Archive for the ‘Fishing’ Category

Fishing and electronic medical record systems: one is a waste of bait, the other is a waste of time.

March 20, 2019

The computer is a drag on my brain

I would rather the cold and the rain

While I’m up in this state

It’s more fun to waste bait

Is it really that hard to explain?

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. I followed 3 years Community Health Center work with a return to traveling and adventures in temporary positions in Alaska, rural Iowa, suburban Pennsylvania, western Nebraska and Canada.  I have now returned to southern Alaska.  Any identifiable patient information has been used with permission.

Bethany and I booked a fishing charter on Sunday. We slept poorly and had the magic moment together of loading the car in the darkness and setting out well before light.

We drove into Homer, immortalized by Tom Beaudette in his literary series as the End of the Road.  It sits on Kachemak Bay, made famous by the TV reality series on Alaska homesteaders.

We shared the charter with a party of 4 from Anchorage: 2 doctors (an OB and the only pediatric orthopedist in the state) and two public defenders.

The morning brought much rain and no nibbles. Bethany and I napped intermittently and the young professionals chatted and waited for fishpole ends to dip, while the captain kept the boat trolling back and forth.

In the afternoon the spell was broken when a doc brought in a very nice salmon, about 10 kilos or 25 pounds.

Pacific salmon spawn once and then die.  The king salmon, also called the chinook, reach the biggest weights and carry the most fat of all the species, even more if you get them in winter, before they make changes for breeding.

The sun came out in the afternoon as we trolled back just off a glacier that sent strong chilly winds.

No one got seasick, and no further salmon showed any interest in the baits.

Perhaps we didn’t catch any salmon, but we saw lots of sea otters, loons, eagles, and a seal.

We went out to eat in Homer at a Mexican restaurant; I showed off my Spanish and told a couple of jokes with the hostess from Guadalajara.  We saw a moose on the way back.

The next morning at orientation, I could still feel the boat rocking.

My computer training started in the afternoon.

I don’t like what computerization of records has done to American medicine: stolen physician time from medicine to data entry.  Few of the quality metrics improve patient care.  New studies are finding examples of patient harms from the electronic medical record.

My experience with this particular system goes back a couple of years, and crosses state lines.  Every update promises improvements and brings functional deterioration.

Such systems hurt the basic functions of health care but aid administration.  Report generation and billing get easier.  Bad systems requiring frequent retraining provide employment.  The government keeps expanding the suite of quality metrics that does not help patients but demands more administration, which now tops the list of American medical system price increases.

I whined for a while.  My trainer didn’t disagree, then I went back to learning.

All in all, if I’m not taking care of patients, I’d rather be fishing.

 

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The big fish that didn’t get away.

August 9, 2010

I really don’t know what to say

At the end of a great fishing day

     I learned how to feel

     With my line, rod, and reel,

So the big ones don’t get away.

We’re back in Anchorage after five days fishing on Prince William Sound, made famous during Exxon Valdez oil spill.

One day of fishing will generate more stories than can be recounted in 1000 words; we had adventures enough for a volume.  But blogging demands brevity.

Prince William Sound was formed when the sea flooded a river valley cut by glaciers.  With frequent weather changes, shifting dense overcasts, sudden fogs and squalls, its beauty is intense but brooding and sullen.

Our skipper, Lee, grew up during the same turbulent times I did.  He started as a fishing guide with his own boat at age fifteen.  He had a long, successful career as a marine diesel mechanic, and graduated to paralegal seventeen years ago.  He describes himself as a farm boy, but when he talks about the law his erudition shines through. 

Lee knows the location of the fish and their dietary preferences, their psychology, size, and habits.  He can tell if bait remains after a nibble on three hundred feet of line.  He knows by looking at the end of the rod if the fish on the line is halibut, ling cod, salmon or rock fish, and can tell you the size.

He has a mystic connection to the fish; one morning he caught three black rock fish in the time it took me to put on my boots.  He was very patient with Bethany and me.  The first day I couldn’t tell a nibble from a bite, and I didn’t know how to set the hook properly; I lost more fish than I landed.

On day one, the silver salmon came, bit leisurely and followed the line to the boat docilely, after that they jumped and spun and ran and fought.

Bethany caught a forty-two inch ling cod the second day.

The 37 foot cabin cruiser was manufactured in 1978, and was not well maintained by the owner who sold it to Lee’s friend, who now wants to sell it.  Lee can fix anything on the boat.

Inside, the comfortable craft sleeps six, has a 3 burner stove, a serviceable head, but no working shower.

Bethany has had problems with motion sickness.  She used the patch behind her ear, and it worked well for her.  I didn’t have a problem with seasickness; to my surprise I found the rocking motion of the boat soothing and promoting of a good night’s sleep.

Fishing on Prince William Sound

We’ve been talking for years about going on a cruise, but Bethany was hesitant because of the seasickness issue.  We can now start making actual plans.

After five days I was baiting my own hook and I could identify the fish before it surfaced.  Very early on I more than doubled my lifetime biomass catch of fish when I pulled up halibut the size of my dinner table (fifty inches, no exaggeration). 

I threw back more fish on this trip than I’d caught in my entire life previously.  Kelp greenling turn to mush when cooked, as do saber-toothed flounder.  The flounder that I caught, microscopic in comparison to the halibut, wasn’t worth cleaning.  Pink, or chum salmon, don’t taste nearly as good as the silver salmon.

Golden eye rock fish look like a kabuki nightmare.  They flare their gills and poisonous spines when brought to surface; their disproportionately large eyes bug out of their blaze orange heads.

While jigging just off the bottom for rock fish one day I hooked something of enormous weight and reeled in a ling cod a few inches shy of the 35 inch minimum, and threw him back.

The big ones didn’t get away this trip.