Against my better judgement (what sane person would want to willingly trek northward to subzero temperatures?), I'm back in Bethel for another round of pummeling on the inpatient wards. There's something very endearing about the staff and the native Alaskan patients...or maybe I'm overconfident and delusional because I have a pair of ice cleats and a goosedown Goretex parka rated to -40 degrees, neither of which are needed at this moment because of the odd weather situation: daytime temperatures in the teens (but mildly subzero with the wind chill factor) and not a speck of snow on the ground.
The roads are hazardous to pedestrians when the climate is dry and windy; sidewalks are rare, and with every car that passes by, a giant cloud of dust swirls up to assault your eyes, nose and mouth. Luckily, I just had my annual respiratory fit test and my teal blue N95 respiratory mask matches my REI windbreaker. Making my twice daily trek between the residence and the hospital armed with the N95 mask and my headlamp, I look like a crazed (but stylish?) coal miner who is afraid of SARS.
Speaking of N95, I seem to be accumulating quite a few patients who require isolation rooms for a TB rule out. They're all awaiting results of sputum cultures for acid-fast bacilli. One patient was admitted for hip pain after being hit by a van and had a RLL cavitary lesion found incidentally on CT. Another was admitted for pneumonia with slightly blood-tinged sputum and mentioned being in contact with someone with active TB a few months ago. The third patient told the nurse she coughed up blood, then later back-pedaled and said the blood came from her nose. Too late, you win an instant PPD placement and a couple of days in isolation, booyah!
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