Sometimes there’s a treatment delay

By some hours or even a day. 

I do what I can

In a multi-port plan

Keep them working if there’s a reasonable way. 

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  I danced back from the brink of burnout in 2010, and, honoring a one-year non-compete clause, went to have adventures and work in out-of-the-way locations.  After jobs in Alaska, New Zealand, Iowa, and Nebraska, I returned home and took up a part-time, 54 hour a week position with a Community Health Center.  I’m taking a working vacation now in Petersburg, Alaska.

Bethany and I got up early and drove out to Sandy Beach, about a mile down the coast, as the tide reached its ebb.  We walked out on the tidal flats.

Tides can run 23 feet here from low tide to high.  Three creeks empty into Frederick Sound here, the flow braids across the area exposed by the dropping water.  As we walked we saw dead pink salmon scattered here and there, their eyes and bellies pecked out by the seabirds.  A commercial fishing boat lay at anchor a hundred yards from the water’s edge.

We searched for the remains of a fish trap the Natives had started constructing 2,000 years ago and kept using till a hundred years ago.  We didn’t find it.

But we saw sea lions.  And we saw salmon with bad timing trying to swim up the creeks’ trickle across the tidal flats.  We crunched across iridescent blue mussel shells as the rain came harder and harder.

After breakfast I walked to work.  In the clinic I attended a number of commercial fishermen.  The more people work in an industry, the more people will come to harm in it, and fishing doesn’t warrant an exception.  What do they catch?  Mostly salmon, cod, and halibut; if they want to run risks in the off-season they go for crab.

But the more people I talk to the more I find have gotten away from crabbing because of the danger, and they don’t miss it.

Every time I have minutes and opportunity, I quiz people on the industry and I learn more.  I still haven’t figured out the relationship of the tenders to the fishing boats except that a tender can hold 700,000 pounds of fish and a typical fishing boat might only hold 120,000.  Of course the peak load diminishes with bad weather, sometimes by 20%.

People work close to machinery in fishing boats, things happen suddenly and unexpectedly, and bodies come away damaged.  Commercial pressures bring stress, family conflicts make things worse.  People delay treatment because the injury might happen two days out of port.

Sometimes I can run lab after an examination but the patient leaves with his boat on the next tide, and I have to say, When you get to Juneau, show the next doctor this piece of paper.  And you HAVE to see a doctor at your next port.

I do what I can to keep them working.

It reminds me of home, when the farmers get sick or hurt during harvest.

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