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Friday, June 3, 2011

The REAL House of God

A short white jacket and name tag. A black medical bag given to us all by Eli Lilly, when such things were acceptable. Schedules were given, with several rotations I had requested!

Surgery-- my least desirable 6 week rotation, was 1st. I figured that was great, because I would get really good at history and physicals-- or H&Ps, as we called them. My preceptors were both females-- a lady surgeon and PA. How cool. Surgery was not my best experience. The air conditioning went out in the operating room of the now defunct/demolished Doctor's Hospital  and the surgeons were sweating while they worked. Still, I was happy to tie the knots and get experience being on call.

Internal Medicine was terrific at the Martinsburg VA Hospital in West Virginia. I was able to function as a respected medical team member, researching cases, writing orders and taking call at night. I came to hate the smell of stale, strong alcohol at 3 a.m., with new admissions and gastritis/pancreatitis patients, but we had a terrific new drug called Tagamet that helped a lot of people. A farmer came in with recurrent fevers and after a lengthy H&P and later, confirming lab tests, I had my working diagnosis: Brucellosis! My supervising PA and physician were impressed. I loved the quiet, cool autumn evenings in West Virginia and often would clear my head on a motorcycle ride over the rolling hills.

Ob/Gyn was a pivotal experience for me at the huge Washington Hospital Center. Although I did not particularly like surgery, I adored my 2 precepting physicians-- both female doctors. I was well utilized, and showed some of the newer med students how to perform wet preps and KOH slides in the clinic, rather than relying on a wait from the lab.Deliveries were miracles--and at my first solo birthing, I held the infant as it gently began its life.

"Clamp the cord!" I was reminded. I also was permitted to perform my first gynecological exam under anesthesia. It was amazing that I would feel the womb, ovaries and even the tiny fallopian tubes. I recently located called Dr. Stockwell and again thanked her for her kind guidance and teaching so long ago.

 It was during this time, I read a popular book "The House of God". It depicted the experiences of a new doctor, learning his trade in a big city hospital. There were rules: in the case of an emergency, first take your own pulse. That has remained my favorite. It was poignant and funny and sometimes I think about reading it again.

My electives were dermatology and neurology.  Both have served me well and both were in DC so I was able stay nearby for both. I also liked stocking up on the creams and soaps in derm-- I still use and recommend Person and Covey products.

Inner city pediatrics was quite an eye opener for me. I saw baby after baby and got really proficient at examinations and the immunization schedule. One of my young patients was diagnosed with active tuberculosis and after my TB test became positive, I had to take isoniazid and vitamin B6 for a full year.

Spring became summer and I prepared for my preceptorship-- in Ketchikan Alaska. I had written my first article for Medical Lab Observer magazine and won 2nd prize for their contest of unusual lab experiences. I told of how I learned of new procedures by visiting other labs-- and then instituted them where I worked. On motorcycle, in Australia-- hospitals were a big part of my life. That honorarium allowed me to purchase my Air Alaska ticket and pursue my next adventure: Alaska!

A pediatrician friend and colleague was on staff at the Indian Health Clinic. Kindly, he agreed to my working there to complete my PA training with theTlingit & Tsimshian Indian Health Service. What a fine experience that was! Indian culture, a LOT of babies, boats and small town life in a series of tiny communities in Southeastern Alaska! I got to travel to the smaller islands in a light plane that landed on pontoons, with a staff PA who was Tlinget himself. Bernie and I provided services at their satellite clinic and I was welcomed by all.

Graduation came and went! The date changed for the ceremony-- after I had purchased my plane ticket. So instead of receiving my diploma in a ceremony in my DC home, I went to Disneyland!

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