Posts Tagged ‘Bethany’

After two unemployed months, back at work

April 7, 2018

Of the patients there’s never a lack

I can tell you it’s good to be back

I think that it’s neat

When the patients repeat

And I can see that they’re on the right track.

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 and western Nebraska. 2017 brought me adventures in Iowa, Alaska, and northern British Columbia. After a month of part-time in northern Iowa, a new granddaughter, and a friend’s funeral, I have returned to British Columbia.  Any identifiable patient information has been included with permission.

Today I cared for 12 patients, 1/3 of whom I had cared for either last summer or in December. Respiratory problems dominated the clinical landscape, but I also saw 3 who came in to find out test results and five who needed prescription refills.

I recognized the first patient and without prompting opened the visit in French. He gave me a heartfelt grin.

I recognized one patient as a New Zealander by his accent. At the end of the visit I got into geographic specifics, and in short order we started talking about Warkworth (pronounced Walkwith), Leigh (pronounced Lee), Matakana, Omaha Beach, the Kauri Museum, Pakiri Beach, and Whangarei (pronounced Fahnga Ray).

Three patients discussed travel to Mexico, either completed or anticipated.

In December I posted about a patient whom I gave the opposite of my usual dietary advice; she returned to see me today. The plan worked, and the problems related to excessive weight loss disappeared.  We discussed favorable labs, and she requested I write about her in more detail.

A quarter of the patients use marijuana regularly. The only smoker wanted to quit.  Nobody admitted to excessive alcohol.

I did yoyo tricks for my one pediatric patient.

The return to work came as a relief after two months without employment. Including those seeking casual medical advice, I averaged less than 3 patients a week since February 1.  Today I fell into the rhythm of my usual questions: tell me about it, tell me more, what else?

News of my Immigration problems circulated here even before I published my last blog post. Patients, staff, doctors, and bystanders commiserated with me.  I pointed out there are few better places to be stuck than Vancouver.  We all agreed if you have to get turned away at a border, none can beat the US-Canada border.

A lot of people, in the clinic, the hotel, and the mall, asked after my wife, Bethany. She made a lot of friends during our last two stays. I got the feeling people missed her as much as they did me.

It was good to be back at work, in a system centered on patients and not cash flow. And it was good to be with a bunch of my colleagues, talking about cases and learning from each other.

At the end of the day, pleasantly tired from the action, but far from exhausted, I stepped out into bright sunshine and temperatures just below freezing. I had finished all my documentation.  I didn’t have to think about anything else but the weekend.

 

 

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When the surgeon advises no surgery

March 1, 2018

From Galveston we drove in the rain

To discuss a tumor of brain.

To our great relief

And we love the belief

That surgery would be in vain.  

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 and western Nebraska. 2017 brought me adventures in Iowa, Alaska, and northern British Columbia. I’m taking some time off after a month of part-time (48 hours per week) work in northern Iowa. Right now we’re in Texas visiting our married daughter, her husband and their new baby. Any identifiable patient information has been included with permission.

MD Andersen could lay claim to the title of America’s Premier Cancer Hospital. The exam room at the Brain and Spine Center on the 7th floor of Building 3 held more than a century of education.

I have had 27 years of formal education; my wife has 20 years of schooling including a bachelor’s, a master’s, a year for her Certified Medical Assistant, and another for advanced educator training; our oldest daughter, a Family Physician in her own right, has 23 years. The two neurosurgeons have at least 27 years each.  Including Anya, our 12 day old granddaughter, the average number of years in school came to 21.

But the two neurosurgeons spoke directly to the patient, my wife Bethany. A routine MRI in the summer of 2016 found a meningioma, a non-malignant thumb-sized brain tumor growing out of the floor of the skull just behind the left eye.  She had radiation therapy that August and has remained symptom free since.

But follow-up MRI in Sioux City showed mistiness suggesting possible tumor growth, and we came to Houston for another opinion about proposed treatment.

Actually, we came to Texas to visit the new grandchild. Jesse arranged for a consultation and drove us through the pouring South Texas rain, up from Galveston.

I listened in while the neurosurgeons explained the findings on the scans. The tumor itself shows a clear-cut outline or capsule; the haziness around it does not connect with the meningioma proper, and probably represents radiation necrosis, that is, death of brain tissue from the radiotherapy.

To our great relief, they strongly recommended against surgery, and prescribed a quartet of drugs: steroids to take down inflammation, Vitamin E as an antioxidant, pentoxifylline to make the blood less viscous, and pantaprazole to prevent an ulcer from the steroids.

We all felt relief flood the room. And I’m sure little Anya, who knows nothing cognitively but stays locked to her mother’s emotions, felt it too.

I had my work calendar cleared out because of worst case scenarios. That night, while thunder rolled over the Gulf of Mexico, Bethany I and snuggled in the darkness and talked about Where To Go Next.

 

What do do about very bad moments.

May 25, 2015

A note for those who’d be wise

If it comes as a surprise

It’s most likely bad.

The good times you’ve had

You could probably already surmise.

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 System (EMR) I can get along with. I spent the winter in Nome, Alaska, and finished a couple of assignments in rural Iowa.

Time comes to us, not as a series of days or years, but as an unbroken chain of moments.  Each moment lasts a second or three.  As human beings, when we awaken in the morning we all know we’ll have good moments and bad moments.  Most moments come and go as neutral.

I enjoy saying that if we let the bad moments contaminate the neutral moments we’re giving them too much power, and if we let them sully the good moments we’re missing the point.

Time spent thinking of bad moments that haven’t happened constitutes a misuse of imagination.  The psychiatric community calls it catastrophizing, thinking of sequences that follow from a bad “what if.”

Most of our good moments come to us announced.  Yes, once I really did find a diamond in a stairwell, and the gift of a soprano saxophone in fact rendered me literally speechless.  But my marriage, my children, my graduations, all arrived more or less on time after much anticipation.

In contrast, with few exceptions, the really bad moments come to us as complete surprises, unannounced and unexpected.   Bad medical news, such as my diagnosis of appendiceal carcinoid, and news of our daughter’s climbing accident, for example, came with no warning.   When I think of my lifetime’s 10 worst moments, I have to admit that they ambushed me, every time.

Both Bethany and I had very bad moments yesterday, the kind of moments that, despite all efforts to the contrary, ruin the rest of the day.  We commiserated, we supported each other, and we hugged.  And later, taking my own advice, I put a rubber band on my wrist for self-administered aversion therapy.  When a negative, useless thought intrudes, I pull the rubber band back about 9 inches and let it go; bad thoughts creep in with less frequency as long as I keep the rubber band on my wrist.

In the late part of the day we attended a social gathering, which celebrated Bethany’s last day on her job.  She has done a lot of good work for the last couple of years, and we’re looking forward to spending more time together.

At that gathering, a former patient I hadn’t seen for years, talked to me about a very bad diagnosis.  I listened, sympathized, and told her about my personal experience with carcinoid of the appendix.  But we also discussed our music community, and the person congratulated me on taking saxophone lessons.

One cutting of hay a year: back at work and talking with farmers.

March 28, 2011

 

And it’s not that I like to shirk

I’ve fought my way out of the murk

    It’s such a relief

    Here’s my belief:

I’m someone who just loves to work.

 Synopsis:  I’m a family practitioner from Sioux City, Iowa.  On sabbatical to avoid burnout, while my non-compete clause ticks away I’m having adventures, visiting family and friends, and working in out-of-the-way places.  Just back from a six-week assignment in Barrow, Alaska, the northernmost point in the United States, right now I’m in Leigh, New Zealand.  My net access has been limited.

Sunday I received confirmation of professional liability coverage while I processed emails in the staff room at the Wellsford clinic. 

Electronic communication started piling up when we arrived in Leigh.  With limited connectivity, I took to deleting chuckle-worthy downloads.  But when  I came to the post detailing my insurance, I grinned and read it out loud to Bethany.

I felt relieved; it meant I could start to work.

Four hours into a marathon net session, we went to lunch.  On our way out, a nurse stopped me for a brief clinical decision interpreting a test.  I confirmed significant abnormality.  She thanked me for the help; I thanked her for the opportunity to make my first clinical decision since I left Barrow four weeks ago.

In the late afternoon we drove back to Leigh, stopping at nearby Omaha Beach.  At the beach house we ate supper al fresco, and afterwards lay on the deck looking up at the stars.

Today I had my first real day of work in New Zealand.  I cared for Maori, Pakeha (non-Maori New Zealanders who have ancestors buried here), and several flavors of Europeans. 

I got to talk to a couple of dairy farmers, and I learned a lot.  Most dairy cattle graze on pasture and do not receive grain supplementation.  The grass descends, apparently, from plants native to New Zealand.  Those who cut hay can expect one cutting per year, two in an exceptional year.  Some milk their cattle twice daily, some once.  They don’t inject cows with hormones to boost production.  Frisian cows put so much into the milk they don’t live very long; a lot of farmers prefer Jerseys.  Modern land measurement uses the hectare, corresponding to about 2.5 acres. 

They call corn maize, and figure yields in metric tons (1000 kilograms) per hectare.  I haven’t compared Iowa yields to New Zealand yields.  Fertilizers here include lime, phosphate, potash, and urea but no anhydrous ammonia.  They call it topdressing.

We pass a lot of sheep when we drive, fewer cattle, and a very few horses; I haven’t seen or smelled pigs though some of the farmers talked about them.

I want to sit down and talk to the farmers, quiz them about what farming in New Zealand means, find out what makes the market tick.

My command of the computer system finished the day considerably stronger than when I started.  By the end of the second session I had gotten a lot better at the paperwork. 

For the last patient of the day I got to experience the transfer process.  The word registrar here refers to a physician advanced in training far enough to do a lot but not be a fellow; I talked to the surgical registrar in Whangatei. 

An easy handover; the doc at the other end didn’t ask me for lab or x-ray and didn’t try to dodge the work.

You won’t believe who I ran into in New Zealand

March 17, 2011

OB, I thought, was a blast

But now I’m a thing of the past

     Because I am male

     And I knew when to bail.

I was sure  the thing couldn’t last.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  On sabbatical to avoid burnout, while my non-compete clause ticks away I’m having adventures, visiting family and friends, and working in out-of-the-way places.  Just back from a six-week assignment in Barrow, Alaska, the northernmost point in the United States, I’m in Wellington, New Zealand taking care of details before I start work.

Yesterday on the way out of Te Papa, the New Zealand museum in Wellington, two American tourists approached us and asked us if we’d enjoyed the museum. 

We had. 

They asked, How much is it?

Free, we said, and fell to chatting as American tourists do in other countries.

They came from California; they had been two weeks in Australia and would spend another two weeks sight-seeing in New Zealand.  

The subject of languages came up, and the female of the couple, a tall blonde, said a few things in Spanish, mentioning that she learned the language at LA Women’s Hospital where she’d worked as a nurse.

“No me digas,(you don’t say),” I said.  I worked there the month of July 1981, doing an externship during residency.  I delivered a lot of babies that month and I quit counting at fifty.

The nurse, it turned out, had been working in the same place at the same time, and had certainly worked with me.

Memories came flooding back.  My schedule in theory went twenty-four hours on, twenty-four hours off, and an eight-hour clinic.  The reality came out differently; after the twenty-four hours on I had to do postpartum rounds which sometimes stretched into late afternoon.

When I finished my long day, I would dress in shorts and t-shirt and go out into the barrio.  I would look for my favorite video game, Battle Zone, and play a few times.  When I had spent all the quarters I was going to, I would look for the dodgiest restaurant I could find.

At a time when, per hour, I earned less than minimum wage, I could spend two dollars and get enough really great food that I would need another eighteen hours to digest it.

Bethany, pregnant with our first child at the time, hung around the apartment till she figured out how terrible the schedule really was, and went off to visit friends in South California.

I don’t blame her.

I learned a lot about obstetrics that month.  I used that knowledge and enjoyed delivering babies for the next thirty years.  As time went on, my resilience faded to the long hours, vigilance, and sleep deprivation.  I gave it up last May.

Here in New Zealand, the midwife movement has pushed the doctor away from intrapartum OB for the majority of births, and an increasing number of deliveries happen at home.

Some of the docts fought the trend, as they’d built practices and careers on that segment of medicine. 

Decades ago I recognized that only an accident of history would have let men into attending births of babies.  I am grateful to have been part of that experience, and each delivery I did left me euphoric and awestruck.

But I don’t miss it.

 

Prepping for a new assignment with the certainty of uncertainty

March 8, 2011

Here’s something to keep you from hurtin’,

Set emotional pain to avertin’

     Whatever’s arranged

    Is bound to get changed

The future is always uncertain

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  On sabbatical to avoid burnout, while my non-compete clause ticks away I’m having adventures, visiting family and friends, and working in out-of-the-way places.  I just got back from a six-week assignment in Barrow, Alaska, the northernmost point in the country.

I’ve been prepping for an assignment in another country but I’ve not written any details about the trip because so many times in the past deals have fallen through at the last minute.

My plans have changed a a lot since I decided to make a career change.  I rejected my first scheme, to stay in Sioux City but work in an allied clinic closer to home, after less than a week of consideration.  Thinking it through I realized I wouldn’t be slowing down at all.

Another plan, involving a local Indian reservation, turned out to be inside the thirty-mile limit of my contract.  Negotiations with another reservation fell through, I suspect because I asked for too much money (and they didn’t even make me a counter-offer). 

Then I had the idea that I should retrace my steps coming here, and work in Michigan, Wyoming, New Mexico, and Nebraska.  The timing turned out to be too complicated. 

I started talking with recruiters from Locum Tenens agencies.  When I finally figured out where to post my bona fides I started getting lots of calls.  Hint for any doctors or recruiters who might be reading this post:  doccafe.com and the New England Journal of Medicine have excellent bulletin boards.  I’m shocked that more agencies and doctors don’t use them.

I keep modifying my agenda, and I’ve stayed flexible.  I’ve assented to 19 jobs so far, of which four didn’t fall through and one is pending.

And I had a great time at all four jobs.

This upcoming placement, if it works, has changed and morphed.  Clinics in towns with exotic names requested a locum tenens (substitute) doctor, then changed their minds.  Other facilities, where I’d like to work, want me but bureaucratic rules could not be circumvented.  In the meantime, I corresponded with the recruiter over and over.  I searched Wikipedia and Googlemaps and Weather.com.  One recruiter left for a different position and another recruiter took her place. 

When we thought things were set, and that I’d for sure have work, I sent off to my licensing boards to send Certificates of Good Standing to the country’s licensing body and we booked tickets. 

Today I got an email titled Change of Plans.

I called the recruiter and turned on the phone’s speaker.

The proposed first placement wasn’t going to work out.  How about something else?

I grinned, but I watched Bethany’s smile fall from her face as we listened to details.  A different climate, and instead of pastoral farm country, we’d be on the beach.  One central hub facility and six outlying clinics.  Temperatures slightly warmer.  Excellent fishing, but marginal hunting.  I remained enthusiastic.

 In the last year I’ve learned to keep myself flexible when it comes to future plans, though I can’t deny the emotional rollercoaster ride from making plans and having them change.

When we hung up I was still smiling.  “It’s all good,” I said.  “Worst comes to worst, we’ll end up having a vacation till we’re tired of vacation, then we’ll come home and I’ll find something else.”

“I want some of what you’re taking,” Bethany said.

I handed her some chocolate chips.  “Take two of these,” I said, “You’ll feel better.”

Highlights of six weeks in Barrow

March 1, 2011

You might say it flew far like a sparrow

Or fast and straight like an arrow.

     But either way time

     Like a vacation sublime

Went fast while we were in Barrow

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  Avoiding burnout, I’m taking a sabbatical while my one-year non-compete clause winds down, having adventures, visiting family and friends, and working in out-of-the-way places.  Currently I just finished an assignment at the hospital in Barrow, Alaska, the northernmost point in the United States, and I’m in Anchorage for two days.

Six weeks in Barrow, Alaska, has flown by.  We arrived at the end of the two-month Arctic night.  We went out in -75 degree F temperatures, and we stayed inside while the worst blizzard in four years raged outside.

Gone!

Blizzard in Barrow

I worked 360 hours while here, but the other doctors worked more hours than I did.  I received the lightest load on the call schedule.  I didn’t work any nights.

I saw a lot of broken ankles, from snow machine accidents and falls on the ice.  I picked up two cases of vitamin B12 deficiency, nine cases of vitamin D deficiency, two cases of hypothyroidism, and not one case of frostbite. 

I took care of people from all over Alaska, including Barrow.  I also saw those from Tonga, the Philippines, Hawaii, Korea, California, Tennessee, Kentucky, Mexico, Canada, Puerto Rico, Florida, England, South Africa, Colombia, and Ireland.

I met people who had survived plane crashes and gunshot wounds.  I made personal acquaintance with more than a dozen whaling captains, and more than two dozen who had personally killed whales.

A lot of the men had taken polar bears, most at close range with low-powered rifles, many in self-defense.  One had killed a polar bear without a firearm at all.  

I talked to women who sew the seal skins onto umiak frames, and the men who hunted the seals.

When a white-out shut the town down for four days, I suited up and went outside.  Twenty paces from the building I thought better of the venture and turned back.

I didn't have to go out in a blizzard to ice up.

We watched the first dawn after sixty-three days of darkness on the afternoon of January 24, and watched it set less than two hours later.

First sunset and first sunrise in 63 days, at the point. January 23 2011

The medical community viewed the Superbowl in the Commons room, farther north than any other medical staff activity in the country.

I talked to other hunters who shot caribou, wolf, goose, duck, wolverine, seal, and walrus.  Several people had been hunted by polar bears, but lived.

We saw the Northern Lights, I for the first time and Bethany for the second.

We attended Kiviuk, the Messenger Feast that happens every two years.  I saw dancers passionately portray heroic stories with their dances.

Afterwards, while the Northern Lights swept mutely across the sky, we watched the best fireworks display I’ve seen.

While we were here we saw pressure ridges form in the ice on the Arctic Ocean.

For every active drunk I took care of I met two in recovery.

Bethany taught sign, Inupiak, Special Ed, third grade and fifth grade.  She made a lot of new friends, one of whom she started into knitting.  She got a lot of exercise.

I drove twice, a total of less than fifteen miles.

We had the best Kung Pao chicken and Mongolian beef we’ve ever had.

Both of us lost a few pounds.

Utilidor, school, NAPA, Brower’s Cafe, a bus ride, and the airport: last day around town in Barrow

March 1, 2011

Please don’t laugh and don’t scoff

Today we took the day off

     We travelled round town

     And toured underground

The famous Utilidor trough.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  Avoiding burnout, I’m taking a sabbatical while my one-year non-compete clause winds down, having adventures, visiting family and friends, and working in out-of-the-way places.  Currently I just finished an assignment at the hospital in Barrow, Alaska, the northernmost point in the United States.

Bethany and I took the day off today and went around Barrow. 

We slept in, ate breakfast, and went to Barrow Utilities and Electric Cooperative, Inc.; they supply water, gas, electric, and sewer service in an area notable for technical difficulty.  We asked for and received a tour of the Utilidor.  Really an engineering marvel, it deserves a post of its own during the next week.  In short: the water pipes don’t freeze in the permafrost because the water circulates.

With temperatures soaring close to positive Fahrenheit and minus 15 Celsius, we walked with our hoods down, and I unzipped my parka.

We stopped at the elementary school where Bethany has been teaching. In a climate as unforgiving as the deep Arctic, and with polar bears a real consideration, the school includes a very large indoor playground.  She picked up her pay slip, and said her goodbyes.  I talked to a woman from South Africa who enjoys picking up a few words of a lot of languages, and taught her a very short joke in Spanish.  I spoke with one of Bethany’s colleagues, originally from Mexico, in English and Spanish.  We turned down offers of lunch (shepherd’s pie, a popular dish here).

We walked another mile to the NAPA store, which will also get its own post later in the week.  I learned more about whaling, and found out one must pass an FBI background check to purchase most whaling supplies.

We decided for lunch at Brower’s Café.  The building, erected in 1881 as a shelter for stranded whalers, now functions as a very decent restaurant, with Chinese, Japanese, Korean, and American dishes.  I introduced Bethany to the cook, a man who coached batting for the Mariners for twenty-five years, retired, and decided he disliked doing nothing.  We ate a very good chicken curry.

Out back of Brower’s Café we found the whale bone arch we’d posed at this summer, and had our picture taken, again.

Winter at the Brower's Cafe whale bone arches

 

The two bones in the background came from a bowhead whale; they stand outside of Brower's Cafe in Barrow, Alaska

Another mile into the heart of Barrow’s business district, I stepped into the Wells Fargo Bank, the northernmost bank in the country, the only such financial institution on Alaska’s north slope, serving an area the size of Wyoming.  From here, all finances go south.

Then we just rode the bus around Barrow.  The town has a public transportation system consisting of a couple of small buses that run one fixed route, including housing five miles outside of town.  Elders, like us, ride for free. 

We got off by the airport in an unsuccessful bid to 1) photograph the sticky hangar door made world-famous in Discovery Channel’s show Flying Wild Alaska and 2) check in early.

But we walked back to the hospital housing, well exercised and ready for supper.

Packing after six weeks went easier than I had hoped but came with emotional difficulty.  Well-wishers stopped in to see us one last time before we left.

I’ve enjoyed my time here.  I don’t have plans to come back but I won’t rule it out. Life is too full of uncertainties.

A blizzard shuts down the hospital

February 23, 2011

Was ever a walker so bold

As to go out into the cold

     Only a wizard

     Could get through this blizzard

And the hospital got put onto hold.

 

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  Avoiding burnout, I’m taking a sabbatical while my one-year non-compete clause winds down, having adventures, visiting family and friends, and working in out-of-the-way places.  Currently I’m on assignment at the hospital in Barrow, Alaska, the northernmost point in the United States.

 

The author, outside in a whiteout

 

Winds howled around the hospital loud enough last night to interfere with slumber.  My Care Initiatives Hospice meeting took place behind schedule because I had overslept.  Skype failed to pick up the nuances of blizzard sounds while we talked.

Bethany walked to her job at the school, about two kilometers away. 

“You’re sure you want to do that?” I asked.

“I’ve got my phone,” she said.  “Worst comes to worst I’ll call a cab.”

Taxis are part of Barrow.  They are quick and cheap.

After she left I started trying to use my cell phone and found I had no service, and no way to call her.

At morning conference we talked about the weather and how it makes medicine in Barrow unique; we can’t do what we can’t do and we don’t have what we don’t have.  For a complex litany of reasons we’ll not be able to do transfusions outside of absolute life-and-death situations until a plane can land with certain vital supplies.

Planes won’t be able to land until the forty mph winds die down.

Bethany called.  She had gotten to school safely, arriving at 730.  Promptly at 735 the administration closed school.  Nonetheless, she said, she had work till 230.  When I rang off I recounted her morning’s exploits; she drew a round of applause.

Though we discuss matters of vast importance, though we may disagree about things, the mood of the meeting stays lighthearted. 

At the Clinic Formerly Known As Mine, we called snow “patient repellant.”  We never got mad at those who didn’t come in during bad weather, we looked forward to a more relaxed schedule.  With a blizzard raging, only one of my scheduled patients showed up.

I used the time to phone other patients about lab work.

Lunch passed leisurely; the snowstorm occupied the conversation.  I learned (in Spanish) that the current storm won’t break for three days.

After lunch, two patients showed despite KBRW’s announcement that the hospital had closed.  Most of us just stood around and chatted.

Bethany called; with school closed she’d gotten a ride to within three blocks.  Safe and warm inside an apartment house, she was considering walking home.  I told her to stay put or get a ride.

Two nurses came in, looking cold, wet, and frightened.  They left early, their truck stuck fast in a drift, and they’d had to call 911.  In the process of walking from the truck to the police they’d gotten wet.  One, on the verge of tears, started to shiver.   I put her on the phone to Bethany as a warning to not try to brave the elements. 

We cut the conversation short when we recognized hypothermia.  As we swarmed around her with towels and warmed blankets, the hospital PA system announced all those not living on hospital grounds needed to report immediately to Medical Staff Administration.  Those employees will form up into a caravan to make sure everyone arrives home safely, even if their vehicles don’t.

 I took these pictures from our apartment window:

Visibility going once...

 

Visibility going twice...

 

Gone!

And…Gone!