Friday, September 18, 2009

The Adventure Continues

There has been a silence from the Little White Donkey for a while. I have been travelling a different path; one that has left me with little spare time over the last week.

Since, aged eleven, I watched Randolph Mantooth and Kevin Tighe racing out of Station 51 in their paramedic vehicle through all the seasons of Emergency! and Emergency One!, I have wanted to be a paramedic. When I took the early steps toward joining the Army in the late ‘80’s, the recruiter looked at my ASVAB results and said: “Ms Asproulla, with your language skills, your test scores, and your college education, we think you’re an ideal candidate for Officer Training School and the Language Program.” I replied: “Sergeant, I want to be a medic in the Airborne Infantry!” and badgered him until he assured me that, should I sign on the dotted line, that’s what I’d be. (Thank goodness I didn’t travel that path, but returned to Egypt instead on the advice of several soldier friends: “Asproulla, you wouldn’t do well in the Army, you argue too much!”)

Now, thirty-five years after I became aware of the job ‘paramedic’, I have just completed a course for Emergency Care Assistants, the first rung on the ladder toward being one.

Paramedics did not officially exist in Cyprus until recently. If you had to call an ambulance, you might or might not get one from the General Hospital. If one came, it would certainly have a driver, but he would probably have little or no first aid training. A nurse might be on board, or another bod to help with lifting, but attendants had little or no medical experience, and at least sixty people died each year because of the lack of trained first responders.

John Thompson and Houston Medical are changing that. For at least five years, John (from here on known as Da Boss) – a former medic with the Royal Army Medical Corps, a paramedic, trainer, and Health and Safety Officer on North Sea oil rigs -- has made the creation of a private ambulance service with trained crews his mission. Alternating working on the rig for two weeks with returning home to Paphos for two weeks, he has managed to build a five-ambulance fleet that serves a small number of – mostly expat – subscribers. Now he is starting to train crews in earnest, and I was in on the first course.

SH, an old friend of Da Boss, came over from the UK where he works as a trainer of paramedics and put Houston’s current employees (J, a twenty-year driver for the Scottish Ambulance Service and a veteran of the Lockerbie bombing; ST, another Scot, a former mechanic and police recovery driver, married to C who worked as a dispatcher for Scottish Ambulance Service – yes, it confuses me when they refer to their time in the SAS; B, twenty-five years in the Royal Engineers who built the beachhead in the Falklands; and R, a Swiss paramedic who has just gone home for an operation) and me (the Cherry) through a forty-hour course that included casualty assessment, diagnoses, advanced first aid, and evacuation techniques as well as discussing mass casualty response and triage.

The week was exhausting and stimulating. Not only were there many hours of lectures, but there were long periods of practical work as well. We – or at least I (it was Old Hat to the others, but they needed their paperwork in order) learned to take blood pressure and blood sugar readings, to insert different types of airways, to suction, to splint, to use an orthopaedic scoop and a spine board; we learned different techniques of helmet removal, and different lifts. On Sunday we provided medical cover to the Paphos Tigers rugby match (some knee injuries, a couple of stubbed toes, and a few gashes requiring Steri-Strips).

When the course finished, SH took me aside saying “Well, you’d better trot down here on Wednesday then, and ask Da Boss about a job. I think you’d be an asset.”

So I did. And for the first time since 1988, I have a job. Part time – event cover for now, until I have more time up on the vehicles and more training -- also until there is more money around in the shape of a full-time contract for medical cover at Pissouri village (several Pissourans have died of heart attacks over the last few years, and the muchtar is keen to have a crew from Houston based there 24/7 – right up my alley since it’s just down the road). I get a nice dark blue uniform and weekly training sessions. In a few months, I hope to be able to get training in advanced driving techniques so that I will be able to drive the ambulances.

All this is not without a degree of angst on my part. Despite all the things I’ve done and all the places I’ve been – many of them hairy – I have never seen as much as a road accident (ok, I was in a bus crash in Egypt, but that was at night, and there were very few injuries, none of them horrific), let alone dealt with heart attacks, broken bones or any of the other conditions that we spent the last week talking about. Except for my parents, who both died at home after illness, I’ve never seen death. I wonder how I’ll cope. “Train hard and fight easy,” was SH’s answer, and Da Boss said: “Don’t worry lass, you’ll no’ panic on us!” (Yes, he’s a Scot, too).

Meanwhile, I’m still working in the field and delivering veg, still ferrying children about, and still trying to find time and head-space for writing. The adventure continues…

Friday, September 4, 2009

On Children and Dentistry

A fortnight ago Zenon told me that he had a pain in the back of his mouth and wanted to see Dr C, the paediatric dentist we have been using for the last nine years. “I think I’m getting a new molar… maybe a wisdom tooth!” So, counting backwards, I realised that about six months had past since the Littles' last uneventful appointment with Dr C -- they've never had any dental problems except for an accident that chipped one of Zenon's front teeth eight years ago, (the Big Ones go to Dr Lenia, my dentist), and made an appointment for the following day.

Zenon went first, clambering into the chair while Leo played quietly with the toys in the colourful reception area.

After agreeing that a molar was indeed breaking through at the back of Zenon’s mouth, Dr C frowned. “You still don’t use fluoride toothpaste?” I confirmed that we are a fluoride-free family. “He has some very bad cavities!”

I peered inside Zenon’s mouth and saw a black area between two teeth. Dr C scraped with a probe. “This tooth is affected, and, “ he scraped its neighbour. “This one, also. He will need two fillings.”

We decided to do them then, as I had plenty of time that morning, so with Leo floating between surgery and waiting room, Dr C drilled and filled Zenon’s teeth. Because one cavity was a little bigger, Dr C had to use local anaesthetic, but Zenon bore the procedure with no complaint and only a few winces and wry expressions.

Then it was Leo’s turn. As soon as he took the chair and opened his mouth ‘as wide as wide!’, Dr C frowned again. “This one needs lots of work, look! At least six teeth are affected with decay, but these are much bigger!”

With no time for him to do Leo’s that morning, Dr C sat me down at his desk, flipped open his lap-top, and began explaining the procedure for ‘pulp amputation’, a procedure that he would have to do on at least four teeth to ensure that there would be no possible infection, abscess, or later trouble. “Even though these are baby teeth,” he explained. “We must work to block any possible route of trouble.” Even though Dr C’s English is fluent, I wanted Best Beloved to hear this, and asked if I could bring him to the next appointment “When we will do the first, easy, filling as I want to see how Leo reacts to the drill.”

“Of course, bring the baby’s father, and I can explain everything to him!”


Next week the three of us trooped into the surgery, Leo endured his filling without a murmur, and Dr C explained his plans to Best Beloved. He also presented his bill.

The fillings that Dr C had done were fifty Euros each. The extensive work that he was planning for my six-year old would work out at one hundred and thirty Euros per tooth.

As we left the surgery, my husband turned to me. “Take him to Dr Lenia and see what she says,” he advised. “Lenia’s a great one for not intervening, and a second opinion is always a good idea, especially when the first opinion says to rush in with all sorts of complicated and expensive solutions.”

Music to my ears. My confidence as a mother had plummeted; my children’s teeth were riddled with decay and I had a crackpot attitude to fluoride. Dr C had made me feel seriously inadequate as a parent.


Our appointment with Dr Lenia was yesterday morning. She peered into Leo’s mouth, said “I can see four teeth affected by two minor areas of decay. My recommendation is to leave it for six months, make sure he brushes every day and use floss a couple of times a week. Continue to use the Mastic toothpaste – it has excellent properties, and I know that you don’t like fluoride. When you bring him back in March, we will fill them if the cavities have deepened, otherwise we will just wait for him to shed the teeth naturally.”

”No pulp amputation?” I asked. She gasped and rolled her eyes.

“Is that what he told you?” she asked. “Do you know how many of my patients have brought me their children after the paediatric dentist has done this and I have to extract the teeth and deal with serious infections?”

Lesson learned. Faith in my ability as a parent restored. Another layer of cynicism added to my carapace concerning certain members of the medical establishment and their addiction to tampering.