Course

Our home for the 5 days was turned over to the Japanese by the US government a number of years ago. Despite the downsize, the US military still maintains a substantial presence here including the remainder of the base across the road from where we are teaching. We heard reveille, the US national anthem and artillery practice from there, daily.

The Japanese government turned this parcel into a conference center. It is not typical of most US conference centers. The class rooms are large and spacious with comfortable seating and good technical support. The living accommodations are much more basic. Although I had a bed in a small room, many rooms are large open spaces where participants slept on futons piled on tatami floors (woven, mat-like). Dharmasuri and I had similar accommodations when we were here last January. We shared the center while with a number of groups with a broad spectrum of interests from adults to kids as young as 5 – 6 years old. Our meals are buffet-style, with some greens and sprouts, dishes with fish or pork and noodles. There is always enough vegetarian fair, and of course white rice with every meal. There was as a relative paucity of fruit and no dessert to speak of.

Each morning at 0600 we are greeted by announcements. At 0700 we have a community assembly complete with a flag raising, a speech or 2, and stretching. Everyone knows the drill. From childhood most people go through the same exact stretching routine called “radio stretching” accompanied by the same tune. When there are children here they raise the flag and stand out in front leading the stretches to music and narration. The other morning 4 kids raised the flag. It was hilarious. The point is to raise the Japanese and center flag in unison to the national anthem, reaching the top just at the end. The kids struggled with the process, getting the halyard twisted in the pulleys and either getting the flag to the top too soon or in a mad rush after the anthem was completed. They were kids being kids. Not once did any of the adults seem angry or frustrated. In fact everyone got a good laugh with their efforts. In addition, the kids had daily clean-up chores around the facility including their rooms.

I continue to be impressed with how well Isamu and Tak (our 2 Japanese instructors) translate for me. This is not as easy as our usual courses because of the amount of technical language used in the Wilderness Advanced Life Support course (WALS). Neither of them have a strong clinical background. It is an ongoing challenge but one we are all meeting. The feedback from our students bear this out.

Tak was worried on the last day because several students complained to him about the course the night before. He wasn’t sure if he should tell me. Because of the varied backgrounds of the students and the instructors I work with on this course, each course has a different feel and emphasis. I think the people he spoke with were expecting more practical skills and less medicine. Although we cover a lot of skills (and this one had more than most), the focus really is on how to use medicine in a remote environment. I sometimes joke that this course is a bait and switch. We entice people in with the word “advanced” but then downplay the value of technology. The advanced part has more to do with knowledge and its application than it does with tools and medication. And when it comes to patient care, basic skills may be even more important. True to form, the most experienced are the most restlessness about having to sit through the basics. They are also the ones who come up short when it is time to perform. My job is to offer opportunities. There are lessons to learn; some students are more open to learn them than others. The beauty here is that it is up to each individual. You can’t possibly meet all of their needs but we do try.

In the end the course turned out okay. The critics were quite happy and the vast majority of the students were thrilled. I have learned to temper my emotions and expectations about each one of these.

Iceland #3 Gufuskalar

Gufuskalar

One of the goods pieces of news I got was that the course was planned for Gufuskalar.  It is a 2.5 hr drive on a good day up the W coast of Iceland, near the tip of the Snæfellsnes Peninsula.  The facility itself is an abandoned Loran – C station that had been maintained by the USCG until 1995.  It must have been a tough location to live for a single enlisted person or young family because of its location and weather.  In the past, I have experienced fierce and persistent winds in the 80s that drives rain and snow like darts and takes your breath away.  Still it is a unique and overall rewarding place to work because of these conditions and the dogged and uncomplaining nature of the Icelanders.

The class turned out to be smaller than expected because a number of potential students withdrew .  It was probably a good idea that our student from Indonesia was one of the ones  who decided to bail.  A medical student, a couple of nurses, physicians and an EMT from Iceland as well as a nurse/paramedic from Finland showed up.

The first day was like most.  I lot of talking about basic stuff.  They are all courteously attentive and no one left.  Although the weather was clear with just a touch of a breeze (about 20+MPH) in the beginning, conditions worsened toward the end of the day.   The second day was pure Iceland and it stayed much the same through Friday.  The attached picts and your imagination

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will give you an idea about the sights and sounds in Iceland.

The true value of this course (Wilderness Advanced Life Support) is really dependent on smart people with good ideas who are open, willing to challenge what I have to say and willing to share their ideas with all of us.  I also have an expectation to learn new ideas that I can steal and then share with students at subsequent courses.  Especially as we look toward doing more international courses, flexibility in what and how we teach are ever more important.  There are new medications, tools, and procedures.  There are even different generic names for familiar medications (e.g., paracetamol for acetaminophen; salbutamol for albuterol).  This course worked for me.

As I intimated earlier, the landscape is breathtaking, some of it practically in our front dooryard.   Snæfell mountain is across the road from the classroom.  This 1450 m+ (4750 ft+) inactive volcano typifies Icelandic geography.  The land begins as flat coastal and then rises abruptly.  Because of the weather, Einar took a different route back to Reykjavik.  Unfortunately, the conditions made taking any good pictures a joke.  Suffice it to say, I saw more of this stark beauty.

I spent my last day in Iceland packing, sightseeing and visiting with Einar and Muncey.  They seemed happy with the outcome and are hopeful we can do this again in 2 or 3 years.  There was a young physician in the class that we hope will be interested in taking over from me in the future.

I made it back to GA despite arriving at the Keflavik airport 35 minutes before departure, lugging 75 lbs pounds of luggage on my back between terminals at JFK and surviving the cattle call for my flight to JAX.

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And you wonder why I do all of this

Iceland #2 This and that

I am here.  On arising Monday, I was met with the kind of weather one expects here in March.  It was blustery, with overcast skies and occasional rain. Before leaving, Einar and I had lunch with Huskie (another instructor) and then spend a few hours in the ICE SAR office. 

Monday was a big news day because it is the first day of the corruption trial of the former PM of Iceland.  Many believe that he is a scapegoat for the financial crisis that befell Iceland in 2008.  In the end, as in the US, it is the privilege of the newly empowered party to beat up their predecessors.  The irony of course is that although he is not completely blameless, the groundwork was laid by his predecessors and others more culpable have been let off.  As Einar said, the former captain steered the ship of state toward an iceberg and then handed the helm over to his successor before the collision.  Though I could not understand the news cast, the former PM had a look of equanimity, an almost resigned sense of amusement.  No one I talked to had any doubt as to the unfairness of it all.  They laughed when I asked if this was a kangaroo court.  It was a new expression for them but one that made sense.

I don’t understand all of the details, but from the govt, to the banks and down to inexperienced investors, the eyes of Icelanders were bigger than their stomachs.  Many individuals were playing fast and loose with investments, with hubris rather than real knowledge.  The banks made choices that were predicated on delusions and they over extended their capabilities.  When things crashed Icelanders were shocked and demoralized.  The announcement came with reassurances that only one large bank would fail.  Soon, others did as well.  Sound familiar?  Despite Parliament’s plan to seek bailout money for the failed private banks, Icelanders resisted.  Their currency has been significantly devalued (1:60; now 1:125), but they are slowly working their way out of the mess. 

They often use the expression “that is a 2007 idea” or some variation to indicate a foolish or unjustifiably optimist idea.  2007 was the apex of their financial delusion.  They are resigned and seem to have surprisingly little bitterness.  

The class starts on Tuesday.

Iceland #1

I didn’t blog for our Africa, Japan and cross country trips.  I wished I had.  So, here I go again. 

ICE SAR (Iceland Search and Rescue) was our first foray into training non-NA WMA instructors.  That it has been modestly successful is a source of great pride for me.  They have offered encouragement and a model for doing business in other countries.  It is because of this and the friendliness of the people here that it is always a treat to come back.

As you may know, I have gotten a device that will allow you to see where I am.  Well actually, it is a house arrest device that allows my parole officer to keep an eye on me.  It is a part of my life that I was reluctant to divulge but the secret is out since Vantuil blew my cover.  Log on as I suggested previously and use the password (maine2georgia).  You will see my current location with a + below and to the R.  Clicking on that will show my entire cookie trail.

The trip itself was uneventful.  I was stuck at JFK for 6 hours.  In the late afternoon I went out for a walk in the sun (you will see why later) and to gain access to open sky for the locator.  At one point, I was approached by JFK security while I sat on the concrete at one end of a traffic island, leaning against a sign post reading my Kindle.  (A scene fitting of Grandfather J.  All I needed was a bag lunch)  The officer was, I suppose, appropriately interested, especially after he noted the stubby antenna of the locator peeking out of my back pack, indicator lights flashing.  Apparently I gave him a plausible explanation.  He sent back to the terminal and suggested I not allow the police to catch me doing the same thing.

The flight was a flight.  No meals were provided so I ate before boarding.  Considering airline food, that is not a bad idea.  After a perfunctory passport check with no questions, I collected my bags and waited for Einar. 

The trip for Keflavik was remarkable for the fact that there was actually blue sky.  In my 4 prior trips, it has always rained or snowed, often with a bluster wind.  In fact, the whole day was sunny.  Einar, Armand (Muncey) and I spent the better part of it in Salfoss talking about curriculum and what they have been up to.  As a surprise, they arranged a flight for me over the S coast and Westman Islands, where both grew up.  This cluster of islands (too small and close to be an archipelago) is part of a volcanic uprising with several obvious, small craters.  The main island supports a year around population of 2400.  This is the tropics of Iceland.  Crops other than grass for cows grows here, even, allegedly the other kind.

As is typical of N Atlantic coastal weather, clouds and fog rolled in cutting things a bit short.  All in all, however, it was really wonderful.  Iceland is one of those places whose beauty is in part highlighted by its subtlety and sometimes starkness.  This was even more apparent today.  The flat coastal plains actually had some interesting bumps and accretions to provide some geography.  There were irrigated fields that were more trapezoidal than rectangular with prior plow furrows outlined by the snow.  Most interesting were the streams and creeks that wended, serpentine-like to the ocean.  It was like looking at an Andy Goldsworthy piece of art, like the poster for the movie Rivers and Tides.  From the air, the clouds and fog looked like a gathering dust storm right out of Lawrence of Arabia, converging on us from both sides.  Our pilot was able to read it all well, maneuvering to get a good look and then landing before we were caught. 

At the end of the day we headed W back to Reykjavik as the sun was dropping behind the mountains.  I was treated to a most beautiful study of gray-scale lighting.  The mountains had horizontal striations, layered irregularly with white snow and shadow-casting boulders.  The effect was what seemed to be a complete spectrum of white to black with more shades of gray than were possible…but there they were.  I wanted to stare but at the same time see everything at once as the shades changed and the contours morphed as we moved forward, the sun falling further behind the mountains.

I know the source of my genes.