A return to work in person

By walkaboutdoc on September 1, 2024

I saw 6 folk face-to-face

And a single in video space.

One might survive

To 105

Another is a puzzling case.

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, months of telemedicine, 2 months of real medicine in Texas, then more months of telemedicine. After a repeat bout of COVID I started into a part-time Pennsylvania position with real patients.

I attended 7 patients today, after having only virtual patients since June 1.

It was good to be back in a social situation, to be able to talk with colleagues and staffers and to share my enthusiasm.

Most of the people I attended could qualify for Social Security. The youngest patient on the schedule didn't make it for the appointment. The oldest might survive, as the song goes, to 105 (I won't give any more clues to age.)

I didn't see anyone with COVID.

I wrestled with the EMR, but it's one I've used before.

One patient has a serious and puzzling array of symptoms. I listened without interrupting, and eventually the patient's spouse made it into the exam room via the magic of video phone calls. I very carefully and enthusiastically declared that the problem did not come down to stress, that a mystery needed solving, and that I would do my best. Much lab work remains.

I don't try to push anyone around after the age of 70. I frequently ask, "What do you enjoy for exercise?" and some patients say, "Nothing."

Again, today I recommended Beryl Markham's book, West With the Night. I also advised exercise. I got cooperation for the book but not for the recommendation for exercise.

At the end of the day I worked on my documentation. As the staff and docs emptied out, I spoke with the clinic manager about the uncertainties of locum tenens work. I got the lowdown on getting the dictation software going. But the minutes slipped by.

I was about to start back into my charting when a BOOM of thunder shook the building and the lights went out.

I had my headlamp in my white coat pocket and turned it on and realized I'd not be able to do anything on my computer without the internet. I made ready to leave.

I requested and received permission to delay documentation till the morning. I slipped on a rain jacket originally intended for duck hunting, and went out into pouring rain. Strangely, the heat of the day did not cool with the gully washer.

And the interior of the car stayed so hot that I needed the air conditioning.