There was an inch of snow on the ground this morning, but it didn't last long. By afternoon it was completely gone and the sun was shining. Still I know that means the mountain passes will be difficult to cross. I called Avis to see whether they would provide tire chains? "No, and you'll have to pay for any damage chains cause, and we don't provide studded tires either." NyahNyahNyah. Never mind that I rented the car in Portland and have to return it in mid-November in Bend, which is on the other side of the mountains. So, I stuck the phone book in the car, and used it to find the Visitor Information Center and get some info. She gave me an Oregon map with a website for road reports, recommended the hour longer drive to Portland by going up Rt 97 to the Columbia Gorge when it was snowing in the mountains, and told me about the Les Schwab Tire store a few blocks away where you could return unused tire chains at the end of the season (at any of their many tire stores in Oregon). I headed over to pick up some chains--if I don't use them, my sister can return them in April for a refund. And we might need them to go skiing. You're required to carry them in the passes when there's snow, or pay a hefty fine (and possibly skid or get stuck). The salesman at Les Schwab asked me whether my owner's manual said chains were allowed on my rental car. Unfortunately, there was no owner's manual in the glovebox, and he pointed out that many newer cars, even SUVs, don't have enough clearance for chains, but the law still requires them. So, the receipt is in the glove compartment, and I'll probably take the longer route up to the Gorge to go to Portland just to play it safe. I guess the car and tire companies are in cahoots: you gotta buy studded tires for the wintertime.
After stocking up on maps and pamphlets, I drove up the Bend Parkway to the Cascade Village Shopping Center. Bend is large enough to have all the major national chain stores. First stop: Trader Joe's, which we don't have in Delaware. Got some good organic soups and fruit, and a couple indulgences too. Then onto Home Depot to check out the wood flooring options for the beach house. (We're ripping up old carpet this coming weekend, then putting down engineered wood floors two weekends after that.) Then onto Michael's to see whether I could find some colorful posters for my white walls. I didn't like any of the choices, so think I'll see whether there are any art supplies at the beach house to make my own. Then I drove around awhile, learning the layout of the town, admiring the fall colors. I finally found the Juniper Swim and Fitness Center run by the Bend Park and Rec Dept. and in the same quarter of town as my apartment. I signed up for 3 months, and went back this afternoon for an hour's swim. They have both a 50 meter outdoor pool which is under a bubble for the winter, and a 25 meter, warmer, indoor pool. The outdoor pool was chilly at first, but just fine after a couple laps. The swim team practices in one half of the pool, and open lap swimming was in the other half--I had a whole 25 meter lane to myself for most of my hour. I'm gonna try to go everyday, now that I have a chlorine resistant suit that won't disintegrate so fast. It feels so good! I may even try to go to COMA, the Central Oregon Masters Aquatics, which is a coached workout for adults. One of the hospitalists I met last week belongs to it, and it sounds like a lot of fun. I have never been, and probably never will be a competitive swimmer, but I would like to improve my strokes.
Tonight I'm headed over to the McMenamin's St. Francis School solo to see Eat, Pray, Love, and sit on a couch in their movie theatre while eating dinner. Rob and I stayed there when we traveled around Oregon after Bryan and Charlotte's Memorial Day wedding. I've read the book, but think it'll be fun to see the movie. Besides, I think the story sort of speaks to my solo adventure for these 3 months. Tomorrow, I head to Portland to visit my sister, Karen, and have dinner with her and cousin Judy. Then I plan to visit my friend Connie, before driving down to Springfield to pick up Bryan, Charlotte, and their friend who made their wedding cake so we can spend the weekend at the beach. Life is good.
Tuesday, October 26, 2010
Saturday, October 23, 2010
Colors and Peaks
I love the colors here. The views out the hospital windows at St. Charles in Bend are scrumptious. Deep blue of the mountains, soon to be white, and reds and yellows of autumn trees scattered about town. The muted green of the Ponderosa Pines sets off the other colors. There are lovely watercolors and pastels with saturated colors throughout the hospital, often reflecting the views outside--I often stop to admire them, and they help keep me oriented in the hospital maze. Across a roof covered in river rock, a fellow is painting a mural of the exact same mountain peaks you can see around the corner of the building. There's a sign 20 feet in front of the mural labelling both the real and the mural mountain peaks. I'll be glad when the construction sign comes off the door, so I can go check out my hunches for which peak is which. I know the Three Sisters, having backpacked to Obsidian Falls there long ago with my sister Joanne (remembering her shock when the campstove when up in flames, and I, as big sister, had to act like I knew what I was doing). One nurse told me they used to call these mountains, "Faith, Hope, and Charity". I remember as a preschooler drawing the "Three Sisters" when my Dad went on a business trip to the town of Sisters. There were just three of us sisters then, since Sandra hadn't been born yet. I guess she would have to be Three Fingered Jack, or one of the other peaks. Of course, I was the North Sister, Karen was the Middle Sister, and Joanne the South Sister in my crayon drawings.
You can also see Mt Bachelor, which is just a few miles up Century Drive, and usually has enough snow for skiing by Thanksgiving. Bend itself is about 3600 feet above sea level, which maybe explains why I felt a little breathless my first few days here. The air is dry too...I'm drinking two large bottles of low cal lemonade a day, just so I don't feel so parched. But I do enjoy the energizing feeling the blue skies give me. Don't think I'd want to live in S.A.D. country again, like the other side of the mountains. Winter blues are a real problem there with the dark rainy days.
For now, I can only admire the views, since my 11 hour work days keep me indoors, then it's dark by the time I get home. But during my upcoming time off, I hope to drive up Pilot Butte, an extinct cinder cone right in Bend, and just a few blocks from the hospital. And downtown Bend with miles of trails along the Deschutes River beckons too. Gotta go there before the snow starts.
You can also see Mt Bachelor, which is just a few miles up Century Drive, and usually has enough snow for skiing by Thanksgiving. Bend itself is about 3600 feet above sea level, which maybe explains why I felt a little breathless my first few days here. The air is dry too...I'm drinking two large bottles of low cal lemonade a day, just so I don't feel so parched. But I do enjoy the energizing feeling the blue skies give me. Don't think I'd want to live in S.A.D. country again, like the other side of the mountains. Winter blues are a real problem there with the dark rainy days.
For now, I can only admire the views, since my 11 hour work days keep me indoors, then it's dark by the time I get home. But during my upcoming time off, I hope to drive up Pilot Butte, an extinct cinder cone right in Bend, and just a few blocks from the hospital. And downtown Bend with miles of trails along the Deschutes River beckons too. Gotta go there before the snow starts.
Wednesday, October 20, 2010
Wending my way to Bend
First stop after landing in Portland was to visit old friends, Judy and Bob, and find that Judy's son and his girlfriend were visiting too. We all had fun catching up, then headed downtown to have dinner at the food carts. Portland has quite a few food carts set up in clusters around town, many run by grads from the Culinary Institutes who can't afford a real restaurant. There's almost every ethnic food you can think of: Egyptian, Korean, Northern Thai, etc. I had a big plate of Pad Thai for Five Bucks. The food carts have a reputation for good quality at reasonable prices and appear to be here to stay. Who knew there were regional variations in Thai food? Then we bar-hopped...a happy hour for Margueritas, and Higgins for a gooey chocolate concoction Bob and Judy discovered. Then I headed over to my sister's house for the night. We went to breakfast at my old favorite cafe, Marco's in Multnomah Village, before I headed out to drive to Bend. I was feeling a little sentimental back in my home town...there are memories around every corner.
Everyone recommended route 20 out of Salem as the fastest way over the mountains. The vine maple was bright red, stunning against black lava fields. I was shocked to see there had been a big forest fire near Santiam Pass, and stopped at the roadside interpretive sign to find out more about it. Turns out it happened in 2003 (have I been gone that long?!). Since they'd been suppressing brush fires, there had been a build up in underbrush fuel, so this forest fire had enough fuel to reach the crowns of the older trees. Normally there are naturally occurring pine forest fires every 5-10 years caused by lightening, which keep the underbrush down, and create a natural parkland with widely spaced mature pine trees. Fir forests have natural forest fires much less often. It will take a long time to recover. All the gray and black tree skeletons reminded me of the aftermath of the St. Helen's eruption, except these dead trees were still standing.
In Bend, I found the Stonebriar apartment complex pretty easily, right on route 20, and only had to wait a few minutes for the manager to give me my keys and a tour. The corporate furnishings folks had supplied basic furniture, dishes, and linens. The electricity was hooked up, but cable access had to wait a day, and replacement of a broken modem before I could get online. The apt is very nice, though it's all beige and white with bare walls. I'm going to try to rustle up some colorful posters just to cheer it up a bit. I made a trip to Costco and Safeway for a few groceries, and unpacked my three suitcases. Still, the cupboards are mostly empty. But it's more comfortable than a hotel, and should be a good space for friends and family to come visit, since there's an extra bedroom.
This Monday I had my orientation at St. Charles Hospital, with several hours devoted to learning about their computer system. I've had half the usual number of patients the last two days, but it takes me all day to see them because I'm so slow with the computer system. The first day with patients, there were two I.T. people shadowing me, and the second day, I had to call the Help Desk numerous times. It's going to take awhile to figure out this one. Lots of nonintuitive, idiosyncrasies. There's a steep learning curve, and even the old timers complain about it all the time...it will get better, but only to a point. It's evolving. St. Charles has McKesson, but everyone believes Cerner was/is better.
Overall, I'm enjoying the new hospital, and it's fun to be a hospitalist again. It's modern, with a very friendly welcoming staff, and beautiful views of the mountains. I see Oregonians everywhere...in their blue jeans and plaid shirts. I can see the Three Sisters, Broken Top, Three Fingered Jack and Mt. Bachelor. I think another peak is Mt Washington, and I can also see Black Butte. I bought a snow brush and ice scraper, and suspect I'll need to get some tire chains too. It should be an exciting winter! Soon I'll try out the Juniper Swim Center, and walk some trails along the Deschutes River in downtown Bend, though I'll probably drive to the top of Pilot Butte. Meanwhile, I'm still catching up on sleep from jet lag and stocking the apartment. Suspect I'll need to buy a few more warm clothes. Luckily they don't seem to mind my wearing scrubs to work, and they don't take much suitcase space (though they're not very warm either!)
Everyone recommended route 20 out of Salem as the fastest way over the mountains. The vine maple was bright red, stunning against black lava fields. I was shocked to see there had been a big forest fire near Santiam Pass, and stopped at the roadside interpretive sign to find out more about it. Turns out it happened in 2003 (have I been gone that long?!). Since they'd been suppressing brush fires, there had been a build up in underbrush fuel, so this forest fire had enough fuel to reach the crowns of the older trees. Normally there are naturally occurring pine forest fires every 5-10 years caused by lightening, which keep the underbrush down, and create a natural parkland with widely spaced mature pine trees. Fir forests have natural forest fires much less often. It will take a long time to recover. All the gray and black tree skeletons reminded me of the aftermath of the St. Helen's eruption, except these dead trees were still standing.
In Bend, I found the Stonebriar apartment complex pretty easily, right on route 20, and only had to wait a few minutes for the manager to give me my keys and a tour. The corporate furnishings folks had supplied basic furniture, dishes, and linens. The electricity was hooked up, but cable access had to wait a day, and replacement of a broken modem before I could get online. The apt is very nice, though it's all beige and white with bare walls. I'm going to try to rustle up some colorful posters just to cheer it up a bit. I made a trip to Costco and Safeway for a few groceries, and unpacked my three suitcases. Still, the cupboards are mostly empty. But it's more comfortable than a hotel, and should be a good space for friends and family to come visit, since there's an extra bedroom.
This Monday I had my orientation at St. Charles Hospital, with several hours devoted to learning about their computer system. I've had half the usual number of patients the last two days, but it takes me all day to see them because I'm so slow with the computer system. The first day with patients, there were two I.T. people shadowing me, and the second day, I had to call the Help Desk numerous times. It's going to take awhile to figure out this one. Lots of nonintuitive, idiosyncrasies. There's a steep learning curve, and even the old timers complain about it all the time...it will get better, but only to a point. It's evolving. St. Charles has McKesson, but everyone believes Cerner was/is better.
Overall, I'm enjoying the new hospital, and it's fun to be a hospitalist again. It's modern, with a very friendly welcoming staff, and beautiful views of the mountains. I see Oregonians everywhere...in their blue jeans and plaid shirts. I can see the Three Sisters, Broken Top, Three Fingered Jack and Mt. Bachelor. I think another peak is Mt Washington, and I can also see Black Butte. I bought a snow brush and ice scraper, and suspect I'll need to get some tire chains too. It should be an exciting winter! Soon I'll try out the Juniper Swim Center, and walk some trails along the Deschutes River in downtown Bend, though I'll probably drive to the top of Pilot Butte. Meanwhile, I'm still catching up on sleep from jet lag and stocking the apartment. Suspect I'll need to buy a few more warm clothes. Luckily they don't seem to mind my wearing scrubs to work, and they don't take much suitcase space (though they're not very warm either!)
Off to a Bang in midair!
My three month adventure as a locum tenens doc in Bend, Oregon started off with a bang...before I even arrived. Halfway between Chicago and Portland, the flight attendant asked, "Is there a doctor on the plane?" I waved my hand, though not very vigorously. She motioned me to come forward, and I had to turn my ear toward her to hear what it was about. There was a woman 3 rows back who had terrible abdominal pain and was vomiting nonstop. She asked me if I had a copy of my medical license with me, and when I assured her I did, we took the woman and her husband to the back of the plane. I took a brief history...turns out she'd had bad pain when she boarded, but it had gotten worse, and now she couldn't stop vomiting. She didn't have a fever, had no help from Pepcid, wasn't on any significant medication, bowels were working okay, and she had a previous appendectomy. I tried to take her blood pressure and listen for bowel sounds, but couldn't hear a thing with my stethoscope due to the roar of the plane. Finally I took her blood pressure by feeling her pulse begin as I deflated the cuff. It was okay initially. But the right side of her abdomen was quite tender.
So, they had me talk to the airline doctor on the ground by radio, and I said I thought she was safe to wait two hours until we landed in Portland. But, the emergency medical supplies on the plane had nothing for pain beyond Tylenol, and nothing for nausea. There weren't even any pillows or blankets on the plane! There were supplies for an i.v., but I thought it would be impossible to start an i.v. with all the motion and vibration. So I kept checking her blood pressure every 20 minutes or so. And it started to go down, to the point her pulse was thready and she was feeling a little dizzy. I insisted she lay down in the last row of seats and put her feet up. Then I changed my mind...we really did need to divert the plane to land sooner. I told the captain, who said he could have us on the ground in 30 minutes...in Billings, Montana! It was pretty intense to make that decision which would make 200 people miss their connections. The captain made it clear, it was my decision to make.
We landed in Billings, and there were no other planes in sight. But there was an ambulance waiting. They rolled a big ramp up to the back door of the plane, but we had to wait while the cabin depressurized before they could open the door. I gave the first EMT a quick history, especially the concern about her falling blood pressure. He came in and immediately started an i.v. while the woman was still lying on the back seats, while another EMT brought a collapsible stretcher aboard, after I stepped outside to clear other equipment from the ramp. Soon they had her rolling out the door, while most of the passengers were standing up watching. I slipped her husband a piece of paper with my cellphone number on it and asked him to let me know how it turned out. The woman's father give me a big hug as he left...I smelled his aftershave the rest of the day. After we landed in Portland, the flight attendant thanked me over the P.A. system, and I received a big round of applause from the passengers.
A couple days later, her husband called me from Billings...turns out she had a small bowel obstruction, probably due to scar tissue from the old appendectomy. I had been thinking more about her gallbladder, but without an xray couldn't say for sure. She'd been on a morphine drip for the first 2 days, then the pain relapsed when it was stopped. They were worried she would need surgery.
I know the flight attendants and the woman's family were grateful for my help, though the woman herself was annoyed at my frequent blood pressure checks and insistence that she lie down when she didn't want to....she was also unhappy when I didn't divert the plane immediately. I was a little relieved when her dropping blood pressure made the decision clear...we couldn't wait for Portland. I know it was an expensive decision. The plane had to refill and recheck everything before we could take off again at an airport they usually didn't fly to. They've got my name and license number now if they want to send me a flight voucher...I'd be happy with that, but I'm not holding my breath. But, mostly I was happy to hear from the husband and know she was going to be all right eventually.
So, they had me talk to the airline doctor on the ground by radio, and I said I thought she was safe to wait two hours until we landed in Portland. But, the emergency medical supplies on the plane had nothing for pain beyond Tylenol, and nothing for nausea. There weren't even any pillows or blankets on the plane! There were supplies for an i.v., but I thought it would be impossible to start an i.v. with all the motion and vibration. So I kept checking her blood pressure every 20 minutes or so. And it started to go down, to the point her pulse was thready and she was feeling a little dizzy. I insisted she lay down in the last row of seats and put her feet up. Then I changed my mind...we really did need to divert the plane to land sooner. I told the captain, who said he could have us on the ground in 30 minutes...in Billings, Montana! It was pretty intense to make that decision which would make 200 people miss their connections. The captain made it clear, it was my decision to make.
We landed in Billings, and there were no other planes in sight. But there was an ambulance waiting. They rolled a big ramp up to the back door of the plane, but we had to wait while the cabin depressurized before they could open the door. I gave the first EMT a quick history, especially the concern about her falling blood pressure. He came in and immediately started an i.v. while the woman was still lying on the back seats, while another EMT brought a collapsible stretcher aboard, after I stepped outside to clear other equipment from the ramp. Soon they had her rolling out the door, while most of the passengers were standing up watching. I slipped her husband a piece of paper with my cellphone number on it and asked him to let me know how it turned out. The woman's father give me a big hug as he left...I smelled his aftershave the rest of the day. After we landed in Portland, the flight attendant thanked me over the P.A. system, and I received a big round of applause from the passengers.
A couple days later, her husband called me from Billings...turns out she had a small bowel obstruction, probably due to scar tissue from the old appendectomy. I had been thinking more about her gallbladder, but without an xray couldn't say for sure. She'd been on a morphine drip for the first 2 days, then the pain relapsed when it was stopped. They were worried she would need surgery.
I know the flight attendants and the woman's family were grateful for my help, though the woman herself was annoyed at my frequent blood pressure checks and insistence that she lie down when she didn't want to....she was also unhappy when I didn't divert the plane immediately. I was a little relieved when her dropping blood pressure made the decision clear...we couldn't wait for Portland. I know it was an expensive decision. The plane had to refill and recheck everything before we could take off again at an airport they usually didn't fly to. They've got my name and license number now if they want to send me a flight voucher...I'd be happy with that, but I'm not holding my breath. But, mostly I was happy to hear from the husband and know she was going to be all right eventually.
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