I officially wrapped up my first assignment as a locum physician! It was a great experience and I am glad I headed out to South Dakota for 6 months. Sure, it would’ve been even nicer in a non-pandemic world but even with a raging pandemic, I had a really good time.
On my last day in front of the critical access Lead-Deadwood Hospital
Each assignment I do will teach me new things about life, medicine, travel, people, and so much more. Even though it was only my first assignment, I’ve learned a few things for future assignments.
Luggage: I arrived at the airport in Rapid City back in October with a full suitcase, a full weekender bag, a full carry-on suitcase, and my purse. I left with the same amount of luggage. However, I shipped three medium-sized boxes of stuff to my dad’s and mom’s places. I really didn’t buy much on my own (except several books) but with Christmas and my birthday occurring during my assignment, a few extra items accumulated. Lesson learned: leave some breathing room in your luggage on the way there to allow for room for items that will accumulate.
Wardrobe: I packed about two weeks’ worth of business casual clothing. Only a few items were for casual wear. I really should’ve asked what the dress code was, especially during a pandemic. I ended up wearing scrubs to work every day! At some point, I stopped wearing my fancy Fig scrubs because I didn’t want to have to run to the laundromat and do laundry constantly. So I wore hospital scrubs daily. I could’ve left all those business casual clothes at home which were most of the contents of my large suitcase. Lesson learned: inquire about dress code. If business casual is required, curate a week’s worth of wardrobe that mixes and matches to minimize items packed.
Textbooks: I packed about 6 medical textbooks with the intention of working through them during the 6 months. I at least opened each book, some more than others. It was too many options though. I also packed several reference books. As you can imagine, this led to a pretty heavy weekender bag. Lesson learned: focus on 1 or 2 books to work through so it’s more realistic it’ll be done. I found that many of my reference books come with online access, so I activated them all and can access them through an app on my phone or computer in the future instead of schlepping them with me! Also, UpToDate is usually my first stop anyways… if you know, you know.
Hobbies: similar to my textbook situation…I packed too many different art supplies: acrylic paints, watercolors, India ink pens, pastels. When faced with too many options, it felt intimidating to start anything legitimate. I did use some of the items for Christmas and Birthday cards but not enough to justify packing all those things. Lesson learned:limit art medium to 1 or 2 options and focus on improving those skills during the assignment.
Family Time
Due to the pandemic, friends and family weren’t as free to come to visit me in South Dakota as they otherwise may have been. Two friends did make it out and I am grateful for that. It was fun showing them the area. Now, I’m happy to have some time with my family before my next assignment starts.
Dairyland
I flew to Wisconsin from South Dakota to visit my father and his wife. It also happened to be Easter weekend so my father’s wife’s children plus partners came to visit. It was a great feeling being surrounded by a fully vaccinated crew of people (except the two small children… but children probably won’t have to wait too much longer to get vaccinated hopefully). The weather was gorgeous and we even went on a boat ride on the lake. I stepped into my role as Easter bunny once again (it has been a while) and hid the eggs for the kiddos. Being able to sit around a table and have conversations with people was so lovely.
After that weekend, I headed towards Ohio. I made a pitstop for the night at my friend/co-resident’s home about halfway along the route. She has an adorable golden retriever that loves to cuddle… bliss!
Buckeye State
Now, I’m spending time at my mom’s place in Ohio. We’ve had a couple of days of really nice weather. I’ve already visited my peeps at my residency. It in no way feels like I graduated 8 months ago. Talking with the other residents about their clinic schedules, I can still very viscerally feel the anxiety associated with 15-minute appointments, precepting, and trying to stay sane. It gets better, my friends!
My mother and I did a little Goodwill run yesterday. I’ve mentioned before how much I love thrift stores. The environmental benefit of reusing clothing, the wallet-friendly prices, and supporting local organizations are just a few of the perks. It’s also so fun not knowing what you’ll find! I found a viscose H&M dress that still had the original tag. The original cost of that dress was more than I spent on my whole purchase. The other purchases were a beautiful rayon jumpsuit from Lucky Brand, two super soft cotton tank tops from Old Navy, and a cotton pajama set from Victoria’s Secret. At retail prices, that would all cost at least $190 (estimated from a quick online search of comparable products on the company websites). I paid $27 for everything. Each piece fits perfectly into my existing wardrobe and fills a void.
I would rather go thrift shopping than go to a mall any day! Macklemore, hit me up!
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!
The past two weeks were quite busy. Apparently it showed in my face since a pediatric patient told me I looked tired during our encounter. Gotta love children’s honesty.
Svikki MD
March Week 1
The first week of March, I spent most of my time in the hospital. I had a quiet call on Tuesday. We cleared house pretty well throughout the week as many of my swing bed patients were either discharged to nursing homes or were able to go home. Wednesday, I gave a virtual lecture about fatigue to the South Dakota Academy of Physicians Assistants via Zoom. Thursday, I had another STEM mentoring meeting… also via Zoom. Due to some shortages of staff in the clinic, I helped out Thursday and Friday afternoon. The other Family Medicine doc was headed off for a week-long vacation and signed out an acute care patient to me on Friday. This bought me the second weekend in a row of coming in to see patients.
March Week 2
This past week was even busier. Since we had cleared the house the week before, we were due to increase our census again. A few of those swing bed admissions didn’t arrive from Rapid City until about 4 or 5 PM, which kept me there late to see them and get all the orders placed. On Wednesday, they were short providers in the clinic and I headed over to help out with walk-ins. On Thursday, one of the clinic providers had to go home due to their child being sick. I discharged a patient and saw two of my inpatients and then headed over to the clinic at 9 AM to see walk-ins for the rest of the day.
As so many times before, there was a walk-in at 4:45 PM for a skiing accident from the nearby mountain. They reported the accident had happened within the hour….it is odd how these accidents keep happening right at the closing time of the mountain at 4 PM. This late walk-in again necessitated a nurse to stay late with me and the radiology tech to stay late for imagining. I was pretty sure the bone wasn’t broken when I saw the image but I always wait for the official radiology read to be sure. It wasn’t broken. I let the nurse leave to get to an appointment she was running late to and ace wrapped the injury myself and got the family out of the office by 6 PM.
I drove home to have dinner and spent the rest of the evening finishing up charts from that day (I hate carrying unfinished charts over to the next day).
A Holiday Weekend that didn’t need to happen IMHO
Friday is really when the madness started. This past weekend was St. Patty’s Day weekend in Deadwood. It is essentially a huge drinking festival all weekend. Although I was told it was a bit scaled back from the normal due to Covid, the radio ads for the pub crawl and party announcements made me think it still wasn’t going to be low-key. I was on call all weekend and I feared I would be called in because the ED would be overrun by drunken people. Luckily, they doubled up on ED providers for the weekend. I started the day with discharging a patient and then had two swing bed admits lined up to arrive.
After the first had arrived, the ED called regarding an intoxicated patient that needed admission. Simultaneously, I was trying to field several prescription requests that were pouring in Friday afternoon. I was the only doctor in the hospital and clinic that day and I was on call, so I got all of the patient messages and prescription requests. Many of them were for controlled substances….which aren’t quick click-of-the-button refills. I make sure the refill is appropriate, check drug monitoring programs, calling pharmacies, and having to decide the minimum amount I can prescribe them so that their primary care doctor can continue the refills if they deem them appropriate. That all takes some time.
In the midst of all of that, I received a text from the office asking if I could come to see patients because two of the three mid-level providers that were working that day had to go home. They were either sick themselves or had a sick child. That left only one mid-level in the office. I was able to find an hour to pop over and help out before the clinic closed. Afterward, I still had my second swing bed admission to take care of. The acute care admission bought me my third weekend in a row of rounding.
Saturday
Throughout Friday night, I received several calls from the ED to go over patients. Saturday morning, the calls from the hospital started regarding the intoxicated patient. The treatment plan wasn’t working properly. I was on the phone 4 or 5 times before I quickly hopped into the shower before heading to the hospital. A call came in the middle of shampooing my hair. I thought it was the hospital nurse again and it would be a quick call. However, it was the call center and a patient’s daughter wanted to speak to the on-call provider. So I hopped out of the shower, shampoo in my hair and dripping wet to go grab something to write down some information. For the next 10 minutes, I was dripping all over the floor while taking care of the call. I quickly finished my shower afterward and headed to the hospital.
For the next 5 hours, I worked on adequately managing the patient going through withdrawal. I was able to take care of a few other tasks with other patients in that time as well before finally going home. I was exhausted and took a nap. My first nap in a really long time.
Sunday
Last night was also interrupted a couple of times with calls. Needless to say, I didn’t feel particularly refreshed this morning. Luckily, I had implemented a functional plan for the withdrawal patient and didn’t receive any calls related to them. I spent a few hours this morning in the hospital and then returned home for another power nap. Since then, it’s been pretty quiet.
Indecisive weather
The weather has been sort of wild these past two weeks as well. During the first weekend, it was 68 degrees Fahrenheit! I went on a beautiful hike at Look Out Mountain in Spearfish. Over the past week, the temperatures have dropped again and as I type this, a winter storm is moving in and it’s snowing out with multiple inches expected to fall.
One thing I love: Working with great nurses. It’s been busy and I’ve worked with some great nurses to get through it. Experienced nurses are such a valuable resource for physicians, especially new grads. We also laugh a lot together which makes the work environment so pleasant here.
One thing I ate: Coconut Miso Ramen from Purple Carrot… nothing like slurping down delicious Ramen in between seeing patients to keep you going!
One thing I’m grateful for: the vaccine rollout going as well as it is and President Biden’s announcement that all adults will be eligible to receive the vaccine by May 1st,… Hallelujah!
Unlike Ariana Grande, I’m not referring to men. The past two weeks have been rather uneventful. It all seemed rather routine… which is also why I’m starting to itch for a change of scenery.
Svikki MD
My patient census number has grown a bit over the past two weeks. There was a steady turnover of patients, nothing too stressful. There were definitely some characters in the mix but for the most part, the patient panel was nice. I was out on time most of the days. A few evenings, I stayed late helping out in the clinic.
Weight-based everything
I had my first pediatric admission this past Friday. I had gone over to the clinic around 3 PM to help the nurse practitioner with a patient. Then, there were a couple of late walk-ins so I offered to see them. That kept me busy until about 6 PM. On my way back to my hospital office, I ran into one of the nurses. She was telling me that they might have an admission. I inquired what the case was and she told me it was a child. My follow-up question was who the physician on-call was. It was one of the internists. I told her they probably wouldn’t be allowed to admit, Internal medicine takes care of patients 18+ years of age. Family medicine sees all ages.
I made a call to the regional president to ensure that I had pediatric admission privileges. Turns out, I do. So then, I had to make sure I had nurses that felt comfortable with a pediatric patient. Once that was all in place, I went and assessed the patient for myself. The orders took a while to enter because medications and IV fluids for pediatric patients are weight-based. Since I don’t admit pediatric patients often, I double-checked every order.
By the time this was all done, it was 8 PM. I drove home to eat some dinner (Girl Scout cookies are not an appropriate dinner… that’s all I had around in the hospital). The admission History and Physical note was submitted at 10 PM and I was spent.
The late evening Friday acute care admission also won me a weekend of rounding. Luckily, kiddos are usually pretty quick to turn around and the patient was ready to go home by Saturday afternoon. That spared me a trip to the hospital today.
Change of Scenery
I’ve been on this assignment in South Dakota for 5 months now, I have one more to go. A workflow is in place and I know most people at the hospital and all the people in the clinic. The work environment is lovely and my co-workers make my job enjoyable. So, now I feel like I’m ready for a change.
I don’t know how much the pandemic plays into this itch for something new. If life was like the “before times”, I would probably be visiting the local movie theater every weekend (one of my favorite activities during residency besides horseback riding). However, I’m not a bargoer and I hardly eat out, so that wouldn’t be any different. Maybe I’d visit a few more of the local museums and attractions if it weren’t for the pandemic.
The major difference in activities would be traveling. If I could take a trip once or twice a month somewhere, I probably wouldn’t be antsy. With the pandemic and (necessary) restrictions currently still in place, that’s not the most feasible option.
Moving forward, assignments that are 4-6 months will probably be ideal depending on workload and where they are. I’m really trying to go to Hawaii for locums and am willing to go there for a year. People have warned me of island fever, and maybe I’ll regret my current stance, but there are many islands to keep me occupied. I’m willing to take that risk 😉
One thing I love: Sunny days after snowfall. We hardly had any snow on the ground last week and then overnight, several inches of snow came down. However, it’s sunny and lovely out today! I’ve already been on a walk.
One thing I ate: Samoas and Tagalong Girl Scout cookies. As a former Girl Scout, I had to support the cause… and my occasional sweet tooth.
One thing I’m grateful for: Books. I feel there is such a slump in interesting shows to watch. Not that there is a lack of content, just a lack of content that interests me. I bought Bill Gate’s new book How to Avoid a Climate Disaster yesterday and look forward to having it on rotation with my medical and finance books!
For all those people who want to start singing “I’ve been looking for freedom” to me
Greetings from what feels like the arctic! With temperatures as low as -18°F/-28°C this past week, South Dakota, like much of the country, has been a bit chilly. Next week we should maintain above 0°F at least. We didn’t get nearly as much snow as other places though. The roads have been decent for the most part (thank goodness for the SUV with 4W drive). Getting into the car in the morning feels like sitting down in a freezer. The condensation from my breath was freezing on the inside of my wind shield!
Reminiscing about last week when socks were optional
Svikki MD
Maintenance was nice enough to install a heating element in my office space this week. The existing heating structures weren’t functional anymore. Unfortunately, I’m not sure the new heating element ever actually started working. Luckily, I wear multiple layers of clothing to work to keep me warm.
Patient numbers were down, across the region, this week. I did have a few new swing bed admissions but for the most part, it was rather quiet. I helped out in the clinic a bit as well.
Casual morning commute in -13°F/-25°C weather
There is a skiing/snowboarding area just 8 miles from work. Something really strange must happen around 4 PM up there. We will start seeing walk-ins to the clinic for ski/snowboarding accidents around 4:30 PM. We had 3 of them Friday evening. Of course they aren’t all tipping over and hurting themselves at 4 PM… the ski lifts close at 4 PM. So, they will fully maximize their ski pass and then head to the clinic. By the time we see them, have X-rays done, wait for the X-ray reads, consult with ortho for broken bones and splint them… it’s 7 PM.
As a locum provider with nobody waiting on me at home, I don’t mind the extra hours. I do feel bad for the rest of the crew though. They have kids to pick up, family waiting at home and have to work overtime. All because people don’t want to leave the lift at the time of injury.
Weekend To-Do List
I make myself a weekend to-do list just about every weekend. It gives me a structure of what I want to accomplish over the next 48 hours. This weekend, it included items such as Hawaii Medical License research (since I reaaaaally want to work there some day), looking over my finances, doing laundry, working on a presentation for a conference in a few weeks, and getting my taxes done.
As a locum physician, I am an independent contractor. That has led to me needing to learn some things about taxes I didn’t need to know as an employee. I’ve learned how to pay estimated quarterly income taxes on the federal, state and local level. That is because as an independent contractor, my paychecks have no taxes deducted from them. Which means, I need to pay the government income taxes quarterly. There are certain deductions I can make that an employee can’t. But I also have to pay taxes an employee doesn’t, like the self-employment tax. Having been both an employee (as a resident and part time faculty at Youngstown State University) and an independent contractor last year, I had to learn to cover both bases.
Working on my financial education
I actually really enjoy working with numbers. Every Friday, I go over my finances after receiving my paycheck. The money is allocated to savings accounts for various purposes. The largest portion is put aside for those quarterly tax payments. I only allow myself to use 12% of my paycheck. Almost everything I purchase is bought with a credit card to earn points/cash back. I pay off the standing balance every week. Whatever is left of those 12% after paying off the credit cards is mine to use. I continue to live almost as frugally as I did as a resident, so a portion of that money still ends up in savings.
I’ve been reading books lately about investing as that is something I definitely want to get into soon. Unfortunately, financial education is not something that is well integrated into our public education system,… although it totally should be! (As should more home ec classes… I mean “Family and Consumer Science” classes as they are now called apparently.) So, I am continuously trying to further my own financial education.
Lit List
Some of the books I’ve read and really enjoyed so far include:
Rich Dad, Poor Dad by Robert Kiyosaki
The Millionaire Next Door by Thomas J Stanley & William D Danko
Cash Flow Quadrant by Robert Kiyosaki
The ABCs of Real Estate Investing by Ken McElroy
I’m currently working through Robert Kiyosaki’s Rich Dad’s Guide to Investing and Ken McElroy’s The ABCs of Buying Rental Property. The goal of all of this is to be informed and someday achieve financial freedom. That financial freedom will then give me the freedom to spend time with family and friends, work when I want to and free up enough time so that I can work as a doctor in various parts of the world in underserved communities while not getting paid for that work.
Have you read any great personal finance books? Please do share! Leave a comment below with the title so I can check it out!
The INSIDE of my kitchen window
One thing I love: FaceTime. It just really makes long distance not feel so long at all <3
One thing I ate: vegan chocolate mug cake,… throw a few ingredients in a microwavable mug, stir it up and microwave for a minute to enjoy. Far less mess than making a whole cake and fewer tempting calories lying around.
One thing I’m grateful for: having a warm place to live. The temperatures are crazy low across the country. I hope people who don’t have a warm place to live are finding enough safe places to stay warm. Unfortunately, I know that’s not the reality for everyone.
The last week of January was less eventful than the one before. There wasn’t so much unsolved mystery surrounding my patients. I did end up having to transfer one of the patients out to a higher level of care hospital in the middle of the night though. We had hit the point where we were no longer able to escalate our care in our facility.
Beyond that though, I was preparing my patient panel to be handed off while I take a week off. I was supposed to be going to Brazil for two weeks for a friend’s wedding but,… you know…. the pandemic. So instead of taking two weeks off, I just decided to take off one to visit my family back in Ohio for a few days and increase my Vitamin D level in Miami for a few days. As always, I try to do everything (short of not going) to reduce my risk of exposure during a pandemic. I try to be as diligent as I am in the hospital out in the real world. That means wearing my N95 during the entire duration of the flight, sanitizing high-touch surfaces, frequent hand washing and sanitizing, and distancing myself as much as I can from others around me.
Brrrr…it’s cold out here
I thought my winter in South Dakota would be heavier than winters in Ohio. Thus far, that hasn’t really been the case. Ohio winters are unfortunately very grey. One of the first things I looked up when I was considering South Dakota as an assignment was the days of sun during the winter. Lucky for me, I found that they averaged more than they did in Wisconsin (a winter location I tend to enjoy) and way more sun than Ohio. I arrived in Ohio shortly before the snow began to come down. Nothing close to what Chicago and the North East were dealing with but it laid a pretty nice blanket over the area. I certainly got my share of winter feeling in during the few days there.
While in Ohio, I stopped by my residency to say hello. It’s crazy to me that graduation was already 5 months ago. It sort of feels like I’ve just been on an away rotation. It felt so good seeing my residency family again; the front desk ladies, the MA’s, the residents, and the attendings. I’m really fortunate that my residency is such a lovely place to return to. I know many people do not have enjoyable residency experiences. The crew in Boardman, Ohio is definitely a special group of people.
Hello Sunshine
I have visited Miami countless times. These trips started during medical school when a German friend and I would fly to Miami and stay with one of my friends in Miami. Some of those trips were pretty wild and served up almost all the components of a good rap song. My Miami Friend has become one of my best friends over the years. I can’t thank her enough for her hospitality, kindness and generosity over the years. We have met up in several places around the world and I can always count on her to be down to travel somewhere. More on her in a bit.
Miami is open
In terms of the pandemic, Miami felt quite different from the places I have been spending my time at over the last several months. People are out in clubs, restaurants and bars like the pandemic doesn’t exist. To their credit, most people I saw walking around in public places were wearing a face mask. Miami also has the advantage of the weather and outdoor venues which are safer in regards to viral transmission than being indoors at a restaurant in say, South Dakota.
However, I still avoided the masses. My friend and I were mainly at her place. We spent an early morning on the beach when there was hardly anyone else around. The Rubell Contemporary Art Museum that we visited had limited visitors. If we ate at a restaurant, it was outdoors and well spaced from other guests. The days of going to the big clubs packed like sardines has been over for us for a while now, so I didn’t really miss that former staple of a Miami visit.
Keith Haring at the Rubell Museum in Miami
It was nice to spend a few days with family and close friends after not having much of any social interactions in South Dakota over the past several months. At the same time, I look forward to returning to work tomorrow in Deadwood. I’ve only got 7.5 weeks left of my assignment in South Dakota and I am sure they will fly by.
The Web
I often like to reflect on my life thus far and the experiences I’ve been fortunate to have. This often happens when I am on trips. It’s fun for me to run through the sequence of events that led me to that particular moment, that connection with someone, or the opportunity that presented itself.
Let’s take my Miami Friend as an example. Because of her, I have had amazing life experiences, met fabulous people I now call my friends and opportunities that I would not have had without her. But what needed to happen for me to meet her?
The Origin Story
Well, when I was about 14-15 years old, my younger sister and I did a photoshoot at home for fun. I showed the pictures to my father who suggested I research local modeling agencies to see if that would be something I could pursue. The Rock Agency in Madison Wisconsin is what I found. I called them and set up an appointment with their New Faces Director. After a short introduction of the agency for all people present at the New Faces Open Call, I met with the New Faces director individually. She saw potential and had me set up my first photoshoot. [The agency owner is one of my best friends now and she has created a whole web of connections and experiences in my life as well.]
My first photoshoot was a blast. I ended up befriending the photographer and make up artist and my family’s home was used as the location for a modeling shoot a few years later. Following the first, I had another photoshoot to build up my portfolio. Then, I was invited to attend a modeling convention in New York City that summer called IMTA. It’s a huge convention with hopeful models and actors from around the United States that participate in various competitions that are judged by model and acting agents from around the world. This lead to my first modeling contract in Milan. [I met one of my other best friends on this first contract in Milan, so our friendship’s origin story is the same up to this point.]
Photographer: Jeff Wilson || Make-Up: Anja Epkes
Ciao Milano
Two years later in 2008, I was back in Milan for my second contract. I was originally put into an apartment with a bunch of girls. However, I quickly befriended one of the other models from the agency who was living in a 2 model apartment in China Town. This model was my now best friend from Miami. We orchestrated a switch between her roommate and myself so that we could live together (the agency wasn’t very happy with us when they found out we did this without telling them…oops.) We would cook together, shop together and travel to other Italian cities. After our contract, she went back to Miami and I returned to Wisconsin. The only connection we continued to have back in that era was being friends on Facebook.
This is easily where our story could’ve ended and my life would be completely different if it had. Seriously, I could draw up a whole web of how many of the major experiences in my life and opportunities that I have had would never have happened the way they did if it wasn’t for having met her in Milan.
The Reconnection
Luckily, it didn’t end there. It was several years later, in 2013 while I was in medical school and wanting to do a bit of modeling on the side, that I had to fill out a form listing agencies I’ve worked with. I couldn’t remember the one we were with however, so I facebook messaged her. We briefly caught up on what the other one has been doing over the past several years. In this conversation, she recommended I come visit Miami if I ever needed a vacation from medical school. In 2014, I took her up on that offer. A German friend and I visited her for a week.
Welcome to Miami
My Miami Friend had worked in nightlife for years. At the time, she was working in the hottest club there was, LIV in the Fontainebleau Hotel. You know, one of the only clubs you will find multiple rap/hip-hop songs referencing? The club that gave the world LIV on Sunday which was THE place to be seen as a rapper or hip-hop artist. Depending on the night and who was performing, the admission rate to the club for general admission was upwards of $300. The amount of money spent on bottles of champagne or just thrown in the air to make it rain was insane. Yes, she worked there.
She introduced my German friend and I to the best nights of our lives. We were introduced to all of her friends who worked at LIV as well. Having worked in nightlife for so long, she had vetted her friends so the ones I ended up meeting and becoming friends with were all awesome, kind and genuine. (Kind and genuine is not always easy to find in a setting like Miami, so I was fortunate that she had done the weeding out beforehand).
The Miami Crew
This group of amazing people not only made sure my German friend and I had nights we will never forget, but they also kept us safe. We were only ever introduced to other good people. The bottle girls, bartenders, security guards, managers, promoters and bus boys I was introduced to became my second Miami family and LIV became my second Miami home. I could walk into a full lobby of people waiting to get into the club, bypass them all and be greeted by my name by the bouncer and let in. It felt unreal.
All thanks to my Miami Friend. And it didn’t stop at LIV, the people who worked there were wildly connected to other people working in Miami which led to great nights at other clubs, comps at restaurants, sporting events and concerts. I was given the opportunity to experience Miami totally different than your average Miami tourist. I can’t even list all the artists I saw perform live at LIV of Sunday but to name a few; Drake, Lil Wayne, Chris Brown, 2 Chainz, Fabolous, DJ Khalid, Trey Songz and so many more. Thanks to the girls, I always had VIP access and drank the yummiest champagne. I’ve partied at the same table as Lil Wayne. I’m telling you, Miami was a different world back then and I am so grateful I was invited into it by my Miami Friend.
Beyond the party
It wasn’t only partying that she made possible for me, through meeting her friends and becoming friends with them myself, many experiences and opportunities started to branch off of me knowing her. After graduating from medical school, I took a year off before starting residency. My goal of that year was to work in a job that made good money so that I could travel around the world for about 4 months prior to starting residency.
Where else in the world would I go but Miami for this?! I knew the greatest people who knew the right people. With the help of my Miami crew, I secured an interview and subsequently job at the second place I worked and ultimately exclusively worked at, Hyde Beach Miami. I’ll share more about that year in particular at a later time but that year created a multitude of new connections, friendships and opportunities for me. For instance, because one of my friends in Miami invited me out to dinner one night with some of her friends, I met my now friend who helped me plan my one-of-a-kind 3 week trip to India! One of the greatest trips of my life! The web is big, my friends.
Moving on
Over the past several years, I often visited Miami as a little get away from residency. As my Miami Friend transitioned from night life to becoming a manager of an Art Gallery, my visits transitioned to a more feasible wake/sleep schedule. Many of our friends also transitioned out of night life into other careers. So instead of spending our nights in the clubs and sleeping all morning, we were meeting up with friends for brunch, visiting museums and traveling to other parts of the country and the world.
My Miami Friend was the first one to visit me in South Dakota. We met up in New Mexico for New Years last month. I’ve celebrated my last three birthdays with her; three years ago in Miami, last year in Tulum and this year, a bit belated, in Miami again. We are already contemplating when we will see each other again and look forward to the world being safe again for international travel. We have quite the extensive bucket list to work on.
Photographer: Dylan Rives
There are so many stories in between that saga that I didn’t even mention. But for me, I trace all of those experiences in my life back to the moment my parents encouraged me to look into finding a modeling agency. You just never know what an experience in life will bring you, so don’t miss an opportunity to do something new, you have no idea how many wonderful consequences can emerge from it!
Hello beautiful people! I know I’ve sort of been on a bi-weekly schedule with posting but it’s been sort of busier at the hospital lately and I had two friends visiting from Wisconsin last weekend.
Svikki MD
So, after a few weeks of a fairly consistent patient census, there was finally some turn over on my list. I family-medicined (we will pretend that’s an actual verb) the heck out of them. Since many were waiting on placement, they didn’t have acute medical issues. This gave me the opportunity to adjust their medications so that their diabetes, hypertension, etc. were wonderfully controlled before they left my care. Once that was all achieved, however, I was ready for some new challenges. I got what I wished for!
A few patients currently are either badly controlled diabetics or hypertensive patients or ones where there are still big question marks in their medical picture for me… I spent a combined 6 hours chart diving on one of the patients this weekend. There are just unanswered questions and the patient is miserable… I’m channeling my inner Dr. House to try to figure out what is going on sans the narcotic addiction and callous attitude.
I’m really enjoying the close work on the floor with the nurses. I try to keep them in the loop at all times and explain why I am doing what I’m doing. It seems to be resonating well with them. This set up also allows me to take a lot more time with each of the patients and keep them educated and informed about what I am doing.
I’ve only ever been a patient myself once when I badly sprained my ankle. For that, I was only in the emergency room, not even an admitted patient. I can only imagine what it feels like to feel so little autonomy while in the hospital as a patient. Thus, I try to involve my patients in my decisions so they know what’s going on and can give their input. I realize this might be easier for me to do with a max census of 10 patients in a critical access hospital, but I think it is so important to try to do this well.
It resembles Veggie Straws!
As I said, I had two friends visiting from Wisconsin last weekend. They have been super conscious about COVID and frequently get tested so I felt it was a reasonable risk to take having them come visit. The county they live in is pretty strict with COVID regulations. It was a bit of a shock to them as soon as they crossed into South Dakota and stopped at a gas station to find that they were (unfortunately) the only ones wearing masks.
Since I still don’t trust doing anything here that involves being around other people, we headed over to Wyoming the first day to check out Devils Tower.
Located only an hour drive from Spearfish, Devils Tower is a large geologic feature that juts up from the earth surrounded by prairie. It is a sacred structure to Northern Plains Native Americans. It’s apparently one of the most famous rock climbing destinations in Northern America. Much of its origin is agreed on but there are still aspects up for debate in the scientific community. It is formed from rare igneous rock and is the largest example of columnar jointing in the world!
We walked the trail around the base of the structure. Along the way, we hypothesized about its formation, the wildlife, and the surrounding area. The comical thing was that after posing a question, a posted sign along the way would answer the question we had just posed. At some point we made it a game to guess what the next sign would tell us.
Where are the bison at?!?
We did a quick pit stop in Deadwood on our second day so that I could show them the historical downtown main street. I had bought them some local chocolate truffles as a welcome gift and they enjoyed them so much, we stopped by the store for them to buy a stash to take home. The place is called Chubby Chipmunk. I was gifted a few truffles upon my arrival at the hospital. They proudly told me that these truffles have been featured in the gift bags at the Academy Awards! They are really good chocolate truffles and look so pretty!
After their chocolate shopping spree, we headed to Custer State Park. The road took us past Crazy Horse Memorial. I stopped and gave them the cliff notes version of its history and purpose. I was so excited to show them Custer State Park. After the amazing time my friend and I had there in November, I felt this was the perfect South Dakota location to take them. The Wildlife loop was a bit of a misnomer this time. Not…a…single…bison!! Not ONE! And let’s be honest, that is the number one animal you want to see. The white-tailed deer may have entertained my friend from Miami, but these Wisconsinites didn’t care about seeing deer.
Luckily, after more than half the drive, we came upon the herd of formerly domesticated donkeys! This time, we got out of the car and hung out with the herd a bit. They were more interested in my car as a salt block and promptly got to work licking it all over.
That was basically all the wildlife we saw… donkeys and deer. Not exactly what I had in mind but they enjoyed the pretty landscape nonetheless.
Veggie Vikki
I have been a vegetarian since I’ve been 9-years-old. Granted, my parents weren’t thrilled at first. I was held hostage at the dinner table until I had a bite of chicken. Luckily, that didn’t last long. People are often intrigued as to why I’m a vegetarian. What about all the delicious burgers, steaks, etc out there?!
I’ve never craved meat. As a 9-year-old, the treatment of the animals was a big factor (and still is). My favorite animal growing up was a pig! I collected about 100 stuffed animal pigs…that didn’t make bacon enticing to me. A few years later, I started getting really interested in the environment. I changed things in my day-to-day to be more eco-friendly. Learning about how many resources a pound of beef uses was mind-blowing. A few years after that, learning about how meat can negatively impact your health just continued to underscore my decision. I’ve never missed it and never craved it.
The transition
A bit over a year ago, I finally made the switch to be as vegan as possible. I don’t like labels. I understand why humans use them, they organize the world around us without getting caught up in details. However, I am still not a fan. I think it’s best to live a life that is kind to your body (you only have one unless you believe in reincarnation) and the world around you as much as possible.
A per-definition vegan would not eat honey since it’s an animal product. However, I still consume honey. I believe in its medicinal benefits besides it just being my preferred sweetener in tea. I will also have the occasional sweet treat which is not always truly vegan. But other than that, I have cut out all dairy products and only eat eggs rarely. If I do, only if they are from happy chickens (pasture-raised and preferably from a farmer I know). My justification there is that chickens lay eggs regardless. If they are living happy pasture lives, my impact is minimal on their lives. (I’m sure there are vegans out there that would disagree with me, and that’s ok. Again, that’s why I’m not a fan of the label.)
Being a vegetarian and traveling has never been easy, but I’ve never starved. I will get full off of sides any day. India was truly the nicest place to travel as a vegetarian. Trying to be vegan definitely ups the ante when trying to find meals outside of the own home.
Dinner time!
The thing I started doing during residency occasionally (on a resident salary) and have increased to fairly consistently now, is using Purple Carrot. Like many meal prep delivery services out there, you pick your meals and all the pre-portioned ingredients are delivered to you. No food waste! Dinner was my favorite part of the day during residency. My then-roommate and I would cook together every night and enjoy a freaking delicious meal together. Now that I am alone in SD, the meals are both dinner and the next day’s lunch! I still enjoy the process of cooking. Last week I made this eggplant Florentine with tofu ricotta and chickpea pasta…delicious!
My intention is not to try to convert anyone to veganism. I’m aware vegans have a bad rep for that. But maybe, take some time to analyze what nutrients (or lack thereof) you are putting into your body. Food is medicine. Your body can only be as healthy as the food you give it to run on. Also, if you don’t know how many resources a pound of beef or a gallon of milk uses and how that impacts the environment, do a quick internet search. Even just reducing the amount of meat you eat or dairy you consume by a little will do your body, the animals, and the environment real good.
I’ll continue to share little aspects of how I try to live a healthier, more eco-friendly life. It’s never meant as a sermon or me wanting you to feel bad about choices you make. I just truly believe many people don’t contemplate the impact their food choices have on themselves and the world. I come from a place of genuine concern for peoples health and the health of our planet. Please don’t hesitate to ask questions if you have them or share the ways you are making your diet better! I’d love to hear what you’re doing!
Well… we’ve all made it into 2021. So much has already happened in the last 10 days…. take a chill pill 2021, no need to show off. No one is expecting you to outdo 2020.
New Years in Santa Fe, NM
I spent a couple of days in Santa Fe with a few girlfriends and the finance of one of them. As we are still in the midst of a raging pandemic, we took certain precautions to reduce our risk of exposure as much as possible. Everyone was either tested 48 prior to arrival or they had already had COVID and recovered. I wore an N95 mask for the entire flight time. Since this is what I wear when I am dealing with actual COVID patients on a daily basis, I felt this would keep me adequately protected during the flight.
Desperately needed a nap after waking up at 3:45 AM to get to the airport.
We rented a beautiful Airbnb a bit outside of downtown Santa Fe. We all wore something shiny and ordered take out for New Year’s Eve. Several intense rounds of Uno were played before we rang in the new year. We were all in bed about 20 minutes after midnight. We all had a long traveling day behind us and they wanted to leave early to go skiing.
While the others went skiing, I stayed home with my friend’s dog and fox. Yes, you read that correctly. My friend has a pet fox. I binge-watched Bridgerton on Netflix and read the book I’ve been waiting to have some time for, “Uncomfortable Conversations with a Black Man” by Emmanuel Acho.
A day downtown
On one of the days, my friend and I checked out downtown Santa Fe. New Mexico has admirably implemented several restrictions to help stop the spread of Covid. You have to wear a mask when walking around, even outside. On our last day, we had time to kill and wanted to check out the Albuquerque Zoo… it was only open to New Mexican residents!
Entrance to Museum of Contemporary Native Arts
Almost all of the museums were closed but we did manage to get some of the limited tickets for the Museum of Contemporary Native Arts. My favorite exhibition was probably “Indigenous Futurisms: Transcending Past/Present/Future”. The artists combined traditional Native American artforms with the subjects of Star Wars, Startrek, and the likes. Check out some pictures on the website by clicking here!
Most of the shops were open. We browsed through Native American made jewelry, pottery and artwork. There were so many beautiful things. If I actually had a house to outfit with things, I probably would’ve bought a piece of the intricately painted black & white pottery.
Santa Fe is VERY artsy. Many of the shops are also galleries. Then there is Canyon Road, just a few blocks from the main street. It apparently has over one hundred galleries, boutiques and restaurants in one-half mile. The road is filled with colorful sculptures and artwork!
The adobe-style buildings are quite visually pleasing. I recommend coming back during warmer weather however because, without any greenery or blooming flowers, the scene is quite monotone. I’m sure the main square is a great place to spend time in a warm, post-pandemic time.
Svikki MD
Back at work, things have been relatively slow this past week. Overall, the system seems to be less full. The number of COVID patients in the large hospital was down substantially. Many of the smaller surrounding hospitals either had only 1 or no COVID positive patients. That is really nice to see considering healthcare is still wary about the aftermath of Christmas and New Years’. We aren’t quite out of the window of that surge but the trend looks good right now. During a meeting, we were told that South Dakota had vaccinated the most people per capita compared to all other states in the nation! Considering how hesitant a majority of the out-and-about public seems about following safety guidelines, that was great to hear.
Uncomfortable Conversations
I was contemplating starting to share insights from my time as a model and how that has positively influenced my life, but then this week was just so crazy in American history, and having just finished my book, I wanted to speak about the book real quick instead.
For those of you who haven’t heard about this or haven’t watched the YouTube episodes, please do! Emmanuel Acho is a former NFL player of Nigerian descent. During the protests this Spring/Summer, he started making episodes called “Uncomfortable Conversations with a Black Man”. I eagerly awaited his new episodes week after week.
Growing up in a small town in Wisconsin, we did not have a lot of racial diversity. You could count the number of black students in my high school on one hand. My experience was a bit different from my peers as I had a bit more exposure to different cultures. I myself was an immigrant and traveled frequently. I also have a love for other cultures and people who are different from me. Learning about other people’s cultures is one of my favorite things. Admittedly, I didn’t find myself immersed more in American black culture until I moved to Germany and ended up befriending a lot of the American basketball players overseas on contract. I learned a lot from them. Then, when I moved to Miami for a year, I learned more!
I’ve dated a few black men in the past and so the episode Emmanuel did about interracial couples was especially interesting. I could relate to a lot of the internal struggles Lindsey Vonn spoke on. There is so much we are afraid to ask or talk about because we are afraid to offend or come off the wrong way. But if we don’t ask, we can not truly learn. You can read all the text books on a topic but it really becomes real when you live it. I have made mistakes in the past and I have learned from them. Through asking questions, being observant and willing to listen, I have learned how I can be a more respectful, understanding person/friend/partner and ally.
Get started!
If you have been watching the social movement and have wondered how you can be more informed, I highly recommend Emmanuel’s book! It is easy to read through, gives examples of many great resources to further your learning if you so wish, and makes you look at your own way of living, and hopefully encourages you to make some positive changes. It is not intimidatingly dense and reads as though you were indeed having a conversation with Emmanuel.
It’s called uncomfortable conversations. I didn’t find them uncomfortable because I was so eager to learn and hear the conversation. My culture has a not so distant horrific history. What I admire about Germany is its openness about what happened, its emphasis on teaching it, and in doing so, hopefully preventing it from happening again. The USA could learn a thing or two from Germany on how to deal with its own horrific history.
Acknowledging your country has a problem doesn’t mean you can’t still be super proud to be from that country and love it for all its goodness. It makes your relationship with your country more real if you acknowledge the flaws. If you are only looking at the pretty surface and pomp and circumstance, your relationship to your country is comparable with that of you and your celebrity crush. You can’t truly love something until you love it for all it is.
Small things add up too
I can’t give up all my time to immerse myself in the civil rights movement of America or drop everything and enroll in African American Studies (although if you are currently in college and have the option, do take a class!). There are also many other critically important issues I am passionate about and am trying to learn about and support including international healthcare and the climate crisis. However, I can try to find things I can improve on or learn in my daily life. Emmanuel’s book was a great choice and gives me so many sources to follow it up with. The following list is some of the things I’m doing or have done. I list them not to “brag” about what I’ve done but to hopefully inspire you to look at your day to day life and see what changes you can make.
following several sites on Instagram related to the BLM movement and antiracism. This gives me little doses of information while scrolling through my feed.
trying to be more aware and support black businesses whenever I can
calling my black friends and having some serious conversations with them and also checking in on their well being
during my last month in residency, I organized a panel discussion with some of my black patients so that my co-residents and attendings and I (none of which are black) could have some real talk conversations with my patients and a black surgeon about what it means to be black in a predominantly white healthcare system.
I used the gift card the Medical Education department gave us for graduating residency to bulk order bandaids in 4 different skin tones for all of our exam rooms and lab. Ever think about how those Bandaids are white skin toned by default? With about 30% black patients and many pediatric patients coming in for shots, I wanted them to have matching bandaids for their skin color.
I continue to look for ways to be a better person and citizen of this Earth daily. From where I spend my money, recycling, lifestyle, personal relationships and really just about every aspect of life. I hope you do too 🙂
With a name like 2020, this year really had the potential to be great. In some ways, it really was. A global pandemic brought people together on a scale that I have not seen in my lifetime. Scientists were able to make an extremely effective vaccine within a year! (They were able to move forward so “quickly” because many of the barriers that usually hold up vaccine development were lifted.) The social movements in the United States and around the world brought necessary awareness to society and will hopefully continue to bring on much-needed change. We’ve seen our lives completely turned upside down and people continue to persevere.
Hopefully, we all get through this experience with a greater appreciation of community, value for our health, and a sense to try to be better in this world. It’ll definitely be a year I don’t forget and will be telling my children and grandchildren about.
From last year’s Christmas and honestly my favorite video of my niece.
Svikki MD
Change is coming to my work schedule…again. If you’ve been following along over the past several weeks (thank you!), you will have noticed that I was reducing my clinic hours to make more time for the volume of patients in the hospital. This week, I finally had to make the move to focus primarily on hospital work.
It was getting to be too much trying to be in two places at once. There was plenty of work that needed to be done in the hospital. I’d have to jump over to the clinic in the afternoon to see patients. That also required time, follow up, and brainpower. I felt like I had to compromise my full commitment to either one side or the other.
Consequently, I spoke with the office manager and laid out observations I had made over the past three months. Physicians and nurses alike seemed frustrated. Doctors in the office were interrupted while with their clinic patients due to calls from the floor nurses. The floor nurses were having a hard time getting timely responses from the clinic docs. The doctors didn’t have time to take on admissions because they were busy in the clinic. However, bigger hospitals had to make room for more acute care patients. Clinic volumes were down so they didn’t really even need me in the office. The mid-levels had nearly empty schedules while they packed my 2.5 hours full.
So, moving forward, I will be solely in the hospital seeing patients and trying to keep our swing bed census around 10 patients. I’ll work in the clinic if many providers are out. However, I won’t have a clinic schedule per se.
Holidays in the Hospital
With the mid-levels out of the office for the holidays, my colleague and I were actually pretty busy in the office on Wednesday and Thursday morning. After the clinic closed Thursday at noon, I headed over to the hospital to see my 9 patients. A couple of patients were discharged home in time for the holidays.
I opened up my gifts on Christmas Eve while FaceTiming with my family. I’m pretty used to working over the Christmas holiday, but I’ve never had a Christmas where I wasn’t physically around my family. Thank goodness for FaceTime because it honestly didn’t feel lonely despite being alone.
Christmas day, I was back in the hospital seeing patients while wearing a light-up necklace my mother sent me. I’m all for bringing a little joy to patients stuck in the hospital for a holiday. My colleague invited me to have lunch with his family. The food was delicious and it was nice getting to know his wife and daughters. It was only the second time since moving here almost three months ago that I have socialized with anyone outside of the hospital setting. My colleague does wood work and made me this bowel from some local wood! I love gifts with a purpose and memory attached to them.
Hopes & Dreams
With a new year only a couple days away, I think most people become sentimental and plan for the future. I am no exception to that. Pre-pandemic, my years were filled with travel, concerts, adventures and so much fun. I’ve made a few videos over the years reflecting back on the previous year with travel videos and pictures.
Birthday in Tulum in January
Despite the global pandemic that changed so much and forced us all to slow down in our private lives, I was still able to do a few things. Pre-covid in the US, I was able to attend my Aunt’s birthday in Germany and sang a set for all her guests.
At my Aunt’s Birthday bash just before Covid hit in March.
I returned to the States to immediately start working in Flu clinics and on the COVID floor as one of the first residents to do so in our hospital. COVID changed how we celebrated our graduation from residency but we made the best of it. The late summer allowed for a brief window where I was able to visit family in Germany and take my little sister on a trip to Italy for a few days. I returned from there to move across the country to South Dakota to start my life as an attending physician.
Photoshoot with one of my best friends in Hamburg in March
Working in healthcare and at times being over-worked in healthcare, I am still very grateful for the fact that I am out here every day helping patients and have a job to go to. I have so much respect for people to go around. To the people who have been working from home for the majority of this year. The utmost respect for the (mainly) mothers that have been keeping a household running, childcare managed and continue to work through it all the best they can. I have so much respect for the teachers who are working crazy overtime to try to continue to educate our future generations. Respect is also due to all the frontline and essential workers. My gratitude goes out to all the people who have been physically distancing, wearing masks, washing their hands, making personal sacrifices, and just being respectful of other people’s wellbeing.
Italy with my younger sister in September
2021
A change on the calendar from one year to the next doesn’t automatically solve all of the problems faced in 2020. Actually, it does nothing of the sort. But it feels like a new beginning. There is so much potential for this specified timeframe of a year to be better than the previous 365 days. Many things indicate positive change: the vaccine rollout, a new administration, and continued knowledge/experience gathered about the challenges we face. On a personal level, I will hopefully be able to safely celebrate a few weddings in 2021. Our family is expanding in size in multiple ways. Although I don’t think we will get quite back to the lives we would like to fully in 2021, I do believe we will be making big strides in the right direction.
At one of my best friend’s sister’s very, very intimate wedding in May.
I hope everyone has a safe New Years and continues to be safe, conscientious and loving.
Things are busy but well in the hospital. We kept our census at the hospital max or just grazing by it all week. We aren’t quite as COVID heavy as some of the surrounding hospitals but we try to offload the bigger facilities with better capabilities and care for less acute cases.
I felt a bit like a zombie for half the week. I didn’t sleep very well Monday night on Tuesday. Tuesday is my call day and I was woken up 5 times throughout the night about an admission of an acute care patient who was pretty sick but due to multiple factors, the patient stayed at our facility. I was woken up 7 times throughout the night about this patient the next night. So, after three consecutive nights of horrible sleep continuity and no chance to catch up during the day,… I looked a bit like death. Luckily, I had the patient stabilized enough by the next night that I didn’t receive any calls from the hospital throughout the night.
Do I look like I need to see a doctor?
It really gives me an appreciation for all the rural docs out there who constantly manage their patients in the hospital and can be called at any time. Not too many jobs that essentially keep you on the clock 24/7. It also made me miss residency hour protection and resident wellness. There are unfortunately a lot of residency programs that still don’t prioritize resident wellness. My residency was amazing at this and I would’ve been given the option to go home after that 2nd horrible night and probably would’ve been sent home even if I didn’t want to after that third night.
I’m gonna get dark and real for a second
A friend of mine recently posted that she was headed into her third 28-hour shift in less than two weeks without a day off. Medicine needs to change its culture of abuse of doctors. You wouldn’t want your pilot telling you at take-off that they haven’t slept in over 24 hours. How is that ok for doctors. Its torture. And there is plenty of data to show that medical errors increase significantly after a certain length of shift. We strive to practice evidence-based medicine, it’s time we live by that too. You aren’t a big shot because you work non-stop. It’s irresponsible and torture and the industry needs to get with it. Physician burnout and suicide is very much real… things need to change. And not just for residents. Attendings need protection too.
Christmas Traditions cont.
Ok, back to some fun Christmas things!
Weihnachtsbäckerei – Christmas bakery
Of course, people bake cookies with their kids here in the USA too. The types of cookies vary some. The thing I instantly have to think of when it comes to baking Christmas cookies however is a song! It’s called “In der Weihnachtsbäckerei” (In the Christmas Bakery) and is a song I listened to so much as a child while baking with my Oma and Great-great-aunt. Rolf Zuckowski is famous for his albums of children’s songs and it seems like he has a yearly performance of this song on TV. Take a look!
My mom was so great to send me a package with her homemade cookies. I’d be lying if I said they weren’t already half gone! Maybe next year I can share some of her recipes when we spend Christmas together. That way, you can make your own little taste of Germany!
Weihnachtspyramide – Christmas pyramid
This is a traditional decoration from the Erzgebirge region in Germany.
This form of folk art goes back as far as the Middle Ages and uses wood to make pyramid structures showing imagery from Christianity or nature. The windmill at the top is moved by the rising heat from the candles. This lets the motives move within the pyramid. It’s a beautiful sight when it’s up and running. My Opa would always set one up in the living room and I remember watching the little figures go round and round in the glistening lights of the candles. I can’t wait to celebrate Christmas in my grandparent’s house again. I know exactly where the Weihnachtspyramide is stored.
Photo: www.erzgebirge-palast.de
You can also find huge Weihnachtspyramiden at Christmas markets! Like this one below in Hannover.
Photo: www.hannover.de
Christmas itself … we do things a bit different
In Germany, Christmas is celebrated on the 24th of December – Heiligabend (Holy Night). Presents are usually opened that evening. We have always done it that way in our household too.
On the day of, we’d usually spend the day doing normal things. Since we had a bit of a hobby farm, my mornings were often spent taking care of the animals. My parents would start preparing and cooking dinner hours in advance. Dinner usually consisted of a duck/goose prepared by my dad and yummy German sides the vegetarian of the family could eat including Kartoffelklöße (potato dumplings) and Rotkohl (red cabbage). As the parents cooked, the kids would get ready for dinner by putting on something nice. The older we girls got, the more time was spent on hair and makeup.
We’d all sit together and enjoy our dinner. Afterward, we would often play board games together… just to draw out the suspense to opening Christmas presents a little more. When the time finally did come, we would gather around the couches by the fireplace and my mother would distribute the presents. After all the gifts were opened, we’d spend the rest of the evening preoccupied with our gifts before going to bed.
Celebrating on the 24th meant that we had to be pretty darn patient to see our friends again during Christmas break because they would be celebrating Christmas the next day.
In Germany, December 25th is considered the 1st holiday day and December 26th is the 2nd holiday day. In many parts, both days are considered official holidays so many people don’t have to go to work and shops are closed.
Christmas 2020
As with every year since graduating medical school, I will be working Christmas. During residency, I often offered to work Christmas because my older sister was a resident too so we would usually find one evening to coordinate as our Christmas evening. That then allowed me to take New Years’ off and do something fun for a few days. This year, I will be on call throughout the holiday as well. Once again, I’ll be taking New Years’ off. This will hopefully be the last year I work Christmas for a while. This year, I didn’t mind working because I knew I wouldn’t be traveling home. Starting next year, I want to properly spend Christmas with my family again. Being a locum physician, I have a much better chance at making that happen too.
I wish you all a Merry Christmas and Happy Holidays! Please be smart, be safe, and be kind to one another,… maybe a little extra this year while we continue to take this pandemic seriously.
