Man, sometimes a week brings a flood of minor upper respiratory tract infections, fungus, and the usual small town clinic maladies…and some weeks, the dam opens and all kinds of situations arrive on the doorstep.  We did a lot of small surgeries, mostly taking off cysts and dealing with minor wounds, and did loads of ultrasounds (lots of ovarian cysts, some gallstones and bladder stones); but we also had a few more unusual cases come in.

First, there was Missty (yes, that is how it is spelled).  She lives on a sailboat with her mom and dad, and climbs all over the place like a wild child.  She is the cutest little girl ever—she came in a week after getting her knee stitched up at the hospital; she sliced it about 4 inches across the front on a piece of sharp metal and then tore ALL her stitches jumping down onto her boat/home and landing in a deep knee bend.  Then it started to get infected, so it was a green mess when I took off the bandage.

Tough as nails, she let me take out the stitches and debride the wound, then I steri stripped it together and rebandaged it and sent her home with some antibiotics and dressing changes… “No more running around like crazy on the boat for one more week!”

Then a guy came in unable to swallow or drink, and unable to lower his chin because his tonsils were so badly inflamed they were like tennis balls, with another tennis ball sized abscess in his

cheek.  He was really dehydrated, so we gave him IV fluids and pumped him full of antibiotics.  The next day he was marginally better, so we kept him on the antibiotics and after a few days he could swallow and take liquids.  Only his cheek abscess remains, and it is shrinking rapidly.

We had a baby come in with a mysterious rash (see the photos below for the case details)…we did two surgical house calls for minor procedures at a shop run by two ladies in French Harbor.  One of the ladies, from whom I removed a ganglion cyst, was in a hurry to get home so she could make dinner for her husband.  I told her he should do it for her while her wrist has just had surgery, and she and her friend agreed…and both laughed at what a delightful fantasy it was, and how impossible.  Still tough to have two X chromosomes around these parts.

Still, our clinic is seeing lots of patients.  It was great to have Megan with us.  She set up two of the clinic rooms for acupuncture and treated patients two at a time every day our clinic was open, and was always running all over the island after hours giving treatments in the community.  Being able to combine acupuncture with western medicine was great—in the community we serve, there is a lot of stress and post-traumatic stress from abuse or violence, and mental health issues are somewhat of a taboo.  These issues are often compounded with some form of chronic pain, usually in the knees or back or feet after years of hard living.

When patients I had treated medically and then referred to Megan came back for follow up, they raved about how much they felt the treatments helped, and I have seen acupuncture be effective way too many times for me to doubt that is has efficacy in a number of situations.  I’m not sure I understand why it actually works, but although I would really like to know for my own interest, ultimately I don’t care—I really only care that it works!  My dad always says that despite their frequent disagreements, there is one way doctors and lawyers are always in agreement:  ‘Ultimately, both are only interested in results!’  Especially doing this kind of remote medicine, a doctor has to be ready to use any tool in the toolbox that can help, and I felt that of lot of patients got a good result from their treatments.  A lot of them burst out crying after or during their treatments and shared all kinds of horrific personal tragedies with Megan…it turned out that often they were crying about it for the first time, even horrible experiences years ago.

I also think the patients were really, really receptive to the concept, too.  Certainly, against the blend of bush medicine, Obia, and traditional home remedies in common use,

acupuncture probably didn’t seem too out of place, and there was also an element of the ‘well, the doctor has suggested this, it must be a good idea’ kind of thinking I often saw among older patients in Ireland and most patients in the developing world. Although in this case that attitude it made it easier to get patients to accept acupuncture treatment, that same outlook can sometimes put patients at risk of medical error.  One way to bring people into more active participation in their health knowledge (i.e., questioning the doctor), is by empowering them with knowledge about their own health, and we spend a lot of time in consults drawing diagrams and explaining people’s physiology to them.

Sometimes, however, one of us becomes a patient…last night, walking barefoot on the deck, the side of my foot kicked the slivered edge of a cut pine board, and a giant splinter wedged itself into the bottom of my foot.  It was wedged in deep and barbed like an arrow, but after I anesthetized it Noah and Sky got a scalpal and some forceps and pulled it out.  Man, it sure is sore today…going to go soak it in salt water before showering tonight.

That’s when you know you have an awesome sister…an awesome sister is one who will hold the light for you when you have to inject yourself on the bottom of your foot, which is pretty much exactly like you imagine.  So much is happening all at once—we just found out there is a possibility we will be going back to Haiti to help with the cholera outbreak, we are investigating ways to keep the Oakridge clinic operating on a permanent basis, we are coordinating containers of medical supplies and gear from California and Florida to Honduras, and in our spare time continuing to improve and strengthen Southern Wind.

With this much on our plates, I sleep a lot better knowing Sky and our crew are facing this with me.

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All patient photos used with patients’ express consent.