Alaskan Picture Pages

I extended my time in Alaska to include a week of vacation. "The Phoenix" came up and joined me, and we spent a week cramming in as many activities as possible.

The first day we went on a bear-viewing tour. We chartered a small float plane and went to a nearby bay where we could safely view the bears from a boat.

Mama grizzly bear fishing for her two cubs:

I wouldn't want to be a salmon!

These two Spring cubs made all sorts of loud whiny, grunty sounds for more fish:

Smaller, adult male grizzly:

Black bears look small and cuddly by comparison:

I think this eagle was hoping for some leftover fish:

We spent a few days in Denali National Park, doing some hiking and white water rafting. We didn't have very much time for hiking, so we took the park shuttle as far as we could to the Savage River and walked around. Denali, by far, had the some of the best scenery. I had hoped to see caribou, moose, and dall sheep, but it didn't pan out. Mount McKinley is only visible a handful of days every month, so we didn't get to see it during our time there. Oh well, more incentive to return for a longer stay next time.

Fall looks entirely different on the tundra:

Me, looking carefree:

Marmot!

This is a ptarmigan, which I think must mean "tastes like chicken" in native tongue. One of our fellow tourists tried to convince us that it was a golden eagle. We just smiled and nodded.

After that, it was on to Seward Peninsula via the Alaskan Railroad (which has great views, but is a REALLY slow trip, so I was glad we took the motorcoach back!). We spent a couple of days on on Fox island at a fairly secluded hotel, where we dined on salmon, kayaked on the ocean, and took advantage of their personal chef.

The next day, we went on a wildlife-viewing day cruise. Highlights included spotting some whales and watching a glacier calve.

I think this sea lion was also on vacation:



Flirty otter:

Mama and baby whale:

It was difficult to go back to work, and I still have tons of photos to sort through, but I'm glad I went, and feel like I took pretty good advantage of the time that I had in Alaska. It's such a huge state, that there's no way to cover everything in one visit, and for some of the things that I wanted to see (Northern Lights), you really have to check it out at different times of the year. August was a great time to go though, as there was still plenty of daylight and tourist season was tapering down, so a lot of places that we went weren't as crowded.

Thunderstorms

Outside it is thundering. There are occasional flashes of light here and there, but nothing like the cracking streaks of light that race across the sky like during monsoon season back home.

Work has been somewhat stormy lately. In med school, one of my friends once likened me to a grizzly bear. She said I was normally independent and peaceful, but when backed into a corner, I would be a "force to be reckoned with." I guess I have been doing a lot more growling at work lately.

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A couple of weeks ago I ran a trauma in which a child had been struck by a car. Reportedly, he was unresponsive on scene and bystanders had to do CPR. When he rolled into our department he was talking, but in a lot of pain. His breath sounds were unequal, and his chest x-ray showed several broken ribs and a huge lung contusion. His oxygen sats were dropping, so I ended up intubating him.

Traumas are always somewhat of a mess. There are often too many people in the room and people get focused on starting IVs and whatnot, and it's hard to get through the most important thing, which is thoroughly examining the patient, looking for injuries. I have learned quickly to be VERY assertive, so I can get in and get through my exam without getting distracted. There's still a lot to learn and improve on, but I'm holding my ground.

This case was somewhat frustrating to me as a resident on another service strolled right in and started talking to my patient when she had no business being there. She introduced herself and then had the audacity to tell him she would hold his hand until his mother arrived. I told her she wasn't needed and had to leave because we were about to do some x-rays. She had the nerve to say she was going to stay and get exposed to the radiation as she was not fertile anyway! I glared at her and kicked her out. I don't have any tolerance for bullshit, particularly in stressful situations. Plus, I already had good rapport with the patient, she didn't ask if I needed help, and it was condescending for her to just waltz in and act like she was there to save the day.

Shortly after that, I intubated the kid and he went up to the ICU on a ventilator for a few days. It turned out he had a head bleed. He just got discharged a few days ago.

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Today, I had another kid that was hit by a car. This one was a complete mess. For some reason, his friends dumped him off bleeding in our parking lot, where a paramedic team happened to come across him on the way out of the hospital. We weren't expecting him, so the charge nurse had him taken to a regular room, rather than a more spacious trauma room.

Tonight the problems arose with a consulting service calling another service without our knowledge and canceling our orders and putting in some requested by a person who had never even laid eyes on the patient. This is a big no-no. While in the ER, we are ultimately in charge of the patient. A consult is technically there to make recommendations, and is not running the show.

Basically, this all came to a head when an x-ray tech called me and asked me cancel some of my own orders because another resident told her they weren't necessary. This ended up causing numerous phone calls and conversations about why orders weren't being carried out. I ended up canceling their unnecessary tests and re-ordering everything all over again. I was fuming, and unfortunately the whole mess caused so much delay in getting the testing done, that by sign-out time, everything was still pending for the oncoming resident.

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Like I said, there has been a lot of growling lately.

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On a lighter note, Ruthie has answered my 5 questions.