Joseph F. Clark, Ph.D.

On occasion I have been involved in discussions concerning medicine and technology with regard to what can be done for patients and what research is on the horizon. Without question I LOVE these discussions; they can be fun, engaging and animated. We use terms like; cutting edge, out of the box, paradigm shifting and groundbreaking. All these discussions require us to discuss the state of the art in science and medicine. State of the art is in reference to what technologies are being done now. When a new cutting edge technology is adopted by the medical community it is no longer cutting edge and becomes state of the art.

For me each of the buzz words mentioned above have specific meaning in my research as well as R&D. I tend to NOT use them capriciously but rather as specific scenarios within the developmental process. So I might talk about a cutting edge technology that is paradigm shifting. That would be a brand new technology destined to change the way we do business. An example would be the first CT scanners. That was new and novel technology and when adopted by the medical community changed the way we look at (in) patients with various diseases and injuries. So that community wide change is a paradigm shift.

In my opinion groundbreaking is used when multiple disciplines and discoveries must occur to achieve something. An enormous and classic example of true groundbreaking work is NASA’s work on the Apollo program to the Moon. While many had thought about going to the moon, it was thus not really out of the box, but it needed many discoveries and new development to get there. That makes the Apollo program groundbreaking.

To a large extent out of the box, as a buzz word-phrase, is overused and it may be difficult to pigeonhole precisely. But I typically consider out of the box thinking as a new way to think about a problem. A ridiculous example of out of the box thinking, using the Apollo program again, is instead of bringing a person to the Moon, bring the moon to a person. That would be out of the box thinking as well as catastrophic on many levels, like ocean tides and gravity etc. Images of George Bailey (It’s a Wonderful Life) lassoing the moon come to mind here.

Buzzwords in science, medicine and technology may seem on the surface to be useless jargon, but to some of us there are appropriate uses for these. So show your colleagues that not only can you use buzzwords but that you know when to use them.

I have several writing methods. In part I think this stems from my varied background in writing. My main job is to write scientific grant applications. Writing grants is an enormous undertaking that takes many years to master. That is if anyone can be called a grant master. No one has a 100% success rate for grants submitted so there are failed grants coming from the so-called masters.

Other than grants, I blog, write papers for trade journals as well as magazines. I also write science text books as well as novels. I’m currently writing my third novel. Note the follow up novel after My Ambulance Education is complete and in search of a publisher. Any takers?

With the eclectic mix of writing tasks, I have ended up with different writing strategies to get the job done. Some methods can be applied to multiple tasks so I end up with a pleasant mix of attack plans for every writing duty I come across.

The scientist in me has trained me to work from a “lab book” when documenting science work. The lab book is a time tested icon of every researcher where our written notes form the foundation of discoveries and patents. I then work off of the lab book to write grants and papers using the computer.

I find that when I’m writing on paper or “old school” the text comes in one of two ways. In one style, I write slow cursive script in a clear flow of thought and syntax. Conversely the other writing style is when I write fast and furious. The text is a mixture of script and print with numerous abbreviations, science symbols and a lack of syntax. This is the writing style I perfected after 9 years of college to take lecture notes. No other human can read the random code that results, but I can decipher it. I guess that is all that really matters because it eventually ends up on the computer.

Don’t get me wrong in thinking I do not live on the computer. I do. I compose nascent text on the computer all the time. I simply engage different strategies to put words down on paper or on screen.

When composing My Ambulance Education I generally wrote the text directly onto the computer. I would often sit in my comfy reclining chair, the notebook on my lap and the computer screen being the only light illuminating my fingers on the keyboard. With one or two cats helping, my eyes closed, the chapters would flow with great speed and emotion.

Yes, I can touch type and pretty fast too. This stems from one typing class I took as a senior in high school. Often 3 to 5 thousand words could be produced in an evening after a day of science writing. On business trips 10,000 words would often result from time spent sitting on a plane or in airports. These free association ramblings always needed heavy proofing and editing but it was a requisite step to get events on “paper.”

Kind of like I have a fast and slow technique on paper; I have a fast and slow method on the computer. When writing science stuff on the computer my slow method has me watching the text very closely on screen. I write, re-write and edit every word and phrase to ensure clear, cogent and acceptable science writing. Even with close scrutiny during composition this science text will of course need to be proofed and polished. This style can be performed with my cat accessories as well. They have learned to not play with the keyboard when I’m typing though I know they are only trying to help when they play at the keyboard.

That about wraps it up for my writing methods so the other thing I wanted to address is the dreaded writers’ block. I pretty much can’t get writers’ block. My work and avocation require writing and not writing is not an option. However I have found that if I’m not productive at science writing I can switch to medical writing and often with success. Generally this switch will be accompanied by a switch in venue. So if I dry up writing science in my comfy chair at home, I’ll head upstairs with the cats and a composition notebook to do some composing in bed with pen and paper. The cats like the bed because there is more room.

When I was younger and I contracted a case of writers’ block (remember I can’t get it now) while writing by hand. My strategy was to go out and buy a new pen. The shopping distraction and the feel of a new pen in my hand got me through many bouts of writers’ block back then. Now however, I guess if I were to get a bad case of writers block I could go shopping for a new cat.

Time is not money in China. The concept of “Person hours” is not a major consideration for projects in China it seems. I think the concept is not a matter of consideration but rather economy. I was recently treated to a wonderful excursion and experience of a scientific conference in China. This was a trip to Chongqing where the meeting started. Then the whole of the conference participants moved to a river cruise ship for the subsequent three days of cruise and conference on the three gorges dam project. As a personal and professional experience this is second to none. I learned a lot of science, medicine and culture and will try to share it here. My hope for this blog is to present a balanced summary of the events that occurred. While a few western readers may think that some of what I talk about may appear less than pleasant that is a personal opinion left to the reader. I personally love adventure and relished this adventure.

At dinner the first night we had hot pot. It is like the Japanese ShaboShabo with a pot of boiling spicy stock in the center of the table and a collection of things to boil in it. So no raw food is eaten, but the food comes to the table raw. If you do not want to read what we ate stop reading now. They served and I tried in the stock pot, cow aorta, pig and cow stomach, intestine, chicken gizzard, stomach, heart, pig brain, cow tendon, pig and cow kidney, cow tongue, fish head, whole catfish – not gutted, squid, eel and jelly fish. There was also seaweed, mushrooms, bamboo shoots and cauliflower.

One of the meat items served was identified as artery. I looked at it and absentmindedly said that it was a section of the thoracic aorta. Everyone at the table is medically trained, but I’m especially geeky even amongst other geeks. I say that I am a geek amongst geeks with pride. With my research I have seen a lot of aorta and I know the thoracic aorta when I see it. It is easily identified by the regularly spaced pairs of intercostal arteries branching off of it and they were clear as day on the morsel I was about to eat. Its flavor and texture reminded me of calamari and I had seconds. Wow I’m stuffed! I tried a bit of everything and aorta was the best!!!

This was a scientific conference of medical, surgical and scientific types. The conference started in a hotel where we had some of the scientific sessions and the opening ceremonies, then moved to a cruise ship. So it was effectively two conferences; one on land and one on the river. The river cruise was unique and highly memorable. Interestingly we were well scripted on the boat with the whole boat having the same wake up call to start a day that looked to be scheduled down to the minute. Or so we thought things were scheduled that way as the reality was that times and things changed as the days went by.

Scheduled departure times and rendezvous times for meetings and excursions are highly variable. It would be very common that a scheduled excursion be delayed by 45 minutes or more and often delayed in 15 minute increments.

In the scientific sessions speakers would spend much too much time talking past their allotted time slot. I know it is hard to believe that an academic would ramble on endlessly but it happens. Personally I have been known to wax lyrical on the different colors of spinal fluid. The result was that one entire session was cancelled at the end of the day and re-scheduled for the next day. Paradoxically, the time for a keynote lecture was moved up by several hours. I’m not sure how this happened because I did not know of the schedule change and missed the lecture. These things are not a matter of being inconsiderate. It seems to be more a matter of time is not money and things get done when they can be done. Schedules are estimates used for guidance. All of us from multiple different cultures need to get used to these differences and the conference attendees seemed to get it.

By the way the science and medicine was great on all levels.

For our conference there would often be 3 or 4 people working as projectionists to ensure that slide shows and power point presentations were managed. There were no traditional slides, but the name still applies.

Several people I talked too from western countries stated that during the boat cruise that they were experiencing allergic reactions in the cabins. We concluded that with a boat built over 20 years ago that the cabins must have had mold and mildew buildup and that this is the source of the allergic reactions. I’m included in this list. After sneezing and a runny nose all the first night I spent the next two nights sleeping with a bandanna over my mouth and nose. It worked pretty well I’m happy to say.

After my constant sneezing, headache, and runny nose was controlled by a bandanna my next concern in the room was the water for drinking and showering. In my cabin I was supplied with a carafe of water and a thermos of water. This was declared to be clean potable water and it is what I used for brushing my teeth and drinking in the cabin. However, over the 3 days it was never replaced or replenished. So, I made sure it lasted. I am sure that I could have had them refilled but it was never clear who to ask to get such things like that done.

Speaking of showering the shower was the size of a closet 2 by 4 ft. In this tiny room was the shower, toilet and sink. The toilet and door to the bathroom could be partitioned off by a curtain. The shower never dried out between showers. The smell was more than just musty. It was more a musty smell mixed with sewer gas kind of smell, so I kept the bathroom door shut.

One time when I was brushing my teeth I used the sink’s water to rinse the toothbrush and immediately re-rinsed it with the ‘clean’ carafe water. Then sprayed it with hand sanitizer, rinsed it again and let it dry completely. Thus far no untoward effects from that transgression. I must admit that I missed my shower at home.

I brought my water purification stuff for camping on this trip. My system was to fill a bottle of water and add the iodine tablets to kill harmful organisms. Then I would filter the water through a standard camping filter which gets rid of chemical toxins and improves the taste from the iodine. I was happy I had that with me and used it multiple times and had no intestinal issues.

The cruise ship had an interesting rule of no drinks of any kind to be brought on board. This formed a kind of monopoly for them to sell refreshments. Of note, is that this restriction appeared to apply to all drinks; alcohol and soft drinks.

To the best of my knowledge there was no internet service or wifi on the ship. Most of us just did without for a few days. I had no phone service, but could send and receive text messages. We shall see what the cost of the texts are on my next bill. Some people did have phone service so I was able to follow local football scores.

We went on several excursions from the boat. These were well organized tours by bus and boat to various sites along the river. We got to see the hanging coffins and the huge three gorges dam as well as some other sights. Unfortunately on the excursion to the ghost city it rained. The tour people supplied all of us with umbrellas – for free and to keep. I also had packed a fold up rain coat, so everything but my feet kept dry. In our cabins on the boat were complimentary slippers which came in handy after getting back with wet shoes and socks.

Some facts that I picked up concerning the 3 gorges dam project. There were 1.5 million displaced people by the project. The project costs 27 billion dollars and 13 billion for the displaced people. This comes out to less than $10,000 per displaced person. Some people when displaced got homes 2 to 3 times their old size homes. None of the people I talked to would comment about the environmental impact of the project. Nor was there any mention of personal hardship caused by the flooding of the gorges. We frequently saw people washing clothes in the river. But it also appeared that the river was very dirty. It seemed like there was a lot of debris including clothes and shoes in the river.

Some of the things I am most happy that I packed for the trip to China are: handiwipes, hand sanitizers, extra business cards, my bandanna, water cleaning stuff, and my pocket rain coat. What I wish I brought was Benadryl, a spare battery for my camera and the chip reader. The chip reader would put my camera pictures on my computer. Unfortunately I forgot that and there were multiple gorgeous shots I missed and had to supplement with postcards. I do wish that I had set up my cell phone to be able to call home, but I am somewhat torn because my concern would be that I might have used it too much. I also wish I had email access but have the same misgivings here as with my cell phone. It was kind of nice to be able to stay focused on the work of the scientific conference. Did I mention that the conference contained excellent science?

The biggest thing I guess I wish I brought was copies of my book; My Ambulance Education. Several people talked about it. One friend brought the copy he was reading with him so he showed it to many people. I just did not think to bring even one copy. I gave out some business cards and copies of the advertisement for the book, so maybe some people will get home to buy it. It was nice to hear flattering feedback from friends and colleagues whom I respect greatly.

When boarding and debarking the boat it was necessary for all the passengers to carry their luggage down and up a substantial number of steps. There were fee for service porters around to facilitate that process but it was doubly difficult because on both occasions for us it was raining and the granite steps and metal planks were treacherously slippery. In the middle of the steps, I estimate about 60 steps up, there was a ramp that allowed people to roll/drag their bags up the incline. Unfortunately a heavy chain cut across this ramp and indeed the steps as a whole which made the climb more onerous. There was actually a shortage of porters and several winded individuals paused to rest at the half way point where there was a brief plateau. As I was dragging my bag up the ramp I looked back down and realized that if I let go of the bag it would roll all the way down and could slide right into the river. So I hung on tightly. My rate of assent was rather slow, not because I was winded or over burdened, but because the couple in front of me were setting the pace.

At the conclusion of the conference I got to my hotel at the airport at about 1:00 PM the day before my flight. I had something to eat and tried to work on the computer. To be frank, I started writing this piece. However, I was not very productive and lay down for a nap at 2:00 PM. I woke up at 3:30 AM the next day in the middle of the night. I felt frustrated because I thought it unlikely that I would be able to sleep until morning but tried again and woke up at 6:00 AM to a new day. Yeah jet lag can do that to you.

Some miscellaneous observations about personal space and body perspectives. On the plane and different public places, people were very prone to squeezing past other people. The ‘my space’ area around individuals is much shorter than in western cultures. It was very common for people to be talking on the phone, to each other etc, at restaurants, on busses, planes and in the conference. My interpretation is that in a more densely populated society cacophony is equivalent to white noise. So… get used to it. On buses and the boat tours the seats very close to each other. This, I think is a reflection of personal space and body size. Westerners are much bigger than Chinese and it is expected to squeeze more people into smaller spaces. Similarly, the beds were very narrow and short on the cruise ship. About 20 inches wide by about 6 feet long. At numerous locations the railings and tables very low often about 24 inches high. Again, this is likely a reflection of the stature of Chinese compared to Westerners.

It was obvious to me that the conference organizers and cruise ship personnel wanted to and tried hard to please. A western audience is used to certain standards and those were often met. As I said above some things may appear unusual by the standards of us from the West, but to me that is a form of variety that we need to get past and see the opportunities we are given and enjoy.

To the conference organizers and cruise staff – thank you for a truly memorable experience. My opinion is you deserve to be congratulated on an excellent job. I understand that some might consider my words as criticism but that is not my intent. What I have said here is meant to be informative for people who may be lucky enough to be able to go on a similar adventure. It is said that “to be forewarned is to be forearmed” and my information might provide first time travelers to China with useful tools for a future visit. I encourage people to put a trip to China on their bucket list.

August 5th 1991 was a Monday and it was to be the first day of work for me in the famed Oxford University. I arrived in Oxford from my parent’s home in New York the previous Friday and was staying in a bed and breakfast. Oxford is a venerated city with a prodigious academic reputation. I had been to the small ancient city, about an hours drive west of London, several times including when I interviewed for my postdoctoral position in the Department of Biochemistry. On this trip to Oxford everything was new despite the architecture dating back to the 14th century.
I was looking at my new hometown. I had no car and was walking or taking the bus everywhere. The streets and buildings that lay before me were now going to be my stomping grounds. As an émigré to a new country I needed a car, a place to live, a desk at work and a bank account to deposit my meager life’s savings. With no family or friends in the country I was on my own in unfamiliar surroundings.
The bed and breakfast on Cowley road was a short walk to the wonderful South Parks road home of the Department of Biochemistry the oldest Biochemistry Department in Europe and steeped in rich history. I made my way to the biochemistry offices for my first day of work and the lab manager Yvonne showed me the lab and desk where I was to work.
I do medical and biochemical research and the lab was renown for metabolic studies and being one of the first places in the world to do Magnetic Resonance Studies on living tissue. When Yvonne showed me my work space I was impressed, not because of the facilities or the equipment in it, but rather because it was hollowed ground. I was to work in the same laboratory where Hans Krebs, the famous biochemist of the 1950s and 60s, discovered the Krebs cycle. The Krebs cycle is the series of reactions that allows all humans to digest and metabolize sugars and fats. His work was a touchstone for all biochemists. His lab therefore should be in the Smithsonian museum but I was now going to be working in his footsteps. I was humbled and honored.
I was in a different country and in a different lab and the unfamiliar surroundings still nagged at me. Believe it or now I was also speaking a different language. I’m American and English is my first language, but I had been living in France speaking French for the previous 1.5 years so even the language felt different. I was feeling a culture shock having moved to a third country in less than 2 years.
People were speaking English but with that distinctive and intellectual sounding Oxford accent. I missed the songful sound of the French language so the day was full of new and different sights and sounds. I did the usual things for a new lab employee including picture ID and library card. My new boss, Professor Sir George Radda was not there that day. I had met him at my interview and he offered me the job during the interview. He said he did not want to delay things with negotiations and wanted to get it over with then. Eminently civilized I thought.
Lunch was a learning experience. I learned that pickle on a sandwich is not pickled cucumber but rather a quite different spread that looks more like jelly. After lunch, Yvonne showed me the Nuclear Magnetic Resonance Spectrophotometer I would be working on. My Ph.D. was doing NMR work on arteries and George Radda hired me to do the same in his cardiovascular lab. He had cardio people working in the lab and I was to be the vascular expert. It was a heady concept that with only 1.5 years of post doctorate experience I would be an expert in a team of world experts. When I saw the NMR spectrophotometer it was like seeing a long lost friend. I remember seeing the gleaming stainless steel superconducting magnet and the huge computer console. The same one I had worked endless hours on for my Ph.D. Like a chef walking into a new kitchen, I knew instantly that despite the new surroundings outside I was looking at the twin sister to the equipment I used in the USA it was like coming home. That room and that huge piece of lab equipment was a sanctuary for me until I moved eight years later.

Hi All,
Sorry for the prolonged absence. I was at a conference on a cruise ship in China. Yes indeed life is rough. A week in China and three days cruising along the three gorges river touring the gorges, the dam and “ghost” city; affectionately known as “hell city” by some of the locals. There is nothing more stimulating than 100 or so science geeks and their significant others assembled in one place for fun and excitement. It was a scientific conference, so excitement was everywhere.
If you missed me, or more appropriately my blogs, I’ve been writing while traveling. I need to buff and polish them without the haze of jet lag but several new blogs are in the queue and will be forthcoming shortly including a blog about the trip. Just as a teaser some less traveled Western visitors to China might find some things surprising, but that is all part of the adventure. I had a great time in China and I tried to capture it in the blog.
Until then I’ve posted a blog I had wanted to upload during the trip but could not because of lack of internet service. Enjoy and look out for a relatively long blog on the trip shortly.

Yours sincerely
Joe

I am a former EMT and have not worked on the streets since 1989. So you can say I’m out of touch and my opinions are dated. But I am also a professor of neurology actively working to develop diagnostics and treatments for neurologic emergencies applicable in pre-hospital settings. So I work hard to keep an eye on the activities associated with ambulance personnel. I therefore believe I can cogently say that NBC’s Trauma will have negative ramifications for the EMS world and should be cancelled. This is not said capriciously but in the best interests of the EMS profession.

The lay society gets an enormous amount of ‘education’ from ‘entertainment’ and Trauma will be seen as a real life reflection of EMS work. So the viewers who are not on the job will believe that when they call an ambulance that the personnel will be able to stick with the patient in the ER and on the way to surgery. Equally it will be expected that the paramedic who worked on a patient will be involved in informing the family of postoperative outcomes. Unfortunately, when in real life an ambulance turns over a patient to medical control that the family may feel abandoned. They will want that same level and type of care from EMS as portrayed on Trauma. It is already well documented in criminal trials that juries expect to see all the technology they have seen on CSI and those of us who are real scientists know that much of what is on CSI is fiction.

A great concern that I have regarding what Trauma may do to the profession is that the lay person with aspirations to enter medicine and EMS will think that every day is like an episode of Trauma. Obviously we all know that a normal day on the ambulance is 90% mundane and 10% adrenaline. Everyone wants the compassionate and caring EMT, not the adrenaline junkie. We can expect that new trainees will start wanting to give versed to agitated patients without repercussions and that you can run into a non-secured shooting or fuel spill scene without police or fire on hand. This cowboy mentality will get newbies killed someday soon. Fire, police and ambulance are a team and should be shown as working together not autonomously as is the case on Trauma.

While I have expressed an opinion on the show I feel compelled to try to give mention to some of the positives. I do appreciate how the show and its characters appear to be human and emotionally bound to the patients. Although one particular scene erroneously had the character staying with the patient and patient’s family through the hospital system. Speaking of emotional bonds, it is interesting that the writers appear to be trying to show how some on the job compartmentalize their lives from the job, however the statement where one character tells another, “you can ask anything about the job, but no questions about my life” goes a bit far. From my experience people on the job including police, fire, ambulance and ER often hang-out together.

I think that my biggest problem with the show is that they use real life places and services. That, in my opinion, tends to legitimize the events and actions. Some people may think that the EMS services involved endorse the activity seen and could come to expect the same activity from their local agencies. If the producers want this to be entertainment then you should not have linked yourself to a real agency. If you want the BRANDING associated with that city you should have listened to your technical advisers associated with EMS and been factual. All I can say to the producers of Trauma is: SHAME ON YOU for trying to capitalize on EMS and SFFD when your actions will end up hurting them. You will be fortunate enough to walk away from the fallout that they will be stuck with. My main hope is that you walk away soon.

My Blog’s Formula:
[(Idea + words) ± wait] x (edit) / Proof read = blog
Did you expect a mathematical formula or a formulaic blurb? As a geek and academic, being formulaic is not a dirty word for me. It provides me with a check list and keeps me in a comfort zone. Somewhere in the blog I also try to have a fairly concise message. It might be self promoting like buy, “My Ambulance Education,” or informative when I blogged on dietary supplements for athletes and the message was, “Always read the label and list of ingredients.”

So what I do when blogging is take an idea and put some words to the idea. Then I wait to see if words need to be added or subtracted. I then edit it a couple of times as needed. Finally I will proof read it and proofing is the foundation (denominator) in this formula. Sometimes this is repeated in a kind of do loop, so the whole formula can be integrated “∫” over a range of days or weeks.

I try to post a blog every 4 or 5 days and cycle through what I consider my blog’s domain. The subjects for this blog’s domain are: Science, Education, EMS, Emergency Medicine, Sports Medicine, Books/Writing and anything I consider geeky enough for me to blog on. I try to put my blogs in categories with key words so people can quickly hit a topic they are interested in.

I usually have multiple blog entries queued up and ready to post. This actually becomes part of the wait formula because I proof them one last time before posting. If I edit too many times before a post I wait and move on to another blog to post.

The point of today’s blog is that while my blogs may be somewhat random and eclectic there is some method and cogent thought that goes into them. Remember “formulaic” is geek-speak for “having a protocol.”

I have the greatest respect and admiration for the NIH but they are missing something.

In the medical and scientific research fields there is the concept of “Translational Research” where research discoveries and developmental research are passed step by step to make things that are useful. Things like drugs, new devices, cutting edge things that enrich our lives. Hopefully everyone reading this will realize new technologies like magnetic resonance imagers (MRI) and “keyhole” surgery are advances that are examples of Translational Research success. However what is happening is that the federal government is missing some important steps in funding “Translational Research” and the result is: The Valley of Death.

The Valley of Death is a research stage where no one wants to fund the next step. It occurs between the “Translational Research” steps. The NIH and NSF are great at funding new discoveries and certain steps in clinical advances. This is referred to as, “Hypothesis Testing” in most research circles. But the NIH and NSF generally do not take a tested hypothesis and make it ready for developing into something useful. That is often done by companies. But companies frequently consider “Hypothesis Tested” research as too soon to fund for development. The resulting the valley of death means that idea or product will fail because it is too far along for the Feds to fund and too immature for a company to take on for product development.

I however see nothing wrong with the NIH, NSF and even charitable foundations in supporting “Valley of Death” research. Unfortunately even if they did decide to fund such work (and some agencies are taking this on) what happens is that researchers are shying away from that type of research (validation, dose ranging, toxicity etc) because it is not publishable. It does not help a professor’s career to validate someone else’s drug as safe. To use a baseball metaphor, that would be a sacrifice fly. As a player I do not mind a sacrifice fly, but it is not what I am hoping for. Everyone wants to hit the home run and validate that the drug is effective. The other part of the reason that few want to do this research is that it takes too much time and effort to over see such a project because of strict FDA rules with minimal chance of professional advancement via publications etc.

So, do I have a suggestion to fix this? Well, yes, I do. I would suggest that the Federal funding agencies give special consideration to fast track the nitty gritty steps needed for “Translational Research.” Say for example, I will agree to verify the safety of a medical device that “X-rays” a patient with out using harmful radiation as required required by the FDA. If I do this it is likely that a company would be interested in making the device and getting it past the FDA for next steps. Therefore, the NIH could fund my work, but decrease the amount of work needed to write the grant, make the grant review faster, and get the funding sooner so that I have time to still be a successful college professor. That way good ideas and technologies will be developed by scientists and professionals with the skills to do the experiments and patients will eventually benefit sooner rather than later.

For anyone who is wondering how long it takes to write and submit a major government grant the short answer is about 3 months. The longer answer is that the average length of a grant application is about 16000 words and 60 references. The 60 references means reading at least twice that number of journal articles as background. There is also hours of meetings and compliance reviews. Finally there are innumerable levels of review and documentation concerning the finances that go into the grant. The result of the long answer is, about 3 months of work.

It is important to note that nothing unethical or untoward is involved with my fast track suggestion. This is because there are multiple regulatory steps which are necessarily involved before such things are approved for use by the FDA. Therefore all the safety steps regarding oversight and disclosure will still be required. Everyone benefits and my sacrifice fly (metaphor above) can be part of a game winning strategy.

Greg Friese interview; My Ambulance Education.

Recently I was interviewed by Greg Friese concerning My Ambulance Education and it was great fun. Greg had graciously supplied me with some sample questions he would start with and that helped break the ice. We talked about the general contents of the book and why I wrote it. I shared with him how some of the specific people talked about in My Ambulance Education have impacted me in my Academic Education and Current Profession as a college Professor. Specifically I talked about how two patients died; one who was a substance abuser and Overdosed and another who died of a stroke. One person slowly killed herself despite the efforts of medical personnel and the other person died slowly as medical care was powerless to intervene. These people helped guide me into medical research because of my belief that productive medical research could help thousands of patients. Helping people is why I entered the ambulance profession in the first place so the goal of my job now is the same as it was 20 years ago when I was working on an ambulance.

Greg was generous with his time as I rambled on answering his questions and he was supportive in the answers that I was giving him. He asked me how I went from being an EMT to a Ph.D. and if I was interested in getting back in the trenches (my wording). While I have thought about doing some things in the EMS setting (see my blog of June 8, “Day in the Emergency Room”) I do not plan to work or volunteer in the ambulance any time soon. I will however ride along and shadow in the ER because my current research concerns developing technologies appropriate to patients experiencing neurologic emergencies. So when practicable I plan to try to get re-acquainted with EMS and ER procedures so that I can help develop better technologies for those settings.

Greg allowed me to conclude the interview with an appeal to the EMS community to help the research community when possible. Research and Development targeting pre-hospital care in the Ambulance can only realistically be done by testing those technologies by doing proper research studies in the ambulance. This will require involvement and feedback from EMTs and ambulance personnel. Hopefully with help and detailed input from those paramedically trained professionals we will see substantial progress in the armament of technologies on the ambulance.
The interview was great fun, thanks to Greg for the opportunity.
The whole interview can be found at:
http://eps411.com/downloads/JoeClarkInterview.mp3

Everyone has a personality, but what people outside of education may not fully realize is that when you put a group of people together they form their own personality. This personality is clearly seen in classes that meet regularly over the school year. It never takes long for the class’ personality to come through after just a few lectures. Some classes are quite serious, others can be playful and a continuum of personalities with everything in between. But after their personality emerges rarely would a significant change in that personality occur during the term or school year.
When I started doing regular college lectures I was surprised at how diverse the depth of classroom personalities could be manifest. I would be giving the exact same lecture to two different groups of students and how they responded to those lectures would be completely different and quite distinct. My observations had nothing to do with the motivation or competency of the students even though I tried to be consistent in my presentation and used the same materials. Nonetheless the classes would behave very differently.
Eventually I came to realize that I needed to modify my teaching style and personality to match the personality of the class. Initially I thought that if I had a playful class I might be more playful to energize them. Well that behavior might work for some classes and even on particular days, but again as the premise of this essay states, “every class has an individual personality” therefore one cannot be formulaic in getting the students engaged. Thus my strategy is to identify the personality of the class and then try to see what behaviors of mine resonate with the class. A morose class may be stimulated to be engaged by dramatics on my part. For example, I teach biochemistry and metabolism to medical students. Often if a patient’s metabolism gets out of whack it will lead to seizure, coma and death. In my more morose classes the endpoint phrase of ‘seizure, coma and death’ became a kind of mantra to my questions about metabolic anomalies. The fun begins when I would get enhanced participation from the class if I asked a question set up for the student to answer, ‘seizure, come and death’ when that was not the case. After I got the wrong answer, I would then explain why it was wrong and often they would, I think, pay better attention to the lesson.
One playful class might respond extremely positively to some of my playful antics in a lecture. However, it is equally possible that another playful class might get out of hand if I behaved too jovially in lecture. So every class needs to be gauged individually and cogently.
There is no simple formula to figure out what strategy will resonate with a class. My experience is entirely empirical, but I try to cycle my repertoire of lecture methods to see what gets the students interested and involved. As with any educator how to reach the students is a ceaseless battle that requires an armament of methods that need to be tailored to address the students’ personalities as well as group mentality. The group responds, often as a group and the personality of that group dictates what it will respond to and how.