Thursday, December 10, 2009

ok.... im moving my blog over to wordpress. (just take out the 'blogspot'). let me know if you like it over there.

Wednesday, December 9, 2009

I'm thinking of moving

Im cosidering a move over to Wordpress. new blog is at (no

do you like the layout better here or over at wordpress? and why? discuss. comment.

Monday, December 7, 2009

Just Unlike Everyone Else

My power ranger son Brandon's hockey game was at 715am yesterday (Sunday!!). Those of you involved in hockey with your kids know that its not just a recreational sport, its a lifestyle- getting up before the sun rises, hot chocolate at the games, donning and doffing all the equipment, its quite an experience.

My son and the other 6 year olds weren't even the first game scheduled to play. As we entered the arena, we could hear the cheers and scraping noises generated by the two teams already on the ice. Brandon felt the excitement and ran into the rink area. There, he saw the game going on, but also the unexpected- the players were on custom built sleds of a sort. Each of the hockey players had a condition, whether it be a missing leg, a missing arm, or the like. Notwithstanding the sleds, the game was like any other- proud parents cheering, random spectators watching, even the guide dogs watched intently in the bleachers. To answer in a form Brandon could digest the barrage of "why" and "how come" questions that her rattled off was truly an art form. The players got off the ice at the end of the game, most with the help of family. The answer to Brandon's last question was the shortest, yet most profound: "Daddy, why aren't they crying?" "Because they aren't sad," I told him. Brandon sat in the bleachers, and watched with humility as all the players disengaged from their sleds. His hands lightly touched his own body parts as he looked on. He listened to their comraderie. He felt their triumph. My little power ranger didn't move from his bleacher seat until they all left. It was his way of saluting them.

Brandon's teammates began to arrive and ready themselves with their equpment. Another six year old boy near us was accompanied by his father. The boy began to whine about the fact that the neck guard he was required to wear before getting on the ice was uncomfortable. "You shouldn't cry," Brandon told the boy. I responded to a car accident later that day. I wanted so badly to say the same thing to the lady I had in the back of my ambulance on the way to the hospital. There wasn't a scratch on her.

I just got done prepping a client for tomorrow's deposition. He suffered a fractured ankle, wore a cast for 7 weeks, and did some physical therapy thereafter. As we explored the topic of how the trip and fall accident for which he is suing affected his life, I thought of those hockey players. "Do you like hockey?" I asked my client. "Love it" he said. I invited him to meet me at the hockey rink next Sunday.

Saturday, December 5, 2009

Health Insurance Companies suck dot com

Health insurance giant Aetna is planning to force up to 650,000 clients to drop their coverage next year as it seeks to raise additional revenue to meet profit expectations.

In a third-quarter earnings conference call in late October, officials at Aetna announced that in an effort to improve on a less-than-anticipated profit margin in 2009, they would be raising prices on their consumers in 2010. The insurance giant predicted that the company would subsequently lose between 300,000 and 350,000 members next year from its national account as well as another 300,000 from smaller group accounts.

"The pricing we put in place for 2009 turned out to not really be what we needed to achieve the results and margins that we had historically been delivering," said chairman and CEO Ron Williams. "We view 2010 as a repositioning year, a year that does not fully reflect the earnings potential of our business. Our pricing actions should have a noticeable effect beginning in the first quarter of 2010, with additional financial impact realized during the remaining three quarters of the year."

Aetna's decision to downsize the number of clients in favor of higher premiums is, as one industry analyst told American Medical News, a "pretty candid" admission. It also reflects the major concerns offered by health care reform proponents and supporters of a public option for insurance coverage, who insist that the private health insurance industry is too consumed with the bottom line. A government-run plan would operate solely off its members' premiums.

Aetna actually made a profit in 2009 but not at levels that it anticipated.

"They were surprised by an acceleration in medical costs in 2009 which pressured their earnings," Josh Raskin, an industry analyst for Barclays Capital, told the Huffington Post. "In an effort to get back to a more profitable level, they are raising their prices to match cost trends. When you raise rates, you run the risk of losing your membership. Health insurance is a very competitive marketplace."

As Williams told investors on the call: "The pricing that we put in place for 2009 turned out to not really be what we needed to achieve the results and margins that we had historically been delivering."

Aetna is one of the largest insurers in the private market, covering roughly 17.7 million people according to its 2008 annual report. It is also a major player in the current health care debate and inside Washington D.C. The insurance company has spent more than $2 million on lobbying just in 2009, according to the Center for Responsive Politics.

American Medical News, which first reported the story, noted that this is not the first time the insurance giant has cut the rolls in an effort to boost profit margins. "As chronicled in a 2004 article in Health Affairs by health economist James C. Robinson, MD, PhD, Aetna completely overhauled its business between 2000 and 2003, going from 21 million members in 1999 down to 13 million in 2003, but boosting its profit margin from about 4% to higher than 7%."

A spokesperson at Aetna did not return calls and emails for comment.

My comments: Here is my favorite part of this article... "Aetna actually made a profit in 2009 but not at levels that it anticipated." Please... someone explain to me how the people at Aetna sleep at night. Makes me sick.

Tuesday, December 1, 2009

I Swear To Uphold The Constitution (Sometimes)

No one really goes to law school, takes courses in Constitutional Law I and II and aspires to be a personal injury attorney, or a workers compensation attorney. But if asked, we all adamantly state without reservation that we will uphold the Constitution of the United States. It's to the point where I 'solemly swear' to uphold the Constitution of the United States a few times a year now, for one professional or volunteer organization or another. But no one will ever be able to arrest me for perjury though. I never use my real name. I just say "I, state your name". I just have to be careful now not to change my real name to 'state your name', and I will never get caught. For anything. Ever. I'm so friggin smart, like Wile E. Coyote, Super Genius!

The authorities don't enforce the law of the land anyway. It was about 9pm, dark and rainy the other night when a "Delta" call (Advanced Life Support Tech required to respond) came over the frequency right after the tones that rang specific for Brentwood. 'Infant trauma'. The adrenaline rushed through my veins. My heart beat faster. Immediately I began organizing the tools in the ambulance I would need to go with (my crew and i were already on the ambulance returning from another call). The ambulance did a hockey stop skid in front of the house. I moved briskly to the front door and knocked somewhat feverishly. I peeked through the window and saw at least 6 hispanic adults scatter about. The hispanic woman who answered the door would only open it a crack, "no here, no here, maybe around back" she muttered and then shut the door on me. The lady was indicating the side area of her house that was without any outside lighting. So around the house we go, where we stop nobody knows. The police department arrived on scene. We fanned out a bit, turned on our flashlights, and stumbled over cracked flagstone onto a broken cement path, which led to a stairwell without lights or handrails, that led to a basement door. There was what looked like a tool shed out to the right about 25 feet, which might have housed another family as well.

We entered the basement door, and found another maze of hallways and bedrooms, and the infant who was (thankfully) peaceful in her grandmother's arms. The baby, 13 months old, had a smile the lit up a room, and shiny bright eyes that seemed to notice every detail around her. She had fallen out of a bed, and the multitude of families living in the basement reacted by calling 911. One of the cops asked to see the baby's crib so that we could determine the height from which the baby girl fell. The police officer and I followed one of the many basement residents into a small, makeshift room with a single bed. "Where's the crib?" I asked. "This is where she sleeps. She doesn't have a crib" the man said. No railings around the bed to be seen or found anywhere. I wonder how many times this little girl had fallen out of this bed before. "Where's mommy?" I asked. "She no here. She in hospital". But none of the many basement occupants could really provide her contact information, or tell me why mommy was in the hospital.

We took the little girl to the hospital just to get checked out, but I'm sure she's fine... for now. The cops left too. No investigation. No tickets issued. Nothing done. Nothing. Nothing about the fire code violations in the basement. Nothing about checking to see where mommy was. Nothing about making sure the baby returned from the hospital to a place where she would have a safe place to sleep, like a crib or a bed with rails. Nothing about an investigation as to whether any of the residents in this house actually paid their taxes. Nothing about the lack of lighting, nothing about investigating whether people were actually living in the shed in the backyard.

So, you see, while we are a nation of laws, and we often swear to uphold the Constitution, we really don't on a consistent basis. Not even the officers of the law do it consistently, maybe some don't at all. Even when the health and safety of a 13 month old baby girl is at stake. The whole thing is more than slightly bizarre to me really. Go to law school to study the law that no one follows or enforces anyway. And then raise your right hand and swear to uphold the Constitution so that everyone listening can feel better about you becoming a member of an organization to which they too belong- just don't take the oath too seriously.

My tour ended after midnight. There were no cars on the expressway as I drove home, except for the one with the red and blue flashing lights behind me - WHAT!!! The cop pulled me over. "I see you have firefighter/EMT license plates". "Yes, sir, I volunteer as a firefighter and an EMT, just going home from my tour tonight." "This won't take long, I will be right back he said. I wasn't worried. Until he came back and handed me a ticket, and wished me a nice night. Oh, the irony!

Monday, November 30, 2009

Ma'am, that was not a Seizure, that was a Dance Move.

How many of you EMS providers in/around Brentwood Legion and those that work at SSH have had this patient at least once a day?

iPhone apps for EMS Providers

There have been some really great apps released for EMS providers who are iPhone users. Here is a link to a list of them:

I highly recommend the paramedic protocol app. It's extremely organized, and very useful especially if you operate in two different EMS jurisdictions, like Nassau and Suffolk Counties on Long Island. You can go to the app creator's website to see all of the jurisdictions he has protocols already loaded into the app. The creator is extremely responsive to requests for additional protocols and feature adds. If you don't see what you like, just email him directly.

Cool 12 Lead EKG Widget

I found this to be pretty useful. Click on the different leads to show what area of the heart it pertains to.

For more widgets please visit

Sunday, November 29, 2009

Recognizing Your Life's Purpose

This is a fantastic post from author/attorney Kevin Houchin. As he has stated, "The more you SURRENDER to your life's purpose, the more POWERFUL you become. You just have to RECOGNIZE the purpose".

Three Ring Circus

Tiger Woods' alleged mistress just hired attorney Gloria Allred. This should be a fun ride for the media. Thankfully there's nothing more important to report on, like, oh, I dunno.... anything else at all?!?!?!

Here is the recording of the actual 911 call placed immediately after the car accident. "FORE!!"

Saturday, November 28, 2009

Well Equipped

Brandon, my power ranger son, got so excited when I told him I was going to take him ice skating. He's going to be playing organized hockey games this year with his team, the Mini-Mites. It took about almost two hours to buy all of the equipment- helmet, skates, mouth guard, elbow pads, knee pads, the works.

I was pretty surprised at how many different types of each piece of equipment there were from which to choose. I could have bought any one of several mouth guards ranging from $2.00 to $28.00, some of which even came with a policy of dental insurance! I opted for a rubbery one that had to be soaked in boiling water and then molded to my power ranger's bite for fit- a cool $6.25. More of a process was buying the helmet. Brandon wanted the flashy black helmet with lightning bolt logos on it. He didn't like the white one that I got him with all of the legal stickers on it that professed compliance with a blur of mnemonics that made me feel safer about it all.

We took all of the equipment to the ice rink. Brandon donned what he called his full 'costume' and whipped around the rink. After a few lessons, his confidence level had peaked. Unfortunately, he didn't get to the lesson on how to stop. As he attempted to exit the rink, his skates hit the door saddle that separated the ice from the walkway. He began to fall. I never felt so close to him and so far at the same time.

My eyes closed tightly as I winced in anticipation of a big thud. But the thud never sounded, thanks to Lenny. As fate would have it, I had responded to Lenny's house, right around the block from my own, on two separate occasions when he called for an ambulance. On both alarms, I responded directly to his house, which is to say that only seconds passed from the time he had called for help until I arrived. This time, however, it was he who helped me. He caught my son right in his arms, evidently while Brandon was mid-air while my eyes were shut.

Intently, I skated to the scene. Lenny recognized me right away, as I did him. 'Seems we both have a habit of being at the right place at the right time' he said with a sigh of relief. And during the few moments that followed, I realized that his sigh was more one of thankfulness for being able to return a favor his inner self needed to repay to my family for that which he perceived to be my favor to his family and himself. Before that minute, I had never before realized that one of the inate benefits of being an EMS provider not only is the life purpose gained from giving unto others. It also enables others to give back- to their communities, to their own families, and even to individuals. Luckily, I was one of those individuals on that day. And giving back is exactly what Lenny needed to do, at that particular moment. Not only to catch my son. But also to assure himself that there was a reason he needed to keep living. One of the two calls for which I went to Lenny's house involved his son. His son still has not come out of the hospital, which consequently led to Lenny's deep depression, self-mutilation, and ultimately the second ambulance call at his house. 'Enjoy your son' he commanded me at the end of our exchange of pleasantries.

Brandon was more angry than anything about the event. He blamed the whole thing on the fact that his equipment didn't fit right. So he ran a hot bath, and threw his hockey helmet, skates, shin guards, ALL of it.... in to the hot water. "Brandon! What are you doing?!?!" I shouted in disbelief. "But dad, I'm just fitting all this stuff better for myelf just like I saw you fit the mouth guard for me! I don't want to fall anymore!".

Thursday, November 26, 2009

Save 911 For The Real Emergencies

Attention, all you hot messes!! I'm particularly talking to you, the 23 year old female who called 911 to be taken to the hospital because she was having her period; and also you, the 48 year old male with an infected bunion; and pretty much the entire community comprised of people who don't want to pay for a taxi to the hospital, or ask a friend for a ride. SAVE 911 calls for the real emergencies!

Here are some examples of 911 calls from real people (click on the link and then the play button), most of whom you have seen on TV. I know you all have TV's. Big ones. Really big ones. like at least 55 inch flat screens. And caller ID and immaculately clean pair of the newest Nike's. And a stylish cell phone. Now all you gotta do is feed your kids, get some furniture, and pay your gas and electric bills. Stop making me and the rest of the tax paying world fund your irresponsibility. And stop abusing the EMS system.

Monday, November 23, 2009

Come and Join The Masquerade

My son has been obsessed every morning with putting his hair in a mohawk. He's only six. Yet, even at such a young age, appearances seem to mean a lot 'round these parts. Of course, the look works for him. He's a cute, precocious blonde haired, blue-eyed boy whose mother dresses him in the usual upper-middle class spec uniform straight outta Denny's Children's Clothing Store each day. So, while the hair says 'Billy Idol', the clothes say 'I live near Starbucks'.

I'm sure that this mohawk thing is just a phase. He will change as he grows. Hopefully in good ways. But alas, it has been said by men wiser than I, that 'the more things change, the more they stay the same' . So true indeed, especially in our Volunteer Emergency Medical Services. Mind you, I pondered all of this even before I got my morning coffee at Dunkin' Donuts; but the idyllic nemesis confronted me in the D and D parking lot nonetheless, in the form of a huge, gas guzzling black truck bearing the logo of one of the agencies for whom I volunteer. My chief climbed out of the truck, donning a high quality shirt and vest to which only chiefs were entitled, bearing his name and agency logo- all paid for out of agency funds (i.e., YOU- the taxpayer). The black monster truck was nice and shiny, equipped with a few tons of emergency lights- enough to set a small village into an epilleptic fit. Oh, and did I mention the custom coffee cup holder on the dash? Two baby seats in the back, camping equipment, and some suitcases. I was using my personal car at the time, wishing I had me one of those cool coffee cup holders. "Where'd you get that?" I asked him. He had no idea who I was. Sure, he was one of the department chiefs, with a shiny cool black truck. But of all the calls I have responded to, he wasn't at a single one. "It was a custom order for the truck" he proudly responded.

Another man came out of Dunkin Donuts with his coffee. "Hi." He said to the chief. "I just want to say thank you for what you do. And you don't even get paid for it!". "My pleasure," responded the chief. "Well," he turned and proclaimed to me, "duty calls", pointing to where he was headed to get his cup of joe. "I'm gonna need a jolt to rip through the work day. Taking the family camping upstate later on."

I was on my way to work too- my law office. I had a suit and tie on. My last rescue call had complications, so I didn't get home to shower and change on time, and as a consequence, I had missed a meeting at my office already. I didn't get a thank you from that man coming out of Dunkin' Donuts. A chief of my own department didn't realize I was a riding member. I didn't get the fancy custom cup holder, nor the shiny truck with all the lights, nor did I get any money for gas to go from home to work (everyday), not to mention the gas money to go upstate camping, or to take my kids to playdates or doctor appointments, or with me on personal errands. I didn't even get the embroidered shirt. All I got to do was to stand near the chief of my EMS department and watch him cavalierly accept the thanks of a passerby, all the while letting that man think that it was all being done with a dash of bravery and another of volunteerism. That, after all, is what it appeared to be to to that passerby.

I didn't get thanks. But neither did the passerby. As a taxpayer, he helped pay for the chief's facade. I guess the chief forgot to get the guy's name and address to where to send the thank you note. The next time you see the chief, make sure you give yours to him. I know why I volunteer doing EMS, and none of it has to do with a truck, or gas money, or embroidered clothes. I would feel better saying that the chief volunteers for these things. But he doesn't- otherwise he would actually show up on EMS calls. To be sure, though, I have absolutely NO idea why the passerby helped pay for the custom coffee cup holder, and all that is attached to it.

My pager went off- a respiratory distress call nearby. I responded directly to the call location, since it would be silly to backtrack to the station house just to then start out to the call location which was only a few blocks away from where I was already. The ambulance crew would have another set of EMS turnout gear for me when they arrived. I could hear the man wheezing from the front door. He let me in, and I set up my oxygen tank and non-rebreather mask for him. His demeanor reminded me a lot of my deceased father, who's soul I feel closer to every time I treat a patient. "Hey,", the man jokingly prodded. " Thanks for coming so dressed up for the occasion in your suit and tie. You look like a lawyer or something!". This man wasn't my father. But pictures of his kids and grandkids were displayed all over his living room- he wasn't my father, but he was a father nonetheless. "No sir," I assured the wheezing man. "It is I who should thank you".

Sunday, January 25, 2009

Is This For You?

No matter who I have met in the EMS field, when I ask them why they went into it in the first place the universal response is something like... "'cuz i like helping people out". And then I listen to the older paramedic generation (who really aren't so old- like 37 or 38) whine about how they are "burnt out".  Hmmmm..... so let me get this straight.... you're 'burnt out' of helping people? Just sounds all like a matter of convenience to me really.  

For some, being in the EMS field just isn't the right job.  Take the guy in this video for example. But if the job isn't for you, it's not as bad to determine that as it is to determine that only AFTER one of your patients is FUBR because of it.  Folks, you can't sprint the entire marathon. 

Saturday, January 24, 2009

I concur

While doing my rotations at various hospitals in the area towards the completion of my AEMT-CC class, I have seen life imitating movies, which has in turn imitated life.  The other night I was either on the set of the movie "Catch Me If You Can", or I was doing rotations in the emergency department.  It went down almost exactly like this, verbatim....  click and listen, and then let me know if you concur. I do. Amazing what a guy like me can do wearing a stethescope around my neck and a lab coat over my street clothes, walking around a hospital. 

Monday, January 12, 2009

People are childish

I think I'm going to throw something through my TV if i have to see that Lexus car commercial where the guy in it has a rambling monologue comparing his new lexus to the Big Wheels toy he got when he was a kid. I would rather just see a copule of views of the car and some statement saying "get this car... it will make you feel like you were a kid again." Or show some nut job driving the car across a high school lawn doing donuts, and drag racing- "this car will make you feel like a kid again."

Everyone likes to try to feel like a kid again. That's why we eat ice cream, and go on amusement park rides. If there was some way for me to feel like a kid while being an attorney, I'm sure I would love my job as much as I do volunteering in EMS/Fire. But right now, I haven't found much that beats the adrenaline rush of going from zero to 100 when a call comes in, and the feeling of satisfaction and comraderie I get after a job well done with a patient or at a fire. My baby sweetheart princess and my power ranger son are always doing kid things- splashing in puddles outside, playing in mud, you know, doing things that 4 and 5 year olds just do because they are kids, and they like being kids. My wife and I constantly tell them not do do those things- but what match could our authority possibly be to their feelings of just being a kid?

All the time I spend going to continuing education classes; doing rotations at hospitals and county ambulances; responding to calls, training at the fire service academy, etc. etc. its all about feeling like a kid again. Even for the paid guys around here though, it certainly ain't for the paycheck! Here is what FDNY pays. Cha Ching, baby.  Yah, right. I don't think my wife would have a problem with me becoming a full time paramedic if there was an extra zero at the end of those figures. She still tells me "don't go on the call, Rich," whenever she hears my pager tones sound off.  That's followed by the obligatory "it's too dangerous" or "you're gonna catch something from these sick people" from her. But what she's really saying is, "help me with the laundry instead." Doesn't matter much though. Same thing's happening... such pleas are no match for a chance to be a kid again, if only for a short while. 

A call was toned out this morning. A kid hurt himself when he slipped on ice on his driveway while horsing around.  He loves ice hockey, just didn't want to put on the skates. The mom kept muttering "I kept telling him he was going to get hurt if he kept on doing that".  Mabye he'll learn to be a paramedic later on in life. It's not as painful. 

Saturday, January 10, 2009

Of mice and gentlemen

I just came back from a birthday party for one of my son's friends. It was in a movie theatre- a private showing of Desperaux, a mouse, who called himself a "gentelman". Following a code of honor is what made him more than a mouse, and even more than a man- Desperaux was a "gentleman". There's not much to do for adults when you're in a movie theatre, other than watch the movie. I, on the other hand, watched my son as he lost himself in the fantasy of the movie. Most of the other kids just chatted with each other about stuff that kindergardeners talk about... diareah, and doody, and what level they got to on DS Mario Brothers.

As we left the theatre, I held the door for a mother wheeling her baby carriage. My firefighter overcoat on, ruggedly unshaven, it was a friggin Norman Rockwell painting from the 1950s. "Daddy, you're a gentleman," my son Brandon told me. I was convinced that Brandon absorbed concepts from the movie that i have tried so hard to teach him since he was born. That is, until he asked me to stop at Waldbaums to get a block of cheese.

Friday, January 9, 2009

Of Belts and Suspenders

Question: "Does what you wear define you?" Even for that day, or moment? I put my belt on this morning. Then I clipped my fire department pager to it, and then my iPhone right next to it. I put on my suit. Then I put my fire department heavy coat on over it on the way to work. I slung my computer case over my shoulder. And then I stuck in its outside pocket copies of the drug protocols I have to study for next week's medic class quiz. Funny thing is, not all of this 'stuff' weighs me down daily as much as my struggle to accept the fact that I HAVE to be satisfied with my career as an attorney while pursuing my passion to be a paramedic.

A call comes over the fire pager on my way out to the car- auto accident, northern state parkway, exit 42. And then some follow up transmissions from various jericho fire and rescue officers- but none from an ambulance. I'm on my way. Oh, wait.... I'm SUSPENDED. That's right. Suspended. For three whole weeks. All because I wasn't able to attend a two hour class on how to use the radio. Later in the year, the fire department decided to make SCBA training part of that class too (thats the breathing apparatus used when you go into fires and such). Regardless... what is the point here??? I am suspended from responding to an auto accident because I supposedly lack training in how to use a breathing apparatus on my fire gear? Or is it the fact that I lack training on how to use a radio? I get it.... my radio skills are good enough to respond to 5 active fires in 2008 amongst the hunddreds of other calls to which I responded; good enough to take part in department operations training at the fire service academy where I took part in extinguishing fires in hi-rises, commercial properties, and vehicles; good enough to handle other auto accidents that resulted in life-threatening injuries; and good enough to ride on Nassau County ambulances for my rotations; but hey there, Ms. auto accident victim at exit 42 this morning, please stop bleeding as soon as you can, I can't help you right now because IM SUSPENDED. Please have your accident at another time and day. Thank you for your courtesy and consideration. It's so macabre, that the first chief who responded isn't an EMT. He did go thru the classroom training though, so, I guess he can use his radio and breathing apparatus to help this lady. Jericho's tax dollars, hard at work. Protecting our citizens and saving lives, one policy at a time.

I'm at my law office now. I took off my warm overcoat decorated with fire rescue patches and the like and threw it on the leather chair, revealing my tie and button down to my employees. One of my paralegals comes in and tells me she is going home because she feels sick. I told her I couldn't help her either- IM SUSPENDED.

New Year but not new here.

I decided to open up my blog again. How can you know where you're going if you don't know where you've been, right? I think my older entries are more interesting than the new. But hopefully even newer entries will be more interesting than those were.

Anyway, if you like or dont like what you see/read here, shout it out. dont be shy.