Stuck in Dutch Harbor and eating lunch

 Ralph and I made it to Dutch Harbor and looks like all flights this evening are going to be cancelled. All checked in to the Grand Aleutian Hotel.

We are sitting in the resturant and our neighboting table is the Sig Hansen (from the F/V Northwestern and Deadliest Catch) family and some boat crew members. 

But guess what folks, they are doing the same things you and I do at a family lunch. Eating, laughing, joking, and enjoying each other. They all are cordial and friendly and deep down just people.

As professional courtesy I introduced myself, I thought introducing Ralph might be a stretch. I told him who I was and what I was doing in Dutch. Since he is currently filming for Deadliest Catch, we wanted him to see what we were going to post to verify we would not be doing anything contrary to his contractual obligations. He approved the text and offered to get a family member to take our picture.

Ralph and I are sharing this to remind all of ya’ll that they are “just folks”.

Special thanks to the Hansen family and crew.

Follow them on Deadliest Catch!

Remember, take care of yourself and each other.

T and Ralph

Continuing to learn about different cultures everyday

 Good morning!

Ralph and I are nearing the end of this evolution in Alaska. You have read, and hopefully learned, about our interaction with a multitude of cultures as we work in rural and remote places. Each day is a welcomed cultural learning opportunity for us. At our current assignment, we are blessed to be learning and interacting with plant staff from 15 different cultures and backgrounds. This morning Ralph and I had blintz for breakfast. We heard some of you say: "a what?". So let's take this opportunity to learn about cultural things. 

First off, what is a blintz and where do they come from. Well, blintz are a large component in the Jewish culture. A cheese blintz (Hebrew: חֲבִיתִית; Yiddish: בלינצע) is a rolled filled pancake in Ashkenazi Jewish cuisine, in essence a wrap based on a crepe or Russian blini. Traditional blintzes are filled with sweetened cheese, sometimes with the addition of raisins, or fruit preserves and then slightly sautéed.  Blintzes represent foods that are now considered typically Jewish, and exemplify the changes in foods that Jews adopted from their Christian neighbors. If the blintzes are served at Passover, matzo meal is used instead of flour.

While we are at it, do any of the non Jewish readers know the major Jewish holidays? Most Jewish holidays are religious holidays observed in Judaism based on the biblical mitzvot and rabbinic mandates. The major Jewish holidays in order from the start of the Hebrew calendar are:

• Rosh Hashanah
• Yom Kippur
• Sukkot
• Shemini Atzeret
• Simchat Torah
• Chanukah (Hanukkah)
• Purim
• Pesach
• Shavuot
• Tish-a B’Av

For the Jewish people around the world, these are 10 of the most important Jewish holidays. Shabbat, which is a day of rest celebrated on the seventh day of the week, is also given the status of a holiday. Rosh Chodesh is a minor observance, occurring on the first day of  each month of the Jewish calendar.

Link to explanation of the Jewish calendar.

Ralph and I get asked all the time: "how do you get so much information about so many things?" The answer to that is simple: we interact with individuals and groups from all over the world, we are naturally curious, we actually talk to people and ask questions, and we definitely are not bashful.

We hope ya'll have a very blessed day.

Till next blog,

T and Ralph

Imaging Decisions

This is for informational purposes only. This is not to be interpreted as “medical advice”.

Ralph and I get asked quite frequently how do we treat patients without imaging capabilities. For those working ER in facilities with imaging capabilities, obtaining x-rays/CT Scans/etc is not an issue. However, when you work in rural or frontier areas imaging may not be obtainable without involving enormous transportation costs. So, today we are sharing some guidelines for determining the necessity and/or urgency of obtaining imaging for certain injuries.

Canadian C-Spine Rule

The "2 and 6 rule" in the context of C-spine fractures refers to the Canadian C-Spine Rule, which uses a system where if a patient meets two high-risk criteria OR a single high-risk criterion with six low-risk criteria then cervical spine imaging is recommended to check for potential fractures; essentially indicating a need for further investigation to rule out a C-spine injury. 

Key points about the Canadian C-Spine Rule:

High-risk factors (mandate imaging):

·         Age greater than 65 years 

·         Dangerous mechanism of injury (e.g., significant fall, high-impact collision) 

·         Numbness or tingling in extremities (paresthesia) 

·         Low-risk factors (allow for clinical assessment without imaging):

·         Simple rear-end collision. 

·         Sitting position in the emergency department.

·         Able to walk at any time since the injury. 

·         Delayed onset of neck pain.

·         Absence of midline cervical spine tenderness.

NEXUS Criteria

What is the Nexus criteria?

NEXUS (National Emergency X-Radiography Utilization Study) is a set of validated criteria used to decide which trauma patients do not require cervical spine imaging. Trauma patients who do not require cervical spine imaging require all of the following: alert and stable. no focal neurologic deficit.

NEXUS Criteria for C-Spine Imaging

Clears patients from cervical spine fracture clinically, without imaging.

Focal neurologic deficit present

No0

Yes+1

Midline spinal tenderness present

No0

Yes+1

Altered level of consciousness present

No0

Yes+1

Intoxication present

No0

Yes+1

Distracting injury present

No0

Yes+1

If none of the above criteria are present, the C-Spine can be cleared clinically by these criteria. Imaging is not required.

These are just two of the guidelines for C-spine imaging, there are several others. Know and learn the guidelines used in your clinical setting.

This is for informational purposes only. This is not to be interpreted as “medical advice”.

Have a great day!

T and Ralph

How does your culture celebrate the New Year?

 With our travels over the years, Ralph and I have been fortunate to meet and become friends with individuals and groups from many countries and cultures. The ways of celebrating events varies greatly from family to family, region to region, culture to culture, and country to country. We are going to list the way some of our friends celebrate the New Year:

 Italy

Eat 12 spoonful's of lentils, one with each chime of the clock at midnight.

• Rosh Hashanah

  The Jewish New Year, which is celebrated on the first and second days of the Hebrew lunar month of Tishrei. It's a time for reflection, atonement, and forgiveness. 

Sinhalese New Year

Marks the end of the harvest season and begins at a time determined by astrological calculations.

Islamic New Year

Starts on the first day of Muharram, the first month of the lunar Hijri calendar.

China

Celebrate Lunar New Year, which marks the beginning of spring and a new year on the lunisolar calendar.

Denmark

Smash old plates and glasses against friends and family's doors to banish bad spirits.

Colombia

Walk around the block with an empty suitcase to wish for a year of travel and adventure.

Spain

Eat 12 grapes, one for each chime of the clock at midnight, for good luck and happiness in the coming year.

Finland

In Finland, people predict the coming year by casting molten tin into a container of water, then interpreting the shape the metal takes after hardening. A heart or ring means a wedding, while a ship predicts travel and a pig declares there will be plenty of food.

Panama

To drive off evil spirits for a fresh New Year’s start, it is tradition to burn effigies (muñecos) of well-known people such as television characters and political figures in Panama. The effigies are meant to represent the old year.

Brazil

In Brazil, as well as other Central and South America countries like Ecuador, Bolivia, and Venezuela, it is thought to be lucky to wear special underwear on New Year’s Eve. The most popular colors are red, thought to bring love in the New Year, and yellow, thought to bring money.

Greece

An onion is traditionally hung on the front door of homes on New Year’s Even in Greece as a symbol of rebirth in the New Year. On New Year’s Day, parents wake their children by tapping them on the head with the onion.

And ya'll think Ralph and I are weird...... 

Thank you for over 36,000 views!

 Thank you all for supporting our blogging. We have officially received over 36,000 views. While this doesn't seem like a large number when compared to many other blogs, to us it gives validity to our efforts. 

Whether you read the blogs because you are considering doing locums assignments, need a good laugh, or just scratch your head and think "wtf" Ralph and I are very appreciative.

We try to inform, occasionally educate, and attempt to give you a small dose of stress relief. But we always want you to remember that we get as much or more from you than we can ever hope top give back to you.

Forever humble,

T and Ralph

Celebrating Two Christmas' in Alaska

 

Ralph and I hope Santa brought you everything you asked for (or at least what you truly needed).

From the title of this posting some of you are already scratching your heads because you "know" there is only one Christmas. Well for all you knowledgeable Christmas scholars we have earth shattering news for you. There are actually two Christmas' celebrated in Alaska. There are six principal calendars in current use around the world. These are the Gregorian, Jewish, Islamic, Indian, Chinese, and Julian calendars.

There is the traditional United States Christmas celebrated on December 25th each year. This is determined because the United States, and most parts of the world, use the Gregorian calendar. Pope Gregory XIII introduced the Gregorian calendar in 1582. This replaced the Julian calendar, which had been the most common calendar in Europe up until this time.

So, why the need to change the calendar? The Gregorian calendar was designed to accurately represent the Earth's solar year and seasons. Scholars of the time used astronomical observations and complex mathematical calculations to create it. The Gregorian calendar has a year length of about 365.24 days. Most years have 365 days, but every fourth year is a leap year, with the exception of years that are divisible by 100 but not 400. For example, 2000 was a leap year, but 2100 and 2200 are not. The Gregorian calendar is used by the United States and the rest of the Western Hemisphere.

So why is one Christmas not enough? With Alaska's close proximity to Russia one can presume (correctly) that as people from across the Bearing Sea migrated to North America (Alaska was the closest point of land) they brought their religion with them. Orthodox communities in Europe, Africa and the Middle East - which make up more than 12% of all Christians - celebrate Christmas Day weeks after most of the Western world. It's because they use a different calendar, called the Julian calendar (developed by Julius Caesar), to work out what day Christmas should be. On the Julian calendar December 25 corresponds to January 7 on the Gregorian calendar. Additionally, they celebrate Advent, which is 40 days long and begins on November 28.

Ralph and I will be celebrating "Second Christmas" with our Alaska friends on Jan 7, 2025. So, what does that entail?

Russian Orthodox Christmas takes place on January 7 and the celebration lasts for six days. 

In the Orthodox tradition nothing is eaten or drunk on Christmas Eve until the first star appears in the sky. The star is symbolic of the great star that led the Magi to the newly born Christ. Once the first star has appeared in the sky, the festivities begin with a Lenten meal - meaning meat or dairy products (including chocolates) are excluded. This Christmas Eve meal is "The Holy Supper" . The family gathers around the table to honor the coming Christ Child. A white tablecloth is used to symbolize Christ's swaddling clothes and hay is displayed as a reminder of the poverty of the place where Jesus was born. A tall white candle is placed in the center of the Table, to symbolize Christ - the "Light of the World." A large round loaf of "pagach", a special Lenten bread, is placed beside the candle to symbolize Christ - the "Bread of Life".

The father begins the Christmas meal by leading the family in the Lord's Prayer, a prayer of thanksgiving for the blessings of the past year and for the good things to come in the new year. The head of the family greets those present with "Christ is Born!" - the traditional Russian Christmas greeting - and the family responds with "Glorify Him!" The Mother then draws a cross with honey on each person's forehead, saying a blessing - "In the Name of the Father and of the Son and of the Holy Spirit, may you have sweetness and many good things in life and in the new year." The Lenten bread (Pagach) is then broken and shared. The bread is dipped first in honey to symbolize the sweetness of life and then in chopped garlic to symbolize life's bitterness. The "Holy Supper" is then eaten. After dinner, no dishes are washed and the Christmas presents are opened. The family goes to church for the Christmas Mass which lasts until after midnight.

Traditionally, the "Holy Supper" consists of 12 different foods, symbolic of the 12 Apostles. Although there was also some variation in the foods from place to place and village to village, the following is a good summary of what is typically served.

1) Mushroom soup with zaprashka (or Sauerkraut soup)
2) Lenten bread ("pagach")
3) Chopped garlic
4) Honey
5) Baked fish
6) Fresh Oranges, Figs and Dates
7) Nuts
8) Kidney beans (cooked slowly all day) seasoned with shredded potatoes, lots of garlic, salt and pepper to taste
9) Peas
10) Parsley Potatoes (boiled new potatoes with chopped parsley and margarine)
11) Bobal'ki (small biscuits combined with sauerkraut or poppy seed with honey)
12) Red Wine

On Christmas morning the family returns to church for the Christmas day Liturgy. After church the family gathers together to exchange gifts and share a special Christmas meal. Children go from door to door caroling the song "Thy Nativity".

"C Rodzhestvom Kristovom"(srod-zshest-vum krist-o-vum) is a common Russian Christmas greeting, meaning "with the Birth of Christ!"

Ralph has a thought for ya'll to ponder:

No matter what your religious beliefs or not beliefs, it is always appropriate to care for one another. If you think yo have little to give or share, think again. We are going to use an example that many of you will either be ready to scrap over or believe it is like comparing apples to raisins. Either way, we are expressing our personal beliefs. 

When I was a preteen, I attended a large Baptist church. Every Wednesday and Sunday (twice) the pastor basically begged for money from the parishioners. Emphasizing that each member should be tithing 10% of their income to this church, "regardless". There was a family with very little financial resources. They were obviously struggling to keep food on the table and a roof over their kids heads. The mother volunteered to clean the church every week since their family had no extra money and they literally were scraping by. In open service the pastor scolded this family for not tithing. He actually made the statement: "we just need you to tithe, we pay a janitorial service to keep this place clean."

To this day Ralph and I do not understand this logic. At the awesome age of 11 I asked the pastor, in front of my parents: "wouldn't it be more money if you didn't pay the janitors?". The pastor explained to my parents that they needed to go home and pray for their "troubled son". Since my only sibling was female, I deduced that he was referring to me. Needless to say this experience made a very lasting impression on me.

You say you have nothing to give. Ralph and I disagree. We all have a few minutes of time we can share with someone. We can always have an open ear to listen, without opinion or judgement. If you have an apple, you can share. It will amaze you the positive impact human touch can have during someone's time of trouble. Each of us has a multitude of gifts to give and share. 

As Ralph and I get down off our soap box, we hope each of you have a Merry Christmas and a blessed New Year in 2025.

We now will go back to our regular programing.

Happy Christmas Eve

 As many are preparing for the arrival this evening of Santa, do you actually know how this tradition came about? Santa is someone who remains in children’s hearts forever. He’s the imaginary make-believe man who magically brings gifts and toys to kids at Christmas. To the “grown-ups”, Santa Claus is the wonderful idea of selfless giving and goodwill.

Santa also has some other names too. Among the common ones are Saint Nicholas and Santa Claus. Both of these names came from the Dutch legend of Sinterklass brought long ago by settlers who arrived in New York. The Dutch long had a legend that Saint Nikolaas brought presents to children. The Dutch honored this kind saint with the annual festival celebrated on December 6th. English-speaking settlers to the new world and who lived nearby took advantage of this enjoyable Dutch festival. They, in turn, brought Sinterklass and the gift-giving custom into their own ritual celebration for Christmas.

World wide there are at least 124 names for the one we call Santa:

1. Aba Chaghaloo (Afghanistan) 
2. Aghios Vassilis (Greece)
3. Ash Man (Germany)
4. Aya Nicola (Turkish)
5. Babadimri, Albania 
6. Baba Noel, Iraq 
7. Babbo Natale (Italy)
8. Baboushka (Russia)
9. Befana (Italy)
10. Bellsnickle (Old American)
11. Bozic Bata (Serbo-Croatian)
12. Bozicek (Slovenia)
13. Christkind (Austria)
14. Christkindl (Switzerland)
15. Christkindle (Germany)
16. Daidina Nollag, Ireland 
17. Ded Moroz “Grandfather Frost” (Russia)
18. Deda Mraz (Bosnia /Serbia/Yugoslavia/Macedonia)
19. Diado Coleda (Bulgaria)
20. Dun Che Lao Ren “Christmas Old Man”(China)
21. Dyado Koleda, Bulgaria
22. Dyed Moroz (Russia)
23. El Niiiito Dios (Mexico) 
24. El Nino Jesus (Central America)
25. Father Christmas (Jamaica/England/N.Z.)
26. Feliz Navidad (Uruguay)
27. Gaghant Baba (Armenia)
28. Ganesha (India)
29. Grandfather Frost/Father Frost (Russia)
30. Gwiazdor (Poland)
31. Hagios Nikolaos (Greece)
32. Hoteiosho “a god or priest who bears gifts” (Japan)
33. Hoteisho (Japan)
34. Ilwyd (Wales)
35. Jizo (Japan)
36. Jolasveinn (Iceland)
37. Joulupukki (Finland)
38. Julemanden (Denmark)
39. Julenissen “Christmas gnome” (Norway)
40. Julgubben (Finland)
41. Jultomten “Christmas brownie” (Sweden)
42. Kaledu Senis (Lithuania)
43. Kanakaloka (Hawaii)
44. Karacsony Apo (Hungary)
45. Kerstman (Belgium/Netherlands)
46. Klees’chen (Luxembourgish)
47. Kolyada (Russia)
48. Korvatunturl (Lapland)
49. Kris Kringle (Aus./Can./U.S.)
50. Los Reys Magos (Spain)
51. Mar Nkoula (Arabic)
52. Menino Jesus (Central America)
53. Mikulas (Hungary)
54. Moss Craciun (Romania)
55. Nicolo (Austria) 
56. Pa Norsk (Norway)
57. Pai Natal (Portugal)
58. Papa Noel (Egypt/Spain)
59. Papai Noel (Brazil)
60. Papal Noel (Spain, Latin America) 
61. Pelznickel (Dutch/Netherlands/Germany)
62. Pere Noel (France/Belgium/Canada)
63. Püha Nikolai (Estonian)
64. Queen Mab, Canada
65. Rauklas (Germany)
66. San Nicola (Italian)
67. San Nicolò (Italian)
68. San Niccolò (Italian)
69. San Niklaw (Malta) 
70. San Nikolas (Basque)
71. San Nikola (Maltese) 
72. San Nicolás (Spanish)
73. Saint Basil (America/England/Greek)
74. Saint Nicholas (Aus./Can./U.S.)
75. Saint Nick (Aus./Can./U.S.
76. Saint Nicolas (French)
77. Saint Nikolaas (Netherlands)
78. Samichlaus (Switzerland)
79. Sanctus Nicolaus (Latin)
80. Sankt Nicolai (German)
81. Sankt Niklaus (German)
82. Sankt Nikolai (Norwegian/Swedish)
83. Sankt Nikolaus (Swedish/German)
84. Sant Nicolau (Catalan)
85. Santa Claus (Aus./Can./U.S.)
86. Santa Dan Short (Oklahoma City)
87. Santa Kurohsu (Japan)
88. Santy (Ireland)
89. São Nicolau (Portuguese) 
90. Sfântul Nicolae (Romanian)
91. Shaggy Goat (eastern Germany)
92. Shakhta Babah (Azerbaijan)
93. Shën Koli (Albanian)
94. Shën Kolli (Albanian)
95. Shën Kollit (Albanian)
96. Shën Nikollië (Albanian)
97. Sing Dan Lo Ian (Hong Kong)
98. Sint Nikolaas (Dutch/Netherlands) 
99. Sint Nicolaas (Dutch/Netherlands) 
100. Sint Sinterklaas (Dutch/Netherlands)
101. Sinterklas (Indonesia)
102. Sinterklass (Colonial Dutch)
103. Sontgaclau Romansch:
104. Sunnercla (Germany)
105. Svätý Mikuláš (Slovakian) 
106. Svatý Mikkuláš (Czech)
107. Svaty Miklas (Czechoslovakia)
108. Svetnik Miklavz (Slovenian) 
109. Sveti Mikalojus (Lithuanian)
110. Sveti Nickola (Serbo-Croatian)
111. Sveti Nikola (Macedonian/Croatian/Bulgarian) 
112. Sviatyij Mykolai (Ukrainian)
113. Sweti Mikolaj (Poland) 
114. Swiety Mikolaj (Poland)
115. Svyatoy Nikolay(Russian)
116. Svyatoy Nikolskay (Russian)
117. Svyatoy Nikolsky (Russian)
118. Szent Miklós (Hungarian)
119. Szent Mikulás (Hungarian)
120. Tsminda Nikolozi (Georgian)
121. Vader Kersfees (South Africa) 
122. Viejo Pascuero “Old Man Christmas”(Chile)
123. Volvo Indo (Brazil)
124. Weihnachtsmann “Christmas Man”(Germany)

The reality is the spirit of Christmas is a mood or attitude that is appropriate for the Christmas season. It is often characterized by spending time with family and friends, feelings of goodwill, a willingness to enjoy oneself, and benevolence.  For many it also refers to the biblical meaning which is celebrating the gift of God's love through his Son. The spirit of Christmas can also be a reminder of childhood innocence and a reminder of our real destination in life.

Ralph and I had a long pondering and discussion about Christmas in the early hours of this morning. Regardless of your religious or spiritual beliefs, here are some things you can do  that will allow you to experience the true spirit of Christmas:

Giving gifts with eternal value: understanding, compassion, service, friendship, gentleness, and kindness.

Sharing kindness: expressing gratitude and offering forgiveness.

Being selfless: Thinking about others, forgiving, and taking stock of what is truly important.

Being aware of our blessings: acknowledge the good in our lives, sharing what we have with those that have not, and letting those that you care about and are important in your lives know your feelings.

Those of you that read our ramblings are truly appreciated. Your presence allows Ralph and I to survey the world from perspectives that differ from our own. You reinforce the fact that we are blessed in so many ways. For this and your ongoing support we are truly humbled.

MERRY CHRISTMAS EVERYONE FROM TRIDENT AKUTAN, AK!

Ralph and T