exam is just as daunting. Twelve stations total for Paramedics: a trauma assessment, two cardiology stations, two IV and a pharmacology station, a random skills station, a spinal immobilization station (yes - even though many states are getting away from long board immobilization the National Registry still requires proficiency, at least for now), and two oral board stations.

My station of choice is the oral board, hence the title of this post. I do it for a couple of reasons. The main reason is because it gives me a good idea how people think and whether or not they indeed think critically. It is disappointing how many don't. The other reason is somewhat selfish on my part; it is much easier to set up and break down.

There are usually two evaluators, one to handle "A" and the other to handle "B". I was on both sides of this in each place I worked at. Plus when there were retests I got to do this in different stations. This is pretty normal; doing the retesting can either be good or bad, depending on the state of mind of the individual candidates.

I try to keep in mind that there is stress no matter what. All of us who do this have been there ourselves, and most of us do our best to not add stress to the load. But it is stressful, even for people who have experience but need National certification.

So when they come up again I'll likely be there.

Images

noreply@blogger.com (Anonymous) — Tue, 30 Dec 2014 18:19:00 +0000

Statue of St. Benedict of Nursia
Photo by W. Trachim

I have always liked photography. There is something to be said about artistry when talking about photographs as opposed to painting, writing, music, or any other artistic medium. I have never, ever considered myself an artist of any sort, even when I was working as a musician. And while many people would say that music is indeed an artistic medium (I would never argue that point, by the way), I think I've always considered music to be more technical. And I suspect I have this view because I have always believed that numbers and music are intimately intertwined.

Photography is a whole other matter. And I don't know how to describe it. Maybe it's because there are no numbers involved. I think it's all about what you see. Interpretation. Viewpoint. Those things that make how you translate a picture into words.

Martha gave me a camera for Christmas. A Canon EOS Rebel. Plus a 300mm zoom lens in addition to the standard 35mm lens that came with the camera. I really think that this is one of the best gifts I've been given. It has given me the ability to look at things from a different perspective. And I have only just started playing with it.

Some of the photographs I have taken over the past few days are on social media. I'm putting some of them here as well. I know I'm not unique, as far as taking photos, A number of my friends are phenomenal photographers, in fact. Those folks are incredibly good at it. I'm just getting started. It's funny; I feel like I graduated from a smartphone. It's not to say I won't use my phone to take photos anymore, but I can definitely tell the difference.

Jasmine and Belle
Photo by W. Trachim

California Pine Cones and a Coloring Book
Photo by W. Trachim

I think I will be putting more of these up as I go on. Let's see if I can get better at this over time.

The 2014 Holidays

noreply@blogger.com (Anonymous) — Thu, 18 Dec 2014 11:49:00 +0000

I often find myself reflecting on this subject - at least once a year. And it only happens because of the difficulty that seems to be present. When it does, I am fully aware of the weight it adds to me. Figuratively, of course. And I am certainly not the only person who has trouble during the holiday season. It's a hard time of year for many people.

Two days ago - Tuesday - was an especially difficult day for no apparent reason. I got up, went to work, and proceeded to find myself feeling as though I'd been grated by sand paper. I don't know another way of describing the feeling, but there it is. Plus, I was feeling depressed. Really sad. It occurred to me that part of the reason for this was that I have had a tough time during the holidays. Between working a lot of hours, the stress that comes with the schedule I keep, and the needs of my family, it had added up. Not to mention the weather; really wet and gloomy.

Fortunately, I have good friends. I commented on my state of mind on social media, and a number of people responded with words of encouragement and support. I am grateful for that. And I certainly won't forget it. Yesterday was a much better day, and right now I am entering the home stretch - two hours left of a ten hour shift in the Emergency Department. The night watch. Little bursts of activity on a given overnight, but not so much this past overnight. I have had much, much worse.

Today? I am working tonight at the firehouse. After I get through with this shift I am going to go home and try to sleep for a while. Friday I am working the second of two 24 hour shifts for the week. And I am off for the weekend. Hopefully I will be able to get whatever stuff that needs to be done completed. The only thing that will be challenging will be Monday, December 22. That would have been my mother's eighty-third birthday. But I will get through that.

Searching For A Subject

noreply@blogger.com (Anonymous) — Wed, 22 Oct 2014 12:03:00 +0000

I've been working on this post off and on for about a week. I have not been writing at all lately, or even infrequently at best. It's not because I've lost interest, but I seem to have run out of steam.

Part of the reason that I write infrequently or sporadically is because of the difficulty I have in finding things to write about. It's not that subjects aren't available; certainly there are. My problem seems to be that there is simply too much to consider. At least I think that is what's going on, but I can't be sure. With that in mind, I have some things percolating in my head that I may actually be able to put in a post.

Over the past week my my work life has undergone a phase shift. A couple of weeks ago I was offered a position with Lifeline Ambulance, which I accepted and started at the beginning of this week. They are an EMS transport provider based out of Woburn, Massachusetts. That also happens to be where I will be working the two 24 hour shifts, Tuesdays and Fridays. I was happy with that schedule but I am having to shift everything else around because I accepted this job, and I may end up with some of my work going away. Or maybe not; I have had to make changes which, for the most part, have been reasonably successful. But like anything else, it is always interesting when change is effected; other things are usually always impacted. So you adjust. Improvise. Adapt. Overcome. Always do your best.

The weather here has fluctuated over the past couple of weeks. A lot. And my body is feeling it. We are supposed to be getting a considerable amount of rain over the next two days. I certainly can tell that this is happening due to the joint soreness, especially in my shoulders, my hips, and the back of my left calf. Plus I have picked up a dry cough. I'm not certain where it comes from but I don't appreciate its presence. It has to be due to dry air in buildings. But I'm likely wrong about that; there has been a lot of illness around. And I'm sure I picked up something I shouldn't be fighting.

As I write this I am watching the sky continue to be dark. At 6:00AM. Over the past 6 hours the Spice Fairy has visited. Multiple patients in with issues related to it. I'm glad I haven't had to deal with most of the associated nonsense, but I hear about it from other staff. In addition, I have no doubt it will continue. I expect nothing less.

Weekend's Early Start

noreply@blogger.com (Anonymous) — Sat, 27 Sep 2014 14:50:00 +0000

Saturday morning and it's growing light.
I look out my window and remember the night.
The story is starting and this story ends
And I feel like I need you again.

Time used to mose softly when I was at home.
It went on without me, and left me alone.
Now it's sits at my shoulder and claws at my hand
And I feel like I need you again.

Well, I recall September, and leaves turned brown
Remember October, left leaves on the ground.
And here comes December like an elderly friend.
And I feel like I need you again.

-- Tom Chapin

It is nice to have weekends off, for the most part. I get to spend time with my family, which is something that was denied to me for years due to the demands of the job. And most of the time I can sleep in. Except for this morning; I was awake at 4:30. For no reason. But I've been relaxing and watching Peyton exercise her incredible imagination. Later on I think Martha and I are going to go to the beach. Even if we don't go, just being able to spend time together is enough.

There is enough to do here that I wouldn't necessarily have to leave, either. That's true enough. However, it is a nice enough day today (and tomorrow is supposed to be nice also) that I may get nothing done. Not a problem, though; sometimes it's perfectly fine to do nothing.

And I'm fine with that.

The Dark Morning

noreply@blogger.com (Anonymous) — Mon, 15 Sep 2014 09:18:00 +0000

"It is always darkest before the dawn breaks" is a quote I have heard more than once. The meaning of this is usually that in a bad situation the worst of it occurs before turning the corner. In this case, however, I have the more literal interpretation that quote in mind.

As I write this I am at work, and there is nearly nothing going on. I'm sitting at the desk us Paramedics refer to as "The Penalty Box." It is approximately the same size as a regulation hockey rink sized penalty box with not a lot of room. On the desk surface in front of me are a computer screen and keyboard, a telephone, a monitor for security cameras, a multifunction device that has a blood pressure cuff, a pulse oximeter, and an oral thermometer, various office supplies, a container of disinfectant wipes, three boxes of nitrile gloves, and a two-way radio. The tablet I am writing this post on goes back and forth between resting on my knee and the table.

It is nearly 5:00AM, and it is pitch black outside. Plus, for early September, it is cold outside. It is 44 degrees Fahrenheit - admittedly not below freezing, but a bit cooler in September than one would expect. I was surprised to see the temperatures, but not as surprised as I should be. We do live in New England; the weather and the temperatures can be somewhat labile. We should expect that, though. I suspect there will be more of the same as the season changes further. We haven't seen changes to leaves yet, but I wouldn't be surprised if that starts soon too.

Tomorrow I have to report to the Federal court in Concord, NH, for jury duty. The second time in that court since 1993, and the fourth time in 20 years. All because I vote.

Perhaps I shouldn't be snarky. It is an obligation, and it isn't like I've never served. But it is inconvenient, and I would be lying if I said that I was looking forward to it. There are other things I would rather be doing. Like working - sounds strange, but yes, I would rather work than do this. However, I have been called. And I will do the right thing.

The sky should start to lighten in the next hour or so. And I will wait for it to happen. Because at that point, it is the beginning of a new day.

The Bounce

noreply@blogger.com (Anonymous) — Fri, 22 Aug 2014 20:51:00 +0000

Well then. I finally drew up the strength to write this post. It has been a challenge this summer, to say the least. It has taken me a while to digest everything I've been working through, but I think I'm finally able to write about it all.

Since the last post I wrote on May 2, a few things have happened that I probably should comment on. The most significant of these is the passing of my mother. She died on May 5 after a long struggle with her health. She had a lot of stuff going on, some of which I have written about in the past. The most significant thing she had to deal with was dementia. She was aware of her memory loss for a great deal of time, which was really hard for her as well for us who survive. By the end of her life, however, her short term memory was pretty much gone.

In addition, she also had pernicious anemia. By itself this played a huge part in her decline. Over the last year of her life she received a huge amount of transfused blood products. I suspect this contributed to her demise by the effect it had on her immune system. Plus, she was the victim of her own choices during her life. COPD, a number of Transient Ischemic Attacks (TIA's) that were likely undiagnosed, and issues with heart disease probably all associated with her lifelong smoking, were all most certainly contributory.

All of that said, she was incredibly stubborn. Fiercely independent, in spite of all of the problems she faced, she lived by herself until about 6 weeks before her death. My brother Jay found her on her living room floor, the result of a fall. One of the last things she did before finally leaving her home was to smoke a cigarette. It would be her last.

When we made my mom's final arrangements, we were all surprised at the number of people who came to her funeral. But that in itself was a testament to how much people cared about her. She was a good person, a great mother, and a wonderful friend to many. And I miss her.

Another significant event was dropping one of my jobs. I no longer work for Cataldo Ambulance. My last shift there was Saturday, August 9. It was time to go - after 6 years there I had enough. The main reason I left was because I wanted to spend more time with my family. Not having Saturday available to me was really starting to wear me down. Plus, the resources that were unavailable during Saturdays and not being able to get anything done was becoming frustrating. I think the straw that broke the camel's back was the Saturday three weeks before my last. Too much happening that day as well as dealing with people who were just making my life really difficult. I simply hit my personal wall. At that point it became clear that it was time to go.

So now I have Saturdays back. The first one was spent with Martha and with my granddaughter Peyton. Great day in Boston. Tomorrow may be a beach day, weather permitting. I look forward to many more.

On that, time to sign off. I will do my best to write more. Maybe now I'll be able to.

Twilight

noreply@blogger.com (Anonymous) — Fri, 02 May 2014 16:14:00 +0000

My mother is dying.

Someday we all will die - that is a fact. In my line of work I see people actively dying often enough, plus I deal with enough situations where efforts to resuscitate someone who is clinically dead is called for. Sometimes we get them back. Most times we don't. And I suspect this will not be one of those times.

We've been watching her decline for some time. Between suffering from dementia and battling the hematologic disorders she was diagnosed with, plus other chronic conditions that have affected her, she has had a difficult time. All of her medications, with the exception of those being given for comfort, have been stopped.

Probably the hardest thing was watching her cognitive abilities slip away. She was talented with various arts and crafts, and she had a way with people. And she could tell good stories.

As I write this I am sitting next to her bed. She is sleeping fitfully; she has been medicated due to her being agitated and disoriented. She has not been eating, either. One of the staff brought her lunch in, but I don't expect she will eat. She stopped that last night, from what I have been told. I don't hold out a lot of hope for her eating anything now, either. But all of us - I and my family - will keep watch over here while she is still with us.

She has a living will and a do not resuscitate order in place. They were implemented when she still had some semblance of memory. We will respect them.

And we will wait.

Marathon Monday

noreply@blogger.com (Anonymous) — Mon, 21 Apr 2014 15:36:00 +0000

As I write this post there are two major events going on in Boston: the 18th Boston Marathon and the Red Sox and Baltimore Orioles at Fenway Park. I'm not certain how many years the Sox have played on Marathon Monday, but I know it has been many. For a number of years I worked during the Marathon with staff covering the portion of the route that runs a through Newton. There are a good number of my friends and colleagues of mine working on the route now.

The air is definitely different this year. Last year, with the events surrounding the race and the aftermath, turned out to be unspeakably hard for so many people. The stories of those who were affected - and came back - have been, to say the least, both encouraging and inspiring. And it has made me realize that the issues I have faced have simply paled in comparison.

I am very proud of the people I work with. They are good at what they do, and their courage and character are unmatched. I think of them, and I am hopeful that they have a really good, positive, and uneventful day on the race course. And I hold out the same feeling for my friends working the game at Fenway Park.

I have the game on now, and the voices of the Red Slx, Don Orsillo and Jerry Remy, are wearing running shoes. They are doing so in support of the runners on the course. And that is awesome.

They and everyone else down there today are Boston Strong.

The Night Shift - Round Two

noreply@blogger.com (Anonymous) — Thu, 10 Apr 2014 08:24:00 +0000

Another mobile post on the overnight shift. It is interesting being the first person people see when they walk in. Regardless of who they are and why they come, in principle all should be treated the same way. Sometimes, however, it's difficult to do that, mainly because the people who come are not always forthcoming with the truth. When that happens, my inner cynic wakes up, and the voices in my head become loud indeed.

Some general observations I've made:

1. The sickest people don't come on their own. And usually they don't want to come here if they can help it. Those are the ones you know will die without help.

2. Those people who could stand to wait until normal business hours to be seen inevitably show up at 3:00 in the morning. And it is usually for problems that don't need intervention then and there.

3. Those who are homeless that are seen here, if it's cold or the weather is inclement, will inevitably try to hide out in the waiting room so they don't have to go outside. That happened last night, in fact; a patient who had been seen for a couple of different issues managed to get under the radar for a couple of hours before she was discovered. Clearly she was stalling; her plan was to get admitted so she would have a place to sleep. But that didn't work out for her. And I discovered her at 6:30 yesterday morning...

4. The people who deserve misfortune the least seem to be the ones who suffer the most, no matter what the reason is.

5. Time flies when you're busy.

Some of these observations bleed over into my work in the field as well. The thoughts I have in the end don't always fit precisely into the same mold, but they are close enough. And I'm sure I'll come up with more as time goes by.

Hands Free

noreply@blogger.com (Anonymous) — Tue, 08 Apr 2014 15:59:00 +0000

I'm trying something new. Rather than use a keyboard, I'm going to compose this with my voice rather than with my fingers. My new phone has hands free capability. My old phone did as well, but I never used it because I didn't think I could. Also, I didn't realize the phone had it until it finally died.

The only thing that I'm having trouble figuring out is how to insert carriage returns or extra spaces or any specific punctuation. I know that if I say certain words like the word "period" or "comma" they will insert automatically. However, I don't know how to plug in other types of punctuation or anything that is special in terms of text. But I'll figure that out as I go.

Between insanity at work and being sick, it's been a rather interesting week. This past saturday wound up being a 20 hour work day. It was mostly do to a lot of volume, but there was a very interesting call that came in from overseas involving a child, a stressed out international medical team, and a big time crunch. That ended up keeping me busy for a lot longer than I planned. In the end, however, it worked out just fine. But it did take a lot out of me. Plus, there were internal shenanigans at the end of the tour that kept me on the clock for about three hours extra. By the time I left it was almost exactly 3:00AM. That made my day twenty hours long instead of the normal sixteen.

On Sunday and yesterday Martha and I were dealing with either an intestinal bug or we ate some bad food. I suspect the former semi colon if it were bad food I believe we both would have had similar symptoms but they were just a bit different. And I was able to go to work yesterday. Martha stayed home and slept because she really needed it.

As I compose this post I am multi-tasking. I'm working on household chores. That means doing dishes , laundry, and the general pick up of household that has a small child living in it. And that work seems to never end as the girl is a four year old tornado. Because she is such a lovable child, though, I overlook a lot. That's tough for me to do because I am somewhat obsessive-compulsive, and seeing anything out of order makes me insane. But I really work at understanding that she is learning about how to avoid entropy in her own time. And hopefully she'll be a lot more casual about it than I am.

Tonight is an overnight shift in the emergency department. Considering how things are, I'm sure it will not be boring. And I have no doubt I'm right about that. As for the hands free writing, I got about three quarters through. The last couple of paragraph so are typed. Not perfect, but it's something new to learn how to fo. It will get easier over time.

A New Toy

noreply@blogger.com (Anonymous) — Fri, 04 Apr 2014 16:47:00 +0000

I had to replace my phone. I was having trouble with applications crashing regularly and with the phone running out of memory. It was starting to become a real issue as this is how most people I know contact me. Plus I wasn't due for an upgrade until October.

Last night Martha surprised me with a new phone. A Samsung Galaxy Note 3. I had an idea she was getting it for me but I wasn't entirely sure. But she showed up at work last night with a Verizon bag in her hands. In the bag was the phone. The tech at the store got the number activated but left the rest for me. I was absolutely fine with that because I am somewhat particular about how I wanted it configured. I have it mostly the way I want it now. With a bit more fine tuning I should be good to go.

As I already have a Galaxy Note 10.1 tablet as well this will be a solid complement to that. I really like Samsung products; they are well designed and very friendly, not to mention powerful. So far I'm very happy with it. And today I put the phone in an Otter Box Defender case as well as a screen protector. This should support the phone quite completely.

This post is coming from the phone, in fact. It is proving to be very easy to write. And I expect to be able to do this more frequently now that I have such a good tool for the job when I'm out and about.

For now, I'm going to recuperate from some long work days before it starts again tomorrow.

The Night Shift

noreply@blogger.com (Anonymous) — Mon, 17 Mar 2014 04:32:00 +0000

About six weeks ago I started working in the Emergency Department at one of our hospitals. I work up front, greeting patients and doing the first step of triage. In a nutshell, that is the core of the job. It is not that difficult, but the key skill someone in this position has to have is the ability to discern who is really sick and needs immediate care as opposed to those who can wait. Most of the time it isn't difficult. Sometimes it is; it depends on the volume and the circumstances.

Most of my scheduled shifts are overnight, from 10PM to 8AM. Occasionally, however, I'll pick up other shifts as well. I work approximately 24 hours a week in this job. I find that between this, my job in Boston, and my shifts with the Fire Department keep me plenty busy.

Right now I am sitting in the greeter chair. I've been here for a couple of hours and it has been a little bit busy. We see mostly minor stuff, but as I said, it can get hairy from time to time. The last tour I worked here had that quality, especially near the end. We'll see what happens here as the night progresses.

I am back here tomorrow, eight hours after this tour ends, but only for six hours instead of ten. That will give me enough time to get some breakfast, take a nap, and do it all again. The good thing is that it is not sixteen hours in a row; I did that yesterday.

It is hard to believe that it is nearly Spring because it is so cold outside. I know the weather will change and start to warm up. Right now it is a waiting game; what I suspect will happen, and always seems to, is that the change of season will occur in the blink of an eye. And people will complain about Summer showing up out of nowhere. But I expect no less.

At the moment I have nothing to pontificate about. But give me time; I will come up with something.

Four Degrees

noreply@blogger.com (Anonymous) — Fri, 07 Feb 2014 06:00:00 +0000

That is the current temperature outside as I write this post. Nearly 1:00AM and I am still awake. What a surprise.... I suppose that has become the new normal over the past few weeks. Probably due to the changes in my work schedule; I have no doubt that the modifications I've made recently have contributed to the weird hours I keep these days.

One of the changes is relatively recent; I started working in the Emergency Department at Catholic Medical Center in Manchester a couple of weeks ago. I was hired for 24 hours per week to work up front, and I am orienting in the department now. It will take me approximately 5-6 weeks to get through the department orientation, but I think once it is done it should be a pretty interesting job. It will certainly add to my experience, and that is something I look forward to. More learning, but it is good to learn new things. Learning is like exercise; the more you learn, and the more different things you learn, the more well-conditioned the brain becomes. And I believe the folks at Lumosity have gotten it right, in terms of the word "neuroplasticity"; the neural networks we possess expand exponentially when they are stressed. And that is as it should be.

We got a load of snow out here yesterday. My back step had a total fall of approximately 10 inches, which was more that what was predicted. And the temperatures reflect the snow counts as normally when there is no snow the air is a bit warmer. Not now, I'm afraid; it is simply cold. But it is winter in New England; shouldn't it be cold? And this one is as I remember it when I was growing up.

As I write this I am working. Not a surprise there; it is technically Friday morning, and I have been here for a bit shy of 7 hours. We got in from a call a little while ago: an elderly male with mental status changes. Hallucinations and visual disturbances, to be more accurate. Pretty interesting and diffucult at the same time. History of end stage kidney disease - he is supposed to have a dialysis shunt implanted soon. Maybe that will take care of some of the issues, but it is hard to know. Also a diabetic; this always compounds things because of the nature of diabetes. It is an insidious, vicious disease that destroys organ systems over time because of the damage done to peripheral nerves if glucose levels are not controlled. And there is no such thing as age discrimination as it can affect anyone no matter how healthy the person is. But it has to be tough to deal with when you're already compromised metabolically, not to mention physically. And the damage to his kidneys is already pretty much complete. Between the two pathologies that are present, he will likely continue to have a rough row to hoe as time goes on.

I am hoping not to have to deal with the cold again tonight. Hopefully I'll be able to get a nap in. But anything can, and usually does, happen, so if I expect crazy things to happen I won't be disappointed when they do.

No Color

noreply@blogger.com (Anonymous) — Tue, 21 Jan 2014 18:16:00 +0000

Or at least very little....

I took this photo right outside of my front door. The only real color that is present is in three distinct areas. The first is the fire hydrant at the bottom left. The second is the stop sign. The third is on the building across the street.

They are splashes, at best. Note that there is really not much else in the picture. The white SUV in the middle of the shot was accidental; I couldn't have planned that if I tried. All I wanted to do was capture the dirty whiteness of the old snow on the ground, the deep gray of the pavement, and the off-gray in the sky. The white building across the street actually jumped out a little more than it usually does because of the lack of color present.

I took this shot because of the conditions of the day. It is roughly 10 degrees Farenheit outside as I write this. Actually, 9 degrees according to the digital thermometer outside my door. There is a major winter storm on the way. Depending on who is providing the forecast, those of us in Southern New Hampshire fortunate enough to live here can expect to see anywhere from a dusting to about 10 inches (25cm for my Canadian and European friends) over the next 24 hours. It is12:45PM as I look at my clock. Snow hasn't started here yet, but I expect to see it anytime.

I am worried a bit about Martha; right now she is in a meeting with a client in Brattleboro, Vermont. She had to cross both Temple Mountain and the Monadnock Region of New Hampshire to get there, not to mention the Connecticut River. I truly hope she gets a head start on the snow. And I don't expect to see her for the next 3-4 hours, depending on what other work she might have to do.

So I found an outlet for my frustration about not being able to start PA school. One of my friends told me about a website that is a hub for online learning, mostly at no cost. So I investigated it, and discovered there were some things I could do to at least keep my mind from withering on the vine. The site is called Coursera. The course offerings are varied as are the institutions offering them. It is all online. And while the courses themselves are provided at no cost, to get what they term "verified certification", or actual proof of completion, there are nominal fees for that if one so chooses to go down that road. I haven't decided about that yet, but we'll see how it goes and whether or not I like what I get out of it. I don't know if any of these can be used for credit or not. That, in itself, doesn't concern me. Right now I have close to 170 hours of undergraduate credit under my belt; I don't think I need any more. But it would be good to know if that is an option. If I become so inclined, I will check that aspect of it out.

I had forgotten how much pleasure I take in writing for its own sake. I have been told that I write well and that I express myself better than most. While I truly appreciate the compliment (and I really, really do), the real reason I write is because it is an outlet for me. Plus, it is a way that I can organize the absolute spider's web of stuff in my mind by putting it down, looking at what I said, re-arranging it in a way that makes sense, looking at it again, then letting it sit. Sometimes I go back to it, look again, discover that I either misspelled a word or two or repeated a phrase, and fix the errors. It is good exercise for the mind.

In some ways, it is sort of like prayer; once I put whatever is on my mind out there, I can let it go. And I find that if I write to pray rather than speak to pray, it is easier for me to do that. I tried to explain that to a priest friend of mine once, and he understood what I meant, but he is really old school; he didn't agree with me. We ended up having a rather spirited discussion where my point was made by using the following teaching of Jesus as an example: "but when you pray, go to your inner room, close the door, and pray to your Father in secret. And your Father who sees in secret will repay you" (Matthew 6:6 NAB). While writing for an audience is not the same thing by any means, there is a parallel. If I kept a private journal - sometimes I consider that in addition to writing this, but I don't think it's a good idea simply because it would be duplication of effort - that could be considered a form of writing that is in secret, like prayer. And that was the crux of the discussion. I don't think he will ever agree with me on this, but that's okay; he knows where I stand, and I feel like maybe that is enough. And I will still ask him to hear my confession from time to time...

On that note, and at the risk of running the battery on my keyboard down, I think this is a good place to end it for the day. More to follow on the weather. And think about the lack of color in the photo. It makes me want to see Spring really soon....

Processing

noreply@blogger.com (Anonymous) — Mon, 20 Jan 2014 01:53:00 +0000

I hate writing hard posts. Unfortunately, this is one of them. While I haven't written one like this in a long time, I find that doing so helps me work through the difficulty I have dealing with what is in front of me. And this is one of those times where I feel a real need to do that.

This past Thursday I worked one of my shifts at the firehouse. Normal, not too difficult. Went out once at 7:15PM-ish for a call. Chris, my partner, and I had planned grab dinner, but we got sent out. I forgot to mention that we had a third rider, a department member that has ridden with me in the past. Andy - nice guy, really bright, but needs to get some more experience. I like him; he simply needs more grooming.

Anyway, we went out to do this call. Ended up taking care of a fall victim. We got back, were finally able to get a bite to eat, and we were for the rest of the evening. We were up until 11:30-ish. Our third rider headed out at that time, so Chris and I settled down to try to get some sleep.

We were woken up at a little before 4:00AM. We were sent to one of the assisted living facilities in town. Fall victim. We arrived on scene, and the patient - a 75 year-old male - had fallen out of bed. As we were walking up to the room our patient lived in, we heard the cries of, "Help! Help" coming from inside. We found our patient sitting on the floor next to his bed. The one thing I thought was interesting was the posters on the walls. All from Broadway shows. Plus, a very extensive collection of CD's and DVD's. Show tunes. Broadway soundtracks. Plus the DVD's were musicals, movies, etc.

We checked on our patient; he wasn't injured, but he couldn't get up. The house custodian told us he was down on the floor for probably 15 minutes before we arrived on scene. So we got him off of the floor. His legs were underneath him; I suspect they had fallen asleep. When we got him on his feet, he was able to move around without difficulty. And he didn't want to go to be evaluated. That was fine; he wasn't injured. So he signed a refusal of treatment and transport, and we were on our way.

Got back to the firehouse about 4:40. I attempted to sleep until my alarm went off 40 minuts later. I packed up and got ready to end shift. As I was walking into the day room, I caught some radio traffic on the police department channel that got my attention. The dispatcher said, "we got a medical call coming in from __ _________ St. I can't understand the caller; she sounds pretty hysterical." About 10 seconds later we got an incoming call tone.

"Respond to __ ___________St. Echo level medical call. Individual not conscious, not breathing. PD en route."

As soon as we got on the road, about a minute later, dispatch came on the air and asked us to call. When I did, I was told that we were headed to the scene of a suicide. We just needed to declare death and help establish a time. When we arrived, we were directed to the basement of the house where we found a man hanging. It was easy to confirm death as he had all of the obvious signs that I was looking for: rigor mortis had set in, there was dependent lividity (pooling of blood) showing in his hands, he was pale, and he had an angle of about 45 degrees at his neck.

Police officers on scene had his information, and when I asked for it and was given his name, it was like I got hit in the face with a brick. This person was somoene I had known for close to thirty years. I hadn't seen him in a very long time, and I didn't recognize him. Plus, this was someone that others I know also knew well.

I spoke with his wife prior to leaving the scene. Apparently there had been an argument the night before. Not the first, from what I gathered. And it was pretty intense. Intense enough, in fact, where she was scared for her safety. She had planned to leave him, and whether or not she intended to follow through with that, he must have gotten scared himself. On my part, however, that is purely conjecture. I have no idea what was in his head. But that doesn't matter now.

I feel badly for his family. Really badly. And while I am less upset than I was before, I am still pretty angry. But it doesn't matter what I feel or think.

If this were someone I didn't know, it would still be difficult, but when it is personal, it is much harder.

Spring Thaw?

noreply@blogger.com (Anonymous) — Tue, 14 Jan 2014 18:49:00 +0000

Interesting. It is winter in New England, but you wouldn't necessarily know it. It isn't cold, but it isn't warm, either - about 42-43 degrees Farenheit. Raining. The rain probably explains why I don't feel especially well. Mild sore throat and a little bit achy. I'm hoping that the concoction of over-the-counter medication I took earlier does its job. The sooner the better; I have to work tonight.

Yesterday should have been the first day of classes for me in PA school. I've been a bit sad because of not being able to go. While I'm hopeful that I'll be able to go next year I'm not terribly certain about it happening. Mainly because I haven't been able to re-apply due to lack of funds for application fees. I'm going to try to get it done by the end of this week, however, and I hope I didn't wait too long. But all I can do is wait and see what happens. If I don't get in to next year's class, then what? The honest answer is that I don't know what I will do. I have to think about it. And thinking about that uncertainty bothers me.

I am working tonight. Goffstown both tonight and Thursday for each overnight. And I volunteered to do a transfer tomorrow in town - a discharge out of one of our local nursing homes to a residence in town. Unless there is something funky about it there shouldn't be a lot of hassle with it; it should be straight-forward. Most discharges are; the only time they aren't is if the patient has some sort of chronic medical problem that complicates lifting and moving. Or if the patient is morbidly obese. Then it will require more than just the two of us that are assigned to do the call. Since I don't know what's going to happen, I'll just wait and see. At least the other person who picked up the transfer is a good, solid EMT. It should be okay.

Yesterday I worked with a Paramedic that I know but had never worked with before. Good man. Solid Paramedic. We only did two calls, but I was extremely impressed with what we did and what I saw. First one was a chest pain call coming out of a medical practice that is on the hospital property. A relatively young man - early 40s - but a number of health-related problems. And it could have gone either way, in terms of whether or not the complaint was legitimate. While more often than not the complaint or nature of illness is indeed real, sometimes that isn't the case. Kind of interesting; his ECG was abnormal and he had some associated symptoms, but something wasn't right about his presentation. I can't quite put my finger on it. But in any case, it doesn't matter; any patient with that sort of complaint needs to be treated as though it is legitimate. It has to be that way, mainly because if the patient is not treated properly and there really is a problem or something goes wrong, the results could be disasterous. And nobody wants that.

The second patient came out of an area nursing home. An 87 year-old male wth a lot of complicating medical problems. The original dispatch was for difficulty swallowing, but when we arrived it turned out that the issue wasn't so much the problems with swallowing (that ended up being secondary) as that he was having difficulty breathing. The reason for that was because he was in the beginning of an episode of congestive heart failure. Wet lungs. Low oxygen levels. Oddly enough, no hypertension. Plus he was able to speak in full sentences. Regardless, he needed help. And the facility originally wanted to wait until this morning to send him out. That would have been a mistake; if they had waited he would have been in fully-blown failure, and the problems associated with that can ultimately be fatal. We weren't having any of that.

Tonight working in town hould be interesting. With the wet weather conditions, visibility could be limited. I'm not convinced that there won't be mishaps with cars on the local roads. But we'll see how it goes. Plus there is a training class tonight that I would like to attend. Getting my partner to go could be an interesting adventure. But we'll see what happens.

Alternative Paths

noreply@blogger.com (Anonymous) — Fri, 10 Jan 2014 17:00:00 +0000

Sometimes we end up going down roads we don't expect to travel on. Other times we know that we're going to have to go places thinking that we'll take a certain path and then discovering that we have to travel to places we hadn't planned on going. It is certainly that way with life; here I expected to be doing something now that is totally different than what I am doing. While I'm not especially happy about the detour I am on, I figure that there has to be a reason for it.

As many of you know, I was planning on starting PA school this week. As you also know, that didn't come to pass. I'm still smarting over that, but I've gotten past the major upset and disappointment I initially felt when I discovered I wasn't going to be able to attend. Since I had to give up my spot in this class start, there have been a number of things that have happened, either to me or to my loved ones, that made me realize that there was probably a good reason why I couldn't go. The people in my life that I'm referring to are my mother and Martha, my wife.

First, my mom. I'm pretty sure I've talked about this in past posts. If not, bear with me.

My mom is in failing health. Among other things, she has dementia. Her short term memory is almost completely gone, her energy levels are nearly non-existent, and she depends on others - namely my siblings and me - for much of her care. It is only a matter of time before she ends up in a situation where she will need to be in long term care. Additionally, she has been dealing with an issue related to internal blood loss, requiring her to undergo regular blood transfusions.This has been ongoing; we noticed the decline in her cognitive function a number of years ago and we've watched her slowly deteriorate further as time has gone on. To make things more interesting, my sister, who as been her primary caregiver for quite some time now, was injured at work back during the late part of the summer. She is still recovering. And while she's been out, my brother and I have picked up much of her load. This actually, at least for me, has been a blessing because while I knew what was going on, I didn't really know the full scope of the issues my mother faces. And my brother has been absolutely wonderful as he has picked up much more than I ever could. Plus, he handles her incredibly well, which is a blessing in itself. Between us we do what we can for her. And it is challenging.

As sick as she is, my mother continues day to day. We are constantly amazed that she is still plugging along the way she is. That said, we figure it is due to one of three things: she either has an incredible will to live, she has an ingrained fear of death, or some combination of the two. I don't know which it is.

The other thing I've dealt with is helping my wife through a difficult period. She had to deal with a terrible situation at her workplace. While I can't discuss details, suffice it to say that it has been really hard for her because of the personalities involved. Ultimately, she has to change jobs because of the issues involved. And she did this at great personal sacrifice. Consequently, it has resulted in some financial losses for us, making life a bit more challenging than either of us would like. But we're getting through it, and we're grateful for the patience we've been shown.

As it turns out, I have student loans coming due starting next week. I'm now having to pay the price for my education. While it has been totally worth it I'm finding that I have to work a little more - actually, a lot more - so that I can cover that debt. I am hopeful that when I actually can start PA school (with any good luck I'll be able to start a year from now, but we'll see) I'll be able to defer the debt or, if possible, find a way to get as much as possible paid off prior to starting the program. But when all is said and done, that simply remains to be seen. I'll just have to do what I can for now.

One sort of positive in this is that I am starting a new, additional job on the 27th of January. I was hired to work as a Paramedic in the Emergency Department at Catholic Medical Center in Manchester. It is part time; I'll be working 24 hours each week there, and I don't know what my schedule will be as of yet. It comes at a good time; with some of the changes we've undergone, the additional income will be helpful.

So the bottom line of this is simple. We don't always have control of the things we plan to do in our lives. Often in fact we have no control. And you can either fight it or roll with it. I've found over time that rolling with it is less injurious, plus we can find when we handle changes in a positive way we are sometimes given gifts as a result. I'm not sure that this will be the case, but I'm interested in seeing if I'm right. If I am, I'm sure I'll talk about it.

New Year's 2014

noreply@blogger.com (Anonymous) — Wed, 01 Jan 2014 22:51:00 +0000

We are now officially into 2014. I can say that 2013 has been a weird year; to characterize it has been difficult at best. Truthfully I don't quite know how to do that.

Personally, I am still reeling with not having been able to go to PA school this year. I honestly don't know what I'm going to do next year; if I can pay for it (and I'm able to get accepted again, which I should be able to do) I will go. God willing of course. But I have to get there first. It is a part of the journey that I absolutely didn't expect to take. And I am not happy about it. But I'll do what I have to, I suppose.

One thing that has been a total joy is watching Peyton, my granddaughter, grow up. She will be four years old this February, but she doesn't act or even look four. She is very tall for her age, plus she speaks really well. It is not hard for people to see her as being six instead of four. She is inquisitive, which is a two-edged sword because while it is great to answer the multitude of questions she asks, there are days that it is a challenge to keep up. But I treasure this because a day will come when she will want nothing to do with me. I remember going through that with my children as they were growing up, and now that they are adults it is like I have them back again.

I'm incredibly happy about that.

Yesterday was a busy day. Between taking care of my mom and working, it was a long, non celebratory kind of day. But we do what is necessary, regardless of when we have to do it. And I understand that this is the way of life right now.

I realized that the title of my previous post referenced Christmas of 2014 instead of 2013. I'll have to fix that.

In the event that nothing else gets written, I wish you all a happy and prosperous 2014.

Christmas 2013

noreply@blogger.com (Anonymous) — Wed, 25 Dec 2013 17:53:00 +0000

Another Christmas is here.

To be honest, I wasn't expecting much. Not the material stuff; I could care less about that. I guess I didn't know how the day would be. Considering the mad insanity the whole month preceding today has been, I think I was expecting more chaos. But there has been none of that. Today has been, at least so far, a fulfilling, quiet day. I expect it should stay that way. The best part is that I am not working, which I am very happy about. I am spending the day with my beloved, and I am most happy about that. It is a great gift.

On that note, I will keep this a short post; I can write more another time.

Merry Christmas.

Measurable Snow

noreply@blogger.com (Anonymous) — Tue, 10 Dec 2013 20:03:00 +0000

As I write this, I am watching snow fall outside of my house. It is not terribly cold out, but the snow is definitely falling. It's not a huge surprise; since we're into the second week of December there should be an expectation of snowfall by now. And I believe we'll see a lot more of it this winter.

I've found as I've gotten older I have a lot less tolerance for cold weather. When I was a young man I really enjoyed going outside and doing things in the snow. But it's more clear as each day goes by that age works on us and time works against us, no matter what. There is considerably more creakiness now than there was ten or even five years ago. Some days it is really tough getting out of bed. But I do my best not to get stuck.

The other thing on my mind when it comes to this weather is the chance of utter stupidity that can occur out on roadways. When I consider how people can sometimes drive, and the consequences of their actions, I get a little concerned because it usually does not end well for those drivers. Probably one of the craziest accidents I responded to was one where a person driving on one of Goffstown's roads early in the morning on a January day went over a patch of black ice, lost control of the vehicle they were driving, which happened to be a full-size Dodge RAM truck, and crashed head-on into a granite sign. The front end of the truck was in pieces all over the road. The driver was out of the vehicle walking around with what I suspect was a broken collarbone as well as a broken nose. Said individual otherwise was not seriously injured, but the airbags in the truck deployed and the vehicle, as it turned out, was a total loss due to the amount of damage sustained. But that driver was very, very lucky, because it could have turned out much worse, and unfortunately it usually does.

So we are hopeful that there is none of that nonsense tonight and early tomorrow. Otherwise the 12-hour tour I'm scheduled to work overnight tonight will be a mess. And nobody wants that.

Even though it is coming down outside, and I suspect it will be a measurable amount, it is not now. So we wait for more.

But it has covered my car....

December

noreply@blogger.com (Anonymous) — Sat, 07 Dec 2013 19:04:00 +0000

Historically, the last 31 days of any given year have been difficult for me. For some reason, this one has been especially hard. I think part of the reason for that is due to the issues I ran into with not being able to go to graduate school. As of right now I have still not gotten over having to put it off. Plus, with the holidays approaching I find life is a little harder.

Also, I have been working a lot more lately. My average work week has been between 55 and 70 hours per week. It is tiring, for sure. But I have to do it. My current situation requires me to do it. No choice.

I had actually started writing about the fiftieth anniversary of the assassination of President Kennedy a couple of weeks ago. Unfortunately I didn't get back to it due to other things that were going on. I would have liked to have talked about its impact on all of us as well as the significance of his presidency on the nation. But I never got back to writing it because I got busy. I feel bad about that; I had some thoughts that I would have liked to have shared. But I'm not sure it's necessarily appropriate to do so now as the timeliness of the post isn't there. And I apologize for that.

On the other hand, I think there is certainly something to be said for the impending Christmas holiday, as well as the New Year. I definitely believe that advertising for the Christmas season starts way too early. Advertising that begins right around Halloween and continues all the way up to Christmas. It is maddening to see it start so soon and go full tilt right before Thanksgiving. Christmas lights on houses, while pretty to look at, being put up and lit up earlier and earlier. The pressure to have perfect holidays.

It is maddening.

What about the real meaning of Christmas? I'm sure I've talked about it in years past, but have people forgotten what it really is about? On one hand, I think that many have. That said, I do think more people are starting to go back to what it really means, just by the things they do. I think there is a lot more giving and sharing that happens, especially now, where there is still so much trouble with the economy and jobs, etc. I think it is a lot more prevalent now than it ever used to be, and that is nice to see.

For now, at least, I am going to try to keep a positive perspective about the craziness that surrounds the holidays. And I am planning to get through it.

Transfers

noreply@blogger.com (Anonymous) — Tue, 05 Nov 2013 05:00:00 +0000

As I write this I'm working on an ALS transfer truck in Boston I should be trying to sleep but I'm practicing two thumb journalism instead. I'm still attempting to figure out why I agreed to work the shifts I'm on as I came in for 12 noon today, worked until 8:00 pm, came back on for an overnight shift, and tomorrow I'm on from 12:00 until 11pm before heading home.

I must be out of my mind, but there is a method to the madness.

My plans for graduate school, unfortunately, are scuttled for the foreseeable future. I'm going to have to put it off for 12 months, like it or not, because I ran into a problem with financing the program. Totally unexpected but nothing I can do about it. All I can do is fix the problem as it presented itself to me.

As far as today is concerned, it was busy earlier. I went out multiple times to deal with some reasonably sick people. And the phone just rang. The other crew is taking the call that just came in, but I'm sure there will be more to come.

For now the fatigue is creeping in....