Now, wait a minute.
Things don t look too familiar ...
I had too much tequila last night.
Shelly West, Jose Cuervo, 1983
You ever had the experience where you suddenly wake up from a sound sleep and you have no idea where you are? You re jolted out of the unconscious fog to find yourself staring blankly at the bedcovers, the pillow, the clock, the person sleeping beside you, the dog chewing your shoes with a particularly satisfied slurp, and you have no clue who you are or how you got there?
That s how I feel coming back onto jems.com.
When last we talked, I was the local health department director in Volusia County, Fla. That was a few weeks before the Hurricanes of 2004, and I had already come to the realization that writing columns is a whole lot easier when life is a set of shifts followed by uninterrupted time at home. Three hurricanes in a row reinforced this opinion, and with the exception of an article published in JEMS ( Dancing with Charley and Frances, November 2004), life took me rapidly away from the keyboard.
To start, I m no longer director of the Volusia County Health Department. This is the direct fault of jems.com. At some point, I had written a column about rural EMS, citing the fact that I was originally a Kansan as granting me the authority to say something anything, really about rural prehospital care ( Country Musings: Thoughts on Rural EMS ). Having been a dedicated student of Mrs. Nora Lambkin in high school, I continued to follow her admonition that the first and last paragraphs of a theme must be linked. So after spending the first third of the work pontificating on the glories of the plains, I had to bring it back around to Kansas in the final sentence. I did so with a line asking, So when does the Director of Health for the State of Kansas retire?
Unbeknownst to me, one of the readers of that column was one Chris Tilden, acting director of the Office of Rural Health. He sent me an e-mail letting me know that, in fact, there was an opening for the director of health. At the time, I sent a Thanks, but no thanks note to him. But after the hurricanes, the recruiter found me again. Given the larger perspective on service gained through the hurricanes, I was open to talking about it. But leaving a community I truly loved was still the most difficult decision of my professional life, and I owe a huge debt to the many community leaders in Volusia County who encouraged me to take up a bigger challenge. After all, if you get a chance to come back to where you started, and to do so in a way where you can cause mischief for nearly 3 million people at once, it would be silly to turn it down.
On a side note, there is actually another, more personal, reason for coming back to Kansas. In high school I participated in a program called the YMCA Youth in Government, where for three days each fall we got to run around the Statehouse. Two years running I was a pretend senator, and the Kansas Senate Chamber is undoubtedly the most ornate in the nation. I can still remember sitting in the big reclining chair in front of the heavy, century-old desk and gazing around the chamber, thinking it would be cool to do this for real someday. When I was shown the Director of Health s office space at the interview, it overlooked the Senate wing of the Statehouse and my old desk was occupied by a Senator who was also a doctor. You couldn t write a story any better than that.
Anyway, I arrived in Topeka at the end of February 2005, and have been here ever since. My office does have the second-best view of the capital in the city a full-wall panorama of the sandstone building covered by the weathered copper dome framed against the ever-changing Kansas skies. The glass panes allow me to experience the full panoply of Kansas weather from my desk. They let in the sunshine in the summer heat; they provide little insulation from the winter cold; they tremble and move with the roaring wind. But they also let me see who s coming and going so I can hide much quicker, and every now and then it s fun to take a large cut-out figure of the Governor that we use for health promotions and put it in the window, overlooking the entrance to the building ( Work harder! She s watching you! Speaking personally, just having her cardboard visage in my office tends to limit my Spider Solitaire time).
So now I ve turned into an official public health person. In most states, that would also make me an EMS person, as EMS oversight usually falls within the Department of Health. Kansas is one of the few states where EMS functions independently under a separate board. I m able to keep my hand in the prehospital world through our interaction in trauma programming and public health preparedness. But while I may not be as intimately tied to EMS as I once may have been, I think the larger perspective allows me to get a better sense of how prehospital care fits into the overall spectrum of health, politics, resources, policy and health economics.
For the record, though, I m not totally out of the game. Several months ago, I crawled into the back of a car to do first responder airway management while the local fire department secured access to the victim, and we re working on an AED program for our state building.
It s not that I ve been totally out of the media loop as well since stopping these website missives. My current position involves a lot of interviews, both in print and on the air. My first big national quote, circulated by the Associated Press, was my answer to a question about the symptoms of avian flu ( I can t tell you the symptoms of avian flu because I m not a chicken ). I m getting better at it.
So here we go again, starting what I hope will be an extended conversation about those things that are important to us. For those of you who were kind enough to read my pieces of a few years ago, you already know what you re in for. For those of you who are new to this expedition, let me give you a window into the level of dialogue you can expect.
As I write this, I ve just finished up a FEMA ICS-400 training designed for heads of cabinet-level agencies. Because these are important people, they discuss important things like how the director of the Center for Public Health Preparedness has to cover the head of a lobster when she eats because it s looking at her. (The lobster s final vision would otherwise be of her smiling face burning through the honeycombed compound eye into the little lobster retinas, thinking I ll see you again in lobster hell, air-breather. ) Which led us to a discussion of how fresh seafood gets to Kansas, which led to a conclave on the presence of lobsters in grocery store fish tanks, which resulted in an observation that there are fewer lobster tanks out there, which produced speculation that this is because people don t want the guilt of selecting a lobster to die, prompting another staffer to mimic a lobster with rubber bands on it s claws squealing, I m cuffed. Let my people go! which prompted us to recall the exodus from Egypt, which led us to keeping kosher, which ended up at Kevin Bacon.Today, I woke up, looked at the keyboard and began the process of waking up trying to figure out where I am, where EMS is and how we re growing old together. Thanks in advance for coming along for the ride.