Another road trip, day 4

It came from out of the blue

For me it was nothing but new

The memory game

Wrapped up in a name

For symptoms, not a what, but a who.

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 in 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 System (EMR) I can get along with. I spent the winter in Nome, Alaska, and I just finished an assignment in rural Iowa. Right now I’m working Urgent Care in suburban Pennsylvania, combining work with a family visit.

Docs get a lot of free information.  We even have a designation for those journals that come our way for free: throwaways.  I have received them since my first week of medical school.  Most merely add to the information overload, and I reflexively toss them into recycling on sight.  A few have proven their worth over the years, and tend to stack up until I get the time to read them or get disgusted at the height of the stack.

Three weeks ago, whittling away at those periodicals, I came across an article which challenged me to guess the diagnosis.  The punch line carried not only a two name eponym but a number; a now deceased physician gave both his first and last name to not 1 but 3 syndromes.  In 35 years of seeing patients I had never seen anything like the photographs, and I scoffed at the uselessness of trying to remember the designation.  A few minutes later, the journal hit the recycling bin.

I saw my first case of that disease yesterday during my orientation to a new assignment.  I did not remember the name, but I did remember the cause and the treatment.

I cared for twenty patients in the course of my 12-hour day, a higher daily production than I have managed for more than a year.  Two had tick-related problems, three had lacerations requiring repair.  Many suffered from allergies.  Several had nothing wrong at all but needed a physical exam documented.

Pediatrics comprised one-quarter of the patients.

Two patients declined my recommendations for various reasons, and I did not argue with them.

Two people suffered from excesses of caffeine, the easiest of all the addictive drugs.  Both had upped their intake in times of stress and would have no problems returning to normal usage, and both had good insight into the problem.

All denied use of marijuana, and I believed them.

I didn’t talk to anyone about their alcohol abuse because it only marginally related to their presenting problem and because I just didn’t have the time.

No one came in requesting narcotics.

Through it all I started the process of learning another new electronic medical record (EMR) system.  This one, DocuTap, has its quirks but functions well and, mostly, intuitively.


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