Lying to myself: something I don’t have much experience with and I haven’t practiced much.


At the clinic for my overnight stay

On a bed with a mattress I lay

    I’ll tell you why

    To myself I did lie

And woke rested at the breaking of day.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  On sabbatical to avoid burnout, while my non-compete clause ticks away I’m having adventures, visiting family and friends, and working in out-of-the-way places.  After a six-week assignment in Barrow, Alaska, the northernmost point in the United States, I’m working on the North Island of New Zealand.

I took call last night and stayed in Wellsford. 

The clinic proper has two emergency bays, three cubicles next to the nurses’ station, a procedure room, an x-ray room, a good-sized phlebotomy room, a waiting room, six doctor’s offices, a birthing center, and a small administrative area,.

The downstairs staff room, 20’x20’ has a microwave, fridge, sink, lockers, and dishwasher; it adjoins a smaller call room with a bed and a non-working TV.

The clinic day went well.  I took care of patients aged 6 weeks to 85 years.  I saw a lot of asthma, impetigo, high blood pressure, high cholesterol, diabetes, accidental trauma, and the ravages of alcohol and tobacco.

After not seeing a new case for more than a decade, two patients came in with thoracic outlet syndrome.  The bundle of nerves that go to the arm (the brachial plexus) have to pass over the first rib and under the collar-bone on the way out of the chest.  If that gap narrows, pinching the structures, the person feels numbness and pain down the arm; intensity of symptoms depend on the position of the body and extremity.

Many people have come to me over the years certain that the infection in their nose needed antibiotics, only to have me tell them that they had a cold.  A patient, who gave me permission to include more information than I have, came in certain he had a cold, only to have me tell him he had an infection in the nose.

I turned down a request for a “sickness benefit” (income from the government while a person is ill); after we discussed the situation, the patient agreed with me.

I’m getting more efficient at filling out the paperwork for the truck drivers’ physicals. 

I finished with the last patient by 8:15, the nursing staff went home and I turned off the lights. 

Once I asked a doctor who took a horrendous amount of night call how he slept well if he knew his beeper might go off.  He said he just told himself he wasn’t on call.  I’ve asked around, few doctors manage the vigilance problem that well.   But for the first time last night, I believed me when I told myself I wasn’t on call, and when I turned out the light, I slept soundly.

In the quiet of the empty building I sat and read a two-day-old paper.  An article on page two of the New Zealand Herald used the Maori words korowai, karakia, marae, whangai’ed,  and hapu without translation.  I understood all of them.

The sun is up now, I can hear the people in the clinic tramping around upstairs and I’m ready for a day off.


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