66606

Topeka. 

      I feel like I am getting the geography under control.  The map books really suck.  really suck.  Literally home made.  Don't understand it.  I think it has something to do with, you really should just know your way around.  It feels like the old days when a ton of responsibility was placed on your shoulders as an EMT and MEDIC.  Many more drugs in the drug box. Much more vast set of protocols. etc.  When the new GM came into town he brought his ideas to the staff and asked what they thought of them.  He, Ken Keller, asked the staff to participate in the routing plans for posts as well as stocking and staffing.  Many of the ideas are what is standard in EMS these days, very similar to the way Paramedics Plus is doing things.  The difference is that when a new entity rolled into town, he respected and listened to the incumbent staff and used their experience to better shape this new system.  I try to imagine what ALCO would be like if we would of had more say in things.

     I have yet to be held over.  When I get off at 0300, I am the 4th 'truck' available.  Typically we are cleared for end of service (EOS) at 0200, we stay on the radio until 0300. then clock out.  No holdovers so far.  

     Many of my old habits still exist here in Topeka.  Some good and some bad.  Its refreshing to have to evaluate yourself, or have someone do it for you.  After so many years it is not that hard to fall into bad habits, and really who will coach you or inform you of you slipping in certain areas.  Nobody will.  Your skills will fall off and not a soul will, or is asked to, help you out.  Occasionally after you screw up you will be put into a peer review situation.  Usually in those situations you will feel like you are fighting for your job and your performance will reflect that.  I don't understand why we can't set up a coaching situation that is not punitive.  My partner and I would occasionally ask ourselves at the end of a call, STAT or not, what could have been done better and what went particularly right.  I have found many small areas in my practice where my habits had become lazy.   I have been forced to reflect on how and why I do this job.  I truly and honestly appreciate this opportunity in my career and in my life to reevaluate and grow.

Image of the 1966 tornado that rolled through the center of Topeka.  16 people killed.

     One of the habits I apparently brought over is this.  Often time in the back of an ambulance I will ask the patient where they are from.  In Oakland the answers varied widely.  A large influx of people in the 40's, 50's and 60's from the south.  It feels like a majority of them had something to do with the shipping yards.  Many people from the North. Seattle, Portland and Canada.  Some from the South. L.A., Mexico, S. America.  I met people from Africa, a large Ethiopian, Eritrean population, people from Europe, many, many non-English speaking Portuguese (?).  It varied so much I never got tired of asking and sometimes felt cheated on STAT calls that I didn't get to know more about my patients personal life. Selfish, I know.  

     The Topeka Zip Code is 666_ _.  Love it.  When I ask people where they are from here, ONE, only one person has been from someplace other that TOPEKA, and they were from somewhere within the state.  I've met a few people who have traveled to unknown parts, some to visit and some to live, but they all have returned, eventually.  I think Topeka may be a black hole.  

     I met a guy who has lived in the same house for 63 years, every day of his life.  through floods, the 1966 tornado.  Nothing could get this guy to move.  I feel like I move sometimes just to mix things up.  Certainly staying in Oakland would have been easier.

     Lastly,  I think we should coin a word to describe a patient who calls 911 for doing something to themselves and then the expected/desired effects happen.  for example.  

- "I have loose stools for 3 days after I started taking this laxative everyday".   OR

-"My heart feels like it's racing after I smoked some crack and took some Ecstasy".  OR

-"I invited my boyfriend over, who I have a restraining order against for beating me up, He came over and beat me up".  

I'm sure we all have a million of these stories.  Please share.  I remember Moose telling me in my internship that "When you hear hoof beats, don't think Zebras" meaning sometimes the problem is right in front of your face, don't try to over think it.  I think we should call these Zebra Calls.  But I am open.

KANSAS.

We’re still on the vineyard for a couple of more weeks.  It really is beautiful.  There is a lot of work and it is HOT, but working with family is a really nice feeling.  The family has been a little excited to have us here. It feels like every weekend somebody is coming over for a show.  Truckstop Honeymoon, Split-lip Rayfield and Goddamn Gallows.

Goddanm Gallows at the Crossroads KC

Or a ball game.

   Typical training at AMR is 2 weeks. Or at least in ALCO it was.  In Topeka things are a little different.  With only 5-6 units up at a time, sometimes you have to hustle to make things work, and that’s what we do, make things work.

 

 

Pic of the new AMR paint job.  Gas not Diesel?

     We got pulled out of our 3^rd day of training to assist with a stand-by.  Easy work.  A “religious freedom rally”.  Not exactly sure what they wanted, It does say ‘In God We Trust’ on our money, what else do they want?  I saw one sign that read “Keep the State out of our Church!”  Funny, I could of sworn I saw a similar sign at an Occupy Oakland rally.  It read “Keep your Church out of our State”.   It seems to me we all want the same damn thing.  I saw another sign that read “HATERS GONNA LOVE AND PRAY” Not sure what that meant, but the young man was sure proud of it.  The Fred Phelps crew was there – The Westboro Baptist church – singing pop songs, Mariah Carey and what not.  Had no idea what that was about.  If you can stomach it the “churches” website is www.godhatesfags.com Their typical array of signs were out and I didn’t feel the need to talk with those sorry fools.

      Typical training on Friday and then we were told to report to our FTO shift.  Medically, I feel fine. Not nearly as worried as I thought I’d be.  The Geography is going to be a trick.  I remember looking at some of the new guys in Oakland and saying “It’s a freaking grid, what don’t you get about that?”  Topeka is a grid and days 1 and 2 have been a headache.  My FTO has been a medic for one year and an EMT for 2 years before that.  He realized pretty quickly that I could handle bizniss (I’ve got Town Biz on my resume, Bizrali Special Forces in full effect, those in the know, KNOW) when it comes to the back of the ambulance.  He promptly placed me in the drivers seat and sent me on my way.  I couldn’t tell which way was North or South after the sun went down.  No Thomas Guide map pages either.  They give you an address and you are supposed to arrive there within 6 minutes.  I’m getting it.  My FTO, John Noonan and I run calls a little differently, but he is a really good medic and I look forward to learning from him over the next month.  John laughed out loud at how many people I talked into going to the hospital.  Honestly all of them went, I know how AMR likes it and technically I am still new.

     AMR Topeka is now a NON-UNION shop.  The story is a little fuzzy to me, but here is the jist.   AMR Topeka was in affiliation with the Teamsters, which everybody I have spoken with, seemed to have liked.  Then NEMSA came in and changed everything and eventually and rather quickly, the workers voted to disband the union.  I am not a fan.  I have been a union man for most of my working life.  So here are some of the changes I have noticed.  I am not sure if they are union related or not but here goes.

-         NO C-7’s.  I was told we eat when we can and we don’t get paid for any missed meal period. PERIOD.  Food options in town are limited at best.

-         NO Strike Pay.  No differential for working an overnight shift. Same pay day, night or weekend.  I do have to admit that because no union was involved AMR was able to give me a pay that was higher than was expected.

-         You are allowed to clock in 7 minutes prior to shift. You are given that 7 minutes to check out your ambulance and then at your start time you have to be on your radio and available for a call.  Head Quarters is a status 2 post and it seems that dispatch is letting the crews hang out at HQ for awhile to finish the check out, but you are available for service.  Two shifts in we have been sent to cover the HQ post about one hour prior to end of shift, but you have to stay available until the very last minute of your shift.  I haven’t been held over in the first two days.

The North side of Topeka, North of the Kansas river.  It IS the bad part of town. Guess what they call it.  OAKLAND!