He’s dying Jim!

Less than a minute after the mountain biker blew by me on the trail I heard the wail. It was scary. I raced forward with my hiking partner and very quickly came upon the accident scene. Thomas was laying in a crumpled mess, his $1500 mountain bike further down the trail with one more bend in the frame than the manufacturer had created it with.  This didn’t look good.

The hillside was steep and Thomas was on his side. I dropped my pack and went to backside of Thomas. Quickly my training kicked in. I introduced myself and asked him his name. His response re-assured me. He was breathing and had a pulse. And in medical terms, he appeared to be alert and oriented times three.

I put on my gloves (yes, I do carry nitrile or latex or material gloves pretty much anyplace I go, you should too!)  I then moved to his backside and palpated his head. So far, so good. No blood or cerebral-spinal fluid.  Since he was on his side, it was an ideal (if one could call his situation that) position for me to check his spine. Working down, so far so good until I got to the top of his lumbar portion. There I felt something very wrong.  Ok, shit just got real.  Upper torso, so far so good. Lower torso, right side, a reaction to pain. Barely noticeable, but definitely some mass internally. Again, not good. I continued down his legs. I got to his feet and normally I’d have saved this for the secondary survey, but since I already had a bad feeling and this wouldn’t take very long, I asked him to press his toes against my hands like he was pressing the gas. Nothing. I asked him to pull up his toes, again nothing.  This was not good. Same lack of reaction on the other side.  I could hear the panic in his voice, “why I can’t I move my legs?”

In all my past training they always taught us, “never lie to the patient. But also remember you’re not a doctor.” So I was honest. “Look, it could be a lot of things. I’m not a doctor so I don’t want to speculate. We’ll leave that to the professionals.” But deep down I knew. Bad tumble off a bike, bad position of a lumbar vertebra, and lack of sensation distal to that all added up to some sort of spinal injury. Would it be permanent, I had no idea.

I also checked his right arm since it was immediately available and this time came up with blood and point pain over the radius/ulna.  This matched what the accident most likely was.  He had hit a rock or something and wrapped his right side around a tree, breaking his arm, damaging his spine and most likely causing internal bleeding.

But I still had the left side to check.

With my partner’s help, we got a ground pad behind him and then rolled him very gently onto it. It’s always a risk moving a patient with apparent trauma like this but we needed to get him isolated from the could ground which was stealing his body heat and I needed to check for injuries on the left side.

Fortunately, this was the only bright news. A thorough check of his left side showed no apparent trauma. But, his shivering was getting worse and his mental state was decomposing. Whereas he was had previously been alert and oriented to who he was, where he was and approximately the time, now he kept asking the time.  Taking a set of vitals, things were not what one would like to get.

My partner was writing down all this information and giving me gear as needed. We had gotten the groundpad under him and clothing on top, but we needed to do more.  At this point, since we confirmed he wasn’t about to bleed out, we worked on splinting his arm. Providing traction in-line proved to be a bit painful at first, but ultimately gave him some pain relief and temporarily solved that particular issue. We did as much as we could in the back-country.

I took another set of vitals, and the numbers were a wee bit worse. In addition, Thomas was now wondering where he was. I repalpated his lower right abdomen and got an increased pain response and the firm area was larger. This was a very worrying sign.

While doing this, my partner ran down the trail with a copy of his notes until he got cell service and called 911. He gave them the details and then came back.  At this point, with his help we decided to get Thomas into a bivy sack to help keep him warm.  This took some effort since Thomas was bigger than either of us, fairly muscular and we were doing out best to protect his spine. But eventually we got it around him. Between this and some liquid “squirt” we were able to give him, his pending hypothermia appeared to stabilize and eventually improve.

But his vitals continued to degrade and the pain and mass in lower right his abdomen continued to get worse. He was dying and there was nothing I could do about it.

Well there was one thing I could do. I looked at Thomas and said, “well I think that’s it. Did I miss anything or do you think we got this exercise covered?”

He looked up and smiled, “Nope, I think you got it.  By the way, the biv sack really did help a lot. I was actually starting to get cold for real.” We removed the biv sack and he remarked, “Wow, you really did have a lot of warm stuff on me.”

Now, fortunately, all this had been an exercise, part of a SOLO Wilderness First Aid class I was taking over the weekend in order to renew my certificate.  The scenario was completely made up. But, I have to say, the feeling of helplessness was real.

Strangely though I’d say that was a good thing. For any skill we want to maintain competency in, we need to practice. Fortunately, I haven’t come across a crumpled mountain biker and most if not all back-country medical emergencies I’ve encountered have basically been fairly simple (an abrasion here, a blister there, or most commonly, mild hypothermia). But, continual practice does help. When arriving at the staged scene, I knew what I wanted to do and I knew how I wanted to do it and how to do it. The years of training and practice came back very easily. I knew how to do a primary survey and what I wanted to look for. I knew what vitals I needed and what trends I wanted.  There wasn’t much searching for knowledge, it bubbled up as needed. Practice really does in a sense “make perfect.”

And, even knowing that my mock patient most likely had internal bleeding that was leading to hypovolemic shock was good to know. Knowing that there was very little I could do if this was a for-real in the back-country was scary, but also strangely reassuring. I was confident that I had done all that I could reasonably do. And sometimes that may have to be enough.

I’ve talked previously about training as one fights. This should be true in any situation you may find yourself in: caving, the back-country, or even something as mundane as being a DBA. When’s the last time you practiced restoring a backup or doing a failover test?

Practice may or may not make perfect, but it does provide confidence.

P.S. if you’re in the Hampton Roads area tomorrow night (October 16th) come check me out speaking on System Databases at the Hampton Roads SQL Server User Group. Rumor has it, they’re serving wings!

Caving along the Great Divide

The title is a rife on a favorite folk song of mine, “Railroading on the Great Divide”, apparently first made famous by the amazing Carter Family. In this case, the Great Divide is a feature of a local cave known as Knox Cave in the town of Knox NY.

So, what do you get when you take 2 Canadians, a number of students who are just starting in college and a pair of cavers who have been caving for over 50 years each, two medical students, a fire chief, and a mixture of other people and toss them into a classroom and then a cave? You get an excellent teaching and learning experience.

I again had the privilege of working with a great group of people teaching a 2 day class on cave rescue. On the first day we test the students patience by seeing how many Powerpoint slides they can sit through. If they successfully survive that, we then unlock the doors to the classroom and let them outside. We then do some patient packaging and patient movement.  We end the day with a large quantity of food.

Often I’ll spend the Saturday night at the fire house (our typical location for these classes) but this time I had to head home. On the way one of my fellow instructors texted me to let me know that the student who was staying with her had not arrived at her house. We started to worry.  About an hour later the missing caver had shown up. Turns out she and several other students had decided to take advantage of a baseball backstop and practice their SRT skills and spend some time teaching each other. Even after a long day of teaching, the students were still eager to share their skills with each other.

On Sunday, we spend less than 1/2 an hour in the classroom, essentially just enough time to grab some breakfast and handle some housekeeping chores. We then start a practice rescue. In this case it was at nearby Knox Cave. While the students had known that the practice would be at Knox, they had no idea what the actual would actually involve.  So when the first group showed up, including the local fire chief who was also part of our training, they sprang into action. The reporting party told them that two cavers were in the cave. Both were at the Great Divide, one with a broken leg, the other taking care of the injured caver.

Very quickly the students found the the injured caver but quickly learned that no plan survives the first encounter with reality; the non-injured caver had wandered off and they had to go find her.  The apparently simple rescue had now become a search problem.

After a few missteps, the students found the missing caver and assisted her to the surface. And shortly later the injured caver was also brought to the surface.  It was a successful practice.

At the end of the weekend, instead of 22 students with very little if any cave rescue experience (including at least one student who had never been in a wild cave before) we now had 22 students who had gained a bit of experience and I would actually trust to call if a real rescue was called. From the reports I got back, everyone had fun and more than one person is now very eager to take our weeklong class next year!

For me, it was a long weekend with not enough sleep, but I ended it more energized than I started it. This is typical when I teach courses like this. It’s because I love the aha moment students often have when they’re learning, and this weekend was full of those.

I’ve been blessed to be surrounded by great groups of people over the years and I must say my cave rescue family is among the best, and I’m proud to welcome even more members to that family.

P.S. Don’t forget to check out my latest article at Redgate’s Simple Talk: How to Use Parameters in PowerShell

Dress for Success?

“Dress for the job you want, not the one you have.” This is advice I once heard years ago. Of course I’m not sure what you do if the job you want is the one you want.

Back around 1999 I mentioned to my dad what I was wearing to work. I think I mentioned something about cargo pants and hiking shoes. He admonished me that perhaps I should dress more appropriately for the office and see what the COO and CFO were wearing as an example.  I replied, “Dad, they wear shorts and sandals without socks to the office. I actually dress up more than the COO and CFO do!”  It took me awhile to convince him that in the new dot-com era, not everyone was wearing a shirt and tie to the office.

This all came to me yesterday afternoon as I was deciding what to wear to the Capital Area SQL Server User Group meeting. Since I’m generally the host, I do want to project a professional, but relaxed atmosphere. So, my usual fallback is khakis. But, I was also the speaker so I figured it wouldn’t hurt to make sure I dressed even a bit more appropriately. Fortunately, having been to a number of SQL Saturdays, I had more than enough choices. I ended up with my SQL Saturday Albany 2016 shirt. But as it is starting to be cool here, I figured tossing a top over that would work, and funny enough, I had my Chicago SQL Saturday 2017 top to toss on over it. I’m nothing if not a shill for SQL Saturday!

My kids will claim I have a certain style when it comes to what I wear and they’re right. And while it may seem I often don’t give much thought to what I wear, the truth is, my choice of clothing, especially t-shirts, is often far more deliberate than it may appear.  I just don’t let on often to that fact.

And the truth is, between t-shirts from SQL Saturday and from National Cave Rescue Commission trainings, I probably have close to a month’s worth of shirts if need be.

Makes me wonder, do I volunteer because I like to give back to my community, or because I need the t-shirts? Hmm.

 

 

“Don’t be so Sensitive”

I’ve mentioned in the past that I have an interest both in the SQL Server world, and the caving world. Often these both overlap in different ways, for example disaster planning and the like.

The other day I was reminded of another way in which they overlap: the ratio of men to women in each activity.  In both areas, though I don’t have firm numbers, far more men participate than women. There are a number of reasons for this, but one I’ll call “the good ol’ boys” attitude. I discussed this in a previous post concerning women in the industry. Recently however I was reminded that sexism continues to be a problem in the caving community. On Facebook, I’m a member of a number of groups with a focus on caving. The other day someone saw fit to post a picture in one of the groups I’m a member of. The picture was of a young woman, in a sports bra and short tights wearing a rock-climbing harness, and holding on to a dangling rope.

Now, there were several problems technically wrong with the picture, including the fact that she was wearing a rock-climbing harness and this was a caving group and the fact that the harness was on backwards.  But, that wasn’t the real problem.  The real issue was, this was that it simply was not appropriate for this group.  Several members posted pointing out that this picture, and pictures like this, objectify women and discourage them from caving.

And then it came, a guy saying, “Don’t be so sensitive.”

In four words, he casually dismissed the concerns and feelings of a large number of his fellow cavers.  He said, without realizing it, “I don’t care how you feel. Your feelings and concerns are not important to me.” In my experience, these are the very same men who then complain there aren’t enough women in caving.

Similar comments included, “Oh, now you’re saying she’s wrong to be proud of her body” or “what’s the matter with a hot body”.  Here the underlying subtext is that anyone who expressed an issue with the photograph in that group was a prude.

I’ve seen similar comments at times in the IT community; “What’s the matter if I call her pretty, she should be proud of that!” “What, DBAs can’t be hot too?”

What some of my fellow cavers and IT professionals fail to understand is that the women in these circles want to be considered by the same standards as their male companions, on their skills and accomplishments, not on what their body looks like.  This does not make them prudes.

Nor, when these same women dress up for a cocktail party, or have a beer, or crack a ribald joke does that make them hypocrites. This is also an important concept for many men to understand. The women I know who cave and are DBAs are just as complex and varied as the men. Some like to dress up, some like to tell off-color jokes in the appropriate setting, some like to smoke a cigar, and often do all the same things that their male compatriots do.  But when it comes to caving or IT, they want to be respected for their skills, not judged for these other attributes.

So, next time you’re about to post a hot sexy photo, or make a comment on a woman’s appearance, ask yourself, “is this the appropriate place for this? Would I do this if it was a hot sexy photo of a man? Would I make the same comment towards a man?” And as a hint, if the name of the group is something like, “Professionals in IT” or “Cavers of the World” the answer is almost certainly “no”. Remember, your fellow cavers and IT professionals are judging you.

The Next Generation

As I’ve mentioned previously, I’m a caver. I mention this when I speak as part of a dad joke, that as a caver, I really do know a certain body part from a hole in the ground. I won’t say it makes me unique, there are literally 1000s of cavers in the US and even more around the world.

Like any group of people, not all cavers are the same. Some love long expeditions where they may spend a week or more underground, mapping new caves and plumbing their depths. Others may go in to study the geology or search for fossils. Some are studying the biosphere within caves. I have a lot of respect for those folks. Me, I like to take beginners caving. I also like to teach cave rescue and to talk about it.

And I think my role in taking new folks caving can be as important as what many of my fellow cavers do. Yes, it means I often go into the same caves over and over again, and that may sound boring, but honestly, it’s generally not. I often get to see the cave again through new eyes.

What brought on this post was the fact that I had the opportunity to take a friend and her twins caving for a second time. The wonder and excitement that their 6 year old eyes brought to the cave was wonderful. Passages I took as boring and mundane they saw as exciting and exhilarating. Their enjoyment was a breath of fresh air.

I’m a member of the National Speleological Society  I support the NSS because it supports cavers. But, I have a nit to pick with some (certainly not all) of my fellow members.

Let me preface by saying that caves can be rare and unique areas. While they can appear to be solid, non-changing areas made of stone, they can be dynamic places and the presence of humans can easily have a dramatic, negative impact.  For example, people hiking a mountain don’t have an impact on it simply by breathing near the mountain (they can certainly have other impacts). But, bringing enough people into a cave can have a dramatic impact on fungal and bacterial growth simply due to the amount of moisture they bring into the cave with them. They can also bring fungi and bacteria into a cave that may not have been there before.

In addition, many once beautiful caves have been destroyed by treasure collectors who have broken off cave formations such as stalactites and stalagmites. Once removed, it can be hundreds of years or more before they’ll reform. Even touching a forming one can alter its formation.

As a result of this, I’ve seen a movement that appears to be growing of both gating caves and of not sharing the location of caves. While cavers have often always been a bit protective of cave locations, the perception, at least to me, is that we’ve become more so. We’re reluctant to share the caving experience because we’re afraid “too many people will come and ruin the cave.” And there’s probably some truth to that.

But, while I certainly favor protecting our caves, I think if we’re too protective, we end up risking losing the next generation of cavers.  And the NSS enrollment numbers suggest this may be happening.

So, I personally prefer to take beginners caving. Many will attempt to go anyway, so I’d rather they learn proper caving techniques and cave conservation.  I encourage others to do the same. Take the time to introduce others to this wonderful activity, and teach them how to do it correctly.  And fortunately for every caver that seems to have the attitude of not wanting to “let” novices into caves, there seem to be two cavers that are willing to take novices caving. So, I remain optimistic.

I’ve thought about this also as I look at the presentations some of my fellow #SQLFamily members and realized I do the same there. Many will have great presentations on complex topics and ideas. They’re great presentations. And I respect them for it and admittedly, I’m sometimes jealous of their knowledge and skills. Myself, I seem to prefer teaching more introductory topics. I think continuing to bring new folks into the world of SQL Server and into SQL Saturday and PASS Summit are important. In fact our speaker this coming Monday is Matt Cushing. He’ll be speaking about Networking 101.

To close, I think in any world, but particularly in the two I inhabit, caving and SQL, it takes all types, those who dive deep into the subject and those who take other paths. I don’t think one path is necessarily better than another. The only ones I have an issue with those are those who take the attitude that novices aren’t welcome. You don’t necessarily have to be the person welcoming novices, but don’t be the one that discourages them either. We need to build the next generation.  And that’s my take away for the week.

Busy Weekend Volunteering

As I mentioned previously, I was on vacation for about 10 days and got back to Albany very early Wednesday morning (or late Tuesday night depending on how one looks at it.) And once back from vacation I had to jump right back into two other events I had previously put on my schedule. This meant I didn’t have much time to catch up on work or sleep. But it was worth it.

A confluence of events meant that I ended up being double booked this past weekend. The first event was some special cave rescue training called a Small Party Assisted Rescue (SPAR) class. This was a 3 day class, Friday through Sunday. However, in addition, students had the chance to show up Thursday night in order to test on their skills before participating.  I was both an instructor for this class as well as the site and course organizer. My second event was SQL Saturday Albany, which I had been selected to speak at. I’m also the User Group coordinator that sponsors this event. This double booking meant that I couldn’t instruct at the SPAR on Saturday. I do want to note that at both events there were a number of other volunteers, and some were doing even more work than I was.

Between these two events, it meant I was getting about 6 hours of sleep a night plus putting in a lot of driving. It was a long, tiring, essentially 3.5 day weekend starting on Thursday. Additionally the jet-lag made it seem even longer.

Why do I mention all this? Because, both events are very important to me and cover two large areas of my life. I’ve previously written about some of my SQL Saturday experiences and SQL Pass experiences.  This is part of my professional life. I feel very strongly about volunteering and speaking at these SQL events. I enjoy running our local Capital Area SQL Server User Group (CASSUG) for the same reason. I’m a better DBA because of the shared experiences of my fellow speakers. I’ve written about this previously here and elsewhere in this blog. I hope I’ve helped others.

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Deborah Melkin discusses normalized vs. star schemas.

On the other side, as my slide deck often points out, I’m a caver. More critically I’m the Northeastern Regional Coordinator for the National Cave Rescue Commission. I’ve had the privilege of teaching 100s of people how to perform cave rescue, been a media resource during the 2018 Thai rescue, and have spoken and written on the subject. I am by no means an expert, I’m always learning, as are all my fellow instructors. But, we all are not only willing, but want to spend the time and money and effort to teach others. We are passionate about it.  I don’t mean this lightly. For this particular SPAR, while about 1/2 the instructors lived within 2 hours of the event and it was an easy drive, the rest either drove 5-8 hours, or spent all day flying on standby to get here or to get home. None were reimbursed for any of their expenses and in fact had to pay for linens if they wanted them.  They also had to take 2 days or more days off of work to come to New York.

Next summer, I will be the course coordinator for our 2020 National Weeklong here in New York State. This will bring close to 100 people to New York for a week of 14 hour days of teaching and learning cave rescue techniques. Fortunately, I will have a LOT of help organizing this event. But again, all the instructors and staff are volunteers who will travel at their own expense to be here and help teach.

So I spent my weekend volunteering, because I’m passionate about it. How was your weekend?

 

Tighter than I Remember

I’ve been reading a book off and on for about a year now called, Being Wrong : Adventures in the Margin of Error. It ties into my interest in meta-cognition and how we think.

We build a model in our head of how the world is. Often times it’s accurate, but often times it’s wrong. In my model of the world, the Sun rises in the East. This model is accurate and corresponds with the model most of us have. But I can easily construct related models that are wrong. Looking back I can remember that it was sunny on a particular day, only to find if I check the records, it was raining. My memory is wrong, but it created the model I had for that day. I can also create a model going forward. Last night, going to bed, the world I was going to wake up to was sunny. This was based on the weather forecast and the fact that the Sun rises in the East. Well, the Sun may have risen today, but it’s not sunny. There’s far too many clouds. So that model was wrong.

This all comes to mind because of a caving trip I did this weekend. There’s a fine little cave near here called Ella Armstrong. It’s really not much of a cave, perhaps 250′ of walkable passage total. But I’ve always liked it even though I hadn’t been there in 15-20 years. It’s got a nice vertical drop at the entrance that’s great for beginners. And it has an easy walk-in entrance.  As a result, I had been considering using it for some cave rescue training next year.

So you can imagine my surprise when two of my fellow cavers who had been there just a few weeks ago said I was in fact wrong and it’s not a walk-in entrance and that in fact it’s rather tight. I was surprised. I didn’t really doubt them, but figured perhaps we had a different definition of what we considered a tight entrance.

Now, let me take a little detour here and mention that almost every caver will at some point joke about how a particular cave has gotten smaller over the years. It’s a little lie we tell ourselves to account for the fact that many of us have put on a few pounds since we first started caving and some passages are in fact harder to get through.  The truth is, rarely due caves get smaller, though sometimes passages sometimes do get larger. There’s a cave in Vermont where I’m pretty sure fitting through 2 of the 3 tightest spots is probably close to impossible for me now. And I know the cave didn’t change sizes, so I’ll have to admit I have.

But back to Ella Armstrong. If you had asked me to describe the entrance prior to this weekend I’d have described it as about 12′ tall at its tallest and 3′-4′ wide most of the way to the top of the drop.

Well, as Saturday proved, the model in my head was only half right. The map lists the entrance as 8′. I’ll call that close enough to 12′ since it simply means there’s no chance to hit my head on the ceiling.

On the other hand, most of the entrance from the surface to the top of the drop is NOT 3′-4′ wide. It probably averages 18″ at most and in parts is just wide enough for me to work my chest through with some contortions. My first reaction when I got to the entrance was, “perhaps some rocks have fallen in and narrowed this from what I remember.” But, after I started to scramble beyond some of the rocks on the surface, I got to the bedrock, which I know hadn’t moved and realized that my model was dramatically wrong. It was tight enough that at one point I considered calling off our trip. It wasn’t that I didn’t think I couldn’t make it further down and past a particular spot; gravity would see to that. It was more that I was afraid I might not get back UP past that spot. Finally after some mental gymnastics I figured a way I could not only get down past the choke point, but felt comfortable thinking I could get back up past it. As I’m writing this from the comfort and safety of my home, you can see my mental gymnastics worked.  Actually, it turned out the crux move on the way out was a bit further up that wasn’t nearly as tight, but had a short shelf about 3′ up in a spot that wasn’t great on foot or handholds. On the way in, that spot didn’t appear to be an issue at all. So again, in the narrow space of about 20 minutes my mental model failed me.

The truth is, we make mental models all the time. It’s how we operate in the world. But sometimes those models are wrong. Sometimes in a positive way, the tight spot getting out wasn’t as bad as I thought, or in a negative way, the spot I thought would be easy, was in fact the hardest sport. But regardless of the errors in many of our models, we generally navigate the world in a successful manner. Being wrong isn’t necessarily the end of the world.

Unfortunately though, as much as I love this cave, it really is too tight to be practical for cave rescue exercises. Which is a shame, because it is a great little cave. And if you’re ever in the area and want to check it out, let me know. I’d love to take you. But I’ll warn you, it’s a bit tight in spots!