Tagalog, flu, and a staff meeting


The patients still suffer the flu,

And I know just what I can do

Though to prevent what they’ve got

We’ve a pretty good shot

But I’m hoping for some drugs that are new.

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, traveled 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 went back to adventures in temporary positions until they have an Electronic Medical Record (EMR) system I can get along with. Assignments in Nome, Alaska, rural Iowa, and suburban Pennsylvania stretched into fall 2015. Since last winter I’ve worked in Alaska and western Nebraska, and taken time to deal with my wife’s (benign) brain tumor. After a moose hunt in Canada, and short jobs in western Iowa and Alaska, I am working in Clarinda, Iowa. Any identifiable patient information has been included with permission.

Most sick people want to get well, and even more don’t want to be around strangers. I’m filling in for a doc whose patients love her.   They won’t come in until they feel sick or worried enough, and I haven’t had time to build a reputation in the community.

I attended one patient every half-hour from 9:00 till 11:00. I ran 5 lab tests, and ordered one x-ray.  Half the patients got prescriptions, half of them got advice because pharmacologic management would have been a good deal more dangerous than helpful.  With the unseasonably warm weather, I advised two to get over the counter Flonase for allergies. Another patient got a simple 5-day prescription that may very well save a life.  One patient has me puzzled and awaiting labs.

I exhausted my very meager Tagalog vocabulary on one person (who gave me permission to write this), prompting my patient to ask me if I’d lived in the Philippines. I explained that the most educated immigrant minority in this country are the Philippino, with a disproportionate number of doctors, nurses, and pharmacists.  Of course I’ve had colleagues from that country.  And, inexplicably, on the North Slope of Alaska, the Tagalog speakers dominate the taxicab business..

Three patients smoked; for each one I held my forefingers 18 inches apart and said, “On a scale of 1 to 10, how ready are you to quit smoking?” No matter what number they came up with, I asked, “Why not 2?” but had to explain that the doctors had already told them the bad things about tobacco, and I wanted the patient to tell the doctor something good about it.  One patient shook her head and said, “You’re good.”  I had to admit that I’d gotten the technique from an educational CD.

We had our monthly med staff meeting from 12:30 to 2:00. They announced my successful vetting (in the trade, we call it credentialing).   We went over changes in the Emergency Medical System (EMS), and talked about criteria for blood transfusions.

The flu came up briefly; the annual epidemic started about 3 weeks ago. It’s weakening but it’s still going.

I had no patients on the schedule after 2:00, and I started reading the handbook that HR gave me. I had two patients after 430, finishing at 6:00 sharp.  I walked out with all my work done.

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