Rural Doctoring

Rural Hospitalist Tip #1: It's Just Like Falling Off a Bicycle

So I've been having one of those funky runs of call in which it seems everyone crashes on my watch. Patients who were as stable as can be on the previous shift suddenly become obtunded or oxygen-starved the minute I've gotten sign-out and the other hospitalist(s) have left the building. This happens to everyone--after all, the patients are in the hospital for many reasons, one of which is the risk of getting sicker--so I'm trying hard not to take it personally.

This Says It All

OK, Maybe Congress Can Gnaw on THIS Problem Next

The pediatric rooms at Nordsrom are equipped with special alarms to deter would-be kidnappers. When activated, they trigger a truly appalling siren at the RN's station, the kind of sound which can strip paint off the walls. Unfortunately, they malfunctioned the other day and would not turn off. We were all in danger of being driven insane, but fortunately the Plant Ops guys managed to rig up a noise-deadening system:

This is a microfiber mop balanced on top of an adjustable desk chair. You can't see it, but there's a 3-ring binder between the two to keep the mop tightly in place. It didn't kill all the sound, but it made the decibel level tolerable for a couple of hours until the snafu was fixed.

Looks Familiar to Me

I was random link-clicking today and found this photo gallery, which could be a portrait of an average hospitalist night at Macy's. 

This is Hard to Say

Of all the recent professional upheavals I've survived recently, there is one which has posed a particular barrier to writing this blog: my departure from childbirth services. You heard that correctly--I'm no longer attending births. Doing so has been such a huge part of my professional identity, and my identity as the writer of this blog, that it has been really difficult for me to talk about the change without succumbing to despair. Today I feel ready to blurt out the truth, and I hope this will release some of the inhibition I've experienced in my writing.

Making Time and Space

In a spread from one of my recent visual journals, I wrote: "GOTTA FIND TIME FOR THE CREATIVE LIFE...No more excuses! Of course I'm busy, but I don't have to sign up for every unfilled shift and I don't have to spend all my downtime surfing the damn internet and shopping aimlessly. I can be working in this mixed-media journal or writing, which has always been in my heart to do."

(Media: watercolors, acrylics, collage elements, rubber stamps by Traci Bunkers and others , paint pens.)

Brave New Blog

During my recent silence I spent a lot of time thinking about the original vision I had for being a rural family doctor. In this vision, I provided full-time primary care, including inpatient coverage for all my patients, whether they were kids, old people, or laboring women. I was going to be a salt-of-the-earth, old-fashioned family doc who was present for birth, death, and the messy interval between the two. For a brief period--about a year--I lived a close approximation of this vision, and although it was a rewarding and happy time, various factors ultimately led me to transition to full-time hospitalist work.

No, This Blog is NOT Dead

It may have been a while, but I think I'm back in the swing of things. Thank you to all the kind people who reached out to me via email and comments. To put everyone's mind at rest, let me say first that everything is going well with Noo's health and reassure you all that my recent silence was not the result of yet another disaster in my personal or professional life. The usual daily mini-crises continue apace--a tree knocked down into my driveway, an infestation of ants in the pantry, five piles of delinquent charts waiting for me at Macys--but these minor annoyances are a welcome distraction compared to the complete upheaval I experienced last July, when Noo was so desperately ill and I bowed out from a job which I both loved and hated at Gimbels--all in the same week.

The Least Sexy Holiday Invite, Ever

The cat is adorable, but the offer--not so much:

Never Mind the CT Scanner

Here's the most important piece of equipment in the hospital:

You got it, the ice machine. Just ask all those parched patients on Med-Surg which device they'd take with them to a deserted island.