EMS Week 2013: Knowing and Not Knowing

About three years ago, I carefully stepped down this short hallway, not all too certain what to expect. The hallway opened into a small, practically empty room. A dusty mammoth of a photocopier sat in the corner beside stacks of office paper. A few framed photographs adorned the otherwise blank white walls. The new summer sunlight streamed through a small window near the ceiling. An open door in front of me led into an even smaller room, lined with cluttered desks. To my right was an open door with a sign saying “PERSONNEL ONLY”.  I froze up, awkwardly standing in the middle of this room in a place I clearly didn’t belong.  What was I doing here anyway? Just as I turned to look at the now very alluring front door behind me, a voice asked, “Can I help you?”

I snapped my head back from over my shoulder, suddenly very aware of how out of place I seemed. I swallowed. A man with salt & pepper hair stood in the doorway, a quizzical but friendly expression on his face? Was he always there? How did I miss him before? He must think I’m crazy for just wandering into this station.

“Uh…hi. My name is Probie To Practitioner. I’m here to uh…see if maybe I could…work on an ambulance?” It was more of a question than a request. The words felt strange coming out of my mouth, and even stranger to my ear. You? On an ambulance? You’re afraid of your own shadow. You’re afraid of talking to this man here. And you’re trying to do what??

He grinned broadly at me. “Ohh, you’re the one who called earlier! Come on in! Let’s show you around, see how you feel, and go from there. Alright?”

“Hey, wanna show her around a little? Show her the ambulance or something?” This gentleman asked a short paramedic, with tired circles under his eyes and a welcoming half-smile on his face. The paramedic agreed, stepping into the doorway, and making a motion for me to follow him. He walked through the door that said “PERSONNEL ONLY”.

This was where I hesitated. I stopped, mid-step, and mentally told myself “No, you’re not ‘personnel’.” I spent a moment internally arguing this point. I just felt odd, barging into the personal space of a place filled with prestige, courage, and tradition. It wasn’t something I was a part of. I realized how stupid I would look, awkwardly posed outside the door, and how much more stupid I would sound trying to explain my reasoning to the paramedic. Quickly, I hurried through the door, catching up with him.

I followed out into the bay, smelling of cool concrete, metal, and rubber. The rest of that afternoon would be spent with an awed smile on my face, feeling like I was half in a dream, going through an ambulance check with this paramedic.

It was a peculiar moment of knowing and not knowing.

At the time, I didn’t know that this station would become my second home. I didn’t realize I’d walk these carpets thin. I didn’t know how many roaring laughs and gravely whispered conversations would reverberate off these walls. I didn’t know I’d be spending countless hours here. I didn’t know that the cool smells of the bay would become so relaxing and cleansing to me.

I didn’t realize that the paramedic who showed me an ambulance for the first time would go on to be my mentor, and one of my dearest friends. I didn’t realize that these same people I had held in my mind as heroes, would one day be held in my heart as family. Some would move. Some would leave. Some would die. Some would come and stay, others would come and go. I didn’t know how much they would do for me.

I didn’t realize the lengths to which I’d go when I was here. I didn’t realize what this job would ask, demand, and take from me. I didn’t realize how much of myself I’d give to this field, this lifestyle. I didn’t know how EMS would bend me, push me, and teach me. I didn’t know how much it would make me grow. I didn’t know how many lives I would touch, or to what extent.

Despite all that I didn’t know, I somehow knew one thing: I belonged here. It may not have been a conscious thought; even if it was, I’m sure it would have been drowned out with all the other thoughts of self-doubt and disbelief. But I felt it. I felt it in my heart, and in every fiber of my being.

EMS Week 2013. We have one mission. We are one team.

And I am beyond honored to be a part of yours.

I Took The Red Pill

I went through a box of old pictures today, and took that trip down memory lane to happier and simpler times. There was one of my second grade friends and I sitting on a brick wall in the park, sticking out Kool-Aid technicolor tongues. Another featuring my eight-year-old sister and I, horrifically sunburnt, carefully sculpting our sand castle–no, impenetrable sand fortess–on a July day at the beach. Fast forward several years, and there I am at 15 with a sports medal around my neck, a boyfriend’s arm around my waist; laughing at something I can’t remember. Towards the bottom of the box, there’s one of  me squinting into the camera, with a 6-year-old toothy grin pushing dimples onto my freckled cheeks.

I know I’m looking back at myself in these pictures, yet I feel like an entirely different person. And I can’t help but wonder…Would these girls in these pictures still feel like such strangers to me if I had made other choices? Would they feel more like memories, and less like different lives? Would they be proud to see the young woman they would go on to become? The young woman that became an EMT?

Maybe, if I hadn’t been an EMT, I never would have left the sports I’d loved. Instead of fighting my way through a community college nursing program, maybe I would be a college athlete now at some university. Perhaps, I’d be majoring in English, pursuing my life-long dream of becoming a writer.

On my breaks, maybe I’d come home and work at the grocery store, or a diner. I’d watch the clock as I worked, counting down the hours until I could go spend the evening with my friends. Instead of having friendships consisting mostly of adults, all of my companions would be stressed, idealistic kids my own age. Instead of trying to find the words to say when hearing about divorces, children, and financial issues; my friends and I would groan about our papers due next week. We’d excitedly share the news of that internship we worked so hard for. We’d look forward to graduating, gazing through dreamy veils at the perceived freedoms of adulthood.

Maybe, if I hadn’t been an EMT, I’d meet some great guy. Instead of constantly apologozing for and juggling my hectic schedule, maybe I’d actually have time to spend getting to know him. Maybe I’d have days to go out and evenings to stay in.  Maybe I’d have someone to say, “I love you” to before I hung up the phone. Instead of hearing, “I can’t do this anymore. We’re done,” maybe I’d hear “I love you” back.

Maybe, if I hadn’t been an EMT, I’d never read the obituary section of the newspaper. I’d pull over for the flashing lights of an ambulance, briefly wonder what happened, and then continue back on my way without giving it another thought. Instead of hearing the screams and cries of those involved echo inside my head when watching the evening news; the stories would only cause sighs of dismay and temporary grief, before drifting back to the dusty corners of my mind, soon to be forgotten.

But, maybe not. I will never know. Sometimes, I look into the pictures of my younger self and think, “God, the things you’re going to see. The things you’re going to hear. The things you’re going to do. If I told you, would you believe me?”

Three years ago, I made the decision to go into the emergency medical services. Unknowingly, I chose a life that would never be “normal” again. Sure, I could quit and change to a regular 9-to-5 job; but the experiences I’ve had will never leave me. Funny thing is, I don’t think I’d ever want them to.

I chose an experience, a brotherhood, a life like nothing else. It wasn’t expected or planned. But despite its occasional ugliness, I fell in love with this field. There’s no turning back now. I will never know what it’s like to have the “traditional college experience.” I’ll never know what it’s like to fumble my way into adulthood hand-in-hand with peers of my age. I will never know what it’s like to have a college sweetheart. I will never read the paper or watch the news the same way again. But, I will live my life knowing I made some small difference in my corner of the world. I will know, as tough as it can be, I did what I absolutely loved.  I will know a great many things about life, mankind, and the human spirit that most people will never understand.

It’s true…some days, I look back at my younger self and say, “What on earth did I get you into?” But I know, I wouldn’t trade this for anything.

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(Image credit)

The Breakdown (And The People Who Helped)

My mind was swirling with a nauseating soup of questions and uncertainties. I felt this sickening pull in my stomach. Yet, it was all muted. I was manipulating red hot emotions through thick welder’s gloves. I couldn’t name it, I couldn’t identify it, but I knew it didn’t sit well with me. I quietly engaged in superficial and meaningless conversation with my partner as we backed into the ambulance bay. I was just politely filling in the silence, while simultaneously trying to figure out what was happening to me internally.

Numb, I climbed out of the ambulance, paperwork in hand. I returned the other crews’ greetings, and headed into the kitchen to grab a glass of water. An officer nonchalantly followed me into the kitchen, and quietly asked, “Are you okay?”

I looked at him, confused. “I don’t really know. I think so,” I mumbled. He patiently waited, watching my face as my eyes nervously shifted around the room. How could I not even know what was going on inside of my own head? I sighed, “I know I’m going to need one of the quieter rooms to write this report. There are phone calls that need to be made about this one.”

His eyes widened, almost imperceptibly, before nodding once. He set me up with a computer in a room away from the commotion of the common area. “If you need anything…let me know. I don’t care what it is…someone to talk to–”

“No,” I fiercely interrupted. “No, I’m fine. I don’t know what my problem is. I’m probably just tired or something.”

“I’ve seen you tired. That’s not it,” He said, looking me dead in the eyes. I broke his gaze, fidgeting with my paperwork. He knew me too well. His tone softened, “If you need anything. Someone to talk to…food…music…I don’t care what. Whatever you need, let me know, and we’ll get it squared away.”

He left me to take care of what I needed to. I didn’t realize it at the time, but he was already working on helping me–even before I properly understood myself. Those strange, detached feelings continued to stir in my head as I went through the familiar monotony of creating the report. And out of nowhere, I just started to cry.

What is wrong with you? I asked myself, disgusted. There was nothing on that call that should elicit that response. I’d run plenty of calls just like that one. This wasn’t some horrendous, gory trauma. This wasn’t a call where the patient was rapidly deteriorating before my eyes. This wasn’t about playing catch-up, or not being able to do a single thing right. Why this time? Why this patient? Why now? Why are you reacting like this? How can you see people horribly mangled and not bat an eye, and then lose it over something like this??? What is the matter with you?

My narrative was getting incredibly long and unruly. While blinking away tears, I wrote about every, single, last, detail I could possibly remember. About halfway through, I just propped my elbows on the table, and rested my head in my hands. I was giving up on holding it together, and figuring out why I couldn’t.

My phone buzzed against the table. Taking a deep, steadying breath, I tried to compose myself and answer it as evenly as possible.

“You sound like hell. What happened to you?” The chief officer on the other end of the line asked. Apparently it’s pretty hard to shake the sound of an unexpected melt down from your voice. Particularly at 1:30 in the morning. I stammered, dismissed, and evaded. He was having none of it. Finally, I got him to hang up. I figured I’d won.

By 2 a.m., there were three of the highest ranking officers at my department were sitting in that room with me–in their pajamas, no less. I offered smiles, thanked them, and tried to dismiss them. But they stayed with me for more than an hour. They told me stories of their distressing calls from back in the day, and the seemingly inexplicable breakdowns.

“That call, for whatever reason, touched you. And it’s okay to be sad. It’s okay to be angry. It’s okay to be confused. It’s the strangest, smallest details of a call sometimes that just hits you. It doesn’t have to be these obviously traumatic calls,” One told me.

I was given heartfelt compliments. I was given reassurance that this call didn’t make me weak or stupid. It didn’t mean the end of my career if I didn’t want it to be. They gave me their personal cell phone numbers, and was given instructions to call them whenever I needed to. They gave me hugs. But most importantly, they gave me their time–even in the dead of night. They gave me confidence, compassion, and understanding.

I don’t know many high-ranking managers that would go to the lengths that these individuals did. They went above and beyond. It’s something I will never forget, and will always be grateful of. Managers or officers, especially those that go out of their way to take care of their own…I can’t thank you enough.

How’d You Get Into EMS?

Like most of the best things in my life, I came into EMS completely unintentionally.

Prior to EMS, I had a particular fondness for swimming. At 17, I was preparing to start my 10th season of competitive swimming, and my fourth season of 10-&-under coaching, when I got a phone call from my head coach. Enrollment was down for the upcoming season, and it looked like I won’t be coaching the little kids after all.

Well. That greatly opened up my summer schedule.

To most people, that would hardly be a bad thing. But I had spent my adolescence as one of those annoying over-achievers that burnt the candle at both ends. In high school, I spent my afternoons, evenings, and weekends darting around to my 13 extra-curricular activities. If I had down time, I was in a panic, trying to remember what project, assignment, meeting, practice, rehearsal, game, meet, or activity I was supposed to be doing. I couldn’t relax during my “time off.” It actually made me more anxious.

So I began my job hunt. Unfortunately, it seemed that every attempt to find a local job ended in “Thanks, but no thanks.” Each small store already had their seasonal adolescent workers hired. Not giving up yet, I figured if I couldn’t get paid to do work, well, maybe I could volunteer. Seeing how I was starting college in the fall for my biology/pre-med degree, I decided I’d give the hospital a call and see how I could volunteer there.

“Sorry,” I was told. My heart started to sink. “We only take volunteers in the ER if they’re EMT students.”

EMT student, huh? That sounds kind of fun. I could learn more about healthcare, get some practice actually treating patients, and ride around in an ambulance. There’s no harm in at least seeing what it’s about, right? And if it’ll be a gateway to get me to work at the hospital–even better!

I set up a meeting with a fire department officer later that week. He had a paramedic take me to do a truck check on one of the ambulances. I sat on the bench seat, and listened intently to his explanation of the equipment, what EMT’s can do, and the EMS culture. I was awestruck.

By the end of that hour, I was so completely in love with EMS. I don’t know what did it, but sitting in that truck just felt right. I didn’t want to leave.

It didn’t matter how much I had to learn. It didn’t matter how long it would take. It didn’t matter that I had no idea how I was going to deal with things like guts, gore, and death. I would figure all of it out in time. For the first time in my life, I knew I could do something. I mean, just knew it. On the days I had my doubts, there was always this determined little whisper in the back of my mind that said that I could get through this.

That night, I researched EMS blogs, almost desperate to find someone’s story or opinion that would take this dreamy glow off of my newest and strongest aspiration. As it turns out, it only deepened my love for the field. The next day, I was enrolled in a local First Responder class, and began my EMS apprenticeship at the fire department.

And the rest, as they say, is history.

Just Be Quiet

This particular male subject was impressively intoxicated. If he wasn’t such a jerk, and if we weren’t so busy dodging (mostly unintentional) swings and (mostly intentional) loogies when he broke the police officers’ grip, we might have all looked at each other with the “Wow. Strong work. Good job.” expression.

At one point, he looked at me and charmingly slurred (minus the expletives), “You look good, so iss alright. Lemme tell you, you’d never leave the kitchen or my room if you wuz my girlfriend. (hiccup)”

As I opened my mouth to reply, my big brother partner snapped back, “Hey, enough! You do not speak to my partner that way. Ever. She’s here to help you. You’re going to sit there and respect that, and we’re not going to have any more problems. Are we clear?”

The patient looks at me and says earnestly, “Sweetheart, I’m sorry.” Then he rolls his head back to my partner and lets out a long-winded, ever-loudening, slurred apology.

“Man, I’m sorry. I’m not meaning to cause no dizzrepeck. Not to you. Not to your lady fran’. Not to the ambalamps. Not to God. Not to the cops…well, maybe to the cops. But not to you. Or her. I’m sorry. I wuz jus’ compamentin’. Because she’s pretty. And you’re pretty. You’re BOTH pretty. I’m sorry. And I’m drunk. So iss h’okay. Maybe iss not okay. No. Iss no’ okay. I’m sorry. And–”

“Sir, don’t be sorry. Just be quiet.”

“H’okay.”

Instead of asking, “Why?”

You don’t have to be an EMT to experience tragedy. Although, we tend to bear witness to it more often. We are professionals at maintaining a level of calmness in the face of crisis. We were called to help, to fix, to save, to salvage; not to participate. We protect our bodies with gloves. We protect our psyches with adrenaline and “it’s not my emergency.”

After the adrenaline subsides and the call is over, you’re left with the aftermath. Sometimes the stories can’t be stripped off with your gloves, or the memories thrown away with the syringe wrappers. Sometimes they stay with you. In this messy and hectic career, you’re bound to get some of the shards of people’s lives embedded in your skin. It doesn’t necessarily have to be something massive and catastrophic. Your partner on that call may not even remember it today. These stories stay with everyone for different reasons.

Eventually in your career, you will find yourself carrying around a few faces, names, dates, or addresses forever. And they will not all be war stories you will flaunt or boast.

With many of these stories comes a simple and powerful question: “Why?” It’s a big impenetrable wall between you and (what you assume will be) peace. If you ever find the answer, it may not be good enough to excuse or explain what happened. More often than not, though, the answer will never come. It will never be clear.  “Why” will haunt your dreams and shadow your days. You will bludgeon yourself with it over and over in dizzying circles, searching for answers that may never come, only to find yourself exactly where you started–if not even worse off. You will kill yourself with “why”.

I try to make peace with my “why’s.” In fact, I try not to ask the question at all. Instead of asking, “Why?” I try to say “Thank you.” Thank you for giving me the chance to help you. Thank you for letting me learn from this, and using it to help my patients in the future. Thank you for asking me to be there to do the best I could at that time with those resources. Thank you for allowing me to look at what I have.

I have a warm bed. I have a roof over my head–and a fairly nice one at that. I live in a safe community. I work at a job I love, and one that challenges me every day. I work with awesome coworkers that I care very much for. They make me laugh and grow, support me, challenge me, and encourage me. Although I complain about it, I’m well on my way to a great and exciting career as a nurse/paramedic. I have a knack for writing. I have a blog that people read, and has allowed me to make connections and friends I never would have dreamed of. I have a wonderful family that cares about and for me. I have friends that love me. As for the things I do not have: I have tomorrows to earn and attain them. I am not perfect, but I am better, and I am enough.

Scared Myself Half to Death

It was quittin’ time. That mid-winter evening darkness had consumed the world outside the station. I tugged on my bright EMS coat, preparing for January’s frigid bite once I left the warmth of the building. I grabbed my keys, wished the new crew well, and headed into the bay.

It was chilly and dark there. A few flickering fluorescent bulbs seemed to provide more shadows than light. I edged my way between the back bumpers of the trucks and the racks of turn-out gear. The smell of old, sooty fires hung in the air. All was quiet, except for the occasional clicking within the settling and cooling engines, and a slow, periodic drip of water onto the concrete floor. I rounded the corner of a fire truck, intending to walk the aisle between the fire engine and the ambulance, make my out of the station and into the night. I didn’t take two paces before the dim light illuminated the silhouette. My heart briefly stopped in my chest. My breath caught in my throat, just before letting out a terrified cry.

The flickering light provided just enough backlighting to make it out. Black boots hung at my eye level. The figure was still. The only movement came from the slow, occasional drip of melting ice off the boot’s soles. I covered my mouth, trying to stifle the scream. This couldn’t be happening.

The door to the living space of the station opened on the other side of the bay. My partner’s voice shouted out my name in concern, followed by the thudding of heavy boots running on the concrete floor.

I broke my gaze from the legs of the figure, and saw another slumped figure only a few yards away. And there was another. And another?

As the crew drew nearer, they flicked on the rest of the lights. In the brilliant light, we could see what had actually happened.

The red cold water exposure suits were hung from a clothesline high above our heads. They had been taken out and used for training purposes that morning, and then hung out to dry overnight. A half-dozen red suits, complete with black rubber boots and gloves, were strung up along this little alleyway. Laughter shattered the unnecessarily horror-filled silence.

Well. At least my reaction was highly amusing to the relief crew. You’re welcome, guys.

 

Overheard at the Station

Cop: Hey, how’s nursing school?

P2P: Good. To be honest, some days I’m sitting in class, staring at my pencil, and considering giving myself a lobotomy with it because that would be more fun and less painful…but, overall, no, it’s not too bad.

Cop: Yeesh. Well, I’d rather have a bottle in front of me than a frontal lobotomy. Good luck to you.

Fake Confidence is Still Confidence

“How are your IV’s coming?” My EMT-I partner asked me, as we responded to a call.

“Ugh. Terrible. I can’t hit the broad side of a barn now. Haven’t gotten one in forever.”

“Ohh, that’s okay, we all get ruts,” The paramedic called out from the back.

“No. This is more than a rut. I learned on one catheter, and then we used another type during clinical, and those have two completely different finesses to them. Now that we use the first catheter type here, I can’t seem to get the hang of it again.”

“You’ll figure it out again. You’ve just got it in your head now that you can’t do it. Cut that out. You gotta have confidence,” The I-tech said.

“Fake it til ya make it?” I asked.

“Hey, fake confidence is still confidence,” He replied. “You’re gonna get this one. Trust me, when the pressure’s really on, and the guy really needs a line, you will somehow find a way.”

Not long afterwards, the medic and I found ourselves on either side of the patient, bouncing down the road to the landing zone. Alcohol swab in hand, I searched up on down her cold, sweaty arm for something, anything, that I could stick. This was my first patient who, without a doubt, needed an IV. I traced my fingers down her arm, poking and tapping where I hoped to find veins. I was starting to get worried when…oh, Perfect!  I could feel that spongy rebound under my fingertips in the crook of her arm. If I looked at it at just the right angle, I could almost make out a tiny raised section of the vein, making it that much easier to go for. I watched for a steady straight-away in the road, painted the vein with the alcohol wipe, and uncapped the needle. As discreetly as possible, I took a deep breath to both steady my nerves and strengthen my courage. I raised my voice and said to our deteriorating patient, “Okay! Big pinch in your arm, ready? One, two, three!”

A smile tried to edge its way onto my face as I watched the flash chamber fill with blood. I couldn’t believe it…when it actually really mattered, I got it! Knowing I wasn’t done yet, I leveled out, and advanced the catheter. I heard the click of the needle into the safety cap, and knew I was in. It flushed beautifully, and was secured with a tegaderm and (probably too much) tape. I even made the stupid little chevron out of tape. I worked to keep myself from visibly shaking from the excitement. No one was coaching me through, or watching over my shoulder, or setting up any of my equipment. For the first time, I got it done all by myself–and when it counted for something, too.

When we watched the helicopter take off with our patient inside, there was something extra satisfying knowing they were using the line that I had started. Those medications could help preserve the patient’s life.

I turned to an ear-to-ear grin on my partner’s face. “What did I tell you? When you need to get it, you’ll get it! Right? Right???”

“Fake confidence is still confidence!” I replied, a huge smile stretching across my face.

The medic clapped my back, saying, “Hey, congratulations on doing your job.”

“Would you hush? Let me enjoy my glow.”

“Well, glow and clean up the back. You and the medic trashed that place,” The EMT-I interrupted. “Then we’re getting a celebratory coffee. Good job, kid. Well done.”

A Newfound Respect

“I don’t know, man,” I said to my partner, “I don’t have a good feeling about this one.”

He sighed, “Yeah, I was gonna say the same thing. And it really doesn’t help that we’re going to Deerbridge.”

I’m not particularly proud to write this, but if you heard the town name “Deerbridge” in a conversation at our fire station, there was usually a rolling of eyes, annoyed grumbling, or “You wouldn’t believe what happened” story carried in the same breath. Some of them were nice enough, but a few members there earned the department the reputation of being “difficult to work with,” and, occasionally, “dense.”

I settled in for the long ride, watching the red lights flicker and reflect off of the occasional “cow crossing” and “moose crossing” signs. In my head, I ran through what we could do for our patient. Dispatch crackled over the radio. “Update for all units responding to Deerbridge, police on the scene asking you expedite. Patient is now unconscious and gasping.”   We still had about 10 minutes until we were supposed to arrive on scene.

“Not good,” My partner mumbled, pressing a little harder on the accelerator. The red lights of a Deerbridge engine flashed in our rearview mirrors. My partner and I looked at each other gravely, realizing they wouldn’t be getting there any sooner than we were.

As our little emergent parade turned onto the road of our destination, dispatch crackled again on the radio. Her voice had lost its edge. “Units responding in Deerbridge, downgrading the call. Patient is unconscious, not breathing. DNR in place.”

Soon, we found ourselves in the home of a shocked and mourning family. My partner went into the kitchen to look over the DNR paperwork. I carried the monitor into the bedroom. The family had gathered around the room, hands over their mouths, silent tears falling from their eyes. I felt intrusive as I placed the electrodes on the man’s still-warm skin. Quickly, I silenced the alarm as the monitor registered the straight green line.

The man’s daughter began to cry openly. “He was fine 30 minutes ago. He was absolutely fine.” Deerbridge EMT’s filed into the room. The teary eyes and flat-lined monitor confirmed dispatch’s report.

The daughter cried louder, “It was so fast. It was so fast.” A Deerbridge EMT pulled the woman in close as she sobbed and repeated herself, patting her back and soothing her. Another Deerbridge firefighter took the smaller children outside to make snowmen while the news settled and shook the adults. Yet another EMT disappeared back into the kitchen, reappearing some time later with hot tea for everyone. More settled in next to family members, offering tissues, giving hugs, and simply listening.

After gathering our information and doing our best to help the family, my partner and I prepared to clear the scene and return to service. Deerbridge EMT’s and firefighters stayed with the family even after we had to clear. In fact, they stayed even after their loved one’s body had been taken to the funeral home.

I left that scene with a completely newfound respect for Deerbridge. Despite the issues we’d had, they handled that call better than I’d ever seen or heard. That day, I saw them truly care for the fellow citizens of their tiny town the best way they knew how. And that will forever stay in my memory.