First Week at the Clinic

Well I survived my first week at the clinic!

A hard thing to get used in the clinic is all the lingo/cultural stuff.  There’s a lot you need to think about when it comes to your patients that you don’t think about every day in practice in Iowa, or somewhere less remote.  Like, is this a patient that’s just stopping through, are they going to have enough medicine to last through their next boat trip, how much longer is the season of why they’re here and when will they be going back home, where IS home for them, what’s their native language, is there anyone in the clinic that can translate for us, are they safe to go back out on a ship where they might not be able to come back in for a while, etc, etc.  It’s very interesting and challenging at the same time.  I didn’t realize how diverse of a population it was going to be here.  There’s a lot of Philippinos, Vietnamese, Hispanics, Samoans, and many others.  Working through translators is always a challenge because a lot of time it feels like you aren’t getting everything across.

Although this is a family practice rotation, it’s pretty different than family practice I’ve done in the past.  It’s much closer to working in an Urgent care clinic than anything (which I really like).  We have more patients come in with acute problems than the chronic problems like hypertension and diabetes.  We have that as well, but a lot of times it’s just refilling their medications till they are able to see their doctors back home.  We also see a lot of injuries: lacerations, smashed fingers (a LOT of people drop boxes of frozen fish on their fingers), sprained ankles.  A lot of it is kind of like working in an ortho clinic (which I also really like).   We also have an emergency room.  There have been a couple emergencies while I’ve been here, but for the most part our job is to stabilize the patient and get them life-lighted to Anchorage.  If they are stable enough to fly commercially but still need to go to Anchorage to see a specialist or get further imaging (the most we have is an x-ray), they’ll get “bumped” on to the day’s flight off the island.

One of the biggest things that is crazy to me is that there are no doctor’s here.  The clinic staff consists of 3 PAs, Josh, Lisa and Kim, and 2 nurse practitioners, Laura and Clare.  It seems crazy to me that they don’t have a doctor here!  While I think they all do a really good job, I don’t think I would feel comfortable working in the same situation.  At least not until I had waaaaay more practice somewhere else!

Overall, it’s a really great experience.  Everyone is fun to work with and the nursing staff is awesome.  There’s a lot to learn, but it keeps things interesting!

Getting to Dutch...

Well my Dad reminded me about this and hinted that maybe I should get at some blogging while I’m here in Alaska.  The internet at my house is pretty slow and spotty, so I’ll do my best at keeping up with it!

I’ll start with my journey here. Whew.  My first three flights went off without a hitch.  I even thought to myself, "wow this is awesome! Not ONE delay, all my flights got in early...no turbulence, etc, etc."  I went from Des Moines to Denver to Seattle to Anchorage.  Since I got into Seattle so late and my flight left very early, I just slept in the airport.  Surprising it was pretty comfortable but I froze my butt off so didn’t get too much sleep in.  Got to Anchorage fine and met a guy on that flight that was also heading to the island (“Dutch” from here on out J ) so he showed me how to get to the terminal for the Dutch flight.  I got off lucky there because I don’t think I would have found it otherwise! 

…So that's when things got messy :) our flight (on a prop plane, mind you) left from Anchorage to head to Dutch.  About two and a half hours into the flight (so, about 20 minutes away from landing), our pilot came over the announcer and said that there was a volcano that had erupted in the Russian part of the “chain” (the Aleutians) and we’d have to turn around.  It took a few seconds for that to sink in!  Actually I think he announced it again before I really thought about what that meant.  The guy (Jon) that I had met on the earlier flight came up to talk to me and told me that that meant it could even be up to a week before we’d be able to get out of Anchorage.  Needless to say I was a little freaked out!! 

Once we got back into Anchorage, they booked everyone for a flight the next morning and told us to be back at the airport at 4 am so we could find out if the flight would be able to leave (why this couldn’t be conducted by a phone call, I’ll never know)  I made all the necessary phone calls back home and to my program advisors and then found myself a hotel.  Again I was lucky that I had the Jon and the other tugboat guys to show me and good place to stay (and I also got their company’s discount too).  I hung out with the hotel’s restaurant with them as well as several other people that were stuck in Anchorage because of the flight…so I got to learn about some of the inner workings of tugboating as well as crabbing here.  It was pretty fascinating!  It was pretty cool to hear one of the crab boat captain’s talk about how the guys on the Deadliest Catch are a little overly dramatic J (sorry Dad!)

Anyways…I got the shuttle back to the airport bright and early at 4 in the morning.  Aaaaand no one was at the terminal to check people in.  However, they showed up soon and I got checked in and my bags rechecked and went down to wait to find out if we would be able to fly out.  Finally around 6 I got impatient with waiting and went to the bathroom to brush my hair and kill some time.  When I got back out: they were boarding everyone!!!!  I was so so so happy.  I had managed not to freak out too much but really, really did not want to be delayed anymore (especially not the WEEK that everyone kept talking about).  This flight was uneventful and did NOT turn around, and landed us safely in Dutch Harbor.

After getting to Dutch I finally figured out who my roommate was (I hadn’t found him on the flight the day before or waiting for the flight in the morning) and we chatted as we waited for our ride to come pick us up and take us to our house.  Kim, one of the PAs at the clinic took us on a short tour and brought us to our house.  We got settled then walked up to the clinic to meet Laura and get the keys to the car.  Laura showed us around the clinic then took us for a drive around the island to show us everything else (not that there’s much going on here besides the scenery J).  Since it was a sunny day (which is a rarity around here) she showed us all of the good hiking trails.  After the tour me and Nate headed back to our house, got ready, and went for a hike.  Nate lives in Anchorage and was in the military for 8 years and is currently a paramedic…I tell you all this to say that he is in A LOT better shape than I am.  I don’t think our hike went as far as he would have liked, but it was fun and just beautiful.

After we got back we went and got dinner to celebrate our first night here (and because we were both too tired to actually cook anything), did some grocery shopping, and came back home.  I promptly went to bed (after skyping with the parents) and slept for 12 hours straight!

Anyways, I’ll leave it at that for now.  I have taken quite a few pictures already, but I have yet to uncover my camera cord to be able to upload them.  Right now I’m just finishing dinner and chatting with my roommate (he’s in the middle of cooking some sort of squash soup that smells and looks delicious).  He’s a pretty neat guy.  He just cracked me up with this joke that I’ll leave you with… “I used to cry a lot when I chopped onions.  Now I just don’t get emotionally attached.”