The yawning mouth of the ferry as it approaches San Juan Island is apparent even from a distance. It rounds the bend from Shaw Island and glides as smoothly as a swan on the most placid lake, magisterial in size, yet dwarfed by the magnificence of Mt. Baker behind it, looming over the still snow-capped Cascades. The foghorn croons one long, low tone announcing its arrival into the port of Friday Harbor, and the echo courses once, twice, three times, off the bluffs of surrounding islands, fading into oblivion like a stone skipping over the water.
Thus begins this Saturday morning, the start of my tenth week on San Juan Island.
I am on a working assignment at the one and only hospital/ outpatient facility in the San Juans, an archipelago off the coast of Washington. I waken each morning, my head on the pillow of a bed whose mattress is raised, literally, to the height of breasts (young breasts, not old ones). There are 2 stairs to climb up onto this Olympian plateau, which I eschew because I am fearful of breaking a toe on them during a nighttime expedition. Instead, I have pushed the stairs under the bed (plenty of room there for a yoga class), and each night opt for a vault, in pike position with full one-and-a-half twist to attain nosebleed height. This degree of physicality is not a great prelude to sleep, so I have to read a while to calm my heart rate, which is a good problem to have. These days I get more than 3 paragraphs in before I recover from the gymnastics. Yay.
But the point is, it became apparent to me after about a week, when the smoke and haze from wildfires in British Columbia and Washington cleared, exactly why the bed had been ordered in giant-size: without moving my head from the pillow I can see no fewer than 3 islands and the mainland, with the water rolling out like a pink, orange, blue or gray carpet, depending on the weather, to the magnificent edifice of Mt. Baker. Then, I get to get up and sip coffee while I leisurely read the morning news, and alternately go stupid watching the sunrise, and the swirling currents of the tides, and the sailboats take wing. I no longer have to set an alarm to wake up—the sun does that for me, and my eagerness to see just what colors the dawn has in store that day. But I do still set my alarm—for the last possible second for when I have to start getting ready for work, because the view is so intoxicating, demanding attention, time, day after day.
Work is a delightful experience, difficult to call, actually, work. I can hear a sigh of wonder erupting from my recent colleagues as they read those words and know, because they are still in the soup and I so recently escaped, just how marvelous this is. I am seeing 12– 15 out-patients per day—just as promised by the client. In addition, I share hospital rounds and overnight calls with 2 other doctors. Our average hospital census is 0.7 patients per day. (I have worked this out to torso, 2 arms and a leg.) I have enough time to spend with each patient on my schedule, most of whom are delightful. They are educated to taking care of themselves. They are genuinely thrilled when I tell them they don’t need an antibiotic. They’ve heard of viral illnesses. Antibiotic resistance. The importance of microbiomes. My first day, when I asked one woman if she smoked, she said, “It’s 2017. Who still smokes?” I almost fell over. Most of my patients back in Ohio.
I do have a few obese patients, not many. Everyone exercises. There is alcoholism here, and heroin abuse. Depression and suicide, and the dying. But there is also community among the 2000+ year-round residents who know one another intimately and support those in all manner of need. There remain the difficult conversations necessary around the country, the world. And because I am filling in for only 3 months while this site searches for a permanent doc, they have not given me the difficult long-term non-compliant diabetics to manage, so part of the la-la land I am in is due to my transience. I am grateful for all of it. In fact it feels like I have died and must have gone to heaven, despite my numerous and serious shortcomings.
Of course, while my colleagues here are so kind, missing from my heaven are the kisses and hugs of family and friends, the eye contact not possible even with face time. Technology only goes so far; I miss just being in the same room with my people. My tribes. Rob was here, and our love child (Tippy, the Adventure Dog) for the first 7 weeks, which was wonderful. Then my sister came for a few days during which we cavorted like the old people we are, which is to say we ate well, celebrated happy hour, laughed a lot, and went to bed early. But everyone is back home now, and I am left here for 3 more weeks. Despite the sadness nibbling around the edges, being here, now, is the best problem in the world to have. Ah, life!
Next up: Tippy, the Adventure Dog