An eyelash at right angles: last clinical day in Barrow


I think it hardly seems fair,

And even the patient might glare

      With a problem left eye

     That wasn’t a stye,

Just an upstart, up-growing hair.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  Avoiding burnout, I’m taking a sabbatical while my one-year non-compete clause winds down, having adventures, visiting family and friends, and working in out-of-the-way places.  Currently I’m on assignment at the hospital in Barrow, Alaska, the northernmost point in the United States.

Yesterday ended my clinical tour of duty here in Barrow, Alaska.  I pulled the “walk-ins” and I have no complaints.

I took my share of Saturday clinics over the years in the Practice Formerly Known As Mine, and I’ve taken my share here.  Barrow never got as frantic as home.

My shift started at 1:00PM and went to 11:00PM.  I slept in, had a leisurely breakfast, napped and read. The sun rose clear and brilliant, late in the morning. I ate my lunch without rushing, and came to work rested and refreshed. 

I didn’t exactly hurry to the clinic.

I didn’t get a call till mid-afternoon, while I was reading in my apartment.  Without stepping into the far subzero temperatures or starting a car, I slipped on my shoes and walked leisurely down the hallway into the hospital proper, past the cafeteria, laundry, medical staff office, patient travel, and case management. 

Patients came in at the rate of two or three an hour as the day waned and the sun slipped behind the southern horizon.  With lab and x-ray pending, I got my supper in Styrofoam from the cafeteria.  I sat down in medical records, an arm’s reach from the clinic proper, and started in on my Salisbury steak. Bethany called and volunteered to sit with me while I ate.

I finished just as results came through.

The patients never piled up more than two deep and I got to spend time with each one.  People came in with problems in the wake of the influenza, and other respiratory complaints related to current viral infections.  One person suffered from strep without complaining of a sore throat.  I ordered x-rays for several folks, none of which showed fractures.  Two people had constipation.  One each had chest pain, foot infection, and urine infection.  Too many abused alcohol, tobacco, and/or marijuana.

In the evening I had enough time between patients to hang out in the commons and write my post, and I read it out loud to a small audience.

I received permission to write this information about the last patient of the evening, who came in with a red eye for a few hours.  The fluorescein dye with the Wood’s lamp (popular name: black light) showed no scratch on the cornea.  But the magnifiers revealed an errant eyelash on the lower lid growing straight up like a telegraph pole, next to a tiny scar.  I could see that every time the patient blinked, the eyelash would jab the upper lid, and probably get poked onto the cornea.

I went looking for a forceps, found a really fine pair and plucked the offending hair, with transient pain but immediate relief for the patient.  In thirty-three years since I graduated from medical school, I never saw anything like it, the patient is one of a kind.

I finished my documentation at one minute before 11:00PM.  I walked out of the clinic in the quiet, the dark and cold close by the window, content with the satisfaction of curing the patient.

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