By Antonio Graceffo
First of three parts

As I spent most of my life learning to end life, it is a bit of a change learning to save it.

“Bakers cover their mistakes with frosting. Carpenters cover their mistakes with paint. Paramedics cover their mistakes with dirt.”

The paramedic course began with a playing of the Philippine national anthem, followed by a prayer. As I was in a Catholic rather than Buddhist country, it was so refreshing not having to take off my shoes. And, unlike Thailand, I was permitted to point my feet at anyone I wanted and even rub their head. It’s good to be among my own people . . . sort of my own people.

Aiden Tasker-Lynch is the owner of our school and the primary instructor. He hates George Bush, which is a good thing. He hates Americans, which I could understand but could also do without. Being Irish, he also hates Britons, which I feel ambivalent about. So when class gets boring, I bring up stories of my family being driven off their land by imperialist British soldiers who burned our thatched hut.

“The f—ing British,” Aiden begins. “They are worse than the Americans.” Once I get him on this subject, we are guaranteed at least twenty minutes that we don’t have to take notes. Or just one note, in case it comes up on the test. I simplified the British/Irish thing for my classmates. It reads, “British bad, Irish good.”

I enjoy studying with the Irish. They are one of my favorite translucent people. And as organ sales are common in Philippines, being the owner of two healthy kidneys, I try to form friendships with rich alcoholics who may need to buy one.

Or is that the liver that alcoholics need? Probably not. Liver and alcohol upset your stomach. Anyway, I could sell them one of my livers if things got really desperate.

You do have two livers, don’t you? That would be an example of one of those times when I should have been taking notes instead of winding Aiden up.

More excitement in EMS
Aiden is recognized as one of the leaders of emergency medical services (EMS) in the world. I was Googling his name the other day and was blown away by how many times he is mentioned in professional journals.

Aiden founded the EMS systems in a number of countries, hired the staff, trained them, and bought the ambulances. He was a dive paramedic and a member of the faculty at the dive academy in the UK. He was a military paramedic and who knows what else. Maybe he was a rescue swimmer like Kevin Costner in The Guardian. The man knows his stuff.

Ma’am Joan is Aiden’s wife. She is a Filipina and is certified as both an RN and a paramedic. She is our second primary instructor. Aiden and Joan both said that once you learn EMS, you don’t want to do normal nursing anymore because ongoing patient care is boring in comparison.

My friend and classmate Ben is an RN, but he is becoming an EMT because he didn’t want to wash the patients. “Sometimes you even have to clean up their poop,” he confessed. I could see why four years of really difficult university studies followed by intimate contact with excrement could be a downer.

Aiden’s take on EMS versus medicine is this: “We see the patient from the time of the injury to the time they get through the emergency room. After that, they become boring. We are lucky to have them at the most interesting time.”

It also seems that in EMS when you rescue someone, they thank you, and the family also thanks you. But once they are in the hospital as long-term patients, they behave like hotel guests and start complaining. Once again, to have four years of university studies capped off by complaints about dinner–it would feel like being a highly specialized waitress.

“I am [probably] the only RN who ever came back to my country,” said Joan.

Ben told me that the normal RN salary in Philippines is P5,000 per month (about US$120) . In most of the world, with the exception of the USA, paramedics actually earn more than nurses. The reason is that the US set up their paramedic programs in the 1970s, so they are already established and well-manned. In the rest of the world, 911-type response systems are new, and training programs are either developing or nonexistent. In these countries, there is no shortage of doctors or nurses but a fully qualified paramedic is a rarity.

English the world over
Most of the course is taught in English, but the students sometimes ask questions in Filipino. It is OK. I am trying to learn the language. Generally, even the instructors don’t know the Filipino words for the specialized medical vocabulary. This country is so America-centric, it is amazing. I think it is one of the few places on earth in which people still like Americans.

When I walk down the street people always shout, “Hey, Joe.” The first time it happened, I looked around for my father, but then I realized it was me. We all look alike.

There are innumerable dialects and languages spoken throughout the more than 7,000 islands of the Philippines. Tagalog was chosen as the national language simply because it was spoken in Luzon, the big island where Manila is located.

Many Filipinos resent being forced to speak Tagalog when they meet their countrymen from other parts of the country. Since they don’t speak to each other’s dialects, English was seen as a politically neutral lingua franca. So it is normal for Filipinos to speak English to each other if they have trouble communicating in dialect. It is also normal that university and school courses are taught in English. So having me in the class only slightly alters the language usage. Still, I am amazed that the Filipinos are so polite that the presence of a single Kano (Amerikano) encourages them all to speak English.

While their accent is American, unlike Hong Kong, their pronunciation is at times, a bit . . . creative. At first I thought I was the only one missing out on one word in seven, then I realized they have trouble understanding each other.

Ma’am Joan was saying something about “blacking the arteries.” We asked her to explain what that meant and she wrote on the board, “Blocking the arteries.”

“Oh! Blocking the arteries. That makes more sense.”

“Yes, blacking the arteries,” she repeated. “Try to listen more closely next time.”

I have no idea what it will be like when I start doing my practice on the streets of Manila and people are shouting at me in a language I don’t speak, and then I discover it is English.

Our first lessons were on human anatomy. Here I had another linguistic adventure in trying to understand Sir Aiden. Apparently, in nearly all biological terminology, the people from UK and Ireland put the accent on a different syllable than the Americans. The spelling is the same, but they move the accent in capillary, bronchioles, and many other words.

They also refer to the gurney or stretcher as a “cot,” which was doubly hard for me because when I used to have a British girlfriend, she taught me that in UK, a cot was what Americans call a crib. But now, in the ghetto, “crib” is what Americans used to call an apartment. And in EMS class, a cot has wheels on it and is used for moving injured patients.

Many of our training videos are from those islands where leprechauns run free, and everyone drinks tea instead of coffee and lives in a castle. Most of the English ones aren’t too bad, but Aiden has a slew of videos from Scotland. Those people should just be fitted with a subtitle generator at birth. I have no idea what they are blabbering on about. I could see from the glazed look on my classmates’ faces that they don’t understand Scottish any better than I do.

This confused me because in school we were taught that the British invented our language, but none of them seem to speak it.

When I protested, Aiden mumbled, “Bloody American.”

From martial arts to EMS
Through years of martial arts training, I knew some of the anatomy, like carotid artery. This is where I strike with a chop, to knock a man out. This technique is often referred to as a “Jap drop.” Not very PC, I know. Kidneys are something I hit with a knee. Trachea is with the open hand. The armpit contains the axially artery, which is one that has to be done with a knife thrust

Aiden told us, “As an EMT you will have life and death in your hands. And what you do will decide if the patient lives or dies.”

As a soldier, I was taught almost the same credo, but in reverse.

During this course I am always amazed at the variety of things we learned in high school. We had basic anatomy, biology, chemistry, etc. I didn’t think I had learned anything useful in those classes, but when we see it in EMT class, although I don’t know it cold, I know I have seen it before. What I like abut EMT is learning all of the life-saving techniques without having to struggle through biology, chemistry, and math, which would be impossible for me. That’s why doctors have to be clever people to get through their years and years of education. I have a huge respect for them now.

Our goal in EMS is very simple: to keep oxygen going to the brain till the patient gets to the hospital. Without oxygen, the brain begins to die in four minutes. Organs take fifty minutes; skin and muscles take five hours.

The EMT must assess quickly and decide to “load and go” or “stay and play.” You have to make a lot of decisions within a short period with the pressure of life or death hanging over you. Being an EMT is not so different from working on Wall Street or even boxing. It appeals to me.

When I teach self-defense, I always tell people not to fight especially if the assailant has a knife. Self-defense is like baseball: the goal is to run home. If you reach your destination alive, you are a winner. In EMS, the goal is to help the patient reach the hospital alive. In most cases, you don’t stay and fight: you run away and save a life.

Aiden and Joan are very religious, and they have a nice philosophy which they live by. “People arrive on the scene and see problems. We see solutions.” That was Aiden’s EMS motto, but his next statement was like a lifestyle mantra: “The only true problem is death, because once it happens it can’t be solved. Everything else has a solution.”

He asked my class, “Have any of you had a problem in your life? Yes, but you solved it, didn’t you? So you didn’t really have a problem. You had a solution. And you know how I know? Because you aren’t dead yet.”

The rule book said, “Safety first: Size up the scene.” Make sure it is safe for you and your patient. Don’t go from being a paramedic to being a patient.

Relating this to going back to Burma as a combat medic, however, you are in the same danger zone as your patients. And you can be injured, but have to focus and work. I had that experience when we had an accident on the Burma border. I was knocked unconscious but still had to crawl around and render aid.

A friend working for a security contractor said that they hire both SWAT and ex-military to work as security contractors. He said that they were both good, but the problem with the SWAT guys was that when they were rushing into a building to get a sniper out, they assume that their back is safe. The danger is only coming form inside the house. But, in real combat the whole area is hot. There is potential danger on all sides. It is the same for combat paramedic. You are almost never safe. In fact, since you are traveling with the troops, then it stands to reason, if they are injured, you are in an unsafe place, but you still have to go about your work.

My family and friends keep sending me e-mails that say things like, “We are so glad you are out of Burma and safe in Manila.”

I like the people here, so I don’t want to insult anyone, but Manila is a lot more dangerous than Burma. Violent crime is rampant, and people get shot here all the time. And, unlike in the States, you can’t trust the police or emergency services to come help you. We are the best EMS in the Philippines, but we didn’t graduate yet. According to Aiden, in Manila, of 280 EMS calls per hour, less than 20 get answered.

One of the UK training videos we watched was of a paramedic on a motorcycle. The idea is motorcycles can arrive at the scene faster and start rendering aid while waiting for the ambulance to come and evacuate the patient.

“Any comments?” Aiden asked, when the video had finished.

“Cool uniform,” I said.

“We all wear that flash-green jacket and helmet in the UK.”

“No, I meant the leather pants. Do we all get to wear leather pants?”

“No, EMTs don’t generally wear leather pants.”

“Well, is there some other career I can pursue where I do wear leather pants? I don’t want to throw away six months of hard work and study only to continue wearing cloth.”

The only career I could think of where I could wear leather pants was go-go boy, but I had already done that one. My go-go license had lapsed, and there were no course openings in Manila.

Aiden told us that in the UK all people are assigned a primary care physician from birth. “For the rest of our lives, if we have a medical problem, we get free medical care. If you are injured and need to get to your physiotherapy appointments, the ambulance will transport you for free. That is what a government can do if it sets its priorities on the people.”

Yes, maybe in a perfect world. But if governments squander their tax budgets on medical care, how will they fund the military?

Saving lives is a calling. Aiden served in the military, but in UK an army medic is a noncombatant. In the US military, he is a soldier first. He is armed and must engage the enemy if called upon to do so. The same is true in the war in Burma where no one can afford to specialize. I want to learn paramedic skills to help save lives, but I favor a military solution in Burma. I believe there are times that violence is justified or even called for.

Aiden, on the other hand, finds killing appalling. For this reason he is better at his job as a paramedic. “Only God can take life,” he said.

Antonio Graceffo is an adventure and martial arts author living in Asia. He is the host of the Web TV show, Martial Arts Odyssey. Currently he is working inside of Shan State, documenting human rights abuses and doing a film and print project to raise awareness of the Shan people. His videos about martial arts, Burma, and other countries are available here.

Antonio is the author of four books available on Amazon.com. E-mail him at antonio@speakingadventure.com or visit his Website. He is self-funded and seeking sponsors. If you wish to contribute to the “In Shanland” film project, you can donate through Paypal, through this page.

 

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