The Idea... Part 3

The next day in the series of that week (Parts 1 and 2 covered the second day of a whirlwind week) was Wednesday, September 19th, 2012... Why is this week standing out to me? It is just neccesary to explore as it is at it's core the time frame that moved me to begin sharing things on this level.

That particular week was one of the busiest of my life and definitely held some significant distances travelled as part of it... not to mention a whole new level of exhaustion... and as you can imagine it created a backlog of work at my primary job as I was only in my office for one day the entire week.

Back to the 19th... I had taken a PTO day so that I could attend and present at the first annual Deaconess EMS Symposium at home in Evansville. Deaconess, through the efforts of Peter Stevenson, MD, Kevin Hendrickson and Lu Weil, set off to make a local educational offering that would mirror and present some of the more important points of the U.S. Metropolitan Medical Director Consortium State of the Sciences EMS Conference that is held in Dallas, TX in late February each year. Dr. Paul Pepe and an entourage of EMS medical directors put on that Conference each year with about 700 people in attendance. It is two solid days of 10-15 minute, data/results driven presentations. The real nuts and bolts of on the edge, just less than scientific, robust presentations. It is the harbinger of the evidence-based prehospital medicine to come.

Stevenson et al wanted to bring home the major information and flavor of that conference. The info is extremely valuable to anyone who wants to affect EMS practice and do the best things for their patients.

Dr. Ed Racht

They lined up the ER docs from Deaconess to present that material... with two exceptions. The first being Dr. Ed Racht, who is the national Chief Medical Officer of my primary employer and myself (yeah... I know... way out of my league and I tend to get very nervous about that issue). All you have to do to learn just how much of a player Dr. Racht is in this country is just Google his name. What I will tell you is that above all, he is a gem of a person. From a paramedics perspective, I can tell you that he gets it. He understands the prehospital side of emergency medicine. He has been a medical director in a response vehicle out making calls.

I almost hated the fact that I had to go to Vegas earlier in the week as I wanted to be in town when Dr. Racht presented at my employer as well. That was not to be. I got to count cities in the dark from 35,000 feet instead. But Wednesday arrived and I got to rub elbows with Dr. Racht and doctors Stevenson, Huhnke, etc... I guess I really do hope to learn more through elbow rubbing osmosis (ERO?).

The day was great. Dr. Racht launched the whole thing talking about the big game changer topics that are coming in EMS. The various docs spoke on the many topics. The Symposium was a sell out and much information was delivered. I closed the conference with my data on response times, which shows a distinct lack of response time impact on the real time physiologic status of the patient. The data does not measure outcomes, but does look at whether patients become more unstable over time waiting for an ambulance.

Good job guys... the Symposium was a success and I did not puke from nervousness on stage. I never do, but I always feel like it.

We adjourned from there to a "meet and greet" for our employees with Dr. Racht.

After that, there was a scheduled dinner for the managers at work with their spouses and also including Dr. Racht, Dr. Stevenson and Dr. Fouts. It was a great setting (looking out over downtown Evansviile from a high vantage point), good food, stories and people. We talked of stories that in many cases were over 20 years old. Stories that framed our EMS experience and had helped make us who we are.

At one point, I noticed my boss standing up with his hand behind his back...

I don't think I have mentioned this before, but this is my 30th year in EMS. In two days, it would be my 25th anniversary with my primary employer.

He brought out THE BOX. I knew the box. It was the box that our anniversary certificates come in.
I instantly wanted to crawl under the table. I knew he would bring this out sometime soon, but from past occurrences, I never thought it would be two days before the anniversary. I usually embarrass very easily with any type of recognition... so...

He thanked me for 25 years of service in a very generous verbal salute. I countered by saying, "Let's now recognize Peter Stevenson for his 32 years of service." Which is very true, but anything at that point to take the spotlight off of me.

25 years at one job. All eight months of that in the same management position I hold today. It is in ways a lifetime.

I have responded to three tornadoes, a C-130 crash, fires with victims, shootings, stabbings (and bears... oh my!), cardiac arrests, choking... I can't even begin to keep it all from running together. On the management side it has mainly been quality improvement and in the last decade trying to sort through mounds of data.

Years of writing protocols, troubleshooting problems and building engineering controls to help keep people from making mistakes.

Teaching everything under the sun related to EMS except for communications and OB/GYN... I don't touch those on a bet. Not that I can't... I just don't enjoy teaching those topics.

Anyway... I suppose it was a wonderful way to have it happen with my wonderful wife there, Dr. Racht, Dr. Stevenson, Dr. Fouts and my cohorts in management.

The night ended all to soon. I took Dr. Racht back to his hotel. It probably meant the most to me that he verbalized that he noticed the extreme efforts we make here in Evansville not only to do good care, but to do evidence-based care and share what we do.

Many things ran through my head that night and I found it hard to sleep. Thursday would be my only day in the office and another trip was coming on Friday that was another new step for me.

We can discuss those in Part 4. We will get into some opinions there for sure!

Namaste

The Idea... Part 2

From Part I you may have surmised that I am sometimes all over the place from a thoughts perspective. I definitely have a multi-track mind, sometimes thinking through multiple things at once. This of course is probably true of any paramedic who has had significant time in the field. Automated, critical thinking regarding what has happened, is happening now and the probability and scripting of what may happen occurs simultaneously.

Anyway… back to where we left off in Dallas (which is a place I really like by the way… hate it when I am trapped in hotels and airports and can’t explore).

“September 18, 2012 – 8:17pm Central Time – Dallas, TX: Am now on the plane preparing to depart for Evansville. Long day.  I can’t wait to see Annette and the kids. I need a glass of Reggae Red before bed. I am glad that I have tomorrow off even if I have a commitment to be at Deaconess for the EMS Symposium, and a company related dinner to follow for my primary employer.

We will be flying at 37,000 feet this time. A two hour flight time.

I had a great Bison Burger at DFW for dinner. Really good. Don’t see much Bison served in Evansville. Talked with Annette on the phone. She advised that we got tagged by the City for the water meter cap in the front of the house being broken. It’s actually the one to the shut off valve and it is on the City side of the connection. Guess we will have to figure out why they expect us to hire a contractor and fix it. It has been broken since we moved in back in 1998.

As we taxi out for takeoff, a crescent moon hangs to the west near the horizon. With the runway lights, this creates an awesome view. The sky is filled with the bright colored and white lights of many planes around the airport.

This flight is not even half full. Everyone looks tired. No one is talking. This is a stark contrast to my last flight. Few reading lights are on… not even mine as I write, secured in my seat.

I wonder how many of them are actually from Evansville? I recognize no one. Several are asleep before takeoff.

Not me.

I can’t wait for the internal game I will play trying to identify cities at night by their light shape, size and our presumed flight path.

Many in-bound lights, dropping as we taxi for many minutes. Hate to leave Texas again, even though I was only at the airport. My life however is at home and I love my family.

The lights rush by. Takeoff. This thing is fast… Embraer jet.

Dallas glows as the landscape tilts into view as we climb. Most likely I am looking at Arlington and Irving as well. The lights go on into darkness at a distance. How would Twain or Thoreau describe this? No words again. It is simply an amazing view in its urban beauty; the night time city-world aglow.

The lights thin out as we fly into the night. I can no longer tell where Earth meets sky.

It looks as if Little Rock will be the first big town we fly by tonight. I may see Texarkana and Memphis off in the distance.

I love geography, can’t you tell?

I never had Geography as a class in elementary or high school. As with a great many things, I am self-taught.

Maybe that is why maps, compass, orienteering and the modern GPS are important to me in Scouting. I seem to be fascinated by knowing elevation as well. Small towns dot the Earth below. Some are larger but so far as big as Evansville since we left Dallas. I lose track of time when flying.

The flight attendant has brought my coffee. I like it at night too. It does not affect my ability to sleep.

I believe I see Texarkana off to the east (I drew a flight line on the magazine map). I know that the Ozarks will be down there soon, even though I will not be able to see the folds of forested hills at night. Only seeing Little Rock will tell me that they are near.

Finally, Little Rock is a spread out splattered star below. I have only been there once. I believe I was seven. My Dad took me and Mom down there to visit his retired partner from the Evansville Police Department, Jim Crawford. Turns out that my Dad and Jim just wanted to hunt for a criminal on the loose in the Ozarks around Little Rock. I remember getting into Jim’s pickup (first time I had ever been in a truck) and going down old, pine needle covered, mountain, two dirt tire track roads. They were acting on a tip. Of course, Jim was retired and my Dad was way outside his jurisdiction.

We found the guy’s campsite, but the fire was cold. He was long gone.

Jim died a few years later. He had been outside chopping wood. He came in the house, sat down in his recliner and asked his wife for a glass of Iced Tea. When she brought it back from the kitchen… he was dead. Heart attack. This would have been about the time that Johnny and Roy were running around on TV in Squad 51 and rural areas were just learning what a Paramedic was from the entertainment box. No paramedics existed for Jim.

That is all I know about Jim Crawford, or remember about him I suppose. I can’t seem to remember his face.

The running lights flash against the metal on the wing in the darkness. I now see Memphis… I have a story to tell there too from when I was seventeen. I may only decide to tell it in person though as I was surprised my friends and I survived and it involved a high degree of parental disobedience on my part.

I am on my 12^th page of journal entry tonight. What has snapped??

Memphis appears as a fireball. It is more densely lit than Dallas earlier. I can see a bridge from where we fly, maybe 12 to 15 miles away and 35,000 feet up. I can also see the highway that brought me there the first time… 31 years ago. I went with a friend named Chris… cannot remember his last name. he wanted to visit a Catholic college he was thinking about attending… oh well, not tonight. The Mississippi River is the large, dark snake forming the abrupt, curved western border of the city.

Somewhere up there soon is New Madrid. Site of the great earthquake and a constant worry for the Midwest… and Evansville, as it will go off again someday. Praying for a no go on that one.

Took a thought break and read I Corinthians Chapter 16. Verse 9 stood out to me tonight for some reason. “There is a wide-open door for a great work here, although many oppose me.” That is from the NLT version (my small travel bible). I will need to look at it in the ESV or maybe even look at the Greek meanings. Still sounds like the world we live in today. In my mind, all Christians have a (or more than one) personal ministry, whether fledgling, strong or weak. The secular world directly opposes the learning of the grace of our Lord Jesus Christ. Many therefore oppose us.

The words of Martin Luther come to mind from across the ages. A Mighty Fortress Is Our God. Enough said?

No clue where or what we are flying over now. I will have to get my bearings and identify a landmark. Paducah, Kentucky may be the next city on this Pathway.

Yes… it was Paducah. I am getting pretty good at this. It would help a bit if I would bring a compass on these trips. Just for fun.



Birdsville Cemetery



The last time I was in Paducah was during the family meal following the burial of Annette’s Grandmother Barton at Birdsville… a cemetery high on a hill overlooking the Ohio River in rural western Kentucky. Her ashes are buried there.

There is a change in the tone of the engines. Must be starting the slow descent into Evansville. I see Marion, Morganfield and the lighted coal beltline that delivers the black rock to the barges on the Ohio. The coal beltline is lit up like a chopped up snake across the dark ground.

Landing prep has started and I can see Henderson Airport (or Geneva International s they called back in 1987 during my paramedic internship there). I can see Evansville to the northeast across the Ohio. Evansville is home. Ree Ree and Peter. Michael and Luke. My wife.

Kat is of course at OSU, many miles to the northeast in Columbus, Ohio.

Five out of six still makes it home and it is easier knowing that Kat is doing well. After all, she is no longer a child, but an adult. It is the strangest feeling to have been on a wine tasting tour with your daughter. It’s fun, but really brings home the fact that you are old.

Over the west side of town now. I can see the Casino and the Lloyd Expressway. We are going straight in to runway 4. I know this angle. Then there is a sudden change. Now we are going around to land on 22, from exactly the opposite direction.  I have never made an approach into Evansville at this low of an altitude before.

The landing… I would describe as way hot with extreme braking. Looked like we overshot two-thirds of the runway. The landing was less than pleasant.

Good to be back in Indiana. Its cold here compared to Nevada and Texas. I guess this hot, drought marked summer had me off guard. Fall is only a few days away (Friday).

I drive home to the Sola Gratia Haus (for it exists by the grace of God).

Time for a glass of Easley Reggae Red. Goodnight.”

That is it for the sum of my written journal from that day… but that week was far from over. There will definitely be a Part 3 of this topic as the idea of this blog reached its fruition… maybe even a Part 4, before I get on my self-designed, four sided soap box.

You will see me use the Sola’s quite a bit from time to time. In Latin, they are:

Sola Scriptura, Sola Gratia, Sola Fide, Solus Christus and Soli Deo Gloria.

Or…

Scripture Alone, Grace Alone, Faith Alone, Christ Alone and Glory to God Alone.

These tend to say it all for me. They may be centuroes old, but the statement fits my beliefs. I even used these in the designs for our Cub Scout Pack and Boy Scout Troop neckerchiefs at our school.

Troop and Pack 310 Neckerchiefs



Although I have no idea who wrote this single sentence description, it is an excellent incorporation of the meaning of the Solas:

“Scripture alone, being our final authority, teaches us that salvation is by His grace alone, through faith alone, in Christ alone, for the glory of God alone.”

That sums it up for me… till next time when we shift gears to EMS for awhile.

Namaste

The Idea... Part 1

For this entry, I would like to start with a rather lengthy set of notations I made in my handwritten journal from early last week. For some reason I got very prolific with a pen and a little leather bound book. Whether it was the sheer combined boredom and terror of air travel, or just the stress of the busiest week of life… I am not sure. So here goes!



One of the late Aircraft



“2:11pm Pacific Time – Las Vegas, NV: On a plane heading to Dallas and from there, home to Evansville. Plane is late arriving at the gate as has been the norm for me lately. Can’t wait to take off and head home. Miss my wife and kids.

Looking down at Lake Mead from about 20,000 feet shortly after take off. No words to describe it. I need to start a blog. It needs to have entries in several areas: Family, Personal Ministry, Scouting and against my personal desires and judgment, logic tells me to include EMS.

It has been less than two weeks since Governor Mitch Daniels appointed me to be Chairman of the Indiana EMS Commission… Now the pressure is on. How do insert positive change? How can we as the Commission become more proactive and less reactive? How do we insert more evidence-based practice into Indiana EMS? Meanwhile, I watch the west slide under me as we fly…

On the flight out to Vegas yesterday I read John Chapter 6. This chapter really clarifies Communion even more for me. I must try to figure out how to explain this better in my own words.

The Captain just came on. We are at 25,000 feet now and we are over the Grand Canyon... amazing site. So many things that I may never see up close. My path is where ever God leads. Not my will but Thine.

Note to self: Must look for the little airport I see near the South Rim on Google Earth. I learned some things about simulation on this trip. We must do more of this in EMS. It will tell us a lot more than just looking at data and using our intuition to affect change. Simulation allows us to live through the scenario and trial minor changes. I do think it is as billed... a key to improvement at a faster rate.



The Grand Canyon - September 18, 2012



I can almost see in my mind's eye Genesis 1:1-10 as I look down at the Grand Canyon, the surrounding plateaus, cliffs and deep valleys. I can see the seas running off as the land was made to divide the waters. It plays like a movie in my head.I simply cannot disbelieve creation. It makes perfect sense to me. The creation lies before me.



I hope I can make my connection in Dallas. It's going to be close.

After awhile, I can see the snow capped Rockies off to the extreme NNW. Maybe we will fly near Philmont and some of its geophysical features might be visible to me, at least maybe some of the ones I know. Hoping. I will wait for the Rockies to align to the north before I try and see the Sangre de Cristo range in New Mexico and Philmont. Uracca Mesa maybe? Rayado?"

{At this point I will spare you from the half page diatribe regarding "boxer" chips and Ginger Ale and the relation to childhood memories}

"Over Albuquerque now with Sante Fe off in the distance to the NW. A few minutes later I can see the Sangre de Cristo range of the Rockies and where Philmont is to the lower horizon to the north. Philmont here's to thee, Scouting paradise... out in God's country... as the song goes. I need to go back!

We just flew ESE over I-40. I can see the New Mexico escarpment off to the north. To think it has been around four years since I was surprised by the sudden turn in the road on NM HWY 39 as we left Mosquero. The road suddenly went from East to South, descending some 800 feet of elevation in 9/10ths of a mile along the wall of the escarpment. It was like a sea turtle 'WHOA' from Finding Nemo.

Texas now? I can see large areas of generating windmills below (to think that each blade is the length of a semi with trailer). Now even more windmills to the north. Both sets were along the upper edges of plateaus. Flight coming to and end. Seems like a fast two hours and forty minutes. Hope so. Will have to run to the gate to make my next flight.

Thank you Lord for taking care of me even when I don't ask!! Gates are close together!"

We will call this the end of Part I as I landed in Dallas. There was yet again another flight delay that allowed a shot at a Bison Burger. Why am I realying this? The week of September 17th was extremely busy for me. The trip to Vegas was short (less than 24 hours on the ground there). And the week had many interesting high points for me... only one of which was a burst of prolific journal entries.

If you choose to stay on this ride with me, you will know me well.

Till I have a few more minutes to type... I will leave you with some pictures of my sons and myself with Governor Daniels from earlier this year. Namaste



My son Michael (middle row on right side - White Neckercheif) with Governor Daniels 2012



Myself meeting Governor Daniels



My son Luke with Governor Daniels



Introduction

Before I go too far with this blog I want to get something straight about my perception of reality. I see things from a jaded point of view... Having five children, spending 30 years in EMS, loving the outdoors and always trying to learn more about what God desires me to do with this life has created a combination of viewpoints that can only be labled as unique. Faith, Family, Forests and the field is just that... musings on the four. 1) What I hold to be true about my faith (doesn't mean I intend to force it upon anyone, just my view and I will be forward in this blog about that), 2) The escapades of my family (anyone who knows us would probably tell you that it is a bit akin to Monty Python's Flying Circus.. we call our home the Sola Gratia Haus... for it exists by the grace of God), 3) Forests... I am a Scouter (I serve as the Scoutmaster for Troop 310), and 4) the Field (this refers to EMS... I steer clear of these discussion points on Facebook most of the time... that will not happen here. There will be EMS venting here). My views will be free to roam.

If you choose to read or follow this blog, I hope it imparts information, enjoyment or understanding... for you and me.

Namaste (as Mike Taigman would say...)