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
As a physician I have learned that we lose so much in the hustle of the modern day clinic. In order to deliver optimal wellness we must be aware and empathetic to the immutable values, vulnerabilities, and often overseen intricacies that make up the persona of our patients.
event date: Nov 2011
The day, or I should say night started like any other night in the plywood palace that was our clinic in Afghanistan. Constituted eggs for breakfast, followed by sick call, or as it should have been known, ambien call. Followed again by constituted eggs for lunch. Somewhere in the monotony the phone rang, and the night got more interesting. A CASEVAC in the SOF world seems to typically be initiated by some guy at a desk that we don’t know, calling some guy at a desk that we do know about some guy in the field that got shot that nobody knows. This was that kind of phone call. The medical planner asked us if we could be ready to go with all of our gear in 15min to respond to a casualty at an out station. Little information was given, he didn’t really know that much just that it was a solider with a gun shot wound to the head that was critical, but stabilized. There would be a plane ready to take off in about 20min. Read more
After a little over a week of night float I’m thankful to report that the first night was by far the worst night. The work load is really hit or miss, and I think it depends who is staffing the ER. Some attendings are seasoned walls and can feel comfortable managing a wide variety of things, and will let very few cases slip by and be admitted to the hospital. While others are sieves that tend to let the simplest of complaints warrant an overnight stay. The two major problems I’m starting to see at least at this military hospital is that a lot of staff are pretty young leading to less seasoned staff running the ER, which means more things slip through to get admitted. Second, there are no observation beds in the ER. Other hospitals tend to have a 24 hour observation section off the side of the ER for lower acuity patients. Not here, so again more patients need to be admitted. So in short, some nights the ER might be full and we won’t get a single call, other nights it may not seem that busy, but we are somehow admitting all night long. Read more
“What is that?”. “I’m not sure. Whats that smell?”. “I think, ya, that’s fear alright”. “poke it with something would ya, I’m a little worried”. As the two senior attendings examine the body quivering underneath the desk it slowly turns toward them and peers back with swollen, sunken beety red eyes. Only a few months ago these same eyes carried a sheen that could captivate the hearts of his friends and speak only the most heartfelt optimism to total strangers. Now when these eyes glance at people on the street they tend to walk the other way. For eyes like this could only mean that this person intends to either kill, or has been on a meth binge for the last week. In fact the only people that find interest in these once human eyes are the police. Read more