Death, dying, mourning, uncertainty, self-doubt, fear of commitment, isolation and burnout.  Put them all together, they spell... trouble.

It never fails, does it? Stepped in it again. I try to be helpful, try to be a good friend, a good partner... and it all just backfires.

You saw how it all started. A sweet old lady at the end of her life. Ready for it to be over.  At peace with how and when it was coming. No regrets about how she lived her life. Saw it all, did it all. The model of how life should be and end.

That one sweet old lady sent Nancy into a tailspin. Well, that and Rabbit talking about moving in together. Boy! Talk about bad timing. For some girls, that would be a good thing -- taking the relationship to that next level. But for Nancy, it's like a one-two punch.

It's funny how Nancy is usually the one trying to prevent other people from spinning -- me especially. But this is like the tunnel all over again, just with a different kind of claustrophobia. It's figurative rather than literal. Her world is closing in on her. She's questioning all those crossroads decisions she's made over the years. Now she's finding herself at yet another crossroads. And she's paralyzed.

Personally? I don't think it's that tough of a decision. Like I've said before, start with you.  Choose what makes you the happiest. And if your friends and family can't support your decision, screw them. Because at the end of the day, you have to be able to live with yourself.

But Nancy isn't built that way. She's grown up taking care of everyone else. She's not sure how to take care of herself. So, she brings even more baggage to this particular crossroads.  It can't be easy. And I don't envy her at all.

So, I get it. I get why she kissed me. A crazy whirlwind of emotions that just needed some kind of outlet. It makes perfect sense. But, dammit! Why me? And why did it have to happen now? When things are finally gelling with Nancy and me as partners... when things between Diana and me are going really well. I mean, what do I do now? How do I talk to Nancy about this? What's Rabbit gonna do when he finds out? And most importantly, how do I tell Diana?

Help me out here. This is all new territory for me you guys...

Pace a voi.

I really don't think there's anything more beautiful in this world than a newborn baby.  So innocent and pure. I guess that's why it really pisses me off when a baby comes into this world already tainted by the mistakes of its mother.

At least our sweet Jane's mother had the presence of mind to drop her off in a safe place.  The stars aligned for this baby to have the best medic in the city at her disposal -- to give her the best of care and not give up on her. Her own guardian angel.

Okay, yes, you're right. I am sucking up just a little. Trying to make amends for whatever it was I did or said to piss Nancy off so badly. She's refusing to take my calls. So, I've been killing myself trying to figure this out on my own. But I think I've got it -- maybe.  

Her time with Jane was special... personal... private. And I defiled the sanctity (for lack of a better word) of that time. And, I could be totally off base here, but there might be a biological clock factor to this too.  

But the thing is (and I know she doesn't realize this), Nancy could talk to me about this kind of stuff. I mean, I know I can't totally relate, but I can understand the pull of family. I'd tell her that it's a natural thing. It's nothing to be ashamed or afraid of.  

But maybe it goes deeper than that. Maybe she's starting to wonder if Rabbit would be a good father. That's a whole other internal struggle. Okay, on second thought, I better stay outta this.

It's weird. Babies are unlike any other patients. The first baby I delivered -- I keep his picture in my locker.  I look at it every day. He starts all my shifts, makes me smile. He reminds me why I do this job. He reminds me that life is an amazing thing. But I guess for Nancy, this particular baby is causing all kinds of turmoil. I just hope she finds her way without incurring or inflicting too much damage.

Pace a voi.

I can't tell you how satisfying it was to see him taken down a couple pegs by my girlfriend and my partner... even though he'd never acknowledge that Nancy had anything to do with it.  I now totally get why Nancy is such a mess.

I guess if I'd grown up with him as a father, my spirit would have been broken a long time ago too.  I kinda feel sorry for Nancy.  She'll go toe-to-toe with a street bum or read a junkie the riot act, but when it comes to her dad, she just shuts up and takes it.  It's kinda sad.  No, it's very sad.

But, I have to say, I'm proud as hell of my girlfriend.  Diana fights back.  Give her time to process and collect herself and she turns into a little spitfire.  She's the kind of handful that's a perfect combination of brains, beauty, passion, control and grit.

I'm telling you, Dr. Carnahan isn't gonna know what hit him.  And he deserves it!  He's got all this power and chooses to wield it in the most ridiculous ways -- like obsessing over the minutia of our run reports.  Why doesn't he redirect all that energy towards saving patients rather than making everyone around him cower in fear or just plain hate his guts?  It makes me wonder if he doesn't get off on it -- the power trip, I mean.

I don't know why I'm wasting my time and energy on this guy.  It must be the protective boyfriend in me.  I really wanted to punch him when he went off on Diana -- wipe the floor with that smug little face of his.  Thank God for self-restraint.  Some days it can really save your ass.

Pace a voi, everyone.

P.S. Today's blog is dedicated...

This whole thing is just tragic.  A young woman is paralyzed.  And an incredibly talented doctor's career is over.  

I understand that people want someone to blame.  I do.  I would want that too.  I feel for the girl's parents.  But no amount of money and no amount of ruining other people's lives is going to change the fact that a cheerleading stunt left their daughter crippled.  It's their way of deflecting the guilt they feel.  And people like us just have to take it.

But hospital versus medics and medics versus hospital...?  This is not the way it's supposed to be.

Sometimes when Nancy goes off the reservation, it's hard to know what is right and what is wrong.  In this instance, I had to ask myself the question of which is worse.  Quadriplegic for life, or dead.  I'm sure her family would prefer alive.  But I sometimes wonder if I could live with being a burden to my family for the rest of my life.  It's a moral dilemma that I really don't want to get into.

But Nancy saved that girl.  Without the intubation, she would have suffocated.  She would have died on the way to the hospital.  But the accident -- the fall -- that's what took her limbs from her.  Not anything that Nancy or anyone at the hospital did.  

I hope Dr. Joe lands on his feet.  I hope that a hospital somewhere will see that he's an asset.  Because he's been good to all of us.  He deserves better than what he's been dealt.  But I can't help but be happy that the scapegoat wasn't Nancy.  She's my partner.

Okay, I'm done being all sentimental.  I'll leave you with one last thought.  Don't take people in your lives for granted, because in this world, they can be gone before you know it and sometimes, for really stupid reasons...

Pace a voi.

Have you ever been shot at? I don't recommend it. Yeah, you're probably wondering why I'm even joking about this. But after everything Nancy and I have been through these past few months, if I really were to dwell on it all, I think they would have to put me in a straightjacket and lock me away.

They say that the measure of a man (or a woman) is how well he/she deals with adversity. And today, my station family measured up pretty damn well. We took care of our own. Under fire. And with little regard for our own personal safety. I have to say, one of the things that I love most about this job is that we put others first. We live to serve. We save lives. And when one of our people is down, we rally... we don't give up... we put it all on the line because, just like in the Army, no one gets left behind.

Then, back at the ranch (a.k.a. the hospital), well... Don't be too hard on Diana. She was dealing with a lot while all this was going on. Badges getting shot at. Losing patients. And being faced with her current... what am I? Her lover? Let's go with that... her current lover's ---um--colorful past? I don't blame her for wigging out a bit. But mostly, I'm glad she came around. Because, the truth is, she's not a... what did she call it? "A random hook-up." She's something pretty damn special.

Well, I'm out. Coming down off the adrenalin of bullets whizzing past your head takes a little work. Take it easy and be safe out there...

Pace a voi.

I'm not sure how I got in the middle of this. I mean, Diana and I are just starting to feel our way around this dating thing. And I think Nancy is starting to feel her way around me not chasing after her anymore. Add to that, stress on the job and Nancy bumping up against the limitations of our chosen career. And Diana being where Nancy sometimes wishes she was. It was the inevitable cat fight and a no-win situation for me.

Complications upon complications.

But seriously, if these are the worst of my problems, I'm doing good. Seeing Valencia again today put a few too many things into perspective for me. Part of me doesn't understand the mentality of someone who can go from one abusive relationship to another. Or stay in the same abusive relationship, incident after incident.

But then I think about all the damaged people we deal with day in and day out and I can kinda see how low self-esteem plays into a lot of these self-destructive behaviors. Sometimes I wonder how it is that more paramedics don't end up like Valencia. It's like that old computer programmer saying--garbage in, garbage out. But in this case, it's damage in, damage out.

I hope that what happened today can shake Valencia out of where she's been. Maybe she finally feels empowered enough, so that next time, she gets out sooner or doesn't enter into it in the first place.

If you take nothing else away from this blog, just remember this. Start with you.

Pace a voi.

I'm still a little numb from everything that happened today. I know that people die on our watch. I know that sometimes we make mistakes. But it's a hard thing to face. And I know Nancy is right - it won't get any easier. I just hope I get better at what I do and this never happens again.

It's times like these when you find out who your true friends are. Nancy and Diana really had my back today. Well, and Tyler too - in the end. He was a dick all day. But then came clean. I was shocked. And... well... touched. He told me the story of his first kill - a story he doesn't really share...

He and his paramedic picked up a kid. He was hit by a car while riding his bike. He rolled over the car, onto the road and ended up under another car. He was a mess. One of his legs was crushed by the second car. Massive trauma everywhere. The slight motion of boarding him ripped open his femoral artery. The paramedic was screaming at Tyler to tie it off while she tried to secure an airway. But the more Tyler pulled on the tourniquet, the more damage he did to the artery. The crushed bone fragments sliced through it with every cinch. The kid bled out on the way to the hospital.

I don't know if I could come back from that. I know that I'll be seeing Sam's dad's face when I go to sleep at night - for a good long time. I don't know that I'd ever be able to sleep again if it were a kid's face.

Tyler's an amazing guy. He carries that around with him. He wears it like a badge. A lesson. And no one really knows. Now every save he makes is kind of a tribute to that kid. It keeps him going.

I'm gonna try to do the same. See if it helps with the nightmares...

Pace a voi.

I promised Nancy I wouldn't talk about it, and I won't.  We had a helluva day.  A great save.  I got to see the dank underbelly of San Francisco.  I helped my partner, instead of her carrying my ass for a change.  And I got to do a pretty amazing intubation.  That's all there is to it.  The rest of it doesn't matter because, at the end of the day, who doesn't have flaws?  Knowing Nancy's somehow makes her more human in my eyes now.  It's a good thing.

But I have to say... if we had a "helluva day," then Rabbit had the day from hell.  We only crawled around in the sewers for a couple hours.  He had to work on people with a gun to his head.  Everybody's talking about it.

I can't believe he had to watch someone get shot right in front of him.  I'd fucking lose it.  People are saying it was his fault.  I don't understand the reasoning behind that one.  They sent him into the bank to do his job - to be a medic - to treat people.  And he did.  He didn't give the order or pull the trigger.  But they're saying it was his fault.

And now he's suspended.  I feel for the guy.  I know he's never been my biggest fan and he's been one of the ones to give me the most s*** as a probie, but he's an awesome medic.  He doesn't deserve this.

But you have to admit - the guy always lands on his feet.  He got the girl!  Him and Nancy.  It's official.  Which means, it's definitely time for me to move on.  There's no denying soulmates.  And those two, in their own messed up way, are perfect together, don't you think?

Well, that's it for now.  Don't go exploring the sewers.  Take it from someone who knows... it's really nasty down there.

Pace a voi.

This is the blog I hoped I'd never have to write.  I don't like talking about my sister.  Sometimes, quite honestly, we pretend she died years ago.  It's easier to cope with.  But it's also a cop-out.  She deserves better than that.  If for no other reason than because she's my sister.  And despite all the shit she's done, I still love her.

At first, we all thought it was just a phase.  We thought she was just experimenting like most college students do.  We figured she'd grow out of it.  But you don't grow out of heroin, meth or crack.  Once you're in... well... it's a long road back...

I used to blame myself.  I should have tried harder to reach her.  I should have dragged her to rehab as soon as I figured out what was going on.  I should have been a better brother.  But then I realized... she chose this path.  It wasn't forced on her.  She invited it into her life.  And then she let it take over.  

That's when all the lies and the cons started -- when we all got sucked into her chaos and learned just how low someone is willing to sink to get their next fix.  That's also when the anger set in -- mine, I mean.  I don't think I've ever really left that stage.  I'm stuck here.  Perpetually.

Don't get me wrong... I'm still her brother.  I still want what's best for her.  I want her to be my sister again, not the shell I saw living in that motel not too long ago.  But she has to want it for herself first.  She has to admit that she has a problem.  She has to ask for help.  Nobody can do it for her.  No matter how much I may want to.  I can point her toward the light and love her.  But she has to find the strength to commit to rejoining the family, clean and sober.

Sorry to be such a downer today.  It's just really hard to deal with junkies all day and not think about her, you know?  I hope none of you ever have to go through what my family went through with my sister.  But, if you do, just know that it doesn't have to be a one-way ticket.

Pace a voi.

Thanksgiving. Seems like it's synonymous with hearth and home for most people. Except for a few of the curmudgeons I work with. I mean, I get where Nancy's coming from. Family dynamics can get pretty screwed up. When you watch some of those holiday movies, you realize that so many people get the family together more out of obligation and to torture each other rather than out of love and togetherness. It's sad really.

But I can't really talk. If I were at home, my brothers would be taking enormous joy in making me miserable. But I still miss it when I'm not there: Mom's awesome turkey, stuffing and pies; Dad refusing to come to the table until the football game is over -- even though Mom's been slaving in the kitchen for two days to make everything perfect; my brothers drinking so much beer that they can't even taste the food. I miss it all.

Tonight, though, eating turkey sandwiches with Diana was pretty cool. If I had to spend Thanksgiving without my family, I'm at least glad I got to hang with DVD. She made it bearable. It's nice to have someone to commiserate with. We understand each other's hell.

I told her about today's insanity. A plane crash on Thanksgiving. I felt like I was in the Twilight Zone. And then Rabbit bogarted my partner. And I couldn't even be pissed because watching them work together was like... I don't know... it was perfect precision. Practically telepathic. Like Boone and Tyler. But with heat.

I don't care what Nancy says, there's something there. Whether she talks about it or not. Whether she sees it or not. Whether she acknowledges it or not. It's there. And I don't stand a chance. Not with that kind of a connection. I'd be an idiot to even try.

Crap. Incoming call. And wouldn't you know it? Possible heart attack. They say that Thanksgiving and the day after are pretty much all cardiac calls. This is gonna be a fun shift.

So, please take it easy this year. Chew your food. Eat and drink responsibly. And be kind to each other. That's what the holidays are all about.

Happy Thanksgiving! Pace a voi.

Holy crap is that Bay water freezing! Home now. Trying to calm this incessant shivering with my perfect hot tottie. 1 part Irish, 1 part Guyanese -- West Indians make the best damn rum! I'll have to share the recipe some time. It'll knock you on your ass.

So anyway, I've been getting a bunch of questions about my "little black book." I don't really get it, but if you really want to know what Nancy was giving me so much crap about, have a look at my top 10 list. It's kinda like that list people make for what they'd like to accomplish in their lives before a certain age -- just more finite and immediate. (I hear chicks sometimes write lists of things they want in their next boyfriend. That's just scary. I mean, how can any one guy live up to something like that? )

So, here it is. I don't think I've quite got them in the right order yet for level of coolness, but you get the idea.

Pace a voi.

GLENN'S TOP TEN LIST OF FIELD PROCEDURES
1. Needle cricothyrotomy
2. Needle bore through the chest/needle thoracostomy
3. Ice-pick intubation
4. Tactical engagement save
5. Fasciotomy
6. Cold saline infusion
7. Baby delivery
8. HazMat save
9. Snake extraction
10. Rapid sequence intubation

I've really stepped in it. I took this job thinking that street medicine could not possibly be a den of political B.S. Apparently I was wrong.

I'm no boy scout. Let me just make that clear. I've traveled. I've worked at a lot of different kinds of jobs. But when I finally decided to settle in one place, I purposely chose a profession where I could make a difference. Something where I could help people. Save lives. A calling -- you know?

You're probably like, "Whatever, dude. You're just an EMT." Yeah, I am an EMT. I'm an EMT who wants to be a paramedic. I'm an EMT who wants to be the best damn emergency medicine paramedic with all the tricks of the trade up my sleeve and under my belt. Part Nancy, part Rabbit. Trained up to the highest level. Tactical and all. The best of the best.

But when you throw the politics of all the departments into this mix, everything seems to get hinky. All I did was tell the truth. And now all this crap is raining down on me. I mean, I get that things aren't always black and white. But this kind of grey isn't cool with me.

I understand the code. I understand the intimidation factor. I see both sides of this. I do. Lyons makes some good points -- a gangbanger who shoots innocent bystanders needs to know that he's gonna pay, one way or another. Especially since this isn't his first serious offense. I get that. But my points are equally valid -- when Lyons was railing on him, the guy was already in handcuffs. What could he really do besides mouth off? I mean, aren't we supposed to be better than them? Aren't we supposed to rise above? Take the high road?

Maybe some of you think I'm crazy. That I'm being naïve. And that's your prerogative. But I figure we all take oaths to serve and protect in our own ways. And if we say it, we should live it. And if we don't, we should be held accountable.

So, now you're probably saying that I should be held accountable for the incident with that bum, Naz. Sure, I could justify it as protecting my partner. And I do. But if it comes back around to bite me in the ass, I won't deny it happened. I'll stand up for what I believe and face the consequences. That's all I'm saying.

I'm gonna go put some ice on my knuckles now. Catch you guys later...

Pace a voi.

What the hell is wrong with me? I almost killed my partner on the way to a routine call and then... I'm such an asshole.

I thought I might be able to help... help fix whatever was bothering her - maybe make up for crashing the rig and her surgery... in some small way.

But I totally invaded her privacy. I just couldn't help myself. God help me - I snuck a peek at the letter - the one Nancy was reading right before the accident.

I should have left it alone. Because now I not only feel like an asshole but also some kind of weird voyeur. You'll see what I mean after you read it.

I mean, when I first saw that it was a recommendation letter for a residency program, I broke out in a cold sweat. I can't imagine my life in the rig without Nancy. She's my teacher. My mentor. My friend. My partner. And she might be leaving me.

But then, as I read the whole letter, I realized that Nancy has bigger problems than me. Bigger problems than just choosing which path to follow. It's that... I'm not sure how to even put this but... I think Dr. Joe's crushing on her in some really creepy-ass way.

Maybe it's just me. You decide for yourself...

Pace a voi.

I sure hope Day of the Dead is better than All Hallows' Eve. There really wasn't anything "hallowed" about today. Just screwed up. I see why Nancy hates this holiday so much.

I mean the Irish part of me is totally in tune with Samhain. Celebrate the bounty of the land. Bid farewell to the season of life that brings forth the season of death. The whole cycle of life thing. (Love The Lion King! Don't you?)

But San Francisco on Halloween is like full moon times a million. All the crazies come out to play... and then some. But it sure is colorful!

The worst part is that tonight should have been a celebration for Kurt of Kurt's Costume Shop in the Castro. And it just turned into mayhem. Full house. Fire. Stampede. Not the kind of night I would want to remember.

After it was all over, the weird thing - when we got off shift, Nancy just kinda disappeared. Didn't say a word. Just snuck out. Like she had somewhere to be. Something about her seemed extra sad today. It wasn't just that she hated being at work. There was something else. She's complicated. I think that's why I like her. But I'm pretty sure you're sick of hearing about that. So, I'll just say Happy Halloween and leave it at that.

Pace a voi. Be safe out there! Don't drink and drive.

So I told Nancy about Street Medicine tonight. Didn't go over well. And I don't think it was because she didn't like the title. What do you think? But I was serious - she would make a great character when I turn all this into a book. You guys get the to see the story evolve. You'll be able to say, "I was there when..." LMAO!

Today was ridiculously intense. Not like the dude who went postal. Not at all like that. This was all about the medicine - medicine that no medic should have to do alone. But today I was introduced to Super-Nancy. Was anyone else blown away by the fact that she's a f***ing doctor?! What kind of person endures the hell of med school to throw it all away to be a paramedic? I don't get it.

I mean, she performed vascular surgery today. Surgery! Without having gone through a residency or anything. Surgery! With spoons! In a guy's house! Not in a hospital. Without anesthesia. Without trained nurses. Just me and few rescue firemen.

She's got the gift. There's no doubt. And she's wasting it out here on the street with drunks, junkies and reprobates. It's not to say I'm not grateful that she's out here with me. Lord knows I'm learning a lot, and let's face it - she's f***ing hot. I got the pick of the litter.

Now if I could just pick her brain. But I think she might be done with me - in more ways than one. There's just no coming back from sticking my foot that far down my throat. But then again, I can be pretty damn persuasive when I turn on the charm. I've still got a couple tricks up my sleeve I can try on her.

Anyway, take it easy out there. Don't play with rebar. And if a dehydrated raccoon ever waddles up to you in the middle of a forest fire, be kind and let the little bugger have a drink from your canteen. It's the human thing to do. (C'mon! You gotta give me credit. That's one of the cutest mental images you've ever seen. Am I right?)

Pace a voi.

Shit. My hands are still shaking from today. I'm really starting to understand how some medics see their patients as nothing more than just meat. It's how they get through days like this.

We started the day working on this girl who got beat up by her boyfriend. Dude was screaming his head off about how much he loved her even though he'd just almost broken her nose. She was fine this time. But what about next time?

I know we're only supposed to treat the patient, the physical stuff. But I really wanted to tell this girl that there's help out there. But it didn't feel like it was my place. So instead, I'm gonna tell all of you. If you're in crisis, please ask for help. You don't have to live like that. It's better to be alone than injured or dead.

And just as I was thinking that, the shit hit the fan. What do you say after you treat a ton of people who've just been shot by a raving lunatic who used to be their co-worker? Beer and pool at the bar can only help so much. The worst part - black tagging... really sucks - marking for everyone to see that you couldn't save someone. It took everything I had not to lose my shit today as more and more people came out of that building - shot, bleeding, screaming - and then some of them dying.

"Jaded." Nancy used that word to describe herself today. But jaded to me means that you've lost your empathy - like the guys who see only meat. Nancy is the opposite of that. Seems like she feels too much sometimes. I think I'd like to be somewhere in the middle. Without the crazy that seems to be Tyler. Does anyone else think Tyler is teetering on the edge? I worry about that guy.

Anyway, I've gotta sign off for now. Think I need another beer to take the edge off... because tomorrow I have to do it all over again.

Pace a voi.

Hey. I'm Glenn. Welcome to my blog. That sounds really lame. But what the hell else am I gonna say? Thanks for reading? Glad you stopped by?
Whatever. You're here, so I guess that means you're interested. I'll try to keep it interesting.

So, you've probably figured out by now that I'm the new guy. Probie, which is synonymous with "dog of the house." If it's menial and borderline degrading, that's my job inside the station. Make the coffee. Take out the trash. Mop the ambulance bay. Clean the bathrooms. This isn't hazing. It's servitude.

But, you know what? It's also what I signed up for. It's a good gig. Probation is only 6 months. I can endure anything as long as I know it has an end date.

These guys I work with... they're tough as nails. And they don't let me get away with s**t. It's like they're waiting for me to screw up just so they can stick it to me. Weird thing is - I like it. It stings sometimes. But it comes with the territory.

Like today, Rabbit totally bit my head off. But I learned my lesson - no moral triaging. Worst is first. Treat, load, transport. Get them to the hospital alive. Then, it's out of our hands.

That's the job. Not as easy as it sounds. Trust me. Some people got it. Some people don't. And everyone's got their own style.

Take my partner Nancy, for example. She's f***ing amazing. Watching her in a crisis is inspiring. I saw it today when she was working on this kid's mom. Nancy didn't miss a beat - got right in there and did what she had to do to save her - her hands and mind working at a million miles an hour. But all the while Nancy kept one eye on the kid - even let him help. And in the end, having her son there was probably the best medicine in the world for mom. Nancy's got that instinct - she knows her s**t.

Nancy's kinda like a cannoli - hard shell, mushy center. She'd kill me for saying that. But underneath all that... there's something else. You've seen it. I know you have. That weird vibe between her and Rabbit? There's a story there. I'm gonna get it out of her. Problem is - she's got one hell of a bulls**t detector. My usual angles just aren't gonna work. I'll keep you posted on my progress.

Pace a voi.