Planning

Benjamin Franklin said "failing to plan is planning to fail."  I do not know the situation upon which he offered this witticism, but it is apropos for me today.

Next week is the 13th anniversary of 9/11 and as I consider my work for Never Forget Foundation, I am still being asked which schools and where I will be at as my itinerary is put together for me.  I am amazed by the details that go into whether or not we speak at a given school or attend a particular event, but that is what life is I guess...jumping from one event to another and hopefully planning ahead for the contingencies at each location.

In any case, it i keeping me busy as I get to consider opportunities and say yes or no while figuring out will I have time to grab something to eat in between event after event sequentially so that we can make the most of limited time.

In any case, I hope you are considering your remembrance of 9/11, even if you do not have the planning that goes with.  Obviously it is a critical date for me, but I hope we do not let it just become another day on the calendar.

Hot Situations

...as Ferguson, Missouri boiled over last week a common theme was the over reach by local police for their response after the shooting with military grade weapons and actions that violate civil rights.  Tampa, Florida seems to have the other problem though.

According to at least two media reports (local and Washington Post) a Tampa area mother watched as her child got "redder and redder" as he was locked in a vehicle that Tampa dispatchers would not respond to when she called 9-1-1.  It took an off duty police officer to come to her aid by calling a second dispatcher and sending resources her way.

Given the number of heat related deaths per year in the United States I am amazed by the callousness of the initial call taker who said that responders would likely just smash her windows.  That is true...they may.  We knuckle dragging fire types though may also find another way in, but either way, that is a decision for responders who should be on the road immediately rather than waiting for a AAA locksmith to show up.

For me, this ranks up there with the DC Fire EMS scandals of non-response except it may be worse in this regard.  All the call taker likely had to do was press a button and/or speak a few words.  How lazy can you get?  You aren't even doing the real work.

You just need to send people willing to handle the situation and perhaps try to help the mother find ways into the car in the meantime.  I know a number of dispatchers who like to wear their career on their sleeve and talk about "I tell YOU where to go."  Maybe so, but if you act like this call taker did, you deserve to go find a new career.

This is one public safety story that has me hot.

** All Point Bulletin -- All Points Bulletin: For Safety's Sake...

I apologize.  I am truly sorry to interrupt my regularly scheduled blogging, but I have to raise awareness on a serious issue affecting those who take selfies.

Okay, granted it might be argued that those who take selfies may have a body image mental health issue I think we may have missed the point.  In Spain, authorities are seeking a man for taking a selfie - while he participated in the Running Of The Bulls.

Their concern is that by taking photos or videos, he is creating a danger.  Let me say that....by taking photos and/or video while running with bulls is dangerous.  The running of the bulls they are not too worried about, but you shouldn't take a photo while doing it.  What?

Somehow I think the point will be missed and personally I hope this guy gets away with it, but the authorities desperately need to re-think the strategy on this one as it isn't the picture taking which is all that bad.

Granted I realize there is all kinds of danger in engaging in a dangerous activity, such as bull running, but the San Fermin Festival rakes in the cash I am sure as thousands of people descend upon Pampalona entirely for the purpose of running with the bulls.  As for those around him, they exposed themselves to a similar danger by running with the bulls and are in no greater danger from them than they were before.  This is I suspect the experience of a lifetime and I hope to do it myself before I can not play along with the younger crowd.

I hope that those who have no issue allowing people to endanger themselves for sport will not endanger their wallets too simply because they want to record it.  Ahem.

Put The Fork Down...It Aint Genetics

A recent article in the British Medical Journal argues that the obesity epidemic is not secondary to a genetic condition that wasn't obvious for hundreds of years, but that obesity is caused by our eating habits and lifestyles.

A follow up from Art Caplan, from the Division of Medical Ethics at the NYU Langone Medical Center, notes that in a thirteen mile stretch of rural Pennsylvania he was driving he counted "19 kings, arches, colonels, and so on."

His point was that while genetics may have an influence on body size, more likely it is lack of discipline and the wide nature of choices we have...everywhere.

The study was clear that those most exposed to fast food were likely to have higher body mass indexes.  Again, I consider myself a foodie and love to eat.  Do I eat to excess?  Probably.  Do I blame it on genetics though?  No.  My family weight issues (to the extent they exist) have everything to do with excuse making and lack of willingness to get off the couch.  I feel lucky I have pretty active kids who want to play baseball with me or who want to run around the block.

For me though, Caplan's piece is equally important as the original study as it comes from the perspective of a medical ethicist.  We need to stop making "easy way out" excuses for our patients.  I know in EMS I have heard way too many partners who provide the excuse to the patient who wants a cigarette.  I have seen a 32 year old woman who I transported for open heart surgery two weeks earlier buying her cigarettes at the local pharmacy.  (She had a weight problem too.)

Weight is no different.  As a culture we need to step up and realize we have an obesity problem.  Part of that is putting the fork down, but the other part of that is putting the excuses down first.

Advice For The Young At Heart

The blog title comes from the Tears For Fears CD of the same name.  (The name Tears For Fears should be bad enough, but the link to a Wikipedia page because they don't maintain their own site should be scary enough.)  The blog meaning has to do with being asked for advice and asked for help, but then following neither.

I guess after my career in EMS, now and then I am seen as a mentor.  I don't claim to have any Phil Jackson Zen like quality though I guess in this business that would belong to the likes of Jon Politis or Dan Gerard.  While I don't put myself in their category, somehow I have managed to speak across the country for the better part of ten years.  Somehow I have survived this industry which tends to chew people up.

So...I understand why I am asked for advice.  I even am honored when people ask for my help.  However, if you ask for advice or help and then ignore it, you are showing more than disrespect, you are showing contempt.

These situations remind me of Proverbs 12, verse 15: "The way of fools is right in their own eyes,

but those who listen to advice are the wise."

I can tell you now, I do not have all the answers, but those I do have, I share.  It confuses me when people ask you how to travel the road you have already been down, but then want to take the steering wheel and return to the mistakes that has their car with three tires.  Oh well.

EMS Week

This is you, right?

You sacrifice.  Miss any of your kid’s birthdays or Christmas or ballgames?

You get up in the middle of the night to take care of strangers.  You might be paid, you might be volunteer, but either way you spend your days and nights caring for those who are in crisis.

If you do this for money, you made the wrong choice.  You can make more money at McDonald’s with less education.  If you did this for the high-speed adrenaline rush nothing will say high-speed and adrenaline like getting puked on by the town drunk at 3 AM.

This is the week we recognize EMS providers their contributions to public safety.

For those of you who I know around the country I hope you find fulfillment in this job I hope you find the honor in taking care of those whose lives seem disposable to so many others.  My original EMT Instructor though started out that when people call 9-1-1, their life puzzle is broken.  They trust two or more strangers to put that puzzle, their puzzle, back together.

That is honor.  That is commitment.

I pray that you are safe every day and night again.  Too many of us leave the job due to back injuries.  Too many of us are assaulted in our rigs trying to care for others.  Too many of us are injured on the side of the road,

For those ambulance drivers out there who aren’t sure if they make a difference this week is not about the free lunch that your local hospital may provide or the coffee mug with your organization’s logo, it is about the brotherhood of those who come together to serve others.  This past week the 9/11 Memorial opened and while there are lots of signs of the commercialism that negatively affects a great deal of our society, those of us who spent some time responding to one of those sites share a bond few understand.  Those of us who did double duty and ended up at Katrina or another nationally recognizable event have a second story, but the bonds are the same.

Again whether you are paid or volunteer, we are the modern good Samaritans.  Use this week to take your bow.  Enjoy our brief moment in the sun because you know it won't last as attention turns to the more popular public safety folks.  Then find the resolve to recommit yourself to your continuing education because we really don’t have any idea what the next one will be so find a way to be ready.  Step up and recommit yourself to what you do and the difference you make.  Finally, come home at the end of your shift.  Come home the same way you came in...maybe a little tired, maybe a little unsure what the next twenty-four hours will bring, but ready to be someone's hero.

EMS Dinosaurs

This morning a friend of mine told me he was headed over to a local college to do EMT testing and the his assignment was long backboard and spinal immobilization testing.

I found this funny because for years we’ve known that the routine immobilization of the spinal column by EMS has more dangers involved with it than positives in terms of preventing cervical spine injury.  It makes me wonder when the National Registry of EMTs will remove this testing station from their catalog of assessments?

While routine spinal mobilization was likely important 30 years ago when National Registry was formed, it has obviously fallen out of favor when you consider the NEXUS study and other data points that show in general we don’t need to be performing spinal mobilization.  Additionally, EMS generally considers this a low risk event because when we do spinally immobilize, we do it poorly.

It is interesting to me that we are teaching the EMS pops a skilled and belongs to the EMS dinosaurs.

Why Start Now?

My question is the same.  A friend on Facebook recently noted how EMS is changing based on an article at EMS1 By David Givot.  The premise of his blogpost was that EMS is becoming more autonomous and that is a good thing because it will weed out the weaker providers, but I have to ask first off, why start now?

I don't want to be dismissive of Mr. Givot or his thoughts, but does he really think it is that easy?

First off, we aren't licensed.  Okay, in Texas there is a Licensed Paramedic level where the state charges you an extra $25 per certification cycle, but it means zero.  There are no practical differences in care delivery between a licensed paramedic, a paramedic, or a National Registry Paramedic in Texas.  All three are the same in that they function under a physician who delegates their practice - like the rest of the country as far as I know.

Second, EMS is hardly a homogenous industry.  There are many places that EMS is run by the fire department, in others county third service by a hospital district, or perhaps the county, or perhaps a for-profit entity.  Additionally, EMS includes inter-facility transport teams which are entirely for profit programs that have less interest in patient care than warm bodies to transport other bodies.

Finally, I have to ask if he is being serious.  Despite news reports a few years back about a Massachusetts company running fake recertification courses, they continue to happen.  Art Hseih had an important post on this in 2012 when he spoke about "The number of personnel involved in the fraud was significant. It spoke to the ease and comfort people had not to attend classes and yet claim they had. It was pretty easy for people in positions of authority to condone the practice and at the very least turn a blind eye."

Yet I see supervisors (and educators) continue to allow the type of behavior that should have shocked all of us, not just Lexington, Massachusetts into action.

How in the world do major companies like Rural/Metro get themselves caught up in certification scandals on issues as basic as CPR cards?  Worse, not only are these companies big and small trying to play this game, you know your company does too.  Those are issues that not only rear up their head in terms of is your card worth having, but also, will you continue to get paid by the federal government.  For some reason, the feds dont seem to enjoy paying for services, much less for services that were obtained by having crews with false credentials.

These are the issues that make people wary of public safety and make me wonder if and/or when issues of similar size will catch up with other educational and EMS service delivery entities.  These are the issues that make me wonder if EMS actually expects to catch up with the rest of medicine and I suspect the answer is no.

It would be nice for EMS responders to truly find themselves more autonomous, but despite being in our infancy as a profession, I don't see us starting off with behaviors likely to help us get there.

Paperwork And Meaningless Comments

Grrr....nothing makes me madder than organizations that self inflict paperwork on themselves for unimportant reasons, but don't communicate on the important stuff except for meaningless comments about how much someone "means to an organization." Again and again, I hear "thank you for being here. We're excited to have you," but again and again it just aint so.

You can see it in the hallways of the people you work with in your organization I bet.

"Thanks for showing up to work (on time)," but no effort is in place to deal with those who don't.  Managers who dilute their own comments by not acting on what they say is important just gives incentives to those performers who see that doing just enough is considered great, so why put forth great effort, when "just enough" is all you need?

To the first part, why do organizations go out of there way to make sure you document things that have zero to do with anything? It isn't billing, it isn't patient care, it isn't anything. Meanwhile you have to constantly guess whether or not you even know your current protocols because major changes occur without anyone informing anybody. Excuse me, when did this drug get added and why didn't we get a basic e-mail? Is our communication really that bad?

On the other, I hate to be needy, but when you say I will get back to you, gosh darn it, I expect you to. This is not complicated, nor should it be. I know you expect me to get back with you, but really is it a two way street or not because I am a little offended. Pick up the phone or type out an e-mail. You know how to do it when you need a shift covered.  We talk about being adults, but when people can not handle their own schedule because it rotates or they have another job or they can't focus or...whatever, you lose the ability to complain about anyone else.

I remember a lecture on Critical Incident Stress Management by Vickey Taylor who was talking about this business and how we wanted big incidents and they may be the cause of significant stress, but how the day to day grind and the goofiness would get to you every time if you let it. I guess it is getting to me. Glad I have downtime coming.  Grrr...

Your human resources are your most important natural resource

I find myself writing about this regularly it seems, but maybe it is because so many people don't seem to get the lesson.

A few years ago, in the August of 2011, I was invited to the Arkansas EMT Association's annual conference in Hot Springs, Arkansas to present an all day session on leadership.  During this time, I used a lesson I learned from General Colin Powell which was about attention to your people.

The crux of his comments were that you had to pay attention to your people.  In a brain based economy, the most important thing you have is not tools or technology, but your people and their critical thinking ability.  This reminds me of a former boss I had when i was doing natural resources policy in Virginia who said our most important natural resources are our human resources.  I don't know General Powell, but in the latter case, she meant it and it was clear every day that her focus was on her people.  Not just a handshake, cup of coffee, or a hello, but a genuine, "what is going on?"

It brings me to the other point General Powell was making about leadership and people which was when folks don't bring their problems to you it is usually for two reasons.

1. Your people think you are incompetent and can't fix them, or
2. Your people don't think you care...and you can't fix them.

Both are problematic for the leader who needs his or her team to function well in an increasingly competitive environment because at that point the team doesn't think you can lead.

It seems appropriate to remember that the guy with the most cool toys or technology is only the guy with the most cool toys and technology, but if his staff isn't buying into the message otherwise or not "getting it" there should be a siren going off.  Especially when you are in public safety.

We all know of organizations where there are cliques - in the firehouse, in the rescue squad, even the patrol room - but when it negatively affects service delivery, it might be time to look at those apples poisoning the bunch.  Do they pick and choose what rules to follow?  Do they hide assets from other team members?  These are the things that should be raising alarms and demand a response.

Things are usually harder to stop the longer they go, so the question becomes do you handle problems when they are small or wait until they are big?

Stay safe!

Which Fish Is On What Hook?

Didn't I just write about public safety eating their young?  I hate to be a broken record, but really I see it up close sometime.

Okay, so my question is why are there older generation folks who sit back, relax, and refuse to assist the next generation of providers....until.  Until they do something they (the older generation) do not like.

"You can't do it that way."

"You're doing it wrong."

"You do it the way I say it."

Ever thought about offering an explanation?

You see, it isn't I don't want to learn from you, but when I watch you pencil whipping your friend's certifications or coming back to a serious questions with pithy answers like "you don't need to learn that because you can't fix it" I tend to wonder about the other advice you have for me.

Crazy idea here, but if you want me to take you serious, be serious.  Stop with the passive aggressive.  Show up on time and be a positive influence.  In fact, when you get asked to take on a project, take it on.  Don't say no, and then yes, and then no, and then yes to feed your ego.  Others of us are already picking up your slack for those days you don't have time to do the basics of your job.  One more task is no big deal.

It infuriates me because all of this is true and we see it again and again in organizations where we allow people to dominate a conversation simply because they speak louder.  The news flash is yelling is not policy and it certainly doesn't help the workplace dynamic.

If you are looking for a meal, go eat lunch, you've jumped some new people one time too many, and the fish may be in the mood to bite back.

Milestones

So almost two weeks ago it was time to celebrate.

Yes, it was a birthday, but due to travel schedules and life, the birthday party was later in the week or was it?  Ash Wednesday, my birthday, was full of presents as was the week.


So...first off, work.  I am required to obtain my certified flight paramedic credential.  I have more than a year to complete it, but it is done already.  I worried when I was told that a small envelope had arrived for me at home the first day I had left for my most recent conference.

A small envelope?  A small envelope is the same thing as college...thanks, but no.  A small means a letter without patches and pins and such, i.e. a "thank you for attempting to pass the test, but your knowledge base is what we call the small size of tiny" letter.  Instead it was a breakdown of my scores with the magic word - passed - on it.  How in the world did this happen?

I'm not sure, but Hallelujah!

Of course if I am being religious I have to note a gift I received as well.  I carry with me a 9/11 rosary when I work.  It is one of those things you do to both remember the past, as well as your own, and an item that provides me hope and determination for the future.  Recently my parish priest joined several other Anglican Ordinariate priests in a pilgrimage to Rome.  My darling girl decided that perhaps our parish priest, Father Timothy, might have the opportunity to have my rosary blessed by Pope Francis.  It was.  To think, the item in which I find my strength, that lies in my breast pocket when I work to ease the suffering of the ill and the injured was blessed by the successor to St. Peter I feel more energized than ever.

Pope Francis has called on us to serve those in need and I always thought I had, but now I find myself wanting to do more...to try more...to anything to succeed.

My birthday came and went without much fanfare - again work and life did not so much get in the way as make it a non-priority - but the milestone birthday was marked by both a personal and professional success that I am not sure I earned.  Even passing the FP-C test I feel was ordered for me as I know I still have so much to learn.  How then can I have had this success laid at my feet?  It still amazes me on so many levels.

However, the next step is I guess the one that matters.  Milestones can show us where we have been, and they may be markers for the future, but only if we enjoy the recent view long enough to start the journey towards the next one.

New Heights

I can not claim to be at the tallest place in America or anything.  The closest I have come is Loveland Pass, but I am at an EMS conference enjoying new friends and good conversation somewhat at altitude and that makes me think of an appropriate drink.

I have to suggest an older coffee-based drink called Pike's Peak.

It is made with half pour of Kahlua and peppermint schnapps into a coffee glass, followed by coffee and then a dollop of whipped crème.

Clothing Colors Make Less Difference Than Effort

So my most recent Dallas Morning News column got posted.  While I normally post the text within my blog, I would love it if you wander over to the DMN site and read it there.  I guess I am being bad and hoping for an extra few hits for my editor to take notice of from my loyal readers.

The bottom line preview for you though is clothing can make the man (or woman), but the usual clothing choices do not show where the real battle is in terms of statistics.

If you have a moment, this Sunday morning, I would be grateful if you would check it out and ruminate on your way to church or whatnot.  Thoughtful comments are always appreciated and I am already busily working on another education column that I have in mind for a few weeks from now.  Everyone stay safe and have a great day.

Teaching Success

One of the problems with being involved with EMS education and training is does the student get it?  Sometimes despite the best intentions, tests, quizzes, and megacodes you don't know if someone "gets it."

Recently I got to hear about a patient who did not compensate post procedure.  Instead of the patient continuing to deteriorate though, a group of students I have been working with intermittently for years, sprang into action and executed a pretty good plan of action which resulted in the patient's condition improving dramatically.

Sometimes you don't realize whether or not you are successful, but is great when you get to see it and see the critical thinking post event in your students as they show not only did they get it, but that they want to then take the next step and go even further.  These are the days I love.

Charge Me Up

Do you recognize the x-ray image?

I know, I know, it could be any kind of metallic disk that is obviously not where it is supposed to be. but today is National Battery Day.  Woo hoo...can you say excitement?  Okay, I don't know that my sarcasm is necessary today.  Let's face it, in 2014, who can get by without their battery driven cellular phone?  Or laptop, or watch, or any number of other items.

Having said that, I am going to use today to highlight a major issue, battery ingestion by youngsters.

Disk batteries contain mercury, silver, zinc, manganese, cadmium, lithium, sulfur oxide, copper, brass, or steel.  They also contain sodium or potassium hydroxide and range in size from about 8 to 20 mm, i.e. pretty and easy to swallow if you are in the everything goes in my mouth stage.

Unfortunately, when junior decides to swallow a battery the sodium hydroxide that is created as a byproduct of energy creation can cause tissue necrosis in the esophagus.  This then leads to perforation - sometimes in as little as six hours.

Even after ingestion and removal, there can be ongoing tissue damage due to residual chemicals.  For those fire guys interested in hazardous materials, these are caustic materials.  For everyone reading, remember caustics eat tissue, corrosives etch metal.

Again, do not get me wrong.  I need batteries as much as the next guy, but today being National Battery Day seemed as good a day as any to talk about accidental ingestion by our little folks.  Keep them and you safe and have a great day.

PS If you find yourself on the scene of a battery ingestion, like poison control, the National Battery Ingestion Hotline might prove useful.  They can be reached at (202) 625-3333.

When The Tables Turn...

Do you remember this video from a few weeks ago?

That's right, it's a California Highway Patrol officer arresting a firefighter on the scene of a working accident.  Do you remember the firefighter's crime?  That's right, he would not move his apparatus from the lane which was providing scene protection to the incident.

Fast forward to yesterday, when I learn that two CHP officers lost their lives responding to a multivehicle accident.  While they weren't on the accident yet, but were responding to it and swrved, losing control of their vehicle, for me the lessons are the same.

Both fire side and police side would do well to remember where they are killed.  The highway.  In 2013, police officers died 47 times in incidents involving automobiles either during pursuit, being struck on the side of the road, etc.  Fire side has similar statistics.  Firefighters don't die in burning buildings, or when they do, it isn't the combustion, but the heart attack that gets them.

What is my point?  Well, crazy idea here...get on the same team before bad things happen.  The incident outside of Chula Vista is totally inappropriate.  I get there are multiple people who could be in command, but when someone is actively caring for a patient, help them get it done, so they can get out of the way and help you move traffic.

This is the kind of stupidity that seems to mark the modern police force though.

Does anyone remember a little incident a few years back called 9/11?  While the attack on the Pentagon could have fallen into any number of command hands that morning, an FBI agent who showed up, Christopher Combs decided instead of taking command of an enormous fire and patient population he was probably undertrained for instead he would find the fire incident commander and ask "what do you need?"

Amazing how quickly a potential problem is defused when we offer help instead of waving our badges around?  To my police colleagues, let me tell you if I may, I have zero desire to be on the side of the road any longer than I have to, but the big red truck keeps us both safe.

Sometimes that isn't even good enough as I was lucky or unlucky enough to be on a scene where a drunk went around the big red truck only to hit a helicopter a few years back because he "didn't know why it was flying so low."

It is stupid that a fatality and an arrest is needed to make Rodney King's point.  We're all in public safety.  Can't we all just get along?

Dining On The Young

I am regularly amazed at those in high speed public safety who are there basically for a paycheck and their ego.

Again and again, there are folks who just don't seem that interested in doing what they signed up to do and are "burned out" or "done" with their career choice.  Well, move over.

These same people so rarely will move out of the way for the next generation that they become the people that then dine on the next generation who want to step into the fold and make a difference.  If it's that bad, (a) why are you doing the job, (b) why are you beating down the people who are trying to make it better?

I read a post a while back over at the Irons and Ladders Blog and it was great.  I just don't get why we have to have posts like this or that?

Is it that hard to actually check your unit in the morning?  How hard is it to make sure your crew is up to speed and ready to go?  And if you aren't part of making things work then get out of the way.

There is the classic line about you're either part of the solution or you're part of the problem or part of the scenery.  While being part of the scenery really doesn't help, at least you aren't slowing down progressive efforts to improve the situation.

In any case, I feel lucky to choose to be with people who want to be successful and are in an environment where we can make a difference.  I realize not everyone in public safety has that opportunity.  I hope one day we can all get there though.

Impact

Some days you don't know the impact you have until you are gone.

Today I was speaking at the South Plains EMS Conference in Lubbock, Texas.  I had mentioned this in the Washington area a few days earlier and the immediate question I got from several people was did I know Jim "Major" Majorowski.

The quick answer is I had no idea who the man was, but the community of Lubbock does.  He and I sound like we might have been pretty similar in our lives.  He coached his daughter in soccer and I coach mine in baseball.  He and I both volunteered in our respective communities at our local fire departments and he and I have both been involved with EMS education and delivery.

I wonder sometimes if we keep in mind the people who serve us and we get to serve.  I think about the times when someone has been on my cot as we went to the hospital and they told me they were so-and-so, the wife, mother, brother of someone who had started the rescue squad I was working for.  I think Mr. Majorowski understood this and the impact on the community he had, not as a caregiver alone, but as an advocate for his patients.  Someone who would provide them good care, but a hug when needed.

It reminded me of a survival course I took once.  They told me a person can last three weeks without food, three days without water, but only three minutes without hope.  I suspect Major dispensed hope with all his might and I wonder if he understood how important it was to keep those strings of hope alive for the sick and the dying.  I suspect God has a response vehicle ready for you to keep offering hope to those in need.  Godspeed Mr. Majorowski. 

Airplanes, Cars, and Hotel

And we made it to part one and two today (i.e. I am on the plane).  Also, on the plane is Dr. Paul Pepe who I used to work with regularly, though he doesn't seem to have noticed me.  I guess I will have to give him a hard time about this later.

Today is one of those days where we enjoy air travel, getting the rental car, and then the hotel as we continue our journey to another city for another conference.  In this case, it is the South Plains EMS Conference in Lubbock, Texas.  The crowd was great the last time I was there and I am hoping for similar this time.

But first, we must get there.  So, a shameless plug for American Airlines who gets me more places than I can remember, Budget Rental Car, who I almost will exclusively use because the same car is usually $10 cheaper per day than their sister company Avis...someone explain that to me.