Cold wind's a-blowin'

There's a chill in the air. And it's taking longer and longer for the sun to come up in the morning. I have deduced this can mean only one thing: winter. It's on the horizon. There's no avoiding it. But I may just be able to sneak out before the true frigidity hits. Everyone seems to be preparing for it somehow. Anyone with free time in the hospital is shopping for long underwear, fleece, or Sorel boots online whenever I glance at the computer screens. Apparently winter survival here requires gear the likes of which Seattle has ne'er seen. Ice cleats. Face shields. I'm getting cold just thinking about it.

But for now, it's just dabbling into cold weather with lows in the 30s at night. It's getting hard to get out of bed, though, with the sun barely up at 8:30. That's the moon still high in the sky at that time. I'm waiting for the sun to poke through to motivate me to run this morning.

I'm working noon to midnight shifts in the ER these days. Yesterday was my first shift, an abbreviated version (9 am to 6 pm) as a sort of orientation. It just so happened that we were overstaffed for the day (Eggimann, myself, a FP resident from Anchorage, and a PA) which of course meant it was the slowest day in the ER in a long time. I did get to do some useful things involving needles (shout out to Tuggy). I did an LP on a baby and aspirated a big fat elbow. Besides that it was a smattering of benign issues: abdominal pain, headache, upper respiratory infections. I think by virtue of the fact that I've admitted it was slow yesterday I should prepare for craziness today.

Dare I say it, I think I prefer the craziness of the wards. I miss the continuity of care that inpatient provides. I like getting to know my patient panel. None of this in and out of the ER. I certainly miss the OB action as well as the potpourri of phone calls from the health aides. Those faxed patient encounter forms are like a box of chocolates (You never know what you're gonna get. You knew that line was coming.) But it'll be valuable to figure out the ER system. I think my next foray to Bethel will be a wards week only. But the jury is still out on that one.

I'm starting to understand the essence of Bethel life. Or all small town living, for that matter. I'm realizing that the woman who cleans the halls in the hospital is the daughter of one of my patients last week. When I go running now, I notice who is in the cars passing me (sometimes the labor and delivery nurses, for example). I know all the cab drivers now, after getting rides to work every day. A patient I saw in the ER yesterday was the grandson of another one of my patients last week. It's kind of eerie. There really is no anonymity here. It is kind of Truman Show-esque. The other day I went running down the main drag (Chief Eddie Hoffman Highway, for those curious) in the opposite direction from my usual route and wondered if I would hit the end of a tv set. I didn't. But I did find the state trooper headquarters and some kids hitting golf balls in the tundra (sand wedges are popular). Don't let anyone tell you golf isn't alive and well in our 49th state.

The morning Alaska Airlines jet to Anchorage just took off (there are 3 in and 3 out a day). I know this because cranberry cottage is right next to the airport. I could use it as an alarm clock. Means I better get my day started. The ER awaits...