The Positive Paramedic Project Episode #112 | 65

This episode of The Positive Paramedic Project comes to us from John Levac of Yarmouth, Nova Scotia.


“65”

I live in a small town.

12,000 strong if you include the county.

When I am driving around it is common to see a 65 sticker on the back of a car.

That is the jersey number of a young football player who passed away in a car accident.  He lost control of his car which ended up on its roof in a small pond.

I was with my children Jonah (10), Jordyn (6), and Johanna (2) at the time when I responded to the scene.  Not something I normally would do but the urgency and proximity had me there.

I arrived to find our first due engine there with driver and operator standing on shore watching a small crowd struggle in the pond. I think they had just arrived as well.

I ditched my radio and phone grabbed the Halligan tool and dove in. It is not a good idea to dive in with a Halligan unless your goal is to get to the bottom in a hurry.

I got to the car. Two occupants were already out. We got a third out quickly but we were struggling with the driver.

I had the seatbelt cut but it would not slide free. After what seemed like forever we managed to roll the car and get him out.

I had no idea he was just a teenager at the time.

I worked him on the banks with a couple of paramedics and some of my firefighters.

Many things still stick with me to this day, the muddy smell and taste of the pond, his chest while I was compressing it and looking up at my van and seeing my daughter watch in terror as I furiously tried to save him.

We managed to get a pulse but he passed a few days later.

For many in our small town 65 is a celebration of his life.

For me it is a constant reminder of the boy I couldn’t save. It still haunts my daughter somewhat as well. She will never look at that pond on the way to the beach the same way.

It’s easy to accumulate baggage, but you need to learn to become friends with it. For quite awhile I let 65 make me angry. It was hard to go for a drive without getting angry.

I’ve come to terms with 65 now.

It will always be the boy that passed away, but he’s no longer the boy I couldn’t save. I didn’t create the accident, I had nothing to down with the cause. We did what we could.

That is an important distinction that will help you live with your baggage and become friends with it.

Be well. Practice big medicine.

– John Levac, November 10, 2017.

The Positive Paramedic Project Episode #111 | Joy’s time

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Time is an essential part of life in EMS.

Counting out the seconds in your head while taking stock of a patient’s pulse.

Watching the chest rise and fall and keeping track of the number of breaths per minute.

Performing compressions while keeping time to Stayin’ Alive looping in your head.

I remember the first time I met Joy.

My office was at the end of the hall in The EMS House.

A straight-line shot from the expanse of the front porch to my cramped chaotic office with its collection of clinical guides, select works of fiction and more than a few choice vinyl LPs, i.e., Lou Reed’s Transformer, Led Zeppelin’s Houses of the Holy, and Bruce Springsteen’s Born to Run. No turntable in sight but I had the soundtrack at the ready should one have ever materialized.

I remember the day she applied to be a medic. Seemingly impossibly young – she sat in the chair next to my desk and I reviewed the form she had completed in the hopes of becoming part of our medic training program. She was an outstanding candidate.

When I got to the part about ‘Emergency Contact’ info, I paused. Her mom’s name was listed. I couldn’t believe it.

“I’m sorry. I don’t think you can be a medic here,” I said with a smile. I didn’t give her time to react. “I grew up with your mom – and well – we can’t be old enough to have children old enough to be street medics… You’re in, Joy. Welcome aboard.”

True enough. I had gone to elementary school with her mom, Heidi.

I asked Heidi if she remembered when Joy applied to join Cote Saint-Luc EMS.

“So my reaction at first was – ha-ha – you were too shy to go for a tour at the station – and now you want to work there? In reality, I knew right away she would be amazing because she always wanted to be on the front line and since she was little liked to help people.”

The shyness wore off quickly. Joy was a ball of positive energy – passionate about providing emergency care and compassionate with those on the receiving end of her care.

Her mom isn’t surprised.

“Joy was delicious and a wonderful child. Structured from day one. Caring, loving and shy – and yet nothing stood in her way.”

Nothing at all. Not even cancer.

Last April – in the midst of balancing life as a mom, a first aid coordinator for an elementary school, and as a medic for Cote Sant-Luc EMS, Joy was diagnosed with aggressive invasive ductal carcinoma. Breast cancer.

I visited Joy somewhere in the middle of her course of chemotherapy treatments. I was worried. I hoped I didn’t show it. Something had told me it was time to tuck in a visit and so after a quick call to ensure it was all right, I was there ringing the doorbell.

No hugs allowed. Her immune system was severely compromised. Her morale was battered and yet – with the support of her husband and children and family and extended family – Joy wasn’t in surrender mode.

Her long blonde hair was gone – along with her eyebrows – and she was wearing a bandana that gave her a bit of the wild child medic edge I had grown very fond of over the years. My concerns were allayed by the spark of fire in her eyes.

At the end of October, after 24 weeks and 16 treatments, Joy became a chemotherapy graduate. She allowed herself the luxury of working a couple of Sunday evening shifts with her beloved partners at CSL EMS and together with her family, they tucked cancer into a dark corner and they focused on living life well.

On Thursday – this coming Thursday – Joy will undergo surgery. The double mastectomy will be performed with the goal of ridding her of any traces of the cancer she has been doing battle with for the past several months.

It will be tough for Joy to allow herself to become a patient again. However, she’s determined to complete the process she set out upon immediately after learning she had cancer.  She’s working hard towards normal – when smoochfests with her children won’t be associated with the end of a round of chemo.

“She is an amazing mom which is the most important. Cares for her family. Her determination and commitment is beyond anything. I could go on but I won’t. I am proud of the woman she has become but she will always be my little girl,” said her mom.

The little girl who became part of my fabric of time as a paramedic. I was there when she was cleared to work as part of the crew for the first time. And then – 14 years later – I worked one of my last shifts as a medic with Joy – who after kicking cancer’s ass – will pass the torch to someone else and continue the cycle of practicing big medicine.

Be well.

Hal

Rooker | The Positive Paramedic Project | #110 You’re not dead?!

Norm

This is a repub of a 2008 Norm Rooker column.

“You’re not dead?!”

Just what is the correct response when this is the initial greeting from someone who knew you from back when? The occasion was the 2008 Fire-Rescue Med Conference in Las Vegas. I was attending the national roll out for the Ambulance Strike Team Leader class. (A good program and one well worth taking by EMS supervisory and middle management types.)

It was the opening part of the class where each of us stood up and introduced ourselves, who we worked for and how long we had been involved in EMS. Because this was a roll out, there were a number of us older dog medics taking the program to evaluate it for our services or areas, so my almost 35 years of EMS experience only earned me a fifth place seniority ranking in the class.

One of those ahead of me turned out to be a coworker for a service I worked for back in the late 70’s after graduating from paramedic school and prior to being hired by the City of St. Louis EMS. After he introduced himself and I was thinking that he looked familiar he turned to me and uttered those words.

We all had a good laugh and when you’re greeted with a public comment like that from a senior medic your class reputation is well on the way to being established. The ASTL course progressed and while we ran a little long with anecdotes about EMS responses to Hurricane Katrina, various earthquakes in California from the 1989 Loma Prieta Earthquake to the North Ridge Earthquake and more recently, the EMS response to last October’s wildland fires in southern California and even the recent papal visit to Washington, DC, the material was all relevant for the tasks that needed to be accomplished.

Afterwards I pondered my former coworker’s statement. This was not the first time I had heard this sentiment. Fourteen years earlier at my 20 year high school reunion I ran into Mr. Petty, one of my senior year English teachers. He was walking towards me and when we got close but before I could say hello he stopped dead in his tracks.

He looked at my name badge. After all I had filled out some since graduation and was well on the way to balding, make that bald. Some of that by nature and maternal genetics and the rest enhanced by an ambulance accident where I flew head first into the front cabinets and avulsed the top of my head down to the skull.

While I had serious railroad tracks and a growing yamaka spot, I still had hair on top of my head until that moment. They had to do a skin graft to cover the wound and I was darn lucky that I hadn’t broken my neck. I still have an arthritic thoracic vertebra from that accident. But that was five years prior to the reunion and I was healed up now.

Anyway Mr. Petty looked at me, looked at my name tag again, sighed and stated something along the lines that I was one of the ones that he was sure would be listed as among the honored dead by this reunion and that he had actually been surprised to see me at the 10-year reunion.

I just snorted and said ‘Nope, I was still here and planned to be for awhile’ but at the same time I was a bit taken aback by his comments. After all, it wasn’t like I was a hood, stoner or troublemaker in school. It was more that I was not what you would call a low maintenance student or employee.

Well that and the fact that I was not afraid of confrontation.

I attribute this to the times and to my parents. And for that matter my grandparents. My maternal grandmother was an active young lady who lived in the fast lane of her times. Think of the musical CABARET. Grandma Stamat was a flapper and was living the Berlin cabaret and nightlife scene when Hitler’s Brown shirts did Krystal Nacht. Being an American citizen she was able to get out but almost my entire maternal family line for her side of the family was lost to the Holocaust.

Her second husband, my mother’s step-dad but the man I knew as my grandfather was a loud character. A merchant seaman stuck in Hong Kong during the Boxer Rebellion, a US Calvary man who was part of the American Expeditionary Forces that chased Pancho Via into Mexico and a few years later was in one of the first units to go to France in World War One. He left the Army after the war and worked a number of jobs including being a union “enforcer” in the Chicago area during the labor troubles and organizing in the post war and depression.

My father was an Iowa share cropper’s son, the third of six kids, born on my grandmother’s 20th birthday. He was an all-state athlete who battled with an abusive father, dropped out of high school at the end of the football season his senior year. And in the American tradition, after meeting and falling in love with my mother, and powering through my grandfather’s initial disapproval, pulled himself up by the bootstraps, worked his way through college and became a very successful Chemical Engineer.

I was the oldest of three kids. My brother JD and my sister Meredith were three years younger. My sister was very severely mentally retarded and had both Down’s Syndrome and Hurler’s Syndrome. So from a young age I always had to come straight home form school to help take care of my brother and sister so mom could do chores like grocery shopping and getting dinner ready, etc.

As we kids grew, my parents were moving into the middle to upper middle class. We were living in a suburb of New York City and had the benefits of their hard work. But my parents wanted us to appreciate how well we had it compared to what they had when they were growing up. So my mom came up with the Christmas letter program.

Each year she would go down to the main post office in New York City and read through the letters to Santa Claus. She and my dad would select a destitute family, contact the parent or parents and make sure it was OK, and then get my brother and I involved in providing Christmas presents and dinner for them.

Everything from going through our own toys and picking out something that was in good condition that the letter identified these kids would like, to purchasing, and gift wrapping other presents. Then as a family we would drive into some of the worst parts of New York City and make the delivery.

It was an eye opener and a tradition that Vicki and I continued for several years with our own children.

It was also a time of the early civil rights and women’s liberation movements. When I was 11 my mother and father signed up for the Fresh Air Program. This was a program where we would host two inner city kids, Larry and Marshal, for what turned out to be the next four summers.

All this BS about race and other differences mostly disappear when kids just get to be kids. I learned that not all black people are natural athletes. That they were able to get sunburned, too.

Each summer we would go down to Fenwick Island near Ocean City, Maryland. It wasn’t until much later that I realized that these weren’t really vacations for my parents, however we kids always had a great time.

Swimming, fishing, crabbing and learning how to play draw and stud poker for sea shells. (I ended up with a pretty neat shell collection which I held onto until my junior year in high school when I passed it on to a lovely young lady.)

This was during the mid to late 60’s and race relations weren’t exactly all they could be in that locale back then. One or the other of my parents had to get up early every morning and accompany us four boys to the beach or to the bay to ensure our safety.

We didn’t appreciate this sacrifice back then. We were just four boys between the ages of 8 and 12 having fun. All four of us would be at the beach playing in the ocean and sand all day. The third day we were there was a particularly bright and brilliant day and boy did we pay for it that night and the next day.

Larry and Marshal became such a part of our family that when my parents decided to divorce after my sister died, they waited until the Christmas Holidays so all four of us kids were together before they announced it.

Prior to that sad moment, my mother had also became involved in the Women’s Liberation Movement. I was 14 when she began hosting women’s self help medical exams at our house the third Sunday of every month. While I had no idea what this meant, it was pretty cool because my brother and I got to go to the movies those afternoons.

I didn’t find out what was actually going on until a few months later when my mom sent me up to her room to grab a flashlight out of her bedside drawer and I found a plastic speculum. My 14 year old mind did not have a clue what this was for but I brought it downstairs with the flashlight, holding it upside down and making quacking noises as I asked my mom what it was.

That old cliché about being careful about what you ask for comes back to mind as I was sat down and learned way more than I ever wanted to. At least at that time in my life.

My sophomore year of high school I was on the wrestling team. After a long six weeks of hard practices I had made the decision that it was time for me to bring my jock strap home and wash it. (You know it’s got to be bad when a 15-year-old boy decides this garment is to gross even for him.)

By now my brother and I had been doing our own laundry for a couple years. While I was sorting my clothing my mother was trying to come up with a poster idea for the first parade for the ratification of the Equal Rights Amendment by the New York State Legislature.

This is where being a creative smart butt sort of got me into trouble, again. As I was moving my crusty bit of athletic apparel to the whites pile I said something along the lines about putting a bra and a jock on a poster with something about equality.

My mom yells “Brilliant!” and snatches this stained and crusty item from my hands. My pleas to at least let me wash it first fell on deaf ears and that is why my jock strap along with one of my mother’s black brassieres and the words, “Ratify the ERA, Connecticut NOW” appeared in what turned out to be one of the most photographed posters of the rally with numerous shots of it in the New York Times and the New York Daily Post.

Needless to say, backing down or shying away from a challenge or trouble was not a family trait.

At that time in my life I was somewhat active in sports. Not a great athlete but game, if a bit on the lazy side. I was active in Boy Scouts and a cadet in the Civil Air Patrol. My squadron ran a ground SAR team.

Through these organizations I took basic and advanced first aid training as well as both the American Red Cross junior and senior lifesaving programs.

I was also in Future Teachers of America and I taught swimming Friday afternoons to the developmentally disabled class as well as wrote and worked on the student newspaper. All of these activities taught me to question what I didn’t think was right or pursue the question until I understood it.

The upside was that all of these activities led me to be selected for the second pilot EMT course they ran in the State of Connecticut in 1973 over the summer between my junior and senior years.

One of the downsides was that I sometimes clashed with or challenged authority. Never, ever in a destructive or mean spirited way. Well, I was suspended for fighting once my senior year but that was a provoked situation and testosterone rather than thinking things through got me in trouble on that one. I made the best of it and spent my entire suspension teaching PE over at Western Junior High School.

But overall I was a good kid. I accepted no for an answer, eventually. Never in trouble with the law and a decent, if underachieving student.

The fall of 1974 I reported to Ripon College, in Ripon, Wisconsin. A small enough school that it was possible to be a walk-on and actually make the football team. I had never played organized football before but I was just big enough and apparently just good enough to make the team.

I was a nose tackle. I had never thought of myself as being particularly small but I quickly learned that at 5’10” I was shortest lineman on the team. It turned out I was the shortest defensive lineman in the entire conference.

I learned very quickly, actually with the “help” of my philosophy instructor that physical size was only part of the equation when it came to battle on the line. You see, my Introduction to Philosophy professor also happened to be the offensive line coach.

If I “discussed” an opposing point of view too much in his class that morning, that afternoon he would “borrow” me from the defensive line unit to run what can be best described by Gary Shaw’s 1972 book, MEAT ON THE HOOF: The Hidden World of Texas Football, as Shit Drills.

I would go one on one with each member of the offensive line. Pass rushing as well as just your standard one on one confrontation for dominance of the line. Then there was the two-on-one, trap blocking drill. This is where the center or offensive guard in front of me would pull away and I would be hit by the offensive guard or tackle next to him.

But my absolute “favorite” was the interception drill.

I would be pass rushing against five of them protecting the coach who would toss the football just over their heads. I would have to leap up and catch it and they would have to react to my “interception” by stopping me from gaining any yardage. I crawled home from those practices.

Heck, I was the third shortest member of the team. I was lining up against guys so much taller than me that at eye level, I was looking at their neck and in two cases, the number on their chest when we both stood up straight.

For that matter only two of our cheerleaders were my height or shorter.

As a lineman I was mediocre at best. But I learned how to hold my own and think through ways to use what I had to my advantage. And I never did seem to learn the other lesson my philosophy instructor was attempting to teach me.

As a nose tackle, I was third-string on a two-string team. Ripon being a small college. But on special teams, that was an entirely different story. Man, for an AADD type, it was the best gig on the team. For me, that was where it was at! All that building excitement and noise leading up to the ball being kicked and running down field, the crowd roaring and the wind whistling through the ear holes of my helmet as I lined up on one or two members of the receiving team and just piled into them.

As with many things in my life, it was a matter of luck and opportunity coming together to help me in ultimately being named “Bomber of the Year” by the coaches. But as usual, I am getting ahead of myself.

In 1975, the NCAA, in an effort to cut down on knee injuries made it illegal to throw a cross body block below the waist on kickoffs. Guys that had been playing football since Jr. High and High School had all been taught the cross body block method or to slide feet first into the opponent.

Consequently, in this first season of the new rule, none of them really knew how to hit or block their opponent on kick offs. I learned by accident the first time. I stumbled while trying to turn to adjust to the ball carrier and in a high speed stumbling fall just happened to wipe out the guy in front of me. That’s when it occurred to me.

Most people don’t want to be hit. No matter what their size. They would rather push and shove. Fortunately I played for a pretty good team and was able to put my theory to test in the next quarter. I picked the biggest guy on the receiving team and cleaned his clock.

After that I would just sail down field, pick my target and take them out — opening up a hole in the wall for the other members of my team to take down the ball carrier. I never once directly tackled the receiver, although one time I did hit a blocker with enough force that he took out his own ball carrier.

Between the values my parents and grandparents taught me, the responsibility for taking care of those less fortunate or weaker than me from an early age, to that lessons I learned on the football field, to finally, the lessons Liz taught me (see March 16th’s column Tough Enough) I apparently was what you might call a high profile EMT and later paramedic.

Staying below the radar just wasn’t in my nature.

I never abused patients or derelicts. I never picked fights. For that matter, I never, ever punched anyone. That is an offensive tactic. My father taught me that there will always be someone bigger stronger or faster so fighting is always an option of last resort.

But if you do take that course. You don’t do it to come in second. And you never do it to showoff, or bully.

This has been my philosophy throughout my career on and off of the streets.

That included Special Operations such as rope rescue, structural collapse rescue, firefighting, Tactical Medic, etc.. Along with some of the interactions at certain fire houses after our “merger of equals” where the Paramedic Division was removed form the San Francisco Department of Public Health and inserted into the SF Fire Department in 1997.

But getting back to last week’s Fire-Rescue Med Conference, I ran into another former coworker, Jonathan Chin, who Vicki and I had worked with at Medevac in Santa Clara County, CA back in 1985/86 while we were waiting for the City of San Francisco to pick us up. Medevac had the contract to provide EMS for the southern half of the City of San Jose and Santa Clara County.

Jonathan is a handsome and articulate Chinese-American who quietly radiates leadership and charm. While neither of us were ever partnered up with Jonathan, we often ran into him and his partner, Cindy Petretto at various hospitals. They were a good solid crew. Medically dialed in and they always pulled their share of the load.

One day my partner and I had brought in a middling-serious trauma patient from a motor vehicle accident to Valley Medical Center — The Big Valley, a level one trauma center. At that time the ER was one long room with gurneys down either side, a nursing station in the center, two trauma rooms and in the back, a sort of three-bed quiet area for less acute patients and folks that needed sobering up.

While I was writing up my PCR, Jonathan and Cindy came in with a huge biker type. I mean pro-wrestler size. Multiple abrasions and reeking of alcohol. As they were wheeling him towards the “Quiet Room” he kept muttering abuse towards Jonathan.

“You Gook”, F***ing Gook”, “You slimy Gook”, ‘You..”, well, you get the picture.

Jonathan ignored him and Cindy rolled her eyes at us as they wheeled him past and into the Quiet Room. A minute later Cindy came bursting back out.

“Help! He’s going to kill Jonathan!”

Paperwork went flying as my partner and I and another crew from SCV, the company that had the EMS contract for the northern half of San Jose and Santa Clara County beat feet for the room while a nurse called security.

I was first through the door and there was Jonathan trapped in a corner between the walls and a hospital gurney. His angry patient was towering over him. But Jonathan wasn’t cowering or blustering. He was standing tall in a neutral stance looking up at the belligerent biker.

As I started to take my leap to tackle this guy high I heard Jonathan say, “Lets get one thing straight. It’s not gook, it’s Chink!”

Now that’s being calm under fire. Jonathan has since gone on to obtain his master’s degree in administration of EMS, has been the EMS Director for the State of Oregon and now runs EMS for a large county in northern Oregon.

While we were catching up on each others lives, respective families and careers I mentioned the comment in class about a coworker acting surprised that I was not dead by now.

He smiled and stated that while I was never a bully or troublemaker, per say, even with union activities, that the reason some people might get that impression is that I was always in the middle of things. That no matter what, an assault on a coworker, a working condition or a protocol or procedure controversy, I always stepped in and did what needed to be done or said what needed to be stated. And for those that sat on the sidelines, that level of risk taking was seen as either threatening or something that could lead to unfortunate or negative consequences.

I smiled back as his observations made sense to me. And yes, there have been rewards, triumphs, consequences and scars. So Mr. Petty, Professor Boweles and countless others I have known, worked with or for over the decades — I’m still here and plan to be for years to come.

Be well. Practice big medicine.

Norm Rooker

Newman | The Positive Paramedic Project #109 | Condition White

coopers-color-codes

I wrote this stream-of-consciousness piece as a ‘soundtrack’ for a series of mixedtapes sent to a few well chosen friends.

Have you ever considered Condition White? Condition White is the lowest end of the mental awareness spectrum developed by American law enforcement instructor Jeff Cooper.

Condition White, according to the disciples of Cooper, is a state of near total relaxation—when you are blissfully unaware of your immediate surroundings.

And for that reason, Condition White is a leave-at-home mental status thing for on-duty street medics. So, it was with beaucoup de surprise that I, a devoted student of the School of Street Survival, found myself floating in Condition White.

We were rolling to a call in The Altered States (aka: the suburbs). Requested to fill in for another Med Unit that was temporarily unavailable.

François was severely into Condition Yellow/Orange—providing me with a running commentary of the things we would have to watch out for on the scene—whenever we got there. François continued his pre-assault coverage, but I was visiting previously charted territory in Condition White.

I was watching the leaves swirl in the wind. I was lost in the rain pounding the pavement into little soldiers. I caught myself remembering the pure innocence of running down Main Street—the wind blowing in my breathless face as the siren wailed.

Running to the firehouse to get lost in the smalltown comraderie of a Bethany fire call. West Liberty needed assistance on a barn fire and Bethany Fire & Rescue was answering the call.

Something special about neighbours responding to each others’ needs without reservation—without concern for payment for services rendered—with only compassion and a willingness to lend a hand in their hearts.

And when I returned to my home there was that unique rearboard windglow on my cheeks. Challenged, the spirit had overcome. The exciting smell of smoke lingered on past the requisite steaming shower. We were good. We were volunteers. It seemed so simple. And right. And maybe just a bit innocent, too.

Condition White is life-threatening in a world gone grey. The innocence lost while screaming to a shooting call in RDP. U2’s Desire pounding out a backbeat to the wailing siren.

The lights of oncoming traffic reflected splitsecond in the windshield. Seven minute high speed slalom through disinterested streets.

The brotherhood of fear linking my partner and I work a trauma code on a blood soaked victim of terminal criminal involvement.

Watching our backs and watching our fronts as too young police officers roam the avenue with flak jackets on and automatic weapons keyed up. Controlled madness leads to shivering teeth inside these tight-clenched jaws. Reflecting calm even in this arena of insanity.

When I get home I am spent. Even the dog’s angled glance of not knowing is too much for me. I turn off the light and drop into dreamless sleep. Work is an exercise in creative confusion.

10881691_10152916542040902_1186545828089801244_nStill I find myself drawn to the station an hour before my shift. Waiting to ride the rig back into my neon war zone.

It is as if I enjoy these excursions into grey.

Be well. Practice big medicine.

Hal

Newman | The Positive Paramedic Project #107 | The guitar doctor

Guillaume

Guillaume Rancourt knew he going to be a luthier when, at the age of 13, the other students in woodworking class were building birdhouses – and he was handcrafting his first guitar.

He says it was, perhaps, his destiny to craft guitars by hand.

My grandfather was a handyman. I would spend complete days with him in his woodworking shop repairing, inventing or creating almost anything. He transferred his to me right away.

“My dad also works with wood and is a longtime Guitar Player. The first time I picked-up a guitar it was his own custom-made classical guitar built by the Ramirez family of Barcelona, Spain. A great instrument he had commissioned and chosen for his own specs and hands. I always loved that craftsmanship.”

“It’s in my genes.”

If he knew he was going to become a luthier, I’m fairly positive Guillaume Rancourt never realized that being a guitar doctor also means playing the role of confidante to his clients – the guitarists themselves.

When I come into his workshop at Bes Musique, Guillaume is working on an old Gibson. The frets are beaten and there are dings and scrapes after countless picks have met their end while being bent on this guitar. He’s working with a file trying to restore some Old School sound and feel to the guitar. It’s a long-term rehab gig for the Gibson.

There’s a Fender Jazz bass waiting in the wings. It needs a checkup, new strings, and a tuneup.

The guitarist walks into the workshop asking after his guitar. Guillaume explains that it’s next in line.

“Ohh,” the 60-something-year-old bassist with long frizzy grey hair and a well-worn Iron Maiden shirt quietly says with a real air of disappointment. “I was looking forward to spending some time playing….”

Guillaume quickly pulls the Gibson up from its spot on the workdesk. He pulls the Fender Jazz bass out of its case. He holds it up. Stares down the neck – ensuring the lines are still true. He examines every component of the guitar. Running his fingers over the frets and then the body, he says to the guitarist, “You’re rough, man.”

“Yes. It’s been a pretty rugged year.” Long pause. “Can you fix it?”

“Sure. I can take care of it right now. It won’t be long. You’ll have it this afternoon. Do you want to wait?”

Guillaume knows his client has been dealing with some tough stuff. He listens carefully to both the guitars and their players – ensuring he understands where the latter want to go while exploring with the former.

“I’m a musician, too,” says Guillaume. “I get it. Many musicians don’t express themselves in words. So I listen to their music, I watch how they interact with the instrument – I try to read between the lines to capture the essentials. It’s a bit like being a navigator, a guide – pausing to ensure I take in the whole picture before applying my skills and knowledge to fine-tuning their guitars.”

The Fender Jazz bass player stands in the workshop while the guitar doctor works.  He talks about being retired, about his son, about his ex – and about music. Mostly, he seems grateful for Guillaume’s rapid intervention so he won’t have to go home alone.

“I know you like a clean sound,” Guillaume says. “These new strings will take some getting used to.. not fuzzy.. just different.” And then they’re both bent over the bass – listening intently – as Guillaume makes it speak.

You can find Guillaume Rancourt online at: http://rancourtguitars.com/

You can find Bès musique online at: http://www.besmusique.ca/

Newman | The Positive Paramedic Project #106 | Kids are, as always, free and welcome

Sheesham & Lotus

We began hosting concerts in our home because we live in a small town (3,000 people) about two hours away from the closest large music venues (e.g., Montreal QC or Burlington VT) and we wanted our twin teenaged daughters to be able to experience top-quality live music in an audience-friendly acoustically-sound environment.

So we embarked on this adventure and applied to be one of the host houses for the Canadian Home Routes program. We were accepted – as one of only three homes in Quebec. Our original commitment included hosting six artists or groups of artists.

The original formula included the artists staying in our home after each show – however we re-invented that idea in favour of ‘spreading the wealth’ in our economically-rugged town. Artists who perform at our home stay in local inns where the owners have agreed to provide discounted rates in order to further promote the house concert project.

By leveraging the whole community we created an ecosystem to support/be supported by the Stanstead House Concerts Network – SHCN. We learned to leverage the heck out of social media in order to take advantage of multiple marketing ‘channels’ – and to ensure we found efficient means of getting information to people who would actually pay attention to our updates.

Shows start at 7:30 pm and consist of two sets. A typical concert winds up (for the audience) at 9:30 pm. We picked a starting time which suits the needs of our audience – many of whom travel more than 60 miles each way to attend these concerts. We want to ensure they can get home safely at a decent hour.

Ticket prices are $20 for adults, $10 for teens – and kids are, as always, free and welcome. And there are several solid reasons for making our concerts a kid-friendly experience:

  • We want to turn kids on to the power of music to broaden their horizons and fire their imaginations;
  • We know how tough it can be to find a sitter (did I mention we have twins?);
  • We know how underserved kids are as an audience for live events – kids want to be able to sit up front and be treated with respect;
  • Kids bring older people with them – parents, grandparents, uncles, aunts – and other adults;
  • Kids talk to kids via social media and good old-fashioned word-of-mouth; and
  • Kids will come back when they’re older kids and young adults and adults.

We’ve learned that people value live micro-venue musical experiences much more than in the recent past. Interestingly, so do the artists – who each reflect on the honesty injected into a performance space where each concert is a truly interactive experience. Artists talk to audience members – they become raconteurs. Audience members chat with artists and share their inspirations, their musical memories – and occasionally their sense of loss soothed through a specific melody.

When Christine Campbell & Blake Johnson (blues & roots singer/songwriters out of Nova Scotia) held court in our livingroom, a young member of the audience – wearing a Metallica t-shirt – shyly asked Christine if she could play Led Zeppelin’s ‘The Immigrant Song’ to lead off her second set. As it turns out, Christine Campbell grew up listening to Led Zep and her cover of The Immigrant Song was spell-blindingly beautiful. Goosebumps all around. Another favourite moment – a young man with a love of harmonica asked his mom to go home to get his harp so The Cumberland Brothers (bluegrass duo out of British Columbia) could autograph it – which they did while posing for pics together in the kitchen between sets.

CumberlandBros1

We precede each concert with a dinner. These have been grand potluck gatherings and the addition of culinary chaos to the mix seems to appeal to the concept of engaging as many of the artists’ and audience members’ senses as possible. So it’s not only the music. It’s the show. It’s the kitchen. It’s the whole unlikely experience.

We have learned people are never too busy to go to a show they really want to see. And they want to experience these concerts.

Where kids, as always, are free & welcome.

Be well. Practice big medicine.

Hal

PS. You can listen to a CBC Radio feature story about our house concerts by clicking on this link.

PS2. You can learn more about upcoming shows from the Stanstead House Concerts Network by joining us on Facebook.

 

Newman | The Positive Paramedic Project #104 | Priorities

I am stubborn. My wife warned me not to try and change that lightbulb on my own. She told me I ought to ask our neighbour from across the street to lend me a hand. I waited for her to go over to one of her friends for tea and muffins and then I decided to give it a go.

“I have fallen and I cannot get up,” I said in slow and determined fashion to the emergency operator who answered the call I placed to 911. I remembered that series of television ads and winced at the realization I had just used the same line to call for help.

“No, I am not having any difficulty breathing. Yes, I hit my head but no, I did not lose consciousness. No, my neck doesn’t hurt. No, no chest pain to speak of. Yes, I do have some terrible pain in my hips. I am 81-years-old. No, I do not take any prescription medications of any kind. No, I am unable to get up on my own. The pain in my hips is quite intense and it gets worse when I try to move.

“Yes, I understand there might be a lengthy delay before the ambulance gets here. I know it’s very cold outside and I understand you must be very busy. I would not have called if I could get up on my own. I fear I have injured my hip otherwise I would not be calling for help.

“Pardon me for asking but I thought we had first responders in our town who might be able to help me before the ambulance crew is available. Oh, I see. They only respond to higher priority calls. Well, I do understand. I will do my best to stay comfortable until the ambulance crew arrives. Yes, I will certainly call you back if anything changes or I feel worse in any way.”

The light of the afternoon faded into the early darkness of a winter evening and the ceramic tile floor quickly lost any of the heat it had retained. I struck up a conversation with the cat but the cat lost interest and walked away. I watched the time on the microwave clock move slowly minute by minute. I fought the urge to pee.

I concentrated on looking at the photographs of our children and grandchildren we had proudly hung on the livingroom wall. I couldn’t remember the phone number at my wife’s friend’s house. I wanted to cry.

I couldn’t believe that I was all alone, had called for help, and no one was on their way yet. I wondered what level of priority my call for help was for that first responder team.

Were they only concerned about life and death? Were they so busy they could not even spare a moment to check on a resident of the community who had confirmed he was in a spot of trouble?

Had they no idea how important it was to provide a physical presence for someone in a time of extraordinary need?

And so, I lay alone on the kitchen floor with a badly bruised hip for more than forty minutes before the ambulance crew and my anxious and bewildered wife arrived simultaneously.
___

Right. The preceding was just me, Hal Newman, trying to imagine what it would be like to be all alone and waiting for emergency medical assistance after having been classified as a priority Two or Three call on a day chockfull of priority One calls.

Calls of every priority should be responded to and not only by an ambulance crew.

Actually, I believe it would be rather interesting to have a first response team specially trained to respond to calls of a lower priority to determine whether or not those patients actually need to be attended to by the much scarcer ambulance-based paramedics.

There should never be a monopoly on saving lives or helping people in an extraordinarily difficult moment of their lives.

The clock begins ticking when someone calls for help. The primary consideration should be who can get there quickest to render aid – not which response organization has a ‘claim’ to the territory.

It’s not about what uniform the responder is wearing. Every EMS organization should take an enormous leap of faith forward, work with all of the stakeholders and establish a model that ensures everyone in the community gets the EMS they deserve.

Be well. Practice big medicine.

Newman | The Positive Paramedic Project #103 | Remembering Dr. Peter Cohen

 

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This was the eulogy I crafted for Dr. Peter Cohen’s farewell service on September 5, 2014 in Verdun QC.

Faith.

That’s the word that comes to mind when I think of Peter Cohen.

He had such faith.

I met Peter for the first time when I was in my late teens. I was fresh out of high school and headed into my first year of CEGEP. High school hadn’t been the best of adventures. My guidance counsellor’s parting words were something along the lines of “Good riddance.”

I thought I wanted to be a paramedic. I say, “I thought” because I hadn’t really shared the concept with anyone else lest they thought I was daft.

And then I went to a fateful meeting on Beaumont Street in Park Extension.

The place was a bit bizarre. Outside, in the parking lot there was an odd-looking pickup truck painted a brutal shade of green with red flashing lights on its roof.

As I approached the building, there was a short dynamo of a man directing the operator of an immense tractor to “crush the car so that it looks like it has been in a real accident. It needs to feel real so the students believe that it’s more than just a drill.”

Such was my introduction to Peter Cohen.

When I confessed that my dream was to become a paramedic, Peter said only one thing as he put his arm across the small of my back, “Well then, we have lots of work to do so you can achieve your dream. Let’s get started on your journey.”

And that was the thing about Peter. He had faith. He believed so I believed – in myself, in my colleagues, in the paramedic program, in Resuscicar, in Medic One, in EMTAQ, JASMU, in prehospital care, in all the myriad possibilities and opportunities that lay before me.

Peter Cohen was a facilitator. He made it easy for many of us to answer our calling of becoming Emergency Medical Services (EMS) providers.

Catherine Booth once said, “There is no improving the future without disturbing the present.” That could have been Peter’s mantra.

Peter Cohen was the godfather of advanced life support paramedics and EMS in Alberta and here – in Quebec. He was considered crazy by many of his peers because he believed, he really believed, that ALS paramedics could change the world of prehospital care.

He had faith that a group of adult students – previously known as ambulance attendants or drivers or brancardiers – could thrive in an environment of academic rigour, complex ideas, and hard science. Peter believed we could do more than merely sustain. He provided us with the inspiration necessary to succeed. He believed. And so we believed, too.

Faith.

Peter instilled certain truths in me that I have kept close to my heart and soul over the years.

We must care for the patient and the family as if they were members of our own family.

We must be gracious and gentle with the dying. We must be a calming and caring presence for the survivors.

Remember that yours may well be the last voice someone hears before they pass. Choose your words carefully. Let them know they are not alone.

Our responsibility to the patient begins at the cradle and ends at the grave. Death is part of the process. And sometimes, despite your best efforts, your patient will die. Death is a part of the cycle of life. Accept this as something that just is and not as a personal defeat.

And most importantly – Be open to others’ beliefs and cultures. Be an ambassador for EMS – always.

Faith.

Peter Cohen believed we were going to make a real difference in Canada and well beyond. And he was right.

Marcel Boucher, a former Director of Professional Services at Urgences-sante, said,

“Peter was a leader and a Don Quixotic character who greatly inspired me over the many years we worked alongside or together. Today’s M4 service (Urgences-Santé’s unique response to expected at home deaths in Montréal and the south shore, a non-urgent humane intervention) was developed by our medical team from a Peter Cohen concept and proposition. So, after being a long time pioneer in prehospital ALS he later championed end of life care and dignity. Thank you Peter Cohen for your service, leadership and enviable human qualities. We will never forget you and are in your debt.”

There is a passage in the Torah that reads:

“Whoever destroys a soul, it is considered as if he destroyed an entire world. And whoever saves a life, it is considered as if he saved an entire world.”

Look around this room – and know that beyond these walls there are so many more students of Peter who have gone on to make wondrous and meaningful impacts around the world. So many lives have been touched. So many lives have been saved. And the legacy continues.

I believe it’s safe to say that it can be considered as if Peter Cohen saved an entire universe.

Rest in peace, Peter – and know that we’ll keep that faith.

Be well. Practice big medicine.

Hal

 

Newman | The Positive Paramedic Project #101 Vital signs

SignsA nugget of Big Medicine for your consideration. #101 Vital signs.
Back in October, I dropped the Bad’Baru off for an oil change and a couple of NASCAR-style body patches at the Garage Generale Stanstead. I loved the place. It was like Cheers! with grease. Everyone really did know your name. There were always folks sitting in the office. Some of them were actually clients. Most were just visiting – sharing a story, sipping a coffee. Kim and his family played the roles of barista, chief mechanic and concierge.When I came back in the afternoon to fetch the Baru, I noticed it was parked out on the apron minus the requested patchwork.

Inside the second bay there was a middle-aged Honda Accord with Maryland plates and its guts spilled out onto two rolling tables brought up close to the engine compartment. Kim and his crew were elbow-deep working in-tight to replace the water pump.

“Did the oil on the Subaru, Hal. We’ll have to do the patches next week. These folks broke down on 55 just outside of town and they’re a long way from home. Gonna try and get them on the road southbound before sunset.”

Standing in the other bay were two older gentlemen. One looked familiar.

“Zack stopped to see if they needed help. Tow truck driver wanted to haul the car up to a dealer in Magog. Zack told him to bring it over here. Good thing. Looks like the last dealer they visited didn’t put the engine back together with all the required parts.”

I asked the other man what part of Maryland was home. He started to describe the state as a map until I gently interrupted with “I used to live in Cockeysville.”

He smiled. “We’re from Bowie. My name is George. My wife and I have been coming up to Canada every year since we honeymooned at Expo 67 in Montreal. We’ve been married 46 years.”

“When we broke down on the highway, I didn’t know what to think. We were a long way from home. Then Zack stopped and we came here. He took us out for a tour of the town. We went for coffee. We visited the Haskell Library, the granite quarry, and that road where the houses on one side of the street are in Quebec and just across the road they’re in Vermont.”

“Canusa Avenue.”

“Yes. Canusa Avenue. In all the years we’ve crossed this border we’ve never stopped in this little town. And here we are – brought here by fate and the kindness of strangers.”

“Well, George, you’re in good hands. I best be getting home to continue working in the garden as promised. It was a pleasure meeting you. Safe travels for the rest of your journey.”

“It was good meeting you, Hal. We’ll see you again the next time we’re up this way. I’ll ask Zack to drop you a line to let you know we got home safe. Seems like the kind of place where folks worry about such things.”

Indeed, George, indeed.

In the months since then, Kim closed the garage to focus on spending time with his family. The garage office irregulars of the office stay in touch with nods, waves, and social media – but it’s just not the same. Almost as if the heart of our little town skipped a beat.

Thanks for your consideration.

Be well. Practice big medicine.

Newman | The Positive Paramedic Project #102 Regularly irregular

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A nugget of Big Medicine for your consideration. #101 Regularly irregular.

My first conscious memory of being unable to adopt a beat was on my 13th birthday when my parents rented a jukebox for my party. Despite listening repeatedly to great tunes like April Wine’s ‘Bad Side Of The Moon,’ I couldn’t dance worth a damn.

The following summer was spent at the Y Country Camp. I remember getting the nerve up to ask a girl to dance at the first ‘social’ of the year. For some reason, I think The Stones’ ‘Ruby Tuesday’ was playing as I did my awful disconnected dance-floor-zombie shuffle.

Verification of my inability to maintain any sort of rhythm followed shortly thereafter with the purchase of a metronome. The metronome was supposed to help me play the trumpet while maintaining some semblance of a song’s inherent pace. Instead, the metronome would tock-tock-tock steadily in the background while my best Louis Armstrong imitations would meander to their own indiscernible bass lines. I was re-inventing jazz and it wasn’t pretty.

While I couldn’t keep a beat, I had no issues detecting a rhythm – anywhere. Although intentional pulses eluded me, I took great joy in the cadence of everyday life. I heard the backbeat of tires crossing train tracks, of elevator doors opening and closing in office building lobbies, and of the 4/4 time of the conveyer belt at the local supermarket.

When I was studying to become a paramedic, there was a great deal of emphasis on learning how to keep track of a patient’s pulse. We had to learn the normal ranges for a heartbeat and the differing qualities that would serve as clues to underlying issues. While my classmates were desperately trying to synch what they were feeling in their fingertips with what they were seeing on their watch faces, I was delighting in exploring entirely new territory – the beat of life.

There shouldn’t have been any surprise when I discovered I was a master at detecting atrial fibrillation, second degree heart block (Wenckebach or Mobitz 1), and sinus arrhythmias. We were talking cardiac heaven for the beatless wonder.

Rolling to calls, I’d take in the reflections of our flashing lights in storefronts while listening to the siren mixing with the honking horns of vehicles trying to get out of our way and the heavy bass beats of backseat boomboxes in cars cruising Ste Catherine Street.

I would find myself immersed in the rhythms of the ER. The patient breathing, the ecg monitor beeping, my partner tapping his wedding ring on the aluminum frame of the stretcher while the radio provided an ambient wash of white noise to fill any gaps in the soundscape.

And, of course, the regularly irregular rhythm of life in EMS was a perfect fit for me. My circadian clock easily adapted to the near-constant interruptions of sleep patterns, eating times, and to the abrupt starts and stops associated with shiftwork when you are lowest on the union seniority food chain.

I had discovered the rhythm of life and took great comfort in being able to tune into my own frequency that included the steady beats, dropped beats, and regularly irregular aural accidents of the physiological soundtrack.

Thanks for your consideration.

Be well. Practice big medicine.

Hal