Posts Tagged ‘taxi’

A very long taxi ride back

July 26, 2017

The day sure started out slow

It went fine, but wouldn’t you know

To make the trip back

I caught a ride in a hack

And the driver made satisfactory dough.

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.

The day on call went smooth and slow to start, with fine, solid naps in the morning and afternoon, caring for 5 patients. On the brink of leaving for the day on time, I knew I had to stay when the ambulance radioed in news of two injuries from the highway.

I have to confess my ambivalence when it comes to airbags. Front airbags don’t add much safety to modern seatbelts, too often they activate when they shouldn’t.  Side airbags, on the other hand, provide another layer of protection that saves lives.

I have never before attended survivors of crashes where airbags deployed. I developed the term “bag rash” to denote an abrasion from the airbag, and the patient gave me permission to write about it (and more).

Right when most people would sit down to dinner, the ambulance brought in another patient with problems exceeding our hospital’s capacities; in fact, requiring trained escort for the trip to Prince George.

The responsibility fell to me because nursing staff could not be spared from the hospital.

The back of the ambulance amplifies a road’s imperfections. I did my best to meditate through my nausea as we sped down the highway.

We stopped at the EMS station at the halfway point. Not all stretchers (in EMS-speak, carts) can lock securely in all ambulances (EMS-speak, cars).  I can’t detail here the complications that demanded a change of ambulances and crews, but I got to stretch my legs and breathe in the cool pure air, and ride in a much more comfortable seat.

I turned the patient over to the ER doctor, we volleyed a bit of French, and then I had to confess to the staff I’m not really Canadian. I have been working on my accent, after all, and I don’t obviously sound like an American at this point.

Then I called a taxi: the ambulance that met us would only go back as far as the halfway point.

A very long time ago, my pre-med biology lab partner drove cab, I rode with her a couple of times. She clued me into the details of the business.  In the States, the cab company rents cars to drivers.  The drivers don’t start making money till they’ve made up the fee, and some shifts they don’t make any money at all.  Bidding on the best cabs goes by seniority, and the new drivers (at that time) drove uncomfortable, unsafe vehicles.

As we rode, I interviewed the driver, just like I interview patients. He speaks fluent Punjabi and Hindi and a bits of Tagalog and Mandarin, but has forgotten the French required of all students in Canadian schools.  His English carried a perfect northern British Columbia accent, but I found out he’d been born in India and at age 10 moved to the very town we were headed to.  As the daylight faded into twilight, and as the long northern twilight deepened to dark, I listened.  He worked in the pulp and paper business till age 55 and started driving cab a couple of years later.  He doesn’t rent the hack from the owner; he keeps 45% of his fares.  He makes good money in the winter, but not in the summers.

We came into town in the darkness, talking about aurora borealis. He pointed out places from his youth, but had to be directed to the new hospital.  He showed me where the movie theater used to be.  They changed the films three times a week, he said, and he went to all the movies, and that’s where he’d learned English.

When he dropped me off at the hospital, I looked at the fare on the meter, and I was glad that the trip had been worth his while.

I dropped the unused morphine and the crash bag at the nurse’s station and walked back to the hotel. I hoped for a glimpse of Northern Lights in the moonless sky, but the clouds hid the stars.

 

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!

A gig at Pepe’s and a visit to a whaling captian

July 11, 2010

I didn’t know it would happen

While I sang with maracas a-snappin’.

    But I dealt with the stress

    Of financial success

And went to the home of a whaling captain.

Saturday the weather turned windy again, the air temp went down to 38 degrees and the sky clouded over.  I called family and friends in the afternoon.  I looked out the dining room window while I talked and watched sea ice floes form and disappear.

It is difficult for people not on the North Slope to imagine what it’s like to live in a place accessible only by plane or by water.  It’s a lot like living on an island and affects the sociology of the town.  Theft is uncommon and mostly petty.  Interpersonal violence is unusual; when the young and the drunk lose their tempers, a wall is the more likely victim of their fist than is another person.  Few households are without a small arsenal of firearms, but shootings (accidental or not) are rare.

At four-thirty in the afternoon I carried my saxophone case in a light, spitting rain to the house of the guitarist, meeting there with the trumpeter.  A Tagalog-speaking cab driver drove us and the equipment to Pepe’s where our other vocalist waited.

Taxis, long a symbol of urbanism, have integrated into North Slope villagescape.  Waits are short, rides are cheap, and tips are not expected.  Most of the taxi drivers come from Pacific islands or southeast Asia.

We played to a crowd that occasionally numbered into the double digits and we had a great time.  I qualified as the percussionist because a waiter handed me a pair of maracas.  I excelled in songs of post-Victorian vintage through the old standards, from Summertime and Five Foot Two through Georgia On My Mind and Sentimental Journey. When I didn’t have the notes under my fingers, I sat out and played maracas and sang.

We played two and a half hours without a break till the trumpeter/ leader had to go back to the hospital to take call (he’s also a family practitioner).

I don’t know who put out the tip jar, nor did I notice people putting money in it, but at the end we had $22 to split four ways.  We also got to order off the menu and Fran, the owner (who deserves her own post), let us eat for free.  We elected the guitarist to be the treasurer (I had to stuff the bills into his pocket) and he paid for the taxi to carry the equipment back to his house.

I’m ambivalent about the money.   I play for the sheer joy of playing, making music I like to hear and seeing peoples’ heads bob while they’re eating their enchiladas. 

Forty years ago when I was a musician we ended jobs at two in the morning and rarely got into bed before four.  I don’t want those kind of hours any more.  Playing dinner music appeals to me much more than playing a dance.

As it is I had time after the gig to go to the house of a whaling captain, taking a taxi all the way across town (about three miles, six dollars).

I got to heft a harpoon and a shoulder gun.  We talked about grades of black powder, number 11 percussion caps, and powder measures.

I watched footage that including him harpooning a whale.  He talked about whaling as a religious experience.

Foil on windows, wax in ears, blood in the nose

June 13, 2010

The patients get sick, we know why

From the outlying village they fly

     Those on four wheelers

     Need the help of the healers

The North Slope is not really dry

Most of the twelve-hour call shift yesterday was reasonably paced.

Weekend medical staffing here covers Emergency Room and what is locally known as Walk-in Clinic.  Heart attacks and ATV accidents, for example, go to Emergency Room and colds, earache,  and allergies go to Walk-in Clinic.  Although the two things happen within steps of each other, and use the same paperwork and staffing, they are conceptually separate. 

The reality of Barrow and the bush hurt people in unique ways.  Four wheelers are a part of life on the North Slope, pavement is not.  Accidents happen and bones break.  Despite the high cost of cigarettes, $100 a carton, people smoke a lot.  They get emphysema and heart attacks.  Soft drinks are consumed by the rack (24 cans) or half rack (12); teeth rot, diabetes and its complications set in, obesity is common.  (My clientele in Sioux City also used an insane amount of soda pop.)  They cut themselves dealing with waterfowl and fish and get peculiar infections.  Alcoholism stumbles side by side with complete abstinence.  I took care of an 8-year-old who weighed twenty pounds more than a 51-year-old.

I talked to people whose relatives died in the tuberculosis and meningitis epidemics.

We sent a patient to Anchorage via Medivac; we had another fly in commercial aircraft from an outlying village.

On three occasions I spoke with Community Health Aides.  Each of the outlying villages has one.  Most are EMT’s, some are paramedics. 

I took care of a patient yesterday with a severe nosebleed, using 1% lidocaine with epinephrine rather than cocaine.  I cured a patient’s earache by taking out a piece of ear wax the size of the patient’s pinky finger.

I admitted a patient yesterday with half a dozen major diagnoses.  I’ve ordered some labs that won’t be back for a week or two.  On rounds this morning the patient is feeling better, but not well enough for discharge.

Being a non-Arctic resident, I admitted defeat in the presence of twenty-four hour daylight and took a trip to the grocery store.  I needed a roll of aluminum foil and a roll of duct tape, and as long as I’d taken the taxi there, I couldn’t pass up a bag of cherries.  And a bag of dark chocolate squares.  Fifty bucks.

I also visited the Cultural Center, a very nice facility.  Being sixty, they consider me a senior and let me in free.  I bought a T-shirt saying “I had a whale of a time.  Barrow, Alaska.”  There’s a one hour show for the tourists who come in with Top of the World Tours; I’ll go with Bethany when she comes.