A Country Doctor Writes:

I have been away from the office for more than two weeks. After two days back at work I am finally able to catch my breath and think about writing again.

I had intended to write a post about the fact that our clinic has a system where providers who have been away for more than a week have half a day dedicated to catching up on incoming laboratory tests, consultant and hospital reports as well as x-ray reports.

Instead, I am marveling about how hard we work. As doctors in rural America, we really do work hard. When I lived in Sweden and when I went back there to work as a locum tenens (“temp“) for one summer, there were regulated coffee breaks and a leisurely pace throughout the day. Swedes are a patient bunch; you can only call your doctor during certain hours, and you never expect anybody to respond in real-time. In America, people expect instant action.

I spent half a day going through reports. My hospice lymphoma patient is still hanging in there. Sally, the woman with a possible pancreatic tumor did go for her pancreatic CT, in spite of her misgivings, and the test was normal. Now she “only” has to deal with a possible kidney cancer; her urology appointment isn’t until next month. Sumner Bell, one of my regulars, died suddenly during a quick trip out to his shed – we don’t know what happened. He had angina and some heart failure and was on warfarin because of a prior history of a blood clot in his lungs.

My first two days back (one and a half seeing patients) have been more hectic and demanding than I anticipated. Today I had three patients go to the city hospital by ambulance – two with breathing problems and one with a broken femur. On top of that, my wife took our second car for a short trip to the post office and lost the brakes due to rusted-out brake lines (replaced only a couple of years ago in a hilly town in Canada – another adventure worth writing about some day). Between the tow truck taking six hours to get here and the hassles of picking up a rental, we haven’t quite landed yet, but life is expecting us to be present.

Moses, our puppy who took the big city by storm, is learning how to deal with the cats and the beagles all over again; I think he enjoyed being an only animal.

I was on call last night; tonight I am off. Now I know why it always takes a couple of days to wind down when I go on vacation – it is a matter of switching between two realities. But, I have to admit, even with the pressure we’re under, I couldn’t imagine myself doing anything else besides what I’m doing. I always wanted to be a doctor, and that’s what I am.