Sioux City Redux

You may recall that this summer I spent a rewarding month in Sioux City for my Family Practice sub-internship, staying in an apartment that featured a rotating reality TV cast of various students. Well, I just heard from a fellow student who recently started a month there and sent greetings from some of the people I knew. It means a lot to me, and I'm sending out a big, warm hello to the folks reading this in Sioux City.

A Sub-Intern's fond farewell to the Siouxland Medical Education Foundation

I came to Sioux City to do Sub-Interning,
Family Practice, a full month of learning.

My day starts with hospital rounds up on Five
Attempting to keep all the patients alive.

Now one of our patients is having a baby!
Will I get to deliver? The answer is... "maybe."

But wait, what's that sound? Could it be my pager?
There's a case of chest pain in the ER, I'll wager.

Later, overnight call keeps us up 'til all hours.
The next day nurses wonder if the Sub-Intern showers.

And so these four weeks have flown by much too fast.
(Will the knowledge I'm trying to memorize last?)

Now, sadly, it's time to be saying "adieu"
To the wonderful folks of the city named Sioux.

What cow?

Had myself a lovely evening tonight. I was in the Family Practice clinic this afternoon and it went quite well. My staff (the doctor in charge is called "staff") let me go see patients on my own and was very good about letting me present my own differential diagnosis and treatment options. (We get more autonomy this year than we did as third-year students.) And I was out of there by 5:30 (going home early by sub-I standards).

So I was riding high when I left and decided to go find a Vietnamese restaurant that my resident had recommended. Find it I did, ate there I did, and enjoyed it very much I did. In fact, it was the best Vietnamese food I've had in Iowa. Charmingly, the restaurant is called Da Kao, and their fliers feature a picture of a smiling cow--a bilingual visual pun! Well, I'm easily amused. Anyway, if you're ever in Sioux City check it out at 800 W 7th Street. It looks like this:



(Picture shamelessly plundered from here.)

After dinner I took the scenic route home through Grandview Park, which lives up to its name. A lovely summer evening with a view and Django Reinhardt's "Bricktop" playing on the radio. Sioux City might be a little rough around the edges here and there, but I'm growing attached to the place.

Things to do in Sioux City when you're not on call

Today was a day off, so I spent today being a tourist. (Except that I brought an OB/Gyn textbook along for a little light reading. It occurs to me that I'll probably be in the hot seat for a delivery sometime soon, and since I haven't done that for about eight months I figured it might behoove me to review the instruction manual.)

I started off at the Lewis & Clark Interpretive Center. They had a nice video showing L&C's encounter with the Blackfeet from both perspectives, but the animatronic Lewis & Clark kind of freaked me out. It turns out that Charles Floyd, the only member of L&C's expedition to die on the journey, expired nearby and was buried on a bluff overlooking the Missouri River. I was delighted to be offered the opportunity by one of the exhibits to retrospectively diagnose Sgt. Floyd's illness. L&C diagnosed "Biliose Chorlick," but it is now thought to have been a ruptured appendix. (I concur.)

Next I stopped by the M.V. Sergeant Floyd, a river steamer that's been put ashore on the riverfront and converted into a museum. (One of many landmarks in the vicinity named after the good sergeant.) Nearby is the Flight 232 memorial. (In 1989 United Flight 232, a DC-10, crashed trying to make an emergency landing at the Sioux City airport, killing 111 out of 296 people on board. It's a gripping story, well worth reading.) Also nearby is the Anderson Dance Pavilion, an open air venue on the river. Visiting these sites I got the message that Sioux City is very serious about its flower gardens. Everywhere I go there are nicely-tended beds of very colorful flowers. Finally, a five-minute drive took me to the charming, Guggenheimy Sioux City Art Center. Spent an enjoyable hour or two there. (I have a thing for small museums, of which more later.)

From the riverfront I headed up into the hills. Specifically, up to the bluff to see the Sergeant Floyd Monument. It's a mini-Washington Monument that dominates the southern approach to Sioux City. It was built after the Missouri had eroded away the original site of Floyd's grave.

Heading upstream from the monument site, I found a vantage point on a high bluff directly overlooking the very easternmost tip of South Dakota, where the Big Sioux River flows into the Missouri. In fact, I was overlooking the triple border of South Dakota, Iowa, and Nebraska (although I couldn't actually stand on the triple point without wading into the river). On the drive back I even had a delightful wildlife encounter: two wild turkeys were crossing the gravel road with about eight young ones (chicks? turkettes?) in one direction, and then a deer came out from where the turkeys were going and crossed the road in the opposite direction.

A very nice day off. Now it's early to bed so I can be up for rounds at 6:00 tomorrow morning.

Dept. of Conspiracy Theories

Confidential to Pynchon devotees: In between the hospitals where I'm working there's a tattoo parlor called Yoyodyne Propulsion Systems. Yeah, sure, a tattoo parlor. Right....

Gender Pharmacostereotyping

Yesterday in the ER I went to see a young man with abdominal pain, a big, tough, muscular guy who worked construction. The big, tough co-worker who brought him in was there, too. As part of my regular history-taking I asked him if he'd taken anything for the pain. He hesitated a second, then said "Midol."

Um, Midol?

"Yeah, my buddy's wife had some and said it worked for her, and I was hurting so bad I was willing to try anything."

Did it help?

"You know, I think it did."

Then last night I was momentarily caught off guard by a gentleman who was taking an old-school antibiotic that I have only ever seen or read about being used for UTIs in women. I like to think of myself as being pretty good about not making gender-based assumptions, but you just can't take anything for granted in this business.

First Impressions

Last night on my way to Sioux City I stopped for gas north of Council Bluffs. When I saw a woman in the store with her jeans tucked into her cowboy boots and wearing a plaid shirt, I was reminded that this part of Iowa has more of a western flavor than the rest of the state.

Although there aren't really wind farms nearby that I saw, there are many single wind turbines here and there. A cool trend: painting the town's name on the windmill pylon, rather than on the traditional water tower. Passed a rest stop with three horizontal windmill pylons loaded onto flatbed trucks. An impressive sight: each one is about three times the length of a semi.

There's a great love of searchlights around here. There was a set of car dealership/movie premiere spots rotating out in the country, looking very eerie in the hot, humid night haze. Sioux City itself has a rotating searchlight right on the riverfront, drawing attention to what I think is a riverboat casino. Saw other searchlight beams on the way in, too. Maybe they're worried about Zeppelin raids.

Finally got to the student apartment around midnight and stumbled inside in the dark. It's a charming 1960s walkup with well-preserved fixtures: tiled bathroom, glassed-in sun room (although far too hot to sit in during the summer heat, even at midnight), wall-mounted pink oven still bearing the proud label "Frigidaire: A Product of General Motors Corporation." Fell asleep to the "thwom, thwom, thwom" of central air, which is much appreciated in this weather. Unfortunately we're going to have a full house--looks like we'll be sharing rooms, and there may be five or six of us sharing a bathroom. Unngh... I'm too old to have a roommate. Well, what are ya gonna do?

Heading off to my first clinic in a few minutes. Still trying to figure out my computer access issues. More guerrilla posting later....

Sub-I in Sioux City

"Oh. Well, how delightfully rustic."
--Sue Warner, Sioux City Sue (1946)

Today I leave for a month-long sub-internship in Sioux City, Iowa.

The preceding sentence probably raises almost as many questions for you, dear reader, as it does for me. Where to begin? I've already spent quite a bit of time in other towns and cities for various clinical rotations (or "clerkships," as they're called in medical school lingo). They have included many of my best educational experiences in med school, but they can also be stressful: learning a new discipline in an unfamiliar hospital; staying in student quarters with varying degrees of maintenance upkeep and varying numbers of fellow students; and generally being away from the comforts and friendly faces of home.

But this is not just any clerkship. This is my Family Medicine Sub-Internship. For the next four weeks I will be performing most of the duties of an intern, or first-year resident. (Hence the unwieldy term "sub-internship." To me it sounds like a character from Star Trek: "Captain, receiving transmission from the Romulan Sub-Intern.") The Sub-I is a chance to kick the tires, experience soul-crushing on-call hours, and generally get a fourth-year med student's feet wet.

So wish me luck as I pack up my white coat, stethoscope, and pocket medical references--I drive there this afternoon. Look for Northwestern Iowa bloggery coming soon....