Locum, Mother Nature, Travel

A hui hou and Mahalo Moloka’i

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Aloha and greetings from gray-skied Germany!

The fact that my last post was in August of 2023 is a good indication of how busy I was over the last 6 months. 

Our time in Hawai’i has bittersweetly come to an end. We departed Moloka’i on January 19th, 2024, just 9 days shy of being there a full year. I am so happy I decided to go and grateful for the experience. 

As previously mentioned, we moved into a new house for the remainder of my contract. The view from that house is perhaps one of my favorite views I’ve had anywhere. The house was spacious but certainly also gave me plenty of work keeping it clean. There seemed to be seasons for critters who tried to join our living situation. Cockroaches, scorpions, centipedes, ants, and mice all seemed to take turns keeping me on alert all the time. I always with house shoes on. I would scan the floor each morning before my toddler awoke to make sure nothing was lying around.

My fear was either of us getting a centipede stab most of all. Many on the island had told me these hurt the worst. I had also seen some infected wounds in the office. I didn’t mind the centipedes’ appearance, just their potential. The scorpions were my least favorite encounters, however. I’m happy to report we both made it off the island unharmed by critters. 

We stayed mostly on the island of Moloka’i the second half of the year. Aside from a weeklong trip to visit my mother and sister in Ohio and New York, respectively, and an extended weekend trip to Miami for a friends wedding. Hawai’i is just so far away! Travel times were longer than my average travel times to Europe from the mainland. Luckily, my toddler is seasoned when it comes to long flights and we managed them relatively well. 

Sunset view from our house
The beautiful driveway
The sunsets were often magical

Mokulele Monopoly

One of the main reasons we didn’t venture to the other islands for short trips was related to the singular and awful local airline. Notoriously unreliable, Mokulele, also called Moku-delay-lay, has made life difficult for the community on the island. Aside from frequently moved flights, delays, or cancellations, they are also quite expensive. A short 20-minute flight to Maui costs about $120. Whereas you can island hop between the other islands with Hawaiian Airlines for a fraction of the price. Although I realize flying small propeller planes is likely more expensive per capita than a full jet plane, it hasn’t always been this expensive. Pre-pandemic airlines used to offer reliable $50 one-way tickets. That company was sadly bought up by Mokulele and well, they certainly didn’t continue their business model in any regard. 

The flight issues have lead medical specialists to stop coming to the island. Home physical therapists stopped their services as well. Patients have a hard time making it to their doctor’s appointments on time in Honolulu. Some offices have resorted to just saying “Get here and we will see you when we can”. I’m positive it is impacting more areas of business than just healthcare. I truly wish and hope that this improves for the people of Moloka’i quickly. 

Waiting once again on our flight after several delays

The People

Besides the beautiful ocean views and ability to visit the beach on the weekends, I will certainly miss the people and community of Moloka’i. There is beauty in small towns and the communities that inhabit them. Certainly, there are also drawbacks. It’s not for nothing that a popular sticker reads “What happens on Moloka’i, everyone already knows!” 

The vast majority of people I interacted with were grateful for my presence as a doctor. I always replied, “It’s my pleasure, a beautiful island is not a bad place to be!”. 

The island doesn’t feel like your typical Hawai’i. It feels like real people, living real lives, with culture and community. I don’t blame them at all for wanting to keep it that way and hold off any major tourist development. This would undoubtably change the vibe of Moloka’i. So, if you are looking to visit Hawai’i, please, go to any of the other islands that are set up for tourism. Not only do those islands need the tourism to sustain so many people’s livelihoods but you’ll also find enough beautiful nature on the other islands with much better infrastructure to accommodate you. Don’t be shocked if you aren’t exactly made to feel welcome on Moloka’i as a tourist. It’s not what she is there for. 

A stroll through our front yard

The Office

The office staff is another area I will miss dearly. The whole staff was female except one male MA (bless his heart for managing to work with all of us). They are fun, fierce, loving, caring, and work hard. My toddler enjoyed visiting all the aunties and especially loved being spoiled with chocolates. 

Being a small town, patient and staff interactions were much more intimate and intertwined than in bigger cities. Many patients were someones relative or they had gone to school together. It often led to the hallways being filled with staff stopping at exam rooms to chit chat with patients or patients chatting across the hallway between rooms with other patients waiting. It was just a really lovely environment to work in. Props to those women and man for supporting their community so well. 

Last day as Dr. Vik

The Beach

Months before our departure, it dawned on me that we only had a limited amount of weekends left on Moloka’i. To not regret not having used the opportunity wisely, I made an effort to go to the beach every weekend, usually on Sundays. It worked most weekends unless it was pouring rain. The few hours on the beach grounded me. My toddler enjoyed our beach days too. Nothing like rolling around in the sand and running into the ocean. We often started our time on the beach by ourselves and as it drew closer to noon, a few others would appear. 

There was a group of paddlers that met most Sundays at one of the beaches we frequently visited. My toddler loved looking at the canoe and climbing all over it while on shore. I knew some of the paddlers through our friend who rented us the house we were living in. They all embraced my toddler’s curiosity and enthusiasm with the canoe and often would allow them to climb in and even handed them paddle to paddle the air. So often, my toddler requested to go out on the water with them. I sadly had to deny the request and said we would have to wait until they were older and bigger for it to be safe. So, while the crew of paddlers took off on their trip, my toddler and I would run, splash and swim in the ocean instead. 

Looking back on those beach moments, I think being on those beaches was when I was most at ease. 

On duty, all the time

Many people asked me if I would be coming back to Moloka’i in the future. I could see myself going back, for a few months at most. Alternatively, when my kid is in their tween years. As much as I enjoyed our year on Moloka’i, it wasn’t always easy. That’s not to say it was hard, but it was very busy. I initially thought it would be a more relaxed year overall given the limited distractions. While this was true in one sense and I certainly felt calm with living the slower-paced, less distracted life and daily views of the ocean,…normal day-to-day things kept me constantly busy. 

On the mainland, I had several factors that helped simplify my life as a single working mother. I would occasionally have a cleaning person clean the house we stayed in. There were many opportunities to entertain a toddler including museums, parks, libraries, playgrounds, etc. I had an au pair last year which allowed for me to have a few hours a week to do something for myself such as work out or sit in a cafe and read. Purple Carrot (a vegan meal kit subscription) was not only extremely convenient but I didn’t have to plan what was for dinner. I’d also have a healthy, delicious lunch left over for the next day. I was closer to family which allowed not only for more visits but also gave me a sense of back up if I needed my mother to fly in to watch my child in case of illness. 

In contrast, on Moloka’i, I had none of this. No one to clean the house (which took up several hours every weekend). No restaurants that catered to vegan or vegetarian diets and Purple Carrot didn’t ship to Hawaii. This meant I was fully responsible for all meals and if I didn’t have the energy to cook, we’d have pasta with tomato sauce. Besides the beach, there was one playground we could go visit. This had to be done in the early morning or late evening otherwise it stood in the hot sun throughout the day. There were no other toddler activities to partake in. My family and friends were so far away, that I hardly had anyone visit (despite SO MANY people saying they would when I announced I’d be going to Hawaii). 

The above essentially meant I was always doing something. Rarely did I just sit and take a deep breath. If I wasn’t working my 40-hour weeks, I was fully engaged in being a mom and taking care of the home. I am aware that this is the reality for many women. Furthermore, I chose to go to a remote island. I’m merely reporting that it was a lot to juggle constantly and now, being around more resources, I more profoundly realize just how busy I was managing it all by myself this past year. Moving forward, I have to ensure certain support systems to prevent burnout on my end and to continue to allow me to enjoy the lifestyle. 

On a whale watching tour
Lilikoi (passion fruit) from our yard
Our adopted feral kitty Cacao
Flowers from the garden

What’s up next?

To be determined. For right now, I am enjoying some much needed time with family and friends in Germany. I’ve eaten my weight in bread because it’s just so darn delicious. The plentiful cafes and restaurants have also made me happy. I have some exciting developments in the works that I will share more on once finalized. So stay tuned for that! Shouldn’t be more than a few weeks.

Not an uncommon occurence on Hawaii
This moon was spectacular
I mean….seriously.

mfg

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Happiness, Locum, Mother Nature, Travel

Aloha from Hawai’i

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It’s been a little over 6 months since we moved to Hawai’i. More specifically, we moved to the island of Moloka’i. It is known as the last island of “real Hawai’i” as all the others have been dominated by tourism. Tourism has its positive and negative aspects, but the majority of the population of Moloka’i has decided they’d rather not have tourism here. Instead, we find ourselves on a rural island with small-town vibes.

A Quick Island Overview

The whole island itself has about 7,000 people. It takes about 1h45 to make it from one side of the island to the other by car. It takes that long mainly due to the winding roads on the East end and speed limits of 20 mph to 45 mph along the whole route. About midway along the main road that runs along the south coast of Moloka’i is the main city of Kaunakakai.

Kaunakakai

Kaunakakai is where our critical access hospital is located, my office is across from it. This is also where you’ll find our main road. It has two grocery stores, the post office, the bakery, a few other shops, an art gallery, and that’s about it. There are no chain stores here. Amazon takes anywhere from 1-2 weeks to deliver goods.

East vs West

The East end of the island is lush with beautiful greenery and a water wall at the very end. The beaches we tend to go to on the weekends are located on the East side. The west side is flatter and drier. There are also some nice beaches that are bigger. But they don’t really have the palm trees lining the shore as the east-end ones do.

The impressive and historic North shore

The whole north side of the island contains the world’s largest sea cliffs. They are truly magical to fly by when you’re headed to or from Maui. Jutting off of those seacliffs is a triangular piece of land at sea level that is called Kalaupapa.

Per the national park services website:

When Hansen’s disease (leprosy) was introduced to the Hawaiian Islands, King Kamehameha V banished all afflicted to the isolated Kalaupapa Peninsula on the north shore of Molokai.  

Since 1866, more than 8,000 people, mostly Hawaiians, have died at Kalaupapa. Once a prison, Kalaupapa is now a refuge for the few remaining residents who are cured but were forced to live their lives in isolation.

https://www.nps.gov/kala/index.htm

Since many of the affected people didn’t know life outside of Kalaupapa, they decided to stay. The park services and state promised to continue to care for them until they passed as an effort to right the wrongs of history.

You used to be able to visit the community by taking donkeys down the cliff side but the community has been closed to visitors since the pandemic. There isn’t a timeline yet for when it’ll reopen to limited amounts of visitors. It’s something I would be extremely interested in seeing firsthand.

Life on Moloka’i

It was certainly a process of getting used to life here. Life is not hectic here, one of the things I looked forward to. We don’t have a movie theater, a mall, or even a Target to entertain you. The main forms of entertainment on the island are beach days, hiking, hunting, fishing, paddling, and spending time with your ‘ohana (family). For my toddler and I, that leaves us mainly with beach days.

Child care

During the first three months we were here, my sister Karoline joined us from Austria to be the nanny while I looked for local childcare. I knew that having an au pair was not going to be an option when I decided to come to Moloka’i. I also think an au pair would be bored out of their mind with minimal opportunity to meet similarly aged people. It wasn’t easy for Karoline either. She would spend four days at the house with my toddler. Our place was located up a steep hill, not within walking distance of a park or beach. On the weekends, we would make several trips to one of the beaches. She definitely got a lot of book reading in and started a bracelet-making business. I really appreciate her coming to help me out and realize it was not the easiest time.

I’m thankful I found a wonderful babysitter who now watches my toddler while I’m at work. There are a few other kids as well which is so much more fun than being the only kid. They play a lot outside in the mud and water. My toddler is even picking up some Hawaiian words!

Work

I work in an office with a really great team. The island went through a lot prior to my arrival. Two primary care physicians passed away (both having had long careers and large patient panels on the island). Two left the office to move back to Oahu (I came as a replacement for one of them). A primary care nurse practitioner also retired at that time. For an island of 7000 people, to lose 5 primary care providers was a lot. The one doc who passed away and was in private practice probably had a patient panel of 2500-3000 people himself. So my first couple of months were spent absorbing a lot of his patient panel into our office while also covering the panel of the doctor that moved away.

Thankfully, my appointment times are all 30 or 60 minutes slots. That is a real luxury as many of my colleagues would attest to. Even so, when I’m not actively seeing patients, I have a bunch of paperwork, orders, and coordination of care that keep me busy. I’ve continued with my four-day work week and don’t plan on returning to a 5-day work week anytime soon. It is such a wonderful work-life balance that I am grateful I can have.

The patients have all been absolutely lovely. Unlike many patient encounters on the mainland where you feel like patients merely use you to get what they want, patients here are truly grateful that I am on their island helping out and it’s a much more collaborative approach than I’ve experienced elsewhere. I think a big contributor to this is the beautiful Hawaiian culture that thrives on this island. They have such a wonderful respect for their kupuna (elders) and a sense of community.

Community

At first, we were rather isolated. The weeks looked pretty much the same. Go to work for four days, and be home with Karoline and my toddler for three days during which we would grocery shop and hit up the beach. But there wasn’t much interaction beyond that.

Thankfully, over time, I have built up a community of people. I’m not extremely close with anyone but I have made friends with neighbors, patients, and co-workers. Through one neighbor in particular (thank you Karoline for the initial connection), I have met many wonderful people who live on the island. We’ve had a few organized group dinners. I’ve been invited to patients’ homes and graduation parties. I’ve hosted a dinner myself too. So though it is mostly my toddler and I who spend time together, there is always a little event here or there to mix things up.

Cost of Living

The cost of living here is horrendous. Groceries are the most expensive I’ve ever seen them. I will easily spend $150 on not really that much. A watermelon costs $10-20 dollars depending on the size. I’ve seen a container of strawberries for $16! A big bag of chips will cost you at least $8. A packet of butter is easily $10. It’s insane. How anyone affords to live here, I do not know. I am privy to the fact that many share fruits and veggies among themselves that they harvest in their yards. I myself have an avocado connection and many patients have brought me mangos. But even so, all the things you can’t grow yourself (and are imported to the island) will cost you a pretty penny. Shockingly, even pineapples grown in Hawai’i cost over $8! It’s just wild.

I make my own soymilk. I initially was not able to find organic unsweetened soymilk. So instead, I ordered organic soybeans on Amazon and made the milk myself. It’s definitely not as creamy or tasty as the store-bought kind but it does the trick for cereal, cooking, and baking. I also made my own coconut yogurt for a while using probiotic capsules. It is not easy finding vegan alternatives. There are a few alternative meat options in the freezer section but two Beyond burgers will cost you $14. I mainly miss soy yogurt and tempeh/seitan. I do plan on trying my hand at my own soy yogurt one of these days.

Traveling Adventures

Traveling to and from the island is truly adventurous. Since the pandemic, there is only one airline that services the island, Mokulele Airlines. Funny enough, Mokulele means plane in Hawaiian, so it’s the plane airlines lol. Anyways, they might also just be the worst airline I’ve experienced. The pilots and staff have always been friendly so I don’t want to throw any shade at them. The issue lies with the schedules.

I have flown with them MANY times since being here (again, my only option) and I don’t think I’ve had a single flight leave on schedule. I’ve had several flights canceled, a flight moved ahead by 3 hours (sorry, I couldn’t leave work early), moved to different days, or delayed with no information given as to when we might leave and spent 5 hours at the airport with a toddler (so fun) before we left late at night. And all of these come without the benefits the big airlines give you. I’ve had to pay for my own hotels in Honolulu because we missed our connecting flight. I’ve gotten vouchers for flights that were canceled but not refunds. It’s as if they know they are the only option and couldn’t care less.

Every trip with them is a gamble. I’ve had appointments in Honolulu that I would fly out two days in advance and spend money on a hotel or Airbnb just to make sure I was there for the appointment. Oh, and they are so expensive! A round-trip flight to Maui (a 20 min flight) or Honolulu (a 35 min flight) costs $250 per person! The ferry that used to go between Maui and Molokai stopped service many years ago. So Mokulele is literally the only commercial way off the island.

Island Hopping

My aunt and uncle came to Hawaii for several weeks back in March. We met up with them on three of the islands on my days off.

Maui

Our first weekend with them was on Maui. Mokulele was doing the most so we ended up actually catching a private boat to and from Maui. My office staff really came through and found a boat with some room on it for us. It ended up being a bit cheaper than what the flight had cost and we got a nice 45-minute ocean boat ride out of it. We even saw several whales along the way. So although it was stressful to get it organized, it ended up being a cool experience.

We landed in the historic harbor of Lahaina. If you’ve been following the news at all lately, you’ll know that it tragically and horrifically all burnt to the ground this past week due to a wildfire fueled by a hurricane over 600 miles away from us. My heart is broken for the people of Maui who have lost their lives, their homes, their communities, and the life they knew. Lahaina was one of the cutest towns I experienced on any of the islands and it seems incomprehensible that it no longer exists. I’ll be posting some ways to donate to help those affected at the end of this post.

After grabbing something to eat and strolling through Lahaina, we drove to the peak of Maui, Haleakala. It holds the world record for the highest climb in the shortest distance- 10,023 feet in a mere 32 miles! The landscape changes several times as you drive up over the clouds to reach the peak.

The following day, we drove along the Road to Hana. There are many attractions along the way. It’s more about the journey than the destination. We stopped by the rainbow bamboo and the botanical garden. There are a few waterfalls to see along the way. We also made a stop at Hamoa Beach before heading back to the AirBnB through rugged terrain.

Kauai

To get to Kauai from Molokai, we first had to fly to Honolulu and then catch a Hawaiian Airlines flight to Kauai. As you probably already guessed, Mokulele royally screwed up this itinerary too. This is when we waited at the airport for 5 hours, only to have to get a hotel for the night in Honolulu and rebook our Hawaiian flight (for a fee as well) to the next day.

When we finally did make it, we had a great time. Kauai is a very beautiful lush island. We mainly spent our time on various beaches. My uncle and I took a helicopter ride around the island and got to see the waterfalls featured in Jurrasic Park. It was a wonderful experience that my toddler was able to join for free and slept through the entire ride.

The farmers market we visited had a lot of cool artists and beautiful flowers. The island had a bit of an artsy hippy vibe to it that I really appreciated.

Big Island

I was under the assumption that Big Island was going to be even more big-city than Honolulu. I was so wrong lol. The island is just that, it is very big but the towns are small. The two main cities are Kona on the west and Hilo on the east. We had our AirBnB on the Kona side. It’s a bit more in the mountains, cooler and wetter than in the east. Kona has an old hippy vibe and is filled with a lot of great shops and restaurants. Hilo gave off an old-time vibe with a bit of art deco flair. We took a trip to see the volcano. At the time, it was quiet, several weeks later in June, it was the active volcano in the news.

Overall, the big island had a very chill aura to it and wasn’t quite as touristy as Maui and Kauai are.

I really only got a small glimpse into each island over just a few days we were there. Given how expensive flights and especially AirBnB’s are though, I don’t have plans to return to the other islands for visits while I’m out here. I wouldn’t mind working a gig in Kauai sometime though, I’d like to explore that place some more.

Homeland

We took a trip to Germany in June. It was a long way to get there. We were there for two weeks and I did nothing else but see friends and family and host a family reunion. I never dealt with jet lag before becoming a mom. I just never had it. But now I get jet-lagged by proxy because my toddler is jet-lagged. It took about 5 days to get into a normal rhythm going there and almost a week when we came back. If I ever were to go to Europe from Hawaii again, it would have to be for at least a month.

What’s up ahead?

My original contract was only until the end of July but I extended it through the end of the year once childcare was established. I recently moved into a new house. After six months, I needed a change of scenery. I liked our first spot but I itch for change after 6 months. Our new place is actually the home of one of the friends we made. He is on the island for 6 months and on the mainland for the other 6. It’s a really beautiful house with a killer view of the ocean, a pool, an in-home movie theater, and plenty of extra space for guests.

My first guests were scheduled to arrive tomorrow but due to the events on Maui, had to cancel their plans. I was really bummed although I completely understood and agree with their decision. Although I’ve made friends here, I was REALLY looking forward to seeing some of my own people again and sharing the experience here with them. If I’m lucky, my next guest may be coming in October but nothing is booked yet. I’ll be headed back to Ohio and Rochester, NY next month for a quick week-long visit to family. Hawaii is really far away from anywhere else, so even a trip to the Midwest is an odyssey.

The above images were captured by the talented local photographer Arinna (ariannapaikii.com)

Support Maui

The wildfires on Maui were devastating. What those people are going through and what they experienced, if they were fortunate enough to survive, is unimaginable. I see Lahaina, or what used to be Lahaina, from our house. We had strong winds and a power outage for a few hours. Beyond a pool, deck, and yard that needed to be cleaned up, we are ok. There was a brush fire on the west side of Molokai that the firefighters were able to extinguish relatively quickly. What happened on Maui easily could’ve happened here and that is just terrifying. I was expecting so many different consequences from a hurricane but a wildfire was not on my radar. Since I am not physically on Maui and don’t have any items to donate with me, I have been donating money to causes that are helping people get what they need.

Please consider donating something. Even if it’s $5, that helps. Here are some links to make it easy for you.

Maui Food Bank

Hawaii Red Cross

Together Rising

Mahalo (thank you) for your support!

That is it for now. Take care and stay safe everyone!

mfg

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Happiness, Locum, Travel

Cows, Water, Flights & Family

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Dairyland

I’m into my last three weeks of work at my assignment in Wisconsin. It certainly hasn’t felt like 5 months altogether. This may be due to the fact, and I’m sure this won’t surprise regular readers, that we were quite busy. If we weren’t off to a different state or country, we were spending weekends visiting friends in Madison, Milwaukee, and Chicago.

I work in a rural family practice with another physician and a nurse practitioner. As a locum, my schedule tends to fill up on the day of or a few days out. These visits are often same-day complaints, pre-op evaluations, ED follow-ups, and such. Things people would ideally see their primary care provider for but they are both essentially booked out for months! It is a different mind game seeing these sorts of visits on a regular basis vs typical primary care follow-up visits. I have a few patients I’ve seen on a regular basis, but the majority of patients are new to me every visit. It is all part of the gig as a locum, however, and I don’t mind it. Keeps things interesting!

I work with two medical assistants I’ve gotten to know quite well over the past few months. The rest of the staff consists of really lovely nurses, medical assistants, radiology techs, lab techs, and front desk workers. The feeling of familiarity amongst the staff was evident from the first day there. We have many laughs throughout the day.

On my drive home
View from the beach on the lake
Beautiful fall in Wisconsin

The substitute teacher of doctors

Many patients have asked if I would consider staying. The administration did that same early on. I make a conscious effort to be clear that I live a nomadic lifestyle and that keeps me sane. The physician I took over for, left primary care to work in urgent care for more of a work-life balance. There is another locum coming in after me to cover the first half of the year before their new hire starts permanently. I feel the era of having the same family physician for 20+ is over but you can still find the occasional doc that has stayed in the same practice over decades. There are a lot of factors that contribute to this trend. Burnout is a big problem among them. The locum lifestyle definitely helps me avoid burnout because I always have a new adventure to look forward to!

Time: A man-made construct

Mausi has done astoundingly well for all the time zones I took them through over the past few months. There have been no “up all night” or “sleeping all day” despite time differences of 12 hours. The kid is made for traveling and I am pumped about it. We’ve also visited the cock pit of two of our flights and run up and down airplane aisles countless times.

September

We started the month off in Waupaca, spending labor day with family and friends. Mausi even went down the water slide a few times…with my help, obviously. The following weekend, Mausi and I hopped over to Cleveland to see my mom and partake in my citizenship interview and civics exam (aced it). By the end of the month, my mother came to Wisconsin to hang out for 9 days.

Always finds buttons to explore
Took a lake cruise to see some of the estates
One of the fancy estates on the lake
Madison Farmer’s Market
Hot-Spicy-Cheesey-Bread at the Farmer’s Market!
Visiting some local farms
Nearby Apple orchard
Wisconsin kiddo with cows and Oshkosh B’gosh overalls

October

The first weekend of October, Mausi and I flew down to New Orleans to visit our dear friend and former Eugene nanny and her two boys. At that time, she was far along in her pregnancy and I helped get stuff done around the apartment to prepare for baby number 3’s arrival a few weeks later. Mausi was ecstatic to see her two friends again. It was a quick trip but filled with fun.

The following weekend, I was lucky enough to witness my best friend from middle school/high school get married. I missed a lot of my high school friends’ weddings because I was in medical school in Germany. Then I missed a lot of my med school friends’ weddings because I was in residency in Ohio. I’m so happy I was able to partake in his!

4/5 of the Fab Five
Fixing the groom’s bowtie

I officially became an American citizen! The judge presiding over the ceremony held a very beautiful speech about the importance of immigrants in a country like the USA. Lovely to hear, especially after the rhetoric of the previous president and his administration.

Personal record

Toward the end of the month, Mausi and I went on our longest airplane ride together. It was a direct flight from Chicago to Delhi, India. The outbound flight lasted about 13.5 hours, and the return flight about 15 hours. On the way there, I was given a new seat assignment during check-in with the hope that I would have a whole row for us. Unfortunately, when it came time to board, we ended up having someone seated in the aisle seat.

Mausi, being their usual curious self, was all over the place; pulling anything that moved, pushing all the buttons, and climbing on the tray table. The travel busy board and busy cube I had purchased the week prior provided a few solid minutes of entertainment. Mausi did end up sleeping for a good 6 hours. I laid them across the two seats we had and tried to position myself around them. That was minimally effective and quite uncomfortable. After trying that for 4 hours, I eventually just laid down on the ground and slept for 2 hours. That was enough for me not to feel like a zombie when we landed.

India – Delhi & Diwali

We were met at the airport by my boyfriend and his son. At their place, we were lovingly greeted and welcomed to their home by his parents and the house staff. We ate delicious home-cooked food and I got a proper nap while Mausi explored the house and had many willing eyes watch her. That evening, we all went to a neighbor’s place for a Diwali celebration.

Diwali is the Indian festival of lights. It’s celebrated by many religions and is one of the most important holidays in Hinduism. We got all dressed up in traditional Indian outfits and ate way too much food. Mausi met a few children at the party and played with them essentially the entire night, just coming to check if I was still around from time to time.

India – Goa

The next day, following our Puja (prayer) for Diwali, my boyfriend, his son, Mausi and I were off to the airport. We caught our flight to Goa. Goa is a coastal town about halfway down the west coast of India. Portuguese architecture is prominent due to the Portuguese history of colonizing the place. My boyfriend’s sister, brother-in-law, and nephew joined us in Goa. Our routine for the next several days was simple; wake up, get ready, go eat a delicious breakfast, and then spend the rest of the day on one of the various beaches.

So well behaved during the Puja
Looking at crabs

I even drove us home at night three times. For those who don’t know, they drive on the left in India. They also drive like crazy people! Very different driving culture than in America or Germany. We survived, no cows were hit (they like to just stand in the middle of the street sometimes), and no traffic tickets were issued.

After five days, it was back to Delhi. We only had the last day to run a few last-minute errands because our flight left at 2:15 AM.

Paging Dr. Hasselhof

While at the airport, it took forever to get checked in. I made it to the border control officer at the time boarding had started. And I arrived at the airport three hours before our flight time. Three stalls down, a man started having a seizure. Luckily, two others caught him and lowered him to the ground. I saw this all unfold and told the border control officer that I am a physician and should go check on that man. The officer was not impressed and told me to wait. Again, I pressed that time is of the essence and that I need to help keep that man safe. The officer continued to be unimpressed.

Finally, someone in the security line shouted out “is there a doctor here!?”. I raised my hand and exclaimed that the officer wasn’t letting me pass. Finally, a supervisor came and waved me through. I lifted Mausi out of the carrier and handed them to the supervisor.

How to help someone having a seizure

The main goal in taking care of a seizing person is to keep them safe. That means ensuring the area around them is clear, cushioning their head so they don’t hit it on a hard surface, and protecting their airway by positioning them on their side. Do NOT wedge something in their mouth. We quickly laid coats under the man’s head and positioned him correctly. I tried obtaining some medical history from his travel companion. He mentioned issues with low blood sugar but couldn’t tell me if the man was diabetic. Eventually, a paramedic came with a suitcase filled with medical supplies. At this point, the man had stopped seizing and was slowly coming to. He was still very confused, as was expected. He was surely even more confused when the seemingly only caucasian person at the airport was now hovering over him asking him questions.

Gotta go!

I stayed long enough for the paramedic to check that his vitals and blood sugar were stable (I had sent someone to fetch apple juice after the comment about low blood sugar in case we needed it). Vitals and blood sugar were good. Then it was time for me to go catch my flight. Luckily, the supervisor had me expedited to the front of the line at security but I still had to run, with a toddler strapped to my chest, to make it on our flight.

November

We were home for a mere 12 days before hopping on a flight to Germany. My cousin turned 40 and the whole family was coming together to celebrate. The week flew by because there were so many people to see. Anytime I am in Germany, there are a number of people I must see every visit. In the town I went to medical school in, there is a group of 6 people I do my all to see while there. Once again, I saw them all! The second half of the week was especially busy because everyone was arriving for the festivities. It was a good time.

Breakfast is my favorite meal of the day in Germany

My older sister came with her husband and kids. None of the extended family had met her kids before. Her youngest and Mausi are only ten days apart in age and are like two peas in a pod when they get together. Pushing them around in my sister’s double stroller made it look like I had twins!

The week involved family complexities I won’t go into detail on this platform. But, I will say, I think it was a very successful week for my family overall.

Now, we are back in Wisconsin and I have been busy over the weekend packing and organizing. The following two weekends are already planned out before we have the last weekend to do the final packing. Then it’ll be off to Ohio and Rochester, NY for Christmas before we head back to India for a three-week vacation with my mother and her fiance.

So, where to next?

It’s official! I will be headed to Molokai, Hawaii for 6 months starting in February! I’m beyond excited about this next assignment. If you have any tips for the island of Molokai or any of the other Hawaiian islands, please send them my way. I plan on spending the majority of the time on Molokai and just enjoying island life. However, one weekend out of the month, I’d like to hop to one of the other islands. My younger sister will be joining me for three months to be Mausi’s nanny. I’ll have to find someone local to take over once she leaves, or open it up here for applications for a three-month nanny stint 😉

I hope everyone in the States had a lovely Thanksgiving with family and friends.

Stay healthy!

mfg

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Locum, Motherhood, Travel

A Tale of Three Months, Four Time Zones, and Five Countries

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Oh gee…I certainly was not planning on waiting 3.5 months before posting again. I know I sound like a broken record since I start off almost every post these days with an apology that it’s been so long. I was posting every two weeks almost consistently when I first started out and was pregnant. It should come as no surprise, especially to the parent readers, that a toddler requires a lot of attention, however. And honestly, I will always pick spending time with my child over engaging in social media. This time is so limited and so precious.

Also, instead of using “my child”, I think I’ll henceforth refer to them as “Mausi”. I continue to want to keep their identity off the internet, but for the sake of more fluid writing and for the sake of not sounding like I’m from a previous century, I’ll go with my nickname for them. But let’s dive in and let me get you caught up on what’s been going on!

June

For the last two months of my assignment in Eugene, we had to relocate to an apartment from the house we had previously lived in. This was known from the beginning as the house was already rented starting in June. The agency found us a 2-bedroom apartment close to the Willamette River. We, unfortunately, didn’t have a playground right down the street from us, but we did have a lovely trail along the river that we visited often.

Abortion is Healthcare.

On June 24th, the day people with a uterus’s constitutional right to bodily autonomy was stripped away, Ally, Mausi, and I attended a protest in Downtown Eugene. It was a peaceful protest and I was happy to see many men in attendance. Frankly, there should have been many more considering how the Supreme Court’s decision to overturn Roe vs Wade affects men too. In this sense, I feel like a broken record here too. The constant injustice we see happening in this country is truly disheartening. The fact that a handful of people get to decide the consequences for the majority of people is scary. They have real power. It is so important that everyone vote and that we elect leaders that will protect the rights of all citizens.

Blushing Blonde moments

Mausi and I spent an afternoon near the Heceta Lighthouse having our pictures taken by a local photographer. I really enjoy finding local photographers everywhere I go to capture moments of Mausi and me. Being a solo mom, there are plenty of pictures on my phone of Mausi, but rarely one where we are together. Having a photoshoot every couple of months makes for a fun way to capture our lives together. It is also a reminder of the places we’ve been.

Silver Falls Park

We finished off the month with a hike in Silver Falls Park. Only a 1.5-hour drive from Eugene, this park has a 7-mile loop that passes 10 waterfalls. We hiked it with another friend of mine with a baby. We’d like to say we made it the whole 7 miles, but then we’d be lying. We did, however, make it about 4.5 miles and passed 7 of the 10 waterfalls. The trail leads behind a few of the falls which were pretty cool. Definitely worth the trip if you find yourself in the area!

July

July and the half of August were several weeks of traveling. After the first week of work, Mausi and I flew to Europe for a two-week trip! The first week of that was the first legit vacation I’ve taken since October of 2019. Sure, there were trips all throughout the years, but they were mainly to Germany, which is like going home, it’s not a vacation in the sense of relaxing and exploring.

Μύκονος

Mausi and I spent a lovely week on the Greek island of Mykonos with my boyfriend. It had been almost 5 years since we were in the same physical space. He and I went on a date during my travels in India in 2017. Sounds crazy, I am aware, but it didn’t feel like we hadn’t seen each other in that long.

We stayed in a nice little boutique hotel just a few minutes’ walk from the beach. We rented a mini cooper convertible for a few days to zip around the very narrow streets of the island. My main touristy objective was to see the windmills that Mykonos is famous for. Mykonos is also known for its glitz, glamour, and party lifestyle. There was no partying for use with Mausi along but I was ok with that. There was an alarming amount of designer handbags to be seen by just about everyone walking around the island. I include myself in this, but in my case, it’s also the only small handbag I own.

There was an Italian restaurant within walking distance of our hotel that served delicious food and was staffed by really friendly people. Honestly, every restaurant we went to was extremely child friendly, and didn’t mind Mausi crawling absolutely everywhere. Often, the waiting staff would even hold on to and play with them while I ate. If you want to do something kind for a mother of a small child, watch their child while they eat their meal. It’s so rare to have an uninterrupted (warm) meal when you’re a mom.

It was a really fun and enjoyable week for our little trio.

Bachelorette Fun and Fancy Pizza

After our island adventure, it was off to Germany to partake in my best friend’s bachelorette festivities. Thankfully, she isn’t one for crazy outfits and silly games. We had a delicious dinner and spent the next day doing a photoshoot and going to a spa. I was really excited to meet some of her good friends that I had only heard of. Our friendship has been strong and thriving since I left Germany in 2015 but I’ve also missed a lot of the day-to-day stuff. I feel much more in the loop now that I know all her other close friends.

Between the bachelorette weekend and the wedding weekend, I crammed in as many get-togethers with my friends as possible. I also jumped on a night train with Mausi and traveled to Vienna to visit my sister Karoline for two days. I enjoy traveling by night train. The rattling of the train on the tracks is a great way to sleep and I am in a position where I can afford my own cabin now. On previous trips as a medical student, I’d book a spot in the 6-person cabin. At the time, I didn’t mind sharing the space with strangers. I didn’t want to do that with a toddler though.

Karoline works in a fun, hip pizzeria as the pizza decorator extrordinaire. We walked all over the city and ate many scrumptious meals together. I adore her and am always so happy to spend time with her. After our short 36-hour visit, we hopped back on the night train and traveled back up north.

Wedding Bells

My best friend’s wedding was a day filled with love, happiness, great conversations, and delicious food. Having missed so many of my friend’s weddings in the past, I would’ve moved mountains to attend hers. Lucky for me, she got married after I finished residency so no mountain moving was necessary.

Hello again and goodbye!

We flew back to Eugene for my last four days of work before heading to Wisconsin. I had a really great time in Eugene. I definitely did not see and do all that I planned to. My coworkers were such a joy to work with. It felt like hanging out with a group of friends every day. The work was not always easy. For the most part, it was actually complex. The patients I cared for were complex both medically and socially. There were a lot of social factors that came into consideration compared to previous jobs. Even “just” seeing 8 patients a day was a lot due to their individual complexities.

I had some great patient relationships build up in the 7 months I was there. For several, I felt like I made a real positive impact on their lives. I was even gifted a thoughtful gift by one of my patients. He had used the box that his medications come in to craft a keepsake box. I’ll have to take a picture of it and share some time (it’s currently in my new office space). I found certainly consider returning to the Lane County Clinics in the future for another few months.

August

As if traveling from Eugene to Europe back to Eugene and then to Wisconsin wasn’t enough of a timezone whirlwind, we traveled the first week of August as well. This trip was originally planned in March when none of my other travels had been planned yet and I felt like I needed a break and some adventure between jobs. But before we jumped on our international flight, we made a pit stop in Waupaca, WI so that I could attend my high school best friend’s wedding shower.

Back in High School, I was friends with the “Fab Five”. Not to be confused with the Fab Five of Queer Eye for the Straight Guy. (My fashion and hair would’ve been much better had that been the case.) Although I was with them a lot, the Sensational Six didn’t have the same ring to it…and I was the only girl in the group. Bryant, Ryan, Kyle, Chase, and Caleb were all back together for the wedding shower and I was thrilled. Zach, an underclassman during High School, an admirer of the Fab Five, and a good friend of ours, was also there.

After that short visit, we were off to Panama!

Panama City

We were only in Panama for 4 full days plus the two travel days on each end. It wasn’t a lot of time but we managed to see a variety of things. We stayed in Casco Viejo while in Panama City. It was built in 1673 after pirates almost completely destroyed the former historical center of Panama Viejo. It was a mix of old and new. Some buildings were filled with fancy restaurants or boutique hotels. Others were just the facade and completely gutted on the inside. We ate some yummy food and did a bit of shopping.

I bought myself, my mother, and my boyfriend each a Panama hat. Panama hat is a bit of a misnomer as they actually come from Ecuador. During the Gold Rush, people would travel from South America through the Panama Canal onwards to California and often bought a hat in Panama to shield themselves from the sun. When asked where they had gotten their hats from, they’d answer Panama. And voila, the Panama hat was named. The really nice thing about the toquilla straw hat is that it can be rolled up and packed for travel. No more filling half a suitcase with a hat or trying to awkwardly wear it on the plane.

Jungle Living

After two days of wandering around Casco Viejo, we headed north towards the coast. Because it seemed silly not to, we stopped by the Panama Canal Locks at Miraflores along the way. If I hadn’t been aware of the monumental engineering feet the locks are, this would’ve been a rather boring stop. However, knowing a bit of the history and the impact that place has on the world economy, put it into perspective and made me appreciate what I was looking at.

We spent two nights in an AirBnB hosted by a very lovely French couple. They spoke French and Spanish and a little bit of English. I speak English and German with a little bit of Spanish and French. Nonetheless, we had pleasant conversations and a great time. Getting to their place was an adventure. We used google maps until Portobelo and then followed several directions sent to us by the host. We counted miles and kept an eye out for the structures that signaled to us that it was time to take a turn. Eventually, we found the entrance to their property. We continued from the gate to about 50 m from the house in their 4-wheel drive car before trekking the remaining distance up a steep muddy hill. Totally worth the trip. Our room overlooked their luscious garden and the ocean.

Island Time

Our hosts took us out on their Waverunner to show us the islands in the area. We zipped past the island Shakira apparently likes to vacation at. We slowly rode through the mangrove trees and what is known as the tunnel of love. One turn was taken a bit too sharply and we were all in the water. Luckily, we could easily stand where we had fallen off.

Ultimately, we decided to spend our day on Isla Mamey. Supposedly, the island used to belong to Pablo Escobar. I’m not really sure what constitutes “used to belong to” or how long it’s been since it was his, but there was a huge skull face etched into the ground. I wasn’t able to find any connection between Escobar and Isla Mamey online though, so maybe it’s just a good story they tell visitors.

Regardless, Isla Mamey will hold a special place in my heart since it’s the place Mausi took their first steps! Way to pick a memorable spot, kiddo!

The beauty of travel

On our last day in Panama, we went to a restaurant that had a great online menu for brunch. I am a sucker for a good brunch. We were the first to arrive. When we reviewed the menu, I was a bit disappointed that it didn’t include all the fun stuff I had seen online. Nonetheless, we stayed and ordered some waffles and eggs. We were the only ones there until about halfway through when a couple came and sat near us.

They received their menus and were trying to decide what they wanted. While verbalizing their options, I realized that we had not received the same menu. Their menu did have the fun stuff I read about online. At this point, it was too late for us though since we had ordered. Mausi, as they do, quickly made friends with our table neighbors and this led to a conversation amongst us all. And what a wonderful conversation it was! I think we spent another hour there just chatting!

Kate (an award-winning author) and her husband Dave have been traveling the world since 2013, house-sitting in various locations. They were both so interesting to talk to. We definitely connected on our desire and need to continue traveling, mixing up our surroundings, and not being in one place for too long. I could see myself doing something similar in the far future if house sitting is still a thing. What a great way to work/retire/live. She blogs about it on her blog Living the Journey.

This is what I love about traveling. What I’ve missed about traveling. Meeting new people with interesting life stories. People’s stories fascinate me and I have met so many cool people on my travels. I look forward to hopefully many more similar events as traveling becomes more frequent again.

Dairyland

After our short Panama excursion, we were back in Wisconsin. I’ll save the rest for the next post, which will hopefully happen before my contract here is done (hehe), but we’ve covered so much already. Props to you if you’ve made it this far. Thanks for hanging in there, I know it was a lot.

Hope everyone is well and healthy.

mfg

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Happiness, Locum, Mother Nature

From Land to Shining Sea

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Oh my! The last month was busy! Before I dive into what I’ve been exploring lately, I want to first address the horrifying things happening in Ukraine right now.

War has always been horrible. There are constantly wars and conflict happening around the world and often times, we are ignorant to them. To a certain extent, we have to be. If we knew about every human suffering occurring in the world, we’d all constantly be depressed and distraught. So we focus on news and events in our more immediate surroundings. When horrible things then happen to people that easily could also be us, it hits harder and deeper.

Since I’ve become a mother, my emotions are on steroids. I love harder, I grieve deeper, and I empathize more intensely. Where I used to see mothers and children of the world suffering and would feel terribly saddened by it, now I see myself and my baby in the women and children being bombed in the Ukraine and fleeing for their lives and its heart wrenching. I walk a fine line between staying informed and protecting my mental health. Since I’m on a contract right now, I can’t be in Germany helping the refugees. So instead, I am supporting various humanitarian aid charities that are helping the people of Ukraine. Hopefully, you’ve been able to do the same.

The clever ways people have been helping the Ukrainian people has been proof of human ingenuity. I’ve seen people booking AirBnB’s in Ukraine with obviously no intention of staying there but rather getting financial aide directly to those Ukrainians. I’ve read about information being shared as reviews on various sites because the Russian government is censoring social media.

It is absolutely despicable that one man can cause so much trauma, heartache, death and destruction. I don’t know how, but this war needs to stop.

Coming to America

A few days after my last post, my AuPair Ally arrived from South Africa. The first few days were spent giving her some orientation and letting her adjust with the jet leg. 10 days after her arrival, my aunt and uncle visited from Germany for 10 days. Thus, the last few weekends were rather busy and I enjoyed them fully. We initially wanted to take a trip to Crater Lake. My aunt had seen a TV show discussing blue colors around the world and Crater Lake was mentioned as being particularly beautiful. It’s still winter season here in Oregon however and the road circumventing the lake is closed at this time. We had a great alternative weekend adventure instead!

Let me share some of the fun things we’ve been up to!

Spencer Butte

The second day Ally was here, our local nanny (and now good friend of ours) took us on a hike up Spencer Butte. It’s located a short drive outside of Eugene. There is a steep ascent and a gradual one. We took the steep way up. My nanny and I each packed a baby and Ally packed our two backpacks. The ascent was not a walk in the park. It had rained a bit before we started our hike, so the paths were a slightly muddy at times. There was also a bit of boulder climbing involved but it was a lot of fun and provided some amazing views. We even saw a full rainbow once at the top!

McCredie Hot Springs

On her second weekend here, Ally, my baby and I drove an hour southeast of Eugene to take a dip in the McCredie hot springs. This was Ally’s first time seeing snow! There were a few pools available. We shared one with just 4 other people. Baby loved it! They love bath time so this was a special treat.

Sweet Creek Falls

The first stop on our weekend tour with my aunt and uncle was at Sweet Creek Falls. Located about 1h15 west of Eugene and on the way to Florence, is where you’ll find the beautiful forest and water falls. The hike was easy and took us through lush greenery up along the river to the waterfalls. The water was cold but I can see myself coming back on a hot summer day and splashing around a bit.

Heceta Lighthouse & Cape Perpetua

After a short stop in Florence to visit the marina and grab lunch and coffee, we headed north up the coast. Our first stop was the look out area overlooking the coast with the Heceta Lighthouse in the background. When I was here with my mother, we discovered hundreds of sea lions hanging out directly below us. Unfortunately, none were to be found this time around. So we snapped a few pictures and headed to the Heceta Lighthouse.

The parking lot for the lighthouse is located at sea level across from a beach. To get to the lighthouse, you have to take an uphill walk past the Bed & Breakfast to the lighthouse. From the top, I was able to take some nice pictures of the coast line. The blue, green, gray and white color palette of the nature is right up my alley.

Upon our decent, we spent some time hanging out on the beach and letting baby play in the sand. Afterwards, we drove 20 minutes north and up to the Cape Perpetua Lookout. From here, we could look down on the coast line and watch as the sun started to set. We didn’t stay for the actual sunset because we still had to find a hotel for the night and cellular reception was nonexistent for us where we were. We had intended to visit Yachats as well but decided to continue north to Newport for the night.

Newport

A few miles north of Yachats, I finally had cellular service and was able to look up a motel for us. We headed to the port of Newport to grab dinner. It was already pretty late and restaurants were close to closing. Luckily, the Clearwater restaurant was open longer than the others. It is situated right on the port. The best part was truly what was happening in front of the restaurant on the marina side. The floating docks were filled with sea lions! They were the first thing we heard when we got out of the car. It was dark, so we were only able to see the ones illuminated by the dock lights. It sounded like there were hundreds more hanging out in the dark bay.

The next morning, we grabbed lunch at the Nye Beach Cafe before going on a walk along Nye Beach. The ocean seems to really ebb and flood on this beach. We found beautiful sea anemones (amenonemomne?) amongst the rocks. There are some pretty cool shops in Nye Beach. We stopped by the Blue Pig Bakery for some delicious treats. The bakery is worth visiting even if you don’t have a sweet tooth because every room, nook and cranny is filled with gifts and goodies.

After stuffing my face with a scrumptious cinnamon roll, we headed back to the port where we had been the night before. The port is lined with a lot of shops, many quite unique. We browsed, snacked, and shopped for a while before heading back to Eugene.

Svikki MD

Work has been good. The patients I see have medical issues all across the board. I’ve had a few no-shows (not uncommon for a FQHC- federally qualified health center) which allowed me to catch up on the copious amount of tasks that flood my in basket. The team I work with is really great and I enjoy my time at work.

We are already looking ahead for the remainder of the year. Usually, jobs don’t get confirmed until 2-3 months before the start date. The job I’m currently at was confirmed unusually early and I’ve don’t it again with my next assignment. I’ve also been able to negotiate a pay raise which feels really good. Anecdotally, I’ve experienced women be less direct about pay raises and negotiating. It’s definitely still a work in progress for myself as well but I definitely scored a win this round.

Starting in August, my baby, Ally and I will be headed to…. Wisconsin! Go Badgers! lol

Me circa 2015

I will be working in a town close to Milwaukee, Madison and Chicago. I’m excited to show Ally the state I grew up in and it’ll be nice to be close to so many lovely friends I have in that area. Eugene doesn’t really get any snow, so we will definitely have to prepare Ally for a Wisconsin winter. She saw her first bit of snow here in Oregon but I’m going to blow her mind with a legitimate snow storm in Wisconsin should we have one this year.

So, to all my Wisconsinites, I look forward to seeing you and introducing my baby to you later this year!

mfg

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Food & Drinks, Locum, Motherhood

Local Leisure

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I’ve spent the last few weekends here in Eugene starting to explore what the city has to offer. We have several different people visiting us over the next months and my AuPair FINALLY arrives this coming Friday. Once she is here and has adjusted, we plan on exploring all sorts of things in Oregon. Knowing that our future weekends will be busy (and thankfully so!), I decided baby and I could spend a few weekends in Eugene. That feeling didn’t last longer than 3 weekends though seeing as we took a day trip to the coast yesterday because I needed a change of scenery.

Food

My local nanny (who is the bees knees, y’all, seriously) gave me a whole list of restaurants to try out. Since eating out is more fun in a group, I’ll try most of them when guests and my AuPair are here. Keeping in mind her and I try to eat mainly vegan, here are her suggestions with notes:

  • Peaceful Palette Food Truck: only open Spring-Fall
  • Bo&Vine: veggie burger & tots
  • Jazzy Ladies: farm fresh brunch
  • Govindas: fully vegan & gluten free
  • Glory Days: veggie-heavy breakfast
  • Wandering Goat: vegan biscuit & gravy and good coffee
  • Grower’s Market: bulk & organic co-op
  • Cornbread: cornbread, vegan chili
  • Vero Espresso: breakfast and lunch in a house with a porch and outdoor seating area

I’ve done a bit of exploring myself and have found a bakery that makes delicious croissants. Croissants are one of my favorite baked goods but I’ve been spoiled and fortunate to have eaten many french croissants, so I have high croissant standards. Noisette Pastry Kitchen is not too far from where we are staying so it makes for a nice walk to pick up some treats. Check out their instagram below. Delicious!

Activites

This is another category where I will have much more to report once I have guests and we check things out together. Baby and I have spent a good amount of time in the public library (also only a short walk away) and local playgrounds.

Cascades Raptor Center is a nature center and wildlife hospital open to the public year-round. We are home to nearly 40 resident education raptors, most native to the Pacific Northwest.

https://cascadesraptorcenter.org

Last weekend, we met up with the nanny and her family at the Cascades Raptor Center. Per their website:

All of the birds have signs posted with their origin story and information about their species. I’ll definitely have to do some more reading the next time I’m there. We witnessed a few feeding and were able to see some of the birds up close. The admission fee is $10 for adults ($9 students age13+ and seniors, $7 for ages 2-7), but it’s money well spent to help keep the place running and saving bird lives.

Local playground exploring

The glorious world of public libraries

I have always apprecitated the existence of public libraries. There is something sort of magical about them. I remember our small public library in Muscoda where I felt so grown up when I got my own library card. The public library in Poland, OH was a beautiful place to study for the board exam. In South Dakota, it was loacted only a block from my apartment and supplied me with the books I read written by or about the Lakota tribes of the area. Here in Eugene, it’s the place my mother took my child and met our local nanny! It is also a place we’ve been to several times now to explore their giant selection of children’s books.

Proud new member of REI

Considering the plethora of hiking trails in Oregon, I figured it was time to get a pair of hiking boots. With a baby on my back or chest, I want to make sure I’ve got a good grip. Furthermore, I also purchased a new baby carrier as my wrap isn’t as functional as I’d like it to be for hiking. I’ve recieved several hiking recommendations (many with waterfalls!) but a lot of them are located outside of Eugene and are on the list to explore with our AuPair/guests. There are however plenty of trails here in Eugene as well.

We checked out one of the trails around Spencer Butte. The trees are so tall here and covered in moss. I’m assuming thats because we are in a valley and there is often heavy fog that rolls through… or stays put for several days. Side note, my collegue told me the Eugen area is one of the worst for seasonal allergies. The pollen content is extremely high here.

Shopping

This is not a category I’ve explored extensively but I did find a few really cute shops the first weekend we stayed in town. Located between Charnleton & Olive Street and 5th & 6th Ave is a row of four adorable and fun shops. Down to Earth Home & Garden has a huge selection of kitchen ware, home decor and garden supplies. Pre-pandemic, they often had workshops there too, according to my medical support staff.

Across from that is Mountain Rose Herbs Mercantile, a store filled with herbs, spices, tea, coffee, lotions and potions. I bought Nurse-Me Rhyme loose-leaf tea and it is delicious. They also are a big supporter of the Raptor Center as evidenced by their logo on many of the signs on the aviaries.

Directly nextdoor, is Farmer’s Union Coffee Roasters. They sell specialty coffees from small co-ops and farmers around the world! The interior decor is light and fun. I enjoyed a decaf oat-milk honey and lavendar latte.

The final store in that lineup is Oak Street Vintage. It’s not just vinatge clothing they sell but also a large selection of cool furniture and decor. Check out their Insta pages for more!

https://www.instagram.com/p/CXewYJOvOx2/

I guess I should pause here for a second and just say that none of the links I’ve posted are sponsored in any way. These are just local places I’ve found and their instagrams do a heck of a lot better job showing what they do than any picture I could take. Additionally, I want anyone coming to the area to have a easy way of finding the places I mentioned. I promise to let you know if I ever get paid or free stuff for something I mention.

Svikki MD

Work is busy. From the moment I get there to the moment I leave, I am non-stop working. I work while I eat and I work while I pump. Between seeing patients, I hurry to finish up notes, refill medications, review labs/image/consults and answer messages. It’s never ending. My inbox usually was empty when I went home during residency. That is nearly impossible now. Some of the other clinics have a refill team that weeds thorugh their refill requests and if certain criteria is met, it gets refilled without needing to ask the provider. I don’t have that service due to staff shortages.

The panel of patients I cover is from a previous provider who worked here for 6 years and accumulated a panel of about 1200 patients. My inbox fluctuates between 20 to 100 tasks throughout the week. It’s usually more on Tuesdays when I first come into work. However, even with working off many of those as the days go on, more tasks come pouring it. I’ve come to terms with the fact that my inbox won’t be empty when I leave for the day and just have to do my best triaging the tasks.

I’ve seen a wide variety of patient presentations in the office and have performed a few procedures. My medical support staff is great! My roomer “scrubs” the charts the day before and makes notes on what the patients are coming in for, which preventative items need to be done, etc. She also knows many of the patients and can provide some context and backstory.

Solo working mom

As busy as I am at work, I’m equally as busy at home during the work week. This will lighten up once my AuPair is here. Currently, my workday mornings are either spent getting ready quickly and packing our bags before the baby wakes up or doing it all with a baby on my hip.

Depending on where the in-home daycare is that day (it varies between two locations) I pack up the car and we drive either 10 or 20 minutes to the daycare. I like to spend 5-10 minutes chatting with the other moms and saying hi to the kids. They adore my baby and my baby absolutely adores the time with the bunch. Then it’s off to work. I’ll usually fill this time listening to music and singing along loudly. As I mentioned previously, when I’m at work, I’m working non-stop.

Before my replacement parts came for my Willow pump (a breast pump that you tuck into your bra without cords), I was using a corded pump and would sit in an empty exam room and pump for 15 minutes twice a day while awkwardly trying to write notes without bumping off the bottles. Thank goodness I can now use my willow. I just pop them into my sports bra and write my notes looking like Pamela Anderson. I’ve even pumped while seeing patients if I don’t have a break. There is time blocked off on my schedule to pump but patient encounters rarely follow an exact schedule.

Once I get home, my baby gets dropped off by the nanny about 15 minutes later. I use that time to quickly unpack my lunch stuff and organize anything I can. Then its time to cook and eat dinner. Following that is our bedtime routine of brushing teeth, reading some books and nursing to sleep. There was a stretch of time where baby would want to stay up until 8 or 9. Luckily that has passed for the time being and baby is usually sleeping by 7. I spend the two hours I have before going to bed largely with cleaning up the kitchen, washing the dishes, the lunch containers and baby’s bottles, and essembling everything for the next day.

The four day work week goes fast because there is so much to do. I am so grateful for my three day weekend. Once my AuPair gets here, I’ll gain back quite a bit of time at home during the workweek. The commute to daycare will no longer be necessary and neither will the packing of baby’s bags. I do still want my baby to see the group of kids so there will be play dates.

I’m so excited for my AuPair to arrive in a few days and look forward to all the guests that will be coming to see us over the next several months! As before, any suggestions of things we should eat, see, or do, send them my way!

mfg

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Food & Drinks, Locum, Motherhood, Travel

Weekend Shenanigans

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Although I am spending this weekend exploring our immediate surroundings in Eugene, I spent the last two doing some traveling. We went to check out Portland with my uncle two weekends ago. Last weekend, we headed to the coast with my mom. I can’t wait for my AuPair to get here so we can start planning all our weekend trips!

Portland

In my head, Portland was going to be this green oasis brimming with bike paths and eclectic people roaming the streets. To be fair, visiting a city in January is hardly ever the time to see a city at its best. Throw in an ongoing pandemic and things look a bit different than you might expect.

We booked a hotel downtown, thinking we would be close to all the action that way. After checking in, we walked directly to the one farmer’s market that was open (again, it’s winter). The walk there was not exciting. However, the Farmer’s Market was a rather decent size and had some delicious things. We grabbed a breakfast burrito, apple cider, and some really yummy, single-source chocolate.

After that, we made our way back towards downtown. While doing so, we passed a lot of empty storefronts and even more tents at seemingly every corner. We stopped at a few coffee shops along the way. While looking at GoogleMaps, we realized that an area northwest of downtown seemed to be rather busy. After a bit of research, we learned that 23rd Ave was lined with shops and restaurants. So, we walked there to see if it was a bit more happening than downtown was.

23rd Ave definitely had more going on. We saw quite a few of the eclectic people I thought might be running around. There were some delicious-looking restaurants but it was still too early for dinner. So instead, we decided to walk back towards downtown and check out Old China Town. Maybe we just weren’t on the right streets, but we basically found nothing interesting in Old China Town. For dinner, we decided my uncle needed a good ole American burger before heading back to Germany and ate at Deschutes Brewery.

Day 2

After a fast and pretty decent breakfast at Cheryl’s on 12th, we took a walk along the Willamette River. I’m sure it is even nicer in the spring or summer when the trees are full of foliage and the temperature is warmer. Before heading back to Eugene, we spent a couple of hours at the Oregon Zoo. It is one of the more beautifully laid out zoos I’ve visited. At times, you feel like you are taking a walk through the woods. We didn’t see as many animals as I had hoped. Perhaps that was due to it being winter. The walk through the zoo itself was already worth our time though.

Someone slept through most of the zoo visit

In the end, Portland didn’t wow us as much as we thought it might. I’m not giving up on it wowing me in the future though. I’m hopeful that with warmer weather, flourishing flora and fauna, reduced pandemic restrictions, and a bit more research, Portland will be more like the Portland I imagined.

Oregon Coast

Last weekend, we headed to the coast with my mother. A little over an hour’s drive due west of Eugene lies Florence. It is a small coastal town with a population of just over 9,000 people. There is a road along the Siuslaw river known as the historic Downtown. The streets are lined with shops, cafes, and restaurants. I immediately felt like I was on vacation when I saw a store selling Salt Water Taffy. For some reason, likely my childhood, I associate that with vacation.

We grabbed some hot drinks at Magnolia Bakery and walked along the historic Downtown road. We stopped to check out a few galleries with local artists before taking a nursing break at the harbor. I grabbed a bagel at River Roasters to eat while we drove to the beach. I’ll have to return to River Roasters sometime though. It was a comfy coffee shop with a fireplace and a back porch overlooking the river.

Hello Ocean!

A quick 10-minute drive from downtown Florence got us to the beach! Getting to the beach was a bit of a workout. First, you had to climb up a dune. Then, once at the top, if you wanted to get to the ocean, you had to maneuver down a steep dune side of sand. After taking in the beautiful view from on top of the dune, I took the baby to go see the ocean up close.

For a while, we were the only two people on that stretch of beach. My baby had never played with sand before and had a blast! We took a walk along the beach and looked for an intact shell. I can’t wait for the weather to warm up a bit to spend the whole day on the beach.

After a good while soaking in the beach views, we headed north up the coast.

Hello Sealions!

The drive along the coastal 101 Highway is very scenic. Every couple miles, there is a sign that reads, “Entering Tsunami Hazard Zone”. The day prior, there had actually been a tsunami wave weather warning due to the underwater volcano that erupted near Tongo. Lucky for us, the warning was over and the sun was shining. This led to some great views.

We stopped along the way to see the Heceta Lighthouse from afar. Little did we know, when we looked down from the cliff, we looked right onto the sealion gathering spot. There were so many of them! They even seemed to have their own little ocean pool.

Our intention was to see the Heceta lighthouse up close as well but when we tried driving there, we realized you actually had to walk a bit to get there. My mother had hurt her foot the day prior, so we decided to skip that part.

At this point, we were hungry for a real meal. Another 20 minutes north, in a town called Yachats, we went to the first place we saw, called Ona. It was very delicious and a co-worker later told me, it’s one of his favorites in that town. So that worked out well.

The last stop was for some ice cream before we embarked on our 1h50 drive home.

The Wishlist

I am making a list of all the recommendations people have been giving me. My AuPair should get here mid-February and I am so excited to spend our 3-day weekends exploring Oregon!

Svikki MD

Work has been going really well. They still had me on a lighter patient schedule these past few weeks. And gee was it necessary! I am getting better at using their electronic medical record system but still feel like I’m not as efficient as I could be.

The patients, for the most part, have been kind. Some are more complicated than others. Some are very complicated. I try to compartmentalize and prioritize, knowing I won’t be able to help fix all their problems in one office visit.

They also closed the previous locum’s in-basket of tasks the other week and all the unfinished tasks, labs, and medication refills dumped into my in-basket. All of a sudden I had nearly 100 tasks to complete. I was quite overwhelmed by this since I tend to have my in-basket cleared before the end of the day. I spent a few hours over last weekend in the office working on tasks. It wasn’t until two days ago, however, that I officially got through it all. Naturally, new things started coming in but 7 tasks aren’t as terrifying as 100.

It takes a village

The first week at work, my uncle was in town watching my baby. The second week, my mom was here to babysit. I had signed up for care.com and messaged about 20 people to see if they’d be interested in babysitting while I am at work and await the arrival of my AuPair. Only two got back to me saying they’d be interested. For many others, our schedules didn’t align. I was starting to get nervous.

The Universe (and my mother) had my back

My mother took the baby to the library the first day they were together. There, my mother observed a woman walk in with a few toddlers and a baby strapped to her back. My mom was impressed by how this woman interacted with the kids. The woman overheard my mother speaking German and struck up a conversation. She told my mother that she had spent an exchange year in Germany (in nearly flawless German pronounciation). My mother then proceeded to tell her of my current childcare situation. The woman said I should give her a call and that she could probably help us out.

I called her that evening. She was amazing. She agreed to add my baby to her cohort of kiddos. They spend their days between the homes of the two families whose kids she watches. One is in the city and the other is out in the country. She stopped by with her two kids last Monday for a face-to-face meeting. Our babies loved each other. I knew my baby would thrive being around this woman and her kids. She is so creative. Her parents were actors and she grew up around the theater. She has puppets to help the kid communicate their feelings, plays instruments, and works on sign language with them. I really hit the jackpot here.

Hopefully, play dates can continue to happen once my AupPair gets here too. The local nanny also gave me a huge list of restaurants to check out. Seriously, she rocks.

mfg

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Locum, Motherhood, Travel

Welcome to Oregon

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Holy moly, time flies! I’d really like to be posting more than once a month (or a month and a half!) and I think it’ll be more likely in the future.

This past month has been exceptionally busy. First, there was enjoying the last few weeks of maternity leave with family and friends in Germany. We celebrated Christmas with some of my aunt’s family by having a nice raclette feast! Shortly thereafter, my aunt and uncle drove us to Frankfurt where we all spent the night before baby and I caught our flight to Ohio.

During our short three days stay in Ohio, we visited my residency program to see everyone. I also had an OBGYN appointment for my Pap smear (make sure you are up to date on your Pap smear, my cervix possessing friends!).

Our journey to Eugene Oregon the next day was a doozy.

Connecting Time – Indefinite

Our journey from Cleveland to Eugene started really early on December 30th. Our flight out of Cleveland was at 6:10 AM (!). The flight to San Fransisco was fine, Baby didn’t sleep much at all but did make friends with the passengers around us. Shortly before landing, I checked the airline app to see if our connecting flight was on time. It was not. Au contraire mon amie! It was CANCELED. Due to staff shortages.

Remember hearing in the news how United had to cancel a bunch of flights between Christmas and New Year. Yeah, mine was one of them.

Once on the ground, I contacted a United agent to see what my next option would be to get to Eugene. The best they could do was put me on standby for a flight at 4:30 PM. Not great, especially since it was only 8:30 AM at the time. All of the flights the next day were only on standby as well. I neither liked my chances nor did I like the idea of being stuck at the airport with a baby for 8 hours. So after some deliberation with my family, I decided to rent a car and drive. Also not ideal with an 8-month-old baby but at least I was getting closer to my destination.

Road Trippin

We were looking at a 540-mile trip ahead of us. It took forever to get out of San Fransisco. Driving over the Golden Gate Bridge somewhat made up for it though. I only made it to Redding, California before booking a motel and spending the night. I don’t typically experience jet lag but I kept us on sort of a wonky schedule in Ohio because we had such an early flight to catch. Now being 3 hours even further behind, we were in bed by 8 PM. However, we then left the motel by 3:30 AM.

The morning drive was adventurous. Once we crossed the Californian border, we were in the mountains. The fog was so thick and it was snowing. At one point, I was only driving 15 mph downhill and hoping my little economy car wouldn’t fail us. Eventually, I started to get hungry and really wondered if there would even be a place to eat since I hadn’t seen an exit in quite some time.

Heaven on Earth

I asked GoogleMaps where the nearest restaurant would be. It suggested a place called Heaven on Earth which was only 20 minutes away. Well, with a name like that, and my options very limited, I decided to give it a try! We left the highway and quickly pulled up to a wood cabin with a big sign that read “Home of the Famous Cinnamon Rolls”. The sun was just starting to rise. We walked in to find cinnamon rolls as big as a plate! A lovely lady seated us. The only other folks there was a table with 4 older gentlemen who all seemed to be cowboys.

The omelet I ordered was exactly what I needed. The open fire made the place very cozy. We chatted a bit with our server and the chef before heading out again for the last 2 hour stretch of our journey. Before dropping off the rental car at the airport, I stopped by the gas station to fill up. I was quickly informed by a nice man that I better not touch the pump or I could be looking at a $1500 fine. … Wait…what? Turns out, you are not allowed to pump your own gas in Oregon and New Jersey. Good to know!

Eugene

I spent New Year’s Eve going to bed around 9 PM. I was in a new city, knew no one, had a baby, and was perfectly content with it all. The following day, we walked around the city a bit and ran some essential errands before picking up my uncle late at night. He flew in from Germany to watch the baby while I went to my first week of work.

My first impressions of Eugene:

  • Weed is omnipresent. There are so many dispensories in and around the downtown area. Holy Grail, Spacebuds, Oregon Weed Oulet… so… many…shops.
  • Homelessness is omnipresent. There are large lots filled with tents. Tents are set up at seemingly random places along the neighborhood. As a co-worker would later let me know, the numbers of homeless people is so high in Eugene due to a combination of skyrocketing rent, strict city expansion laws and liberal policies which make it a more welcoming place. In contrast, in Springfield, a more conservative town, which is literally right next to Eugene, it is illegal to hand anything out of your car window. Apparently its a law to stop people from giving food or drinks to the homeless. Supposedly, other more conservative cities in Oregon give the homeless a one-way ticket to Eugene and tell them they’ll be taken care of here.
  • Kindness is omnipresent. Everyone I have met has been kind. There are countless Black Lives Matter signs in the businesses and “Choose Kindness” signs in the neighborhood.

Svikki MD

My first week at work was all orientation. I work at a community health center. There are several offices throughout Eugene and I was able to shadow at several of them throughout the week. Not only was it nice to shadow providers to get a feeling of how their electronic medical record program works (vastly different than the Epic program I am used to) but it was also nice to shadow them seeing patients. It’s been 9 months since I’ve seen patients. Although I wasn’t afraid of having forgotten how to use a stethoscope, it was nice to ease back into the clinical setting by being a fly on the wall.

Everyone, from the providers to the support staff, really seem to enjoy the work that they do. The patients we see in the clinic are mainly Medicare, Medicaid, uninsured and underserved. They tend to be fairly complex, both medically and socially. However, the people working in the clinics really seem to have a passion for helping these people get the healthcare they deserve.

I was happy to find out that I would be working in a clinic closer to home than the one I originally was told I would be at. Since I was all over the place for orientation week, I was able to stop by at home for lunch a few times. My first week was Monday through Friday. Going forward, I’ll only be working Tuesday through Friday.

My first week of orientation went well and my first week of being back at work went well for Baby too. My uncle did a great job and I really enjoyed having him here with me.

I receive very intense kisses when I get home from work.

Three Day Weekend

I’m so excited to spend our 3-day weekends exploring Oregon. My coworkers have given me some fun suggestions of things to check out. My uncle, the baby, and I spent our first weekend in Portland. I’ll write about that and my first week back seeing patients in the next post (which hopefully will be next weekend…truly, I hope). If you have any suggestions of what I need to see, eat, do, or experience in Oregon, PLEASE let me know! I’m here for 7 months and I want to explore!

mfg

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Locum

From Sea to Shining Sea

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Originally, I thought I would be starting a new job this week. I’m so happy I’m not. It was a bit of a rollercoaster ride getting here though!

{Bridge near where I was living in Germany}

The Search

Often, with locum work, a job is found and agreed upon a few months prior to the start date. I work with two locum agencies. Doing so provides me a broader range of job offers. I told my recruiters that I would like to have a job near my mother in Ohio for September through December and starting January 2022, start traveling again.

One of my recruiters reached out in April with a job offer in Oregon. We presented me with a start date in January. Simultaneously, we were looking for a job for Sept-Dec.

Ohio Option #1

One of the first offers was an outpatient position about 3.5 hours from my mother’s place. I offered 4 days a week instead of 5. They countered and asked if I would work 3 days. Heck yes! More time with my child? I’ll take it. They offered to pay for a hotel as our accommodations. I found an Airbnb in the area and suggested that instead. That way, I could get set up in one place for the duration of the contract. Now that a child is in the picture….so is their crib, diapers, toys, etc. I did not want to move all of that every week. I also didn’t really look forward to a 3.5-hour drive twice a week but I did like the possibility of a 3-day workweek.

Ohio Option #2

While option 1 was being discussed back and forth, my recruiter from the other company reached out with an urgent care option 3.5-hours in a different direction from my mother’s place. They were looking for a physician to work 8-10 twelve-hour shifts a month. I figured I’d at most want to do four shifts in a row. That would cut down the 3.5-hour drives from weekly to about every other week. More pros included fewer workdays, freedom to create my schedule, and a higher hourly wage.

This option moved quickly and within a few days, I had an interview. The interview went really well. They even actively helped me look for child care options. I started filling out paperwork for credentialing and handed in the days I wanted to work in September. However, a few days later, they decided that they only needed night shifts covered. … Well obviously that wasn’t going to work.

Ohio Option #3

While option #2 was falling apart, my recruiter was already working in the background to find a backup option. Usually, hospitals or clinics reach out to the locum company with a need for a doctor. However, my recruiter and her co-worker flipped the script and started reaching out to clients around Ohio. A clinic 50 mins away took the bait. At this point, I was already in Germany. So instead of telephone interviews, we did Zoom calls to avoid international charges.

The first interview was with the CEO and COO. It went well. The second interview was with the medical director. It went well also. A few hours after that interview, the medical director called me back and asked if I would seriously consider a permanent position. I told him that I am a traveler and I could commit to four months. They were looking for at least a 6-12 month commitment. With that, this option was over.

{Stade, Germany}

Many, many options

After option #3 fell through, I reconnected with my agent from the first agency. I had told her about option 2 when it seemed like that was going to happen so she didn’t need to continue looking for Sept-Dec. Since we weren’t finding an option in Ohio, I opened up our search to everywhere. Within a few hours, I had so many options emailed to me. There were offers including New Mexico, Colorado, New Hampshire, Kansas, and Washington. I really liked the Washington offer but getting a license in Washington can take several months.

Simultaneously, my other agent really wanted to get me placed somewhere (I’m pretty sure they get paid a commission for placing physicians). She called me with an option in Indianapolis. I got really excited because one of my best friends and former co-resident/roommate lives and works in Indianapolis. The office looking for a locum was located RIGHT NEXTDOOR to the office of my friend! I was so excited.

An interview was scheduled a few days later. I know I mentioned that the other interviews went well but this one didn’t only go well, it was also a lot of fun. I instantly connected with the ladies. The work environment they described sounded great: a very diverse patient population with many non-English speaking patients. I like caring for patients from different cultures and working with translators. My friend and I discussed all the fun we would have if/when this option worked out.

Of course, the Indianapolis job was just too good to be true. They wanted me but there was an issue with licensing which wouldn’t allow me to work there in time.

{Stade, Germany}

Running the numbers

After the Indianapolis job fell through, I decided to run some financial numbers to see if I could afford just not working for the remainder of the year. Having saved most of the money I earned in South Dakota, falling into a lower tax bracket if I didn’t make any more money this year and that freeing up the money I had put aside for taxes, I was fortunate enough to be able to afford to extend my maternity leave!

If the perfect job had presented itself (the Indianapolis job was indeed my favorite), I would’ve liked to be back in the office seeing patients. My mom guilt would likely be a bit reduced for a job I truly enjoyed rather than just working any job. I definitely could have found just any ole job if I wasn’t the one being so restrictive. However, I refuse to work more than 4 days a week while my child is so young. I didn’t want to go to such a remote area that child care options weren’t available. Additionally, I wanted to be somewhere new and not work somewhere I’ve worked before. I’m grateful that I am in a position to be that picky.

So, I have extended my maternity leave through the end of the year! I’m back in the US for a few weeks before heading back over to Germany until shortly after Christmas.

{Altes Land, Germany}

2022

The job I mentioned at the beginning of this post, the one in Oregon, worked out! I am scheduled to work in a Family Medicine Clinic four days a week starting in January through July 2022. I’m currently in the process of finding an Au Pair to come live with us.

I am beyond excited to spend a few more months full-time with my child and family/friends. It’s great that I have new adventures to look forward to in January.

The process of finding a locum contract might seem messy and stressful. However, I actually find the journey rather exciting and thrilling. It can definitely be an emotional roller coaster to imagine yourself in various places from coast to coast in a 24 hour period. The process is not for everyone. But as of right now, it’s exactly what I want and need.

mfg

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Locum

Wrapping It Up

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As this month comes to an end, so does my assignment out here in South Dakota. It seems like 6 months flew by!

Svikki MD

The past two weeks have once again been a mix of hospital work and jumping in at the clinic several days. On the floors, we had a lower census for most of the time. That changed some with three admissions at once Friday afternoon and an admission yesterday bringing our census to eight. For my friends who work in large hospitals, a census of eight sounds like nothing. It’s 2/3 of our capacity though in our little critical access hospital with 12 beds.

Walking in halls filled with history

I was given the opportunity to have a look at the unfinished document that will become a booklet about the history of medicine in the Black Hills. Although I work in a small critical access hospital, this particular one has a pretty interesting history. Deadwood and the neighboring town Lead are at the center of what once was the Homestake gold mines. With an influx of people looking for gold followed an influx of nuns and doctors looking to take care of the people working in the mines and the towns. Multiple hospital buildings have existed over the years, each growing in size and sophistication with every new building/renovation.

At one point, everyone in the area wanted their healthcare performed in my current hospital because healthcare was free to the people working for Homestake. They would have a copay if they went somewhere else. One of the docs I work with has told me stories of how he assisted in his patient’s open-heart surgeries, orthopedic surgeries, delivered uncountable babies, and did all kinds of procedures. A real badass doctor if you ask me! I’m sure that was a super interesting time to be working as a doctor. Kinda bummed I missed out on it!

After the Homestake mine closed, more and more business left town, and it’s down to a skeleton crew in the hospital these days. Babies are only delivered if they show up in the ED. Endoscopies and vasectomies are the extents of surgery. A few specialties are located in Spearfish, a 20 min drive away. Most are located in Rapid City, however.

Reflections

Looking back at the six months of my time here, let me share some thoughts.

The Medicine

Medicine is the reason I came here. Having worked in University Hospitals and a fairly well-sized hospital during residency, it was definitely a change of scenery coming to a critical access hospital. People here are more independent than a lot of their counterparts in larger hospitals. That is because they have to be. In large hospitals, specialists get involved quickly and patient care gets divided up amongst multiple consultants. That definitely has pros and cons. Ideally, it gives you more specialized care. For the primary care provider coordinating the care during a hospital stay, it sometimes feels like coordinating multiple chefs in a kitchen, however.

Here, the providers in the ED and clinic have to make a decision early on: can we handle this here or does it need to be shipped out. That decision takes into account staffing, therapeutic possibilities, and the need for specialized consultation. I’ve had some interesting case presentations come through but we had to transport the patients to Rapid City because our facility was not appropriate for the care. As a doctor, you miss out on managing some interesting and more complex cases because of it. When they do stay, however, it’s you managing everything which is a good experience to have.

The ED is staffed by mid-level providers (Physician Assistants and Nurse Practitioners). I have respect for the work they do. It is them and a nurse on shift and one of us docs on call as back up. They assess, stabilize and transfer patients to the appropriate level of care. I respect the stabilization part of that the most. Patients can come in in cardiac arrest or as trauma patients and they have to stabilize the patient for transport. That is a lot of responsibility. There are some great providers working in that ED and I’ve enjoyed helping them out and learning from them during the past couple of months.

The People

The majority of people I have encountered here have been delightful and friendly. They are down-to-earth and easygoing. Many are interested in my thoughts of the area and they feel proud about what the area has to offer. Due to the pandemic, I did not socialize with anyone outside of work.

When I initially arrived, the Covid-19 virus was just starting to pick up in the community. I became very frustrated with “the South Dakotans” because I saw masses of mask-less people in the restaurants/bars/casinos on my drive home, mask-less people in the grocery stores, ads on the radio for parties on every holiday. I had several encounters in the clinic with people who contracted the virus and either didn’t want to believe it or didn’t want to be tested. There were even some very unpleasant encounters where it took a lot of strength to remain professional. Announcements from the state’s governor and establishments not following CDC guidelines added fuel to my fire.

Then I started noticing how many people were coming in to get their influenza shot. Once the Covid vaccine became available, I saw how high the demand was. I noticed how afraid many patients were to come to the clinic because they were isolating at home. I realized that the people I called “the South Dakotans” and was mad at, did not represent all South Dakotans. There is a large proportion of sensible people here, I just wasn’t seeing them because they were staying home, avoiding crowds, and using telemedicine for their healthcare to reduce their risk of exposure. Additionally, I realized many of the maskless people and people in crowds weren’t even from here! They came from out of state due to the relatively non-existent restrictions.

So, I apologize to South Dakotans for generalizing my frustration at first and thank you to those who have been helping combat this pandemic.

The Area

Talk about wide-open spaces! From the Badlands to the Black Hills, the landscape is beautiful out here. I would’ve explored more of it had it been the other 6 months of the year that I was here. I got a few nice hikes in at Spearfish Canyon when I first got here. On the two occasions I had visitors, we explored various national parks that supplied us with grand views and up-close encounters with wildlife. Again, if it weren’t for the pandemic, I would’ve looked into doing more things like finding some horses to ride, festivals to attend, and maybe would’ve checked out the notorious Terry Peak mountain that has supplied us with so many orthopedic injuries.

Since the weather has gotten warmer on occasion over the past few weeks, I’ve really enjoyed going on hikes at Lookout Mountain in Spearfish. I don’t overdo it or wander into the forest too deep since I’m by myself. I know I haven’t even begun to see what the area has to offer on trails. I’ll have to come back in the summer months and with some friends or family to explore some more.

Speaking of wide-open spaces. The area was featured in the movie Nomadland (streaming on Hulu and nominated for various awards). It’s worth watching. If you watch it, pay attention to the hospital scene when the characters are in South Dakota working at Wall Drug and one of them gets ill. The nursing station you see at 57:21 is the place I work at! Shout out to nurse Courtney and PCT Karin for making it into an Oscar-nominated movie (their names are seen on the board in the shot).

The Culture

Not to sound like a broken record, but the pandemic sort of ruined this one for me. I really wanted to learn so much first-hand about the indigenous people of the area. Due to the pandemic, museums, attractions, and reservations were closed. I did read a few books which helped me gain a little insight into the Lakota culture. The books helped me understand some of the things I saw at Crazy Horse Memorial and in the Adam’s Museum. I wanted to immerse myself so much more though. I had several Native American patients and some did share insights but I did not press others for information. They were there to heal, not to educate me.

I also didn’t experience much of the Cowboy culture you might expect out here. I did have some tough-as-rocks ranchers as patients though. One is a nonagenarian lady and is tougher than several 30 something year olds I saw. I’ll have to come back to get on a horse and ride out on a ranch sometime.

The Coworkers

This is truly the saddest part about my assignment being over here. The people who work in this small hospital and clinic have been amazing. They took me up in their work-family and made me feel exceptionally welcome. Over the months, I got to know the majority of the people working in the hospital and know everyone in the clinic. I was invited to Thanksgiving and Christmas family dinners. I received flowers on my birthday. They even organized a get-together tomorrow afternoon in the clinic in my honor before I head out later this week.

I’ve had some great laughs with the people here. We’ve worked through some tough cases together.

I have to move on because my wanderlust demands it and the next job is lined up to start in the next couple of weeks (more details about this once the start date and details have been solidified). Aside from that, I definitely could’ve continued working in this environment. So, thank you to everyone in Deadwood and the greater area for making my time here great despite it being during a pandemic. I look forward to coming back in the future to visit, explore, and catch up!

mfg

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