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About Greg Moore

Founder and owner of Green Mountain Software, a consulting firm based in the Capital District of New York focusing on SQL Server. Formerly, a consulting DBA ("and other duties as assigned") by day, and sometimes night, and caver by night (and sometimes day). Now, a PA student working to add PA-C after my name so I can work as a Physician Assistant. When I'm not in front of a computer or with my family I'm often out hiking, biking, caving or teaching cave rescue skills.

A Door Closing

So I’ve hinted a bit on some social media about a change. The change has come. I would have posted more details yesterday, but given that particular date, I didn’t want anyone thinking I was trying to do an April Fool’s Joke.

So the door closing is that as of March 31st, my contract with my largest client is over. This was actually a mutually agreed upon date. In fact, when my manager scheduled a meeting with me in December, I knew it was coming and expected he would want to end things in January or even perhaps December, so honestly, I was quite pleased to have the extra time.

That said, it was obvious to both parties that this was coming. I was spending less and less time on projects for them. This was due to actually a variety of factors. Strangely, a huge part of it was something that I hadn’t planned on: Grand Jury Duty. During the weeks I was on the Grand Jury, between that, the class I was taking and my ED Tech work, I had very little time left over to spend with this client, so they didn’t assign me any real projects at that time. But even besides that they had been using my skills less and less and I had been allocating less time to them. So, the end was inevitable.

And to be honest, I’m actually very excited about this. When I made the decision over two years ago to apply to PA School, it was driven in a huge part because I was tired of IT. I was also tired in part of having to learn new things in IT. Specifically, I didn’t want to learn who to do what I was doing in new ways. For example, the SQL Server world is moving more and more to Azure and other cloud providers. I’m actually in favor of this. But it’s really simply doing much of what I do in a new way. That’s not a challenge that excited me.

If I am to learn new things, I want to learn them in a new domain of knowledge. Becoming an ED Tech and eventually a PA is just that, learning new things in a completely new field. Some of my skills remain the same. One of them is my ability to solve problems. I’m just applying that skill in a new arena. This is exciting.

What’s also exciting is for the first time in over a decade, and ignoring two breaks, really since before the turn of the millennium, that I don’t need to be checking my email almost constantly. For a variety of reasons, most of my IT jobs over the past 3 decades have, if not required me to be available 24/7, at least highly encouraged me to be available 24/7. With my ED work, when I’m done with a shift, I’m truly done. No one is going to call me at home and ask me to log in and do an EKG on a patient. Right now my ED work is officially only part time, but I can pick up shifts, something I’ve been doing a lot. But on the flip side, I’m under zero obligation to pick up shifts if I don’t want to. The fact that I’m not on call and that I can pick up or not pick up when I want to is very liberating. I’ve been looking forward to this for awhile.

Another short-term change is that I don’t have to worry about trying to fit in client meetings with my currently highly variable sleep patterns. Last week for example, because of the shifts I picked up and one regular shift and my client needing meetings, I basically only got about 8 hours of sleep in a 56 hour period. I couldn’t get a solid “night’s” (since I generally sleep during the day because of the ED night shifts I work) sleep. I had to wake up and attend meetings. That’s over with.

And in some ways, there’s no going back. That’s not strictly true. My IT skills are still fresh and relevant and I have enough industry contacts that if I wanted to change course back, I could. But I don’t see happening.

Really the only downside is the change in income. Trust me, IT work pays a lot better than ED Tech work. However, fortunately we’re the point where total income isn’t as big as factor as it once was. Basically I can afford to “follow my dream” and we can still maintain our lifestyle. We’re fortunate that way.

So what’s next? Well later this month the application process for my second round of PA School applications begins. I’m much more hopeful this time around, though we’ll still have to wait and see. Assuming that’s successful, sometime in 2025, I’ll start a two plus year journey of again diving deep into learning with very little free time and I’m looking forward to that.

But in the meantime, I expect to travel a bit more, relax a bit more, work on some more projects around the house. Overall, I expect to simply enjoy life more.

And perhaps even blog a bit more than I have been.

Pride in my Work

I was driving home from my work in the ER the other night and a thought passed through my head, “You know, I’m damn good at my job.”

Now this may sound a bit conceited and perhaps it is, but I went with it. The truth is, it applies to by my IT work and my ER Tech work.

Now, let me be clear, I’m not saying I’m the best there is. I’m not even sure I would say I’m great, nor would I claim I’m the best ED Tech there is in our department. I’m not even sure there is a single “best” since our job responsibilities are so broad. But I am damn good.

I’ve talked about my IT work and how some of my code is still running years later without any real issues. It’s not world shattering code, I didn’t write the next LLM AI code (and I’m not even sure where I’d begin on that) but it does its job and is solid. So I’d say I was damn good at my IT work. I’m a published author (though last year apparently my book sold zero copies according to my most recent royalties statement) and have several online articles to my name. I’ve also spoken at numerous conferences. I’m proud of my work. Yeah, there’s better folks out there in many specific SQL areas, but I’m still proud of what I’ve done.

Similarly, with my ER work, I’m at the point where I think I’m pretty solid. There’s one skill I definitely am NOT solid on (blood draws for those curious) but other than that, I look back at where I started over 3000 hours ago and I’m proud of where I am.

There are several reasons I like to think I’m good at my job. One for example is that I’m often the “go to” person. More than once a nurse or even doctor has told a colleague, “oh, go ask Greg, he’ll probably know.” Often this is in relation to where particular equipment or materials is stocked, but sometimes it’s on a policy or procedure.

I also appreciate the fact that in terms of general skills I have received positive comments.

Lately I’ve also been doing a lot of precepting new techs, something I very much enjoy and I like to think I’m good at (and based on the comments from more than one, they seem to appreciate my teaching). I also received a HUGE compliment from one of my managers who praised me for how I teach and what I was teaching. One of my real joys in life is to be an effective teacher and to have that recognized really meant a lot to me.

And, as I am about to begin the second round of PA School applications, I’ve had more than one of the provider offer to write a letter of recommendation for me. This also means a lot to me.

Now that all said, as I stated at the top, I’m not great at my job. I think anyone who starts to claim that is probably wrong and should have a close eye kept on them. But I think I’m damn good and every day I strive to be a bit better than the previous day and to keep getting better.

So I’m good, but every day, a bit better. I hope.

Ending an Era, Starting Another

First, a quick update on my PA school applications. Another school reached out to me yesterday to say “Thank you for applying, but no.” There’s a longer story there, but suffice to say, I’m now down to waiting to hear from one last school, which is a super longshot, so at this point, I’m basically considering my first round of PA school applications over. (Astute readers may recall I’m still waitlisted on one, but it’s doubtful, even if I move to “accepted” I’d attend there at this point.)

And I’m fine with that. It’s very hard to get into PA school on your first round from what I understand. But more so, now, it gives me some closure for the rest of the year. Several events I had been trying to plan, but were in limbo lest this most recent school accepted me, can now be finalized. So, the no, while a bit disappointing gives me some certainity.

Meanwhile, another step in the process been moving forward, and that’s ending my consulting status with my largest (by far) client. This has been a mutually agreed upon process and if anything, my work with them extended longer than I had originally hoped or expected.

It’s a bit bittersweet though. For one thing, the money is pretty good, and that makes a difference when making my plans for school and other projects. But honestly, I haven’t been able to dedicate as much time to the client as I’d like because of my ER schedule and how much time I’ve been dedicating there. Most of the time I’m now working overnights in the ER. This client has required my time for meetings and other events during the day. This has meant a few weeks where I’m definitely sleep deprived for multiple days in a row. So while I’ll be making less money, I’ll definitely be getting more sleep. I think that’s a good trade-off.

It’s been clear to me for awhile, that the move to medical is the right one. This is evident in my paychecks as much as anything else. I honestly make about 6-12x as much doing IT work (depending on scheduled work or overtime work) as I do for my ER Tech work. This means I can easily work 2 hours of IT and then go into the ER and work a 12 hour shift and make about the same at each. Obviously, in general most of us would rather work the 2 hours than the 12 hours for the same pay, but I 100% enjoy the ER work more.

So, at the end of this month, I’ll be removing a number of scheduled ongoing meetings from my calendar. I won’t be checking my work email account nearly as much. I’ll sleep in a bit more. I’ll evolve my non-work schedule around my night shifts. And I’m good with that.

When I started working in the ER over 15 months, and 3100 hours ago, I saw it as sort of a “necessary evil” to get my patient contact hours for PA school. I wouldn’t say I wasn’t looking forward to it, but I definitely did not expect to enjoy it quite as much as I did. Fortunately I have. It’s reinforced to me that medicine, in some capacity, is where I want to be.

So, one era, IT is closing, and the other, medical continues to open.

Transporting a Patient

One of my duties as a tech in the Emergency Department is to occasionally transport patients to surgery. These transports are generally one of two types. The first is what’s often called a “red-sheet” surgical procedure. These are usually traumas where we’ve done all that we can in the trauma room and have to race them to the Operating Room for emergency surgery. These require a nurse or two, often a provider and generally a tech or two to help drive the stretcher. This isn’t always the case. One night an assistant manager nurse and I were the only two to transport a dying patient to the OR. We were moving fast. I was pushing and she was monitoring his pulse the entire time, basically running backwards as I pushed. At one point in a hallway a column was in our way and she nearly got clipped as I wasn’t about to slow down. Knowing her, I think she’d rather I had clipped her than slow down the transport. As a side note, I can’t recall if I’ve mentioned it, but personal space often isn’t a priority during traumas or situations like this. As we turned a corner I felt her reach down to my leg and grab my stethoscope out of my side pocket so she could quickly check his breathing. There wasn’t a request or warning, simply the grab. In cases like this immediate patient care is more important than the personal space.

The second type of transport are far less urgent, but still more urgent than waiting until a convenient time during the day. The patient isn’t within minutes of dying like the above, but the situation is serious enough that the surgeon wants to start cutting within the next couple of hours. That was the case the other night.

This patient had come in with a small, but growing growth inside her. It was causing them incredible pain. But more serious, if it continued to grow, it would certainly burst the tissue it was growing in, causing severe bleeding and possibly cause sepsis and in 9-14% of cases the death of the patient. This was a surgery that perhaps could have waited until the next day, but the surgeons decided it was more prudent to do it as soon as possible.

As I wheeled her up to the OR I reflected on how it had taken no longer than 1-2 hours from the initial diagnosis to getting her consent and then getting her to the OR. All in all there wasn’t really anything remarkable about this.

And there shouldn’t be anything remarkable about this. If I were describing a patient with appendicitis or some cancerous tumor threatening to burst it wouldn’t be remarkable in any state.

However, in this case, it was an ectopic pregnancy.

Now, let me be clear, a quick search of the literature does not find any state that outright bans treatment for ectopic pregnancies (and to be clear, treatment in this case means either a chemical or a surgical abortion). However, that hasn’t made doctors and hospitals nervous over the lack of clarity at times. This can lead to a delay in treatment. This is unacceptable.

In cases like this, medical treatment should be determined by competent medical personal and their patients.

https://www.healthline.com/health-news/ectopic-pregnancy-and-abortion-laws-what-to-know

2024 A Year in Preview

Ok, yesterday I looked back at my goals for 2023 and reviewed what I had achieved and what I hadn’t. There was a smattering of accomplishments and a smattering non-accomplishments. Happens every year.

So, that said, what am I looking to do for 2024.

  • Get into PA School! My goal had been to be accepted in 2023, but that didn’t happen (though I did get waitlisted at one!) This is going to be perhaps the hardest goal to achieve, but the one I’m most focused on. What makes it hard is my undergrad GPA is holding me back. This has been an ongoing issue, one I can’t really change. But I’m working several avenues to get in anyway.
  • Keep working in the Emergency Department. Technically this is a part-time job, but because they’re often chronically short of techs, I’m often able to pick up extra hours. Last year for example (including training and a few days I took off for vacation) I worked 2200 hours. I’m not sure I’ll work that hard this year, but my goal at least is to be at over 3000 hours by the time I start my second round of PA School applications (this includes the 300+ I achieved in 2022).
  • Keep my Red Badge certification in the ED. This allows me to be the Lead Tech on Traumas. This won’t be hard. I simply need to lead 3 traumas in 2024 and I’ll have my Red Badge for 2025. I’ve honestly had shifts where I’ve done that in one shift.
  • Cut back on my IT consulting. This is a mixed bag for me. It’s honestly where the bucks are. But I’m enjoying it less and less. That said, to any of my #SQLFamily members reading, if there are quick projects you need help with or short term items, let’s talk.
  • Work on me and be a better person. While I think I’m generally a pretty decent guy, I’m aware of some issues I want to work on. That’s about all I’ll say for now.
  • Meditate – even if it’s just a minute or two a day. This is related to the previous goal. I want to be more relaxed in life.
  • Relax more. Sometimes it seems like I do that a lot, but honestly this past year I took a number of classes, did my IT consulting and worked in the ED. I want to slow down just a bit. And honestly, my 56 year old body is telling me this a bit more.
  • Hiking – I put this down every year and rarely get out and do more. But perhaps this is the year.
  • Biking – I definitely didn’t make my goal last year. Perhaps this year. My new schedule for work might actually allow me to bike to/from work. We’ll see if I actually do that at all.
  • Caving – again, need to do more. With the NCRC weeklong in NY this year, I’ll be busy planning that.
  • See friends – twice in December we had friends over for an evening of hanging out. We’re going to do more of that. We used to do more pre-Covid, it’s time to do more. In fact, I think we already have a night setup to watch a few episodes of From the Earth to the Moon (Spider and Galileo Was Right for those wondering).
  • Travel – nothing big this year due to budget and time. Though, if I get accepted into a PA School, I may take more time off from my work in the ED to do more travel.
  • Get our new septic system in. This was a goal last year that didn’t happen for a variety of reasons.
  • Finish several projects around the house. I think once I’m done with the IT work, I’ll try to focus on this.
  • MAYBE take a class or two. I’ve taken pretty much every conceivable pre-req I can for any PA school I’ve looked at, but it might be fun to take more classes anyway.
  • Blogging – I definitely won’t be doing this every week, but I’ll continue from time to time.

2023 A Year in Review

Well, it’s that time to look back on the year and see how I made progress on my goals for 2023.

  • It was a mixed bag. For one thing, I was looking to up my patient contact hours to hit the minimum required to apply to my programs. I hit 1000+ hours by the end of April. I’m now at over 2500 hours and closing in on 3000 hours. (For those doing the math, yes, that’s over 2200 hours this year alone. That’s on top of my IT work and taking classes!) The nice thing about these numbers is they put me above the average for all the programs I’m applying for.
  • And yes, I said applying for. While a goal for 2023 was to get accepted into a PA program, it didn’t happen. I will admit it’s been discouraging. It became even more discouraging to learn, via email, that one of the programs I had the most hope for, despite not having an official minimum GPA, hasn’t accepted anyone below a 3.2 GPA in the last 5 years. I’m not irked so much about that number, but as much about how they market the fact that they don’t have a minimum when effectively they do. Oh well. Now the good news is, I did get wait-listed at one program. We’ll see how that progresses. I’m undecided on if I’ll actually attend if I move from wait-list to accepted. And there’s at least one long-shot of a program I have yet to hear from. So we’ll see.
  • But, I will be applying to a number of the programs again this year. I’ll have a stronger resume in a number of ways, so I’m more hopeful. But I’ll be honest, if I don’t get accepted this year, I may explore other options in my life. If I were 5 or 10 years younger I might consider a lot more rounds and work more on my GPA, but the truth is, I’m not as young as I might like to be.
  • That said, I did get a lot of classes in over the year, including the microbiology class I needed. This was sort of a freebie. My employer, Albany Medical Center, offers this free to its employees over the summer, so I took it then. It was actually a lot of fun and I have to admit, I was a bit surprised to learn how much had changed since I took it 30+ years ago. Science really has marched on.
  • In addition, this fall I took Genetics. Not many programs required it, but one or two did and I figured I’d add it to my transcript. I’m glad I did. While the mechanics of the class was a bit frustrating at times (all virtual, some lectures had no videos, only PowerPoints), it was really interesting and I learned a LOT.
  • For my NCRC work, we will be hosting the 2024 National Weeklong here in NYS and I’m the site coordinator, so I’ll be getting busier and busier as June approaches. Interest has been great. We filled all the available class slots in 25 hours and as of today have 13 waitlisted for Level 1 and several each for Level 2 and Level 3. And as for TOTS, our medical focused class, I think we have a curriculum and will be asking for approval to do a trial teaching of it this year. So that’s all coming together!
  • I mentioned continuing to blog, but the truth is, I didn’t blog as much as I used to. Between needing sleep (see above about working, school, and more) and not having much to say, I just didn’t blog much this year. Oh well.
  • Reading: Honestly, I dropped the ball on this. I expect to continue to do so. I did reread Echo Heron’s book, Intensive Care: The Story of a Nurse. I recommend picking up a copy.
  • My goal of speaking once this year didn’t come to fruition. I was hoping to be picked to speak at Pass Summit about how to do a career change, but wasn’t accepted. Oh well.
  • I can’t say I saw more of my friends, but I did see a number. I also worked on schedule changes, twice now, so that should free up more time. So time won’t be a huge issue, but money will as I’ll be being frugal to save up money for PA School. But hey, let’s get together!
  • Septic System: well we got the design approved (that only cost around $10K!) but didn’t get it in this year. We’re hoping to get the quotes and get it started as soon as Spring comes.
  • Hiking, Biking, Caving – I did far less than I’d have liked. That’s all I’ll say for now. I will add though that I’m feeling a bit older and my body reminds me of it.

One thing that was NOT on my list of things to do, but happened anyway, was serving on a Grand Jury. On top of serving, I was also the jury foreperson. This was quite an experience. I saw a lot about how the justice system works and as foreperson I got to swear folks in (which I’ll admit, is kind of cool) and also review the final paperwork before it was sent to the judge.

So, that’s my year in review. Stick around until tomorrow and I’ll see what my goals for 2024 are. Hint, a few of them are listed above already!

And thanks for everyone who was with my on this journey through this crazy thing we call life.

Missing SQL Summit

I’m not going to be at Summit this year. And I have mixed feelings about that. This would have been my first in-person Summit since 2019.

I had hoped to go. In fact moreover, I had hoped to present. I even had a topic submitted on exiting the industry. As many of you know, my plans are to get into Physician’s Assistant school and change careers and become a PA. You can read about my adventures in numerous posts here. So I figured, instead of the plethora of talks on “So you’re new to being a DBA” or similar, I’d offer the opposite, how to exit the industry in a positive and productive way. But as a hedge, I made sure to buy a ticket at the early bird pricing, figuring if I was accepted to speak I could get a refund then.

Sadly, my topic wasn’t chosen. That said, if you’re interested in hearing it presented, let me know. Just give me enough time to actually finish writing the presentation.

But at least I had a ticket. I was set.

But then I started to wonder. Was it worth the time and money? I don’t make a whole lot as a ED Tech, and I’d be using vacation time, so I wouldn’t actually lose any money, but I also wouldn’t be able to pick up extra shifts. And of course I’d need flights, and a rental car (I stay with friends so lodging was covered). And I realized that the main reason I wanted to go was to see my #SQLFamily. And I’ll say, that’s not a bad reason. But it’s also not inexpensive.

I finally started to put feelers out about selling my pass, but wasn’t really pushing it. And then, Grand Jury duty happened. There’s a decent chance I could have impressed upon the judge how important it was for me to attend Summit, but I didn’t think that was really right. Though, had I been selected to speak, I think I’d have made that argument. It wasn’t clear exactly when my Grand Jury commitment would end, but it was fairly clear it would overlap with Summit, and it has. Though, in a cruel twist of fate, it appears that we will in fact finish up this week!

But enough about why I’m not there. I’m here to say, I miss you all. I miss the lack of sleep, the plethora of food, hanging out on the couch at Minionware, getting massages at the VMWare booth, catching up with friends, oh and actually learning about SQL Server and the entire Microsoft data platform.

I’ve been giving my departure from the SQL arena a lot of thought and a phrase keeps popping into my head, “the long goodbye”. For now it’s not a binary process. It’s not “one day I’m a DBA, the next a PA”. For now it’s more of a DBA by day (and sometimes nights and weekends) a student taking pre-reqs (and in fact just took notes on a prerecorded genetics lecture this morning) and an ED Tech by night and weekends (and sometimes days). But I’m drawing back. I can’t recall the last presentation I gave. I haven’t signed up for SQL Saturdays. I barely attend my own local User Group. Even my consulting hours have been cut back.

But every day I’m more and more sure I’m making the right career move. I find myself missing my IT work less and less.

I’m saying good-bye, slowly. And sometimes it’s bittersweet.

This is not my final goodbye. I don’t know if there will ever be a final goodbye to any of you. But for now, however, you all… I miss you. Enjoy Summit for me!

Life is Grand…. jury

Up until now, every time I’ve gotten notice about possible jury duty, I’ve been passed over. In NY, at least in my county, they have had a fairly sweet setup for decades. In the early days you’d receive a card in the mail with two numbers on it, one was your juror number, the other a phone number. You’d call the phone number on Sunday evening and listen to hear if your juror number was among those being called. For example, if your number was 190, the prerecorded message might be something like, “Jurors numbered 1 through 85 are required to report to the courthouse at 9:00 AM. Jurors 86-150 have to call back Monday night for further instructors. If your number is 151 or higher, your services are not required and you are excused for the next 6 years from jury duty.”

Up until this time, my number was always high enough I never had to report. But this time it was different. It was also for grand jury duty. And, being 2023, this time I could call in or check a webpage. I even received a text message the day of, to remind me to check. Sure enough, I was instructed to report Wednesday morning at 9:00 AM to the county courthouse.

This was the first time I had been inside and it was as I expected, lots of oak woodwork and portraits of judges overlooking the courtroom. And of course, uncomfortable chairs and benches to sit in.

After waiting what seemed like an interminable amount of time things finally started moving. We had to watch a video about implicit bias and how we should try to avoid it. Then the judge came in and gave us instructions. She then asked everyone who thought they met the criteria for excusal to form a line and she’d speak to them. I didn’t meet any of the criteria, and honestly, I was a bit curious about being on a jury, and I feel that it’s an important part of our civic duty to try to serve when called, so I sat, and admittedly fell asleep during this time.

Finally the excusals were done and 23 of the remaining 60-80 folks waited to be selected via lottery. For our grand jury there are 23 members, 16 of which constitutes a quorum and 12 required to move forward on a vote (so a majority if all 23 show up.) I was I think, probably about 18th to be selected.

After one final question regarding anyone being unable to serve and one woman being excused and replaced, we were given final instructions. Among these was the selection of a jury foreperson. Some poor fool volunteered for that role. So now I have to swear in each witness and when it comes time, take the votes on indictments report them to the judge.

A little aside: for those not familiar with what a grand jury and what it does, a little background. When post people think of a jury, they’re thinking of what’s known as a petit (small) jury or a trial jury. In the US, this typically composed of 12 jurors and usually all 12 are required for a verdict. This is what you see on most criminal tv shows and what Perry Mason was always able to (except once) convince of his client’s non-guilt. From talking to friends here in NY, those who have served on such have often served for a case lasting 1-2 days. It’s not a lot of commitment and as I said above, I think it’s a critical part of our duties in our civil system.

A grand jury is a bit different. In this case, only the prosecution is present and the goal is simply to determine if there’s enough evidence to go to trial. For example, a prosecutor might think that John Smith is guilty of robbing a grocery store. Before this can go to trial, the prosecutor has to convince at least 12 jurors (out of the 23) that she has enough evidence that a petit jury would likely find Mr. Smith guilty. Say, the prosecution has a video tape of John going into the grocery store at the time the crime took place, video of him inside the store holding a gun, and then video of him leaving with bags of goods. It’s very likely the grand jury would move forward with an indictment. The case would then go to trial. At the trial the defense can then present their evidence and argument.

But let’s say the prosecutor simply says, “well I know John is a criminal and two days later he deposited $500 dollars in his account, and we think that came from the robbery.” Well the grand jury probably wouldn’t be convinced and vote against moving forward with an indictment.

Also, during a grand jury, the jury can and in fact is expected to ask questions. This may be done to clarify a point or to try to get more information to help us make a more informed decision. And in fact, if we think there should be additional charges, we can recommend those to the prosecutor.

Anyway, back to my grand jury. I can’t speak of any details for a variety of reasons. Among them, simply saying, “Oh yeah, I was on a grand jury looking at if John Smith robbed a store” would be unfair to Mr. Smith. People might stop associating with him even if it’s determined there was no evidence supporting the claim. And of course if I said something during the grand jury proceedings and Mr. Smith IS in fact guilty, he might flee the area to avoid arrest.

All I can say in my case (and the Assistant Attorney General has clearly stated we can say this) is that my service is required 3 days a week, most likely for a minimum of 4 more weeks. In theory I’m supposed to be available until December 30th and if necessary they could even extend that. But, all expectations are that we’ll be done in the 4 weeks.

What I can add is that most if not all of us are taking our responsibilities quite seriously. After the first witness for one case (grand juries may or may not sit for multiple cases) was called, I had some questions I wanted to ask, but didn’t want to be the first person to ask a question. Fortunately someone else was willing to be the first and asked their questions. Then I asked mine. And from then on we were off to the races.

So far, out of the 23 of us, I’d say maybe 6 of us are the most likely to ask questions. The prosecutor has the legal right to deny an answer however, or to reword it. For example if a juror simply wanted to ask “Witness Pimba, what’s your favorite color?” That would be denied. It’s not a fact related to the case.

The prosecutor might reword the question in order to better meet certain legal requirements. “Witness Pimba, can you clarify what the speed limit was in that location?” The prosecutor might turn that into two questions, “Witness Pimba, what is the speed limit in that location and how are you aware of it.” This might be phrased this way in order to introduce into the record that the witness saw the speed limit sign there, or that that’s some statutory reason for their knowledge.

This relates to one of the details I find very interesting and that’s how evidence and testimony is introduced into the record. Sometimes there are a bunch of questions that seem trivial or irrelevant, but are there in order to form the building blocks to a bigger question, to set the foundation as you will. This means if there’s 3 similar charges, say on check fraud, the witness might be asked the same or similar question 3 times, one for each charge. For example, “When you received the check from Stacy Fromme, how did you handle it as evidence?” Since each charge is separate, the question has to be asked for each, otherwise subsequent questions couldn’t be introduced into the record. Even if the same procedure was done every single time, the question has to be asked each time.

Right now we’re in the listening and questioning phase. The only folks allowed in the room are us, the prosecutor, the witness, a translator if necessary, and the court reporter. The judge can be called upon to clarify a particular aspect of a law, but otherwise is not there. Technically there’s no defendant because they haven’t been charged yet. And of course because there’s no defendant, there is no defense lawyer. Even if a janitor walks in by mistake to empty the trash, all proceedings stop. Again the idea is to ensure the confidentiality of the proceedings.

So, for now, 3 days a week, I sit in a closed room listening to testimony and examining evidence. At one or more points, even the prosecutor and court reporter will leave the room and we’ll deliberate and votes on charges.

So, in the meantime, life is Grand… jury.

One Year In

Officially tomorrow, the 17th, will mark one year as an ED Tech for me. Unofficially, that’s not quite accurate. The first week was spent in a lecture hall on the first day, and then 3 of the next 4 days in a classroom learning some basic skills, including some I’ve honestly never used in the ED. The one skill I learned that I have used multiple times since, on Friday a year ago, was CPR.

Since then I’ve marked some milestones, such as 100 hours in, 500 hours in, a big one, getting my Red Badge so I’m allowed to be a lead tech on traumas, and of course 1000 hours, which was important, since that was the minimum required to apply to several of my top choice schools. I’ve at times felt like between my IT job, school, and this I’ve been running as fast as I can. Last week was such an example, over 56 hours in the ED as well as school and other work.

But, that 56 hours allowed me to hit another landmark. I’ve mentioned in the past that technically my job in the ED is only part time. I’m a .6 FTE, i.e. I’m scheduled to work 24 hours a week. That means in a year, I should 1248 hours. A full time job is typically 2080 hours in a year. I’m proud (and tired) to say, I hit the 2080 mark sometime mid-shift on Saturday night. I’ve picked up the extra hours for a number of reasons, but among them, I really am enjoying what I do and really am dedicated to showing the schools I’m applying to that I’m serious about my efforts. That said, I’m not averse to taking a bit of time off in the future. We’ll see. I have several more goals to hit, but this was one I didn’t really expect expect to hit until a few weeks ago when I did the math and realize it was possible.

I should note too that in theory for the first 7 weeks I couldn’t pick up any overtime.

In this year I’ve done and seen so much. I’ve done:

  • EKGs – more than I count, one shift I counted at least a dozen and that wasn’t all that atypical, so I’ve probably easily done several hundred by now
  • Traumas – these have ranged from the guy that came in with what was really not much worse than a nick to the neck (but at the time since the depth was unknown it was called in as a trauma) to stuff that I won’t describe or get into.
  • Sits – these can range from easy to difficult to even violent. I did get a black and blue from one psych patient that forcibly grabbed my arm.
  • Covid Swabs – again, more than I can count and while over the summer it became rare to do them, the number is ticking up again.
  • Intubations – I’ve written about this. It’s an amazing thing to see and I’m still in awe of the whole process
  • Deaths – yes, it’s a sad part of my job. I’ve seen those who have died peacefully and those who have died despite our best efforts. There’s a lot more I mean to write on this subject at some time. But the reality is, if you make it through our doors, you’re probably going to make it.
  • Raced stretchers to the OR – while a very rare thing, occasionally we have to get a patient to the OR as quickly as possible. We had one such event several weeks ago where the assistant nurse manager and I had to move one such patient. She was so busy doing a manual pulse check and then blood pressure on the patient as I was pushing the stretcher I had to warn her more than once when there was an obstacle in the way less she get squeezed between it and the stretcher.
  • Responded to Stroke Pages – among my duties here, besides gathering vitals, is to sit with the patient and nurse while they perform the CT and then getting the patient to their room and getting an EKG. Fortunately, most of the stroke pages turn out to be false alarms, but not always, and even then, if we get them in time, there’s a lot that can be done. As an aside, if you think someone is having a stroke, get help as fast as you can. Time matters.
  • CRP – I’ve lost track of how many times I’ve had to do compressions. I’ve also lost track of how many times I’ve gotten ROSC (return of spontaneous circulation). I did get one just a week or two ago as a matter of fact. Honestly, it’s pretty much the drugs and other efforts, I’m just circulating the blood until they can take effect, but it’s still a great feeling when it happens.
  • Emptied Hampers – yeah, part of the job. I do it pretty much every shift.
  • Restocked IV and linen carts – not fancy, but a necessary part of the job. It sucks to be in the middle of care for a critical patient and have a nurse ask for something, say IV tubing and realizing the cabinet in the room doesn’t have any!
  • Procedures – I’ve helped with a number, including some spinal taps, some suturing and more. Now to be clear, helping is pretty much limited to “hold the patient or this equipment…” but it’s still great to be in the room.
  • Made some great friends – I really love working with the folks I work with.
  • Had some fun along the way – yes, we’ve had our fun moments.
  • And so much more – Honestly, the stuff us techs do is pretty diverse and I’ll be honest, I probably couldn’t list it all (and if I did, I’d bore you more than I already have.)

So, what’s next?

Good question. Right now I’m still waiting to hear from a number of the PA schools I’ve applied to. If I get into any of the ones with a January start date and I decide to attend them, then I’ll probably break the 2300 hour barrier. One I’m interested in has a start date of August of next year, so that would mean breaking the 3000 hour barrier most likely. If I end up going into a second round of applications, I suspect I’ll have 4000 hours of Tech experience under my belt by then.

But until then, I’ll keep plugging.

As always: none of my statements here are endorsed by or reflect the views of my employer, Albany Medical Health Systems.

No CPR Tonight

Tonight there would be no CPR. I know often I promote the virtues of CPR, but it’s not always the answer and tonight was certainly one of those nights.

The overhead monitor was telling the tale. The patient’s blood pressure was currently 64/40 and the cardiac monitor was showing she was basically in asystole with a pulse measured sometimes in single digits per minute, sometimes a bit more. Right now only the drugs and fluids coursing into her were keeping her alive. Attached to her were the pads from the defibrillator.

At least twice the button on the defibrillator would be pushed and her body would jump as her muscles would spasm. She was dying. She had been dying all day. Her blood pressure and pulse had been up and down all day long. her body had been fighting to stay alive and a few hours ago it seemed like it might win the battle. But not now. Now it was just minutes instead of hours.

She had indicated she didn’t want CPR. So we stood there, waiting. For us she was a patient, but for the stranger in the room, she was his mother, she was the grandmother to his kids, the aunt to his cousins and the wife of his father. He watched, silently, a tear forming. The doctor was explaining to him what was happening and how she wasn’t in pain, but without the drugs her body would die in minutes, but meanwhile the drugs could keep her alive a bit longer if the rest of her family was on the way. They were. We left, as there was no more we could do in the meantime, and he needed to be alone with his mother more than he or his mother needed us.

I saw her family file into the room; quietly. I recall my own dad passing. Me sitting there, waiting for his final breath. More than once I thought his body had quit, but one more time he’d draw a breath. Finally he drew his last. I knew they’d watch the same thing.

It’s never an easy thing to have to say goodbye to a loved one. But sometimes you know it’s the right thing. Their body has given up the fight and to prolong it would only be a cruelty and indignity. Yes, perhaps with CPR and the right combination of drugs we could have given her another day, but it would have been a day of unconsciousness and sadness, not a day of joy and happiness, for her or her loved ones. Sometimes we just have to say good-bye. Tonight was such a night. She died surrounded with her loved ones, her ribs and cartilage intact, no bruises for the coroner to see, no sweat falling on her from techs giving her CPR. But she would did surrounded by her loved ones and that was right.

Disclaimer: My views and writings do not reflect those of my employer and in this case especially details have been fictionalized or altered.