Posts Tagged ‘smokers’

Locks on the Clothes, Keys on the Shoelace: the dress of a millwright.

July 9, 2017

The millwrights has many a key

For the mill cuts up many a tree

On the machine go the locks

Preventing visits to docs

And keeping the workplace accident-free

 

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 traveling and adventures in temporary positions. Assignments in Alaska, rural Iowa, suburban Pennsylvania and western Nebraska have followed.  I finished my most recent assignment in Clarinda on May 18.  Right now I’m in northern British Columbia, getting a first-hand look at the Canadian system. Any identifiable patient information has been included with permission.

Thursday I took care of 17 patients. One pediatric patient required all my patience, skill, and accumulated experience to get the job done without alienating the kid.  The oldest patients barely qualified as septuagenarians.

I wrote a lot of prescriptions for blood pressure drugs.

I used my deep-breathing techniques on three patients to bring blood pressures into the acceptable range.

Though only 15% of Canadians smoke, the nicotine addicted comprised more than half my patients.

I wrote several back-to-work slips, all employees in the timber industry.

I cared for even more millwrights and former millwrights. Changing logs into useable products involves a lot of dangerous machinery, and the people who fix the machinery come in loaded with padlocks on their clothing.  They lock a machine before they work on it, to make sure it won’t start accidentally.  Spare keys get carried where they can’t get lost, such as tied into shoe laces.  During the work day, a “whistle” signals a need for a millwright.

One of my patients in frustration said, “Can you give us a referral to see a specialist we can actually see?’ and we laughed after I asked for and received permission to use the quote in my blog. While I know my way around the human body, and most of the things that go wrong with it, I don’t know the local medical community.  Yet the permanent doctors trained near here, and know the consultants personally.

There’s also a province-wide network providing phone-in advice for docs . The consultants get paid on a fee-for-service basis; the patient has a unique identifying number, and the doc has a bunch of unique numbers (I have 8), one of which is the right one to use.  Computer algorithms coordinate compensation.

New Zealand Road Trip : Punakaiki to Hari Hari

June 6, 2011

The greenstone’s a gem just like jade

For jewelry, for bowls, or for blades

     What it looked so official,

     Just like my initial

Was the thing that the artist had made.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  On sabbatical to dance back from the verge of burnout, I’m having adventures and working in out-of-the-way places.  We’re touring after a month-long assignment an hour outside of quake-stricken Christchurch, in New Zealand’s South Island.

This morning we got off to a leisurely start to the Paparoa National Park, famous for pancake rocks and blow-holes. 

The mood of the beaches of the South Island’s West Coast differs from the beaches of the East Coast, where we started our New Zealand odyssey, as much as Big Sur differs from New Jersey.  The Tasman Sea, which separates New Zealand and Australia, generates much bigger surf than the Pacific. 

We found the East Coast rainy, but the West Coast, where parts flow with 3 meters (ten feet) of rain in an average year, makes all that greenery look positively drought-stricken.

We took the short Truman Walk down to the beach north of Punkaiki proper as the tide rose. We entered the cool zone of the rain forest and followed the path downhill out into the open where trees give way to New Zealand flax, then down the rocks to the sand.  Bethany found a piece of jade.

“Look how gorgeous this is,” she said, “and with the main attraction by the visitor’s center, I’ll bet almost no one comes here.”

In fact, the number of tourists at the Pancake Rocks increased steadily as high tide approached.  We went out on the path across the rocks and looked over the eroded, layered dolomite, feeling the ground shake as the waves pounded through the grottos under our feet.  A brief rain made me zip up my duck-hunting jacket and drove the other tourists away.  When the number of smokers reached critical mass, we left.

An easy afternoon’s drive through driving rain, past brooding mountains with low hanging clouds brought us to Hokitika, famous for greenstone and jade.

The Maori prized greenstone for its beauty and utility, and grew ceremony and custom to go with it.  Found nowhere else in the world, greenstone jewelry finds favor with Maori and Pakeha alike, and two years ago attained recognition as a gemstone separate from jade.  You don’t find the greenstone, the Maori say, the greenstone finds you; never purchased for oneself, it should only be bought as a gift.

The local Maori iwi owns the only privately held river in the country; they find jade and greenstone in the bed, and carve it for market at their shop in Hokitika. 

We walked in, and as I looked through the display case, the goose bumps hit.

Fifty years ago I combined my first and last initial into a monogram; it evolved as I finished medical school and started signing things hundreds of times a day.  Not particularly legible, but consistent and distinctive, the center resembles a treble clef.

I called Bethany over and pointed; she gasped.  The piece could pass for my signature.  The greenstone had found me, but Bethany would have to make the actual purchase.

The Maori clerk, a nurse, also works full-time at the Greymouth hospital, and in short order we fell to talking about medicine.

Their hospital has lab and x-ray.  Depending on who has the duty, surgery can be performed there, but complicated fractures get flown to Christchurch on weekends.  A top-heavy administration uses resources to make rules for the sake of rules, while such facilities as an Alzheimer’s unit lack the money for beds.

I told her that, outside the specialty hospitals, the same problems crop up in American facilities. Here, as in the US, rural areas and small towns have problems recruiting doctors.

I explained the Medical Council of New Zealand’s rules for provisional licensure the first year; the registration comes tied to a specific location, and the doc has to notify the Council before any practice move.  My registration expired yesterday, I told her, and I smiled.