These Boots Were Made For Walk-Ins

The clinic has 6 exam rooms and 1 small trauma room which is often used for minor accidents, since the closest hospital is 60 miles away in Forks (the land of Twilight aficionados).  Most of the visits are walk-ins, and after a while it all blurs together at a very brisk pace: from the woman who marched into the waiting room demanding "PowerPoint injections" for bilateral elbow pain (I'll call Microsoft, stat! I thought to myself) to the young man who sheepishly admitted his chief complaint wasn't coughing, as he told the nurse, but actually a 3-day history of green penile discharge (Condoms! I croaked, while injecting him with ceftriaxone and making him swallow 1 gram of azithromycin)...at the end of the day, I'm usually dazed and hypoglycemic--that is, if I'm not too busy cursing the cumbersome Cro-Magnon era EMR.

I had the opportunity to use the trauma room yesterday when we received a radio report about a grass fire, which turned out to be a man on the grass who was on fire.  The town was hit with an influx of visitors for the Makah Days Festival, a celebration of Makah culture involving canoe races, traditional dancing, vendors, a talent show, and a salmon bake.  In the midst of all the excitement, a large barrel of heated roofing tar spontaneously combusted, and the patient sustained 2nd degree burns on his R hand and R leg.  The EMTs brought him in on high-flow oxygen with a nonrebreather mask, already hooked up by IV to a 1-liter bag of normal saline.  Although his nasal mucosa was mildly singed, he was breathing normally with no signs of airway edema.  The blisters on his skin were starting to pop, and we debrided quite a bit of the dead skin from the burns.

After all the drama, I was able to slip away quietly this morning to meet up with my brother & his family who were camping 54 miles away at the Olympic National Park.  We took a trip to La Push to spend the day at Rialto Beach which has a wildly beautiful rocky shoreline punctuated with silvery driftwood that has been tempered by centuries of ocean waves to look quite sculptural.

When I arrived back at Neah Bay just as the sun was setting, I found the entire town shrouded in fog and the main road blocked off by an ambulance, a fire truck, and 2 police cars.  Which somehow did not surprise me...