You’re not in Kansas anymore…

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In the past couple of months I have been in a discussion on 2 instances where EMS providers wound up in the news for actions (or rather inactions) that were clearly the result of fear for their personal safety. In both instances, the providers took the very posture they were taught in school, “If the scene is not safe, you don’t go into it.”

Of course after each incident, all the brilliant minds on the internet got into mob justice mode and started screaming these providers be jailed, fired, and all other manner of punishment for their doing exactly what they were instructed to do. 1 is facing criminal charges.

In my not always humble opinion, ok…In my rarely humble opinion, we should expect much more of this and there by the grace of god go you.

But in one of the discussions on the matter, an obviously experienced provider and I were basically reflecting on our experiences working in “the ‘hood” and survival skills we learned there. The consensus was many providers who find themselves working in dangerous neighborhoods are actually unaware and unprepared for working with an entirely different culture of people.

Because of the same cretins on the internet, let me just get something straight right now… Color is 1. Not a distinction of race. All humans on this planet meet the scientific requirements to be considered Homo Sapien Sapien.(AKA modern humans).   2. The differences in our behaviors are cultural.

The purpose of culture is to identify members of a group for the security and distribution of home range resources and reproductive rights. While it is possible for one culture to antagonize another, it is not possible for different colors of people to antagonize each other based on which species they belong to.

But now that we got that out of the way, let’s imagine for a moment?

If you went to a different country, where people looked different, had different values, spoke a different language, and were complimented or insulted by different forms of speech or gestures than you, would you be a little nervous? Perhaps you would be outright terrified or any level in between?

If you have lived in your home for any length of time, you are probably rather comfortable there; perhaps comfortable with your whole neighborhood. It is your world; it is familiar and puts you at ease. Your neighbors are probably just like you. You are not afraid of the dark in your home. You may not be afraid to walk outside at night. For the most part you can anticipate and predict what events will occur. It feels “safe.”

Depending on what source in anthropology you want to cite, the USA is made up of at least 6 and depending on how “culture” and “subculture” is defined, probably many more. In a country of 330,000,000 people, with such an enormous landmass, it should not come as a shock to anyone that not everyone is like they are. Compare the USA with Europe. In roughly ½ the area of the USA, there are approximately 50 different countries, speaking 24 official languages and a few unofficial languages and immigrant communities from outside the continent speaking their native dialects.

The differences of these cultures and languages in Europe are responsible for some of the greatest wars and man-made calamities the Earth has ever known. An area ½ the size of the USA! Let that sink in for a minute…

So, when you go to a different neighborhood or community in the USA, it is very possible your experience can be like being in another country. Whether you are from a middle class suburb going to a poor inner-city neighborhood, a liberal Yankee from New York City visiting Southern Louisiana, or a Mid-Westerner visiting California, you are for all intents and purposes, going to what is a completely different culture than your own. The language may even be different! The people might be a different color. They may be complimented or insulted by different gestures. Think of it like going to a different country.

You can expect to be afraid. You can expect to not be able to anticipate or predict what will happen. You may feel threatened by “normal” behaviors of the natives which in your culture are not common or acceptable. Your fear is physiologic. It is natural.

Understanding your feelings and physiologic responses to this noxious stimuli can help you manage your actions when interacting with people from a different culture. In order to reduce your anxieties, to be able to comfortably interact and feel at ease, you must learn the culture (and language) of the people you are interacting with.

Quick history and culture lesson, originally the Northwest Territory, which encompassed a multitude of modern states, including Ohio was huge. Have a look…

NWT

Now when this large territory was divided, whoever drew the lines certainly didn’t draw the lines based on culture or language. Modern Ohio has 3 distinct cultures. The Northeast is similar in culture to the East Coast and most of its people do not identify as being part of “The Midwest US.” The Northwest culture is almost indistinguishable from the people and culture of Michigan. Then there is Southern Ohio…or as it is sometimes called “West Virginia Annex.” For all intents and purposes, they speak a different language.

Let me give you an example. Some years ago I really wanted to impress a girl from Southern Ohio. I am from Northeast Ohio.  She actually agreed to go to lunch with me. Think about this… We are from the same State. We supposedly both speak English. We are the same color. We worked in the same industry. This should have had all the makings of a great date. The first thing we tried to do was order something to drink. She asked for a soda. I asked for a coke. When the waitress brought the drinks, I had a caramel flavored cola product from the Coca Cola Company. She had a glass of ice cream with carbonated water and chocolate syrup.

There is a catchy little poem somebody once made up. “You’ve done it I exclaimed with a scream and a taunt; it’s just what I asked for, but it’s not what I want.”

She was not happy with her order. She wanted the same thing I had ordered. This caused stress to both the waitress and me; the waitress because she had to make this right and me because my good date was not starting off as I had anticipated. Fortunately, we both had a good laugh over Ohio being 3 different countries.

But the difference doesn’t have to be 4 hours across the state. Some 15 miles, not 20 minutes’ drive, from my childhood home is according to one source, the second most dangerous neighborhood in the USA. It boasts that your chances of being a victim of violent crime are 1 in 6. It is certainly not the predominantly middle class suburb with a population that 90% identify as “white” I was from.

Until a certain point in my career, that is what I knew, middle and upper class suburbs. The “emergencies” and “illnesses” people suffered from in those places were for the most part the problems of a wealthy society (power outages, broken pipes, the occasional fire which destroyed insured possessions, heart attacks, strokes, the occasional serious car accident, etc.). Myself and many of the people who lived in those suburbs knew of what we called “the bad part of town” was.  Aka lower middleclass and “poor” people. This is where you could find drugs, petty thefts, and other “undesirables” with the occasional fight broken up by the police in minutes.

But in my quest to be a top quality provider I knew I had to go where the action was. When the opportunity came up I signed up to work (and volunteer extra shifts just for experience) without hesitation or doubt in the second most dangerous place in the country. If I had the opportunity to sign up for number 1, I would have. It just wasn’t conveniently 20 minutes from home.

I went from the pristine fire stations and trucks cleaner than your dinner plates, of the suburbs to a red brick building that looked like it had never been cleaned in history. The only “windows” were glass block at nearly the height of the roof (for safety). The door was heavy steel, and looked more like a bank vault. The parking lot a chain linked fence topped with cyclone wire. I was looking for action, and I had come to the right place. Surprisingly, there were no calls…until the sun went down… After hearing a few gunshots sitting in the station, I expected to be dispatched to a gunshot victim. Those calls never came. I didn’t even hear sirens indicated the police were on their way. Then it happened! Respond to just a cross street for “a man trapped in a car on fire.” Score!!! A few blocks away, in a street I would describe as an alley, unworthy of a name, much less a major cross street, was a burning car, people were shouting “there was a man in the trunk.” Without hesitation some firefighters started putting water on the fire. I was not really helping, more observing, as the crew I was with opened the trunk, and pulled out a conscious man who was suffering from burns (that’s when I actually got involved hands on). It was evident from their efficiency and skill, the guys I was with had done this before. This was the start of what would be a busy night. It was what I always dreamed of.

The next morning I was tired, dirty, and really just wanted to go home and sleep… For at least 20 hours. But just before the relief came, the doorbell rang. After the many security devices were disabled and unlocked, the lady, barely standing, said “I just overdosed on crack…” She said it matter-of-factly. As if she was explaining the sky is blue or the grass is green. If ever there was a stereotypical street-walking prostitute outfit, she was wearing it. (I had never knowingly seen a prostitute in my life before at the time.) We dragged her by the arms to the tailboard of the truck and sat her down. I was going to start an IV, and she had the absolutely perfect vein in her right arm. After swabbing the area with alcohol (we didn’t have chlorhexidine at the time), I gripped her arm tightly, and had an 18g needle almost touching her skin. She turned her head towards me and said with the voice of a mother, “Oh honey, don’t use that vein, I save that one for when I score morphine…”

I was dumbstruck. Never in my prior years working in the suburbs had I seen or even heard of such a sight. Without missing a beat a fireman I admire and respect to this day blurted out “Do I tell you how to smoke crack? No! Don’t tell him how to do his job…” Well, as if her statement wasn’t enough, I was in total mental meltdown. I could not believe he just said that to a patient! I couldn’t move. I couldn’t speak. He took the needle from me and started the IV. After we took her to the hospital, he was laughing at me. He rhetorically asked: “Don’t talk like that in the burbs do you?” I was not upset or concerned about his “professionalism” I just laughed, smiled, and he could plainly see I was going to like it here, and he added “I am sure the mayor will be right down to this neighborhood to yell at me.” That was the first of many great days, and many lessons learned. Including how to understand and adapt to a completely different culture; with people who were nothing like me, in a world with realities and challenges I could not have ever imagined.

In my next job, I made working in the worst neighborhood in the outfit at the time a condition of my employment. The human resource guy looked at me like I had just said something he never heard anyone say before. “Done and done. “ So I went to see the place. It didn’t look so different than from where I had just been. Then I met the people I would be working with… They were the same, highly capable; highly experienced. They worked and understood a world many will never see or imagine, but you certainly wouldn’t want them to be on your company’s recruiting poster.  When one of the trade magazines was doing an exclusive on the company, we laughed that they would never come and ride in our neighborhood and the corporate guys would never let them interview us. We were not disappointed in our predictions…

I applied for different jobs after these 2 incidents, and finally ended up at a hospital in such a ‘hood. Doing what I love to do, where I like to do it, with the people just like me. Some would say “crazy”, some will say “tainted”, but their ability, compassion, and intelligence irrefutable. They have stood in the eye of the storm in hell, have been measured, and are found without equal on this Earth.

Then I found myself in Europe… I was warned not to go to the “bad” neighborhoods. So I waited until dark and went right to them… “Bad neighborhoods”…  Yea… In every sense of the appraisal of middle- class suburbanites. I haven’t seen a ‘hood anywhere in Europe from Kyiv to Bucharest, to France, I would call “bad,” which is probably why they get so worked up when somebody gets gunned down in their streets. I feel useless and wasted if I don’t get to be there for that 3 or more times a day. As some of my previous posts indicated, I also don’t look so good on the check-box paperwork here. They cannot imagine what my experience is. They have no point of reference. People have even been amazed by “my ability” in places like Afghanistan. It is no different…It’s what I am. It’s what I do.

But for all my reminiscing and lamenting, back to culture… I was taught how to work in “bad places” by people who had done it for years before me. I have come to know the culture of the poor and undesirable all over the world. I have seen and touched their world. I am not afraid of them. I am just, perhaps more, comfortable in their world as I am in mine. My pilgrimage in medicine has made me experienced in going places I have never been, to try to help people who are not like me, in environments dangerous and unknown, people who speak in languages I will never speak or understand. I understand that I must help them from their perspective of help.

You cannot learn these skills without being taught. You cannot be good at them without practicing them. Even then, sometimes people are hurt, killed, and have many close calls. Working effectively and being comfortable in them cannot be taught by people who have not experienced it. Your safety depends on understanding their culture; on working with them. Knowing the signs of danger vs. signs of respect vs. normal behavior. You will not make yourself safer negatively judging them or complicating their life constantly making them the target of the respective criminal justice system. These people fear the police. They are punished disproportionately, for nothing more serious than trying to survive and cope in their world. A terrible world that is merciless and unforgiving.

You cannot “help” these people unless you can walk among them, understand them. The scene will never be safe. Not going into it means not helping. No EMS education I have seen anywhere in the world teaches students how to work and be safe in these environments. If they talk about culture at all, it is basically lip service. The “safety” training is laughable and totally impractical. When people look to you for help and you choose not to help, even if it is because you are not capable or prepared to, because you were never taught or mentored in the knowledge or skills needed, they see you as abandoning them in their time of need. Of not living up to the position of admiration and respect society gives you. It looks really bad on the 6pm news.

But for other providers, who are no more educated, skilled, or experienced to call for blood from the safety of behind their keyboard, forget professionalism, it is outright betrayal. Then everyone stands around wondering what they could do to prevent the next provider from abusing drugs or alcohol to cope. They wonder why their colleagues do not reach out to them before committing suicide. They are second guessing from a position of hindsight and safety. To the ones who have learned to work in these harsh environments, before you judge, do you teach? Do you mentor? Do you remember what it was like to not know and be scared?

Your patients may not be like you.  You are there to help, not judge or make things worse. If you do not have the knowledge and skills you need to work in different cultures, seek them out. I promise you that you didn’t learn anywhere near enough in school to actually do what is being asked of you. Especially if your teacher has never done it and is just parroting what they were told or read on their instructor notes on a commercial PowerPoint.

You must learn to identify and to be comfortable in different cultures and customs, with people who effectively live in a different world and reality than you do. They speak a different language. They are not like you. But they are still people asking for your help. They still look up to you and think you have no fear, can do anything, and are larger than life. Don’t disappoint.

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What exactly do we do?

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Firstly, this post has little to do with the current tribulations in my life. Secondly, I have written about this before, using different words, but maybe if I keep saying it, people will start to catch on…

The fact is regardless of my job title or place of employment, I am an emergency provider. I bring the emergency mind and skill set with me wherever I go. Once employers actually see it, they really like it.

However, there are some emergency providers, both in the ED and outside of it, who do not understand exactly what it means to be an emergency provider in the year 2015. It is a bit more complex than many people imagine.

Historically, starting in about the 1960s in the US and yet earlier outside of it, there was this idea called “emergency medicine.” The idea was basically that temporizing treatments could be used in order to treat “medical emergencies” and save lives and limbs. The knowledge of things like pathophysiology, pathology, etc, were by today’s standards archaic.

The reality today is that it is a continuum of care, starting with the first people to render aid, such as bystander CPR, all the way through post emergency, surgical, and intensive medicine, areas to disciplines like occupational therapy that “saves” lives and preserves function. The idea that there are “emergency” treatments as a unique and specialized body of knowledge is just antique. Does anyone really believe cardiologists and cardiac surgeons are not taught how to handle cardiac emergencies? The same for a host of other conditions and specialties.

So what exactly does an “emergency provider” do? Well, as I have eluded to already, it is more of a mindset than a skill set. Necessary and valuable for sure. But valuable for what?

I would first like to give proper credit and call attention to an article that I have found puts it into words better than I can. But the error of the article is that it focuses on holiday times. In reality, it is everyday! Please read it here:

http://www.huffingtonpost.com/edwin-leap-md/the-er-holiday-sanctuary-_b_6217066.html

I think Dr. Leap describes it perfectly. The ED, and by extension out of the ivory tower and into the fire departments, EMS agencies, and police departments, who actually help people at the point of impact in their own neighborhoods at 0’dark 30, are the modern embodiment of help and sanctuary once provided by the Catholic church in Western countries.

Casting aside religious dogma, the fact is most nursing and palliative care was once provided by church authorities. You can hate that all you want, but it changes nothing.

As described above by Dr. Leap, the Church doesn’t really take an active role in that anymore. It does to a lesser degree in some places, but for the most part, if you show up at a church after hours, at best you will find a locked door, and worst you will set off an alarm and get arrested by the authorities without benefit of first seeking asylum.

That brings me to a US Coast Guard recruiting commercial.

Taken together with the other blog spot, this is what a modern emergency provider is.

The port in the Storm is the ED. It stands out among its surroundings, a bright beacon of light in the darkness. Walk around any city with an emergency department in it after 11PM. It’s light shines all through the night. In every Western Country, whether it says “Emergency Department”, “Accident and Emergency”, ” Oddział Ratunkowy“, or any other translation, in big red and white letters. Even in the most uncivilized of places, you can find a Red Cross, Red Crescent, the Star of David, and other “protected” symbols of medicine, emergency, and sanctuary.

Emergency service is the line in the sand. Whether an accident victim, a fire victim, an abused/trafficked person, crime victim, or even unwanted newborn, it is a place of safety.

Again as described above by somebody else, even people who have just lost their way in life, homeless, hungry, addicted, lonely, scared, or even criminal, it is a place of sanctuary, where help, not judgment, is sought and found.

We are the rescuers in the dark. Whether it is a concerned and medically uneducated mother at her wits end because she doesn’t know what to do for her crying child with a fever, a person burned over 90% of their body, the neglected elderly person who has outlived their friends and family, when they call or show up at our door, we help them. Some just need directions.

We are the time honored exceptions of society, our primary concern is humanity. We strive for benevolence in our endeavors. We are not people who respond to cries for help with “that is not my job.” I know many providers now see themselves as public officials. These same providers don’t understand that mantra makes them “government agents” not helpers of humanity. When enough of them are hurt or killed, they’ll come around again. Good people are working on it.

Our “job” is to help those in need. Sometimes it is with medicine. Most of the time it is not. It is always an “emergency”. People who do not know what else to do or where to turn seek our aid, for our mindset, our problem solving ability, our knowledge of the system, to know and be able to do things they cannot.

Anyone who thinks otherwise is a worthless relic of a bygone era. In that era we believed we could cheat death and live forever. In that era we thought what was done by emergency providers was separate from everything and everyone else. There was less to know and less to need, people did not lose their way very often because life was simpler. Today anthropologists no longer consider Homo Sapiens as modern humans. We are now Homo Sapien Sapien, we are reliant on technology. Human knowledge is so vast people have become hyper-specialized in what knowledge they possess and require the rest of society to act as part of the team, playing the positions they cannot.

This is our world. While the world may have changed, our role has not. We are the port in the storm. We are the line in the sand. We are the rescuers in the dark. There is no problem too big for us. There is no problem to small for us.

According to the Oxford dictionary.

Succor:
A noun and a verb.
Assistance and support in times of hardship and distress.

The next time you or somebody else dismisses what they feel are “not real emergencies” beneath them, remember this word. It is exactly what we do.

In the original Battle Hymn of the Republic (Not the bastardized, happy, religious versions sung by church choirs) there is a stanza:

He is coming like the glory of the morning on the wave,

He is Wisdom to the mighty, He is Succour to the brave,

So the world shall be His footstool, and the soul of Time His slave,

Our God is marching on.

All narcissism aside, when people seek out our help. It is in frustration and desperation. Nobody stops by the ED, ICU, or Surgery for a chat. Nobody calls 112, 911, etc. Because they are having a good day and want to see how we are doing. Nobody summons the police, fire, or EMS when everything is fine and they have life under control.

In some places people cannot afford to pay upfront for the GP. Even if they don’t have to pay, in modern times, this provider almost never helps people with their problems. They are not open at night. They are an antique specialization of medicine no longer relevant in today’s world. More like concierge medicine than actual help. That makes emergency the providers of both first and last resort, everywhere in the world. Day and Night. Weekends and Holidays. That means us.

I have said it before and I will say it again…If I have time to help people with minor problems, to get them a glass of water, to tell them how not to get dehydrated, to teach first aid to non-medical people, to offer simply knowledge and support, so do you. If you do not, you are the problem, not the people who call for your help. If you are constrained by your system, you are responsible to change it. If you think the world and society is going to change to meet the definition of the work you would always like to do, I have bad news for you. It won’t. I have some other news for you too…Not all aspects of work are enjoyable. It doesn’t mean you can slack off on the parts you don’t like.

So while providing a glorified taxi ride, handing out pillows and turkey sandwiches, relieving pain for conditions that cannot be cured, and palliating those whose lives cannot be saved doesn’t seem exciting or glamorous, it is a part of that whole port in the storm, line in the sand, rescuer in the dark, thing. It is a part of providing Succor and sanctuary.

I am not asking you to like it. But if you cannot do it, and do it well, you have failed to be a competent emergency provider. Get with the program or take a walk; but stop embarrassing us and dishonoring the position the public has bestowed upon us who do live up to our part. We don’t need or want you. You are not an emergency provider. You are just a little kid pretending to act like a hero.

Anything about this you don’t understand?

The world just doesn’t want me

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After what seemed like an insurmountable battle to get my UK medical license, I have now discovered it is basically worthless.

In order to apply for a job, I need paperwork I do not have. In order to get the paperwork, I have to have a job. Everyone failed to mention that in this months long process.

Hope dashed by clerks…I hate clerks. They have always caused me a rather miserable time. It seems I simply do not fit into their world of checkboxes and 9-5 lives. This doesn’t really come as a surprise to me, but it is always stressful and demoralizing.

But clerks have invented something even more distressing. Automated employment applications. A computer system where some mindless half-wit creates a set of “requirements” that must be met. Some include “key word searches.” Some include redundant questions and scripts. I cannot even recount the times, in one that took me 4 hours to fill out, it asked me if I had a license number. Then after the form was saved, every time I submit it to a different job, I have to answer that question twice more! It even asks me to refill questions already completed and saved on the same page!

The best is when they list things like “for more information, call or email this person.” I did that, they seemingly never answer. If they do it is with one or two words. In 29 requests for information, I received exactly 2 replies by email. No calls were answered or returned. Both of the replies were nearly a week after I sent them. It seems sort of crazy to me it takes that long to return a one or two word email. It is not like they give it any thought. If they do, I hope they don’t have any important decisions to make. I can only imagine how long it takes to think something like that through.

I figure like this though… The form asks for a lot of useless information. I suspect on both ends. The form probably has as a posting requirement a contact name and number. This person like the rest of the world probably has either a junk email account they use for such purposes, or automatic filters which prevent any unsolicited email from reaching them. The other alternative is they just don’t care. Healthcare providers who don’t care and can’t be bothered. That is a chilling thought. If that is the way they treat peers, can you imagine what to expect as a patient?

One of my colleagues likes to claim that as a species, we have now reached the peak of our civilization and it is all down-hill now. I don’t have to imagine it. I live it. A world in which if you do not meet the automated process you effectively do not exist. After all, this is the same process which doubted I spoke English. It is the same process that couldn’t figure out it was possible to have more than one job at the same time. A process which couldn’t reconcile it is possible to have a job and go to school. That it is possible to have a job in more than one country at the same time. I guess modern air travel and the internet are not taken into account.

The only other option if it is not stupidity is malice. I understand one should never attribute to malice what can be explained by stupidity, but I just cannot reconcile the idea people really are this stupid. After my lifetime, it really should not be a surprise. Perhaps the Dunning-Kruger effect is in full force. I mistakenly believe others are more capable than they are. Of course I will now be labeled as elitist and arrogant. I don’t even consider that an insult anymore. If anyone disagrees, prove me wrong. Step up and actually do something to make a difference. Let me see what you can do. I’ll wait…

All of this makes me wonder…Once we dehumanize as many of our processes as possible, what happens next? Do we lie on the paperwork making it useless in order to even exist on this Earth? Do we become automations, incapable of critical thought or definitive action, simply attempting to fit into the check boxes being enough? I am glad I don’t have to date that way. “In order to be considered for reproduction, please fill out this 20 page form and provide standard documentation of the following…”

So I must ask the question, “What benefit does any of this provide?” Does it save time? Who’s time? It takes time to create these specifications and documents. It takes time to fill them all out. It takes time to wait for replies that may never come for “more information.” Plus, in my experience hiring people and creating teams, almost everyone that looks good on paper doesn’t live up to their profile, the job recruitment version of keyboard commandos. Anyone who has hired people or had to create a team should be able to attest no matter how somebody looks on paper, they could be utterly destructive to your organization. You create stress, waste time and resources to get them. Once that is done, you basically destroy any level of workplace efficiency or productivity dealing with them. You alienate your other employees. Some of your best people may even quit. In the end when this person (who is simply nothing other than culturally incompatible) quits or is fired, your losses are far higher than just them as individuals.

At the same time, a lesser skilled person who is more culturally in tune or even has the right attitude can return a far higher rate on an employer’s investment. But if these people are utterly eliminated by check boxes or lack of them, how can anyone realistically hope for such an outcome?

One of my friends, not me I promise, because I did remember laughing at the situation when he found himself in it,(there is no way to make this stuff up) applied for a job and had to go through an automated application. The person in question had a PhD and was applying for a job that required a bachelor’s degree. Ultimately, he never got a reply and called to find out why he was not given an interview. He was told “you did not indicate you had a bachelor’s degree and so was automatically rejected.” When he tried to explain there was no option for a higher degree, the reply was basically “oh well…your loss”
Which makes me wonder…What kind of mindless waste of sperm would take such an attitude and be considered an asset to their employer? “Yea the guy with a PhD wanted a job, but he didn’t check the box that said “bachelor’s degree, so fuck him, no loss to the company.”

I recently heard a proponent of this system claim there is still an interview. But is there? My PhD friend didn’t get an interview. If you are using this system to preselect candidates, are you not using a scoring system to grade them? I have encountered this too. I sat in an interview that was scheduled to last 15 minutes. After 45 minutes the lead interviewer on the panel, with a look of amazement said to me “you don’t fit into our scoring system at all, so we don’t know how to grade you, but surely you will get an offer.” Yea, I got an offer. An offer so bad and in contra to every value I stated in that interview I wasn’t sure they had the right person. “Somebody” who clearly didn’t sit at that table nor even bother to read my CV or interview notes “selected me.” Then they were shocked I declined the position.

The process was fundamentally flawed anyway. You were awarded points for academic publications, maximum of 2. Maximum? Who puts a maximum on effort? I had 4 at the time; double that maximum. Yet I received no credit for doing twice the max? When I questioned it I was told “nobody had ever done that much before.”

Perhaps my thinking is flawed, but I always figured if somebody does double what everyone else ever did, that would make them a better candidate than somebody who did just enough to check the boxes. Apparently I am wrong. It is not the first time, and probably won’t be the last time, but it really is disappointing. It is like being punished for being successful.

Who comes up with this stuff? How insignificant must they be in life?

When I first started my fire career, I was told many times, by many people, I was too smart to be a fireman. I didn’t believe them. I didn’t think I was smarter than anyone else. Eventually I had to admit to myself these people who said that, who I loathed as much as any human could for making my dream seem insignificant, were ultimately right. Now I am too smart to be a doctor. I was always told doctors and lawyers were the peak of human capability. (Even when you don’t like them).

But it really isn’t an issue of what I am, it is an issue of what I am not. I am not the minimum. I am not somebody whose life is to satisfy check boxes. I am not a mindless clerk. I am not a buzzword. I measure myself by how outstanding my successes are. Perfection, not mediocrity, is the uncompromising standard. Unfortunately for me, it is the mediocre who are creating these systems. People who simply are not as intelligent as I am. People who are not as capable as I am. If they were, there would be no issue. There would not be replies like “nobody has ever done that much before.” They would realize how inadequate their check boxes and buzzword searches are. I might be called “smart” or “motivated” but certainly never “too smart” or “too motivated.”

The best way I can possibly describe it is I feel like Michael Phelps being told he is not qualified to get into a swimming pool because he didn’t check the box stating he was currently enrolled in swimming lessons.

But unlike Michael Phelps, I really do need a job. I am not asking for lots of money or even good hours. Just something I enjoy doing. Something I have always looked forward to doing. I remember having jobs like that. Jobs I actually looked forward to going to. Something that mattered, surrounded by great and like-minded people. People I looked up to. People I respect and admire even to this day. People who were not better on paper. People who could make the world spin in the other direction at a moment’s notice. I am a champion stuck in a world of losers and in “furthering” my career, I actually made it worse.

I am told my attitude is distinctly American. It is an attitude of “can.” If that is what defines Americans, then I guess it is a title I will have no matter what my citizenship status. On the list of historical figures I admire: Sun Tzu. Leonardo da Vinci. Miyamoto Musashi , Marcus Aurelius, I wonder if they were “too smart”, “too American”, had done things “nobody ever did before” and were penalized for it? I suggest my life would be so much easier if I was a mindless cunt who looked up to a football player or movie star. Some days I just wish the limits of my intelligence were tabloid news.

I once asked one of the people who told me I was too smart to be a fireman that on the day their house was on fire, when their family was trapped, if they wanted the smartest most capable person that could be summoned or some dude who had reached the maximum of his capability pulling a hose coming to the rescue? I received only silence in reply. Now I know the answer… They want the guy who did the minimum needed to check off the boxes. They want that because it is more comfortable for them to determine the person coming to their rescue is their equal or inferior. Tomorrow I will play the automation game again. I will not fit in. I will not lie. The people making hiring decisions don’t want me as a doctor. They want the minimum. They want the guy who did just enough to check off the boxes. They want to know the person they select is equal or not as capable. I know this because if they actually wanted me, I would be on my way into a job I enjoy tomorrow. Sadly for me, it will not be the case.
The conflict of man vs. society.

The battle continues tomorrow. Let us raise a glass to “the good fight.”