The story behind the Yukon Valley, Alaska series, part 1

As promised in the back material of DR. ALASKA, I will be spilling all the tea in regards to what is real about rural medicine as depicted in DR. ALASKA! To order, click on this link:

WARNING! There may be spoilers in this tell-all. If you haven't read DR. ALASKA, you may want to wait until you do so before you check out my insider information! If you're interested in reading the book, here's where you can get DR. ALASKA: https://books2read.com/DrAlaska

1) Is the on-call doc ever really alone in the hospital?

Yep. Now, let me blow your mind even further. There are a few very small hospitals where there is no in-house doctor at all. The nurses triage patients and then have the on-call doc come in from home to assess, treat, admit, or transfer the patient. That includes ER patients. It's done at facilities where the hospital volume is extremely low.

That said, every rural place I've worked there's a 24/7 ER doc of some sort in-house. At times, I've been the ER doc. Yes, you heard that right. From 2004-2010 I picked up ER shifts in our level 3 hospital. Without a doubt, I am not as comfortable in the ER as I am with a crashing Ob patient situation, and that should tell you something about my relative comfort level. In quite a few small hospitals in rural areas, the ER doc is the hospital doc is the Ob doc.

2) What's a "peripheral brain" and do you use it?

The peripheral brain before cell phones was our pockets crammed full of little books containing formulas, meds, and emergency algorithms. Now the peripheral brain is limited only by how many apps we can squeeze into our phone and the presence of Wi-fi at any time. Without Wi-fi, if you want information on that phone, then you're out of luck and you need to start looking for textbooks. Nowadays these textbooks will be old. I recommend searching in the doctor's lounge, the dusty top shelf of the doctor's dictation area of the inpatient unit, or in the office of any doc over age 50...

3) The CRNA (nurse anesthetist) took call from home. Is that normal?

First of all, it's common in small, rural facilities to have all anesthesia services covered by several CRNA's 24/7. The idea is any super high-risk anesthesia cases wouldn't be handled at a small facility and so they are transported to a level 1 or level 2 facility with MDA's (MD anesthesiologists) to manage, say, cardiac or thoracic anesthesia cases.

(go to my next blog entry for more secrets of Yukon Valley Hospital!)