What's in a Name?

"What's in a name?  That which we call a rose

By any other name would smell as sweet."

~ William Shakespeare, Romeo and Juliet

This is my 25th year working in the city of Newark; officially more than half of my entire life has been spent working alongside some of the best providers in the history of this still relatively young profession.  To work in Newark, to succeed at working in Newark, is to have it become ingrained as part of your identity.  Even those long gone from our department still wear it proudly somewhere on their person - whether it’s as obvious as a shirt or as subtle as a different perspective on the world in general. 

You cannot see what we have seen and remain the same.

To the outside world, misconceptions swirl around us in murky eddies of grudging respect and poor assumptions.  People are often surprised to find out just how much medicine we actually do and how quickly we can do it in.  Necessity is not only the mother of invention; it is the rock on which we hone our skills shift after shift.  In this environment we are given no other choice.

Do or do not, there is no try.

Please do not misunderstand, my rose-colored glasses shattered long ago.  We are not a department filled with saints and prehospital paragons.  We fail as much as we succeed in all arenas; there is no pretty picture here.  It is a ghetto, it is violent and it is poor in many places, our trucks are often held together with more hope than screws, hours are spent on street corners, the clientele is often more angry than grateful, the living conditions we enter range from executive to horrific, we do not get slurpee machines or warm receptions at the ERs - and it never … stops.

Still we come back, shift after shift, each one changing us just a little bit more - a fraternity forged in filth and exhaustion, picking each other up time after time (even if we do not like each other).  Eventually you find that despite it all, you are given three remarkable gifts. 

The first is experience, period.  A year spent in Newark is equal to five years or even more spent working somewhere else.  For sheer volume and patient contact alone, this is professionally invaluable and if you use it to your advantage it will make a tremendous difference on the type and quality of provider you are. 

The second is fraternity.  When presenting our department to the city not too long ago our Director, John Grembowiec said “We are not providing you with a service; we are providing you with a system.”  You are now part of something larger than yourself that relies on your individual performance while wearing the uniform in order to carry it forward.  You were given the patch to wear, yet every day you come to work you earn it over again in some fashion.

The third is a gift you will not immediately recognize, but one that will grow on you slowly - deepening with each turn of the season until it is a part of you.  That is the gift of an entire city that you will come to claim as your own.  A city with a remarkable history, defunct canals and ghost-laden ruins, centuries-old cobblestones and scars from riots - three and a half centuries of all the good, the bad and the ugly of America, yours for the exploring.  You will know this city better than your hometown, become invested in a geography not your own because it will make you good at what you do, and in the end because you want to.

That is what it means to work in Newark.

What does this have to do with names?  It means that as pointed out elsewhere by Dan and Terry, the change in our name and our patch does not change who we are.  I have worked under the “UMDNJ” logo my entire time here, yet by and large it means nothing to people outside of the area.  Yet “I work in Newark, NJ” gets their attention every time.  

UMDNJ brought an era of growth to a scarred city; it is (was) the single largest employer in Newark.  It became synonymous with trauma care and has provided the administrative umbrella under which we have worked hard to become one of the most comprehensive EMS systems in the state, if not the country.  Things come to us when we need them; UMDNJ was that for the city and for us.  It is time to close the umbrella; we are strong enough to withstand the rain on our own.

Tomorrow I will go to work and those big red letters, which have served as a beacon for so long, will be different - that will make me a little sad.  I will drive past the place where NorthSTAR first landed and I will cross the same rocky parking lot that I have since 1988, go into that “temporary” building I walked into when I was still 18 years old and have the same opportunity I am blessed with every day I’m there - to work with some of the best in the business doing a job I sincerely enjoy. 

I am not a patch, I am not an ambulance driver, I am a Paramedic.  I am not UMDNJ, I am not University Hospital, I am Newark EMS.

Damned glad to meet you.

Not the breach, the ditch.

Momwatch 2013: Me: "Mom are you alright? The Trooper said the car was in a ditch."
Mom: "Yes I know."
Me: "Where were you headed?"
Mom: "Into a ditch, obviously."
Me: "Obviously."
Mom: "Where are you?"
Me: "Home, in PA."
Mom: "What are you doing in Pennsylvania?"
Me: "Mom ... what's my husband's name?"
Mom: "Ummmmmm. Errrrr. Huh."
Me: "Put the doctor back on the phone Ma."

Deceiver

As I'm fueling the car, preparing to head north.

Mom (watching me): "You know, I have yet to pump my own gas."
Me: "Oh? You haven't fueled since Dad died?"
Mom: "No, I mean ever. I never do my own gas."
Me: "There's a place around here that does it for you?"
Mom: "Oh no. I just stand outside the car and look lost and helpless, which is easy for me. Someone always comes over and offers to help."
Me: "So what you're saying is that you use your elderly wiles on these nice small town people in order to get out of a simple menial task?"
Mom: "Hey, if you got it, use it. In my case it's looking like a breeze would knock me over and I'd break a hip and die."
Me: "How long have you lived here?"
Mom: "Over ten years."
Me: "Not once?"
Mom: "Not once."
Me:

(Author's Note regarding breaking of hips - my mother has proven beyond any ability of modern science to explain it that she's indestructible. The only thing falling in a gas station would do is likely expose her Terminator-esque endoskeleton. Then her secret would be out and she'd have to pump her own gas.)

Hoarders, the Prequel

In response to a large box left by UPS (what you see is a quarter of her latest inventory):

Me: "Mom, why did you buy a bird feeder shaped like an Airstream trailer? "
Mom: "It's cute isn't it?" 
Me: "You have eleven, that makes it more like a bird trailer park."
Me: "And the banister post shaped like an Uncle Sam nutcracker?"
Mom: "To show I'm American. Duh."
Me: “Of course, how silly of me. The surfboard clock?"
Mom: "Ya got me on that one. I don't think I surf. Do I? "
Me: "No, not unless you count escaping death in a statistical impossibility."
Me: "Mom, you don't wear hats. Ever."
Mom: "They had one in every color! And you know I love pink!"
Me: "You're a hoarder."
Mom: "I'm just insuring you have enough to do when I finally go."

This, this is why I tell her that I can't teach her the internet. She manages all this with an ink pen, catalogs and a cordless phone. So I tell her that if she breaks the internet she will get electrocuted and all the ventilators in the nearby hospital will short-circuit. It's a lie I can live with.

Tempting Gravel

Me: "I'm going for a run."
Mom: "I don't like the idea of you running. They say it's not good for you, too much of a strain on your system."
Me: "Those who live in glass tobacco plantations shouldn't throw Lucky Strikes."
Mom: "I hate menthol."
Me: "Then unless you're going to cowgirl up and lasso me with that there nasal cannula, I'm headed for the wharf."
Mom: "Ok, you win - I don't have enough slack on this thing anyway."

Two and a quarter miles at a sloths pace. But the sun was shining on the water and the huge vulture that was pacing me flew off disappointed when I didn't drop. Win win for first time out in a month.

Momwatch 2013 - Meet the new Doc

Doctor: "Have you had the flu shot?"
Mom: "I'm allergic."
Me: "Lie."
Mom:
Me: "Doctor, she doesn't do vaccines - she says 'allergic' but means 'control freak who doesn't trust the system."
Mom: "Yes."
Doctor: "I see. So, we don't have a lot of records for you from the last couple of years."
Mom: "That's because until recently I was healthy as a horse."
Me: "Lie."
Mom:
Me: "She says 'healthy as a horse' but really means 'I was an ER nurse for several decades and thus I speak your language oh medical one, therefore with a polite smile and the right keywords I know you will likely let me off with a script and a smile. That is how I have successfully evaded capture for all of these years for my uncontrolled COPD."
Mom: "Yes."
Doctor: "I see. And you brought your mom here to see me because ..."
Me: "Jeff Corwin was unavailable and Steve Irwin is dead. You were the next logical choice. You want my tranquilizer gun? It's in the car."
Doctor (to Mom): "Does she always talk like this?"
Mom: "No. Sometimes she gets mad too. It's probably why I'm still alive."
Doctor: "Strong work."

Autumn Leaves (Behind)

Association is a powerful, powerful thing.  It serves so many purposes, but perhaps none so much as the ability to retain a memory.  It is an indifferent mistress, neutral in the extreme it cares little whether those memories are good, bad, helpful or painful – it simply serves its purpose, attaching memories and sensations in an intricate web of gossamer slivers of time.  It creates for the brain snapshots of consequences, outcomes, decisions good and bad – creating ghosts where none existed before, rekindling flagging fires of past pain so that they can singe their way along embattled nerves time and time again.  Warm vignettes of loved ones and joyful experiences ride alongside, caring not which flavor of memory will be summoned next.

Association is capricious, predicting when it might surface is a chancy thing.  A tendril of wood smoke on the air, the whiff of a cologne or perfume, the refrain of a favorite though forgotten song, the roll of the ocean or cry of gulls – simple, daily sensations that could be seared permanently into the recesses of your mind simply by adding enough trauma or enough joy.  Days on a calendar, seasons of the year, holidays with now-specific significance, brought forth in splendid relief or ruined forever in the space of a heartbeat.

I love autumn, it is far and away my favorite season and has retained that spot my entire life.  I love the turning of the wheel, the earth settling to sleep, the blazes of color that come with the land’s spectacular death knell.  I got engaged under a spectacular blue sky in autumn, my son learning to say “trick-or-treat,” my daughter’s first horse show, the list of my favorite sights and smells of autumn is long and boring to anyone but myself. 

The cusp of autumn also represents the time of year when my notion of family fell apart. 

It is standing in the heat of a late August afternoon, staring blankly at the trees and noticing that the leaves were just starting to change - as I listened to the tremor in my father’s voice as he told me my brother had died.

Autumn is the sound of my mother screaming at my father, demanding that he go buy her more wine – trying desperately and deliberately to use the same measures that took her son to drown out the pain of his loss.

Autumn is listening to the strain in my husband’s voice as he made one of the hardest decisions in his life – then watching him be vilified for it by his own children and never once being given the chance to explain … and being unable to stop it.

Autumn is the last time I saw the first two children of my heart, the ones that I accepted unconditionally fourteen years ago and remained content being relegated to the background for.

Autumn is the first time that I had to look at my own children and listen to the question, “When are we going to see them again? “ 

“Mommy doesn’t know.  They don’t want to see us right now and that is their choice.”

Autumn is the beginning of coming to grips with the fact that for whatever the reason, my little ones and I have been discarded – tossed carelessly aside as if we never existed.  That because of skew and bias and bureaucracy, bundled with base concepts like greed, anger and retribution, what I thought made up my family was shredded and consigned to picking up scraps and trying to heal undeserved wounds. 

I look at the changing leaves and it takes me back to last October, sitting in a hayride with my family … all of my children.  The late afternoon sun is slanting over cornfields; the track taking us through some hokey Halloween attractions nestled in the fields along the trail.  The kids are flushed and laughing, bouncing on the hay bales.  The sun is warm and the air smells like fall, apples and pumpkins, warm sweaters and crunchy hay.  It is the quintessential autumn day.

What autumn leaves behind breaks my heart.