Did your day begin with a man entering your work space and announcing, "I'm from the Pentagon, I'm looking for who's in charge here."
If it didn't, then there are some things we did not have in common this morning. We did not share the next few moments thinking that this man looked surprisingly similar to a down sized version of Oliver North, because that's what I did for the next moment.
I also spent a fraction of a second thinking about who the person was he may be looking for (this person in charge), simultaneously pondering the purpose of the arrival of anyone from the Pentagon, and finally in the split of the same second left before it became awkward, sizing him up as advocate or adversary.
Or was he just lost in this construction zone?
The jarring reality was that he was in fact looking for the two PAs here, and he had found us. We were in charge. We are. At that moment I was making coffee and my colleague from another company was deciding between antifungals for tinea cruris for a patient who was listening to all of this unfold.
So I offered the small version of Mr. North a cup of coffee and introduced myself and my colleague, and he was satisfied that he had established himself at the correct place. He declined the coffee; he had a plane to catch right away. He needed to know if our equipment needs had been met by the surplus that the military had left behind. It seemed to be nothing more than a yes/no answer that he needed. A simple answer for a potentially complicated question.
His assistant was taking photographs of my office, within which there was no surplus equipment, if that answered his question, except for one filing cabinet that says "small arms" in Sharpie on the top drawer. (There are no small arms inside, just medical files, by the way.) He suggested this vast resource of equipment was somewhere else in this country, just not here.
There was no clear way to connect the need with the surplus, not in this visit anyway, not that was shared at this time. But maybe being in charge of this office wasn't the view from which one could see the whole mystery of this potential miracle of sharing. We are not that much in charge. Or more likely, the answer has yet to reveal itself, kind of like that 8-ball game you played as a kid.
They left as abruptedly as they arrived. The morning went on with barely a wrinkle from the event, as we continue to make do with what we have. There remains no substitute for good clinical medicine and careful procurement of the medications that we can actually acquire. Working smart and lean is not difficult; being asked who's in charge before the coffee's made can sometimes be a challenge however.
Meanwhile, the desert air is so desperate for moisture that it pulls any precious drops of liquid from hair and skin before you can get back to your canned home from the shower. It's not a long distance to walk, although at daylight it may seem that way. Just like a desert in the winter, the sun comes up to meet these sands at a freezing temperature. Then it gets better.
The absence of humidity along with the uneven, rocky surface has taken a toll on my canine patient's feet today. His pads have become cracked and nearly bleeding, even with the best of care from his handler. This happy labrador works on his feet as long as his handler will allow him too. His endurance being very nearly unlimited, however not always matched by this 20 month old's ability to focus.
I carefully check for signs of infection or foreign bodies in the fissures. There are none. There also seems to be no gait disturbance, and so no secondary pain or swelling associated with the original complaint.
For a plan, the human who lives and works with this dog and I talk about wound care. We also discuss the pad hardening spray that the kennel master tells us he can get. Meanwhile, the dog is on light duty, just like any worker would be with a short term disability. He seems delighted to have my company, and I scratch his belly to share the mutual pleasure. This is far better than billing.
The other species I treat here, the men who do security for diplomats and others, also must risk their fate in this unforgiving environment. In the case night before last, the environment was a pick up basketball game on the only paved surface known on these 100 acres. Basketball is not a sport for those with vulnerable connective tissue in their working joints.
In this case: "Did you hear that pop?!" And for anyone in this basketball game, the answer was yes, because that's how loud an achilles tendon can be when this is its day to pop. Sadly so, this was the case, and the hobbled gentleman was brought to the clinic with a colleague on each arm and a cardboard splint already affixed on his ankle. These security guys are capable of so many things.
However, none of us here are capable of even minor orthopedic surgery. So a transfer all the way back to the US was arranged. It should be a simple surgery and a quick rehab in this healthy non smoker, but it can't be done here.
This reminded me of when I broke my bicycle chain somewhere in the Stewart Cassier Mountains of British Columbia. It is very simple to repair this, but you do need a tool that's specialized for the cause. Unfortunately, I hadn't packed it.
What followed from that tactical packing error was a 400+ mile hitch hiking adventure to the nearest bicycle shop. It happened to be in the adjacent province to the east, in Calgary, Alberta. Things you need are not necessarily close by in the western part of North America.
My cycling partner and I lashed the bikes to the back of a cab of a tractor trailer, and off we went. Calgary was an entirely different place than western B.C.. There were wide open spaces and a cowboy atmosphere. We had left behind steep mountains, ferns, creeks, and bear country. Then of course we had to bicycle back once I had repaired the chain, and experienced B.C. from east to west for the first time.
I trust that my patient with the newly repaired tendon will return to us as well. He'll have some stories from home that will include the holidays, and hopefully be prepared to shoot some hoops again. We will welcome his return. Just as we welcome strangers who stop in from the US. The coffee is on.
If it didn't, then there are some things we did not have in common this morning. We did not share the next few moments thinking that this man looked surprisingly similar to a down sized version of Oliver North, because that's what I did for the next moment.
I also spent a fraction of a second thinking about who the person was he may be looking for (this person in charge), simultaneously pondering the purpose of the arrival of anyone from the Pentagon, and finally in the split of the same second left before it became awkward, sizing him up as advocate or adversary.
Or was he just lost in this construction zone?
The jarring reality was that he was in fact looking for the two PAs here, and he had found us. We were in charge. We are. At that moment I was making coffee and my colleague from another company was deciding between antifungals for tinea cruris for a patient who was listening to all of this unfold.
So I offered the small version of Mr. North a cup of coffee and introduced myself and my colleague, and he was satisfied that he had established himself at the correct place. He declined the coffee; he had a plane to catch right away. He needed to know if our equipment needs had been met by the surplus that the military had left behind. It seemed to be nothing more than a yes/no answer that he needed. A simple answer for a potentially complicated question.
His assistant was taking photographs of my office, within which there was no surplus equipment, if that answered his question, except for one filing cabinet that says "small arms" in Sharpie on the top drawer. (There are no small arms inside, just medical files, by the way.) He suggested this vast resource of equipment was somewhere else in this country, just not here.
There was no clear way to connect the need with the surplus, not in this visit anyway, not that was shared at this time. But maybe being in charge of this office wasn't the view from which one could see the whole mystery of this potential miracle of sharing. We are not that much in charge. Or more likely, the answer has yet to reveal itself, kind of like that 8-ball game you played as a kid.
They left as abruptedly as they arrived. The morning went on with barely a wrinkle from the event, as we continue to make do with what we have. There remains no substitute for good clinical medicine and careful procurement of the medications that we can actually acquire. Working smart and lean is not difficult; being asked who's in charge before the coffee's made can sometimes be a challenge however.
Meanwhile, the desert air is so desperate for moisture that it pulls any precious drops of liquid from hair and skin before you can get back to your canned home from the shower. It's not a long distance to walk, although at daylight it may seem that way. Just like a desert in the winter, the sun comes up to meet these sands at a freezing temperature. Then it gets better.
The absence of humidity along with the uneven, rocky surface has taken a toll on my canine patient's feet today. His pads have become cracked and nearly bleeding, even with the best of care from his handler. This happy labrador works on his feet as long as his handler will allow him too. His endurance being very nearly unlimited, however not always matched by this 20 month old's ability to focus.
I carefully check for signs of infection or foreign bodies in the fissures. There are none. There also seems to be no gait disturbance, and so no secondary pain or swelling associated with the original complaint.
For a plan, the human who lives and works with this dog and I talk about wound care. We also discuss the pad hardening spray that the kennel master tells us he can get. Meanwhile, the dog is on light duty, just like any worker would be with a short term disability. He seems delighted to have my company, and I scratch his belly to share the mutual pleasure. This is far better than billing.
The other species I treat here, the men who do security for diplomats and others, also must risk their fate in this unforgiving environment. In the case night before last, the environment was a pick up basketball game on the only paved surface known on these 100 acres. Basketball is not a sport for those with vulnerable connective tissue in their working joints.
In this case: "Did you hear that pop?!" And for anyone in this basketball game, the answer was yes, because that's how loud an achilles tendon can be when this is its day to pop. Sadly so, this was the case, and the hobbled gentleman was brought to the clinic with a colleague on each arm and a cardboard splint already affixed on his ankle. These security guys are capable of so many things.
However, none of us here are capable of even minor orthopedic surgery. So a transfer all the way back to the US was arranged. It should be a simple surgery and a quick rehab in this healthy non smoker, but it can't be done here.
This reminded me of when I broke my bicycle chain somewhere in the Stewart Cassier Mountains of British Columbia. It is very simple to repair this, but you do need a tool that's specialized for the cause. Unfortunately, I hadn't packed it.
What followed from that tactical packing error was a 400+ mile hitch hiking adventure to the nearest bicycle shop. It happened to be in the adjacent province to the east, in Calgary, Alberta. Things you need are not necessarily close by in the western part of North America.
My cycling partner and I lashed the bikes to the back of a cab of a tractor trailer, and off we went. Calgary was an entirely different place than western B.C.. There were wide open spaces and a cowboy atmosphere. We had left behind steep mountains, ferns, creeks, and bear country. Then of course we had to bicycle back once I had repaired the chain, and experienced B.C. from east to west for the first time.
I trust that my patient with the newly repaired tendon will return to us as well. He'll have some stories from home that will include the holidays, and hopefully be prepared to shoot some hoops again. We will welcome his return. Just as we welcome strangers who stop in from the US. The coffee is on.
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