Monday, October 8, 2007

Columbus Day

I was off work today because of the holiday, but not really. I was on call and my phone rang at 8 AM with the first of many calls today. I'm on the first day of my next 12-day call stint. In I went at 9 AM and then back at 10 AM and then a few phone calls during the rest of the day but I didn't need to go in. At 7:30 PM, though, I got the right lower quadrant pain phone call. You know, the one that could be nothing or could be every other "quick surgery" thing in the book. And when you live on an island, you have to make decisions. The flights have already shut down for the night, so if your patient has to go to Saipan quickly, I have to call the helicopter. If I were on the mainland, I would send the patient for a CT scan, but since that's not possible, I called in my radiology tech and he did an ultrasound on the patient. Not the ideal test, but at least a "peak" inside. You see, I can't do labs either. I can do a dipstick urine, which will tell me some things, but it doesn't define specific illness either. I can draw blood, but it will have to wait until the first flight out in the morning . . . 6 AM.

Thank goodness for good physical exam skills. In I went and decisions were made. I have great staff support and my patient has been tucked into a hospital bed for the night.

So, at 10 PM I starting walking home with my iPod in my ears, listening to Rhapsody in Blue played by the 5 Browns and a gorgeous night sky. Millions and millions of stars are visible, including the Milky Way! There I was walking down the middle of Main Street in paradise. We may have geckos and gnats but we don't have mosquitos and it was a magnificent walk home.

So here I am practicing the best kind of medicine - person-to-person medicine - in a tropical paradise. Who could ask for more?

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