http://news.yahoo.com/s/nm/20100211/pl_nm/us_tobacco_tax

The interesting thing I found was that the article starts by saying that the US could reap BILLIONS of dollars from a higher tobacco tax but my the third paragraph the tone changes away from raising money to simply stopping people from smoking by pricing them out of their habit.

Evidence shows, however, that this rarely actually ends up being the case. Most of the time with a tax hike like this consumers simply find a way to circumvent the tax by either buying their item from the internet, or in this case, from an Indian Reservation where they don't charge the tax portion. The billions in profit that were predicted would then turn out to be a loss.

How?

Because say your selling an egg and that egg comes with a tax of $1. The government wants more money so they raise the tax to $2 thinking that with twice the tax comes twice the money. Problem is Johnny Consumer thinks that taxes suck but at $1 he was willing to go along with the game. $2 though? Outrageous! So he goes over to the Outlaw Egg Emporium on tribal lands to buy his egg where the lovely gentlemen behind the counter is happy to sell Johnny any egg he wants tax free. Johnny loves this idea so he continues to shop there. Thing is, now the government isn't making the $2 they hoped to make nor the $1 they were making before they raised the egg tax. Now they are making $0.

The government doesn't learn lessons though and they will continue to try to choke more out of the golden goose until the poor creature dies.

But not always.

Today I got a call for a gentlemen who had fallen. We'll call him Mr. Smith for the sake of simplicity and not getting my ass sued off for divulging patient information. As it turned out Mr. Smith had fallen out of his motorized scooter while trying to collect wood for his fireplace. When asked why he was doing this he looked at me and said, "young man, even at 88 years old, you get cold."

I suppose it really was a dumb question.

I did my standard evaluation which he went along with just enough patience to be polite but he was by no means enjoying the attention. When I was convinced enough that he was not only medically sound but mentally capable of taking care of himself I started looking around his house while the local PD talked to him.

What used to be a very splended house was now starting to fall into disrepair. A story all too often told; a person spends his entire life building a nest egg and surrounding himself with the things he cherrishes only to watch old age steal it away through the inability to maintain. Dust covered hand painted art, china vases, brass sculptures, and all manor of knicknacks. Mr. Smith himself is no exception to this. A once dapper man is still dressed in the fine slacks, dress shirt, tie, and sweater-vest that probably defined his entire life but now his tie isn't as straight as it used to be, the vest has evidence of his last meal, and the slacks are just a little ill-fitting.

But as I observe my surroundings I notice a rack on the wall holding half a dozen very fine pipes. Half are brier, the others appear to be porcilin. All are either inlaid with hand carved designs or painted with depictions of wind-mills.

"You're staring mighty hard at those pipes,son." I hear from behind me.

"They are beautiful. I take it you're a man who enjoys a pipe now and then?"

"Used to, don't anymore. Haven't for 10 years. Got tired of the gal who comes here and cleans bitching about it all the time. Was just easier to stop to shut her up. Though I do miss it."

"Well, I just happen to be a pipe smoker myself and I just happen to have a little tobacco and my pipe right here in my pocket."

Mr. Smiths eyes light up for the briefest of seconds, then he regains his composure.

"Well, I don't suppose it would be right, taking you from your job to waste time with an old man."

"Sir, I couldn't think of a better way to spend time. Which of these pipes shall I get for you."

"None of them, thank you." He muttered as he pulled a very plain, very simple Billiard from his vest pocket. "Got my pipe right here where its been since I was 17."

I smile as I hand over my tobacco.

"This isn't some of that sissy fruity stuff is it?"

"No, its a smoky flavored English."

"Wouldn't have figured you for an English type." He said with a smile.

His stiff hands held the pipe expertly as his arthritic fingers dug into my bag and loaded his pipe as if only seconds had passed since his last smoke, not years. He handed my bag back to me and watched me fill my pipe as only a novice could.

"Egad man, how long you been puffing on that thing?"

"Couple weeks is all."

"You'll get better, takes practice. I'd say it takes a year at least to get really good. Got a match?"

I dug into my pocket and handed him my lighter.

"Son, I asked for a match. Only way to light a pipe is with a match, you remember that."

He dug into his vest pocket and produced a box of matches that was easily as old as I am and struck one against the bottom of his pipe and lit his tobacco. The look of pleasure that came across his face was more than I can describe. It was like he was having a secret conversation with a very dear friend who he hadn't sen in years and had thought was gone forever.

As he smoked he told me stories of his youth. How he had won the pipe he was smoking in a poker game, had smoked it right up to entering the war, how the stem had been broken off by a flying rock as a tank shell exploded near him, how he had found the Jewish pipesmith who had made the pipe in Italy and traded him a stow-away voyage in a supply truck for a pipe repair, and how that same man had been killed in the Belzek concentration camp just months later.

I heard stories of the girl he loved back home, how he loved her through the war, married her after the war, and had lost a piece of his mind when she passed and had never gotten it back.

He told me about his time as a professor of Theology, Philosophy, and Logic. He had been fired in the late 70's because he refused to stop smoking his pipe on school grounds so he written books on the subjects he'd loved.

We chatted back and forth for nearly an hour, he refilling his pipe about halfway through. He finally ended the conversation by stating that he was tired and wished to go to bed. I shook his hand and thanked him for the conversation and turned to leave.

"Son, you forgot your tobacco."

"I didn't forget it, its yours now. Payment for a pleasant evening. And tell that girl that comes here that its your house and you'll do as you please in it."

He just smiled and as I walked through the front door I heard his match strike again and him mutter "Thanks son."

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None. It only takes one EMT who isn't paying a whole lot of attention to push a gurney out of another ER room, clothe-line the old bat, and send her sailing over the gurney head first and into an opposing wall. *Sigh*

Pierre: Sam! It's so good to see you again. It seems like we don't get together like this nearly enough.

Sam: Yeah, I think the last time was when we got together in Indonesia for Mary's birthday.

Pierre: Yeah, good times, good times.

Both get a wistful look and sigh.

Pierre: So, what did you get Harriet for her birthday? I got her a spoon. It's really nice, all shiny.

Sam: Sweet dude! I got her a television.

Pierre: A television? Wow, look at you big spender! Harriet is going to go wild when she finds out you got her a plasma.

Sam: Oh, I didn't get her a plasma, just a regular TV.

Pierre: Wait, what? You didn't get her a plasma? Why the hell not?

Sam: I don't know, I just didn't. I knew she didn't have a TV at all so I just got her this one.

Pierre: Yeah, but Harriet is poor dude. Don't be such a tight ass.

Sam: Pierre, chill. I don't know if you realize it but I've got a few financial problems of my own.

Pierre: Carlos! Hey Carlos! Come here and listen to this.

Carlos: Hey Pierre, Sam, long time no see. What's up?

Pierre: What did you get Harriet for her birthday?

Carlos: Oh! She'll love it. I got her a AA battery. Cool huh?

Pierre: See, that's a cool gift. Sam here got her a TV.

Carlos: Hey, nothing wrong with that. Everyone can use a flat screen.

Pierre: No, no. Friend of the year here just got her a regular TV.

Carlos: Trying to stiffle laughter but failing. A regular TV? Come on, seriously?

Sam: Whats with you two? I thought she would like it.

Pierre: Maybe if it was something good like a LCD or a plasma, but just a regular old TV? You have got to be the cheapest person on the face of this Earth.

Sam: Wait a second, you two got her a spoon and a battery? How can you criticize me for getting her a TV when you guys barely got her anything?

Carlos: Our gifts rock. You really shouldn't be so insenstive.

Sam: Ya know, I don't know why I hang out with you guys. I got the same ration of crap when I bought Mary that car for her birthday. And what did you two get her? A single tea bag and a rock.

Carlos: That rock had sentemental value! And that car you bought didn't even have heated seats. What if Mary had gotten cold.

Sam: Then she could have turned on the heater! I bought her a car for Gods sake.

Pierre: Not a very good car if you ask me.

Sam: You know what, screw you guys. I'm going to go help Harriet set up her TV. Next time someone throws a party I'm not coming.

Carlos: Yes you will you doormat.

Pierre: He'll probably show up with another crappy gift too.

Being a complete ass I decided to make a mockery of our morning radio and pager tests at First Responder. Enjoy!

This is off subject for this blog but I thought I'd share it anyways. Let's call it: A Once but Never Future EMS Flight Career.

I got an email Thursday night letting me know that we'd hired a new paramedic and that I'd have to train him. That's fine, I signed up for that. The employee handbook says that the Quality Assurance officer has to train new employees their first 72 hours on the job...and I'm the Quality Assurance officer...and I wrote the handbook. So, Friday morning rolls around. I walk into the hangar and see a fresh-faced young lad, looking at the several maps on the wall with a look of major fascination. Most people have never seen aeronautical maps and once they figure out how to read them they're fascinating accumulations of knowledge. As I walked up he turned and beamed at me. For the sake of simplicity, we'll just call him New Guy.

New Guy: You must be Monkey, I'm New Guy. I think I'm supposed to train with you today.

Me: You're correct. Let me set my crap down and grab a cup of coffee. We have a lot of stuff to cover today and not enough time to cover it. And that's if we don't fly.

NG: Well I don't drink coffee, but I do hope we fly. I'll just have to make sure I get it all the first time so we don't waste a bunch of time (One point added for enthusiasm, one subtracted for not drinking coffee. Running total: 0)

My first line of business was to show him around, the kitchen, the day room, the library, the bathroom, where his bunk would be, etc. Then we went out to the aircraft. I explained what aircraft we were using, which aircraft were in a state of purchase, and when we could expect to see them. I then set about showing him how to handle patient care in a cramped, either too hot or too cold, loud environment. True to his word, the kid was a quick study. He wrote a few things down, mostly radio protocol stuff, and asked the right questions at the right times. He had an easy personality and I thought we'd be doing pretty good. (One point added for being a quick learner, one point added for me liking your attitude. Running total +2) We took a little break for lunch and piled into the ambulance to go to town. We grabbed a couple sandwiches and I showed him where the hospital was, where to go to get fuel for the rigs, and a few other points of interest. The only down point was when we left the hospital he thumped his chest twice and offered a hearty "Peace Out" to all in the room. (One point deducted for being a tool. Running total: +1)

On the way back to the airport things took a massive turn in a bad direction. Here's a snippit of dialogue:

NG: So, dix...how many calls are you guys running a day.

Me: In the winter we cut down to about 0.7 due to the weather, but in the summer we hit about 2.5. Did you just call me a dick?

NG (Laughing a bit): No not Dick, Dix. Like Dixie McCall. Me: Oh, yea, the chick from that TV show. Got it.

A minute or so passes.

NG: Hey Dix, think next time we go to town I can drive.

Me: If you're on the company insurance the next time we go to town, sure thing. Do me a favor though, and quit calling me Dix, huh. I got a nickname and it's Monkey. That'll work or you can use my real name, either one.

NG: Hey, Dix. No worries. If you don't like being called Dix we can try something different. How's Fokker (sp?).

(Aside: This wasn't said with any sense of humor, it was said in an almost condescending manner)

Me: Monkey or J*****, please.

NG: Hey, don't get upset with me because you're a male nurse. I'm not the one that made you do it.

Me: Hey, Scooter. Lets get something straight. I answer to two names when I'm at work. Monkey or J*****. Nothing else. One more thing. I'm your FTO and while I'm a pretty good ol' dog, if you walk up and kick me enough time I'll turn around and bite. And by bite, I mean I'll fire you.

NG: You can't fire me for that!

Me: Boy, within the first 72 hours of you working, your ass and all attached belongs to me. I'll fire you because your socks don't match. So lets stop the male nurse cracks, okay? We have a lot of crap to get done today. (We pull into the airport and I stop the ambulance at the dock, shut it down, and start to get out.)

Me: Ready to get back at it?

NG: Sure thing.....Fokker.

Me: What's your deal with male nurses?

NG (Dead serious): I just think that if a guy wants to be in medicine he needs to be a medic or a doctor. Male nurses are closet homos.

Me: Boy, you're so fired.

NG: You can't fire me!

Me: Boy, didn't you read all that crap they had you sign the other day? Particularly the Probationary Agreement. It says that as long as you're a probie, we can terminate your ignorant ass for any reason. Or for no reason at all, for that matter. So go inside, gather up your shit, and bounce. I don't mind being made fun of a bit, hell I have to take it for all I dish out. But you're not making fun, you're being malicious. Did you notice that there are no female nurses here? All dudes. If you think that you're going to get along here with that attitude of yours, you're as wrong as can be.

NG: Fine, I don't need this job. I can get a job with another flight service in a second.

Me: Think again, Scooter. It's a small world, this EMS Flight Community of ours. When word gets out of this, and trust me, it will, you'll be black balled from ever service on the continent. Smarten up. And while you're doing that, get the fuck out of our hangar. You have five minutes. (A million points deducted for being too stupid to read the room. Running total: Ah, fuck it...he's done.)

This, folks, is how you cut an EMS Flight Career short in under 6 hours.

See, it's a family trait.

When you're going to have a baby, it's like planning a fabulous vacation trip - to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It's all very exciting.

After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, "Welcome to Holland."

"Holland?!?" you say. "What do you mean Holland?? I signed up for Italy! I'm supposed to be in Italy. All my life I've dreamed of going to Italy."

But there's been a change in the flight plan. They've landed in Holland and there you must stay.

The important thing is that they haven't taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It's just a different place.

So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met.

It's just a different place. It's slower-paced than Italy, less flashy than Italy. But after you've been there for a while and you catch your breath, you look around.... and you begin to notice that Holland has windmills....and Holland has tulips. Holland even has Rembrandts.

But everyone you know is busy coming and going from Italy... and they're all bragging about what a wonderful time they had there. And for the rest of your life, you will say "Yes, that's where I was supposed to go. That's what I had planned."

And the pain of that will never, ever, ever, ever go away... because the loss of that dream is a very very significant loss.

But... if you spend your life mourning the fact that you didn't get to Italy, you may never be free to enjoy the very special, the very lovely things ... about Holland.

Emily Perl Kingsley

I read this short essay on another blog and it struck home. As the father of three, two of which are determined to be "special needs" and I've been asked more than once what its like. I couldn't have said this better so I chose not to.

Every day with my boys is an adventure and every day is new. Some days they will wake up the sweetest happiest boys on Earth, others they will wake up angry at everything and violent, others they are clingy and seem frightened by their surroundings.

The fact is, no one knows what meth does to kids brains but everyone agrees it's bad. Just as using meth as an adult intensifys certain feelings and turns off others, it does the same thing in the developing fetus. Problem is, the feeling being intensified or turned off in the fetus hasn't been learned yet. How this plays out in the long run with the growing child is anyone guess but I can tell you it often isn't pretty.

That being said I wouldn't trade the frustration for the world. Like the essay said, Holland isn't Italy, but it can be just as beautiful as long as you learn to appreciate whats there. My boys are amazing little creatures. They have a sense of logic that blows me away. Yeah, it may take them longer than average to learn to count to ten but the feeling of accomplishment they feel when they do it could blast a rocket to the moon. Everything they do they do all the way. There's no in between. If they are frustrated, you see every bit of it, but when they are happy their laughter fills the house.

I'm a better man for being a father. When my wife and I figured out we wouldn't be having biological children of our own we were pretty bummed but I realize now that it was just part of the bigger challenge God had in store for us so we could be the people He wanted us to be. Some days we rise to the challenge, others not as much, but in the end we will prove to be up for it because all in all, Holland is beautiful.

You're welcome!

But working prehospital medicine isn't all about death and destruction. Oh no, more often it's about biting your tongue as your patient describes the full scope and extent of their medical malidy. The following illustrates a few of the real gems:

*A woman stands beside the pay phone in front of the local hospital.

Patient: I think I got the West Nile Virus.

Me: Really? What makes you think so?

Patient: Got bit by a 'skeeter.

Me: ... Huh?

Patient: A little slower, in case I'm "special" I. Got. Bit. By. A. Skeeter.

Me: So, you got bit by a mosquito, and now you think you may have West Nile?

Patient: Yup, thats what I just tol' you.

Me: When did you get bit?

Patient: Right 'fore I called y'all. Bit me on my butt. Wanna see it?

Me: N....

Too late, she just yanked her skirt up and is now bending over mooning me in front of my partner, the fire department, and all the drivers on two very busy streets.

Me: There's nothing there.

Patient: Yes there is, it's right here someplace.

Slaps her beefy rear causing a Jello-like effect

Me: Ma'am, there's nothing there. Please, pull your skirt down. Right now. Please.

Growing slighty irate

Patient: Well I felt it and I know my body.

Me: Yes ma'am. Well, I couldn't see anything obvious. My suggestion is if you're concerned you make an appointment with your private physician.

Patient: I'll be dead by then! I need to see a doctor right now and get The Cure.

Me: I see. Well in that case I'd more than happy to walk you into the ER if you would like.

Patient: Walk? No. You're an ambulance driver, you're suppose to take me where I want to go. You can drive me to the ER.

"God, please strike me with lightning..."

Me: Right. Okay, the ambulance is right there. Watch your head as you get in.

Patient: You're not going to bring y'alls bed to me?

Me: No.

*We load the patient up, transport for literally 5 seconds and all of 30 feet and drop her off in the waiting room. A month later she called back to complain about the bill.

Me: Evening sir, what seems to be the problem?

Long drag off his cigarette.

Patient: Well, got a new stove today. Hooked it up and put some stuff in that storage bin under the stove and then it just started smoking real bad. I got some of that smoke in me now.

Me: What kind of "stuff" are we talking about.

Patient: You know, the instruction manual and stuff like that.

Me: Okay, are you having any trouble breathing?

Long drag off cigarette

Patient: Yeah, real bad.

Checking his O2 saturation shows 98%. Damn good for a smoker.

Me: Well my machine tells me you have pleanty of oxygen in your blood. Your pulse is strong and regular. Everything looks really good from my end but if you want to go in I'll be happy to take you.

Patient: Well I gotta go in, I might have inhaled poison you know!

Long drag off cigarette

Me: From the plastic?

Long drag off cigarette

Patient: Um yeah! What else would I mean?

Me: Nothing. Ambulance is this way, follow me.

Me: Hello ma'am. What's going on today?

Patient: I'm having a seizure.

Me: You had a seizure?

Patient: No, I'm having one, right now.

Arms and legs jerk and twitch to prove the point

Me: Oh, I see. Well, how long have you been having a seizure?

Patient: About half an hour or so.

Twitch, twitch

Me: Who called 911?

Patient: Me, I'm the only one here so I called 911 and tol' them I was having a seizure.

Me: Ever had seizures before today?

Patient: Yeah, doctor tol' me I had them Psudo Seizures. The bad ones.

Twitch, twitch

Me: Yes, I can see that. Well, you'll be wanting to go to the emergency room, right?

Jumps to her feet, walks to the gurney, lifts the head rest up and lies down.

Patient: Yup, I'll have to get some Valium to get rid of em. Or Versed. Whatever you got.

Me: Yeah, I don't think that will be necessary today.

Patient: But, I gots the seizures!

Me: Yeah, well I want the doc to see this. He's an expert in this sort of thing.

Patient: Oh good. Think he'll give me Valium?

Me: Never hurts to ask.

*A middle aged man sits on his sofa clutching his groin

Me: Hello sir, what seems to be the problem?

Patient: My groin, it hurts something fierce!

Me: Can you describe the pain?

Patient: Feels like someones squeezing my boys off.

Me: Alright, how long has this been going on?

Patient: Since this morning. I woke up, got dressed, and shortly after my boys started hurten'.

Me: Do any heavy lifting this morning?

Patient: Nah, only thing I've lifted this morning was the paper off the drive and a cup of coffee. Damn this hurts!

Me: Ever had a UTI before?

Patient: Yeah, but this isn't like that. Doesn't feel like it's inside. Its like it's outside, ya know?

Dreading what's coming next.

Me: Okay, I think you had better drop your pants and let me see what's going on.

Patient: Clearly embarassed and gazing at the ceiling. Okay.

The patient drops his pants and displays a bright peach, very lacy pair of obviously womens underwear.

Me: Um, sir. Any chance you got dressed in the dark this morning?

Patient: Yeah, I was up way before the sun. Why?

Me: You're wearing your wifes underwear.

Patient looks down at his groin and sighs.

Patient: Damn, I shoulda known it. She's going to be mad that I ruined another pair.

ANOTHER pair???

Patient: Well, I'm going to go change. Sorry for dragging you out here.

Me: No problem sir. It's what were here for.

I recently read one of Kellys posts regarding a pediatric full arrest he ran. The story was so captivating and honest that it brought me back to my first similar incident way back when I was a brand new, arrogant/ignorant EMT.

I was working with the man who eventually would become my full time partner. It was my first time working with him and things were a little uncomfortable. He was quiet, mostly sat on the sofa reading his book and not saying a whole lot. I assumed he either didn't like me or was just an asshole. Later experience proved me wrong on both accounts but at the time I felt very out of place.

As the clock hit 8pm my partner looked up, quietly reached for the TV remote and clicked it on. He surfed the channels with a purpose and eventually came across the show "Lost" and set the remote down.

Finally, common ground! I love this show!

I was asked if this choice was okay with me and I affirmed that I often watched Lost. He smiled and settled sofa for an hour of blinking-light entertainment.

*BEEP*BEEP*BEEP* RESPOND FOR MAN DOWN.

Damn, of course it's when Lost was just starting. Oh well, might be a Good Call.

As we climbed into the ambulance and drove to the address given by the dispatcher my partner sat quietly in the passenger seat with the map. If he was nervous he'd gotten past it years ago. He was no new-comer to pre-hospital medicine unlike his partner du jour. He asked if I needed directions and I declined. I had grown up in this neighborhood. This was my old stomping grounds. I knew every main road, back road, ditch road and cow path.

We made it on scene in just as the fire department pulled up and they had half the distance to travel.

Damn, I'm good!

We loaded the usual assortment of goodies on the gurney. O2 tank, heart monitor, suction device, airway bag and drug bag. Everything there.

My confidence died as soon as we entered the house. It was chaos. Probably 20 adults and countless children milled around in various states of anger, confustion, or sadness. Everything seemed oddly out of place in contrast to the festive holiday decorations. The tree had been carefully decorated, stockings were hung on one wall, Christmas cards on another. Under the tree were piles of presents most of which were wrapped in paper depicting Elmo, Big Bird, and Oscar the Grouch holding candy canes, holly, or gifts; obviously gifts for a child.

As we entered the commotion died just long enough for a frantic, tear streaked mother to come up to us and thrust a very blue child into my partners arms.

The gravity of the situation hit me like a ton of bricks. This wasn't someones old grandfather who had lived their long, full life to its very end we were about to run a code on. This was a child, maybe four or five months old, just starting off in life and even in my green-as-a-stick EMT mind I knew he was too far gone.

My partner laid the baby down on the floor amongst the presents and examined him quickly as I hooked the pediatric electrodes up and snapped the monitor to the "On" position. The immediate responce from the machine confirmed what be both already knew but prayed not to be true. Flat line in all three leads. No electrical activity from the heart what-so-ever. My partner gently tried to move the babies fingers, wrists and ankles without success. Rigor was already setting in. This baby had been dead for a while.

With a sigh that started at his toes my partner stood up, turned around and explained to the family that their baby was too far gone for us to do anything and that any effort on our part to save him would be brutal, messy, graphic, and futile. I don't think they understood what was being explained to them but the certainly got the gist of it. Their baby was dead and there was nothing that was going to change that.

A monster of the man who was standing in the back moved forward. Standing easily over six foot tall, 250 pounds of rippling muscle and tattoos he made an imposing figure. He moved away from the crowd as if in a daze, made it almost to the hall way, and collapsed into a pile of sobs on the floor. The sounds he made were so startling that all other emotion in the room came to a halt as all heads turned towards him. There he sat, not two feet from the child with his head in his hands sobbing from his very soul. The woman who had presented us with the child rushed forward, kneeled to the floor and wrapped her arms around the man. He in turn put his head on her shoulder and together they cried.

That's the boys father...shit.

As the boys parents laid their hands on their son tears ran unchecked down two young faces that would forever bear scars of grief. My partner gently muttered, "Let's go, we can't do anything here."

As we loaded our gear up and started walking out my eyes turned once again towards the wall with the stockings. There in the middle was a brand new one, the smallest of the lot colored powder blue with gold thread spelling the words "Primara Navidad".

First Chirstmas.

"Did you notice the bruises on that kids chest?" I ask my partner.

"Yeah." He replied. "Someone was trying to do CPR."

So as I sat and read Kelly's post I couldn't help but be paid a visit once again as memories flooded my mind. As my partner came back into the dispatch center, where I had been reading the post in the first place, I hoped she wouldn't noticed moistened eyes.

I never even knew the babies name.

Regardless I'd like to share what I got for Christmas this year.

I got another year of life on this Earth in good health.

I got to enjoy a lovely Christmas morning with my wife and kids.

I got to enjoy the wonder and confusion in a new born babys eyes as his first Chirstmas present was opened for him.

I got to marvel in how my wifes face lights up when she sees that the gifts she bought were "just right" and brought endless happiness to her loved ones.

I got to chat it up with my cousins, my brothers, and their wives whom I get to see far too infrequently.

I got to see that my cousin, Toni, is growing up to be a very lovely, polite, and kind young lady proving without a doubt that she got absolutely none of her genes from the rest of the family.

But most of all I got to see the absolute amazement in my 3 year olds eyes when he walked into the living room and found the cookies eaten, the milk drank, and a whole pile of gifts under the tree proving what his mother and I have been telling him for weeks. That Santa Claus is real.

My other job is dispatching ambulances. Huge leap, I know. I enjoy it though. Dispatching is how I got my official start in EMS over ten years ago. It's stressful and manic but I think that's why I enjoy it. You have to stay on your toes and be able to accomplish 10 things all at once. For a scatter-brained ADD kid its the perfect gig.

Mostly the job is pretty benign. The county 911 center takes the call from the public and simply passes the information on to us. We dispatch our ambulance, track their status through the call, and call it a job well done.

Well, usually that's how it goes.

Most of the skilled nursing facilities in the area won't call 911, they just pick up the phone and call the ambulance company directly if they need someone tranported (which in the case of most of these places is way more frequently than you might think). What's interesting is that in almost every single one of these places starts the call with "Now, this isn't an emergency, but..." It's like they all went to the same siminar or something. What's really funny, and by funny I mean pathetic and sad, is what their definition of "not an emergency" actually is.

For example, a 67 year old man sitting up in his bed gasping of breath, O2 saturation of 77%, and presenting with blue colored lips needs evaluation by the ER doc, but it's not an emergency. A 73 year old female just fell on the sidewalk outside the facility striking her head on the concrete. She's now laying in a pool of blood and isn't responding when they call her name. But she only needs transport, it's not an emergency.

"What difference does it make?" you may ask. The difference is that an "emergency" gets lights, sirens, the fire department for support, and an ambulance as quickly as possible. "Not an emergency" get's none of that. The ambulance will respond promptly but if an "emergency" call comes down the ambulance responding to the "not an emergency" may get diverted and patient care may be delayed.

Luckily we dispatchers have a handy ace in the hole. Its called "ignore the SNF and do what's right". It works every time. See if the patient is exhibiting priority symptoms, such as difficulty breathing, chest pain, or altered mental status, it doesn't matter what the snarling nurse on the other end of the phone asks for, she's going to get what's in the best interest of the patient.

And for any of you SNF nurses that might be reading this here's a message, direct from me to you. I don't care if you get mad at me, I really don't. I could care less that our presence at your facility may or may not upset the other residents forcing you to actually get up off your ever-widening ass and attend to your patients. I'm guessing that gasping like a fish for air while waiting for someone to help you gets pretty upsetting too. Being dead, that probably really ruins someones day.

So if you don't like that I politely tell you "Ok" when you say, "this isn't an emergency" and then completely ignore you, tough. Take a moment, think about how you would feel if you were the one having a heart attack while no one helped you.

Now, next time you pick up the phone think long and hard about what an emergency really is and make the right decision.

Today I tried a new local bakery that many of you may know absolutely nothing about. It's called the Country Morning Bakery & Cafe and holy bejeebers is it good!

The bakery was opened about a month ago by a group you don't often see in much prominance around the community, the Mennonites. Private and quiet by nature the Mennonites, as a rule, go about their daily lives with barely a notice by the people around them. They like it that way.

This is the first time I've seen a Mennonite family open a business to the public. Not to say there aren't more out there, but this is the first I've seen.

Upon entering you'll be greeted by the smell of warm, fresh bread, yeast, and cinnamon. The cafe is immaculately clean from top to bottom, the staff dressed in very conservative, neat and tidy clothes. The ladies wear long skirts of the home-sewn variety and traditional head coverings, the gentlemen wearing button-up shirts tucked into jeans or casual slacks. They were very friendly and very helpful yet not to the point of being invasive or annoying. The attitude was "I'll give you your space to look around if you want but I'm right here if you need me."

I ordered a BLT on wheat bread. What I got was about 10 thick slices of delicious smoked bacony goodness, crisp lettuce, tomatos that, dispite the time of year, tasted like tomatos, on two thick slices of freshly baked, toasted and buttered bread. The sandwich smelled so good that the desire to consume it while sitting in my car in the parking lot was nearly overwhelming but I waited until I was back at work.

It was worth the wait.

The bread was by far the star (this coming from a carb-fiend). It was so soft and so flavorful that my taste buds actually jumped out of my mouth, shook my hand, and thanked me for the sandwich. Darndest thing. I'm not about to advertise their prices but lets just say that they are much less than the other semi-corprate bakery/sandwich shop in town and the sandwich was a far sight better.

Plus, they serve cinnamon rolls! Fresh ones! Huge ones! Oozing here and there and everywhere with cinnamon-y goodness and icing. On top of that you can buy fresh baked breads, pies, breakfast sandwiches, coffee, soups, muffins, and cookies.

AAAAAAAnd, cassaroles.

Next to the cash register and bakery case there is a large stand-up refrigerator filled with home made lasagna, enchiladas, chicken cassaroles, potato cassaroles, pot pies, and pizzas all of which you can take home and cook in your own oven for a home-made taste without the fuss. A "large" lasagna could easily feed 6-8 hungry adults for just a couple dollars a person. I haven't tried any of the cassaroles yet (and yes, culinarily speaking these are all cassaroles, even the pizza) but I've heard from those who have that they are wonderful.

So if you're in the area they are located at 2625 Aztec Drive off of Hagen Lane out by the old cemetary and the huge petrolium tanks. Call them if you need directions, 899-0527. As a community lets try to get together and help a great bakery and a great group of people.

What I do know is that when I went to college I went for Computer Science. I spent a year learning HTML, C++, Basic, V-Basic, and Assembly. It was during that time that I figured out that staring at 30 pages of written code that wont compile because somewhere a comma needs to be changed to a period really sucked. A friend of mine talked me into becoming a volunteer fire fighter and I got hooked. I wasn't fond to death of the fires but I loved the medical aids and the traffic accidents. I enrolled in the Yuba College EMT program (which I highly reccomend!) and the rest is history.

Thing is, had I realzed that working EMS was basically a glorified taxi service with repetitive, mindless drudgery, endless hours, and a pay check that would make the homeless laugh out loud I may have never gotten into this field in the first place.

And a bigger mistake I could not have made.

See dispite all its short comings EMS grows on you...kinda like fungus. Not so much because you get to "save a life" beacuse, to be honest, that doesn't happen as much as TV would have you believe. No, it's because, on a daily basis, you get to change a life. For good or for bad, an ambulance trip and a visit to the ER changes lives and you get to be a part of it. My goal, every working day, is to try to steer that change toward the positive.

So is EMS a hard career choice? Yeah, it is. You're a slave to a schedule that, no matter how much you give it, will ALWAYS demand more. It's hard on your family, it's hard on your friends, and it's hard on your health. In the end EMS is a vampire that will keep you around as long as it needs you, suck you dry, and leave you a husk to blow away on the winds.

I wouldn't have it any other way.

That being said if my kids decide to follow in ol' dads footsteps I'll beat them to death.

Here are the rules: Each player starts with 7 random facts/habits about themselves. People who are tagged need to write on their own blog about their seven things and add a copy of these rules. THEN, you need to choose 7 people to tag and list their names. Don't forget to leave them a comment telling them that they have been tagged and to read your blog!

I'm not tagging anyone, I'm just filling out the survey...I'm a rebel like that.

1. I'm really good at math. Like, really good. I can do algebra, geometry, even some calc in my head. Thing is, I HATE math so I was only ever an C student.

2. I have a hard time saying repetitive R and TH sounds. Words like "sixth street" "railroad" and "roadwork" leave me babbling like a complete moron. Great fun when I'm working dispatch, let me tell ya: "Medic 32, respond Code 3, 2345 Sixth Threet. Be advised, CalTrans will be performing roadrerk near the wailwoad tracks." Awesome.

3. I'm not a huge fan of decorating Christmas cookies. I know everyone gets a warm fuzzy feeling at the thought of sitting around with friends and family and putting frosting and sparkles and sprinkles on little bell shaped confections but I don't. I just find it kind of repetitive and I have an attention span that keeps me focused for all of about a tenth of a second. Look a bird...

4. I dispise laziness. I don't see any excuse for it. When I see the young man that works at the local hospital with Down Syndrome so bad he can barely walk or talk show up to work every day and clean that hospital to a shine so spotless that I'd be proud to eat off the floor it makes me really hate the 30 year old lazy sack of shit who claims that the broken leg he sustained in his teens keeps him on disability. You're not disabled, you're lazy. Now get off your ass and do something productive.

5. I'm really OCD about my morning get-up-for-work routine. Probably because I'm half asleep for the majority of it. If there is any deviation from the normal, carefully measured routine I'm screwed. Doubtless I'll forget something. Like my wallet, shaving...pants. It happens.

6. I've had more retail jobs than I can count. Never worked food service, unless you count doing dishes at an old-farts home, but I've done enough retail to Willy Loman puke. I've even sold shoes in a sporting goods store. During Christmas time no less. What a treat that was:

Christmas Eve, about 10 minutes to closing. Enter Extremely Frantic Husband

Me: Welcome to Small 10 Sporting Goods. I hate my job. How can I help you.

EFH: Ineedtobuysomethingformywife. What do you have here that she'll like?

Me: Nothing whatsoever. Go put your face in a blender, it will be much less painful in the long run.

EFH: Ill buy her a basketball yeah. She'll like that right?

Me: She like sports?

EFH: No, hates sports.

Me: Why don't you buy her a vaccuum and a Suzzane Summers diet book. That will win her over.

EFH: You think?

Me: I'm trying damn hard not to.

7. I love Christmas music. L O V E love it. I'd listen to it year 'round if my friends, family, and complete strangers didn't look at me like I was growing a new penis from the middle of my forehead. The Time Life Treasury of Christmas is my favorite of all time. I still have my first copy of it, on vinyl! I may need an intervention.