Hoh Hoh Hoh

The Hoh Rain Forest, which is part of the Olympic National Park, is truly a wonder of the Pacific Northwest.  One of just a few temperate rain forests in the U.S., it encompasses 24 miles of low elevation forest along the Hoh River, and the average annual precipitation is an astonishing 12 to 14 feet of rain.

There are a couple of short trails that loop through the forest near the visitor's center (one of which was closed because the park rangers didn't want a family of Roosevelt elks to be disturbed), as well as the more hardcore 17 mile Hoh River Trail which leads to Glacier Meadows near Mount Olympus.

Maybe because of my lack of height, I find myself entranced by the intricate network of intertwined tree roots, especially evident in seedlings that begin their growth on top of fallen logs.

The high humidity, deep soil and mild temperatures contribute to the astounding size of the trees.  I have the sneaking suspicion that if I fell down in the rain forest, moss would immediately start growing on me.

I would probably have to call for help from this phone booth...

Trying To Act Like A Professional

Imagine you're seeing a 58-yr-old patient in clinic for the first time who is having problems with chronic hip pain.  He is very tan, and his weathered face slightly resembles Mel Brooks.

You are, of course, sympathetic to his pain, and you conduct a thorough exam which finds that his symptoms are consistent with a R hip bursitis with tenderness to palpation at the greater trochanter.  You want to offer a steroid injection into the bursa for pain relief, but you are becoming increasingly more distracted by this patient's...hair.

He has amazingly shiny and very dark hair, styled in a manner that looks a bit like this wig, but in a much deeper shade of brown:

The distraction becomes overwhelming, and you step out of the room briefly, run into a colleague who looks at you quizzically, and, unable to suppress the inevitable burst of glee, you whisper furtively, "I've got a 58-yr-old male with Prince Valiant hair!"

Flattery Will Get You Everywhere

Cape Flattery is just 8 miles away, and it's known as the northwesternmost point of the contiguous United States.  It was named in 1778 by British explorer Captain James Cook who noted from his ship, "there appeared to be a small opening which flattered us with the hopes of finding a harbour".  The often muddy trail to the Cape is made less treacherous by strategic placement of cedar plank boardwalk constructed in 1996 by 7 members of the Makah tribe.

Once you get about halfway through the 3/4 mile trail, you start to hear the sound of the ocean, but you can't really tell where it's coming from until you approach the first observation deck.

There are 5 observation decks constructed with cedar planks and guard rails, with breathtaking views overlooking both the Pacific Ocean and the Strait of Juan de Fuca.  You can see picturesque sea stacks with trees growing on top, sometimes populated by puffins.  If you're lucky, you may catch otters sunning themselves on the rocks below.

Tatoosh Island, 1/2 mile off the coast from the Cape Flattery, is a former Makah fishing and whaling camp; the lighthouse on the island was built in 1857 and is owned & operated by the Coast Guard.

Also visible are a proliferation of sea caves which are dramatic openings worn into the cliffs by the constant pounding of the ocean waves.  The entire experience of traveling through the forest, then suddenly being confronted by the stunning beauty of the coast is surprisingly emotional and awe-inspiring.

Blackberry Teeth and the Neah Bay Rumor Mill

Sometimes clinic staff will bring in a homemade treat to share with everyone.  Today it was a beautiful and impressively large blackberry cobbler baked in a cast iron pan.  Most of us managed to nibble on it intermittently throughout the morning, but it wasn't until 11:30 that the pharmacy assistant sidled up to me and whispered, "Everyone who ate the cobbler has blue teeth!"  I surreptitiously glanced at my mouth in the nearest mirror, and lo & behold--my teeth had freakishly taken on the same shade as the blue sclera of osteogenesis imperfecta.

The nurse practitioner tells me that some of the older aunties of the town have been gossiping that Dr Chan "doesn't touch patients".  I'm not sure what that means--could they be referring to my habit of donning latex gloves before coming into contact with bodily fluids (e.g. during a bimanual exam, while palpating a lesion on someone's buccal mucosa, or while lancing an abscess)?? Because that's called taking universal precautions.  The lab tech joked that I should do trigger point injections by administering the lidocaine & kenalog via blowdart, instead of the usual syringe with 27-gauge needle, so I can continue "not touching patients".

Escape to Victoria

I can't imagine what it's like to be one of only two full-time permanent doctors in a remote rural community, constantly being on call and rarely taking time off.  One of the doctors has been here for 7 years, and he's familiar with all the idiosyncracies of our more--shall we say?--eccentric clinic patients; he's a proponent of kickin' it old school, meaning that he still spends the whole day in clinic after being on call the night before.  He enjoys canning salmon by dividing the fish to fit half-pint mason jars to stew for 100 minutes in a pressure cooker.  The result is surprisingly fresh and has a shelf life of two years.  The other doctor is about a year out of residency (like me) with additional training in acupuncture and other types of alternative medicine, which is wonderful for the abundance of patients with chronic pain.  So many people who work in the commercial fishing industry don't have time to drive 60 miles & back to see the nearest physical therapist, but they're willing to try a 15 to 20 minute session of acupuncture in the clinic.

Over Labor Day weekend, I drove to Port Angeles and hopped a ferry to Vancouver Island where I was absolutely delighted to eat gelato in a waffle cone (for breakfast!), catch an afternoon of the Vancouver Island Blues Bash, tour the Butchart Gardens, and just stroll around marveling at the architecture of the faintly Anglophilic city of Victoria, British Columbia.

The Empress Fairmont, where High Tea is served

The Legislative Building, where the government lives

The Japanese Garden at Butchart Gardens