This gig has come to an end
I noted a gallbladder trend
The blues seem to vanish
While I'm speaking Spanish
Or mixing in Tex-Mex, a blend
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. Since the pandemic, I did telemedicine, staffed a COVID-19 clinic in Iowa, worked at the Veterans Administration in South Dakota, held part-time positions close to home, worked 10 weeks in western Pennsylvania, had a 5-month assignment in Northern Iowa, then several months of telemedicine. I am now in Texas, a big place with a lot of Spanish speakers.
I rarely sleep well the night before an assignment's last day, and last night was no exception.
I bicycled in a heavy mist that bordered on a fine rain, not quit enough to dampen either my shirt or the road surface. I arrived about 10 minutes early.
Three of my 7 morning patients didn't show, and I had already met 3 of the four who did. I sent one to ER. I signed off a form for another, and while I agreed with the patient about a choice of medication, I knew that the dosage required titration that really needed continuity of care.
For one patient I summoned Google Images as an instructional tool, but not from my most common requests: piriformis syndrome, trochanteric bursitis, and DeQuervain's tenosynovitis.
My electronic in-box had a refill request, and 6 patients worth of lab work containing no surprises.
After a noon snack in the break room with Bethany, I sold my bicycle to one of the staff. I demonstrated the pump, helped fit the helmet, adjusted the seat height, and gave a lesson in using the gears.
Then we went to a popular local destination for art.
I gave away the archery target and 6 arrows I have been using to another staffer, and returned the borrowed bow to its owner.
I enjoyed the gig. I found four cases of B12 deficiency, and 5 cases of thyroid disease, one of them serious. I went through the stepwise process of identifying gallbladder disease more than a dozen times, and on two occasions had to push for emergency surgery.
Most my ER referrals went because of chest pain, some others because of serious infection.
As with every other venue, alcohol and tobacco brought a lot of patients. Increasing acceptance of marijuana brings an increasing pathology load.
About 20% of my patients preferred Spanish, another 20% came in as English only. Many work in agriculture.
The town owes much of its unique mood to the social structure. The vast majority of people have more than 10 relatives less than 5 miles away.
Bethany and I talked it over. Would we want to come back? We definitely would. But not during the summer. As I write this, the mercury is inching to 95 despite cloudy skies.
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