Happiness, Locum

Getting into the Spirit of Christmas

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It’s officially December and thus officially one of my favorite times of the year! Although Christmas looks much different this year around the world as years prior, I am still doing what I can to make it feel like Christmas time around me.

Svikki MD

My new schedule at work with hospital work in the morning and clinic in the afternoon is working out much better than what I was doing.

Inpatient

I had 8 of the 12 admitted patients on my census this week. I admitted three of them on my call day Tuesday. That was a busy day… I didn’t leave the office until 10:30 PM. My new schedule allows me to sit in on the regional hospital capacity calls. I hear about the patient numbers in the surrounding hospitals are, how many COVID patients each location has, and what the capacity of the facilities is to admit patients. In such a rural area, it’s nice to have an idea of just how hard it will be to transfer a patient if need be.

I also get to meet with the case manager, physical therapist, occupation therapist, pharmacy and nutrition daily and go through our census. I feel much more connected with the hospital staff now.

Outpatient

Now that I am only in the clinic for half a day, my schedule tends to be pretty full with patients. I still see a lot of the walk-ins (a lot with respiratory complaints), pre-operation evaluations and hospital/ED follow ups. I only have a few patients that I am following on a more regular basis. Being a locum physician that plans to switch locations every 6 months or so, I won’t ever have a whole lot of continuity with patients. That is something I’m giving up in such a setting. I quite enjoyed many of my residency patients, knowing I’d see them every couple months.

Vorweihnachtszeit

I mentioned “Vorweihnachtszeit” in a previous post when I experienced South Dakota snow for the first time. It means pre-Christmas time in German. Germans have many beautiful Christmas traditions. Let me share a few with you each week leading up to Christmas! I will preface this by saying that my family is not very religious or churchgoers. I like to say I grew up culturally Christian. Both Germany and the area I grew up in Wisconsin were mainly Christian and thus we celebrated many of the Christian holidays. As I’ve grown, traveled, and met many wonderful people and cultures, I have begun to celebrate other holidays from different religions and cultures with my friends.

Adventskalender – Advent calendar

An advent calendar comes in many forms and makes the countdown to Christmas fun every day! They were first used by German Lutherans in the 19th and 20th centuries. You can buy them pre-filled and quite inexpensively, filled with chocolate or other sweets. My favorite kind, however, are the homemade ones!

As a child, we had a large rectangular cloth that hung from the wall that had 24 little hoops on it. My mother would fill various treats or small gifts into little bags and hang them on the loops. Each day, one of us four children, would find the right number, untie the treats and share amongst the siblings.

A few years ago, my aunt made me an advent calendar by clipping little bags to a wire with numbered paperclips. I can’t wait to have kids to make advent calendars for!

Nikolaustag – Saint Nikolaus Day

December 6th is a day to celebrate Saint Nikolaus the Myra. During his lifetime (born 270 AD), he was known to have worked a lot of wonders. Nikolaus was known to be especially warm-hearted and helpful towards weaker people. He was known as a strict yet fair person (sounds pretty German to me lol). He would ask children if they had been good during the past year. If yes, they would receive a small gift. If not, they didn’t receive coal but rather were threatened to be put in a sack and carried away (…I don’t believe this actually ever happened and remained a threat).

Nowadays, children place one of their shoes or boots in front of the door on the night of December 5th to awaken the next morning to it being filled with treats, small gifts, and fruit! And yes, us greedy little kids would always look for the biggest, tallest boot we owned to put out. Again, can’t wait to have kids to continue this tradition!

Adventssonntag – Advent Sunday

The four Sundays leading up to Christmas are considered Advent Sundays. Certain branches of Christianity consider the six Sundays leading up to Christmas the Advent time. For most of Germany however, four Sundays are included. Sometimes, like this year, the first one actually happens in November. Last Sunday, November 29th, was the first Advent.

Many households will have a wreath adorned with 4 candles. Every week, an additional candle is lit. Traditionally, you might have friends and family come over for mulled wine, cookies, games and spending time together. During medical school, my friends and I would often take turns hosting the others.

As a young child living with my grandparents in Germany, I would grab a box filled with small Christmas decorations and adorn the wreath. While at the cabin last week, I collected branches from pine trees that had been cut down and made a wreath of my own out of them. I added four candles and some small ornaments and now diligently watch it when it’s lit because it looks like a fire ready to happen. LOL

My Weihnachtsbaum

I’ll talk about German Christmas trees specifically in a future post, but I did want to share the little tree I bought this weekend. I actually could have gotten a permit to cut down a tree in the Black Hills. That just seemed like a few too many steps for me this year… I’d have to buy a saw for starters. So instead, I went to Lowe’s and bought one. Remember the sweet St. Vincent de Paul Thrift Store deal I talked about two weeks ago? The box of Christmas decorations for $10? They finally had their moment.

I didn’t have my own tree during medical school but I always came home for Christmas. When I lived in Miami, I was surrounded by lit up palm trees. I never had a tree during residency. So, I’m super excited to have one this year. In the future, I hope to have my tree decorated with more personal items, but this will do for this year.

One thing I love: Clearly Christmas time. And not the commercialness of it all. I love the hanging out with friends and family part, the decorations and traditions. The gifts are just a bonus.

One thing I ate: Christmas sugar cookie… and the season is just beginning.

One thing I’m grateful for: Traditions. They make me feel connected to my family and friends despite being hundreds if not thousands of miles away from them.

mfg

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Locum, Mother Nature

Speared Fish & Sweet Deals

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I’m on call all weekend and it’s actually been a bit busy. But I definitely wanted to keep up with the weekly post. So let’s dive in!

Svikki MD

Outpatient

We were very unstaffed from a nursing standpoint this week. The nurses that were there rocked it though and got us through. I probably saw the most patients this week since starting work. It was a mix of interesting cases and a lot of COVID.

Inpatient

I spent Thursday in Rapid City working with a hospitalist who has been taking care of COVID patients for the past 5 months. We reviewed treatment protocols, his experience with patients, the patterns of decline/improvement he has been seeing with them and discussed safe patient scenarios to keep at my hospital in Deadwood (and when to transfer). I’m very grateful they were willing to let me come and discuss with their doctors. There is also more awareness for them now that we will be admitting COVID patients.

Call

I’ve been on call for 4 of the last 7 days. That lead to a few more admissions to my inpatient panel. Between seeing them on the floors and seeing patients in the clinic, this week has once again flown by.

I’m getting used to constantly being on call for my own patients. Late night and early morning phone calls don’t surprise me anymore.

Spearfish

I live in a town called Spearfish. The town symbol is exactly what you might think it is…a speared fish. Exhibit A:

Spearfish is a quaint community with the main street filled with restaurants, bars, and shops. The public library is a block off of the main street, just next to the police station and fire department. There is a community bank up the road. It reminds me a bit of a larger version of the town I grew up in. However, unlike Muscoda Wisconsin, you don’t have to drive a mile before you hit your grocery store, fast food restaurants, and the local hospital.

The surrounding land is pretty flat and sits adjacent to the Black Hills. Someone recently mentioned to me that there is a recreational path that runs through Spearfish. This seemed like a safer option for me to explore than finding trails in Spearfish canyon without cellular reception. You never know, something could happen and no one would be able to find me.

Spearfish Recreational Path

I’ve spent the last two weekends exploring the rec path. It’s a concrete path that works it’s way through meadows and woods. The people are friendly and almost everyone you cross paths with smiles and says hello. I’ve been doing a power walk/jog combo for the 3.5-miles back and forth. The trail itself is much longer than that. It feels great to be outdoors and amongst nature. I’m interested to see how well maintained the path will be when we start having snowfall again.

Along the trail, there is the D.C. Booth Historic National Fish Hatchery. It’s free to enter. According to their pamphlet:

Created in 1896 to propagate, stock, and establish trout populations in the Black Hills of SD and WY, D.C. Booth Historic National Fish Hatchery is dedicated to fish culture and resource management. After a very successful fish production history, the hatchery’s current mission is to help preserve the U.S. Fish and Wildlife Service’s historic and cultural heritage.

I took a walk around the grounds for a bit and checked out the fishies from below in the Underwater Viewing Windows area.

Although there are many, many trails in the broader area, the rec path seems like a safer alternative for the time being. The weather has been fairly sunny recently and the temperatures tolerable with a fleece while working out. I don’t think it’ll be long though before I switch out the sports shoes for the snow boots again.

Hey Macklemore, can we go thrift shopping?

I love thrift shopping. It’s something I learned to love from my mother. In big metropolitan cities, I shop for clothes and shoes and in smaller cities, I check out the thrift store before buying items new if I can. The environmental impact our consumer society has on the planet has not gone unnoticed. Also, I will save money any day I can! Most (if not all) of my Ralph Lauren sweaters, J. Crew jeans shirts, and Gap turtle necks are thrifted. I usually can’t find pants for my long legs but I have issues with that in regular stores too.

When I first arrived in Spearfish, I noticed the kitchen was missing a few essentials I needed for meal prep. I found most of them in good condition at the St. Vincent de Paul store a few blocks away. When I needed winter gloves and some shopping totes for groceries, St. VdP had me covered. My greatest deal I’ve made so far was yesterday.

I won’t be home for Christmas

I’ve decided that if I am going to spend Christmas far away from family and friends, I’m going to decorate my apartment this year and have a Christmas tree. I stopped by St. VdP to look for decorations. They currently have a deal going where you can fill as many Christmas decorations into a box as you can for just $10! I filled up on ornaments, beads, lights, stockings, a snowman mug for hot cocoa, two decorative small trees, and a Christmas tree stand. All for just $10. I felt like a rock star. Now I just need to find a tree. When the Christmas season is over, I’ll repack everything and donate it back to St. VdP. So, it’s really more like a $10 rental fee.

I’ll show you the tree once I have one and it’s decorated

If the other items I purchase during my time here are in good condition when I am ready to leave, I will donate them back. It’s an earth-friendly, wallet-friendly alternative to Amazon Prime.

It’s almost the most wonderful time of the year!

One thing I love: Pre-Christmas season….it’s so close, I can taste it. Literally, see the next section.

One thing I ate: Lindt Lindor White Peppermint Truffles. That melting white chocolate with the refreshing taste of peppermint…I’m in trouble.  

One thing I’m grateful for: the invitation I received to have Thanksgiving at my colleague’s house with his family. Although I declined because I already have plans for myself that day, I truly appreciated the thought of inviting me to their family time since I’m out here in South Dakota alone. That being said, please remember, a Zoom Thanksgiving is better than an ICU Christmas. Please only celebrate with your household or core group of people. Our healthcare system can’t handle much more and I want everyone to be as healthy as possible.

mfg

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Herstory, Locum

Scenic views, Svikki’s origin, & the scariest Halloween

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I just got back from a 3.5-mile hike in the Black Hills. The weather did an about-face over the past week and there was a high of 60 degrees Fahrenheit today with a beautiful sunny sky. I wasn’t going to let that opportunity pass by. I didn’t see another human being the whole time I was out there. It was just me, the forest and the wind. At one point, I caught myself singing “Colors of the Wind”.

Svikki MD

The other Family doc was out of the office this week. They have been in the area for decades and have a well-established panel of patients. I was on call four times last week. Between covering the other doc’s messages and prescription refills while on call and having quite a few of their patients stop by for same-day appointments, I was pretty busy last week.

Clinic

I am currently still seeing mainly same-day appointments as patients are establishing care with one of the other providers when able. It’s only fair to the patient, I’m only around for 5 more months. The same day appointments have led to some pretty interesting cases. I’ve called up other specialists more than once last week. Although our clinic only has Family Medicine and Internal Medicine physicians, I can find most other specialists either in Spearfish (20 min drive) or in Rapid City (50 min drive).

My instinct to call the specialists turned out to be right every time. Sometimes, I feel doctors are afraid to ask for help because they think they should know how to manage it themselves. I see no shame in consulting a colleague who has more expertise on a subject… at the end of the day, it’s best for my patient’s care and my ego can take it.

Hospital

I took over several of the other doc’s admitted patients while they were on vacation. Consequently, I had a different swing bed patient to check in on every day. My second to last clinic patient on Friday ended up needing admission. That bought me my second weekend in a row going in on the weekend days as well for acute care visits.

On call

There were a lot of call shifts last week. Two docs were out of the office which left me and one of the internists to cover the call schedule. Luckily, the nights were quiet. During the day, however, I was covering calls, prescription refills, and patient messages which kept me busy between clinic visits.

So why Svikki?

I wanted to use this week’s post to explain why my site is called Svikki. Most people know me as Viktoria or Viky or Vik. Only a few people call me Svikki…well, really, it is only my aunt and uncle that do. I have used the name for my social media handles ever since it’s creation though. My aunt is the one who came up with it many, many years ago.

My aunt is a master of fabric crafts. Her quilts are prized possessions in our family. Her basement has a room filled with fabrics, a fancy sewing machine, and colorful creations on the walls. One of my favorite things to do when visiting is hanging out in that room with her. She had fabric tags made for me that say “Svikki” on them so that I can sew them into the things I make. If only I wasn’t hundreds of miles away from my stored things, I’d be able to show you what they look like.

I’ve also used “Svikki” in art work I’ve made for my aunt. For example, this painting I made based on a 1950’s Zwicky Ad. I replaced the cat in the Ad with one of my aunt’s favorite cats she’s had, Pauli. He was a pretty cool cat.

Happy Halloween

Halloween is one of my favorite holidays. I’ve always been in awe of the annual parties Heidi Klum would throw. When I moved to Germany for medical school, I started hosting Halloween parties of my own. Halloween really wasn’t that big in Germany. It came as no surprise to me that for the first year, I saw a lot of your classics: witches, mummies, ghosts. The people kept on raising the bar year after year though and there were some really impressive costumes over the years.

I would start grocery shopping a week in advance of the party because I would bake so many Halloween themed treats. I’d decorate the apartment for days. Every year was unique and so much fun. Each year the party grew in size and popularity. I love hosting parties and seeing others get invested in the holiday brought me so much joy.

Working in Miami for a year, Halloween was a particularly fun time to be there. I had partied in Miami during Halloween before. However, working there with a crew of super fun people and dressing up for themed nights took it to another level!

The scariest Halloween yet… 2020

Sadly, I spent this year’s Halloween on the couch watching a movie. I’m sure I’m not alone in this. Unfortunately, I also am aware that many people were out celebrating this year. Trick or treating can be done in a safe, pandemic aware fashion, but what truly scared me, more than any scary movie could, is how many people I know went out to clubs or house parties to celebrate.

I TOTALLY understand wanting to dress up and head to the club for a night of fun, but people, we are in the middle of a raging pandemic. Many sacrifices have been made, many get-togethers canceled,… I understand. But last night probably should’ve been another one of those sacrifices. We aren’t ready for that yet,…not safely anyways. It scares me to think about how many more cases will be fueled by this. It scares me to think about my fellow health care workers and myself who have put their own lives at risk to take care of Covid patients.

The ICUs around the country are filling up. The USA does not have the capacity like some other countries do in terms of ICU beds per capita. Even less so in rural areas like Deadwood, South Dakota. Yet, the people were out last night. I don’t want to be mad at people because I know people have sacrificed a lot and want to go back to how life used to be. However, today’s decisions carry much heavier consequences with them currently. I can only hope you are spared but I can in no way guarantee that. So please, stay healthy, stay kind, stay strong, and be considerate of your fellow human beings.

One thing I love: scrolling through old pictures on my hard drive. I’ve had so many fun times in my life and time-traveling back to those times brings me a lot of joy.

One thing I drank: Hot apple cider. It’s that time of the year and I can’t get enough!

One thing I’m grateful for: my friends and family sending me packages. I LOVE getting (and sending) mail. From winter care packages to edible arrangements. Thank you! <3

mfg

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