Easter Sunday in the ER


Readers:  Connectivity problems slowed the flow of posts.  To preserve the sequence, this is a week late.

It could have been nothing at all

With the cold and a sudden snow fall

I thought I would try it

It was 6 hours of quiet

This Easter when I took ER call

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 last winter in Nome, Alaska, followed by assignments in rural Iowa. The summer and fall included a medical conference in Denver, working Urgent Care in suburban Pennsylvania, and Thanksgiving in Virginia. Just finished with 2 months in western Nebraska at the most reasonable job I’ve ever had, I am back in coastal Alaska.  Any specific patient information has been included with permission.

When the Russians took possession of the part of North America we now call Alaska, they enslaved the indigenous people but had more interest in furs than in land. But they brought their religion, and it stayed when they left. Thus this town celebrates Easter at two different times. And this year the Orthodox Easter comes almost a month after the Catholic Easter.

If one of my colleagues celebrates a religious holiday that I don’t, I do my best to take call for that person, thus I find myself this morning in the Emergency Room.

0750AM: Arrived in ER to find no one here. I sat down in the doctor’s corner, fired up my computer, and started looking through the inpatient census.

0800: Spoke with a helicopter pilot in follow up and got to quizzing about the other professional’s job. I learned about darting wolves and moose. I found out what can happen when a compressor goes out and the engine fails between 60 and 600 feet up, what the helicopter pilots call the death curve. At such altitudes the helicopter can fall hard enough to kill, but can’t build speed enough to use the rotor as a brake. The problem being, of course, that most helicopter work involves just those altitudes.

Spoke with the doc who had taken call for the 12 hours previous. Not much to report.

0830: Started inpatient rounds on three patients. I can’t write about individuals, and, in this case, writing about disease states might identify people who didn’t give their permission.  But I can say that I dealt with the respiratory system and the gastrointestinal system.

Newton’s laws of physics don’t account for certain large parts of the universe, but one of those laws says two things can’t be in the same place at the same time. And human bodies suffer in consequence. If the person damaged by that inescapable reality lives in a small village accessible only by air or water, the consequent injurious effects ripple throughout the community.

10:00 AM Heavy snow fall started. Nap time.

10:20 AM One of the inpatients worsened. I got information and facts straight before I called the consultant at Alaska Native Medical Center (ANMC) in Anchorage. The light-hearted interaction brought me new information. The decision to send a patient out in a Medevac plane brings risks, especially in a snow storm.

11:00: Watched YouTube videos on Eskimo Scouts, racist Cold War Propaganda, but sympathetic to the people of Shishmaref outside of Nome.

11:45AM Called my wife to meet me for lunch in the cafeteria. The soup was excellent.

1230: Phone call requesting a medication refill. I said yes to a blood pressure medication with multiple uses and no resale value. I put a note in the electronic health record, but didn’t see the patient face to face.

13:00: Colleague called. Church finished. Take your time, I said.

14:00:  Colleague arrived.  Left in a slush flurry.

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