Page 12 of Dr. Alaska
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On Friday thatweek, Lee adjusted her green Max Mara blouse under her lab coat as she hurried from the inpatient area of the hospital to the clinic. Running late. Again. She waved at a smiling Deirdre Steen in passing and kept on speed-walking in her ruined leather shoes. The new ones she’d ordered had pushed her credit card balance to the limit, but with luck the shoes and a few other garments would be here soon. She smoothed a hand over her slacks and focused on her day’s work.
Two new babies plus several adult patients with pneumonias, COPD flares, and one serious case of sepsis meant that today’s rounds had started early and lasted until late morning.
Yukon Valley might be a small facility, but there was nothing small about the patient care here. She had worked in Dahlonega, Georgia, technically a rural facility, but her inpatient work there had been limited to laboring patients and newborns. A hospitalist team managed all of the inpatient cases, shipping out any severely ill patients. ER doctors treated ER patients. Outreach specialists visited frequently, making clinic and hospital consultations easier to access. Every doctor had a narrowly defined scope of practice.
Not so in Yukon Valley Hospital. Lee, the other two family doctors, and two physician assistants held the line here at the end of the world. They literally treated everyone and everything because there was no one else to care for the people living in this area. Not just the town but she’d been told the hospital also covered several Native tribes—no, she reminded herself, the tribes were called corporations here—within a sixty-mile radius.
Lee peered out the hospital’s main entrance windows at the snow blowing sideways across the parking lot. On days like this, sending sick patients to Fairbanks or Anchorage wasn’t an option.
She popped into the ER. No patients. No ambulances bringing patients in. No paramedics with broad shoulders and a broad smile.
Not that she was looking for anyone.
She headed to the opposite side of the facility, stepping through an unmarked door into the back entrance of the clinic. She slipped into the break room, nearly running over Dr. Kathy Moore, a rural physician who had thirty years of experience. Kathy yelped and curled her entire body around a steaming cup of coffee.
“Sorry!” Lee held her hands up.
“My precious.” Kathy stroked the mug which readI Heart ATPon one side and had a picture of the Krebs cycle on the other. She straightened, took a sip, and sighed, the numerous lines on her face relaxing. “How’s Ruth Sampson doing?”
Lee mentally reviewed the hospital census while eyeing the homemade treats on the table. Staff often brought in yummy snacks.
“Prednisone is helping the COPD exacerbation, but on the downside, blood sugars have become hard to control.”
“Nothing a little sliding scale insulin won’t fix,” Kathy quipped.
“Ah, but then add in a smidge of likely sepsis on top of the COPD flare, because who wants something easy? Blood, sputum, and urine cultures are pending, so for now, I’m sprinkling her with IV pip-tazo and vancomycin until I can narrow the antibiotic coverage. Giving saline boluses to improve perfusion until, of course, she inevitably gets fluid overloaded—because that will be my luck.” Lee paused as she poured herself a cup of coffee and added sugar. “Would you prefer to round on her this week? One of the nurses said she’s kind of a VIP.”
Each of the doctors took hospital call in blocks of up to a week at a time and part of that duty involved rounding on all of the hospitalized patients. Taking call in longer blocks provided continuity of care, which was better for patient safety and outcomes. But being on call for multiple days at a time? Not as restful for the doctors.
Kathy smiled and sipped her coffee. “Ruth is a local village elder who I have seen for many years.” She leaned a hip against the break room table. “However, I’m enjoying the fact that right now my phone doesn’t ring and my pager doesn’t beep. It’s been great having you here, picking up hospital rounds, taking weight off of our shoulders. Shay was relieved to know her maternity leave would be covered.”
Lee smiled. She hadn’t met Dr. Pitka yet, but all the staff seemed to adore her. “I’m sure she and her family are enjoying the time off.”
“Hmm. Sure.” Kathy seemed to slip around the comment. “Here’s what I know is true: Getting up at three a.m. feels different at age thirty than it does at age fifty… something.” She smoothed a tendril of slate-gray hair back behind an ear. “That’s not to say Paul and I aren’t available to help if you need us. Dial-A-Friend is an option at any time.” Paul Burmeister was the other family physician here, younger than Kathy by ten or so years and married to a radiology tech who was from the area.
“Good to know.” Lee picked a chocolate chunk cookie, bit into it, and hummed to herself as the rich semisweet chocolate melted on her tongue.
“If you ever want to stick around, we can always use excellent rural doctors. The more the merrier.”
Lee chewed and swallowed. “That’s nice of you to say.”
After a moment, Kathy asked, “So. Any more EMS rescues on the side of the road lately?” She peeked at Lee over the rim of the mug. “With cute paramedics around?”
“Smooth, Kathy.” Lee cursed how her cheeks warmed. “Don’t you have clinic patients to see?”
“My 10:30 patient was Ruth.” Kathy pointed at the clock on the wall. “She no-showed me becausesomeoneadmitted her early this morning. I have nothing but time.”
Great. “Has my start in Yukon Valley become local legend?”
“Oh yes. We love new people and funny stories!” Another sip. “Everyone’s heard about your introduction to Yukon Valley and warm welcome from the EMS crew.”
Lee’s heart fluttered, like a young girl reacting to a crush. No. She would not let herself think about Maverick in any way aside from a professional one. She knew the value of learning from history. Lee had been fooled by a handsome face before. Besides, her work in Yukon Valley had an expiration date. “It’s as if a person could run naked from one end of town to the other and back, and the rumor would still beat them to the starting point.”
Kathy shoved up the sleeves of her thick sweater. “Well, the windchill out thereisminus twenty, so I’d like a heads-up on the arrival of the naked person so we can properly treat their hypothermia and frostbite.” She snagged a snickerdoodle from a plate and dunked it in the coffee before taking a bite. “Come on. Throw an old lady a bone. I don’t get out much, so these sorts of happenings in town are always exciting. Besides, the guy who works at the deli—”
“Tuli?”
