Qayagaluku

The difficulty of working on the wards is that your attention is pulled into 3 different directions:
1. Hospitalized patients (both adult and pediatric): the most prevalent reasons for admission on my service currently are multilobar pneumonia, frighteningly large & out-of-control abscesses, and alcohol withdrawal.  There was a bit of drama today with a young lady brought in for suicidal ideation who turned out to have been diagnosed with TB one year ago and somehow successfully evaded treatment.  Now she's captured in a negative-pressure isolation chamber, moody and crying, while Public Health tries to get a court order for her to remain in isolation until adequate treatment has begun.
Alcohol withdrawal came in the form of a married couple, both prone to DTs, sharing a room and a 24-hour sitter.
Day 1: Rowdy and drunk
Day 2: Still drunk
Day 3: Sleepy and drunk
2. OB patients: I delivered my first Native Alaskan baby a few days ago, an adorable rosy-cheeked infant who popped out after just 3 pushes.   The L&D nurses here are refreshingly pleasant and extraordinarily helpful.  And they gave me a salad!  My first fresh veggies since arriving a week ago!  I feel like my hospital-issue lime green scrubs are mocking the lack of fresh fruit in my diet:

3. RMT: a.k.a. Radio Medical Traffic, a term from the old days when communication was via two-way radio.  In order to provide health care even in the most remote villages, each village has health aides who are on-call 24 hours.  The health aides are equipped with a rudimentary clinic and modern technology that enables them to transmit digital images of patients and fax clinical notes to doctors at the hospital for feedback.  I'm responsible for reviewing the notes & images from health aides, then calling them to discuss the patients.  If you don't call them soon enough, they will hunt you down and have you paged repeatedly. In my head, I've been lumping the cases into 3 different categories: Benign (OK to treat in the village), Scary (take a commercial flight to Bethel for further evaluation!), and Scarier (medevac NOW!).  Sometimes the health aides are frighteningly complacent.
Me: Is this 4-month-old baby really breathing 80 breaths per minute?
Health aide: (calmly) yes
Me:  AAAAEEEEEEEEAAGGGGGHH! (translation: give her oxygen & a nebulizer treatment while I activate the medevac!)