Here I am on Day number 2
And my patients were 9, just a few
4 were seriously ill
Not just run of the mill,
And one had emergency true.
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 3 Community Health years, I took temporary gigs in Iowa, Pennsylvania, Nebraska, Canada, and Alaska. After the pandemic started, I did telemedicine in my basement, staffed a COVID-19 clinic in southeast Iowa, visited family, attended funerals, worked at the Veterans Administration in South Dakota, held a part-time position close to home, and worked 10 weeks in western Pennsylvania. I took a couple weeks off to attend my brother's BSN graduation and have doctor appointments. I'm working again, part time, in northwest Iowa.
Yesterday I had orientation in the morning and saw 4 patients in the afternoon. As it turns out, I worked with this electronic medical record (EMR) system more than once, and muscle memory started to kick in.
Muscle memory doesn't exist but people like to use the phrase. Memory resides in the brain, not the muscle.
Today, my second, I cared for 9 patients. The three smokers had no interest in quitting. Four patients had serious illness, and one had an emergency.
The doc who addressed my med school class at graduation gave us a lot of good advice, much of it remains true. Write out everything you need to know about the true emergencies on 3x5 cards, he said, keep those cards in your pocket until you've memorized them.
True emergencies come rarely in medicine, and today I took care of such a patient. I recognized the emergency immediately, by the sheerest of coincidences a problem I read about 2 weeks ago. And I wouldn't have had any credibility with the consultant if I hadn't worked in the area before.
Not everyone knows how to tell a coherent story to their doctor. I make allowances for those who can't. I listen for the red flags, such symptoms as weight loss. Numbness, weakness, bloody secretions (besides from the nose), loss of appetite for food, loss of nicotine craving and personality change get my attention, too.
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We have a nice apartment very close to the hospital. I don't remember such good lighting since my first trip to the Arctic featured 8 continuous weeks without a sunset.
Different towns have different emotional foci. Barrow (now Utqiavik) centered attention on whaling. Sioux City's heart beats with the corn cycle. Keosauqua lived for the deer season.
It seems everyone in this town likes to fish, men, women, and children. Some laugh at their lack of sophistication when they talk about bobbers and worms, others get technical discussing Texas rigs and bottom fishing. People easily access small bodies of water close to town.
Which give rise to a large number of biting insects.
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