Monday, April 29

Morpheus is fighting Neo!

In 1999 we were introduced the concept of the Matrix.  An electronic dreamland wherein machines of the future have enslaved human kind and keep us around as power sources.  Since the body can not survive without the mind, the machines have created an elaborate computer world that we all live in, oblivious to the truth.

A select few humans have discovered this fact and escaped, creating an underground resistance to fight the machines in the future and free human kind.

Spoiler Alert: I kind of doesn't work.

Every time I hear someone in EMS complain about kidnapping, or having their chart blown up in court for all to see or some other urban legend of our Profession, I have to wonder what they would do if Morpheus arrived to show them the truth:

I picture Kelly Grayson sitting in a leather chair in some sweet shades and a fancy coat, holding out 2 pills to new EMTs.

You can take the blue pill, go along pretending this is all there is.  Backboards for everyone and NRBs at 15 liters per minute,  partners who torture with 14g catheters and refuse to tuck in their shirts, merit badge refreshers that rehash what we think we know and another conference class on how things used to be.

OR

You can take the red pill, and see the truth.

We are keeping you poorly educated and poorly paid because we need a steady stream of adrenaline junkies to replace you when you get burned out in 6 months.  You're living in a dream world, new EMT, a dream world where the bare minimum is acceptable, even encouraged, and we make sure you're just happy enough to accept it.

You go to work, collect billing information, treat from the cookbook, follow your patient's every demand no matter how outrageous and it bothers you.

But what to do about it?

You're here because you know something is wrong, but you can't seem to put your finger on it.  No matter how many conferences you attend, magazines you read or managers you talk to, the answer seems to be the same:

"The future is now!"

But you don't see it.  How can the future be here if it looks just like the last 30 years of guessing at science and pretending that taking them all and letting the MDs sort it out has ever worked?  When will you realize that "that's the way we've always done it" is the last excuse of the desperate?

Take the blue pill and you'll wake up tomorrow thinking your desire to improve was misguided, a waste, a dream.  You'll strap up your boots and go to work, still wondering what is bothering you about what you do.

Take the red pill, stay with me, and see just how far we have to go.  Learn more about why, expand your horizons and seek out solutions.  I can show you the truth behind the lies, but you have to forget everything you know and trust me.

I offer only the truth.  Nothing more.

Morpheus: I imagine that right now you're feeling a bit like Alice. Tumbling down the rabbit hole?
Neo: You could say that.
Morpheus: I can see it in your eyes. You have the look of a man who accepts what he sees because he's expecting to wake up. Ironically, this is not far from the truth. Do you believe in fate, Neo?
Neo: No.
Morpheus: Why not?
Neo: 'Cause I don't like the idea that I'm not in control of my life.
Morpheus: I know exactly what you mean. Let me tell you why you're here. You're here because you know something. What you know, you can't explain. But you feel it. You felt it your entire life. That there's something wrong with the world. You don't know what it is, but it's there. Like a splinter in your mind -- driving you mad. It is this feeling that has brought you to me. Do you know what I'm talking about?
Neo: The Matrix?
Morpheus: Do you want to know what it is?
(Neo nods his head.)
Morpheus: The Matrix is everywhere, it is all around us. Even now, in this very room. You can see it when you look out your window, or when you turn on your television. You can feel it when you go to work, or when go to church or when you pay your taxes. It is the world that has been pulled over your eyes to blind you from the truth.
Neo: What truth?
Morpheus: That you are a slave, Neo. Like everyone else, you were born into bondage, born inside a prison that you cannot smell, taste, or touch. A prison for your mind. (long pause, sighs) Unfortunately, no one can be told what the Matrix is. You have to see it for yourself. This is your last chance. After this, there is no turning back.
(In his left hand, Morpheus shows a blue pill.)
Morpheus: You take the blue pill and the story ends. You wake in your bed and believe whatever you want to believe. (a red pill is shown in his other hand) You take the red pill and you stay in Wonderland and I show you how deep the rabbit-hole goes.

 

It should be noted that many Matrix fans believe that the "real world" and Zion are also parts of the Matrix used to control the radical element and that the machines have anticipated their desire to rebel.

EMS doesn't need a Neo to come and save us, or even a Morpheus to show us the way to the Oracle to hear what we need to hear.  But what we do need to do is wake up, look around and stop taking half truths and scare tactics as solutions for our patients.

Which will it be?  The red?  Or the blue?

Saturday, April 20

Keg Bot

Friend of the blog Jody Fielder casually sent me this link this morning via facebook:

 

KegBot

 

Mother. Of. God.

Video to follow.

Wednesday, April 10

What vs Why - Ramsay vs Hunter

In the 1995 submarine film Crimson Tide Gene Hackman plays experienced Navy Captain Frank Ramsay assigned to the nuclear missile submarine Alabama.  Playing opposite him is the younger, up and coming Lieutenant Commander Ron Hunter played by Denzel Washington.

I enjoy the film and constantly find myself watching the battle of wits between "Old School" and "New School" often wondering who will win the upper hand.

Ramsay is from the Old School of Navy warfare and he knows it.  Hunter is the new Executive Officer (XO) on the boat and one night at dinner the conversation turns to the glaring difference in style between old and new.  Ramsay mentions that the Navy doesn't want him complicated, but simple.  With just a hint of sarcasm the young Hunter replies that Ramsay has the Navy fooled, indicating that he is indeed more complicated than he'd like to let on.

"Be careful there, Mr. Hunter. It's all I've got to rely on, being a simple-minded son of a bitch. Rickover gave me my command, a checklist, a target and a button to push. All I gotta know is how to push it, they tell me when. They seem to want you to know why."

The conversation continues to explore the reasons for war and the different views on the subject which I won't go into here, but it's a great back and forth.

"They seem to want you to know why" sticks in my head though.

I see this conversation all the time in Fire Stations and Hospital ambulance bays.  The salty old anchor who is good at what they do questions the up and coming schooled rookie, assured that simply knowing what to do is better than worrying about why.  The rookie, educated and trained far beyond the salty anchor lacks experience and needs to find a balance.

Cut off from command, their last message was cryptic and incomplete.  Nuclear war is feared and the two schools are pitted against one another.  Old school sees it as an order to fire while the new school sees it as a chance to get more information.  The What vs the Why.  Ramsay orders a launch, Hunter refuses and the battle of wits has begun.  Old school bends the rules to meet their ends and new school tries to outwit him at every turn.

Throughout Crimson Tide we see a struggle between old school and new school during a crisis situation as each of the leads falls back to their comfort zones for support.  Ramsay leans on loyalty while Hunter seeks out new members to join him in opposing the Captain's actions.

Don't get me wrong, knowing what to do is important, but I think you know I'm a bigger fan of knowing Why.

One of my instructors used to say "I can teach a cat to intubate, but I can't teach him when not to."  He was the same instructor that, when faced with a scenario in lab and someone would initiate a treatment he would always ask "Why?"

BP is low, start a  line.

"Why does their blood pressure bother you?"

We're here to fight.

"Why do we fight wars?"

Pulse is 50, hand me the atropine.

"Why is Atropine indicated here and why will giving it make things worse?"

I don't think this is a good idea.

"Why can't you just do what you're told?"

 

In the end of the film, we discover that Why wins the day as the information was incomplete.  Had What been victorious a bad decision would have been flawlessly executed.  You can perfectly intubate every time, I get it, you're a salty dog, but the last 4 you got were completely unnecessary.

 

Let me show you Why.

 

Which one are you?