Monday, December 27, 2010

Chrome saves a puppy!

We're driving to AT's house on Christmas Eve for dinner (awesome dinner), and Angel and I spied a basset hound wandering around on a busy road. Never mind that we have three dogs in the car already (two freakin' out, and one passed out), we belt out a u-turn, and check the pooch out.

He's shivering, but otherwise looks ok. He immediately stopped to look at me, and came when I called to him. The second any proximity was established, his tail starts going fast enough to whip cream. Cold as he is, he sits down, and looks at me with those mournful basset hound eyes. His tag reads "Capone" and a Florida phone number.

After several attempts at the phone number (can't be completed as dialed, not available, etc), we decide to load him into the car (we're 5 minutes from AT's), and figure it out there (I don't like hanging out on the side of busy roads. That's a place people die).

We get to AT's, and everyone is already there, including Lizard's big dog, Adam. Adam is a very nice dog, once he is willing to get to know you. Before then, he comes off as a pretty aggressive puppy. We're bringing our three dogs in, Capone, and Adam's already there. Top it off with AT's two cats... It's a lot to ask.

But this is why I love my family. I walked in, leaving Angel in the car to tend to the animals, an explained what's going on. No hesitation, no questions, nothing, just a "Bring him in, we'll figure it out".

So in we troop. Four dogs, and a quick snag of the Cr-48 (AT's internet can be spotty, and I just don't have time to troubleshoot it). Within seconds, Angel is pulling up local animal hospitals (to check Capone for an RFID tag), and we're calling them. Being Christmas Eve evening, we're not getting any success. Then she's pulling up the local police non-emergency number. They advise us to call the animal shelter (but we didn't get their number). Again, the Chrome-Book is there in a flash, getting us the animal shelter's number. I get on the phone with them, and they dispatch an officer to come get the little guy.

The Cr-48 didn't do anything that another laptop couldn't have done. Well, except all of the searches and interactions were performed by someone completely naive to the system. And the fact that we had anywhere internet helped. No, what made it cool was that it was the right tool at the time. We probably had half a dozen laptops at the dinner, but this was the one we grabbed.

Of course, it happened so fast, we didn't think to snap a picture of Capone.... grrrr

Thursday, December 23, 2010

How long does 100MB last?

It looks like it's going to be less than three days.
I just got a quick little pop-up in the lower right corner, telling me that I've used 49 of my 100MB.

I'm not complaining, at all. In fact, I'd like to commend Verizon and Google for this unobtrusive notification. No surprises, no difficult to find usage summary. This is a far change from the typical wireless service that I've seen, where companies appear to work hard to surprise you with overages.

So, I need to tone down my playing around with this thing, and try to use it for real projects and work. I can do that.

Changed my mind

After showing off the Cr-48, and taking an evening to think about it, I can think of an ideal customer for this system: businesses.

Buy a bunch of laptops, all completely identical, all capable of providing business functions, anywhere, anytime. Set the system up so that the entire computer experience is archived on the web (or your proprietary network). Keep your personal computer IT support costs to a bare minimum.

I'm trying to see what there is not to like.

As a business machine, this thing could be killer. It's going to run into problems when dealing with ultra-proprietary or confidential information, but I'm going to bet that Google is considering that.
It's going to run into problems when dealing with business specific software packages. Again, I'm going to bet that Google is examining this problem (Google Citrix?).
The Google collaborative apps have been a little cumbersome (Google Wave was hard to use, no matter how often we tried to get into it), but their online office package is incredibly easy to share with others. I think the tough nut there is remote, real-time collaboration.

The more I consider it, the more the idea of equipping a mobile business force with these systems is appealing.

And then it's not. I'm an IT consultant on the side (lately, WAY on the side). I need people to come to me with computer problems. This would do away with my tech support costs.

Hey, Google, any chance you're looking for a troubleshooter?

Wednesday, December 22, 2010

Free data service through Verizon Wireless

The Cr-48 comes with 100MB of free data service, per month, for two years, from VZW. I activated it today, with no problems. It took about five minutes, during which time I furnished my personal information, including a credit card. I don't really have an objection to the credit card. It establishes my identity with the company, and it provides insurance/assurance to them that I won't run amok.

So, I'm on the subway blogger. Bizarre. Not something I ever really considered, and the sound of it makes me want to punch my hipster alter-ego in the face.
Still, I feel that Google provided me with this great piece of tech and great opportunity, I should keep a log of how it's going and impacting my life (and it is a great piece of tech).

So far, I'm really liking this thing. The Cr-48 is not going to replace my primary computer. Right now, it won't replace my primary laptop. However, I frequently have two laptops in tow, One for work, and another to "work from". That second laptop is currently a mini-netbook. I think as an experiment, for the next couple of months, I'll be leaving that on the shelf.

The Cr-48 always has internet access. I can pull down notes, web pages, technical documents (I haven't tried PDF's yet. The lack of PDF capability is a definite e-reader killer. If your e-reader doesn't have it, I won't buy it), run a couple of programs on it, and use it to check a couple of things.

Speaking of programs: Google! Please figure out how to let us run and code Python programs on these things (The Cr-48 and the Android OS). You'll see more amateurs (like me) flocking to the platform because we can make it do what we want.

The 100MB a month is interesting. It's a very limited connection to the net (you can buy more, but I'm broke as hell). You're not going to be playing any of the latest and greatest video games on this thing, but then again, the Cr-48 isn't capable of playing the latest and greatest video games (In fact, as of this post, the Cr-48 is having trouble playing a couple of the games in their app store).

But like I said, the Cr-48 is not going to replace your primary computer. It's going to be sitting there next to you at home while you're fragging your friends. A quiet little chat window will pop up when your other friends are trying to figure out if you want to come out to dinner with them (or which server you're on, so they can join in). It's going to let you check your email when the round is over. It's going to go with you when you leave the house to jump on the bus to go to work.

Let's see how far I can stretch those 100MB.
I'd like to have a bar on my browser, that shows how far I've used my data allotment, versus the time left in the month. Something tiny and out of the way.

Ok, a couple of dings: I still haven't gotten used to the double-fingered right-click. I'm still working on that.
The screen needs to open just a little bit further. Curled up with this laptop can be difficult in some positions, and this laptop begs to be curled up with. Light, and lap friendly.
In that same vein (this is not a ding, but I direction I want to see this go), I really want to somehow flip the screen around, and have a tablet option with this computer. This thing just screams "usability", and I think that would be an addition I would pay extra for.
The system really bogs down if you have multiple tabs open. For an attention deficit disorder guy, like me, this can be annoying. However, you really don't need to have 15 tabs open. Finish what you started, then go play Steambirds (excellent game).
I'm having trouble with the touchpad at times. I love it, but it seems that the cursor jumps around a bit at times. It seems that this is happening more when I'm tired, which makes me think user error. It also doesn't help that one of my fingers is in a massive metal splint, which probably has a near field effect on the trackpad.
I still haven't figured out what the SD card slot is for. I tried loading music onto it, but nothing.
Oh yeah, music. The currently offered music player, mSpot (I think) needs work. Generating a playlist on it was a pretty painful operation (to the point that I gave up, and pulled out my laptop to play music while I was working). Google, please figure out a way to make this a local app.

Big bonuses, and things I like:
The keyboard is just stellar. Engineers, please take note: This is how to do it

The battery life is incredible. On 3g, it's saying that I have close to eight hours remaining on the charge.

Instant on OS, that seems to remember everything that I was doing.

Easy help feature.

I love the documentation that came with this thing. Two pages. I read them start to finish, back to front, and I'm saving them to show to people.

ok, here's my stop. Gotta go

Puppy time!

So, this is Ruffian (Ruff for short. He's barked at his name a couple of times now. Really, really cute).
As I said before, he's a Christmas gift from Angel, and he came a little early (about 5 days early) so that we could try to get him settled before the chaos of Christmas (whether we can pull that off is another story).

A puppy for Christmas... I thought this was the coolest gift I'd get, by far. Then my parents called last night, and just blew me away. They're getting me very nice pet insurance for the little guy. OK, maybe it's not as cool as the puppy (Chicken and Egg problem here), but it's incredibly thoughtful, and massively contributive (does that construction work?) towards the epic puppy coolness.

I was blown away. Very blown away. Like "Dust in my eyes, and kinda choking me" kind of way. Even more so, because I was looking at VPI's website that morning, and trying to figure out how to get the pet insurance thing to happen with my budget. It wasn't a question of not doing it (I'm that idiot that will run back into the burning building for the dog. You read about them in the newspaper and think "What an idiot, it's just a dog). I was just going to be stretched to do it.

Actually, that's really not true. I could have gotten him some basic coverage for just $20. I could do that. That's us eating ramen noodles two more times a month, but I knew I wanted more than just basic coverage.

Awesome job, Mom and Pop. And one of those gifts that I'll be thanking you for continuously.

Tuesday, December 21, 2010

New Year's Resolution (And why I don't like them)

It's a couple of days before Christmas. A full 10 days before New Year's Eve (Which I'm not working, thank God).

So I'm going to make a resolution. Which is bizarre, because I hate New Year's Resolutions. Not from others. I love self improvement, and if it takes a certain day of the year for people to adopt better habits, I'm all for it. No, I don't like them because I don't see a need to wait for a certain day to make improvements.

So I guess I'm not really making a New Year's Resolution, because I'm not waiting.

I'm going to try to keep up with this blog. That's it. Simple. Small. I should be able to do this.

I've got some incentive, and some reasons to keep writing. First, it's been a rough couple of months. Not just for me, I know, but I can really only write for myself. Money, friends, family, school, even work (and I love work).

But there is also some great good happening. Friends, family, school, even work (You see what I did there?).

So, we're going to start with the good. The pic above is my new family member, Ruffian (Ruff for short). Angel (My girlfriend, who is all sorts of good news) gave him to me for Christmas. Yeah, I know, you should never give pets for presents during Christmas. I'm going to amend that, and say you should never give pets as surprises for Christmas (Or Hanukkah, or any other big holiday). We've now been prepping for this puppy for two months (Well, I think Angel has been prepping for at least six months, maybe more than that).

I'm going to rant and rave about Ruff in another post. Maybe after I've had some sleep. He's been here for two nights, and has only given us a couple of hours (maybe 4-5 over the two nights) of sleep. We're trying to crate train him (he already goes into it voluntarily), but at night he just starts howling. Last night we scheduled potty breaks, but he still didn't sleep more than an hour or two. I finally went over and stroked him till he fell asleep. I know, probably not a good idea, but we're seriously bent right now from sleep deprivation. Tonight, Angel will get some sleep, as I'm up all night for my work cycle change.

Other great news: I'm working at an emergency room again (totally not saying which one, and I'd appreciate it if any commenters kept that information out). After Haiti, I realized how much I needed to continue working in medicine. I know I feel better, all around (lost 20lbs from running around over there).

Med school applications are in! I'm currently working on secondaries (and trying to afford the fees for it). I'm just applying to DO schools this year. I really just like their philosophy better. I'm going to keep writing about that experience.

I'd like to dedicate this post to one other thing, the enabler of this post, if you will.

Yesterday a surprise package came UPS. It's Christmas, so I wasn't sure what it was (I'm so sleep deprived that I wasn't sure it was something that I ordered). I opened the box, and inside was another box that screamed "Laptop".
I got a little nervous. I didn't order a laptop. No one would send me a laptop. I checked the box again. Angel needs a new laptop... Nope. My name.

I opened the box. Yep. It's a laptop! Very matte black finish, on the smallish side. Very thin. Light. And the first piece of paper that I see (one of three, single pieces of paper, one of which is a business card) has a chrome label and emblem on it.

Could it be....?

Yeah, it totally is.
For the less geeky of you (and I'm probably the geekiest guy you know), it's a Cr-48.
Google has created a pilot program showcasing their reference platform (the Cr-48), and their Chrome Operating system (Chrome OS). The whole concept behind the program is a web based OS. No downloading or installing tons of software onto your system. Google has everything hosted on their servers. In fact, go one step further. Store the majority of your personal files on their servers. That way, wherever you go, whichever computer you're using, you have access to your files. Even cooler: Sign on as a guest on someone else's Cr-48, and the computer will behave just like your computer.

So the laptop arrived on my door, unannounced. I have to admit, the effect was striking. I wandered around for a full ten minutes, just saying "Wow". Early Christmas, for a little kid... I already got a puppy this Christmas, so an unexpected, cutting edge laptop..... Wow.

Cutting edge... OK, I'm going to bet that this thing doesn't have an unlocked Core i7 in it's guts, or a multi-GPU setup to drive insane graphics. What it does have is an always on web link (I don't know what deal Google and Verizon worked out, but thank you Verizon for helping make this piece of tech happen. If you're not on WiFi, then a 3G modem kicks in, and you have 100MB of data transfer a month, free, from Verizon. OK, not exactly cutting edge, as other laptops have been doing that for years.
Turn the thing on, and it boots in seconds. Yes, truly, in seconds. Less than 10. From a cold start. That's cutting edge. My current laptop has a Seagate Momentus Hybrid Drive, and it's fast into Windows 7, but not that fast. I'm pretty sure that this thing is using a solid state drive (SSD), but I don't have the details.
No, what's cutting edge is the whole overall product. Everything is coming together in one package, in a novel beta-test (Free laptop! Really?!), in an incredible design.

Let me talk about the design. First, the battery is a Li-Ion pack that is removable. It takes up a full half of the bottom of the computer. Yeah, it's still removable. People, get with the program, and start doing this.... always. Its ridiculous that companies still make non-user changeable batteries.
The laptop itself is completely matte black, in a sexy, good feel rubberized plastic.
This chassis just feels really good in your hands. On the left is a VGA output port (Here, I wish for an HDMI port, just because that's a port that is going to be on every display technology for the foreseeable future). On the right, a power jack, USB port (USB 2? I think), an audio port (single) and an SD card slot. That's it. Simple. I'm sure people will argue that there are not enough USB ports. Maybe... I don't know. This laptop isn't about huge numbers of external devices. It's the internet, everywhere. Already it has an infinite increase in connectivity over an iPad.
The keyboard is great. This is important to me. My number one piece of advice for people looking at netbooks is to demo the keyboard first. In my experience, the keyboard is the make or break factor for netbooks (this thing feels like a really nice netbook). Chicklet style keys, with a great feel to them. Properly spaced, and easy to type with (Oh yeah, this whole post is written on this thing).
The keyboard has some changes. No, the shift keys are in the proper places, no bizarre punctuation keys. Google has made one significant change to the keyboard, that I'm hoping revolutionizes the keyboard as we know it: No CAPSLOCK. That's right. It's gone, been replaced with a "Search Key". I'm just glad that people who use this thing are going to, by default, have to use proper capitalization. Google, if you're listening, please don't ever change this feature. You hit this one out of the park.
Oh yeah, the function keys are gone, and have been replaced with internet keys (reload, forward, backward), screen keys (Brightness), and audio control (Volume, but no "Next Track" feature.... Can't really comment on it yet, I haven't tried audio yet). I can't see a "Screen Capture" key, but it may be in the shortcuts (Control-Alt-?).

So the keyboard kicks ass.

The mouse pad is huge. I mean really big. It's multi-touch enabled, so it allows for two fingered scrolling. It's a clickpad, which I'm not a huge fan of, but I can learn to enjoy. The "clickyness" feels good, I just keep moving my finger slightly when I use it.
However, there isn't a "Right-Click" button. In order to right-click, you have to press with two fingers. So far this has been a major hit-or-miss proposition for me (and my friend who has tried it out). This is a major change for me, and I'm having a fair amount of problems with the right-click interface. BUT, I'll get it.
In their defense, Google has provided all sorts of customization features for the controls. I just haven't had a chance to use them. I'll post on that at a later date.

As I've said, startup is fast. Really fast. When you first boot up, the system asks for your Gmail information (or allows you to create a new account). It takes a picture (I was so excited, I let the thing take my picture. I look like crap. It'll be interesting to see how many geeks, like me, are too excited to groom themselves for their pictures, upon receiving this thing). Then, you're onto the internet.

Security seems to be decent, though I'll admit I haven't delved into it. You have to sign into your Gmail account to gain access to the laptop. I typically have a different password on my computer than on my email accounts, so that hacking one doesn't give you access to the other, but this is how Google set it up.

The screen looks exactly like a Chrome browser window, with some very minor changes. No task bar at the bottom, a bug report button to the right of the "omni-bar", time, signal strength and battery indicator in the upper right. That's it.

Browsing around is easy, and just like Chrome (and pretty much just like every other browser). Open up a new window (Control-N for a new window or Control-T for a new tab) and you get access to your apps, including a small web store. The game "Entanglement" is pretty cool.

However, it's here, that I have a small problem with the whole system. There doesn't appear to be a way to split the screen. You can't consult notes on one side of the screen, while you are working on another screen. This is a great innovation of Windows that I love. Hell, I have a multi-monitor setup downstairs, and I use it continuously. Google, please find a way to do this. If you can set it up so I can split the screen, left/right and/or top/bottom, that would really upgrade my usability for this.

My only other gripe so far is the inability to code Python on this platform. I'm in the middle of a major project, so I need to be able to use a computer that lets me code (And test the code). For this reason, the Cr-48 is in use next to my other computers.

However, the Cr-48 is going to be by my side for the foreseeable future. I'll be posting up my further impressions, as I get them.

Thanks Google, I hope to give you the info you need!

Tuesday, March 23, 2010

Saving lives

I'm currently sick, but still finding ways to help.
We're saving lives everyday here.

At a meeting the other night (we have one every night), a team was named to help provide a critical surgery to save this woman's leg. We were going to need the team, because we had three different disciplines that needed to be involved. The surgeons were going to perform the surgery (duh. That's what they do). The nurses were going to provide the care for the patient. This is critical for cases like this. Aggressive (and they're aggressive down here!) nursing maintains the patient in a state of optimal healing for their injury, and provides the best environment for optimal outcomes. These nurses will also be in charge of instructing the Haitian nurses on what we're doing.

Optimal outcomes. It's interesting hearing about that in Milot, Haiti. We can't drink the water, we lose power everyday, and we just don't have anything near the resources that we have at home. Still, we're shooting for optimal. Not "Best under the circumstances", but optimal. These people down here are really that good.

So, my part with this team is to build the traction device that is going to hold tension on this woman's leg while it heals. She'll be in it for three to six weeks, so it is going to need to be durable enough to last long after I'm gone, but simple enough that it can be used without complicated instruction.

I met briefly with the team after the meeting. We set out with our objectives in mind. Within minutes I found a draftsman (a 19 year old who is here helping out every way he can. He's incredibly busy. Elijah, if you ever read this, you done good). Twenty minutes later he had the drawing to me. The next day (It was around 10:30 at night at this time) I would go see the local metalsmiths, and see what they could come up with.

The next day was one of running around for me. I made at least 15 trips to the hospital and the tent city where many of the patients were kept, all before lunch. The vendors on the side of the road were beginning to make jokes, and we had some laughs during my trips. Finally, lunchtime rolled around. A quick meal, and I was back at the command center waiting for my translator.

I try to make do without a translator as much as possible. So far, it's been pretty easy. Patients speak a universal language, involving their bodies. We have a primer right in front of us. My other "occupation" down here has been as an engineer, or really a maintenance man. Tools are tools, all over the world. None of the engineers at the hospital spoke any English, but thankfully a wrench is a wrench no matter where you go.

Today was different. The surgery was going to be done quickly. It had gotten pushed back from the original date of two days after the meeting. Instead I had four days. Two days for fabrication, one day for revisions, and surgery on the last day. We could do this, but I wanted the translator to make sure we did this right.

We went down to the shop, and met the foreman, Patrick. We sat on a rusted out truck, and showed him the plans. We went back and forth for a bit, and he even made some improvements. Instead of bolting to the bed, he was going to make a clamp, that would allow it to be moved along the bottom of the bed, or even moved to a different bed entirely.

The only problem was he needed a baseboard to build the traction device on. He wanted to make the device as close as possible to the baseboard specs, so that it be built as efficiently as possible.

Back to the hospital I went. I borrowed some tools again, and attacked an old bed lying behind the ICU. I attracted a bit of a crowd as I did this. One of my translator friends said that the people wanted to see what else I was doing, as I was always running around doing something interesting. I was worried that they were getting pissed because I was destroying an old bed. I'd seen people sleeping on this in the past, but I really needed this board.

I didn't need to worry. I grabbed the big piece of wood, and marched out of the hospital, with no one raising a cry. Back to the smith's, and time for a break.

A couple of hours later I was walking to the command center when I saw my baseboard being walked through the bushes. I went to investigate, and lo and behold the traction device was done. These guys had made a beautiful system, in record time, and were already delivering it.

I ran back into the kitchen, grabbed everyone a Prestige beer (This is a hot commodity down here. Prestige is the good local brew. However, the brewery was damaged during the quake. It's currently shut down. The first time one of the workers here saw me with one in my hand, he almost wept, asking where I found it). We all shared a toast, and snapped a picture (which I can't seem to upload).

Tuesday, March 16, 2010


The rest of the email social club at the command center.

The command center computer, and the front of the line.

This is my trained Haitian dog. I'm gonna really have a hard time leaving him here.

This is our goat, Nutsack (I didn't name him.... really!). He's currently pissed at us because we ate his fatter cousin. Still, it keeps his feed costs down, so I'm not too worried about it.

This is my room, where I try to sleep during the day. The mosquito netting really helps, but the big thing that makes it happen is the fan.

This is convent kitty. One of those cats that comes on all friendly until you try to pet her. Then she runs. Sorry about the blurry pics. It's humid as heck down here.

This is lunchtime kitty. She cries whenever she sees me, but she won't eat anything I give her.

Monday, March 15, 2010

I owe you all pictures

OK, I know I said I'd keep the blog up while I was down here.
I know I haven't.

If it helps, I've been savin' lives, so work with me a bit, 'kay?

So there's one.

These are the biomedical guys moving a portable x-ray machine from the compound to the hospital. These things have to weigh a quarter of a ton. They're huge. I've treated several broken feet in the States from one of these rolling over an unobservant foot.

First, the locals were going to load this thing onto the back of a tractor. Thankfully the biomed guys heard this and put a stop to it. The tractor would have flipped, crushing the team of four workers.

So they found three sturdy pieces of plywood (rare here, the termites eat anything wooden), and just started rolling it to the hospital (approximately a quarter of a mile away). The machine is designed to "Power-assist" it's movement, so that you aren't dying trying to move it from patient to patient.

I was dead tired, so I didn't stop to see if the batteries held out. When I came on shift tonight, the new machine was right outside the door to my ICU.

I love the attitude out here. Out here being either Haiti, or on deployment. The "Can-do's" and "Makin' it happen!" are out in force, and we're getting incredible things done.

I'll be in the ER/ICU for at least the immediate time being. I've been given the job of critical care "Union Leader", so I'm trying to do my best for the staff.

The staff, in turn, are doing the best for the people of Haiti. It's incredible, and when I stop to think about it, I do get a bit misty.

It's not just the patients. We're working hard with the patients, and their families. It's 4am, and I've got as many family members sleeping here as I do have patients. Everyone is sleeping (Except for Kerry, the other US night nurse), but in an instant, they will hop up and help their family member (or even another patient!) turn in bed, empty a bedpan, or find some food.

The food is really calling to me. There is good food to be had here. Particularly if you're not picky. Flavored beans and rice are a staple. I don't know where they get it, but it smells fantastic. So far the night shift has not been getting fed well, but hopefully some of the new changes will fix that.

Short and sweet. I have to keep remembering that for the blog. I'll sign off now, with one final thank you to all of you that sent me down, and you folks that are following along.

Thank you

Saturday, March 13, 2010

Last plane ride (for awhile)

Met the team last night for about a minute or two. They knocked on the door around the time I was getting ready for bed. They'd already had the briefing, and were just now getting around to meeting with me.

I was a little disappointed.

Hopefully things will get better once I get down there.

Heading out to the airport now to make the final leg of the journey to Haiti. I'll post some more up when I get a chance.

Friday, March 12, 2010

Hit the beach

When I'm whining about the work down in Milot, shove this picture in my face. It was beautiful today. I went for a swim for about an hour. Didn't see anywhere near as many fish today. Saw a decent sized mackerel, a little more than a meter long. He didn't want to have anything to do with me, but I followed him for a little more than 100 meters.

I found a massive starfish. I'm not sure if he was alive or not. I turned him over with my blade, and thought I saw some movement, but I wasn't sure. I didn't want to touch him, as I couldn't remember if they had any toxins or anything.

Then, as I was swimming back to shore, I realized I had company. A single of the massive school of fish I encountered yesterday was enjoying the shade under me. He was swimming quite close, and seemed very content.

I relaxed and floated in place for awhile. The little guy was very tolerant, not moving while I lifted my head to breathe (again, really missing my snorkel). A couple of times he came right up to my face, and examined my mask closely. After about five minutes of the extreme close up, I decided to call it a day, and wandered back to shore.

The weather is interesting here. It always seems like there is a storm just off shore. Even now, sitting by the pool, it seems like it could open up any minute.

But it hasn't.

In Jamaica or St. Maarten, when the weather looked like this, it inevitably stormed. Beautiful storms, with blowing wind. Very spectacular as you could watch them coming to shore.

I wish I could find the money to spring for a week at a resort. I miss diving on an actual reef, or exploring a new island. St. Maarten was incredible this way. If you go, rent a car. Great beaches, beautiful scenery, and easy driving.

I think my team just arrived. Time to go find out what I'm in for.

My breakfast companion

There are a ton of these guys running around during the morning hours. They tolerate each other, until they cross a certain distance between each other. Then the chase begins. Humorously, if the chase happens out in the open, they begin chasing each other in a circle. They're not willing to actually catch each other (from what I've seen). They'll just run at each other in a massive bluff, then circle each other furiously.

Good entertainment for breakfast.

Provo, Turks and Caicos

I originally felt guilty about planning to do my stop over here. Not anymore.

I got here around noon yesterday, exhausted. I hadn't slept in a long time, and the hassle with the hotel had made it even more tiring (Thanks Tadpole, you rock!). Still, I didn't want to disrupt my sleep schedule, and I don't like naps. So I kept pushing. I went to the beach (less waves than we saw at Tahoe last year, or even Osawa). Quiet little place.

However, just beneath the surface, was action. The ocean floor was a stark white sandy bottom that dropped pretty quickly. 20 yards off shore, the water was easily 8 feet. I rapidly got to a point where it was deeper than I could comfortably dive (I only brought my crappy diving mask to use for helicopter ops. Doesn't matter if it gets scratched up). After about 25 minutes of swimming in the calm water two bonitos swam up and kept me company. I had just decided to head back in when they appeared. I decided to stay and swim with them for a bit longer.

Five minutes later, in a flash, they disappeared, swimming for the shallows. I did a slow scan around me, but could only see faint flickers of light at the limit of my vision. I decided to follow the two fish towards shore.

On my next scan, I came face to face with a four foot barracuda. Well, it seemed like it was face to face. I'm pretty sure he was four feet, because he was longer than my arm, but not truly terrifying.

If you've never seen a barracuda, it's something to behold. A skinny, long fish. It looks fast. It moves in very sudden jolts of movement, between hovering stock still, staring at you. The staring is very unnerving. It's very clear that it has its attention on you.

Oh yeah, and the teeth. Mustn't forget the teeth. Barracudas have great teeth. Something that HR Giger used to draw. They are the stuff of nightmares. Snicker-snack

So this thing is out there, initially at around ten feet. Looking all large and sinister. I decided (on my own, no prompting needed, thank you) to head back to the hotel. I swam about thirty of the thirty five yards back to the beach, watching my escort the whole time (I'm never going to mask swim without a snorkel. I should have brought it). He was perfectly happy to swim behind me. Really close to my toes. Too unnervingly close to my toes.

Suddenly, he took off. When a barracuda leaves, it's a Coppefield Act. One second he's there, the next second, poof, he's gone. If the sun hits him right, there's a quick flicker, but that didn't happen this time. Just poof. Gone

I continued my swim towards shore, watching behind me. When I finally turned, to finish my swim in, I was maybe ten feet from shore, and the water was filled with small (6-10 inches) silvery white fish. Thousands of them. They swarmed around me, leaving a polite foot and a half between us. They had no problem with me being there.

It was incredible. I could almost jump to the shore, and I knew from experience that the majority of the people on the beach had no idea I was surrounded by these fish. At times they were so dense I could only barely make out the ocean bottom two feet below me.

I must have stayed there for ten minutes, just quietly paddling. I really wished I could float at this point, with a snorkel. I could have just laid there, face down, watching this beautiful dance in front of me. Each time the school turned, it picked the light up a different way. The turn happened in a wave like fashion, so I was surrounded by this gorgeous, undulating wave of light.

Eventually I had to get out. I had already stayed longer than I had planned, and I hadn't put on sunscreen (It's combined with my bug spray, and I'm saving that for Haiti).

I walked the 300 yards back to the hotel, more relaxed than before. A couple of quick emails (still nothing from PayPal....grrrr), and I set out to find dinner.

Money's tight, and the nearby "local" restaurant was pretty expensive ($15 for a burger?), so I settled on a quiet looking pizza place (Pizza Port, in Provo). It was really quiet. I was the only one there for about 5 minutes, until the lady of the house came out to greet me. She reassured me that it wasn't too early for dinner (it wasn't even 5 yet), and showed me the menu.

I asked her what was good, and she pointed to the top item, an Islander Meat Lovers Pizza. I'm big into trying the local food when I'm abroad, so this really dovetailed with my love of meat lover's pizza (Ask my friends, I'm a Tyrannosaur!). I went with that.

The pizza came with a baked cheese surface, on a crunchy, but moderately thick crust. It smelled heavenly (when was the last time I ate?), and I dived right into it.

This has to be one of the best pizzas I've ever had. Jerk seasoning in the sauce, pepperoni, ham and a jerk seasoned sausage. It was spicy, but not extremely spicy like jerk sometimes is. It was a unique flavor that I have to try to duplicate when I get home.

I sat almost quietly. A family was letting their little girl have a full-on tantrum for half an hour down in the courtyard. People, I sympathize, but when your child is a burden, it is your burden. Please don't inflict the screaming on all of us. My parents removed me to the car, a private corner, or back alley, and tried to reason with us, before smacking our bottoms raw. It worked, and I fully appreciate them for their administrations. Indeed, I remember diners coming to our table when we did behave, and comment on how well behaved we were. Thirty years later, and I remember.

The food was excellent. The breeze was lovely. I sat and ate as I finished my one book (uh-oh.... no more books??? This will be a long dry spell. I've never gone a week without reading a book. Holy shit! What was I doing). Alistair Reynolds is a pretty good author, but damn, it seems his stories have a pretty dark bent at times. I've only read one (Thank you, Jim-Jim. Awesome book to take with me, matched my mood perfectly), Diamond Dogs and Turquoise Days, but I'm going to have to get more.

Finished dinner and back to the room. I stayed up just long enough to talk to my father and my girlfriend. I love the internet. I passed out and just slept. No alarm clocks, no meetings to make in the morning. No critical phone calls to make.

I feel cleansed. I've left behind the stress of home, and I can concentrate on what is ahead of me. Next deployment I'm going to plan on this. The pricing structure made it easier (it was about $100 cheaper for me to come a day earlier, and get another night at the hotel).

OK, gonna go drop the laptop off at the room, and wander down to the beach. Maybe my friends will be waiting for me.

Thursday, March 11, 2010

Kind of a rational post about weed

Quick, to the point. A good, realistic viewpoint.

Though I seem to get my cognition changes through concussions and sleepless nights...

Yeah, for the record, Charlotte International SUCKS. Not the place to do a ten hour layover.

Oh yeah, also: Credit Card Companies! Please! If you think a hotel room is a suspicious charge, let it go, and arrest the guy when he gets there, if it isn't me.

If it is me, you can let me go.

If it is really me, and you deny the charge, I'm probably screwed due to my poor financial planning, and PayPal's withholding of funds.

I think I'm going to be seeing how friendly the Turks and Caicos is to free-range camping.

In transit

Holy crap, goodbyes are hard.

I miss my sister, my parents. I miss the dogs and the cats (even the psycho little one). I miss my neighbor sitting outside. I miss my friends up the street.

I miss my girlfriend. She took the day off today, to see me take off. Instead, she saw me run around like an idiot, trying to make 110lbs of stuff fit into two 50lb bags (stupid airline regs). We did it. Yeah, I can bend space/time.

It was hard today. I first got choked up at Staples, when my girl walked out of sight. Dunno why, but it was difficult. Then my sister called. I was worried I wasn't going to see her before I left. That was rough.

I love them both. Different ways, but lots. All of them, actually. Each in their own individual ways.

I said goodbye to my dad tonight. He said he was proud of me.
We don't always see eye to eye. Heck, sometimes I think he doesn't understand how much he says means to me.
And he's certainly said it before.
But tonight, wow. It was crushing. It was the summation of the night. A couple of simple words, and I'm really getting that I'm doing good here.

Yeah, I'm that shallow that I still need occasional validation from others, ok? Typically I'll spit in your face and argue my point till I'm blue in the face, BUT it's nice to hear sentiment like this every once in awhile.

My girlfriend has said it a couple of times too. Again, it's like a giant weight rolling over me. A nice one. I was married, and I don't think I ever heard that. I certainly didn't hear it with this kind of weight. That could be the divorce talking. You don't do that when everything's going great.

Baby, if you're reading this, I love you.

I found out that the Milot hospital is getting an ambulance. I may have an honest to god job when I get there on Saturday. I'll be posting pictures.

OK, it's 1am at Charlotte International airport. A tiny little airport that doesn't even have wifi at the Starbucks. I was hoping to catch a nap, but unfortunately it appears that 1am is when the construction starts... Only 9 more hours until my connecting flight.... wow

Tuesday, March 9, 2010

One day to go


Wow, I'm getting tired. Lot's of running around.

Work swells to fill the time around it.

If that hasn't been said before, we'll make it Ty's Rule, number 11.

The thing above is a QR code. It's like a high tech bar code. When I get back, we'll play with them some more. Right now, it's just the QR code for this site.

My bag is packed. It's 47lbs right now, and I'm going to top it off with candy for my patients. I need to make a mix of rice tomorrow, to take with me (My "run for the border" food stash). I'm pretty well equipped. I wish I had more medical supplies, but I seem to have hit some dry holes in this area. To be fair, I believe every local hospital has teams in Haiti.

I found out this weekend that one of my sister's co-workers was contributing to the cause. I'm incredibly touched when people donate (always restating my mantra "Please don't let me screw up"). This one got even better. I don't have the whole story, but this may be my last chance to blog it (I can't believe I just used blog as a verb).

I'm going to change the names, because I'm a big believer in privacy. If she happens to stumble across this blog, and wants to leave her name in the comments, I hope fame finds her and treats her well.

So Mrs. X's kids have done something wrong. I'm not sure what, but mom was angry.
Apparently Mrs. X started yelling at the kids, explaining to them how Mr. Ty (I can see her calling me "Mr. Ty") was going to Haiti, where the people have lost everything. In my mind, I can hear her talking about the destroyed buildings, horrible conditions, the lack of supplies, walking uphill both ways in the snow (wait, what?). I dunno. I can really see Mrs. X doing a great rant with this.

Apparently it worked. My sister says that the next day, they came to her with some money they had collected (I don't think either of them are even teenagers yet), and asked if this would be enough to help Mr. Ty.

Excuse me for a second, there's something in my eye.

Both of 'em.

Whew. I know it looks like a short period of time between this line and the last, but it's not. Took me a minute or two.

I've heard a lot of "Oh Ty, I wish we could do more!"
And yeah, I wish you folks could. It would mean that your comfort levels are higher. It would mean your level of security is higher.

It would mean we were all better off than we are.

I had a child run out to me the other day in a parking lot. I had just left a business, talking about the deployment to Haiti. He couldn't have been 8 years old. He yelled at me twice "Mister! Mister!" and then gave me two quarters. I told him "Thank you. You can keep these, you know?"
He looked at me and I think he almost started crying.
"I want you to use this to keep the earthquakes away" (I can't do the cute voice, but this kid was really pulling no punches)
Now the kid's got me going. I make it a general rule not to lie to kids. They'll handle the truth better than we give them credit for.
I just looked at him. I didn't have the words yet. Again, he filled in the blanks.
"My dad says you're going to help the people with the earthquakes"
OK, this I could handle, at least until I got to the car.
"OK kiddo. Yeah, I can do that. I'm going to help the people with the earthquakes. Some of them are sick, and I'm going to help. OK?"
I'm not sure why I asked him "OK?" I guess I needed him to nod, and give his blessing to my efforts at keeping the earthquakes away.
He nodded his head and ran back towards the store.

I went to the car, pulled out another two quarters. I think I'm going to have to use his dollar for something special.

I'm not going to put the donate button up today. Paypal is having fits because I'm taking donations but I'm not a 501c3 organization.

Folks, I want to be clear. I want others to understand. I'm not a tax deductible organization. I am volunteering with one, but they cannot cover my travel costs (almost $1000 of it) or any of my other costs. It's just me.

Friday, March 5, 2010

5 Days to Go

The date is rapidly approaching. I spent the morning upgrading my father's computer, and the afternoon finding the equipment I needed.

The folks at Casual Adventure ( have been incredible. This deployment is very different from any that I have done before, but it is right up their alley. Lightweight, quality gear, and they have the expertise to help you select the right tools for the job.

It was interesting. While I was there, a gentleman was looking for a new pack. He already had a pack purchased from another store, but it was uncomfortable, and didn't seem to fit right. The staff offered to help him set the pack up correctly. He declined, saying that it had been setup before. The staff offered to help him pick out a new pack. He declined, stating that his current pack was cheaper.
The staff was very pleasant and polite, even as he became more and more antagonistic. I was pretty surprised at the lengths that they went to, to try and help this man out. In every case, he preferred his problems over solutions. You aren't going to be able to make everyone happy, all the time.

I really valued their input. The staff there are all big time outdoorsmen (and women!), with a very wide variety of experiences. They're very quick to use each other's expertise to help out their clients. I've been using them for years, but for minor purchases, or critical parts (these folks seem to be able to find anything). This was the first time I needed to be kitted out for something like this. It's incredibly reassuring to know that someone in the shop had been in an environment like Haiti before, and has had experience with all of the equipment I purchased.

As I was leaving, I started checking off my pre-deployment checklist. It ended with my old prayer, "Please god, don't let me screw up." Familiar to all of us. I know I've heard it muttered many times past, either in the ER, outside the door before a warrant service, or before throwing the switch on a multi-thousand dollar custom computer, it's a very familiar mantra.
This is a big leap. I've never deployed solo. It's going to be easier because I'll start in a relatively supported location. However, Port au Prince is going to be tough. I've got a couple of leads for organizations there, but much of the work is going to happen with boots on the ground. These uncertainties are what make me nervous.

On the bright side, it's date night! My girlfriend and I are going to grab a nice dinner, and check out Alice in Wonderland. Then tomorrow we're going to go see the horses before meeting some friends for a 30th birthday. We'll close the weekend by going out to see a bunch of my family. I'm glad this final weekend is going to be filled with everything I want.

On a final note, I'm pleased to hear that my friend's book, They Fought for Each other, is kicking serious ass on the Amazon Top Seller's List. Kelly Kennedy is an incredibly fascinating lady, and I can't wait to get my hands on the book. Unfortunately it's going to have to wait till I get back. No where to stash it in my pack.

Wednesday, March 3, 2010

Seven days to go

I feel like I'm getting ready for a shuttle launch, or something of that magnitude. Something big is coming. I know it is going to be more of the same, completely different patients (something an ER guru once told me).

In seven days I take off, but that won't be the real change. That will simply be me, leaving what is comfortable behind. Leaving my friends, family, and numerous supporters (Nova Scotia? I also got a contribution from a Belgian, but I think he was only 100 miles away when he did it. My family has done a great effort on the West Coast, and I think they have the true distance award so far).

After that great takeoff, down the runway (I love taking off in planes. I wish they'd let me listen to my music), I'll coast for a bit. Actually, a couple of days. Getting further and further away from my home. Sure, I'll have an electronic link (thank god for the internet), but that's not the same.

Then the big change. Weightlessness. I wish. I'd love to go into space.

No, my big change will be Haiti. Cap Haitien, then Milot. Then a series of days at the hospital, hopefully in the ER, where I'll at least be comfortable in my work, if not my surroundings.

And I'll have a team. This is where the real draw is. I love working with a good team. There's nothing else like it. I pick my friends based on how well I can "work" with them. They're the greatest people in the world...

Hopefully I'll find new ones in Haiti.

We had our fund raiser dinner last night. The local restaurant bailed kinda at the last minute, so we hosted a shin-dig at the house. Good friends, old friends, even surprise guests showed up. It was a great time, with plenty of depth that I found surprising. I only had to do my Haiti "Song and Dance" twice (don't think I completed it at all, to be honest).

We talked all night. About everything. A couple of times the controversy regarding the Haiti relief efforts came up. I heard numerous opinions about who was screwing things up, and why. Why things were screwed up. How it could be done better. How the Haitians needed to do better. It kind struck me on numerous levels.

The Haitians just didn't have much before the quake. Then a huge chunk of their world fell apart. The world is coming in to help them, but how are they going to react? Are they going to ask us to build them new tin shacks? Are they going to ask us to build brand new houses? State of the art infrastructure? Build some new hospitals?
These poor people had next to nothing, and they really worked hard to make it better for themselves (I'm not going to believe that a whole, independent nation is nothing but lay-abouts). Now, as a nation, they're in a rough place (no matter how you slice it). Do they embrace the help, and profit from their disaster? Do they stoically, and pridefully turn away the help, and try to rebuild their status quo? I really hope not, but some of the things I've heard have made me think that this option is something that people want.

The other thing that has struck me is the number of people who know exactly what is wrong with any given problem/solution/situation. Wow, it's simply incredible. What's horrifying is the level to which we elevate some of these people. Celebrities, news personalities, pop icons. What the hell are we doing listening to them? (I won't get started about the Vaccine debate. It looks like Jenny McCarthy may try to shut up. Possibly too little too late. Amanda Peet, there's someone I could listen to).
Sure we arm-chair quarterback. All of us do. However, I'm beginning to see that there is a segment of the population that simply delights in that. No matter what is going on in front of them, they're going to accentuate the negative. No matter that your efforts are bearing fruit, they'll decry your mistakes, your inability to save everyone. They'll do this while you sweat, bleed, and succeed. They'll sit in their chairs and drag you down, while you do the best that you can.

And when you're done, they'll let out a sigh. Then roll over, and take a nap. Cynicism is exhausting. Or idle cynicism is exhausting. I'll be the first to admit, I'm pretty cynical. However, I'm cynical as I'm sweatin' bullets trying to fix the problem.

And finally, I was struck by the problems I'm leaving here at home. I apologize for this downer of an ending to the entry, but it's on my mind (and it's my blog!).

I'm not looking to save the world. I know I can't. I know I can try, and I know that sometimes, despite everything I throw at it, bad things will happen. However, there are times, where I just wish I could save something beautiful. Something that I see is going wrong, and that I just don't have the power to fix.

I'm leaving the virtual paradise of the US for Haiti. I'm leaving problems here that need fixing. Problems that I probably can't fix, but that are near and dear to my heart.

I'm hoping people get better about taking care of each other.

Keep 'em coming!

Saturday, February 27, 2010

Social Networking Experiment

Welcome Farkers!

Using Facebook Causes, and Fark (C'mon, answer the question! Is Fark more powerful than Facebook??) I'm hoping to generate some more money for the trip to Haiti. Every dollar helps, and 100% of that dollar (minus the handling fee from PayPal) will go to the operation in Haiti.

Welcome newcomers. If you want the quick and short:
My name is Ty. I've been a medic for almost 20 years. I've been incredibly lucky in my career to receive some intense training, and to even teach some of those schools. I'm a student right now (Well, actually a drop-out. I cut school to do this trip), so I have the time and training to go to Haiti to help out.

Most of us don't. People have real jobs, big commitments, and incredible constraints on their time. Not everyone has training in emergency medicine, even fewer have training in medical operations in austere conditions. Still fewer have experience in these conditions.

I can do this, but I need help. Not much, at least not much from everyone. A couple of bucks, that's it. I'm paying for my transportation to and from Haiti, and I need to contribute for food while I'm there (this money goes directly to the Haitians who are also working at the hospital).

I'm not a massive organization, I don't have tons of overhead. I'm just a guy that can help. You can send me down there. YOU! The person reading that. It's kinda cool. You can literally tell your friends "Yeah, I couldn't go down to Haiti, but I just sent a medic down, so he can help." You can do that. For just a couple of bucks.

Initially I'll be going to Milot, Haiti, to help at the Sacred Heart Hospital (Hopital Sacre Coeur, sorry, I can't figure out the accents on this editor). I'm hoping to work in their ER (Which has been upgraded to a big tent, think MASH), but I'll likely wind up doing whatever needs to be done at the moment. Wrestling with a generator, digging latrines, moving supplies (I'm an expert a moving supplies), washing dishes. I don't know. I know they need help. It looks like their ER is pretty busy (check out That's the organization I'm going with).

After Milot, I'm hoping to hike north to Port au Prince, to see if I can help there. That's still up in the air, and will require some significant equipment (The hospital has food and clean water. The minute I leave, I have to start providing for myself).

I don't need you to send me a paycheck (Though if you have it to spare, sure, send it). If everyone can send a couple of bucks, and then tell their friends, then this will come off.

I'm going to keep this blog going. The hospital has occasional internet access. My commitment to you is that I'll keep this updated as I can. Once I leave the hospital, this will be more difficult, but I won't forget my pledge.

Thank you!

Friday, February 26, 2010

Really fast, crazy day

It seems like today is the point where things are really starting to come together.

I went to bed last night, with a friend of mine creating a post on the MAAPR website ( talking about the deployment to Haiti. Earlier in the day, I had set up a Facebook group to try and get people interested in helping out.

This morning I woke to a ton of emails, questions, well-wishers and donations. Most of them just a couple of bucks, but it is adding up. Fast. Yesterday I was worried about the price of anti-malarials. Today, I'm realizing that I'm going to be able to afford them.

Some people are sending me contact information for individuals from Haiti, or who have recently returned. I'm really hoping to meet or talk with all of them before I head down. Getting good information about what is happening on the ground is incredibly useful.

THE local pizza place, Joe's Pizza and Pasta, at 5555 Lee Highway, Arlington, Virginia, is hosting an all day fund-raiser at their restaurant. Anyone who asks will be allowed to donate a portion of their bill to the cause. Wow! Great support from a local business.

Unfortunately, none of my traditional "Community Boards" are still up. Safeway, Harris Teeter, even Starbucks, don't allow for the soliciting of donations on their community boards (or don't have them). Dogma, the local pet bakery, does have a community board. Casual Adventure (wow, I can't say enough about those guys) is also putting up a flyer.

Donations are starting to come in. I've gotten my first donation from someone I've never met, or even heard of. What do you say, beyond the obvious "Thank you!"? How do you convey that $12, from someone you haven't met, means so much? Is it wrong to ask "Why twelve dollars? Why not ten?" Does that mean something to them? Should I be thanking their father, who died when they were 12? It seems silly, but it seems like it should mean something, beyond this simple donation.

Thank you. Thank you. Thank you.

Donate Button

Click the above link to donate

This one should work.

Thursday, February 25, 2010

Your personal security

OK, another tangential post. Well, not even tangential, but completely off topic.

Harriton High School required all students to use school designated Macbooks (I'm wondering who picked up the cost for these items). Students noticed several bizarre glitches, occasionally the webcam light would flicker. The students were told that this was a glitch with the computer, and there was no problem with it.

It turns out that the school system had installed, what they call, remote management/administration software on the computer. They claim that this was designed to allow the school system to track the computers. In reality, it allowed the school system to remotely access the computers, including the web cam.

The question now, is when was this web cam activation used? Well, that's the question that the FBI wants to have answered.

My question is how did this ever happen in the first place? This is an invasion of privacy of an incredibly high degree. The fact that incredible measures were taken to conceal the invasion, and that it was repeatedly lied about, just makes it more insidious. The crime happened when the software was installed. It became a major issue when the school system lied about it.

Imagine you're a teenager. You already have trust issues (I did). You're in an incredible transition. You're not a child. You want to be treated like an adult. People continually expect more from you. Then the school district pulls this crap on you.

Good job.

If you're interested in the technical aspects of this piece of software, here's a great blog. Some of it is really technical, but the guy does a good job of explaining the meat of the matter.

We need to take responsibility for our own security. No where is this more important than in the security of our privacy. No one is going to tell you when they're nefariously invading your privacy.

I'm just incredibly struck by this incident at the high school. The students were forced to use the computers. If they attempted to bypass the monitoring features, they were threatened with expulsion. Even if they had the knowledge and ability to take control of their privacy (something we should be advocating), they weren't allowed to.

OK, 'nuff said.

Wednesday, February 24, 2010

Begging for money

So I set up a Facebook Cause. Lets see if this social networking thing works.

I've been trying to find contributions for this cause.
The hospital has grown a tremendous amount. They need some laptops, so I tried Microcenter. Anyone who knows me knows that I have probably carried Microcenter through the recession. Certainly if you add my father into the mix, we've spent a bundle there (OK, maybe not that much, I'm just trying to give you a sense of my geekitude, and the thousands of dollars spent there).
I thought this business would be perfect. A couple of laptops. No problem. The technology recently changed, so there should be some older models, at the back of the shelf, that wouldn't go missing.

Except Microcenter only does their donations in August....


Look, I know you're a big company. I know you have to have a process, but seriously? Once a year? That's it?

It's funny. I've asked a couple of businesses now. So far, I've only had two notable encounters. The first, at the local grocery store. The minute I talked to the pharmacist about a 21 day supply of Malarone (a current generation anti-malarial), she said "God bless you. Let me see what I can do."
She can get me a 10% discount on $180 worth of medication. Yikes. One hundred and eighty dollars of medicine. For three weeks. We can do better! We need to find better medications, or even a vaccine.

The next (and actually my first stop once I found out I was going) was Casual Adventure, in Arlington, Virginia. I wanted to talk to these guys because they outfit people going all over the planet (I'm surprised they don't have a photo of their sticker, located on the space station). I had some questions about water purifiers, mosquito netting, well, stuff. I also wanted to find out how much this stuff was going to cost. More importantly, I wanted to talk to guys who sold you what you needed, not what you could afford.

So I walked in the store, and saw that they were already collecting for Haiti. I told them where I was going, and they (Well, Eric, actually) lit up, with a smile. They're going to try to put together what they can for the hospital. They'd rather send it with a guy they know, than to a general supply depot in Haiti.

Local business, working locally, to help globally. I love this.

On the flip side, I helped some friends consolidate their business this week. Consolidate is a nice word for "take two locations and merge it into one". It sucked.

I was really hit hard by this. The restaurant was a local place, just up the street. Good food, lots of beers, really friendly staff. I started volunteering there right after my divorce. It was a project to throw myself into, and something I could really believe in (Good food, good drink, within stumbling distance of the hosue? Hell yeah, this was a local project I could get behind!).

The two owners are local minded ladies as well. I was thrilled when I saw the T-Shirts blazed with "Drink Local" across the back. They worked incredibly hard, not just with the businesses (which were their whole lives, 24/7), but to improve the community on so many levels. It's a real privilege to work with them.

So I definitely recognize that we're still in the tough times. Watching someone fight for their business is just like watching a parent fight for their child, except for the constraints of professionalism. It's truly incredible watching their passion, and perseverance through incredibly tough times.

And still they're fighting

I'm going to try to end each post with the "Donate" button. I'm going to Haiti. I need help. 'nuff said

Donation Button

Friday, February 19, 2010

Some Milot Facts of Life

First, I found out that I'm the only emergency medicine guy on the team going to Milot. Seeing my name on the list was a bit of a thrill. I guess I'm getting too cynical, but it didn't seem real until I saw it in print.

So I got a little additional thrill this morning. Then I read the rest of the email. A frequently asked questions (FAQ) attached to it was pretty sobering.

The good news: I can take one change of clothes with me. The rest of the time I'll be in hospital provided scrubs. This is going to be the first time I've been practicing medicine in the field, in scrubs! Hot showers are available. Also pretty nice.

Unfortunately, that's the good news.

There are specific warnings about tetanus. They've already had patients succumb to tetanus. There are docs in the US who will never see a case of tetanus in their lives. It's a vaccine we (should) all get as children, and updated as a matter of course every 5 to 10 years. The Haitians may survive being crushed under a building, only to die from a completely preventable disease. It's chilling.

We're advised to make sure we eat, and get 5-6 hours of sleep a night. This is going to be good practice for medical school and residency!

The hospital has a 6-8 bed ICU. Ventilators will probably be available by the time I get there. Once again, something that we take for granted in the US, simply doesn't exist down there. In the US, if you need a vent, we get you one. If this hospital doesn't have one, they'll rent one, or transport you to a hospital that does.
Think about all those hospital TV dramas you watch. The ones where the hero (or mom, or dad, the son or daughter) is hooked up to the scary looking machines, while the loved one holds their hand, and tells them to come back. We won't get to that scene, in this drama. The realities will end the show (the season, the show) much earlier.

This is also a safety net that just isn't there. Miss something early on, and you won't have the option of intubating the patient, and supporting their breathing until they heal enough to breathe on their own. You have to stay completely on the ball, and not miss anything.

This is made all the more scary by the numerous times the FAQ says "You need to time manage", or "You need to hurry". Those aren't the exact words, but that is the impression. We're going to be seeing a ton of patients. We're not going to have enough time for the numbers of patients (Do you ever?), but the consequences for missing those subtle, crucial signs, will be dire. I'll be saying that most famous prayer, "Dear God, please don't let me screw up"

The lab sounds better and worse than I expected. Most conventional blood and urine tests will be available. That's good news. Apparently everyone is anemic, so H&H's are getting run continuously. However, no cultures are done at the hospital. None. Something in my mind made me think: If they have a lab, they must be running cultures. Assigning antibiotics to challenging patients is going to be another challenge.

Most patients arrive by helicopter. In the States, this would be a very ominous sign, as typically only the critically ill arrive by helicopter. Now I'm worried that the sick are arriving by the helicopter load (You can fit a literal ton of people into a Blackhawk). However, this is the beautiful thing about emergency medicine: The sick show up, and you start working. You keep going until everyone is taken care of. You'll always have work, and it will always change and surprise you.

The skills of local personnel appear to be highly variable. There are definite cultural, educational, and experiential differences. It sounds like there are problems with night shift workers making sure that patients are getting care throughout the night. IV's are running dry, and clotting off over night. It looks like I may be spending some nights in the ER tent... I haven't done that in a while, but those were good nights too.

Pain medication is in short supply. To top it off, the recommendations are to "Be prepared and willing to give more pain medication than you are accustomed to prescribing". I heard that before in certain operational medicine seminars, but I've never been in a situation where there was such a need, with nothing to give. This is going to be hard, really hard. Our hospitals have tremendous amounts and types of pain medication. Our job is to alleviate suffering. Pain control is so pivotal to medicine, and a patient's perception of their care. I think this is going to be where my limits will be tested. A minute in severe pain is a lifetime to a sufferer.

There are two principal sets of rounds. Morning and night. This is similar to US practices. However, evening rounds may not happen till after midnight, or even 4am. These are some really long days.

Deep Vein Thrombosis is a common complication. For those that aren't big time medical people, I'll run this down. Clotting is a fantastic adaption that we have. If we get a cut, our blood (hopefully) gums up, plugs the hole, and begins the healing process. However, through disease, injury, or loss of homeostatic control, we can develop clots within our body. When these clots form in our veins (typically the large, deep veins in the legs), it's called Deep Vein Thrombosis (DVT). There are a large number of complications that can arise from this, so it is something that we want to prevent. In the US, this is typically done with specific doses of heparin (a blood thinner). In Milot, they're looking at using aspirin. It's quicker to administer, and may be just as effective. Everyone gets assessed for DVT.

Lessons learned, and I haven't even set foot on the island.

I had a nice talk with one of my sponsor's last night. They're working on my travel arrangements. With that taken care of, it makes the deployment even more "Real". I'm hoping they'll let me name names. Too often these quiet benefactors remain in the shadows. I gotta be honest, this trip wouldn't be happening without their support. I'm a poor college student (I'm not starving, but only through the benevolence of others, and occasional honest work), there's no way I could afford to fund this on my own.

I've got to go beg more supplies from businesses. It looks like Casual Adventure is going to be able to get some of our needs (One of greatest local businesses. I really love those guys). I need to hit Home Depot, Microcenter, maybe even Best Buy.

It's going to be a busy day. I'm probably going to take the weekend off from blogging. I'm hoping to get out and see my horse. My girlfriend and I are going to spend the weekend at her place, something we haven't done for a month (though the weekends I've spent at my sister's house have been fantastic), it'll be nice to get away and relax.

Thursday, February 18, 2010

Deployment to Haiti

It's official. Sometime around March 12th, I leave to volunteer at the Sacred Heart Hospital, in Milot, Haiti. The hospital is approximately 70 miles north of Port Au Prince, so it was not directly affected by the earthquake. However, they have surged in capacity to handle the massive patient influx from the disaster region. What started as a small local hospital has exploded in size to a massive medical center. The emergency room started out as a tarp over the concrete courtyard. It has since been replace/augmented by massive tents, capable of holding dozens of patients.

These patients look like they come any way they can. The hospital has "borrowed" one of the local school's soccer fields, and turned it into a helicopter landing zone. From the blogs and online photo galleries, it looks like the tent gets emptied, only to fill up completely in minutes.

Looks like my old ER, maybe a little worse :)

Another unfortunate staple of the postings from Milot is the number of amputations that are occurring. This is a tragic fact of life in austere medical conditions, particularly with the crush injuries that are common in natural disasters. Even more tragic is the lack of physical therapists. With the scarcity of resources (They're lucky to have x-ray capability, forget a CAT Scan or C-Arm), the surgeons have to operate to save lives, not limbs. It looks like they're doing a tremendous job, in difficult circumstances.

It looks like incredible work. The kind of work that I really miss. The downtime pictures show teams that looked tired, but happy. Caregivers are frequently seen with convalescing patients, with smiles on all their faces.

It looks like most deployments last a week. The folks that I've talked to have said it's an exhausting week. I'm hoping I can last more than a week. I've got the time, and I miss the work. Still, I think this is one of those things that you won't be able to judge until you see the conditions.

I'm running around now. Studying topics relevant to the conditions. There are a number of tropical diseases that I've never seen, but will be incredibly common there (Filariasis is a fact of life down there, and I've heard the mosquitoes are a sight to be seen). I'm also trying to learn a little bit of creole. My sister picked up a great book for healthcare providers, English/Haitian Creole Medical Dictionary, By Heurtelou and Vilsaint. The book looks like a kid's coloring book, but the simplicity of it will make it incredibly easy to use. Despite the simplicity, it provides significant depth in medical terminology. This was a great find.

I need gear. I haven't heard how the ER operates. I think I'm going to need to find a nice, adjustable headlamp for night shifts.
Also, while the hospital has filtered water capability, I imagine if the generator stops, so does the water... I need to find a decent portable water filter.
Malaria prevention is a big deal (at least to me). I just found out that one friend who deployed without taking anti-malarials is now laid up with malaria. Yeah, one guy is not a good statistical sample. Still, I'm a preventative medicine kind of guy. I'm going to work pretty hard not to get nailed with that little bug. So, I need to find mosquito netting, or even one of those combined hammocks. That would come in handy up in Canada as well.

Anti-malarials aren't cheap. In fact, the newer generation ones are insanely expensive. That's going to be a significant expense.

I'm only allowed 50lbs of personal gear. I'm hoping to find a cheap netbook. The hospital has occasional internet, and I should be able to upload things (like this blog). Hell, I wish I'd kicked my butt in gear awhile ago, and built that USB EKG box. That would be pretty useful right now.

I'll try to keep this updated. I guess I'll have to make sure I keep it clean and on topic, since I don't know who will be showing up. So if you read my earlier posts, I guess I have to change those rules. If there is information that you need, let me know. I'll try to get it on here.