Friday, September 12, 2014

The Skinny On the Dispatch Job

I waited to tell this story.  Partly because we were busy moving and adjusting to life in isolation, and partly because I needed to ensure telling this story wouldn't hurt anyone.  Including myself.

Two Septembers ago, I started seriously looking for a job.  Living where we were living and surviving on one income (plus a tiny bit extra from me doing some online copywriting work and social media stuff for small businesses) was not working, the cost of living being rather high.  Brent was working his ass off doing crazy amounts of overtime and we were still chronically broke.  I actually considered the food bank a few times, that's how broke we were.  The only things that really stopped me were that I didn't know how you go about getting food from the food bank (do you fill out forms? Go through an approval process? Do they want to know your income level?), and it felt ridiculous to own a home and have a decent income and go take food that could go to people who don't even have the choice of either of the above.  But you can't eat your house.

There's a ton of shame involved in being in your thirties and being shit broke.  It fucking sucks.

So, after struggling for awhile on a single income and getting nowhere, I said enough is enough and started looking for a job.  I'm a big girl with tons to offer, lots of years of work experience, and certainly no lack of work ethic, so I hit the pavement with my resume.

These days hitting the pavement is an introvert's dream because you apply for stuff with your computer and email address and never have to meet anyone until they're already interested in you. Coolio.

At first I figured I would get a job with Parks and Rec or something, something low stress, do my job and go home, minimal commute, and minimal chance of developing PTSD just from the daily ins and outs of my job (unlike my previous decade in emergency services). I applied for a bunch of jobs but pretty quickly got drawn into one in police dispatch... I just can't get away from being an adrenaline junkie and an emergency response addict. When I saw they were hiring in a nearby city, I jumped at it.  It seemed as though it was perhaps meant to be, because I kept passing their 87640976 steps to getting hired.  All those steps meant months and months of waiting and hoping and more and more financial stress.  I was torn: keep looking elsewhere?  Or hang in there for a job I was truly interested in?

Simultaneous to this process, we applied for Brent to be released from Surrey and relocated to any remote posting in the Yukon or BC. These are separate but you must be released before you can be relocated, and it can take years for either to happen.  So it was a long shot, but we shot.

At first I was hoping for a paycheque before Christmas. Then maybe before February. March? But it wasn't til the end of April that I was called in for the three week training session and, finally, a paycheque.

I had not tipped my hand as being a parent during the entire application process, as I know it can unfairly bias employers against you. I don't just know this as information; I know this from personal experience.

But once I was in training, I figured I was in.  I was hired.  What was I going to do; pretend I had no kids the entire time I was employed?  So on the first day during our introductions, I said I have four kids. Oops.  Thereafter, I kept getting ambiguous vibes from my trainer. She was funny and personable and we seemed to operate along a similar wavelength.  In another context we could definitely be friends. But she kept giving me this push-pull dynamic and squashing my enthusiasm or purposefully misinterpreting my statements as evidence I was unfit for this job. The reason became clear in my second week performance review when she leveled at me, point blank:

"I have serious reservations about your ability to learn this job with the amount of family responsibilities you have at home."

My jaw almost hit the floor. You cannot discriminate against an employee or potential employee in Canada based on whether or not they have children. You cannot assume anyone is unfit for a position based on their age, race, sex, sexual orientation, whether they are pregnant, breastfeeding, have children, are married, single, or born with six toes. It is illegal.

This girl, whom I like and respect, didn't tell me she has serious reservations about my skill set, job experience, or work ethic. She told me she has serious reservations about me doing this job while having four kids.

Would she have ever, EVER, EVER have had the same reservations about a man with four kids? Would it even have crossed her mind as an obstacle for a man to be a father and a dispatcher? I guarantee not.

I wish I had pointed out all of the above. But what power did I have? At any point during the training they could simply mark me as unsuccessful and that would be the end. If I kicked up a fuss they could just not schedule me to work, or only schedule me very few shifts so I flounder or go look for another job out of financial desperation. So I scrambled around trying to justify my presence in their midst, stammering about working hard and getting a chance to actually prove myself and try it out rather than memorize policies and navigate some rather tricky amounts of information in a poorly designed classroom setting, and got out of that meeting rather flustered. I went to the bathroom and cried. I knew I was done for. I knew I had been targeted for exit from the training program before it even began, that first day when I revealed that I had four kids. It explained the ambiguous attitude from my trainer. It explained the push-pull where one minute we were joking around and the next she was clearly showing me ways in which she believed I would be challenged too much.

Complicating this were two major factors. One, that I knew we were moving. We had gotten notice that Brent had been released from his previous position, and been granted a remote post. But the thing about Brent's job is that nothing is guaranteed until it's actually done. If it all fell through and we stayed put, I needed this fucking job. Two, that I wasn't a spectacularly talented call taker. I can multi task and I can navigate emergencies. I can navigate software and data entry. But (as my trainer accurately pointed out in my second performance review a week later) I don't have an 'instinct for policing.' I'm meticulous and focused, which is well suited to medicine. But for policing, you need a more global instinct-based-on-knowledge-of-policy approach. So I wasn't terrible for the job. But I wasn't born to do it, either.

I still believe I would have made a positive addition to that team. I think they made a mistake and wrote me off the first day based on incorrect assumptions about my ability to balance work and family, about how much my co parent shoulders the work of raising our kids, about what kind of childcare and community support networks I had in place, and about my personal energy level as a human being. Possibly also some assumptions about what mothers "should" do or not do once they have kids. But they weren't entirely wrong in noticing that I wasn't the most talented person in the room for this particular job.

The second week included a bank of practical tests. I will never know if I performed so poorly on those tests because I was set up to fail, or because the clear lack of support for my continuing threw me off, or if I really was just that bad. But I was brought into the boss' office the next day and given the option to continue slogging through the training (with heavy discouragement towards that choice), or exiting. The choice was left to me, and my 'family responsibilities' were not mentioned. I have a hunch that the boss likely hit the floor when she heard what was said to me in that first performance review and that my trainer was taken to task for exposing the department to a human rights violation. That boss was not born yesterday. She knows.

I asked for a casual position in switchboard instead and was given one. I think I worked six days total in May, June, and July. Including three days of training. It was a charity move on their part. One with not much charity in it, apparently.

I don't regret applying for the position or going through the process of training and failing, as painful as it was. Although my trainer was WAY out of line for being prejudiced against me for having a family, she was eerily accurate in her ability to assess my skill set and strengths. But everything she was telling me re-enforced that I am well suited to being a paramedic. I like algorithms. I like methodology. I like approaching complex problems by breaking them down and attacking them with focus and tenacity and scientific accuracy. Time pressure? Chaotic scene? Emotional bystanders? BONUS!
You can't apply algorithms to people's behaviour the same way you can their physiology. There's no Airway, Breathing, Circulation Primary Survey-Secondary Survey for crime. But there sure the fuck is for emergency medicine.

My brain had always told me that I wasn't well suited to emergency medicine. That I just passed training because I was a good academic and could pass with my book knowledge but that I didn't have an 'instinct' or talent for it. I felt like a fraud for most of my nine years as a paramedic. It didn't help that I saw my peers shoot past me while I had baby after baby and they built their careers and applied for full time positions without a second thought for the demand on their bodies or the extra commute that would steal away hours away from their babies. It didn't help that I worked part time hours while they all worked 100+ hours a week so they got proficient at the short cuts and efficiencies that I just couldn't get as quick as them at because I didn't do them as often. It didn't help that no one ever gives you feedback in the current system unless they hate you, so all I heard was silence or harrassment. It didn't help that my anxiety disorder re enforced my feelings of being a fraud.

My brain had always told me these things about me being poorly suited to paramedic work, but my brain was wrong. The experience of failing at police dispatch center training showed me exactly how wrong my brain was. It gave me new confidence, which I had never had in the decade I worked as a paramedic, that I was a good paramedic. It re-ignited my passion for medicine. And it gave me the energy and confidence to reapply once we moved here and I realized the ambulance service in our town was hiring.

I'm no fraud. I kick ass at the ABCs. I love physiology. My brain loves to store random facts about weird, little known deviations from normal body reactions and functioning that result in disease process. I can perform algorithms in my sleep and never get bored. I come alive when people get sick and injured. I am meticulous. The entire world disappears beyond the scene I'm in when I'm at work. I will never stop learning and adjusting what I do, but I will also never stop doing Airway, Breathing, and Circulation checks.

I'm not a perfect paramedic. I've made epic mistakes. I can get too focused and forget about the peripheral details of a scene like traffic control or calling for extra help. I have trouble taking leadership over people who I know have more extensive experience than me. When weird or unexpected things happen it can take me a minute (or seven) to wrap my mind around a change in plans. But largely, I'm good at what I do and I've re entered the ambulance service with an enthusiasm and passion I thought I'd lost.

I found a wooden sign on our travels this summer, and it sums this story up nicely;

wrong turns are as important as
right turns

more important

Exactly that.

Thursday, August 21, 2014

SIX Years Old!

This baby is six!!!  Wha?!  What just happened.  He was just born yesterday!?!!!  Remember?!  Here he is at 5:09 a.m. on his big day.

And here he is later, with his placenta tree and birthday sign.  Well you can't really see his tree but it's at the far right in this picture.  He's too cute.  His sign has drawings of his favourite things; rabbits and fish.

Riley is a ball of positive energy.  He bounces and dances from when he gets up until when he goes to bed at night.  He is enthusiastic about everything.  When he gets upset (which is rare) he's quite theatrical about it and it takes some serious empathy and love to talk him back down.  He likes to sleep in.  But when he wakes up, he's smiling!  He loves to read, swim, dance, ride his bike, eat mushrooms, eat almost anything, all day long... He loves daycare, school, fishing, adventures, ferry rides, and birthdays.  He does not like long car rides.  He does not like long walks.  He does not like going to bed.

Riley is pretty articulate.  He's medium on the empathy scale--he can tell you his own feelings in a New York minute but really empathizing with someone else hasn't totally floated his boat quite yet.  He can also argue persuasively in his favour especially regarding treats and surprises.  He loves gifts.  He takes after his daddy in that area!  He will spontaneously suggest gift ideas for his brothers, grandparents, and friends just because he loves them (these usually involve construction paper and lots of glue).  He still likes pink and purple but has decided these are 'girl colours' and now embraces 'all the colours' as his favourites.

He is his own guy.  People are drawn to his charisma and easy going approach to life, and of course also to his eyelashes.  Which are difficult to truly capture in a photograph, and are epic.  Riley means "valiant" and Alexander means "defender" but I'm not sure what he's a defender of aside from any opportunity for a good joke.

Riley is sensitive and sentimental.  Small changes and goodbyes really impact his heart.  Like, he gets very attached to sticks and rocks.  The family car.  His outgrown socks.  Artwork.  The Way Things Were When He Was Younger.  He's so sweet!  And yet it drives me nuts that I can't throw away holey socks without a ceremony paramount to a funeral.  He also has a strong sense of what is right and wrong and doesn't sit idly by if injustice is happening.

When he grows up he would like to be a garbage collector, or a ferry captian.

Love you sweetheart!  Stay you.  Just the way you are.
So grateful you are mine.

Tuesday, August 12, 2014

Vose Summer Road Trip 2014

We took an epic road trip in July.  We booked most of the month off work, loaded the kids and a shit ton of stuff into our Grand Caravan, and hit the road.  It was awesome!  Our littles are finally big enough to survive a road trip without permanent mental damage from utter discontent, and we got to see so much geography and so many people.  It was fabulous.

Our first leg is long.  Four hours in the car, two hours on the ferry, and another hour on the other side and then we arrived in Langley.  That first day of travel took us a little over ten hours, with pit stops and waiting for the ferry.  Then we stayed two nights in Langley at Brent's parents' place, resting, visiting a few friends, and gearing up for the next leg. 

Then we split up; the boys travelled with their grandparents and we took Amarys and did another long day from Langley to Astoria (camping on the Oregon Coast with Brent's parents is a bit of a tradition, and we always camp at Fort Stevens State Park).  That day took about seven hours. 
We love Oregon!  It's so beautiful and peaceful there.  The campground itself is very quiet and clean, considering there are hundreds of campsites and Yurts scattered throughout the park.  Usually we eat breakfast (after sleeping in), strike out to explore a beach or town, and return to eat dinner at the campground. 

The beaches are stunning.  We always visit the Tillimook Cheese Factory because Riley LOVES it.  We always hit Canon Beach a few times.  Climb the Astoria Column.  Eat fresh seafood.  Rest.  Enjoy each other's company.  Forget about jobs and housework and the logistics of raising a family. 

After five days in Astoria (overlapping with Brent's sister and her hubby and baby Dylan, who joined us part way through), we visited Portland.  We have several friends in Portland but they were all out of town while we were there, nasty friends.  Except one, who we didn't realize lived in Portland until after we left (sorry April!).  We spent just the day there, shopping and soaking up the Portland Weirdness-- we both would love to live in Portland if we could choose any city...
We hit Powell's Books, which was a first visit for the kids and it was so fun to let them loose in the largest bookstore in the world!  Each kid chose a book (or five), and Matthew also chose a set of straws that you stick together with removable joints to make fancy, ridiculous, twisty straws out of.  It kept him busy for days.
Then we hit the Nike factory store and got everyone in the family shoes for $140.  Yay back to school!  Then we drove to Kennewick, WA. 

I never realized how dry and flat Oregon was, because I'd not been East of Portland.  It's a hot, dry prairie.  And then it's downright desert.  With no one.  No towns, no villages, no people--just the odd rest stop and some dirt.  Then as we got closer to the Columbia River, it got prairie like again and there were towns and people again.  It was very stark and hot and amazingly gorgeous.  It also made me deeply appreciate living in a coastal rain forest  =)
There are three or four hydro dams and miles and miles of wind farms along the river that divides Oregon and Washington.  That was really neat to see.  We have a wind farm on the North Island but the only time I see it is when we fly North for medivacs.  We had to stop fairly frequently for cool drinks or boxes of popsicles because the air conditioner on our van is still broken.  But no sales tax and US prices means an entire box of popsicles is under $2!!  For 12 popsicles!!!  We would buy two boxes and eat them all within twenty minutes.  That's how hot it was.  And it was evening.  Crazy.

We got into Kennewick pretty late.  Near midnight, I think.  Several of Brent's cousins and an aunt and uncle live in Kennewick so we stayed with Billy and Jana, who have EIGHT kids, and in the morning Billy's brother and sister in law brought over their EIGHT kids, and his sister brought her three, and his other sister came as well... We had quite a houseful.  That was a fun breakfast!  We were so grateful Billy and Jana welcomed us in, and it was nice to reconnect with these cousins who we see for the occasional Gigi birthday or family reunion, but not often enough.


We forgot to get a group photo.

That day around noon we hit the road again, shooting for the Kootenays.  We drove east and north, through Spokane and across the border again into Canada (yay Canada! And yay rockies!).  My sister and brother in law and little nephew live in Fernie BC.  The forest fires were heavy and close enough to make us a little worried about the route we chose; we didn't want to get detoured so far from familiar territory... But although the air was smoky, all the roads were open so we were okay.

We stayed four or five days in Fernie, visiting my sister's family.  My brother's fiancée came to Fernie from McBride, and brought our nieces!  That was awesome too, because all the cousins from the Smith side were all in one place for an entire five days.  They played.  We hit the farmer's market and an amazing bagel shop and explored the town.  It was the first time we had been to Fernie, the first time we met my littlest niece Bennett, and the first time we had seen my sister's house.  Lots of firsts.

Then we hit the road again.  We wanted to pass west along the southernmost part of the province, and were going to camp halfway, but the kids all voted to do one long assed day of travel (took us over 12 hours) and do the entire leg in one day so they could have an extra day in Langley instead.  So we did!  We saw a ton of geography; the rockies, alpine passes, wild strawberries, dry desert, and then the South Okanagan.  Which is dry and rocky with lush orchards carpeting the valleys and fruit stands every fifty feet.  We bought peaches, cherries, apricots, and tomatoes for canning and jam.  We ate dinner during a thunderstorm, at a McDonald's in Osoyoos.  =)  And we got into Langley close to midnight again.

After two more days in Langley we packed two weeks worth of dirty laundry, $150 worth of Powell's books, too many shoes (except one vital Keene sandal, which was lost somewhere between Kennewick and Fernie), an Ikea trip, a Costco trip, and camping gear back into the Caravan and completed the final leg of our journey, home again. 

We saw every cousin.  We cuddled every baby.  We rested all our bodies.  We twisted all our backs on the ground of the tent.  And we had a great time.  Yay road trip 2014! 

Saturday, August 9, 2014

Assorted Pieces--My Entry for CBC Canada Writes Non Fiction, Which Was Longlisted

One of the biggest things I've learned in nearly a decade of emergency medicine is that we don’t often save lives. We deal with death, tragedy, grave illness, and everyday hurts, but most frequently, a person marches towards death with an unstoppable character, like an individual tsunami or a meteor impact: we are witness to it, but powerless to stop it. We are well trained, apply all our tricks, drugs, artificial pumpings and blowings (colloquial for CPR), needles, IVs, oxygen, investigative assessment skills, high quality teamwork, paramedic prayers (uttered by most, and often along the lines of 'SHIT,' 'DAMMIT,' 'FUCK,' or 'Oh, GOD,' but really in spirit are, 'HELP GOD, PLEASE!'), and emotional supportiveness, but the vast majority of the time, if someone is dying, we can't stop it. I've learned that I am small. I'm in awe.

I have also learned that people are not compartmentalized into parts. You cannot simply treat a person's physical symptoms and have done your job with any measure of completeness. It's hardly even possible to treat people this way. People have emotions and souls and families and lives that are inextricably tangled up with their physical selves. Fixing an unstable injury while extricating someone from a car is meaningless if you don't make eye contact or reassure the person attached to that injury. Nobody teaches you this in school.

Nobody teaches you, either, how difficult it might be to make this type of connection with someone who was drunk behind the wheel of their car, and hit someone while driving, but who is themselves still trapped and injured and afraid...but it's still essential.

Since the beginning of my career it has been repeated to and by me, and become more and more evident, that alcohol is job security for emergency services. Without alcohol, much of what we see and treat would not exist. It does not take an alcoholic disease for it to be evident how destructive this stuff can be: the destruction is self afflicted, and runs the gamut from MOST assaults, MANY domestic disturbances or violent situations, many traffic accidents, falls, drownings, broken limbs, head injuries, deaths, neglect of children, and unnecessary tragedies. A Friday night party, one too many drinks, underestimation of how much is too much, and people across the social stratosphere cause destruction with alcohol.
I'm no saint. I propose no solution. But this is what I've learned.

Aggression can be a conscious buildup of anger, or it can be a symptom of a medical condition.

Vomit is overwhelmingly disgusting, no matter its origin or cause.

Preserving peoples' dignity is a huge component of my job, and takes enormous skill and compassion in some cases, because nakedness and feces and out of control emotions are so commonplace, and so easily strip someone of their dignity if not handled well by those who witness it. People in need are highly sensitive to the deconstruction of their dignity, more so than in everyday life.

Drugs are not scary. Dark alleys are not scary. Aggressive people are not scary. Mentally ill people are not scary. Skid row is not scary. Prostitutes are not scary. Blood, guts, tears, and screaming is not scary. People are people, wherever they live, whatever they do, and they generally operate the same as you and I. Compassion, eye contact, kindness, and a strong foundation of common sense and boundaries (ie, trust your gut, yell if you need to, get out while you can) serves you well in a 4,000 square foot house or the back alley behind the mall.
What is scary? Poverty. How people get trapped by their own self definitions more than any other factor. Hatred. Complacent medicine. Bullying coworkers. Loneliness. Women who starve to death in Canada, a wealthy country, which is tossing food in the garbage like fish guts and with social assistance for hungry people, but where a 67 pound woman can starve to death of anorexia.

Prison is scary. For similar reasons, so are nursing homes.

People have an incredible capacity to heal. I saw a man once stuck in a rotating planer at the sawmill, his arm was in pieces and I thought for sure he would die, but in the end not only did he survive, but his arm did, too. They managed to piece it back together in surgery, and he was able to work again within a year. I've met survivors of Rwanda, the depression, the Holocaust, Residential schools, horrific childhoods, and terrible tragedies, who have healed.  And some who have not.

Sometimes, silence is a gift.

People really are poor enough to necessitate burning their own furniture in the winter, in Canada, this affluent place.

Poverty has nothing to do with money. It's about emotional pain, lack of resources, drug addiction, alcoholism, emotional trauma, lack of education, lack of healthy community, and lack of an ability to see that life could be any different in any way.

Sometimes, it is just as difficult to die as it is at other times to live. LIFE marches on, and the Universe/God/Fate/Providence has something else in store for us, sometimes. I once met a man who slashed his wrists and survived. A few months later he drove his car off a cliff, landed on train tracks, and was struck by a train traveling over 80 kilometers an hour. When paramedics arrived he was looking up through the sunroof of his car, with broken limbs, still alive.
It's not your day to die. Dude, stop trying and start figuring out what it is you're alive for.

Death can be really, really funny. I mean, you have to have a somewhat dark sense of humor to cope with a job like mine, but some of the most hilarious moments I have encountered in life have been juxtaposed with death. How can I explain this? It sounds so insensitive. But really, it feels more appropriate a response somehow, because it is celebratory of life.

The only place death is consistently never funny is the cancer clinic. Another place that never loses its fearful quality, for me.

Most laypeople don't like to think or talk about death. In an abstract way, they're fascinated with it: in massive catastrophes on television, set in Pakistan or Texas or Southern Russia, or in statistical form: Many Thousands Die in Darfur. But "I did CPR yesterday." Or "last night I saw three dead bodies." Not so much. I mean, it is a bit weird. What does one say in response?  

But paramedics march towards death. Alongside us, firefighters and police officers. Every few years we lose more paramedics to the hazards of the job. Firefighters and police officers, too. Most of the people I work with love to face this primal need for flight in the face of danger, and to fight it instead. This is pretty damn cool.

The handiest paramedic tools are the simplest: large elastic bands, six inches across and about a foot long, with velcro on them. Multiple, multiple uses: hold broken limbs in a splinted position. Affix a pillow splint to a foot/ankle injury. Hold legs together on a spine board. Tie down the wrists of combative overdoses or head injuries. Hold sandbags or ice packs in place. Splint pelvic fractures. Improvise a rapid infuser by wrapping it around an IV bag very tightly. Improvise a clipboard holder, IV ready pack, Saline bag holder, Yankaur suction tip ready pack holder, lunch bag, coffee sleeve, pressure bandage, or garbage can. I love those things. We call them "Zap Straps," or "Zaps."
Other useful tools: pillows and blankets. Heavy duty vinyl gloves (my favorites are green and have long cuffs that go halfway up the arms). "Sam Splints," a flexible piece of mesh wire wrapped in a thin blue foam: also multiple uses! Mainly for splinting any limb, and holding the head in place when strapped to a spine board. Also good as a coffee cup holder.

The most useful tool is my own brain, and my two hands. I can do more with questions and a physical exam than I can do with any of the expensive gadgets in my ambulance or jump kit.

Any call with Search and Rescue is a hell of a good time.

Babies compensate well and then crash hard and fast.

It's amazing how rapidly a human being moves from a dynamic presence in the room, to an inanimate object once they die. We're generally aware of each others' presence, and recognize each other as human, but once someone has died their body rapidly becomes something markedly non alive. Significant, but inanimate.

Kneeling on one's stethescope will bend its arm so you can't hear properly on one side.

Driving fast with lights and sirens is really fucking fun.