20 July 2016

Locum - A Day In The Life

06:00 - Cell phone alarm goes off.  Most annoying sound ever.  Rouse enough to locate baby in our "shared bed" aka mattress on the floor.  She has not rolled off the mattress and crawled off to touch the space heater.  I win at parenting.  I deserve to go back to sleep. Snooze.  The baby snuggles into my armpit.

06:09 - Cell phone alarm goes off.  Most annoying sound ever.  Snooze.

6:35 - Cell phone alarm goes off.  Really must get out of bed now.  It is cold outside of this blanket.  I was pretty sure I was going to a tropical island, why is it so cold? Roll over to get out of bed.  Come face-to-face with the big kid, who has apparently been watching me sleep.  Creepy.
     "Is it morning time? Can we get up now?"

07:45 - Drop off the big kid at school.  Helpful notice by the sign in sheet informs me that tomorrow is "Pyjama Day." Realize big kid does not own pyjamas.  Or even pajamas.  As a rule, he sleeps in nothing but a iron man pull-up.  Hmmm.

08:05 - Swing by the "hospital" to round on all the inpatients.  All one of them.  Nurse reports the patient is his nephew and the hospitalization has given them some much needed time to catch up.  I also get a full report on the well-being and living situations of every other member of the family vis a vis their ability to care for my patient after discharge.  Not that anyone is rushing him out.  There is literally no such thing as admission criteria.  In fact, I am encouraged to admit people so that the district keeps the hospital open in the future.

08:20 - Morning staff meeting.  My cup of instant coffee is waiting for me.

10:30 - The electronic medical record has a feature where it shows you how long a patient has been waiting.  I am proud to be keeping mine under 40 minutes today.

11:00 - Every pakeha (white person) I see has skin cancer.  Farmers have at least two kinds of skin cancer each.  I have done more punch biopsies in the past two weeks than I did in three years of residency.  All of them have come back positive.  Seriously, northern hemisphere friends - thank your ozone layer.

12:30 - Lunch time! There are seven restaurants within two blocks of work.  I only frequent three of them so my general choices are meat pie, sandwich, or sushi.  Today is a sushi day.  I eat in the staff room while perusing the Opotiki News.  There are two articles detailing the separate perspectives in a dispute between some guests and the managers at the near by campground.  The classified ads have pigs for $250.  After eating I retreat to my office to pump.
     Let me say those words again: My. Office.  *cue choir of angels singing*  My office has a computer, an electrical outlet, a desk surface, a door, and a sink.  It is truly the nicest place I have ever pumped.

14:30 - It is frustrating that I have to stop and look up every single medication to find out what is subsidized/available here.  Some strange things are missing.  This afternoon is a sea of impetigo and I just wish I could just throw Bacitracin at everyone - but alas, it is not subsidized.

15:40 - Afternoon tea!

16:35 - Finished with patients! Now to write all my notes.

17:30 - Done with notes, I head back to the hospital to check on my patient.  We chat a bit, I scribble a note.  I walk home in the dark, thinking about all I left undone for tomorrow.  Glancing up to check the street before I cross, I am startled by the flat disc of the full moon hanging in the sky over the tyre centre.  The porch light is on for me at home.  Benjamin has made dinner.  And bought Bear some pyjamas for tomorrow.

18:35 - "If you eat five big bites of dinner you can have three cookies."  Bear stares at me like I am trying to trick him.
     "I don't really want cookies,' he declares with a flippant shrug of his bony, naked shoulders.  He goes back to playing with wooden trains on the floor.  Thirty minutes later, he does take a single bite of dinner.  It consists of two grains of rice, one of which may have touched some curry sauce.  He chews them for seven minutes before swallowing.
   "See?" I say, "was that so bad?"
    "Disgusting,' says Bear.

19:30 - I am changing into my 'pyjamas' when I hear a knock at the door.  Benjamin answers and I hear him say "oh yeah, she's right here," as I emerge from the bedroom carrying the baby and wearing a nursing tank and sweatpants.
     There is a woman standing in our front hall, where we keep our clothes drying racks and have a spare mattress leaning against the wall at the moment.  She introduces herself but I already recognize her from her picture in the Opotiki News - she's the other American doctor in town.  She works across the street and is from Delaware.  She was walking to the grocery store and decided to stop by and say hi.  I am equal parts happy to meet her and mortified that I am wearing basically underwear.  Bear literally IS wearing underwear.  Oh well.

20:30 - Bedtime ritual is cut slightly short by my work phone ringing. (I am on call tonight.) I listen as the nurse explains the presentation of the patient.  In the end, I advise sending them on to the nearest emergency room, forty-five minutes away.  Using one of my favorite pieces of kiwi medical parlance, I ask the nurse, "Are you happy with that plan?" Yes, she is happy.  We hang up.

22:00 - The eternal question: sleep or Game of Thrones?

23:00 - Bedtime.  We have four bedrooms (one is actually the living room but it also has a bed in it.) We start the night like this: me and Benjamin in room 1, Bear in room 2, Pax in room 3.  It is never the same by the end of the night.  Two nights ago it ended up like this: Benjamin in room 1, me in room 2, and Bear and Pax in room 3.  After living in the RV, we are apparently keen to spread out as much as possible.  Also, I have apparently been in this country long enough to start saying people are "keen to" do things.  And now, sleep.  Because tomorrow I get up and do it all over again.


  1. Patti and I loved reading this together at midnight. We hope the patient made it to the ER. What room do everyone wake up in? Patti wants to know if you need some Bacytracin. Keep journalin' and grinnin' 'cuz this to you shall overcome ;-)

  2. Thanks for taking the time to write. Brings me lots of smiles. I am of course relieved that life is returning to something approaching normal and that you seem to be enjoying things Kiwi as much as we did during our time there. "Disgusting" says Bear. Just love it.