Thursday
The homeless clinic was pretty cool because I was able to conduct six new client evals. And the last one was one of the most interesting cases I've seen all month. He had lots of Axis II stuff going on, like Borderline and Histrionic. He wanted an excessive amount of meds, that someone had previously prescribed, and threatened that if he didn't get it he would wind up in jail as a sex offender which would be OK because then he could get some and quiet to finish writing his book. He also had a creepy of saying "sugar" and "honey" to the NP, weird gyrations and some very grandiose expressions. Oh, did I mention he had been in jail because a "kangaroo court" charged him with possession of folding stock tactical weapons? He made for a great finale to my psych rotation.
Friday
Well after a long two hour commute from Herron Island I finally found the community clinic where I worked with a PA all day. It was slower than we expected and a couple patients didn't want me in the room. But I did see a couple STDs, a pre-leukemia anemic patient and general check-ups. The PA and I ended up having a fair amount of time to talk about careers and such as well. The long commutes and Herron Island ferry rides also gave me time for career contemplation.
At this point, rural medicine is sounding pretty good. I've sure gotten positive feedback from Becky, family and all the Docs, NPs, PAs, etc. that I've talked to. It is a bit a of gamble, but what isn't? Finding a community to help with loans and start-up costs while being attractive enough for us and hiring staff may be a bit tricky but there are a lot of opportunities in the Northwest.
Herron Island
Becky and kids sure loved this place. The idea of living in a scenic, quiet place with lots nature around for the kids sure appealed to her. The boys loved exploring the beach with their cousins and soaking most of their clothes every day. They rode bikes, collected shells, hiked around the 1.5 mile wide island and just had a good time. Other than the long commute and my ribs not giving me much sleep on the beds we were provided with, I like it as well.
I can definitely envision being a country Doc driving a short distance to work in my SUV (so I can tow toys and make rural house calls), working for myself with a small staff and then enjoying bike riding, hikes with the dogs, cross country skiing, etc. The kids would miss suburban services like the YMCA and I might have to invest in a pool, but I think they enjoy there their high school years in this kind of environment. Schools though are probably the biggest question at this point.
At this point I need to reevaluate my elective rotation options at the end of the year. I would still like to check out HemeOnc, RadOnc, Rads, etc. but I might be better off with a rural FP rotation (someone who does some of the procedures I'm interested in like C-sections) and another IM rotation (rural if possible).
B-day
Today is Colton's B-day, so it's time for the big event here in WA with all the family and friends. Then packing and the flight back to AZ tomorrow. I'm already trying to mentally prepare for my FP/OMM rotation starting Monday. I think I'm going to need to study a lot more, including many hours of Kaplan Step 2 review lectures and reading Step-up for Medicine. Oh, and I really need to go over all the OMM I've forgotten to!