The Rural EMT
I have an x-ray collection. I love the big sheets of film, the look inside. I started nabbing them wherever and whenever I could; then people started giving me x-rays as presents. A new friend, not knowing my penchant for x-rays, recently sent me one in the mail (you know who you are :) But this is a tangent; this post is not about my x-ray fetish, this post is where I shall answer the questions you left me here, regarding my EMT studies and rural Emergency Medical Services.
What made you want to do this?
Around here, there is no paid fire department nor a paid ambulance service. That means, if there were no volunteers, one could have a house on fire or terrible car crash or a medical emergency and call 911 and no one would show up. Can you imagine? When the ambulance coordinator approached me this past summer and asked if I wanted to be in this class, I couldn’t say no, for several reasons:
~ It’s an amazing opportunity ~ I’ve dated EMTs and firefighters and know how hard it is to get on a crew in the city.
~ It’s a skill set I find incredibly valuable ~ especially because I know I will continue spending my life largely distant from the hubs of civilization – if not here, then in other mountains, deserts, oceans – and I’m pretty sure I won’t be alone.
~ Dare I be perfectly honest? When I was offered a spot in this class, it was at the height of the stalker stuff. And I thought, ‘if I know how to fix it, I’ll know better how to break it.’ This is like 2% of my reason behind doing this. I’m 2% vicious. Please don’t get fixated on it.
~ Most of all, it’s because I can ~ I know I’m physically and mentally capable of doing this job and, being self-employed, my life is structured in such a way that I have the time and ability to help my community (and travelers passing though) in this way. How could I not?
Why EMT instead of vet tech, fire fighter, tutor, etc?
Interesting question, and though this was not part of my conscious decision-making process, the answer is: the fire dept is pretty healthy (lots of volunteers), the school system is pretty insular and I made too many waves when I was there for certain members of the administration to welcome me back (I was a substitute teacher for about 18 months before Charlie), and there are a number of vets in the area and most of them host interns from veterinary schools across the country. On the flip side, there are currently only four EMTs in my town. Four is not enough, especially when those four might be unable to respond if they are sick or working cows or doing errands out of town or what have you. That number will more than double when our class finishes. Everyone in town is thrilled about this.
Will this be a full time gig? Are you on call for certain days out of the month with days off? How many people report to a call?
No, this is not full time. It is volunteer. It is unpaid, and without a set schedule. There are no on-call days or days off ~ if you can show up, you show up. If you can’t, you don’t. There could be six people who respond to one call, and only one on the next. If more people are needed, you call in for assistance and sometimes they have to come in from the next town, which can take upwards of half an hour or more. This, again, is why it’s so important to have a number of certified EMTs in this rural area.
Are there limits to what an EMT is allowed to do?
There are three levels of EMT: Basic, Intermediate, and Paramedic. I am in Basic training, and there are limits to what I am trained in and allowed to do, such as administering an IV ~ one must have Intermediate status to administer an IV. Paramedics go even further.
Do you have to have prior medical background? How long is the training? Is there any lab training with the course?
No medical background is required. EMT Basic training is 160 hours; the hours for Intermediate and Paramedic training jump exponentially. There’s no cadaver work, if that’s what you’re asking, but there is a ton of hands on training ~ we do everything to ourselves in class. Getting strapped into the stair chair and rolled down a long flight of cement steps by two of my classmates taught me more about how to do that well on a call than any book could!
Is your county divided into sections, so you are only responsible for covering a portion of it?
Yes. There are two towns in my county, my little town (population 300) and the neighboring big town (population 5000) where the hospital is. There is an ambulance service for each town, but they work together as needed. My classmates are from both parts of the county.
What is the average number of calls for Emergency Services each year?
For my little town, there are about 50 calls per year. My town covers the mountain highway and area ranches, along with the little town. About forty of those calls are trauma (car wreck, motorcycle wreck, horse wreck, etc) and ten are medical. For the big town, there are 500+ calls per year; of those, about 50 are trauma and the bulk are medical.
How close is the nearest hospital?
The hospital is thirty miles away from my town. But town is just town. It can be an hour’s drive, or even more, to the hospital from many of the ranches around here and from the highway that crosses the mountain (scene of many crashes).
How will you respond quickly if you live in the middle of nowhere?
That is precisely the point. Everyone out here lives and works in the middle of nowhere. It’s a 45-minute to two-hour wait for the life flight helicopter. The more EMTs that are scattered around the countryside, the greater the chance of someone arriving on scene quickly enough to make a difference. I’m five minutes away from a number of people. Another EMT might live or work at the other end of the valley, thirty miles away from me, but they are five minutes away from everyone on that end of the valley.
What is the signaling system?
It’s a pager kind of thing. Kind of a hybrid between a pager and a radio.
How often do you have to renew your certification?
A certain number of hours of continuing medical education have to be completed every two years (over the course of those two years) in order to remain certified.
Any chance you’ll take this further? Med school? Vet school?
I doubt it. Though perhaps I’ll go further within EMS.
I’m curious about how you are learning CPR – the Red Cross had put out something saying they were recommending people only do chest compressions, not mouth-to-mouth?
We do compressions + ventilations (mouth-to-mouth, though we use a little mask to separate the mouth of the patient from the mouth of the practitioner, along with other techniques such as the bag valve mask and using supplemental oxygen). We were told that the “compressions only” notice from the Red Cross was in response to the fact that, these days, bystanders are less likely to give any assistance because they are (justifiably) wary of the diseases that can be transmitted via mouth-to-mouth. So the Red Cross said, Do Compressions Only! because that can buy a tiny bit of time and maybe help someone, rather than doing nothing. EDIT: But this may not be the whole story – see the links in the comment section for more info on this!
Do you get any training/preparation for the psychological effects of coming upon accidents/trauma?
Yes ~ that’s actually what our class covered first, before learning anything about helping others. I have a weird philosophy – well, I don’t know if it’s weird because people don’t generally talk about this stuff. I’ll try to explain it. OK, I just tried typing it out and could not do a decent job of it. I’ll put this on the list of things to try to work out well in writing. I can say, that as the weeks go by, the class is becoming more like a unit, a team, there’s a closeness growing. And I think that will be really important and valuable in working through tough calls, both on scene and after the fact.
She’s a brainiac, brainiac…
My brainiac status was cemented in EMT class tonight
when I got 100% on our first major exam!
Though seemingly contrary to my lifestyle and recreational activities,
deep inside I am a nerd.
I have a psychic feeling (and the emails to back it up)
that some of you out there are curious about this EMT stuff.
I’m not really sure what to write about it
{except to say that, after anatomy class,
I can now declare that Sir Baby, at the shoulder,
reaches my axilla}.
{That’s armpit for the rest of you.}
So, leave your questions in the comment section of this post
and I’ll answer what I can in another post!
Part VI
Earlier posts:
Intro, Intro Addendum
Part I, Part II, Part III, Part IV, Part V
About two weeks after the bond hearing – during which the stalker remained in jail as he could not produce $10,000 cash – I got a call from the Victim’s Advocate in the court. This is a woman who works in the Prosecuting Attorney’s office and, as her title indicates, acts as a liaison between the court and the victim. She was the one truly competent, invested individual I encountered during my dealings with the court and has become a friend.
The stalker had plead ‘not guilty’ at the initial hearing, and he wanted to get out of jail until the jury trial which was scheduled for two months out. The Victim’s Advocate was calling to inform me that the stalker had, through his court-appointed attorney, requested a hearing to have his bond waived. WAIVED. Seriously? I mean, even in Monopoly, unless you are lucky enough to draw a Get Out Of Jail Free card, you SIT THERE OR PAY TO LEAVE. Does the United States judicial system now hand out Get Out Of Jail Free cards upon request? Apparently so. Because the Victim’s Advocate urged me to appear in court and testify, stating that if I did not, it was very likely his request would be accepted by the judge.
I did not want to testify, but I thought, at the very least, it would be good practice for the jury trial and at best, could keep him in jail until the trial. Mike took the day off and went with me, and I drenched myself in Golden Armor, which did its job – even though I was in a small room with the stalker and on the stand in front of him, I felt that he could not see me, could not access me. He was in an orange jumpsuit, chains shackled around his ankles and wrists cuffed to a chain around his waist.
I took the stand first, and the Prosecuting Attorney asked me questions that allowed me to describe the history of the stalking and the measures taken to try to stop it. He ended with the question, “Do you think the bond should be waived?” I said, “No. When I told him to stop, he said he would stop but he didn’t; it escalated. When the Chief of Police called him and told him to stop, he said he would stop but he didn’t; it escalated further. He says he will stop now but there is nothing in his past behavior to indicate that he will stop if he is released, in fact, the pattern shows the opposite. I hope the court recognizes this and will hold him accountable for his actions.”
I was told to remain on the stand because it was now the defense attorney’s turn to question me. The court-appointed defense attorney was a misogynistic incarnation of evil. God, she was vile. SHE. And not just with me. She defends rapists, abusers, and stalkers, and I heard much about her treatment of other female victims – her attempts to blatantly humiliate and denigrate victims while they’re on the stand – and that she was chronically rude and unprofessional to the staff of the county attorney’s office.
When she had her chance with me, she tried. Oh, how she tried to slander my character and upset me. But it soon became evident to everyone in the room that she was no match for me. I wanted to say, “Lady, don’t waste your time. I BLOG. The worst you’ve got won’t come close to the hatemail I’ve gotten. The trolls have made me immune.”
She became visibly filled with hatred because I didn’t crack under her words. And her defense was ludicrous. Here’s an example:
Her: Have you read anything by Stephen King?
Me: No.
Her: {accusatory tone} What??
Me: No.
Her: {pause} Well, you know who he is?
Me: Yes.
Her: {sing-song voice} My client is creative. He wants to be a writer. Say he was just acting this way as research for a novel he’s working on. There’s no law against that, is there?
Me: Yes, there is. That’s why he was ARRESTED.
So, by her logic, it’s OK to kill someone, as long as you write a book about it afterward? Idiot.
Then it was the stalker’s turn to take the stand. The defense attorney made a big fuss about how I had accepted his “friend request” on Facebook, nevermind that I’ve accepted over 3,000 friend requests, that it happened months before the stalking began, and that I had since blocked him. That, and the “he’s the next Stephen King,” were their only defense.
When it was the Prosecuting Attorney’s chance to question the defendant, he asked, among other things, why the stalker had a loaded .44 Magnum with him. The stalker launched into a long, detailed, disturbing monologue about how he had creditors after him. The creditors would not leave him alone. And so he carried a loaded gun at all times because if those creditors got close he was going to shoot the first one in the face, and the last thing the second one was going to see was the bullet exiting the giant hole in the back of his partner’s head and the blood splattering all over right before it then entered his brain. He was going to kill both those creditors with one bullet. And then those creditors wouldn’t be bothering him anymore.
The courtroom was silent. The judge had his jaw on the desk in front of him. You could see the defense attorney saying “SHUT UP! SHUT UP!” in her head. The Prosecuting Attorney told me afterward that the hair on the back of his neck was standing on end.
The judge made his declaration. He was red in the face and said, directly to the stalker, “You are crazy, you are dangerous, and bail stands at $10,000.”
But this is not the end of the story.
Part VII is HERE
The Crazies
{The Crazy Mountains, Montana}
OK, so, I take back what I said in the post below. I love the deep country too, too much to pine for city life, a fact re-evidenced over the past few days. I spent a long weekend in Bozeman with my sister, and Bozeman ~ which isn’t even a city, just a college town ~ was far too much “civilization” for my taste.
The Yay’s and Nay’s of the outside world:
yay: olive bars
nay: ubiquitous cell phones
yay: gluten-free pizza
nay: cars cars cars cars cars cars
yay: organic groceries
nay: gray snow
{hmm… all my “yay’s” are food-related}
yay: seeing my sis
I’ll brave the crazies of civilization to visit her….
but an even better plan:
a
greenhouse
a
cheese cave
a
root cellar
a
guest cabin
YES.
The Skin Skinny
This post is so overdue. Like three years overdue! I get a lot of email from people wondering what I do for my skin and how I keep it moisturized in this dry clime. The answer is ridiculously simple and cheap. I don’t use commercial face creams or lotions. None at all. I moisturize with cold-pressed oils in their raw and purest form.
My daily moisturizer is cold-pressed pure jojoba oil (pronounced ho-ho-bah). Jojoba oil has a molecular structure that is extremely similar to the oils our bodies naturally produce. Thus, jojoba assimilates into the body smoothly and is absorbed quickly. My skin loves it. So does my wallet ~ it’s extremely inexpensive. And so does the planet, because I buy it in bulk and don’t go through all those little jars and plastic bottles like I did when I used regular face creams and body lotions.
I started using cold-pressed oils as my primary moisturizer when I was 24, so…. NINE years ago. This has been my regimen for nine years. Gah, that makes me feel old. And yet I look young!
I have experimented with several different brands along with different oils and would suggest anyone do this to find the right match for their skin. Jojoba oil from Mountain Rose Herbs is my main standby. I have also used apricot kernel oil and currently use kukui nut oil on occasion ~ these are slightly heavier oils that I use when I need a deeper, richer moisturizer, usually at night in the wintertime. Cold pressed olive oil is a great everyday moisturizer, too. I promise, you won’t smell like food.
I also use cold-pressed shea butter on my face after a sunburn (rare) or windburn (sometimes it can’t be avoided). Shea butter is a thick butter that melts as it hits the skin, and it is absorbed more slowly. It’s not something I’d put on my face right before work or a date, but it’s a very nourishing treatment when you’re just sitting around watching a movie or something. Sometimes I use it just around my eyes and on my lips for a deep moisturizing treatment. It’s also great for hands and cuticles. Though the best cuticle treatment, which I recently discovered, is Liquid Lanolin
Cold-pressed oils have not been heated, and these are the only oils I will use on my skin. They have not undergone heat treatment during the extraction process, nor been heated as a result of friction during the extraction process, nor heated after extraction during processing. They are pure, raw oils. We are pure, raw beings, and to me, it only makes sense to use a similar product on my skin. Our skin is our largest organ, and the popularity of dermal patches proves that what we put on our skin goes into our body. I don’t want synthetics, dyes, artificial fragrances, or petroleum products in my bod! And, contrary to what the commercials will tell you, I know I don’t need any of that stuff to have great skin.
Because they are cold-pressed, these oils are not inert and “stable” ~ they will spoil if left in the heat or sunlight for long periods of time. I keep the bulk bottles in my fridge (I usually buy the 16oz bottles which last a very long time), and have small amber and cobalt glass bottles out for daily use which I refill as necessary.
I often add a few drops of essential oil to these bottles to create natural, custom scents. While I keep a bottle of jojoba oil unscented for my face, I have bottles with spray diffusers which I infuse with essential oil and use on my body (I don’t use commercial lotion on my body, either). I love the scent of jasmine and bought a teeny tiny vial of jasmine essential oil ~ it’s crazy expensive! But it, too, lasts for ages. Three drops of jasmine in one of the larger glass bottles infuses the oil with a gorgeous, discreet fragrance. NOTE: Before using essential oils on the skin, do read up on safety and dilution ratios. Here’s a place to start.
See? So simple! So easy! Budget-friendly and luxurious all at once! So, go forth and moisturize. And don’t forget your neck. Every time you moisturize your face, moisturize your neck as well!
MY NEW BOOK!
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