Eternal Verities of the Human Condition


When patients come in by the mob

And I can feel my feet start to throb

Though the place is a zoo

I can tell you it’s true

I really do love my job.

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 (EMR) system I can get along with. I spent the winter in Nome, Alaska, followed by assignments in rural Iowa. This summer included a funeral, a bicycle tour in Michigan, cherry picking in Iowa, a medical conference in Denver, and two weeks a month working Urgent Care in suburban Pennsylvania. Any patient information has been included with permission.

I walked into work full of energy this morning, to an Urgent Care site where I’d never worked before.

At home I generally see a patient or two a day when I’m not working, mostly informal visits.  Some people leave with concrete advice.  Sometimes I enforce an exercise prescription by going on a walk with the person.  Occasionally I’ll serve breakfast.  People most often get advice, rarely a prescription for a pharmaceutical.

Frequently a person goes to a specialist as already scheduled, with advice on how to use buzzwords, give an accurate history, or ask for lab tests.

This particular clinic has a history, and it made me appreciate the care put into other clinic’s floor plans.

Over the course of the day I saw people with broken bones, skin problems, and respiratory infections.  I brought into play recent information from the conference I attended in Denver, especially about when to use and when not to use antibiotics and narcotics.  Some people left disappointed, but no-one left without attention to their problem.

Starting slowly, I soon had a five-hour crush of patients.  At two in the afternoon things slowed down enough that I could attend to my raging hunger.  Bethany sat with me in the break room while I bolted fries and smoked brisket.

After lunch I caught up with my documentation.

A quick run through my email showed me that my planned next step had fallen through.  I have no work on schedule as of November 1.

Weight loss in 21st century America demands investigation.  People who delay treatment for trauma will generally suffer more problems than if they’d come in early.

I did most of my antibiotic prescribing in the late afternoon and evening.

I didn’t get to speak a word of Spanish.

I don’t do much surgery, but I got the chance to remove a patient’s problem and found the experience delightful.

During a slow hour I asked Bethany to bring food at six, when she showed up things had backed up badly.  But I took 4 minutes to inhale some hot sour soup and orange chicken.

Without permission, I can’t give identifying details about the last patient of the day, leaving the philosophical distillation in a jumble..  My business sees the exquisite drama and irony because of these inherent truths:  mortality tinges human love with an urgency, we all climb a ladder of development, our bodies age no matter how we try for a perfection we cannot attain, and we spring from, in Kahlil Gibran’s words, “life’s longing for itself.”

I walked out into the cool October night, full of wonder.

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