Wednesday, April 29, 2009

Beat Me, Please

A sea lion suns itself on San Francisco's Pier 39. In retrospect, probably not the right image for the title of this post.

I've been an athlete for as long as I can remember, and all of that time I've been balancing my athletic performance against my ego. At times, especially when I was younger, I was wildly unsuccessful and let my ego run amok much to my detriment as a person and a friend.

When given a choice between competing or practicing with those that are better than I was or playing with a group that is not quite as fast or strong, I always chose the later, simply because it made my ego feel better. I remember one evening getting in the pool with the Masters Swimming program at the University of Miami, the pool was filled with ex-Olympic and competitive NCAA swimmers. Needless to say I got my ass handed to me, and never returned; my ego got bent. If I had stuck it out I would surely be a better swimmer today for it.

At 45-years old, I can see what's happening now. If my ego gets slapped around a little; well, that's a good thing. It deserves the beating.

Tuesday, April 21, 2009

The Big Sit

I've decided to take on Tricycle magazine's 90-day Zen Meditation Challenge. I haven't been sitting much lately, and this "Commit To Sit" seems to strike the right Type-A cords in my life. Here's what it entails:

- Sit in formal meditation (zazen) for 20 minutes each day.
- Listen to one dharma talk online each week.
- Study Dogen's Genjokoan.
- Commit to the sixteen bodhisattva precepts

I try desperately to maintain a balance between my intellectual, physical, and spiritual pursuits, but sometimes I get a bit out of whack, like I am now. I've just spent almost twenty weeks dedicated to my paramedic certifications, I'm training like a fiend for the upcoming triathlon season, but I've let my spiritual side slide a bit. Time to bring things back into shape.

Monday, April 20, 2009

Taking The Tuition Leap

After a bachelor's degree and two different masters degrees I like to tell people that "I'm educated far beyond my intelligence". This normally elicits a chuckle upon the realization of the difference between education and intelligence. I chide my wife that I'm "one up" in the degree count, which annoys her to no end since I'm a proud product of a rural public school system and she comes from many years of elite private schooling. Trust me, she's pretty quick to point out the education-intelligence mismatch as well, and I sometimes think that she would tattoo it on my forehead if she could.

In all honesty I do think the link between formal education and intelligence is tenuous. I've meet some people that just barely got out of high school and can intellectually man-handle me with abandon. On the other hand, I've met PhD candidates that didn't know enough (or care) to brush their teeth in the morning. So what does thousands of dollars of formal education buy you? Firstly, I think there's a bit of "right of passage" there. In other words, "That's the route I came up from, so you have to follow". Secondly, I think that it's a measure of commitment to one's chosen vocation. If you're going to drop untold amounts of money and many years of your life on becoming a physician, then most can rest assured that you're serious about medicine. The final argument is, it's better to be safe than sorry. Few have not gotten hired for being over-educated.

So as I stare are my 5-year old's first tuition bill I take heart that he'll at least have a good start. Where he goes from will be influenced by many factors, not the least of which is himself. My wife and I promise to do our part, but in the end I want him to have the tools to be happy in life. It's the intelligent thing to do.

Wednesday, April 15, 2009

Messengers, Free Runners, and Paramedics

I had one of those life-reflecting ahhhh moments this morning driving to school. In the early morning light a bicycle messenger darted past my Jeep on his fixed-gear and disappeared up the road. It sparked a memory in me; at one time I would have been very happy working as a bicycle messenger, deftly negotiating the streets of a big city, cheating both the laws of physics and traffic. I came to define that romantic dream by using the oft-used Buddhist concept of "being in the world, but not of it". In other words, I exist within the world of traffic, cars, congestion, but I operate on a totally separate plane, one of grace, speed, and finesse.

This brief "ahhhh moment" led to others. During another moment in my life I fell in love with Parkour, also known as Free Running, e.g. the opening scene of Casino Royale; again, being of the world but not necessarily in it.

Now here I stand, ready to begin work as a street paramedic, and I'm coming to the realization that it's nothing more than an extension of the original concept, that of living and working within the cityscape with all of the muck and dirt, but existing on a separate plane. The thought of swooping in to the side of a critical patient, working some medical magic, stealing death, and then moving on again is very enticing. I'm still trying to wrap my head around this oddity that has seemingly connected various pieces of my life together along a common thread.

Of course all of it is meaningless, and nothing more than a misty dream-like desire. I realize that, but I just found the commonalities very interesting.

Sunday, April 12, 2009

I Can Smell A Battlefield

Serenity next to the river.

I spent the weekend in Knoxville visiting my family. On the way back to Bloomington I decided to stop off at Louisville and take a look at the venue to the Ironman Louisville triathlon coming up in August of this year. Ironman Louisville will be my biggest race this year, and I wanted to "walk the ground" as it were. Strolling along the river-side swim exit I was reminded of George C Scott's line in the movie Patton, "I can smell a battlefield". I tried to envision the endless rows of bikes lined up on the shore; tens of thousands of spectators, volunteers, and athletes; lights; blaring music; the finishing line; the spectacle that is Ironman. I'm sure that on race day I won't even recognize the serene environment that I strolled through today.

Wednesday, April 8, 2009

Anger and Tibetan Buddhism

I visited the Dagom Gaden Tensung Ling Tibetan Buddhist Monastery in Bloomington. I would have been very remiss if I had not.

I was having dinner at a local bar and the guy next to me was describing his Alcoholics Anonymous (AA) meeting to a couple of women that were sitting there. Of course the guy had a picture of "leaded" margaritas in front of him. He went on to explain how stupid the whole DUI process was that landed him in court-ordered AA. I think I was the only one sitting there that got the irony of the whole situation. I couldn't help but think, "Yea, you hit my family and court-ordered AA is going to be the least of your worries". Yup, that was anger.

Sunday, April 5, 2009

Making The Best Out Of...

Getting ready to head out on a ride.

I've spent all winter on an indoor bicycle trainer, hammering out miles with the assistance of Troy Jacobson's Spinnerval DVDs. The result is that I'm crazy strong on a bike, but can't ride in a straight line to save my life. My bike handling skills are at best, atrocious, and at worst, dangerous.

I braved the blackening skies this afternoon to join a group ride around Bloomington. Two people showed up; a guy on a 1980s spray-painted Cannondale and wearing Ho Chi Ming slippers, and another rider who was working hard to drop a hundred pounds or so. Now I'm not a bike snob, and have been dusted by all sorts of people, but I was really struggling to find a graceful way out of this gathering. The thought of getting caught in the rain, which was definitely coming, with these two lads and being lost miles from home was not very inviting. No good, I was committed and I was going to ride.

The result was just as I predicted; rain, lost, and not a lot else. I decided to use the opportunity, instead of grumbling, to work on my weakness, bike handling. At low speeds I worked on staying in a straight line, breaking and cornering. Even though we barely broke 15 mph, I got something out of what would normally be a bad situation. I'm happy that I did it.

Friday, April 3, 2009


The setting sun is reflected on the side of a Bloomington ambulance.

I spent an hour yesterday transporting a 70+ -year old cancer patient to definitive treatment in Indianapolis. We sat in the back of the ambulance and quietly chatted while I kept an eye on the monitor that I had him hooked up to. I listened to his life, and realized that he was coming to grips with his own mortality. This still robust man had worked hard all of his life trying to make ends meet, never really traveling outside the state of Indiana; working in the stone quarries, as a farmer, and as an auto mechanic. He spoke about wishing that he had gotten an education; equating that to making a better life for himself and his family.

I felt honored to sit and listen to his story. It saddened me a little, for what reason I haven't really come to grips with yet. Maybe its a man who is looking at the end of his life rushing at him and he is still filled with so many regrets. This scares me.

Thursday, April 2, 2009

Ahhhhh Moments

A paramedic student works on his intubation technique.

I'm in the middle of what I term as "clinical sprints"; every day I work on a different 911 ambulance as the lead paramedic often for 14-24 hours per shift. This grueling schedule will go on for the next week or so until I graduate the course.

During these clinicals I feel myself learning and maturing as a new street medic. Today we responded to a 96-year old woman who had fallen outside on her deck and fractured her hip. When we arrived I found her sitting up against a hot-tub with her left leg rotated inward and shortened in length, a tell tale sign of a fracture. Normally these injuries are excruciatingly painful and have catastrophic results for the elderly. A week ago I would have splinted the leg, started and IV, and began pushing narcotics for pain management. Today I stepped back and realized that the woman was not, for some reason, in a great deal of pain. This is often the case with elderly women; maybe they've seen so much in their lives that pain is often relative.

I withheld the IV and the narcotics, realizing that I don't need to do some procedures just because I am able to, but rather its better to use my clinical judgment and make the best choice for my patient. There was no need to start what could have been a painful IV in the arm of my patient while bouncing down the road in the back of an ambulance for nothing more than to push a pain medication that this lady really didn't need in the first place. If the ER wants an IV they can start one themselves in a more clean and stable environment.

I was happy with my decision, and believe that it was a step forward for me; sort of an "ahhhh moment" Realization comes in small steps.