Posts Tagged ‘abdominal aortic aneurysm’

Title 47, a pulsatile mass in the abdomen, a conversation in Spanish, and a lecture on snowy owls

July 14, 2010


Consider that whitest of fowl

Whose scream sure isn’t a growl

     Avoiding conjecture

     I went to a lecture

About the North Slope’s famed snowy owl

All patient information in this post was included with the permission of the patient.

Because schizophrenia exists worldwide, all cultures have a mechanism to deal with people who act irrationally.  No two states have the same laws;  the phrase “danger to him/herself or others” recurs frequently. 

Alaska’s physical realities do not permit such leniency; those whose thought processes are clearly out of control warrant safe placement because of carnivores and a hostile climate.

Our morning conference featured a long discussion of Title 47, the state law that deals with involuntary commitment.

Later in the day a person came in with pain in the top middle part of the abdomen, just below the ribs, where I could feel an apparently enlarged aorta.

An aneurysm happens when an artery becomes more like a water balloon than a garden hose; the larger the aneurysm the greater the chance of rupture.  If the aorta, the largest blood vessel in the chest and abdomen, develops an aneurysm and the aneurysm ruptures, the patient usually dies. 

Ultrasound makes the diagnosis, surgery cures the problem. 

With one ultrasound machine and tech for an area the size of Minnesota, I had to scurry to bump another patient off the ultrasound schedule.

The Medevac planes are still out of commission.

I attended a Mexican patient whose last name was not at all Hispanic.  I showed off my Spanish and put the patient at ease.  I hadn’t realized how much I missed speaking Spanish.

A  lot of people from tropical countries moved from the Caribbean or the South Pacific or Florida right to the most Arctic place in the country.  They never complain about the cold.

The ultrasound was OK, I was able to reassure the patient with the tummy ache and diagnose a much more prosaic problem.

At seven in the evening I went to the Heritage center, next to the library.  I walked past the Arctic Ocean crashing onto the ice on the shore, the wind at my back, to a lecture about snowy owls.  Most of the people in the audience were young non-Inuit.  The lecturer has been coming from Montana to Barrow to research owls for nineteen years, and spoke with a Boston accent.

They are very large birds.  They kill snow geese and Arctic foxes on a routine basis; aggressively protective males attack human researchers approaching the nest.  Their favorite prey is the lemming.  Once the females have eggs, they scream loudly to the male for food, all summer.  A physically aggressive male and a loudly screaming female have the best chance of successfully rearing young.  The females are bigger than the males.  Males are pure white, females have bars and spots and look like dirty, melting snow.  Owls banded near Barrow travel from eastern Canada to Siberia. The Russians trap them for their eyeballs, which are marketed as an aphrodisiac.  

Walking back, the fifteen mile per hour wind was in my face, and I still need the long johns.  Last summer was much warmer here.