I've been Betheled

Day 2 on the wards here in Bethel.  Dare I say it's going fairly smoothly?  Darn, I just did. But let's pretend I didn't type that in case I jinx anything.  Although there is still plenty to say about life and times here in the tundra, I've been feeling more mentally cloudy and less creative than usual.  I attribute that to attempting to function on more than a few sleepless nights in a row (travel with an already somewhat sleep-challenged child has proven to be...difficult).  But I'll do my darndest to keep you all abreast of life here.

In addition to my general feeling of foggy headedness, It's also taken awhile for me to readjust to medicine Bethel style.  It feels akin to competing in a triathlon without having properly trained, leaving me feeling a bit pained and stiff.  My brain hurts.

It's a far cry from outpatient family medicine in Seattle where follow up and access to patients is quite simple.  There, it's easy to be more conservative with treatment.  Here, I have to assume the worst possible outcomes for patients and the worst possible follow up when we discharge them from the hospital.  This at first feels like a whole lotta overkill. That is, until the next septic scary patient rolls in and I remember that this is a land of medical extremes.  For now, I'm rolling with it. But it certainly does contribute to the nagging, anxiety-inducing feeling of unpreparedness in the pit of my belly.

This time around, I was so preoccupied with bringing the proper things for the little man, I spent little time bringing things for myself (ahh, motherhood!).  I'm impressed I even remembered underwear (I supposed I could have just borrowed one of the 50 diapers I brought).  Just before sealing up the suitcase in Seattle it hit me that I may find a stethoscope useful.  So that made the cut, but not any helpful reference books (twice today I longed for my Gumby guide and Children's hospital guide).  Oh well.

I just had a classic Bethel moment on the phone with a health aide.  I didn't have the patient encounter form in front me as the aide was telling me the story: 31 year old woman with right sided low back pain, pain with urination.  She proceeds to tell me about 5 minutes worth of less than useful details about her symptoms.  Finally I cut in (more out of time management than fear for the patient, since it all sounded like a good ol' routine UTI) and asked her vital signs. Heart rate 120, blood pressure 80/50....  It felt like an announcer should have come over the loud speaker with a deep voice proclaiming "Why no, it's not a UTI behind door number one... it's... Sepsis!!" 

Or maybe a Nickelodeon throw-back bucket of green slime should fall onto my head while the same announcer states "You've been Betheled!"

After telling the aide to get the patient on the next flight to Bethel she responded in the usual soft, monotone voice that is common in these parts, "Ok. I can do that." (insert uncomfortably long pause).  "You know, if she takes a boat on the river we can get her there in about 15 min."  The second round of imaginary green slime pours onto my head.  Get thee to a boat, woman!

Betheled again...