Sunshine and Silliness...

Long days, learning a bit, and learning where I need to read/experience more. There's a lot to do to prepare for next year.

Planning on working Tues, Thurs (turkey-day) and Sunday this week. Hope to hang out with Scott and Erin one of the off-days, and Stephanie maybe another off-day.

So really, I have only 6 days of work left to finish the whole month-long rotation/interview. So how many c-sections can I scrub in that time?... we'll have to see. (there are uteruses out there relying on my repair work...scary? exciting? I guess that's the question)

And I've decided to do some work on ME when I get home. Fun reading, self-exploration, affirmations, and yes, even the cheesy say-to-my-reflection-"I-like-me" stuff. It's been a long haul (20-odd years of schooling) and I want the next bunch of years of life and career to be growth forward.

Second day of work and this was the real thing-- up at 5:45, on the bus at 6:15, round on patients (figuring out how to write notes, find vitals, etc on the EMR), assist a c-section, meet two labor patients and follow them, admit new antenatals and answer nursing calls in between labor checks, deliver a patient, continue to work on new admits and notes from the morning, assist in another c-section, and finish up notes before 8ish pm signout. (and ride the bus home)

And they tell me that today was a more usual schedule.

This is fun. really. :)

For my adoring fans (yes, all two of you)... another post to say that I arrived safely in Seattle and that it appears the Universe is still taking care of me. My last-minute plans to stay with a friend's cousin has worked the past couple days and she has been soooo generous in her time-- she figured out which buses get me closest to the hospital, and then walked me through downtown Seattle and Pike Place.
All in all, I'm very excited to start tomorrow! New town, new hospital, and lotsa babies!

I had a great time working on Mackinac Island from october 10-26.  I was the last resident, so I was on call all the last week.  I had a few interesting cases, and experienced family medicine on an island (it's somehow different when you have to take a boat to see a specialist, or fly someone off the island after 5 if they need a hospital...)

Part of my rotation experience this month has been the informal assignment of getting to know the local people, culture, and area. What a fun assignment! I've traveled to quite a few of the national parks nearby the past two weekends.

I started with Petrified Forest, south of Keams Canyon, which consists of a 35 mile drive through a small painted desert dotted with petrified logs. The Painted desert is amazing: hills of purple, red, tan and white stone and clay in horizontal layers. The clay itself is marked by lines where the water has flowed down for years. They look like foothills of a larger mountain. The best part is that for the most part they are only 60-80 feet tall!

The petrified wood is spectacular. The Crystal Forest walk is dotted with large and small examples of the stone that has been uncovered from the dirt over the years. The colors are primarily red (iron) and yellow, but also purple (manganese), white (quartz) and black. The quartz glints in the sunshine.






I also visited the Navajo National Monument (site of the Batatakin ruins and Keet Seel ruins). We were able to walk to an overlook near the Batatakin ruins, and another trail halfway down into the canyon. There is a 5 mile round-trip hike down into the canyon to actually enter the ruins, but only two groups a day (and not the day we visited). The Keet Seel hike is 8 miles one way, so that's something else for the future.





The same day we visited Monument Valley, which is a large valley filled with tall mesas and buttes. All of them have names, given likely by europeans (the Navajo names aren't revealed to bahanas like us) like "Camel," "Elephant," right and left "Mittens," "Sleeping Dragon" and others. There are natural arches like the "Eye" and "Ear of the Wind." We took the long tour and our guide Roy showed us a few places other tours don't routinely visit. (Look left, it's Michigan! I think Traverse City is in the dark shadow at the left)


Then yesterday afternoon my mom and I drove to the Grand Canyon (if I'm in Arizona I have to see it!) The sun highlighted the western-facing walls and the almost-endless number of layers of stone. The haze (pollution) blowing from California made the shaded eastern-facing hills look misty and the contours difficult to discern. We stayed until sunset to get pictures (along with about 300 other photographers and visitors at the same point!)

Today, Sedona and Jerome...

Labels: all about the national parks, baby

After a long and daring trip to Arizona (two days of driving) I reached my destination, the Hopi reservation. Little did I understand how far from wireless and running water I was going. The compound where I live and the Health Center of course have electricity and running water, but you can't assume that when you send a patient home with a nebulizer that there's a socket to plug it into in their home.

So starting at the beginning: I heard about rotations on the Hopi and Navajo reservation, and I'd been looking for an adventure... Not that I had realized the NEED for adventure until I was already driving. I passed through IN, IL, MS, KS, OK, TX, NM, and then AZ (the last four of which are new states for me). The drive gave me time to prepare for the next step in the journey.

I am working at an Indian Health Service Hospital, the Hopi Health Center. Many doctors, PA, and NPs are from elsewhere-- some doing military service or getting loan repayment (might be a good option for me someday). The clinic provides outpatient, ER, Urgent Care, PT, social and behavioral treatment; someone told me last night that it's set up like a Hopi village-- public space in the center, with twisting halls and clinics tucked back in one behind the other. It's a nice space, overall. The electronic health record is a nightmare for a resident, who needs to precept and have all the orders co-signed. But mostly I use paper charting.

I live in a bright, white trailer on the IHS housing site in Keams Canyon, 12 miles from the Health Center, with two other rotators. It's pretty fun. No internet, unless you sit in your car two streets away borrowing someone's wireless. No tv. But I have dvds (and no working player on my computer)

The Hopi live on a reservation in the middle of the Navajo reservation; archeologically they actually lived here earlier than the Navajo, but it seems the latter were more vocal to the US Government and received more land (the story depends on who you ask). The Hopi live primarily near three large mesas; traditionally they lived below until the Navajo and Ute and Spanish raided them too much; they moved up on top in the 1600s and many still live up top in the "old" villages, most without running water or electric lines. Villages have grown below, and most there have running water and electricity. Many speak the Hopi language, especially the elders. I've had to use translators for Hopi and Navajo elders at the clinic. The spiritual traditions are VERY important to the people here.

Last weekend I hiked Canyon de Chelles, Sunset Crater, Wupatki, and one of the SanFrancisco peaks near Flagstaff. Few trees are in leaves, but on the mountain very little is budding yet. It'll be gorgeous with the aspen stands. I visited my brother and his girlfriend, and we had a great time. I'm looking forward to seeing them again when my mom visits soon.

The closest city with wireless and reasonable gas and groceries is Winslow. (Gas is $3.40 at the Flying J here, and $3.65 plus on the Res) Flagstaff is 2.5 hours away. But I drive out on weekends anyway because there are too many places to explore to stay home. And next weekend there is a katchina dance in one of the Hopi villages! It's very special to see one of these!

Enough for now. I hope you all are well!

I found two interesting articles on the NY Times today. First, it's a sad day for constitutional freedom as the House and Senate worked out a compromise bill that made permanent 12 provisions of the "Patriot Act" and renewed for 4 years two more controversial provisions. Great. I don't think most Americans even know what the consequences of this law could be; I'm not a huge slippery slope fan, but there are some great dangers to increasing the government's ability to secretly monitor our private lives. I'm tempted to find the "I wasn't using my civil liberties anyway" bumper sticker for my car.

And second, "Dog's Genome Could Provide Clues to Disorders in Humans." According to this article, "the researchers chose to sequence Tasha's genome because boxers are quite inbred, easing the decoding task. Also, because of her sex they did not have to bother with a Y chromosome, which is particularly hard to decode." (I agree-- the Y is definitely less useful... I suppose they might've found the dog "crotch sniffing" gene or clues to the human "Sunday football and beer" gene)
And, "the dog genome is a wonderful playground for geneticists." Those silly scientists. Can you picture it: the DNA helical slide and monkey bars, or the amino acid swingset...?

who is this writer, and what fun drugs is he on??