Still making housecalls



The sun on the snow gets so bright
Reflecting the light off the white
The stuff new to me
Is wonderful, see,
And Aurora brightens the night.

Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, travelled and worked out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I am back having adventures in temporary positions until they have an Electronic Medical Record (EMR) I can get along with. Right now I’m on temporary detail to Brevig Mission from the hospital in Nome, Alaska.

I make house calls. I enjoy them. I don’t do them very often.

When I worked in Navajoland, the war between the bureaucracies resulted in the demolition of a perfectly good clinic with the empty promise of a quick replacement; I got mean after two weeks of pay with no work and talked the Public Health Nurse into driving to hogans. I treasure those memories of the community I got that way.

Sometimes at home “housecall” means the patient comes to my house.

Here in Brevig I made three house calls on foot today. The Community Health Aide (CHA) and I walked together, through the blinding bright sun-on-snow, in bitter cold and wind.

Confidentiality precludes discussion of patients and problems in any but the most general terms. All three patients would have had difficulty getting to the clinic.

But I can talk about the context.

All the houses had portico closed on three sides, protecting the outside door and a space between the inner and outer doors. Two had firearms casually stacked in that space; I noted .22s, .223s, 12 gauges shotguns, all with outer finishes roughened by prolonged use in hard conditions. Each home had a first-class wood stove in the living area; no trees grow here but lots of wood drifts on the beach.

I saw frozen pizza boxes and traditionally dried salmon. Tabasco sauce bottles sat next to peanut butter jars. A single gleaming spark plug sat on a washing machine next to a rusty box/open end wrench. People sewed furs from sheep, beaver, seal, and wolf with waxed dental floss.

I commented to the CHA how the smallest, most mundane details of someone’s daily life fascinate people from other places; for me a flock of wild turkeys or a doe and her fawns in my backyard rate a yawn but would bring her wonder, while Northern Lights every night and a nearby island good for hunting seal knock my sox off.

During the visits people talked about bingo. I don’t gamble, but bingo on the Bering shore promised a unique experience, and at 7:00PM, my clinic documentation done, I suited up and walked out into the brightness.

I did not find the bingo game.

In a village this small and this isolated, the children play as freely as I played in the 50’s. Two, who recognized me from clinic, came up to show me their puppy while I wandered.

Back inside, my glasses frosted over, rendering me sightless till the ice sublimated and the temporary darkening relaxed.

I napped and read until a patient came in with a CHA at 9:00PM.

Not sick enough to warrant a Medevac, but definitely in need of an IV and a few 21st century pills, they left in the dark an hour and half later.

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