Wednesday, November 21, 2007


I took part in a departmental continuing education class for EMS last Sunday.  There were several stations set up- stretcher operation, stair chair, assisting ALS, things like that. These are the basics.  The things that are so rote, if you will, that you skip every other line while reading about it in a textbook.  But these things, nonetheless, are things you have to know. And know so well.  

One of the stations was how to properly fill out a PCR (patient call report).  One of my preceptors taught me to write "PFA" (psychological first aid) under the "other" category of the sheet when treating a patient.  PFA would consist of saying things to the patient like "Is this your first time in an ambulance? Yeah, mine too." Works wonders, actually.  But how in the world can any EMT get to that point of treating a patient without first getting through these rote basics? And, since there is no specific space on the PCR for indicating that PFA was administered (aside from the "other" line), the EMS system doesn't even expect PFA to be administered.  

Heck, even barbers have externship programs set up so that barber students can practice their profession before going out into the real world.  Not law though.  So long as you score high enough on the bar exam, you're good to go.   So, all you newly admitted attorneys out there, remember- give your clients a little PFA once in a while, even if you're not tested on it on the bar exam.  

And, while you're at it, don't be like all the recent law job applicants I have had to face in the last month.  Don't tell me that you "love the law".  Don't tell me that you really expect to "change the world".  Don't tell me that you want to "do some good in this world" with your law degree.  The only good you really want to do is get rich.  It's ok to use the money the way you want to use it, for, by the time you have earned the money, you have earned the right to do with it what you want.  Just be honest about it.  And cut the crap already.  

My dad was my preceptor.  He died some seven years ago or so, but he is still teaching me all about how to fill out the "other" section on my own personal PCR form. But its still so hard for me to get to that spot on the sheet, even more so nowadays in light of my ( almost) 3 year old princess and my sweet 4 year old hockey star.  There's no school to teach the formalities, or objective requirements, of being a daddy.  But no dad can beat themselves up too much over it all, for that would only detract from the kids. 

Learn. Absorb.  Get as much as you can from your preceptors while you still can.  And make sure that when you throw your stone in the pond, the water's ripples caress the shore with lessons of PFA.  If that's too esoteric for you, then just give the form back to the girl at the desk.   

Monday, November 12, 2007

Health Insurers are Leeches

Interesting story out of Minnesota.  Tom Cary lost his wife to medical malpractice.  His health insurance paid for her treatment. He filed a lawsuit against the negligent doctor.  The health insurer, instead of pooling its resources with Tom to fight and recover the money, put a lien on his deceased wife's estate to recover the money it paid out.  Yes, the premium that Tom paid for years didn't matter.  The health insurer wanted to get paid.  

And get paid they did.  $60,000 out of an undisclosed settlement.  And yes, this can and will happen to you if you have an ERISA plan. 

In addtion to all fo the other reasons you have to contact an attorney, you need to see if you have an ERISA policy and if your health insurer may be entitled to reimbursement before you recover any money!!!

Sweet dreams. 

Sunday, November 11, 2007

Just Killin' It

I must have been about 15 years old.  The proportions of the rest of my body had just about caught up with the length of my arms, I was showering everyday, and it was really important to have a boom box. I was the paper boy too.  And upon delivering to one of the houses on my route, I happened upon an outdated amplifier that had a blown fuse.  The visions of stardom erupted.  And my rock star fantasy was ample fuel for my blast-off from paper boy slavery to jukebox hero.  The few days that led up to hooking up my keyboard synthesizer to the amplifier with two other high schoolers who shared my fantasy are blurry at best.  They played guitar and drums.  Together, the three of us rocked, playing cover songs and such.  Well, we never really played for anyone but ourselves, but who cared- we talked a big game.  We were larger than life.  And I brought that feeling home with me.  I talked to my dad about our sound.  He was hesitant to express his true feelings to me at first.  Surely, he was asking himself, 'how could my son, whom I have heard play oversimplified arrangements of broadway tunes on our baby grand piano, want to play a gig in front of a live audience?' He did ask me what the definition of a 'rif' was though.  I was so ready to pounce on the first indication of doubt he might have uttered.  But my dad kept quiet.  Until the next day:
"You know, Rich, there are night clubs in New York City where, if you think you can do it, you can step right up onto the stage, improvise, and play with other musicians.It's mostly jazz bands.  But I will do whatever I can to help you explore it. Who knows where it will take you to." 

What a lucky boy I was. What a good man my dad was.  

Manny Roth was an influential New York City nightclub owner and entertainment entrepeneur.  Manny Roth owned the famous New York establishment Cafe Wha?.  In the early 1960s, Cafe Wha? provided a stage for ameteur acts such as Bob Dylan and Bill Cosby.  Manny Roth is an uncle to David Lee Roth.  So, basically, because I didn't have the balls to pursue my pipe dream, I gave up living a life like Diamond Dave's.  I would have to settle for seeing the Van Halen concert at the Nassau Coleseum a couple of days ago.  Alex Van Halen, the drum player, was a perfect blend of Buddy Rich and 'Animal' from the muppets.  Eddie Van Halen shredded tunes on his guitar. And David Lee Roth was the ultimate entertainer- Bruce Lee spinning back kicks, top hats, outfits, you name it- he pulled out all the stops.   The guy is 53 years old, and he is still 'killin it' out there.  

Just like Diamond Dave, I get such a rush outta 'killin it' as an EMT.  Hope I can still do it when I'm 53.  But the types of calls we have been getting lately have really been buzz kills- a guy riding a bicycle gets hit by a car, and refuses medical attention.  An elderly lady falls, bruises her hip, and calls the EMT taxi service.  A guy gets drunk at a local restaurant. But time and time again, I will respond.  I will do whatever I have to do to capture that clarity of thought I experience when I remove all compassion, all emotion, all sympathy- and help- really help a patient.  

I had my son in my car when the tones came across my pager today, so I couldn't respond to the call.  'The Circle of Life' from the Lion King soundtrack began playing on the radio:

"Daddy, is the song about us?" my sweet 4 year old boy asked innocently, yet so much more keenly than he will ever know.  My dad died before my son met him.  

"Yes," I explained.  "It's about us."

Friday, November 9, 2007

Don't Throw Water on a Kitchen Oil Fire

Don't throw water over a grease/oil fire.

This is a dramatic video (30-second, very short) about how to deal
with a common kitchen fire ... oil in a frying pan. Please read
the following introduction and then watch the show .. It's a real
eye-opener !!

At the Fire Fighting Training school they would demonstrate this
with a deep fat fryer set on the fire field. An instructor would
don a fire suit and using an 8 oz cup a t the end of a 10 foot
pole toss water onto the grease fire. The results got the
attention of the students.

The water, being heavier than the oil, sinks to the bottom where
it instantly becomes superheated. The explosive force of the steam
blows the burning oil up and out. On the open field, it became a
thirty foot high fireball that resembled a nuclear blast. Inside
the confines of a kitchen, the fire ball
Hits the ceiling and fills the entire room.

Also, do not throw sugar or flour on a grease fire. One cup
creates the explosive force of two sticks of dynamite.

Please view this video clip by clicking HERE:

Please watch this video, learn, remember, and tell others.

Tuesday, November 6, 2007

Bet With Your Head, Not Over It

My wife and I actually got to spend some time together for about 24 hours straight.  Spontaneously, after dropping the kids off at my in-laws, we headed down to Atlantic City and scored a couple of tickets to a Police concert, thanks to Sue, the best casino host in the world.  The last time The Police played Atlantic City was 1984.  I was in 10th Grade.  I love their music.  They opened up with "Mesage In A Bottle". They rocked. But they got old. Really old. They were still wearing the same outfits they wore back in the day- Sting with his sleeves cut off, the guitarist Andy Summers with black and white stripes, and the drummer Stewart Copeland sporting a black shirt with the emblem from "Ghost In The Machine".  And there were big Atlantic City style banners all around the concert hall which read "Bet With Your Head, Not Over It."  But who am I, but an almost-40 year old guy who used to hang out at the mall.  I still go to the mall nowadays, just with my wife and kids instead of with any of my teenage friends who were adventurous enough to ride a public bus.  

Back in the day (way way WAY back), I didn't go to any concerts.  My parents were pretty much conditioned by my sister.  She's 8 years older than I am, and she took the liberty of telling my parents all the terrible things that happen at these concerts.  And me, being so naive at the time (I grew up in Pleasantville), I actually started to believe the hype myself.  So I stopped wanting to go, thinking that in all my Pleasantville suburban-ness I would be over my head at such a ruckus.  So I decided instead, back then, to act with my head. 

I still experience that sentiment today on occasion, pausing to decide whether or not to take a risk.  I love emergency medicine.  I love being an emergency responder. And in a perfect world, I would do it 24/7, all instead of being an attorney.  The problem is, the world is far from perfect.  There are so many days I wake up asking myself whether today is the day I will take the plunge out of my finely tailored Armani attorney suit and into my Medic gear.  The attorney , self-sacrificing for my wife and kids, or the Medic, selfish, self-satisfying pursuits of uncelebrated glory.  

Hindsight is 20/20.  So I suppose that no one, including myself, can truly tell whether a decision to become a full time Medic would be betting with or over my head.  Here's part of the rub:  ever hear of a successful gambler who didn't take crazy risks? Ever know a successful business owner who didn't put it all on the line to parlay his hunch into a walk on easy street? Ever think about how any pioneer in any field was prejudged? We marvel at what we now call their foresight.  But take yourself back, if you can, to the very instant they all made their decision to act- were they betting with their head, or over it?

I have tickets to go see Van Halen on Thursday.  David Lee Roth is with them on this tour.  He's an EMT.  

Monday, November 5, 2007

Pleasure: a Temporary Respite from Reality

I took the following from "Monday Monday", a brilliant publication distributed via fax every week, authored by Jay L.T. Breakstone, Esq. Mr. Breakstone is an exceptional attorney and an amazing writer. Mr. Breakstone's website can be found by clicking here.

Mr. Breakstone touches on many of the ideas which serve as common threads between my posts.


Lovely day, yesterday. Perfect temperature for the New York City Marathon. It found us on First Avenue and 89th Street, en famille, like Jean Valjean and Eponine at the barricades. We cheered and clapped, bewildered at the colors and the spectacle, all while looking for an uncle/brother/brother-in-law/son (who finished in sub-3:45 time, besting his past year's performance.) The day was uniquely New York.

Ah, but something unsettles. There is much valiant, but little aesthetically pleasing about 39,000 ectomorphs running in their skivvies. Perhaps, it's the images of starving people or prison camp survivors. Now, don't jump. We disgustingly large people recognize that we will die young, if full. But don't fool us into believing that the pleasure of running 26.2 miles is equivalent to Junior's cheesecake or a roll in the hay.

Perhaps we see beyond the act of running, to the more difficult question of what one is running from or to. The "runner's high" must disappear if you arrive home, only to find that you forgot to pay the cable bill and your kids can't watch the Disney channel.

So, is there any difference between the act of running and the act of, let us say, drinking a perfect martini? Not really. In both cases, the pleasure is a respite from the difficulty of conquering life's everyday problems. For the moment, whether pounding the pavement or bending the elbow, we have gone beyond, risen above, and spent some time with the gods. The martini is better, however, because at the end, you get an olive and you don't chafe.

Friday, November 2, 2007

Evil Knievel Through a Window

My local library has windows that look exactly like the windows of the library where I grew up in Greenburgh, New York.  The sight of those windows instantly cleared the cobwebs off some of my visions of childhood.  

I remember when I was a little boy, growing up in a garden apartment complex in the early 70's, idolizing Evil Knievel and imitating him by riding my Big Wheels down the hill and "popping a wheelie".  I had the best of friends that all lived within a 3 block radius. I had sleepovers. I told my kindergarden teacher that Nixon was a crook, but I didn't really know why. My sister wore Dr. Scholl's clogs.  And the world was fascinated with bell bottomed jeans. 

As the song goes, "those were the days".  You knew who the bullies were. You knew who the kids you wanted to hang around with were.  And you didn't really care whether the spaghetti you were eating for dinner had ketchup or marinara sauce on it.  Whereas now I would be going to Houlihan's or Ruby Tuesday's, I would go to Burger King or McDonald's back then.  Tres bourgoise!  But it didn't matter.  Everything was OK. You had a bed to sleep in, under a roof to keep you dry, some 33 1/3 speed records, baseball cards, various types of balls, and if you were good, you could stay up late to watch TV.  All of life's essentials.   I remember feeling good back then. Safe. I wasn't even humiliated by my "bowl" haircut or red plaid pants.  Had the seven year old kid I was been asked  back then how my quality of life was, I probably would have responded with a resounding "good" and turn the corners of my mouth upwards just enough to make you wonder whether I was sincere or just a kid with a pleasant disposition who didn't really understand such a question.  

I had been to "John's" house for a 'signal 9' (rescue call) about six months or so ago when his feeding tube came out.  He wasn't smiling yesterday when my bus came to his house again.  He couldn't.  See, he was non-verbal, non communicative, with a long medical history, including a couple of CVAs that had left this frail man in his 80's in the custody of his wife and a specially rigged bed for the remainder of his life.  This time he had managed to bite and mutilate his thumb to such a degree that it got badly infected and required him to be transported to the hospital for further treatment.  His wife was with him. but no other family members were.  They were represented only by old, dusty photographs around the house.  

I never saw such a situation like John's when I was a boy.  I wonder if it would have made me cherish my childhood days with the same inensity then as I do now.  I can tell you that there are a lot of times when I handle legal cases for clients whose situations are something akin to an episode of Maury Povich or Jerry Springer.  I admit, that on occasion, I watch those shows.  And when I do, there is one prevailing thought that goes through my head - "thank GOD that is not me."  When I was treating John, my 'heart' was in it. When I deal with my clients, my 'heart' is not.   Regardless of their situations, I do my best for my patients when I am an EMT, and my clients when I am an attorney.  Nonetheless, there is a "disdain", if you will, that exists for most of my clients.  I think it's because they seem to accept their social status, and refuse to fight their weariness for the benefit of their future generations.  The patients are somehow, more "helpless".  

I went into the library, and I asked the librarian for a book on how to bring up my children the right way.  She chuckled for a second, then stopped laughing when she thought there was a possibility that my question might have been a serious one.  She must have been a mother herself.  She cocked her head a little, flashed a comforting smile, and told me "if you're thinking about it that much, I'm sure they will be fine."  So I took an Ansel Adams book out with loads of black and white photographs of windows.