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Contemplating life.

SF thoughts

June 2011

Walking home to the hostel one night, I came across quite a few people getting ready for bed, making themselves comfortable on their mattresses, tucking themselves in for the chilly night.

Unfortunately for them, their mattresses consisted of flattened cardboard boxes, and their tucking in was limited to zipping their jackets up to the neckline – if they had the luxury of a jacket.

Made me think how lucky I am to be able to tour the world.

I am glad that fate has ‘looked after me’; that I have not been subjected to situations where I would have fallen through societies cracks and ended on the streets. I am glad that people have been there to guide me and help me along the rocky path called life. But I am most of all glad that I have the capacity to have made, make and hopefully continue to make wise decisions to keep me out of such situations.

This trip has been a real boost to my self confidence and conscience; meeting people,  touring on my own, making new friends, doing all this paramedic related stuff on an international scale –  a great experience.

This trip has also been an eye opener and reminder in regards to my self awareness – living in a relatively small city for four years and being dumped in a mass of people they call London or New York makes you realise how physically insignificant ones self is – literally one of millions. Then again, getting all this positive feedback from readers has again boosted self confidence. It is really great that I could inspire people to go out on an EMS trip of their own, and I will strive to continue to promote that cause, as I firmly believe that an international perspective, a macroscopic birds eye view of affairs coupled with foreign experience really has a positive impact on self awareness, self confidence, learning etc. Never forget the big picture – we are all wheels in the machinery, but that machine needs reliable cogs to work.

Border Security

June 2011

My flight from Toronto to San Francisco was uneventful, except for the border security.

Arriving in the US, I presented my passport and was greeted not with a smile, but a with an onslaught of questions in rapid succession, which I managed to answer in a fairly timely manner.

Border Control: “Where have you come from?”

Me: Canada

BC: “Why are you here?”

Me: Pleasure

BC: “Where will you be staying?”

Me: Hotel X

BC: “What is your occupation?”

Me: Paramedic

And with that, whether he had run out of questions or was happy to have a travelling paramedic in front of him, he wished me a good day and I was on my merry way in to ‘Cisco.

Go!

“Travel is fatal to prejudice, bigotry and narrow-mindedness and many of our people need it sorely on these accounts. Broad, wholesome, charitable views of men and things cannot be acquired by vegetating in one little corner of the earth all one’s lifetime.”

 

– Mark Twain

Toronto

June 2011

From New York Air Canada took me up to Toronto. I was looking forward to visiting Canadia; I had a preconcieved notion of something excellent, and was eager to find out if my expectations would be met.

First impressions were good. A big airport leading in to a big city, and everything seemed a bit more…normal. This was a feeling I had throughout my time in Canada, and has been echoed by other people I talked to that have been there – Canadians are just that bit more down to earth than their border-buddies. No disrespect at all to the citizens of the USA (they looked after me well), but when you look around, talk to people and soak up the atmosphere…there is a certain je ne sais quoi that made me little more comfortable. Everything doesn’t have to be the biggest – including cars and people. Not everything has to be AWESOME and AMAZING. I can’t put my finger on it, but I do like Canada and Canadians (well, Toronto, unfortunately I didn’t get round to seeing much else).

Bit of a let down when it came to experiencing their Paramedic Services. I had organised (in advance) for a ride along with Toronto EMS, including an application letter to the Chief of EMS with a recommendation from my university Professor and supporting letter from my employer (all required by Toronto EMS). All I needed was a P95 mask fitting prior to actually heading out. I arrived Wednesday, got hold of Toronto EMS on Thursday, Friday was a public holiday, mask fitting aren’t done on weekends, and I was leaving Monday.

So no shift.

Slightly annoying, luckily though through some friends I was able to catch up with a Paramedic from the Peel Region Paramedic Services and compare our services over a cuppa. Unfortunately I forgot my notepad, so all I can tell you is that it seems to be a great service, with decent shifts, pay, guidelines, trials and general training. One thing the Canadians haven’t picked up on yet is tertiary education for paramedics – one area where Australia, the UK and South Africa (for their advanced level practitioners) are ahead.

And because I’m sure you don’t want to hear about the occasional boozy night in Toronto or the angry woman in the recorded announcement on the Toronto Subway, I’ll leave you with some impressions of Toronto and Niagara Falls:

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A Toronto Tram in front of the architecturally excellent Toronto Art Museum

 

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An ORNGE (their spelling mistake, not mine) helicopter landing at Toronto’s “Sick Kids” hospital (no imagination whatsoever).

 

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A Seattle fire truck on the streets of Toronto? Just another film set!

 

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Niagara Falls #1

 

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Niagara Falls #2

 

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Niagara Falls #3, the mist

 

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A tow truck towing a tow truck towing a car. Brilliant!

NYC: Aftermath

June 2011

Image via Wikimedia Commons

In one word: Wow.

I was really looking forward to visiting New York City, and I was not disappointed. The size, the vibrancy, just everything is amazing. Being a tourist in Manhattan is excellent on its own, but to see the streets of Brooklyn and Queens from a paramedics perspective is the ultimate sightseeing – going inside people homes, seeing how they live, being able to help out, and getting a proper tour of the streets with like minded people – other paramedics.

I spent five days on my own in NYC, which was my dedicated Paramedic exploration time. Later that holiday Sophie joined me (I had eight weeks off, she only had four), and we visited NYC together. We met up and went out with both the Paramedics from my last shift, Gozo and Drew, which allowed for a bit more of a social exchange in an excellent culinary setting – one night we stuffed ourselves with southern food, another night Gozo ‘kidnapped’ us to Spanish Queens: everything was in Spanish, and we couldn’t understand a word that was written around me. Sophie and I were the only white people around. I would have felt seriously lost, out of place, and probably a little uncomfortable if Gozo wasn’t around, but he navigated us to a locals restaurant that luckily had many pictures on the menu, which made decisions a little easier. Needless to say, the three of us ordered for about five people, which cost for what I thought would have been appropriate for two people, and ended up paying for nothing.

And thats it. Say what you want about Americans but they are such a friendly and hospitable bunch. I couldn’t have paid the ransom money for my own mum it seems, I was “their guest” and any attempts to foot the bill taken with a smile, a dirty look and the bill was jokingly yet violently pulled out of my reach.

I am very much deep in your debt for your hospitality and making us feel right at ease in your great city. There may be some things that I fundamentally cannot agree with (your healthcare system is screwed in my opinion), but as a bunch of people, you made me feel very welcome. And for that, I am very grateful.

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NYC: Caribbean Care part II

June 2011…a continuation from NYC: Caribbean Care part I

So, this shift we would be doubling up – two qualified NYC Paramedics, two student Paramedics; one from New York, the other from Perth, Western Australia (me, in case you’ve missed the point). Me, the one wearing green with reflective bits. Working for St John Ambulance. Which is funny, because the other student is doing his Paramedic course through St John College. Coincidences!

Doubling turned out to be a great thing. For the whole shift, we now had an even number of people on the ambulance, no third wheel feelings. Whilst driving, the two paramedics sat up front, and the two students in the back. I could compare the courses we have been going through, with plenty of time. Education levels, content, delivery of material etc. were all discussed. On the job, he attended, one paramedic always at hand to give help out if needed (which wasn’t), the other paramedic grabbing the stretcher if needed. And I hovered in between, but never felt spare. Jobs were discussed together, food was eaten together, I learnt a whole lot. Driving to hospital space was tight in the back and if the patient wasn’t too sick, I hopped up in the front and chatted with the driver medic. The shift flew by, and we all had a ball of a time.

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Ready to go!

So, what did we do all day? We were en route (“enn rauwt” as opposed to “on root”) to a standby when we get diverted code three (lights and sirens) to a fifty something year old female feeling faint with leg pain. Woo woo, flash flash, woo woo woo woooooo…in the US, especially in NYC, paramedics love to play around with their sirens. Little woop here, longer wail there, chuck in some yelp and phaser, ending with a blast from the air horn. It’s their culture I guess, though sometimes I wish they’d just leave the bloody thing on. They’re a playful bunch.

We fight our way through traffic, our red and white beacons ricocheting off street signs. I miss the blue of our Aussie ambulances – a colour only recently allowed on ambulances in NYC, and even then only facing the rear. This is explained by the fundamental difference in retinal physiology between UK and NYC citizens – the cone cells are structurally completely different between these two species – the NYC kind would be mesmerised and perplexed by forward facing blue lights, hence the laws to prevent such horrors. The UK specimens would equally be in deep strife, but in a different way. Here, red flashing lights are only allowed to be rear-facing. Imagine how the British would be confused if this were not regulated by the law. This, I presume, is also the reason for strict border controls, limiting the intermingling of these fragile species in unfamiliar environments.

Anyway, back to our call. We turn on to our destination street, and immediately know where the house is – there’s a big red fire truck with fifty million flashing lights parked right outside. FDNY (pronounced Fidney, rhyming with my hometown Sydney) respond to all emergency medical call outs as first responders – helpful in some situations, overkill in others. We crowd inside the little house, six firemen, four paramedics, and begin history taking and treatment. It is quickly assessed that the Firefighters are superfluous on this call, and, after answering a few questions why the heck I am running around like an employee from the sanitation department, they are about to leave…when two police officers poke their heads round the doors. Apparently NYPD are also dispatched to every emergency call, slightly over the top in my humble opinion. They know they are not needed, but we thank them anyway and they head off, probably to the nearby donut shop.

I am amazed at the amount of resources thrown at this job. Three vehicles on a lights and sirens response, ten professionals from three different services. America is the land of plenty, think big, but it begs the questions “is it worth it?” and “can they afford it?”

I’ll let you discuss and decide that one.

Back to our patient, we treat, transport and joke, all the way to hospital. Our patient is stable, her spirits are high. Then we arriving at the hospital – a bit of an eye opener. It’s bursting at the seams it seems, and it’s only a tuesday afternoon. Three people to a cubicle, nil privacy. If you were to draw the curtains, they would drape over the person lying on the centre bed. This isn’t a quite place. Staff scurrying around, some barking orders. Some guy is screaming for food. I position myself in a corner for a better overview of the department, and realise that this “some guys” deep coarse voice actually originates from some haggard old woman with an haggard old face on a haggard old body. Rough times indeed.

In the other corner, someone else starts shouting. A trauma call is brought in by an EMT crew (trauma is a BLS call in New York City, unless it is obvious that ALS intervention is needed and subsequently requested). We are quickly triaged briefly, vital signs are taken by EMS in hospital. Pt is loaded on to a bed in the exam room, examined, and we leave.

Outside, a FDNY EMS lieutenant is having a discussion with paramedics about using the scoop stretcher as an immobilisation device. He skims around the point, not accepting it for such a use; the paramedics insisting that it can be used (we certainly did in Western Australia…we didn’t even have spineboards until the beginning of 2011!). His way or the highway. We don’t bother to get involved, and choose the highway, outta here for more street action.

Mind you, on the subject of spinal immobilisation (or attempted stabilisation), the 15 minutes I spent at hospital was quite an eye opener: three more people are brought in to the ER strapped on to spineboards. And there are more lining up outside. Overkill.

It’s time for restocking the van as well as our stomachs. We head to a German Deli, where I grab the highly recommended roast beef roll. Well, a small to medium sized roll with a ton of roast beef stuffed inside.

We have enough time to eat without having to wolve it down – then right on the last bite, back to the truck for another call. It is now pouring outside.

We pull up outside the apartment building. A family get together, they have come from everywhere: Puerto rico, hawaii, and nana wants to fly back home tomorrow…well probably not, as she has a chest infection. Treat, transport, joke – a good routine. At hospital, we are told that our last patient has been discharged with nothing serious to report.

We make ourselves clear for another job. The radio crackles to life…and…standby. We park up on a nearby corner, and let our bellies digest teh roast beef a little more. Andrew (the NYC student) and I compare our education programmes a little more. He has gone through EMT school for three months, graduated as a basic, then decided to go to paramedic school. Generally this is one year full time, and costs around 9000 US$. This is then followed by taking the State and National Registry tests to become a qualified Paramedic. Quite compressed compared to what I’m going through (three years university plus three years on road experience).

The day wears on…do I want to go home, I am asked? No brainer there: “Hell no, I’m going to stay right until the end! Having too much of a good time!”

Waiting is tough and uses up a lit of energy. It’s food time again, so the collective agreement. Spanish pork with rice, we have to show you this stuff they insist.

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Food. A lot of food. Too much food. Yummy food.

Full to the brim. Cannot walk. Roll to the ambulance. I want to explode.

The last job of the day comes in (burp, ooh my yummy tummy hurts), a girl in her twenties complaining of a sore throat. Yup, gotta end the shift on a high note – ALS, lights and sirens to our patient with a cold…and a bit of attitude as well. Apparently she has been prescribed penicillin…but she has ben taking it now for six hours, and its not working. Gozo explains how penicillin works, but she’s having none of that, and wants to go to hospital. She happily walks to the van.

I pop myself in the front, and chat to Drew, who has been a paramedic for five years. He is studying psychology; his long term aim to get out of EMS, as he can’t see EMS providing a long term future for himself. Hoping to progress on to a Masters and possibly an PhD, things he laments that are missing in the world of Paramedicine…until I explain how things work in Australia, how the majority of education is university based, how you can get in to research, you don’t necessarily have to work for a state/county/municipal paramedic service; you can end up working/teaching at a university…or so much more. His jaw nearly hit the floor, and I may have detected a bit of envy oozing out of his pores.

At hospital, we bump in to relatives of our chest infection nanna, who confirm the paramedics provisional Dx of a chest infection. They thank us again for helping out, and we say our goodbyes.

Then a commotion from a few beds down the aisle – a loud moan, a shriek of a relative, followed by much rattling, wailing and high pitched screaming.

A patient is having a tonic-clonic seizure in his hospital bed, together with a screaming and freaked out relative at his bedside, having no idea what is happening. Hospital staff are extremely slow to respond, but my trusted paramedic colleagues are quick to take action, positioning the patent on their side, trying to calm the relative down, explaining what is happening. A junior doctor arrives after a minute, and is completely flustered. The nurses aren’t much better. Gozo orders the doc to get some Midazolam for this patient, all whilst continually talking to the relative, explaining what is happening (“no, the devil has not taken possession of you loved one”, he explains in Spanish), and occasionally interjecting with some paramedic wisdom directed and Andrew and myself. Andrew is especially interested and excited, as he has never seen a seizure before – and we were just discussing different seizure presentations and treatments earlier on in the shift. And not playing my own interest down, this was only the second seizure I witnessed, and in quite a different environment I’d expected – an overcrowded emergency room in NYC.

The seizure subsides, the situation is under control, and we stroll back to the Ambulance. But what do I spot there? As we leave, we walk past some EMTs who have come rom La Guardia Airport – and they don’t look like regular EMTs. Probably because of the gun and cuffs next to their penlight and trauma shears on their belts. They are police officers from the Port Authority Police. Their uniforms have EMT and Police written all over them. Police officers in EMS duty. Not sure If i agree with the concept, but there you go. They’re a BLS only system, ALS backup is called from NYC EMS.

Outside, another interesting sight: a FDNY ambulance, but this is a HazTac/Rescue unit…cool. These are the guys that go in with the dirty stuff, CBRN, confined space rescue etc – similar what the UK HART units do.

Image from Wikimedia Commons

One of the FDNY Haz-Tac EMTs spots us, a big brawny bloke with a crew cut, and walks towards us with a quizzical look on his face (the look of the day, it seems):

“Two questions: 1) are you gay, and 2) can you keep a secret? He winks at me with a dirty smile, slaps me on the shoulder, and I explain myself (yet again) why I look like I work for the sanitation department. He gives us a bit of an insight to the ins and outs of the HazTac units.

And thats it. Not many calls, no life or death situations, but what an informative and exciting day! We finish out shift half an hour late, but no-one really cares, we all enjoyed ourselves. We drive a few minutes back to the depot, clean and restock the van with the other crew that is taking it over for the rest of the night. Drew is on for a double shift, and so keeps the keys of the van.

Gozo looks at his watch: “I was told you’re taking the subway home. Nope. No way you’re taking the subway home, it’s hell dodgy at this time of night! Wait for me, I just need to finish this paperwork and I’ll drive you home. No ifs or buts.”

Can’t argue with that!

NYC: Caribbean Care, part I

June 2011

 

[general chatter in the background, footsteps, doors opening and closing]

*cling*

*clink cling*

*tap tap tap*…pause…*tap tap tap tap, tap tap*

*beep beep*

*beep beep*

Such would have been the backdrop standing next to me at the payphone of the hostel I was staying in. I’m following up from the previous nights offer of getting out on shift with Paramedics in the New York City borough of Queens, having dialled Barry’s number. After a short wait my call is answered.

“Hello it’s Barry” it comes in a thick New York accent, reminding me more of “The Godfather” than “The Paramedic”. It seems that I am on speakerphone, and that he is driving. I imagine the telephone on the other side of the line set in a massive black Cadillac being driven though the streets of Manhattan, tommy gun on the passenger seat and a dead body in the boot. And the Fedora casually slanted on his head in true gangster fashion. I give myself a mental kick to focus back on the task at hand.

“Hey Barry, Flo here – the Paramedic from Australia. We met last night at the REMSCO dinner.”

“Yeah, how ya doin’ ?. You got something to write? June 32nd (obviously that’s not what he said, I’m just de-identifying the date for the blog), you come to our Hospital in Queens, and we’ll get you on a truck!”

Times and directions were exchanged. I was being picked up from the subway station. The shift was sorted. Brilliant. Gold Class service right there.

On the day, I arrive in Queens, find the hospital (no problems due to the easy directions) and call call Barry to let him know I have arrived. He’ll be there in ten minutes, I should have a look around in the meantime – something I don’t need to be told twice. There were a few ambulances parked near the Emergency Room entrance, so I went to have a sticky beak at the closest one, and take a picture whilst I was awaiting my chauffeur.

“Hey, you can’t take a picture of that without us!”

A loud female voice carried from the next ambulance parked just down the road, slightly bossy but with a distinctive giggle in there.

The three EMTs are just restocking their vehicle a few metres down the road, and are obviously not envious of the attention the other ambulance is getting. “Well, you better clean up the van and pose for the lens!” I reply, beginning to walk towards them. Apparently the girls didn’t quite anticipate this reaction, and looked rather startled. When you tell somebody to point their camera in your direction, you would never in a million years expect them to actually do just that, would you? Must be female logic…

Anyway, the three of them turned out to be bright and chirpy, with the startled face quickly turning in to a quizzical face, what I am doing here and what’s with the green trousers and the reflective stripe? Apparently, in NYC, green uniforms are associated with the sanitation department (some old medics will remember that NYC ambulance uniforms actually were green back 20+ years ago), but I was quick to take my jumper off and show my work shirt, revealing the (to Americans) foreign term “Ambulance Officer”. We all had a good chat, laughs; Discussions and comparisons followed, and a few minutes later i think we have three potential new visitors to Australia. Barry, the supervisor turns up, and sees me chatting away to to a bunch of his girls. He shakes his head with a grin.

We drive ten minutes down the road, talk about how things in NYC run, his history (active paramedic, paramedic and EMT instructor, his roles as supervisor). The station is again a large garage, parked full with about 10 ambulances, lockers, mechanical stands around, mess room adjacent. I am first introduced to the head of the service, we exchange a few introducturies and I quickly explain what I’m doing on this trip. No time for much more, I whizz off with Barry to the mess room, he has sorted out a crew that he wants to put me with, only the hand picked best guys for the Australian visitor apparently!

There are about ten EMTs and paramedics milling around the mess room, some on break, some ending their shift, some getting ready for their upcoming shift. Then I am privileged to one of the best introductions towards the staff:

“Everyone, i want you to welcome flobach – all the way from Australia! I met him at the REMSCO dinner the other night, a good guy, and I wanted to show him how we  do EMS in New York City (Yeah! show him the real NYC, people mutter, and nod their heads in a mix of love towards their home city and profession). I want you to look after him. Flobach will be going out with you, Drew and and Gozo. Your shift goes until 11pm – I want you to drop him off at the subway station, I don’t want him running around here on his own at night, do you hear? Take him right to the station, and look after him. Have fun guys!”

With that, he shakes my hand, gives me a smile, and leaves. None of this wandering in to foreign paramedic quarters, trying to explain to disinterested crews why you are giving up your spare time to do a shift. This was a smooth start!

With that introduction, I slot right in. The crews are interested about my background. We chat about Australia, their service, my trip, the lot. I feel more than welcome.

I show them pictures from Australia, and all of a sudden everybody wants to move there. Conveniently, I tell them, my service is just having a massive recruitment push…eyes light up…and I wonder if I should charge my employer commission for recruiting potential new employees. They like the idea how things in Aussie run. No calling for orders. The drug range is decent. The working conditions are great, leave, pay, vehicles, roads. A very attractive place indeed. Surgical cricothyroidotomy raises eyebrows. They may be getting ondansetron next year…I tell them to look forward to it:-)

Meanwhile, Gozo is twirling his neatly trimmed moustache, worried about the unilateral greying. I suggest colouring it in with a piece of charcoal a trick I learnt from my dad. He’ll give it a try, he reckons.

Finally, our truck arrives, after being held up on a late job for 45 minutes. A student on placement, Andrew, shows me around the truck, as he is attending today – the paramedics are really only there to help with extrication and make sure he is up to standards.

I need to briefly pop back in to the office to sign an indemnity form so I won’t sue them – fair enough – when one of the paramedics pokes his head around the office door and asks for Barry to come in to the mess room.

“Um, boss, student is out with us today, can’t really take flobach.”

“No way, he’s going out with you guys! He’s come all the way form Australia!”

“But student actually pays money (via his paramedic course) to come out on a shift…”

“But this guy has travelled all the way around the world from Australia!”

“Put him with the other crew”

“No”

Hmm…pensive silence.

“Can they both come out with us?”

“I guess so…nothing stopping you really!”

 

Stay tuned for part two…

The Royal London Museum

Today, I visited the The Royal London Museum, the…erm…Museum attached to The Royal London. Stop me if I’m stating the obvious here.

The museum documents the hospitals history through the 18th, 19th and 20th centuries; from the idea behind the building it in the first place (1740), carrying through to the future.
It’s an interesting concept: The hospital was built as a voluntary hospital, meaning it was funded by donations only, and available to the sick and the poor. Quite remarkable I believe – we’re talking over two hundred years before the National Health Service (NHS) was born. East London was (is) the poor part of town with a health record lagging behind the rest of the city (and country). Healthcare for the population, mainly made up of immigrants, was direly needed. The Royal London was one of five voluntary hospitals built at the time, and it was only after they were built that the birth rate once again exceeded the death rate in the city; London began to grow and prosper again (now there’s a good argument for public healthcare!).

I won’t rattle on about the whole history – it is already available in book and exhibition form, plus I wouldn’t want to take the experience away from you.

If you’ve got half and hour to an hour, it is well worth a visit to learn about the development of healthcare over the past 300 odd years, what it has achieved, and what we owe to our forefathers (and -mothers). Exciting, interesting, gruesome…you’ll find it there.

Visiting Information
Where: St Augustine with St Philip’s Church, Newark Street, London E1 2AA.
When: Opens weekdays 1000-1630, except Christmas, New Year, Easter and Public Holidays. It’s worth calling ahead, as staff shortage can affect opening hours.
How much: FREE, as all good museums in the UK. (I feel sorry for you American folk). Donations are welcome, though
Web: Official website: http://www.bartsandthelondon.nhs.uk/about-us/museums-and-archives/the-royal-london-museum/

The Royal London Museum is a part of the “London Museums of Health and Medicine“. It is my goal to visit all 25 of them

NYC: Maimonides Medics

June 2011

The day had come: Time to see what New York City Paramedics do. The grime of the city. The hustle and bustle. The intensity. The size. New York City. I was excited.

I had sorted a shift out from Australia via some contacts (thank you again if you’re reading this!). A few emails and a phone call later, I’m booked in. After borrowing The Worlds Smallest Ironing Board from the hostel, coupled with The Worlds Worst Iron, my crease free shirt (NOT!) and I were on their merry way to Brooklyn.

The Subway, or any underground train for that matter, is a semi-magical type of transport. Descending in the the depths of the earths core, you are whisked away in a steel can on wheels, propelled through a network of subterranean tunnels, only to submerge in a completely different biotope.

I felt like I had come out on the Wrong Side Of The Tracks:

[youtube http://www.youtube.com/watch?v=uAFDeC7TVyQ]

…and when you’re in f*ckin’ Brooklyn, you best watch your back!

Woah. Dirty streets, rubbish lying around, big mean-looking guys with tats walking around. A dark freeway underpass. A broken fence. I looked around, and felt like the proverbial sore thumb sticking out. No one really took notice of me, but There was no way in the world I was going to do anything to draw further attention towards my person. No way was I taking my iPhone out to take pictures. I made sure my valuable were as safe as possible, and out of sight. I morphed in to “man on a mission”, and headed straight to the ambulance station, trying not to leak any signs of curiosity of the neighbours or indeed the neighbourhood. Because I was just that – curious. But I was attached to my health and my life. (I’m sure this was a bit of an overreaction, but you can never be sure…and this was precisely the landscape that is always portrayed in various US gang films…).

I arrived in one piece at Maimonides EMS depot (pronounced May Mo Nuh Deez. Maimonides was a medieval Jewish Scholar). Phew. Knock Knock? Noone. I walk in, and am greeted by some paramedics, who direct me upstairs to the supervisors office. A few doors and some very narrow stairs later, Henry greets me with a big smile, welcomes me, and eagerly gets right in to it: “Let’s head downstairs, I’ll show you around and introduce you to the paramedics”.

We head back down, but the crew for the shift is not there yet (admittedly, I am very early).  “Here, I’ll show you your truck!”. And yes, it really was a truck:
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We chat for a short while about the service, but then his phone rings and Henry excuses himself. “Grab some food in the meantime! It’s EMS week, help yourself, go right ahead”. Well, free food, can’t decline a friendly offer, can we? The banquet had been ransacked by earlier crews (it was early afternoon already), but still plenty to be had.
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Eventually, some people in uniform wandered in, who turned out to be the medics I would be riding with soon. We go through the different kit they carry, compare each others respective guidelines and protocols, and are bleeped immediately for a standby position. You see, in New York, all Ambulances except FDNY (pronounced fid-nee, or fud-nee if you’re from New Zealand) get dispatched from street corners, not from stations (more on that in another post).

Halfway to our streetcorner, we are sent on our first job. Oh yeah, this ALS truck is now running hot! Big, boxy, bouncy, bad. Together with the fine and silky smooth roads (NOT!) of NYC, it would make for quite an unpleasant ride if I were not so excited. And another thing: Drivers of all emergency vehicles are quite playful when it comes to sirens: wooowoop. wup. wuup woop. wooohoooowailwailwail. woop. wail wail. HONK yelp yelp HiLo. HONK woop.

A haemophiliac in a high rise building has called, thinking he has broken a bone. We’re in “The Projects”, the New York term for low income (generally ugly high rise) housing. And I get the picture pretty quickly: Dark and dirty entryway, a lift smelling of stale urine with goodness-knows-what smeared over the graffiti. Creaking, the lift sneaks us up multiple floors, spits us out in a tight hallway, where mum (or should I write mom) awaits us: her brother has a bleeding disorder, heard and felt a snap in his thigh, which is now slightly swollen and tender. And he can’t weight bear.

Luckily we have the carry chair handy.

Our patient is comfortable as long as he isn’t standing, but the upper leg is tender to touch. All vitals within normal range, declines pain relief, so apart from monitoring and transport there is is not much more to do.

We arrive at hospital after an uneventful transfer where, once again, it becomes painfully (for the seasoned US medic, not me) obvious of the stretcher systems that are in place in most of the US & Canada: Person A must hold half the patient + stretcher weight, whilst Person B must fold or unfold the legs of the stretcher. Man, you gotta hold a lot of weight, that can’t be good for your back! I think that topic alone is worth an additional blog post (at the risk of even more wrath in the comments section)

Back in the van, restocked and roomy (yes, this thing is rather large), we are sent to our street corner again. Not a bad corner, as far as street corners go: Close to a major road, yet quiet, a supermarket for food nearby, and free public WiFi.

And we wait for another job.

And wait.

And wait.

And wait.

And fall asleep.

A nine hour shift with one job. It’s light. Nothing. Then it turns dark. Nothing. BLS crews whizzing past us on lights and sirens. NYPD screeching past. Firetrucks honking their airhorns as they hurl past. But this ALS crew isn’t needed anywhere.

Observers Curse.

NYC EMS: An Introduction

June 2011

What would NYC be without EMS? Only half a trip for me!

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My first encounter with an ambulance. It conveniently parked in front of me, inconveniently the fence would not move out of the picture, despite much begging and pleading on my behalf (note to self: fences a much better behaved back home).

That day, twitter came to the rescue for my evening plans. Murphy (@Murphquake) told me about the Dinner Presentation that was being put on for EMS week by the NYC Regional EMS Council. A free event? Dinner? I’m there!

And there I was. Standing there, in my lonesome, in a big hallway, people with all sorts of uniforms coming and going. I enquired politely about the evening at the entrance desk, explaining that I was a visiting Paramedic from Australia.

“AUSTRALIA!? Wow, come right in. What T-Shirt size are you? (wow, free tshirt too??). Here, grab one, head that way, the buffet is in that corner, help yourself, grab a seat anywhere you like, and enjoy the evening. Speeches etc begin in 45 minutes. Here is a guide to the evening. Enjoy yourself!”

Right, thats sorted then. I may not know anybody by face, but there is free food, lots of people in the same profession, and a few empty seats around. Jump right in, I say.

With a precariously heaped plate in each hand, I navigate myself to a table where people seem cheery enough to accommodate myself. Turns out they were a whole family dedicated to EMS, from Daughter and Son in law right through to the grandparents. We got some great insights from each others country over copious mounds of food (this is America after all), and I was asked if I was heading out on a shift in New York at all. Even before I could answer, one of them had run of to fetch ‘a friend of theirs’, who came back shortly after. I was introduced to Barry, one of the Paramedic supervisors in the Borough of Queens.

“Here’s my number. You call me tomorrow, and I’ll get ya sorted”. Spoken in a perfect New York accent.

This was going to be excellent.