After not finding a better (is there one?) alternative job, I have returned to Condo B and the Lake clinic in Yellowstone National Park for the summer. I had a side trip to Cuba for two weeks, but that's a different story. E and I packed up the car and made the 3 day trek to the Park. We made a side trip through Salt Lake City so I could have my "Trusted Traveler interview with Customs. They said it would take months to get an interview. It only took two weeks. Huh, who'd a thunk that the gov-mn't would become efficient?
I have been here two weeks and have been through orientation. My buddy Tim, the other PA went to Afghanistan then Iraq and then back to Salt Lake City, but that's a whole 'nother story. It is great because lots of other folks are back and will make it easier to train the new folks and solve the never ending challenges of working amongst the bison and bullshit that comes with working at 8000 feet in a National Park 85 miles from the closet hospital and 200 miles from the closest trauma center. All in a days work.
Speaking of which...
I did my first shift at the Old Faithful Clinic. Opening day, should be quiet. Nothing but a physical and a boo-boo or "ouwie" or two. It's about an hour drive from Lake. Probably the most beautiful commute on the planet. Lake to the left of me, geysers to the right of me. Maybe a bison or bear jam, but wtf I can't believe that they pay me for this. Then I arrived at the clinic. There were two people waiting outside for me. One had his hand wrapped in a towel with an ice pack. The other, well...
Hand guy had had a drink or two and punched a wall. He ended up with a boxer fracture. I wonder why they call it that? He got a splint and a call to Mom to explain that he was no longer employed, needed a plane ticket home and an Orthopedic surgeon. Oh, yeah, by the way can you put me back on your insurance? Man number 2 wanted antibiotics until October when he had saved up enough money to have his rotten tooth pulled. Seriously, I think not. I found him a dentist who will pull his tooth for a low fee. On Wednesday. Please leave my clinic now. Then the tail of two balls. One ball for each young man who came in back to back with a complaint of "swollen testicle." OK, only one had that complaint. The other was too shy to tell the female nurse about his swollen nut. He said "groin pain." He was so relieved that there was a male PA working that day. I checked out his swollen manhood and decided that he need an ultrasound. There is a condition called "testicular torsion" that can kill a testicle. I called around and found him an ultrasound. An hour and a half drive away. No problem for him, he jumped into his car and was on his way. Just a shot and antibiotics for grande cojones number two (dos?). I told him about the shot and he asked me if it was going to be in his nut. {long pause} The wheels started turning, the angel and devil appeared on each shoulder, but professionalism kicked in at an inappropriate time and I advised him that it would be in the butt, not the nut. Then I saw bronchitis, a growth on an ear, shortness of breath because of stuffed up nose and altitude, and a request for a therapy dog. Seriously. Long story that I can't tell. At the end of the day in walked a dizzy man about to pass out. Pulse of 150 and dehydrated. Did I mention his chest pain three days ago? Neither did he. I know what you're thinking, helicopter. Not so fast rotor boy. I gave him 800cc's of IV fluid, slowed his heart rate down and re-did his EKG which was flashing "STEMI alert" I wasn't buying it. After his pulse slowed a wee bit the STEMI (google it) alert went away. He got an ambulance ride for some blood tests and observation. During all this the phone rang with a message for me to call the ultrasound tech. Cool, a report on dude number one, probably all good, or to tell me that he sent him to the ER for treatment. His exact words were, "you're dude has cancer on his left nut." I said, out loud, to the clinic "Fuck!" Maybe a little too loud. I got a wee talking to about it. Didn't really care. He has to come back to the clinic for the news. I won't be there. I had to call my relief to explain the situation to her. Imagine how happy she was about that. Maybe I can write her a prescription for a therapy dog...
