Category Archives: rural doctor

by

snow day

I am having a snow day. It snowed yesterday! Schools are closed and the roads are ice and it was 25 degrees when I walked into clinic. Clinic is cold and power and phones and computers are all out.

Now I have power back but internet is iffy. I have cancelled today’s patient. Some are 45 minutes or an hour away on good roads! We only have an inch of snow but the people north of me are reporting 6-8 inches. I have called people about tomorrow as well. Clinic will proceed if we have power and heat, but the people an hour away are cancelling. The weather forecast is that it will freeze at night all week, which is unusual here.

I am less than a mile from clinic and have ski clothes, so I should be able to get in unless we have an ice storm. We have paper files for back up so I could find phone numbers even with the power out. All except one new patient and now I’ve tracked that one down. We also have a battery lantern because the bathroom is really really dark with the power out. No windows.

I took the photograph last night. My ornamental plums were budding. I don’t know how happy they will be with a week of freezing weather!

by

Mundane Monday #197: underlighting

The prompt for Mundane Monday #197 is underlighting.

How have you played with light in photographs and light from below? I took this last night at around 5 pm, on the bluff in town. The setting sun was adding gold light to the bottoms of the clouds and there were gold reflections in the water.

Link your photograph and I will list the links next week. Have a wonderful week.

________________________________________

Last week’s prompt is nurse log.

klallendoerfer send beautiful moss covered nurse logs.

by

Fragrance Lake 2

For the Ragtag Daily Prompt: wanderlust.

“And how are you getting back?” I ask my daughter. “Are you going to edge backwards?”

She laughs.

Out on two limbs. Logs. Woman balanced on two logs sticking out into a lake.
Out on two limbs. Logs. Woman balanced on two logs sticking out into a lake.
Steady….
Ta-da! Woman turned around on logs, to return, arms out!
Ta-da! Woman turned around on logs, to return, arms out!

And she returns without falling in the lake.

by

Mundane Monday #196: nurse log

For Mundane Monday #196, my prompt is nurse log.

I hike with my daughter around Fragrance Lake, in Larrabee State Park on Saturday. There are lots of people, many with dogs. Fragrance Lake is 0.75 miles around. It is a little overcast and the lake is quite still, surrounded by trees and hills.

This is a nurse log, or really more of a nurse stump. The young tree is getting nutrition and support from the remains of the older tree.

Link your photographs on the topic nurse log. I will list them next week.

___________________________________

Last week’s topic: gull.

klallendoerfer sends wonderful gull photographs.

by

eagle angles

For the Ragtag Daily Prompt: angle.

My daughter and I walked the beach on Saturday and I spotted this eagle. We walked towards the lighthouse and so were essentially circling this tree slowly and from a distance. Photos of the eagle from many angles. It was a beautiful day!

It was gone from this tree by the time we worked our way around, but there was another tree.

The trees that survive are sculpted by the wind, with very little protection.

My daughter was barefoot, so we did not go quickly.


beach with driftwood with barefoot person in down jacket and winter coat, all in shades of blue, gray and turquoise
Fort Worden beach
by

door to the past

For Norm2.0’s Thursday doors.

These are taken on a 2004 school trip to a pioneer farm and native american village site with a school trip. I don’t think I got a photograph of any of the cabin doors, but it was certainly an interesting trip. The parents chaparoned the kids, staying in the cabin over night. We all slept in sleeping bags on the floor. I did sleep, since I am lucky enough to be able to ignore noise. The kids got to dip candles, explore the cabin, explore the village, and were assigned the farm chores in the morning. My son was delighted by a young pig. I think the parents enjoyed it as well and were glad not to wash clothes using washtubs and a wringer.

students hanging dipped candles to dry
Dipping candles
student in vest, cowboy hat and bandana
dressing as a settler
students at pioneer cabin learning about curling iron that you heat in a fire
curling iron and other tools
two students in sun bonnets using washtubs outside a cabin, while two others watch
old style laundry
three students patting a sleeping pig
morning chores
by

Connections between Pain, Opioid use, Suicide and Opioid Use Disorder.

Excellent blog by Janaburson: https://janaburson.wordpress.com/2019/01/14/complex-connections-pain-opioid-use-suicide-and-opioid-use-disorder/

The picture is the tree with berries that the robins are eating, outside my clinic window. They clear it from the top down. Deer come too and stand on their back legs to reach up for berries.

by

Vital signs II

For the Ragtag Daily Prompt: vital. For me, vital brings up vital signs. I wrote this poem in 2006. Pain was made the fifth vital sign in 1996. I have written about it here. In June of 2016, the American Medical Association recommended dropping pain as a vital sign. The idea that we should be “free” of pain has not died yet and the latest CDC report says that the overdose death rate for women has risen a horrifying 240% from 1999 to 2017. That report is here: Drug Overdose Deaths Among Women Aged 30–64 Years β€” United States, 1999–2017. My poem is still relevant and we still have to change our ideas about pain.

Vital signs II

Pain
Is now a vital sign
On a scale of 1:10
What is your pain?
The nurses document
Every shift

Why isn’t joy
a vital sign?

In the hospital
we do see joy

and pain

I want feeling cared for
to be a vital sign

My initial thought
is that it isn’t
because we can’t treat it

But that isn’t true

I have been brainwashed

We can’t treat it
with drugs

We measure pain
and are told to treat it
helpful pamphlets
sponsored by the pharmaceutical companies
have articles
from experts

Pain is under treated
by primary care
in the hospital
and there are all
these helpful medicines

I find
in my practice
that much of the pain
I see
cannot be treated
with narcotics
and responds better
to my ear

To have someone
really listen
and be curious
and be present
when the person
speaks

If feeling cared for
were a vital sign
imagine

Some people
I think
have almost never felt cared for
in their lives

They might say
I feel cared for 2 on a scale of 10

And what could the nurses do?

No pills to fix the problem

But perhaps
if that question
were followed by another

Is there anything we can do
to make you feel more cared for?

I wonder
if asking the question
is all we need

I took the photograph yesterday with my cell phone. It was so gloriously sunny that the water really was turquoise and I did no photoshop changes.