Monday, September 13, 2010

The Differences Between Lucky and Unlucky People


The Differences Between Lucky and Unlucky People

by Lockup Doc

What separates the lucky from the unlucky in the world? Do people have control over their “luck,” or is luck an entirely random phenomenon?

I’ve often wondered about these questions. I have heard many successful people mention that an element of luck was one important ingredient in their success, but what exactly does this mean?

A couple of years ago I discovered a book called The Luck Factor. It was written by a British psychologist, Dr. Richard Wiseman. He carried out various research studies in order to better understand luck.

Here are some of his findings:

1. “Lucky people create, notice, and act upon the chance opportunities in their lives.” 

The way that lucky people think and behave makes them more likely to experience good fortune.  They expect positive results.

a. “Lucky people build and maintain a strong ‘network of luck.’” Generally speaking, lucky people are more social and more extroverted than unlucky people. They smile more; tend to like people and strike up conversations with strangers. They naturally develop networks of people. In turn, they increase their odds of coming across chance opportunities that more introverted persons might not.  This makes perfect sense to me. While I believe people should be able to happily exist as introverts or extroverts, this point presents a great argument for why introverts might want force themselves out of their comfort zones occasionally and learn to network with others.

b. “Lucky people have a relaxed attitude toward life.” Dr. Wiseman found that people who tended to be uptight and therefore too focused on a particular task at hand were less likely to see opportunities that those with more laid-back approaches to life. He cited several specific examples to illustrate this point. Interesting!

c. “Lucky people are open to new experiences in their lives.” Those who crave predictability and sameness are less likely to come across new opportunities than those who like variety and unpredictability. Again, there’s nothing inherently wrong with existing with either mindset, but those who fear change might find new opportunities if they shake the humdrum routine up a bit.

2. “Lucky people make successful decisions by using their intuition and gut feelings.”

a. "Lucky people listen to their gut feelings and hunches.” A larger percentage of lucky than unlucky people used their intuition; their gut feeling of whether something was right or wrong; in financial decisions, career choices, business, decisions, and personal relationships. Of course lucky people use more than just intuition in making most decisions, but this was one important aspect.

b. “Lucky people take steps to boost their intuition.” Lucky people were more likely than unlikely people to use strategies such as meditation, returning to a problem later, clearing their minds, or finding a quiet place.

3. “Lucky people’s expectations about the future help them fulfill their dreams and ambitions.”

a. “Lucky people expect their good luck to continue in the future.”  I think this is one of the most important points to emphasize from this book. Lucky people have lucky expectations. On questionnaires about their expectations of positive things manifesting and negative events not occurring, positive people expect the positive and do not expect the negative. The converse was true for the unlucky. I truly believe that what we put our attention on is what expands in our lives. I spend half of my professional time treating inmates, and every day that I work with them I encounter many who have such low expectations for their own lives that it’s no surprise that they fail to achieve what they say they want.

b. “Lucky people attempt to achieve their goals, even if their chances of success seem slim, and persevere in the face of failure.” Along these lines, both lucky and unlucky people create self-fulfilling prophecies. In other words, because of their positive or negative beliefs, they behave in ways that significantly increase the odds of the expected positive or negative outcome to occur. Although the author did not specifically mention that the positive and negative groups define failure differently, I suspect that they do. I personally believe that lucky people are more likely to see failure as nothing more than a negative judgment about a result that has been produced. It’s what one does with that result that matters. I suspect that many unlucky people are more likely to see the failure to produce a desired result as a personal failure.

c. “Lucky people expect their interactions with others to be lucky and successful.” This expectation often becomes another self-fulfilling prophecy: Lucky people behave in a manner that results in others responding to them positively.

4. “Lucky people are able to transform their bad luck into good fortune.”  

It’s not that lucky people never experience misfortune. However, when they do, they tend to approach it very differently than do those with an unlucky mindset.

a. “Lucky people see the positive side of their bad luck.” I think we all know that the concept of luck is relative. Whether or not we consider ourselves lucky in a particular situation really comes down to how we frame it. When involved in unfortunate circumstances, lucky people were far more likely than unlucky people to appreciate how much worse their circumstances could have been. Conversely, unlucky people tended to dwell on the negative any time that something happened that they didn’t like. For me personally, this point was the one I found most useful. While I generally have a ‘lucky’ mindset and expect good fortune, I realized that this was the one point on which I could most improve. 

b. “Lucky people are convinced that any ill fortune in their lives will, in the long run, work out for the best.” Often when something happens that we didn’t expect and don’t like, we assume it is a negative. But in the bigger picture, we really don’t know—events that appear negative at the time often become blessings in disguise. Regardless of apparent adversity, lucky people hold on to their belief that in the end, everything will work out for the better.

c. “Lucky people do not dwell on their ill fortune.”  This is an important point in our victim culture where people are often encouraged to bond to their wounds, forming an emotionally unhealthy identity tied to their misfortune.

d. “Lucky people take constructive steps to prevent more bad luck in the future.”  When things don’t work out, unlucky people are more likely to give up and feel defeated whereas lucky people are more likely to persist and to try to learn from their mistakes.

This book was a fun and at times enlightening read. If you’re expecting a book filled with rigorous objective scientific tests, this isn’t it. But if you want to learn about some of the practical differences between those who are more successful and less successful in life, then I believe the book has some valid points. Personally I found it useful.

What do you think about this?

Photo by Greencolander

Thursday, September 2, 2010

Rules of EMS, Part One


Rules of EMS, Part One

  1. Skin signs tell all.
  2. Sick people don’t bitch.
  3. Air goes in and out, blood goes round and round, any variation on this is a bad thing.
  4. About 70% of the battery patients more than likely deserved it.
  5. The more equipment you see on a EMT’s belt, the newer they are.
  6. When dealing with patients, supervisors, or citizens, if it felt good saying it, it was the wrong thing to say.
  7. All bleeding stops… eventually.
  8. If the child is quiet, be scared.
  9. EMS is extended periods of intense boredom, interrupted by occasional moments of sheer terror.
  10. Always follow the rules, but be wise enough to leave them sometimes.
  11. If the patient vomits, try to hold the head to the side of the bus with the least difficult-to-clean equipment.
  12. If someone dies by chemical hazards, electrical shocks or other on-scene dangers it should be the patient, not you. (Also known as rule 1313)
  13. Any EMT, FF, LEO and/or scene chief who is more drunk than the patient is the realproblem.
  14. There will be problems.
  15. The severity of the injury(s) is directly proportional to the difficulty in accessing, as well as the weight, of the patient.
  16. Make sure the rookie EMT knows that a med patch is a radio term, and not a medicated bandage.
  17. Paramedics save lives; EMTs save Paramedics.
  18. If the patient looks sick, than the patient is sick.
  19. If the patient is sitting up and talking to you, then the patient is not in V-Fib, no matter what the monitor says.
  20. It is that bad.
  21. Full spinal precautions were custom made for obnoxious drunks. So were NPAs.
  22. If you absolutely must vomit, than it is probably best to turn your head away from the patient.
  23. It is generally bad to use the words “holy s***” on scene, in reference to the patient’s condition.
  24. Patients that crash in separate vehicles should be transported in separate vehicles.
  25. Just because someone is fully immobilized doesn’t mean they can’t be violent.
  26. If I’m up, EVERYONE is up!
  27. Better them (another unit) than me.
  28. I saved the patient… from the fire department.
  29. When responding to a call, always remember that your ambulance was built by the lowest bidder.
  30. Never get into the front of the ambulance with someone that is braver than you are.
  31. When in doubt, use industrial strength therapy.
  32. If it’s stupid, but it works… then it ain’t stupid.
  33. Algorithms never survive the first thirty seconds of patient contact.
  34. Always honor a threat.
  35. Always know WHEN to get out of Dodge.  Always know HOW to get out of Dodge. Don’t go INTO Dodge without the marshal.
  36. The important things are always simple.
  37. The simple things are always hard.
  38. If the patient is going to vomit (especially projectile) be sure to aim towards any bystanders that would NOT clear the scene. (This also works for OIC’s)
  39. Sometimes it’s easier to beg forgiveness than get permission.
  40. You can’t please any of the people any of the time.
  41. They said, “Smile, things could be worse.” So we smiled and sure enough, things got worse!
  42. Always answer a newbie’s questions. You once asked them, too.
  43. Always trust bad feelings
  44. Touch no one’s genitalia but your own.
  45. The number of drugs a patient has on board is directly proportional to the number of knuckles tattooed. If the patient has every knuckle tattooed, the drug screen will simply say, “YES.”
  46. PVC’s can be eliminated by sending a strip to the hospital.
  47. The likelihood of a lethal arrhythmia increases with the distance of the paramedic from the “SHOCK” button on the monitor.
  48. The ultimate QA program in EMS is an autopsy.
  49. Best time to work a code: overtime.
  50. Pain never killed anyone.
  51. All fevers eventually fall to room temperature.
  52. A patient’s weight is directly proportional to the chances the elevator will be non-functioning.
  53. Here is a simple ETOH test: Hold your hands about 6 inches apart with thumbs and forefingers touching and ask the patient what color string you are holding. If he indicates a color, it is a positive test.
  54. A tourniquet around the neck solves all problems.
  55. If you drop the baby, pick it up.
  56. Oxygen is good, blue is bad.
  57. Never trust an ER doc with anything sharper than a tongue depressor.
  58. GCS less than 8, intubate.
  59. Asystole is a very stable rhythm.
  60. A patient’s weight is in direct proportion to their altitude in the building.
  61. A patient’s weight is directly related to the number of stair flights between him/her and the bus.
  62. “When in trouble, when in doubt, run in circles, scream and shout”.
  63. EMS RULE OF THREES (as it relates to codes) 300 pounds; <30 minutes to shift change; 3 stories up in the building.
  64. Whoops: 1) the monitor just fell down the stairs, 2) the cold and flu patient just coded; 3) the wrong house. (Hint: the one with the Lab probably didn’t call 911)
  65. Rules: 1) Don’t get dirty, 2) Don’t run, you may violate rule #1, 3) If it looks like you might get dirty doing something, let the new guy do it.
  66. For every ALS skill we learn, we forget a BLS one.
  67. The fire tetrahedron consists of the following: heat, oxygen, fuel, chief officer. Take any of them away and the fire goes out.
  68. “Compassion kills.” Don’t dive into incidents.
  69. If there is little to be gained, there is little to be lost. If there is a lot to gain, there is a lot to be lost.
  70. If you lift an inch, crib an inch.
  71. What do you call a medical student who finishes last in their class? Doctor.
  72. If you think the cost of education is expensive, check out the cost of ignorance.
  73. If it’s wet and sticky and not yours, leave it alone.
  74. Death is a stabilization of the patient’s condition.
  75. Every emergency has three phases; PANIC, FEAR, REMORSE.
  76. You are bound to get a call either during dinner, while you are on the can, or at 02:00 in the middle of a great dream.
  77. Training is learning the rules, experience is learning the exceptions.
  78. Good judgment comes from experience, and experience comes from bad judgment.
  79. Rocket scientists that get into stupid car crashes are the first ones to complain how bumpy the ambulance ride is.
  80. “Poke & Hope” = blind sticking
  81. Why do fire chiefs where white helmets? So you know where the Preparation H goes.
  82. Never trust your bus, drug box, or airway bag to be fully stocked, in spite of the assurances of the off going crew.
  83. If you don’t have it, don’t give up. Adapt, improvise, overcome. And if that doesn’t work, call for a second unit.
  84. There is no such thing as a “textbook case.” Patients don’t read the textbook.
  85. Newbies always look for large things in the smallest compartments, and vice versa.
  86. There is no such thing as a bad call, only calls that didn’t go the way you planned.
  87. Just because someone’s EMT or Paramedic original license date is before yours, does not mean they know what they are doing.
  88. There are very few paramedics with 20 years of experience. There are thousands of paramedics with 1 year of experience, repeated 20 times.
  89. Truckies are people who are over 6 feet tall and their hands drag the ground while walking upright.
  90. Newbies have their own way of doing things.
  91. When it comes to needles, ’tis better to give than to receive.
  92. Listening to some EMTs talk on the radio makes you wonder why they don’t become professional auctioneers.
  93. For every 25 calls you run, only 1 will be exciting.
  94. Take comfort in the fact that most of your patients survive, no matter what you do to them.
  95. The old EMS constant; no matter how bad the politics get, the doors go up and the trucks go out.
  96. ALS really stands for “absolute loss of sense.”
  97. Many of your patients will be healthier than you are.
  98. Being in emergency services means you get to celebrate your holidays with all your friends, while on-duty.
  99. Being an EMT means you get to expose yourself to rare, exotic and exciting new diseases.
  100. EMS does not save lives; EMS is to care for people. It is 95% of what we do.

Rules of EMS, Part Two

Rules of EMS, Part Two

  1. You fall, you call, we haul, that’s all.
  2. There are two kinds of EMS calls: “Oh, shit!” and “Bullshit!”
  3. When you join the kidney club, you usually cannot go.
  4. Common sense isn’t.
  5. The more reflective striping there is on your jumpsuit, the easier it is for the only drunk driver going by the MVA to find you.
  6. If you have a ride-along you want to show the real world, nothing will happen that shift.
  7. 95% of the time, EMS is simply thwarting the process of natural selection.
  8. Just because you’re paranoid doesn’t mean your supervisor is not around the corner.
  9. You can’t cure stupid.
  10. If at all possible, avoid any edible item that firefighters prepare, especially the tuna casserole.
  11. Heaven protects fools and drunks.
  12. We are all slaves to the god “Motorola.” And that god requires sacrifices of hot food at least once a shift.
  13. The address is never clearly marked.
  14. Avoid bringing your patients to teaching hospitals in July.
  15. EMS doesn’t save lives. We only postpone the inevitable.
  16. Even sterile water tastes great on a hot day.
  17. The stereo must always be louder than the siren.
  18. At the beginning of your shift, your main O2 tank, fuel tank, and stomach will be empty…but the call volume will be full.
  19. You know you are in trouble when the directions to a patient’s house include, “Turn off of the paved surface…”
  20. Anyone with a tooth: tattoo ratio of less than 5:1 is guaranteed to be drunk, on drugs, or both.
  21. Anyone with more than five listed drug allergies is automatically a psych diagnosis.
  22. Avoid hospitals with Saint, Mercy, or Memorial in their names. And St. Mary of Mercy Memorial Medical Center is a definite no-no.
  23. All arrhythmias eventually straighten themselves out.
  24. Dead is dead, leave it at that.
  25. Your seriously ill patient will miraculously get better after five minutes in the ER. We call this “fluorescent light therapy.”
  26. Periodically, aliens will abduct your patient and replace him with an exact duplicate with a totally different chief complaint and set of symptoms. This usually happens right after you call report.
  27. Don’t get excited about blood unless it’s your own.
  28. The pain will go away when it stops hurting.
  29. If nothing has gone wrong, you obviously don’t understand the situation.
  30. You should always stop CPR after the second “ouch!” from the pt.
  31. People don’t call an ambulance because they did something right.
  32. The quickest way to gather the relatives is to leave the primaries on while at the scene.
  33. Every nurse is right, as long as you are in their E.D.
  34. When in doubt, always take another set of vital signs.
  35. If your patient is violent, you can always use topical oxygen therapy. The green paint usually wears off in about a week.
  36. The larger the house, the furthest from a door the patient will be, and the sickest patients are always in the back bedroom.
  37. If the patient fell and was moved by the family, they will have moved them so that climbing stairs will be involved.
  38. The furniture will always be arranged so that a stretcher or stair chair will never fit easily.
  39. The problem won’t be that bad until a major disaster strikes: “You’ve had chest pain for three days and you waited until the middle of a blizzard to call?”
  40. History never repeats itself. This is never more apparent than in the E.D., when the nurse asks the patient the same questions you did five minutes ago.
  41. You’ve never been as sick as just before you stop breathing.
  42. If someone is pointing a gun at you, two things become apparent: 1) You should have waited for law enforcement; 2) You wish you just hadn’t made that wise-assed comment.
  43. Fellow medics always have a better story than yours.
  44. Just when you say, “You know, I have never had a hanging….” you will get one.
  45. The only time you go out on a limb (as a dispatcher), and not provide coverage so a crew can eat, a serious call will come in that area.
  46. The only time you need to fart is when you have your patient loaded in the elevator.
  47. The only time your pants split is when there are gorgeous police officers there to assist you.
  48. You will get caught sleeping, eventually.
  49. Never say the kind of call you are in the mood for in the beginning of the shift, because you will get it in the worst way, i.e. an MVC in the pouring rain.
  50. God made Paramedics and EMTs to give him a chance to change his mind.
  51. Beware when a firefighter says, “Y’all check this out.”
  52. Your driver will never hit a pot hole or curb unless your patient has a bad fracture.
  53. The worse your patient’s breath, the more quietly they will talk, forcing you to lean very close to hear them.
  54. If ever in doubt of which house you were called to, look for the stairs.
  55. If there aren’t nurses around when you get called to a nursing home, go to the last room in the hallway. That’s always where the sickest patients are.
  56. Never start putting your stuff away before you are told to go home, because you have just given yourself another call.
  57. When in doubt, let your partner handle it.
  58. When getting a TMJ (too much Jesus) call on a Sunday, never say it around your patient. It sucks when you have to tell them what it means.
  59. If the patient pukes, it is not unprofessional to puke along with them, it is sympathetic puking. You have something in common with your patient and can relate to how they feel. This is why they made the big step well by the side door.
  60. If the patient only moans when you listen to lung sounds, they aren’t as sick as they want to be.
  61. If a patient calmly tells you they are going to die, you had better believe them.
  62. When the patient is really sick, remember that the ambulance has wheels for a reason.
  63. 911: The government’s answer to Dial-A-Prayer.
  64. The more addicted your patient is to morphine, Demerol, Fentanyl, etc…. the more allergic they are to Toradal.
  65. You can have circulation with no breathing, but you can not have breathing with no circulation.
  66. On trauma calls, survivability is inversely proportionate to social worth.
  67. How you know an unconscious is a DOA: 1) If it weighs over 300 pounds… DOA; 2) if it lives more than three flights up in a walkup apartment… DOA; 3) if it’s less than 30 minutes left in the shift… DOA.
  68. EMS providers know how to say “got shoes?” in 7 different languages.
  69. At haz-mat scenes, remember to use the Copological Indicators: If the stripe on the officer’s trouser leg is vertical, it’s safe to go in. If the stripe is horizontal, wait for the haz-mat team. At a gas leak, send the cop in with a lit road flare. If the cop passes out and the flare goes out, it’s an asphyxiant. If the cop explodes, it’s a flammable.
  70. Never go past the first dead cop.
  71. There will be no dying or multiplying in the back of my unit.
  72. The worse you have to use the restroom, the farther the distance it will be from the location of the call to the hospital.
  73. If you haven’t yet had to use a patient’s bathroom… you haven’t been in EMS very long.
  74. Some people can do this job, some can’t. Pray your partner is one who can.
  75. All rhythms will eventually degenerate into one you will recognize and can treat.
  76. If God had intended you to have a rapid response to the call, you would have been parked in front of the location.
  77. Upon arrival at a code, check your own pulse first. If it is still there, everything else is easy.
  78. As soon as you finish cleaning the rig up for a parade, you’ll have to drive ten miles down a muddy, unpaved road for a difficulty breathing.
  79. If you ever go to a call and find the cops laughing on the front lawn…worry!
  80. Remember, it’s the patient’s emergency, not yours. Try to keep your pulse rate lower than theirs.
  81. If you drop the baby, fake a seizure.
  82. The most effective prehospital fluid for trauma patients is a diesel bolus.
  83. Sometimes people will die despite our best efforts.
  84. Dead people very seldom get any better, but they never get worse.
  85. “Can you walk? Have you tried?”
  86. If EMS workers never eat, sleep, or go to the bathroom, nobody would ever get sick or injured.
  87. Better to be looking at it than looking for it.
  88. Go to work expecting to get screwed. You will occasionally be pleasantly surprised, but you will never be disappointed.
  89. The size of the IV needle and the number of attempts is directly proportionate to the patient’s attitude.
  90. All people eventually die.
  91. If there is a God, you are not him. This even applies to paramedics.
  92. The patient’s need of medical attention is inversely proportional to the amount of noise he/she is making.
  93. If the patient says she’s in labor, it’s a UTI. If the doctor said it was a UTI, break out the OB kit.
  94. If she says the baby is coming, believe her.
  95. If a patient presents you with a problem you don’t know how to treat, change it into something you do.
  96. All bystanders, and the majority of your patients, have more medical training, experience and knowledge than you. And they’re never shy about offering advice.
  97. The best way to make a bystander go away is to ask for help.
  98. The amount of vomit produced always exceeds the size of the container by at least a factor of 2.
  99. The seriousness of an injury is inversely proportional to the number of escorts wanting to accompany the patient to hospital.
  100. When your patient says, “I’ve called my doctor, and he’ll be meeting us at the hospital,” this actually means, “I am a hypochondriac and my doctor doesn’t have caller ID.”