Tag Archives: paramedic

A Personal Ethnographic Narrative

I have always viewed my being from philosophy. I do not believe that I have ever appreciated myself from an anthropological viewpoint. Though I have always been more interested in where did we come from, anthropology and ethnography certainly does help to answer how did we get here.

On December 7, 1975, at 4:48 a.m., I was born in Providence, Rhode Island. A healthy boy of healthy weight, I never suffered much in childhood. I do remember the chicken pox, however. My mother was sure to make me play with every child suffering from the chicken pox until it finally gripped me. This was my first experience in active inoculation. I was always well cared for, received all of my shots in timely fashion, and the doctor’s office remains a fond childhood memory. Medicine was just practiced differently in those days.

My early childhood was based primarily around my grandparents. My mother was a single parent, and though it irked her to do so, she relied heavily on State-sponsored welfare. My mother was a strong and determined woman, however. She continued her schooling, found a job with a sustainable wage, and made a great home for us. Until this time, though, I spent the majority of time with my grandfather. From a very young age, I was learning his trade as well as his life lessons. Today, I do not think many five-year-olds would be able to cut and wet sand glass in a licensed shop. Working with my grandfather, once a week when I attended school, framed my work ethic and provided an early education in engineering. This opportunity allowed me comfort in engineering at an early age. In fact, my interest in engineering was so pronounced that I was already considering California Institute of Technology at age ten. Massachusetts Institute of Technology was my second choice.

My family had it hard. My grandparents raised five children and helped to raise 13 grandchildren. We were not an affluent family by any means, but we lived comfortably if not rustic. Though my ancestry is primarily Italian, my mother’s parents are primarily Irish, English, and German, and this is how we ate. Meat and potatoes were the staples of dinner while fresh vegetables were cultivated in my grandfather’s garden. Simplicity did not end at the kitchen door. My grandfather’s first meaningful gift to me was a knife. Very simple with a fork and spoon on the sides, the knife was very utilitarian in nature. His belief was that you could not be a good steward of the environment without a knife: “How can you take a walk in the woods if you can’t even whittle a walking stick?” (personal communication with Malcolm Webb, n.d.). It was very important to him that I had honed my outdoor skills.

For leisure and sport, my grandfather would hunt rabbit with beagles. He belonged to a club in Rhode Island that held competition trials, and I was always made welcome. After a few years, I started to enter dogs that I helped to raise and train. Immediately, I began accumulating trophies that were taller than me. To be honest, the trophies might have had my name on them, but the dogs earned them more than I had. It was this foray into competition that introduced me to the team concept. Thinking back on this today, however, I find that this concept is alien to most people. Many people today, I find, want to do no work and take most of the credit. It is only when you stand up to these people that you hear comments about being a part of the team. It is a shame. It seems that yesterday’s definitions need to be defended today.

I have always been aloof and wondrous as a child. With translation assistance from the Native Languages of the Americas website (2009), my name might have been mautáubon tamóccon nemík kéesuck túppaco (morning fog sees the heavens by night or one with many questions) if I was Narragansett. Rhode Island has a rich Narragansett and Algonquin heritage and history, and this is transmitted to every inhabitant of Rhode Island. Many of our streets, villages, cities, and towns are named with Indian words and names, such as Apponaug, Chepatchet, Metacom, Misquamacut, Woonasquatucket, and Pawtucket. We are very proud of the relationship that Roger Williams, our State founder, had with the local tribes. This lasting relationship may be the reason why Rhode Islanders are typically naturalistic and prefer a rustic life proximate to water over city life.

During my formative years, my mother married and we moved to North Providence from Warwick. My step-father was Italian, and it was from his family that I learned of my Italian heritage and culture. Beyond the Mediterranean-style food, the most important lesson that I learned was loyalty. Many people have a misconception about Italian loyalty. Hollywood often depicts Italians as mafioso who shakedown store owners on a daily basis. In fact, we are very supportive of each other. So long as you are considered loyal, as an Italian, people will do you favors. It is expected that you return the favor. I have applied this lesson many times throughout my life. Again, this is a trait that many hold as one-sided, like teamwork.

After moving to North Providence, it seems that I did not much care for school. I always felt that I was being cheated out of an education. I am a reader, a learner, a student, and a teacher. I do not appreciate being taught incomplete and erroneous facts merely because it is written in the textbook. I began my own education from this point onward focusing on the arts and music, taking up drawing, poetry, and studying music theory and some of the classical languages. These, though, were hobbies and I made sure to keep them that way.

Aside from school, I remained focused on the outdoors. I would walk everywhere within the State. Distance was not a barrier. Rhode Islanders are known for staying local. If a Rhode Islander had to travel 10 miles or more, the joke was that they had to get a motel room for the night. As true as this held for most, it was not descriptive of me. I always took the road less traveled.

Throughout my high school years, I gave up on the engineering dream. I started to focus more on giving back to my community. A friend of mine introduced me to one of the local volunteer fire departments and I was hooked. After graduating from high school, I enlisted in the Marine Corps, but when I returned to civilian life, I focused on the fire service. This was the impetus for my attaining my emergency medical technician license and, ultimately, my paramedic and critical care credentials.

Though I have traveled extensively, I always seem to return to New England. I am currently living just beyond the Western border of Rhode Island in Connecticut (another Indian name).

Considering the anthropological roles outlined in Omohundro (2008), I would have to align myself with all five roles. The reformer looks to make the world a better place, regardless of his or her motivations. The critic is necessary to use introspection to identify personal weaknesses ingrained in cultural learning so that he or she may contemplate self-improvement. This, I feel, is the best role to take on first. Only after seeking to improve one’s intrinsic nature should someone seek to change the extrinsic. The scientist role is important to really think about the factors relating to certain problems. Without this role, one could have lofty goals only to find failure in execution for a lack of understanding. The role of the humanist should be used as an umbrella. When considering anthropology, we need to have a certain understanding and tolerance. This role allows us be compassionate when considering cultural issues. Finally, the means to the end is the cosmopolite role. This role gives us more tools to further our understanding. Hand-in-hand with the humanist role, the cosmopolite has a truer understanding of origination and context when dealing with the various cultures of the world.

Personally, I take on more aspects of the critic and the scientist. I am not an anthropologist, and I do not consider myself as having a platform to affect cultural change, but I do like to identify and understand problems so that I do not contribute to them negatively. More so, being mindful of the critical and scientific anthropology roles leads me to understand that there is still much to learn about my own culture and heritage and how this identity relates to the world around me. Foremost, I want to know the effect that my ancestors have had on world. I want to understand the problems they faced and the means employed to overcome them. I want to know decisions that have been made and the fallout associated with these decisions. I have always found it important to learn from the past, and though the sins of the father shall not encumber the son, we should still strive to avoid repeating historical mistakes. Second, I want to find a means to assess my own life and better understand how my existence impacts my community. I have always believed that I should make positive contributions to my community, but there is no benchmark. As a critical care paramedic, I assume that alleviating suffering and saving lives positively contributes to my community, but how can I know the harm that I might be causing in other aspects of my life? We cannot only understand the good we impart, but we must know the bad in order to prevent it.


Native languages of the Americas website. (2009). Retrieved from http://www.native-languages.org

Omohundro, J. T. (2008). Thinking like an anthropologist: A practical introduction to cultural anthropology. New York, NY: McGraw-Hill.

Flawed Conclusions in Literature Review

For this week’s discussion, I have chosen to analyze an article (Sakr et al., 2006) that attempts to outline the efficacy and potential dangers of certain drugs used to treat shock. As a critical care paramedic, the discussion surrounding this article can provide insight to choosing alternative therapies when caring for my patients, but it is important for me to understand the potential biases and limitations of such a study that could lead to flawed conclusions (Gluud, 2006).

Sakr et al. (2006) collected data on ICU admissions over a two week period to further understand how dopamine effects mortality and morbidity when administered in response to hemodynamic compromise. Also, other administered vasoactive drugs were included in the analysis whether administered concomitantly with dopamine or instead of dopamine. The researchers did not distinguish between etiologies except to delineate between septic shock and non-septic shock. Patients who presented with shock or suffered a shock state within the first 24 hours of admission were included in the analysis. Patients admitted to the ICU mainly for 24 hour surgical observation where not included.

Shock is defined as “a state of inadequate cellular sustenance associated with inadequate or inappropriate tissue perfusion resulting in abnormal cellular metabolism” (Hillman & Bishop, 2004, p. 121). There are many etiologies of shock, including sepsis, anaphylactic, neurogenic, hypovolemic, cardiogenic, and others, which respond differently to various therapies. This confounder creates an information bias, as this variable is not identified in the data collection and cannot be scrutinized. Simply identifying the etiology of each shock state would limit this bias. The researchers, however, acknowledge this limitation and others.

Another confounding variables is the time constraint of the data. In regards to septic shock, this variable becomes evident. Many pathogens spread predictively during certain times of the year. The concomitant treatment of these infections could predispose patients to suffer a prolonged state of shock (in cases where the pathogen might not be immediately recognized) or provide for an ideal treatment pathway when the pathogen and the antibiotic regimen are fully understood and effective. This selection bias could be controlled by choosing patients who present throughout the year.

As Gluud (2006) points out:

When intervention effects are moderate or small, the human processing of data, unsystematic data collection, and the human capacity to overcome illnesses spontaneously limit the value of uncontrolled observations. Experimental models are essential for estimation of toxicity and pathophysiology.
(p. 494)


Gluud, L. L. (2006). Bias in Clinical Intervention Research. American Journal of Epidemiology, 163(6), 493–501. doi:10.1093/aje/kwj069

Hillman, K. & Bishop, G. (2004). Clinical Intensive Care and Acute Medicine. West Nyack, N.Y.: Cambridge University Press.

Sakr, Y., Reinhart, K., Vincent, J., Sprung, C. L., Moreno, R., Ranieri, V. M., De Backer, D., & Payen, D. (2006). Does Dopamine Administration in Shock Influence Outcome? Results of the Sepsis Occurrence in Acutely Ill Patients (SOAP) Study. Critical Care Medicine, 34(3), 589-597. doi:10.1097/01.CCM.0000201896.45809.E3

Patient Safety Considerations for EMS

 In the out-of-hospital emergency care setting, patient safety is paramount. Initially, victims of trauma or illness are already suffering in an uncontrolled environment. It is this same environment where first responders, emergency medical technicians, and paramedics must operate to stabilize and transport the victim to the hospital, a more controlled environment. Unfortunately, there is little research in the area of patient safety in this setting (Meisel, Hargarten, & Vernick, 2008; Paris & O’Conner, 2008).


Focusing on patient safety and developing processes to ensure optimal safety would allow the study of inherently dangerous, yet potentially beneficial therapies, such as rapid sequence intubation where the clinician uses a series of medications to rapidly sedate and paralyze a critical patient for ease of inserting a breathing tube. Focusing on safety, an EMS department in Maryland successfully instituted such a program (Sullivan, King, Rosenbaum, & Smith, 2010).

With more research in this area, the Emergency Medical Services (EMS) can improve the care they seek to deliver to their patients.


There are many challenges facing EMS as they seek to deliver safe and effective care to their patients. Motor vehicle accidents (including air transportation accidents), dropped patients, medication and dosage errors, other inappropriate care, and assessment errors all contribute to the number of adverse events in the EMS out-of-hospital care setting (Meisel et al., 2008). Unfortunately, it has proved difficult to identify both the existence and the cause of each event (Meisel et al., 2008; Paris et al., 2008). Additionally, there are adverse events that are impossible to track, such as the iatrogenic exposure to a pathogen. It would be very difficult to distinguish how and when a patient was first exposed to the infecting pathogen without considering community-acquired infections and hospital-acquired infections, which are both equally difficult to ascertain (Taigman, 2007).

Strategies for improvement

As EMS seeks to increase the professionalism among its ranks, the stakeholders must acknowledge responsibility for providing evidence-based processes to ensure patient safety.


Meisel, Z. F., Hargarten, S., & Vernick, J. (2008, October). Addressing prehospital patient safety using the science of injury prevention and control.Prehospital Emergency Care, 12(4), 4-14.

Paris, P. M. & O’Connor, R. E. (2008, January). A national center for EMS provider and patient safety: helping EMS providers help us. Prehospital Emergency Care, 12(1), 92-94.

Sullivan, R. J., King, B. D., Rosenbaum, R. A., & Shiuh, T. (2010, January). RSI: the first two years. One agency’s experience implementing an RSI protocol. EMS Magazine, 39(1), 34-51.

Taigman, M. (2007, July). We don’t mean to hurt patients. EMS Magazine, 52(4), 36-42.

Relationships Among Health Services Organizations

 As a critical care paramedic, I am fortunate enough to experience our health care system as an active participant, caring for the sick and injured, and as a passive observer, following the pathways of the patients whom I have treated. The health care system in the United States is, admittedly, fractured (Kovner & Knickman, 2008), but there are components that serve to create harmony and efficiency within this system, and I will describe just a few of them.

The primary care physician is meant to be the coordinator of all care for his or her patients. The importance of this role cannot be overstated, as it is the keystone to “health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses” (American Academy of Family Physicians, 2010, para. 7). When appropriately utilized, the primary care physician can coordinate a patient’s care to ensure efficiency and efficacy of treatment while ensuring safe and comprehensive care (Kovner et al., 2008).

There is a growing number of specialties and sub-specialties within the practice of medicine today (Bureau of Labor Statistics, 2010b). Specialists focus on their chosen area of practice and are an asset to the general practitioner, or primary care physician, who can concentrate on the coordination of the patient’s care. The inclusion of specialists in medicine is an efficient and effective means of offering the patient a level of expertise not otherwise available. One of these specialties is emergency medicine.

Emergency departments are necessary entry points into the health care system for victims of acute trauma and illness, but often times, the emergency department is used as the primary portal for those who lack insurance or other means of accessing health care appropriately (Committee on the Future of Emergency Care, 2006; Kovner et al., 2008). These patients tend to utilize the emergency room for even minor ailments, distressing this important component of the system, causing a “nationwide epidemic of [emergency department] overcrowding, boarding, and ambulance diversion” (Committee on the Future of Emergency Care, 2006, p. 19).

Laboratories and radiology departments are great assets to providers, allowing technicians to perform tests at the behest of the physicians and only requiring the physician to interpret the results of the tests. This seems to be a cost-effective and efficient component of the system, so long as the tests are performed timely and accurately.

Pharmacists have been regarded as patient-focused consultants who can provide both patient-specific and general information regarding over-the-counter medications as well as prescription medications. In our health care system, pharmacists have a valuable role of safeguarding patients from over-medication, as well as under-medication, medication compatibility, and also educating patients to the possible side-effects of their prescribed medicines (Bureau of Labor Statistics, 2010a).

In conclusion, the safest and most efficient use of our health care system begins at primary care. Though, in emergency situations, there is certainly a need to seek immediate care by other means, patients can suffer financial challenges as well as safety issues by trying to remove the primary care physician from the health care paradigm. Not only is this unsafe for the patient seeking primary care elsewhere, but misuse of emergency departments cause unnecessary delays for truly emergent patients. The health care system in the United States is vast and can be confusing. The primary care physician can provide a safe and efficient pathway of care that will save a patient time, money, and, possibly, his or her life.


American Academy of Family Physicians. (2010). AAFP policy on primary care. Retrieved May 1, 2010, from http://www.aafp.org/online/en/home/policy/policies/p/primarycare.html

Bureau of Labor Statistics, U. S. Department of Labor. (2010a). Pharmacists. Occupational outlook handbook (2010-11 ed.). Retrieved from http://www.bls.gov/oco/ocos079.htm

Bureau of Labor Statistics, U. S. Department of Labor. (2010b). Physicians and surgeons. Occupational outlook handbook (2010-11 ed.). Retrieved from http://www.bls.gov/oco/ ocos074.htm

Committee on the Future of Emergency Care in the United States Health System. (2006). Hospital-based emergency care : At the breaking point. Washington, DC: National Academies Press.

Kovner, A. R., & Knickman, J. R. (Eds.). (2008). Jonas & Kovner’s health care delivery in the United States (9th ed.). New York, NY: Springer.

Improving Traffic Safety for Emergency Responders

The Emergency Medical Services (EMS) is an occupational field wrought with opportunities for workers to become ill, injured, or succumb to death while performing the functions of their job (Maguire, Hunting, Smith, & Levick, 2002). In the mid-1980’s, Iglewicz, Rosenman, Iglewicz, O’Leary, and Hockmeier (1984) were among the first to perform research into the occupational health of EMS workers by uncovering unhealthy carbon monoxide levels in the work area. This appears to have been the impetus for further research into uncovering some of the causes and contributing factors of illness and injury incidents, as well as safer alternatives to current work practices.

One of the more recent efforts to protect EMS workers relates to traffic-related injuries and fatalities of EMS workers while responding to calls and working on the scenes of traffic accidents. As important it is for the EMS workers to be able to get to the scene of an emergency and work without threat of injury, the safety of the community is important to consider. Solomon (1990) realized the need to improve safety in this area and recommended changing the paint color of emergency apparatus to more visible lime-green. Emergency workers were continuing to fall victim to “secondary incidents” at roadway scenes (Cumberland Valley Volunteer Firemen’s Association, 1999). An analysis of EMS worker fatalities between 1992 and 1997 reveals an occupational fatality rate that continues to exceed that of the general population (Maguire, Hunting, Smith, & Levick, 2002).

Across the pond, in the United Kingdom, efforts were also underway to improve the visibility of police vehicles by considering various paint design schemes, including the Battenburg design: alternating blocks of contrasting colour (Harrison, 2004). Harrison concluded that the half-Battenburg design showed promise as it increased visibility and recognition of police cars in the United Kingdom, and the United States National Institute of Justice was considering research on the efficacy of the Battenburg design here in the United States to promote officer safety. EMS administrations are known for paying special attention to the bandwagon, that is they frequently make changes based on inconclusive and sporadic evidence. This is the case with recent ambulance designs.

Many ambulances in the New England, as well as other parts of the country, are being designed with the half-Battenburg markings applied to the sides of the vehicles in attempts to improve the safety of EMS workers. Unfortunately, we may find that these markings might have an unintended effect of confusing other drivers and causing more problems. A recent study found that Harrison (2004) was correct in that the Battenburg design assisted British drivers in quickly identifying British police vehicles, but the “effectiveness of the ‘Battenburg’ pattern in the UK appears primarily related to its association with police vehicles in that country” (Federal Emergency Management Agency, Department of Homeland Security, 2009, p. 6) having little effect on the recognition potential of American drivers.

Perhaps with the evolving data, we can begin using an evidence-based approach at helping the EMS worker perform his or her job safely at traffic scenes.


Cumberland Valley Volunteer Firemen’s Association. (1999). Protecting Emergency Responders on the Highways: A White Paper. Emmitsburg, MD: United States Fire Administration.

Federal Emergency Management Agency, Department of Homeland Security. (2009). Emergency vehicle visibility and conspicuity study [Catalog No. FEMA FA-323]. Emmittsburg, MD: United States Fire Administration.

Harrison, P. (2004). High-conspicuity livery for police vehicles [Publication No. 14/04]. Hertfordshire, U.K.: Home Office, Police Scientific Development Branch. Retrieved from http://scienceandresearch.homeoffice.gov.uk/hosdb/publications/road-policing-publications/14-04-High-Conspicuity-Li12835.pdf

Iglewicz, R., Rosenman, K.D., Iglewicz, B., O’Leary, K., & Hockmeier, R. (1984). Elevated levels of carbon monoxide in the patient compartment of ambulances. American Journal of Public Health, 74(5).

Maguire, B.J., Hunting, K.L., Smith, G.S., and Levick, N.R. (2002). Occupational fatalities in emergency medical services: A hidden crisis. Annals of Emergency Medicine, 40(6), 625-632. doi: 10.1067/mem.2002.128681

Solomon, S.S. (1990). Lime-yellow color as related to reduction of serious fire apparatus accidents: The case for visibility in emergency vehicle accident avoidance. Journal of the American Optometric Association, 61, 827-831.


Living in such a small community as I do, there is little need for grassroots organizations to assist in the health and welfare of the community. Most of the organizations that are available in my community are business-based, healthcare focused institutions.

Day-Kimball Hospital (http://www.daykimball.org) is the center of healthcare and wellness in Northeastern Connecticut. Partnering with the community, Day-Kimball Hospital provides a host of services through its many facilities to provide outreach programs which help to make a healthier community. Employment and volunteer opportunities are available within the hospital for those with a desire to help promote health and wellness within the community.

There are two other local agencies, United Services (http://www.unitedservicesct.org) and Quinebaug Valley Youth and Family Services, which have partnered to provide a community-centered approach to the psychological welfare of adults, adolescents, youths, and their families. United Services, Inc. also provides employee assistance programs to workers of participating local businesses. Providing psychiatric consultation services for addiction and recovery, family violence, and family structure support, these agencies promote social change as both entities themselves and through their contact with members of our community.

The town of Killingly, Connecticut, also offers a Little League program where children can learn to play baseball and softball while learning the values of sportsmanship, loyalty, courage, and commitment. This program helps to promote social change through encouraging positive mentor relationships at a young and impressionable age. Little League is also an outlet where interested parties can help through sponsorships, umpiring, coaching, or just attending games and showing support for the program and the kids.

I have volunteered most of my life through the volunteer fire departments in my area, and I still do. I am an active member of the South Killingly Fire Department where I serve as a mentor and instructor in Emergency Medical Services. As an experienced paramedic, the least that I can do for my community is to ensure that those who will come after me are trained appropriately and to a high standard. Though my full-time job requires me to provide the same service in the same area, I enjoy a different role with South Killingly Fire Department which allows me the freedom to help others in a different manner than usual within the same occupational field.

Volunteering with others instills teamwork, dedication, and other core values that lend especially well to the promotion of positive social change. I am glad to help.

Communicate Clearly – Streamlining the Communication Process

In my current profession, I am tasked with responding to disaster areas and treating the afflicted and displaced. I must communicate my intent and direction clearly and with a presence of authority. Understanding the various communication modes and methods that different people utilize and respond to, perhaps across cultures or socio-economic backgrounds, will allow me to streamline my communication processes to directly impact the most people in the most efficient manner possible.

Previously, I stated that I only have one long-term personal goal: leave a positive mark on the society in which I live. My attention to this goal is unwavering and will never change. Technology being what it is today, effortless communications across lines previously drawn is paramount in improving society. I value improving the lives of others: individuals and society as a whole. I feel I have already met the outcome objective of Walden University which is one of the reasons why I chose to enroll here. Apparently, others share many of the same goals.

In college, I have found a chance to interact with a variety of people from a variety of backgrounds without ever really knowing who they are. Not unlike a double-blind study, the results of the discourse are authentic to the environment. I found this to be quite interesting and attempted to hone my communication skills in such ways as to be a benefit for as many of my classmates as possible. I will never know if I have succeeded in this, but I feel the intent and the experience will stay with me far longer than the results. Being able to communicate clearly with yourself, however simple a task that may seem at first, allows one a clearer understanding of one’s needs and allows for the development of a plan for attaining those goals that meet these needs. That is being true to one’s self!

Professional Networks – The Internet, EMS, & Social Media

In the emergency medical service arena, there are a number of online networks designed to provide support for EMS personnel. Most of these networks are listservs or discussion groups aimed at bolstering education and best current practices.

I first started in EMS as a route to become a firefighter, but after working for a short time as an EMT, I decided that I enjoyed the practice of medicine much more than fire suppression. It was about this time that I formed a goal to be the best that I could be in this industry. There is an inherent problem with this: most in EMS feel that they are the best at what they do. I had to figure out a benchmark to compare myself to.

Searching the internet, I found a small group of EMTs, paramedics and physicians who promoted teaching as learning. This group also debated best practices constantly. Most importantly, all were welcome to contribute. Partaking in many discussions over the years has broadened my knowledge and has made me keenly aware of many of the problems facing EMS that I was going to have to deal with. This group has helped me to grow as an EMT, motivated me through my education as a paramedic and instilled in me some of the virtues of being an effective educator and a mentor within the EMS community. This same group has helped turn inexperienced and insecure providers into authors, consultants, researchers, managers, and educators. These truly were the best and the brightest in the field. Many of group participants were only known to me by their email address or the initials with which they signed their posts, but now, after meeting and forming in-person relationships, I count many of them among my friends and colleagues.

This only outlines one of my professional networks. I truly understand the value of professional networking, and I have promoted this within the educational environment in the past. Networking among colleagues, whether professionally or academically, encourages teamwork and collaboration. It also encourages a healthy competitive nature in the participants which translates to more overall growth. In the academic arena, students are able to rely on other students’ expertise in some areas while, at the same time, providing expertise in others.

The new online social networking venues (LinkedIn, Facebook, MySpace, et al.) appear to be replacing the listservs of old. These applications provide the user a broader, more personal sense of their social and professional network. Opening one’s self up to your colleagues in this manner can only encourage more personal growth and professionalism.