As I finish my second week at the Health Center, it seems like a great place to work and learn. I have split my time between the slower outpatient (appointment only) clinic and the busier triage (walk-in) clinic. The hours are nice, 9:00-4:00, with every-other Friday off (all government workers have these "austerity" days, to save the gov't payroll--nice for those of us on salary, hard for hourly wage earners).
I have enjoyed my co-workers and patients. The doctors are mostly Canadian, but also native Chamorran, American, German, and Indian. They are glad to have me, a warm body with whom they can spread the wealth of their work load. They are especially excited to know that Kim is here and might be able to offer Neurology and/or Sleep Medicine services/advice. The only specialists available are nephrologists and an ENT. No radiologist, no cardiologist, no orthopedic surgeon, etc, etc. We are asked to stretch ourselves professionally to meet these needs.
As I have found in my short career, nurses make or break the experience in such a setting. Fortunately, the nurses here are great. They are here from the Philippines, and they really run the show. They are smart, helpful, motivated, hardworking, and fun--and tolerant of me. It makes a big difference.
But the best part so far are the patients. I have seen mostly Chamorrans, and they have been universally sweet and gracious. They are simple, easy-going folks who are open to my assessments and patient with my proposed plans. Many chew betelnuts, a mild stimulant. There are signs posted everywhere in the hospital stating "no smoking, no betelnut chewing". This habit makes their teeth brownish red, and they excuse themselves in mid sentence to spit in a trash can in my exam room (men and women). I guess this is very common all over the region, and there is a character in the play "South Pacific" called "Bloody Mary" because of the red spit. I haven't gotten the courage to try it.
Most of the patients I have seen have diabetes and high blood pressure, and many have complications of advanced and untreated disease. I have excised a man's finger to remove a fish bone, and I have seen a man with gout so bad that it oozed from his ankles.