FM FTW

 Me and colleague Christopher (known to us as Kiff, Kiffifer, 

Kiffey or Lord Kiffington Meriwether) begin a long night and

early morning in Labor & Delivery.

NOTE: Any possibly identifying information contained within medical stories such as names, genders, conditions, etc. have been modified to protect privacy.

I have learned that there is never a dull moment in rural family medicine, especially with the positively adorable paragon of cheer, Dr. Mary-Lou.

I expected to see an endless string of upper respiratory infections and to hand out a lot of Metformin for the diabetes. Instead, I saw no URIs. I handed out a lot of Metformin, but often it was secondary to some other wild shiz that was going on. A brief recap of the last month: cellulitis, abscess, wound debridement, mood disorders, seborrheic keratosis, pelvics and rectals, lots of moles that I got to cut off, a rare sheep virus called Orf, tons of low back pain, psoriatic arthritis, 2 births, lots of illicit drug abuse, joint injections, amniotic embolism (that did not lead to DIC--a miracle of all miracles), poison oak, shingles, mysterious chronic pain, intractable headaches, mysterious fatigue, lots of peripheral vascular disease, a very large aortic stenosis murmur, a fractured hand sustained from "mutton bustin'" and the insides of many tiny baby ears--I still find using an otoscope on anyone less than 3 months old to be abjectly terrifying.

OK good story:  So when a person goes to the doctor with a problem, we have a system for identifying, describing and solving that problem. For instance, if I went to the doctor with a headache, the student would ask me questions, do a focused physical exam and then go report to the doctor as follows: "Lindsey is a 30 year old caucasian female presenting with a headache 7/10 severity x 3days, unrelieved by Tylenol and improved by resting..." blah blah blah, you get the picture. But when you do a well-child exam, the kid is fine. So I found myself at a loss as to how I should report this. 19 day old infant female presents...good? No. Uh...well-child check within normal limits. Nope. Not right. So it typically went like this: I would enter my preceptor's office who would lean on her hand and ask excitedly, "So tell me! What is going with our gorgeous baby girl out there?" I would stare stupidly, wondering frantically how to answer in a way that would mask the depth of my dumb. She watched me expectantly. Finally I kind of shrugged my shoulders and said, "She...looks good...to...me...?" She smiled at me, waved her hand in my direction saying, "Oh you are too cute," and proceeded to bait me with questions, which (thankfully) I could answer. Then we would go together to see said baby. Well, after 4 or 5 of these repeat scenarios, she stood up to go see the baby, paused with a hand on my shoulder and said cheerfully, "You know, pediatrics might not be for you. Not in a bad way! It just might not be quite your thing."

Yeah.

But all in all family medicine, it turns out, is A-OK.

Three moments stand out to me. The first occurred during my day with hospice, when a patient pleaded with us to kill him. I will readily admit that my classroom training thus far failed to prepare me for that brazen request, and I was shocked into open mouthed silence as I stood powerless to ameliorate his overwhelming pain. The second moment was when I saw my first patient in intractable pain. Never before have I felt so useless, so shocked and so out of control. I became very hot and breathless. I actually had to sit down, lest I risk a true faint. Uncool to faint in the 2nd week of work. The third moment was in between brand new babies, when we were sure we had at least 6 hours until our next delivery. By the time I got home, got cleaned up, got into bed and fell asleep, I only lasted two hours before my phone began its delightful chicken cluck, heralding a sudden progression that required my and my preceptor's presences. It was the first time in my life that I was so disoriented by sleep that I couldn't figure out A) why I could hear a chicken B) how to answer a phone, and C) who, exactly, I was. Babies, it seems, don't do what you expect them or want them to. So instead of an easy 7:30am start, I was up at 4:55 to deliver placentas and greet the dawn.

Next up is General Surgery. There was some logistical drama about how I was appointed to this rotation, which I will spare you dear Constant Reader. We are supposed to be given 30 days notice about our next rotation. I found out 5 days ago. I was expecting to be assigned to Corvallis, a mere 20 minute drive from my apartment. Instead, I was assigned to Newport, 63 miles from my apartment. Google maps revealed that the drive is too long and too twisty to commute daily--especially on a surgical rotation where you may be required to arrive at 4:30am and won't again see the light of day until well after dark. Craigslist revealed that there are no respectable places for rent for a mere month that are clean, furnished, secure and cost less than $500 + deposit. I started to sweat when I realized, in between deliveries in the wee hours, that I was down to 3 business days before my first day of work. All connections were leading nowhere. I was coming to terms with the possibility of showing up for work at 7:30am, doing a full day, and returning to my tiny car to sleep in the parking lot. Neat.

Oh and my surgery preceptor is a Navy Seal.

Anyway, in the eleventh hour, a friend of a friend of a friend came through to offer either a spare room in her house, OR the use of her other house on a 60 acre horse farm in Siletz. Now, this beggar ain't no chooser, so it looks like I'll be enjoying the small town quiet life for the next month.

Literally. There's no cell service.