Just like a river must flow round a bend
Another gig has come to an end.
Part gratifying
And part satisfying,
And I watched the pandemic trend.
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 further travel and adventures in temporary positions in Iowa, Pennsylvania, Nebraska, Canada, and Alaska. 2019 included hospitalist work in my home town and rural medicine in northern British Columbia. During COVID-19, I did telemedicine, got COVID-19 and then the vaccinations, and a week of in-person medicine close to home. My current Iowa gig works me 2 weeks on/1 week off; I took some time off to attend my beloved stepmother’s funeral. Any identifiable patient information, including that of my wife, has been used with permission.
I have worked this particular job since March. I have not worked at a better organized facility. Two top-notch RNs call patients in follow-up. The clinic manager, a nurse, used decades of experience to solve small problems and prevent big ones.
My job consisted mostly of caring for people with symptoms related to COVID-19, thus most came unvaccinated and a few had legitimate reasons. I watched the disease shift from the lungs to the gut; in the end, patients had more diarrhea than cough.
Other patients came as well. I got to diagnose some of my favorite problems: 14 cases of B12 deficiency, 4 cases of Parkinson’s, 2 cases of folate deficiency, 3 cases of low thyroid, 8 cases of polymyalgia rheumatica (PMR, an arterial inflammation that responds to steroids like prednisone).
I had to learn about mycoplasma, the smallest free-living germ. It infects people, pigs, and cattle. Because the lab has the capability of running the right test, I could make the diagnosis accurately.
But I delivered bad news in the wake of CT scans or MRIs. The patients received the reports with courage and dignity.
The set-up offered the immediate gratification of Urgent Care, and the deeper satisfaction of following patients with treatable, longer-term problems.
I had the weekends free. Bethany and I drove to Fairfield, home of Maharishi International University. A couple of times we went to Kirksville, the home of Osteopathy. And we got to the Davis County Rodeo. We toured one of the county courthouses, but we missed the oldest continuously used courthouse west of the Mississippi (and the second oldest continuously used courthouse in the country).
My last morning, I attended 6 patients; the last afternoon, 3. The only positive COVID-19 test came in the first part of the morning.
The final patient visit ran long, at a time when I had to turn in my key and get final clearance from Health Information Management before I left. I regret I had to interrupt the patient at the very last, and plead for leave to take care of the final administrative clearance.
I had almost nothing left in my office except my ball cap and my raincoat, which I needed for the drizzle as we left town.
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