Can Ya Hear Me Now??? #4

Bet not!!! Ain't no "more bars" here. My $500.00 phone is now a travel alarm! I'm so happy to have Internet access I can't begin to tell you. It's pretty slow, but at least I have some way to stay in contact.

I had a little trouble getting here. Besides the difficulty getting the rotation set up, the damn volcano near Anchorage started acting up, and I had my flights delayed two times before I finally got to Nome. The first time was alright cause I was stuck in Seattle where I had stopped to spend a couple of nights with my cousin Craig and his family so the extra night didn't bother me.

The next day I got up at 4:00 to fly to Nome, and made it without a hitch. When I got off the plane however, my flight to Nome had been canceled till the next day. I was about to leave the airport and get a room in Anchorage when I got a call on my cell from a med student who was also stuck. The people at Norton Sound Health Corporation had given her my number, and figured that we could at least support each other. She is a fourth year med student from Long Island, and looks a lot like a friend of mine from New Mexico that is from New York, only her accent wasn’t quite as strong. We talked for a while in the airport while I was finding my luggage she had found a flight that got us out of Anchorage that night at 5:30, so we were in Nome by 9:00. The NSHC put her up in her apartment that she will live in through her rotation, and then told me I was going to have to sleep on the floor of a PA's apartment that was doing a rotation in Nome...so that's what I did for 2 nights. I did get a blanket and a pillow.

The next day we had orientation, which was a crack up. The instructors seemed so happy to have someone to lecture to. The lectures were infantile and over subjects that we have covered every time we step into a hospital. The really should have a universal card for this stuff so you could just flash it and they would know you've heard this all. One of the instructors even did magic tricks during his lecture "to keep our interest up". I think he could use a few more lessons. So that nap took about 3 hours. Then we filled out our obligatory paperwork and they through us in the Pit.

We were sent to the walk-in patient clinic, showed where the charts were and told that it was bad form to patient shop (which is where you look at the charts and only pick out the patients you think it would be cool to see) and we were told to pick up the next chart in line and see the patient, write up a diagnosis and plan, and get it approved by one of the Docs in the clinic. There were about 4. The idea was to get us broken in to how the system worked, and get used to how they keep records, order tests, get x-rays, etc.

It reminded me of MASH. What a bunch of characters. The guy in X-ray was kind of the "Radar". He wore bright purple scrubs, and a surgical cap that was pulled down so low that you could hardly see his eyes. He had that attitude like the weasel on the old cartoons that is constantly wringing his hands and smacking his lips...you know the one I mean?? He could not have been more wired if you popped him in the ass with a shot of speed! There was a PA there who was one of our supervisors who was the "Charles Emerson Winchester", too smart, too cool, and an arrogant ass. We didn't have a "Clinger" but we did have a gay Eskimo who took up the slack. Fortunately he was a patient, and shortly after arrival had a pseudo seizure (fake) and was hauled off to the ER for them to deal with. Of course there was a "Hot Lips". I hit on her, but to no avail. Damn this belly!

So I grabbed my first chart. Under chief complaint (the reason they are there) was written:

Penile discharge.

Yep, my first Alaskan case was the clap. I'm so glad I came to the wilderness to help the poor under served population of natives. So I went into the room had him show me his problem, and took a swab for culture and sensitivity to confirm what he had, and what to treat him with. Basically you run a q-tip up the guy’s urethra to get a sample of the offending matter to send to the lab. When I came out I found a nurse and asked her how I labeled it, and where the lab requisition forms were. She looked at it and said, "Ah… that's not the way we do that here. We take a dirty catch urine specimen." A dirty catch is just a urine specimen with the exudate in it. Ooops. It was painless. I didn't feel a thing. To bad the patient didn't have the same view. Maybe he will remember this and think about a condom next time he finds new love. At any rate, I gave him his dose and sent him on his way.

The staff had great fun at our expense for the rest of the evening. They weren't very helpful because it was just too funny watching us screw up everything we touched. When I say we, I mean me, Coralynn the med student from NY, and Chad the PA student from the University of Washington, who's floor I was sleeping on. At least I wasn't alone, and we formed a pretty tight bond that evening. The Three Musketeers. Did get to see a lot of different types of cases, and it was a lot of fun and good experience. I saw a guy who had been in a snow machine wreck, a new pregnancy, examined and helped a couple of sick kids, an abdominal complaint. All in all a good variety of patients. By the time it was over we did know where everything was, how to order (and take) tests, and learned the procedures for NSHC. A very good experience. Afterward the three of us went downtown and had a big dinner, and a great laugh.

I guess everything went OK, cause the next day they shipped me out to the village. Pretty scary flight. Single engine plane over about 100 miles of semi-frozen Bering Straight. Did a little praying on that one. If you go down, life expectancy is in the neighborhood of 35 seconds...if you survive the crash. Happy to say I didn't get that experience. Landed in two other villages before I got to Unalakleet. I'm happy to report that this is the nicest one. I'm living in the clinic, which at first sounded a little funky, but this clinic is the jewel of the system, and the clinic is state of the art, and in a brand new building. It's like I have the nicest house in town. The building I would say is probably over 5000 sq ft. Lots of windows. Great view of the town. Nice and warm, and I have a comfortable bed and good hot shower. And it's just me.

And the guy in the morgue...

Just kidding. He moved yesterday...

Still kidding.

rto