A movie, an owl, and patient getting worse.


Last night we went out to a flick

It got prizes for being so slick

But a hoot from an owl

Who was out on the prowl

Warned of patients, who got desperately sick


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. The summer and fall included a funeral, a bicycle tour in Michigan, cherry picking in Iowa, a medical conference in Denver, working Urgent Care in suburban Pennsylvania, and Thanksgiving in Virginia. Right now I’m in western Nebraska. Any patient information has been included with permission.

Last night Bethany and I went to the two-screen theater in town and saw The Revenant, an Academy Award winning movie.

On the way out of the theater, I got a call from the hospital; one of my inpatients requested a sleeping pill. Hospitals thwart the sleep that healing requires, and I gave the order over the phone

We talked about the film on the way back. It featured a lot of action, it got some bits of woodcraft and history right, and a lot wrong.  I enjoyed the Shawnee and Arikara dialogue.  We agreed that we could have done without so much gratuitous violence.  Bethany asked some medical questions, and we tried to figure out at what point the French traders stole Powaqa.

On the net, researching the real story of Hugh Glass that served as the basis for the film, I heard an owl hoot 4 times outside the north part of our townhouse. I glanced out the sliding doors to the deck, but saw nothing.

In my years with the Indian Health Service, I learned that most Native Americans regard owls as terrible omens, bringers of bad luck and death, and the sound chilled me. The film had brought memories of working in a tribal context, bringing that milieu back into my consciousness.

But I slept soundly, because call here means nothing. The doc covering the ER handles problems in the hospital as they arise.  Thus finding a “missed call” message from the hospital from 1:00AM brought alarm.  The voice mail asked me to call back immediately.

When I got to the hospital, I found that my patient, the one who had requested the sleeper, had just been transferred out. After the ironic decision to change after decades of bad health decisions, the dramatic payment to the piper came, and the patient’s fast glissade downhill started about the time I heard the owl.  His medical needs exceeded our capabilities.

And despite all the right decisions and all the right medications, just like Humpty Dumpty, some things can’t be repaired.

But the clinic patients started well and got better. One of the follow-up patients looked and felt dramatically improved on a scheduled dose reduction.  Two people had ear infections.  Nobody quit smiling when I wouldn’t give antibiotics for colds.  I had time to do some online research about testing for cystic fibrosis, and I caught a power nap over the lunch break.

The pace picked up in the afternoon. I got to speak Spanish, and I used the osteopathic part of my training to make a person well before departure.

Without the gloom of the first part of the morning, the rest of the day wouldn’t have gone so sweetly. Contrast is the essence of meaning.



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