post vacation blues

My wife and I had a wonderful vacation in sometimes sunny California during the last 2 weeks of May. We drove the Pacific Coast highway, visited the Hearst Castle, hiked in Muir woods, sampled wines in Sonoma, and enjoyed San Francisco. We were privileged to attend the graduation of our youngest niece, as she received her doctorate from Berkeley. Fun times, good food, fine wines, and 2 weeks with my best friend; a great vacation.

My wife is never completely on vacation. Her trusty I-phone was given a daily workout. Being an ER doc, when not at the hospital, I am free of any work obligations. I did keep in touch with Robin, my PA. I took more than 500 digital pictures and generally acted like a typical tourist.

My trained diagnostic visioscope is never turned off. I note gait disorders, Parkinsonian tremors and head titubations, orthopedic injuries and signs of cardiopulmonary distress. I even encountered a bipolar, hypomanic woman sitting behind me on the return flight. Observing and noting physical and mental illness is ingrained in me. People watching and bird watching are two of my avocations.

As I flew home with the "chatty" woman behind me, I was reminded of my only other trip to California. In 1988 I attended a wilderness medicine conference in the Sierra Mountains. It had very little relevance to the practice of emergency medicine in a city in the Northeast, but my wife and I enjoyed Lake Tahoe and hiking in the Sierras. During the flight home from that conference, the head flight attendant asked if there were any physicians on the 747. There were 3 docs, an obstectrician, an orthopedic surgeon and a much younger "world's oldest ER doc". An elderly passenger was having difficulty breathing, so I was elected to provide care. Airlines have made significant strides in the equipment carried on planes. In 1988 I was lucky to find a cheap stethoscope and a blood pressure cuff.

The woman had a slightly elevated blood pressure and a few rales at her lung bases. She denied chest pain and felt much better with oxygen. The flight engineer came back to where I was treating the woman (pre 9/11) and asked me if the plane needed to make an emergency landing. It took me a minute to fully comprehend that the flight crew would follow my recommendations. The woman felt better. I stayed with her until the plane landed at our scheduled destination, and I handed her over to EMS personnel. The flight attendants gave my wife and I a bottle of champagne (domestic) as we deplaned. I also received a letter from the CEO of the airline, thanking me for my efforts.

Resuming my usual schedule, I worked the Memorial Day weekend. Issues in my wife's business have required her to work nonstop since we got home. We are ready for another vacation.