I remember back in residency there would occasionally be the wild, rude, drug seeking patient that we would have to call security on for threatening the staff when they were told they weren’t getting a bump in their opioid prescription. There were also the patients that would constantly no-show for clinic appointments, were never compliant with any treatment regiment, and when confronted would become verbally abusive. These types of patients had one thing in common. They were fired from clinic. Exiled into the world to find another poor provider never to be allowed in the doors of our clinic again. Conversely, if our patients weren’t happy with our care they could fire us as well, quit the clinic and seek out another provider.
In the correctional environment we are stuck with each other, I can’t fire my patients, and they can’t fire me. It’s like being a doc in some bizarre summer camp, we are all on the same canoe. To illustrate the contrast in this topic between the normal world and the parallel universe that is prison medicine a few recent patient encounters come to mind.
Of the four facilities I currently work at the high security penitentiary is my favorite, and where I spend most of my week. I find the higher security Uber maximum prison to be draining. The inmates are constantly locked down, they have nothing to do most of the day but fester on their problems which often makes their quasi-medical issues become immediately life threatening in their own minds. The inmates at the low security and medium security facilities sometimes don’t realize they are in prison. I often get of mirage of complaints about the wait time for medical, or why they can’t have their turmeric ginger tea shipped in. At the pen the inmates know they are in prison, most are convicts that have been in for the greater part of their life and still have several years to go. The Penn is what you imagine prison to be like. Gangs, fights, drugs, it’s all there. What follows is an average day in my life. Read more
In life there are often a few defining moments that result in our courses being forever altered. We tend to follow a very structured path, even if we think our lives are chaotic when compared to those around us. We still have a plan and a path in front of us about where we at least think is pointing us in a good direction that we can make sense of. Then there are moments that are sometimes tragic and sometimes magic that flip us right off our path and into the abyss of uncertainty. We feel unraveled in these moments, these are moments when one path is gone and no others are apparent. We feel lost, scared, and just generally anxious and confused . It’s only when we grab back on to a new path and climb aboard that we start to feel more stable, when all the intangible components of our personality and our desires find hope in a new direction, even if it’s just a sliver of such. I feel like it’s like a black box. Like we are all just chugging along and then we hit a black box, we go inside, a bunch of stuff happens, and we come out on the other side in a new direction. Sort of like the kidney, we don’t really get it, but our blood somehow turns to piss, and all is well. Read more
To those of us in the services, remember that today when you put on your uniform you serve for American ideals. To combat authoritarianism, to call out lies and to struggle honorably in the pursuit and defense of the ideals that built this country. The current socio-polictical landscape of our country does not alter those underlying core staples of what makes this country what it is, and where it has come from. No president nor policy should shake your pride in representing what America is meant to stand for and the value in serving those ideals.
Since moving to southern Oregon I’ve been taunted by the constant roar of fighter jets buzzing the skies. One of my main motivations for moving to K-falls was the appeal of being able to be a National Guard flight surgeon at Kingsley Field. Kingsley houses the only full time F-15C Eagle training program for the entire Air Force. Which means that anyone guard or active duty that is slated to be an Eagle pilot has to come through here for six months in a demanding course before they can boast the pick up line of being a full up fighter pilot.
I feel that whenever I have a story to share from the chronicles of residency or life it is typically an outlandish outlier from the day to day events of normal life. These patient stories and tales of inpatient medical adventurism are of course entertaining to share with other residents, and useful in doing so to blow off steam. These stories are also typically the traumatic or heart wrenching memories that have a profound shaping effect on our careers and insights as physicians. But, what often gets missed I feel is the mundane days that fill the void between the outrageous tales of crazy and noteworthy patients. I also think we as health care providers get so used to this monotony that we sometimes fail to see just how amazing and equally outlandish our typical normal days have become for better or for worse.
So I feel justice should be paid to an average day in the life of a resident. One random day while on inpatient medicine I decided to chronicle the entire day. The following is the story of that day. If not for taking note of it, this day would have likely been lost from all memory and would have passed as just another drip of water on my forehead in the endless water torture that is general medical education.