Greg's work

Recently was my 1st day in clinic, at the Carna Health Centre. As one would expect from their 1st day on any job, it was a bit stressful, yet rewarding and informative. The patients are very kind, and patient, as I became behind schedule. As in any primary care clinic, you don't know what will walk in the door next. It could be a patient with a cold, or with a heart attack. Fortunately, I saw some of the former that day, and none of the latter. Over the next days, I have seen some quite seriously ill patients. The resources here are that I use one room, which has my desk. The patient initially sits opposite the desk, then gets on the exam table. I check their blood pressure and vitals as needed, and I draw the bloods, do the simple labs and run the EKG, all without the help that I am so accustomed to in the states. I also give injections, including non narcotic pain medications, and some immunizations and B12 injections. There is a significant number of B12 deficient people here, as well as iron overload, called hemochromatosis. II am doing nursing things that I have not done since my residency, 20 years ago. As one gets older, one tends to do less "new stuff" in medicine. It is challenging, yet refreshing, to do these "new" things in medicine again.

Two of the three total staff were also on their first day too. Fortunately, our clinical manager, Allison, is quite experienced, the glue for the newbies. She has helped me immensely. She knows the patients, which helped me in approaching certain situations. Also, the clinic founder, Dr. Michael Casey,dropped in with words of support. He developed the clinic, took call 24/7 for many years, and remains loved by the patients, as he splits his time here with two other out of town clinics that he also runs. He has an impressive resume, as a GP (general practitioner=family physician in the states) and also Dermatologist. He discussed the possibility of using TPA in the field, which the clinic has, since the hospital is over an hour away. TPA helps reverse heart attacks, acutely. I was solo the 1st and many days since, as Dr. Gerard Hooke, the other part time physician here, was motorcycling in the states, with some politically opposite leaning friends,bonded by their 2 wheelers and like for speed (160 mph?!), somewhere very rural.

After clinic, I took off on my 1st house call, something else that I have not done for many years. It was a beautiful drive in the rural countryside, and since there are no signs, I stopped a couple of times for directions, and finally arrived at the house. I am a little nervous about doing this on night call, as the roads are a bit of a challenge (I am gaining confidence-now listening to the radio to/from work) and directions can sound vague (I wasn't here when that landmark "used to be there") and houses are scattered over a rural 30 mile diameter. I have started to organize a doctor's bag for some home visits and emergencies. Dr. Hooke has described some of the emergency responses that he has gone to, some of which were quite sobering and tragic. Fortunately those are not common. Clinic patients varied the first day from a 2 year old to a 72 year old. Most have the government sponsored general medical insurance, which is the vast majority of our clinic's patient's medical insurance coverage. It covers almost any medicine that you could think of, including new on the market medications. In the states, I would need special authorization, a nightmare paperwork hassle, to get some of these medicines. I even saw a drug rep, with a new medication for gout, that is covered. The Sea Mar Community Health Center, where I have worked for 18 years in the states, does not see drug reps, due to the time and often biased information they give the doctors, promoting more expensive drugs.

Well I finally made it home, 28 patients and a home visit later, to see a pretty stunning sunset, over the flower colored fields, with big cumulus clouds raising up over the vast Atlantic, and islands dotting the waters. Stephen and I scrambled up the hillside, behind the house, to pick some blackberries and snap some photos. This was my 1st XC adventure, and you have to stay on the trails, otherwise you can step onto false shrub surfaces, going in 4 feet. There are rocks everywhere, many overgrown by shrubs. As We walked I pondered what our future days would be like in this mysterious and beautiful country. Justine made a delicious blackberry cobbler that disappeared quickly.