Family Medicine: Part 1

I'm back from the boonies for the weekend and I wanted to report on life in Crewe! I usually wait until the end of a rotation, but I'm just too excited to wait!

First, I'm staying at a lovely Bed & Breakfast called the Grey Swan Inn in Blackstone, VA just down the road from Crewe. It's cozy with a fireplace and endless bookshelves and floral sheets like my Grandma's. Every morning I eat breakfast with the other guests (they have been from near and far--Washington state even!). I have sat with an astronomer, two gents who are working on remote controlled helicopters for the military, and travelling substance abuse counselors to name a few. The Innkeepers make fresh breakfasts every morning with bottomless coffee, thick slices of bacon, creamy eggs, rhubarb crisps, homemade pumpkin butter...you get the idea. Heaven.

After filling up, I hop in the Mini and drive about 20 minutes through the countryside and down tree-lined highways bursting with fall colors to Crewe Medical Center. Patients are always lined up well before I arrive, since the clinic allows walk-ins. Dr. Hall and I review lab results that came in from previous days before seeing our first patients. We typically see patients non-stop until 2pm when Dr. Hall decides it's time for a lunch break (see, that big breakfast is key!). Then we power through until 5-6pm.

Since CMC is a little isolated (the nearest hospital is almost 20 miles away), we double as an emergency room too, it seems. The doctors joke as we sometimes "admit" patients to CMC to give IV fluids if someone is orthostatic or to suture lacerations. We also see the full spectrum of patients (young to old, well to quite ill), though many also make the trip to Richmond to see specialists. There is some division of labor within the practice though, as there are 3 docs and 2 Nurse Practitioners. One of the docs sees most of the kids, while the NP's see most of the OB/Gyn.

I mostly see chronic and acute adult medicine. I have helped diagnose and treat diabetes, heart failure, osteoarthritis, nephrolithiasis (a fancy word for kidney stones), a diverticular abscess, and a host of other problems! I have also gotten to do steroid injections of the knee and sacroiliac joints and my first fecal occult blood test.

In next week's edition I will talk more about my progress as a baby doc. This is my first real medicine rotation (on surgery and neurology most patients came in the door with a diagnosis), so I am finally getting to work on my differential diagnosis and reaching way back into the dusty cobwebs of my brain-space to remember how to test and treat for these diagnoses. It was a steep learning curve this first week, but I know I am making good progress!