View from Dr. Schott's office. Gorgeous!It seems that every patient I see is the parent, sibling, grandparent, cousin, or close friend of someone in the office or another patient. This greatly contributes to the aforementioned sense of community within the clinic. I didn't realize how much I'd like this aspect of living in a small town. There is a sense of connectedness and interdependence that I find very appealing and comforting here. I feel safe. It seems like everyone is looking out for everyone else.
Yesterday I was walking around during the lunch hour and stumbled upon a counter with four crockpots, each full of steaming stew. I was told that the departments (e.g. medical records, front desk staff, and the different medical teams) take turn hosting a potluck and taking donations, which they contribute to Relay for Life. I commented, "This epitomizes the community spirit of this clinic!" I was quickly corrected, "Actually, this epitomizes this clinic's love of food." :) That may be true, but I still stand by my statement.
With regard to crock pots, I asked Aaron, EOMA's IT guru, "Wow, does everyone have a crock pot?" "At least one," he replied. Nice. :)
Medically, this was an awesome week. Dr. Schott sees a lot of patients with chronic conditions, many of which are bread and butter primary care issues. I'm thankful for this because I'm getting more comfortable every day talking to patients about hypertension, diabetes, asthma, hyperlipidemia, and doing the appropriate physical exam tests and discussing the appropriate management. I've also started learning more about pharmacotherapy dosing, thanks to Dr. Schott. It makes me feel kind of "doctory," I must admit.
Dr. Schott is wonderful and encourages me to really take responsibility for my patients, as I should. "They are your patients." He empowers and supports me, which means a lot. I'm writing orders and prescribing medications (filling out the necessary info and specifying doses, not actually prescribing the meds. That's illegal!). It's fun, new, and challenging, and I feel like I'm learning so much each day.
Dr. Schott also includes me in all of his daily activities. "Do what your doctors do," we were advised at orientation. Well, thanks to Dr. Schott, I have been able to do exactly that. He has invited me to join him at all his meetings, accompany him during patient visits, and spend time with his family. Indeed, tonight he invited me to his son's basketball game. What a treat! 7th grade boys vs. 8th grade girls. Final score: 45 Boys 44 Girls. Dr. Schott and Dawn knew pretty much everyone there. So many of the children's parents and grandparents came. Turns out a lot of the parents grew up together; how cool for them to stay so close and see their own kids grow up together. Another cute tidbit: a lot of the parents know whose kids have crushes on whom, and during the game some of the crushers would be guarding their crushees. Too cute!
Stephen, Dr. Schott's son, with the ball!
Another highlight was a delivery on Tuesday night. Dr. Smithson let me catch the baby, but he was of course by my side the whole time, which I was grateful for. I always try to visualize and run through what I'm going to do during the delivery, but one thing I've learned in OB is that there is no "normal" or "standard" way that things happen. Baby always seems to come out in a different position from what we were expecting. I remember asking at the beginning of third year, "How long does it usually take for a baby to be delivered after Mom becomes fully dilated?" This question was met with a kind and understanding smile and "Honey, one thing about OB is that nothing, and I mean nothing, is predictable." Noted. :)
I've also moved forward with my community project this week. As part of my rotation, we have a community health project, and I was presented with an opportunity by Dr. Kelley to help out with the new non-stress test machine. For my project, I will be creating a training manual on how to perform the test and a patient education handout about the test. I will be teaching the nurses next week on how to use the machine and will provide some context. By the end of the session, I hope they will leave with a greater understanding of the indications, results, tocography, and fetal heart tracings. I feel like they are so much more experienced than me and that I have much more to learn from them than vice versa, but I'll do my best to teach them about NSTs.
Speaking of the nurses and MAs, they rock too! They're all so supportive and fun to work with. I learned from Angie and Shelley today that Wednesdays are "Purple scrub Wednesdays" and Thursdays are "Casual Thursdays." A lot of them wore jeans and a black polo with the EOMA name and logo embroidered on the left breast. I'll have to pull out the ol' blue jeans next week. :) In reality, a lot of the doctors wear jeans all the time! And with cowboy boots and flannel shirts. This is my kinda clinic! In all seriousness though, I really appreciate how down to earth everyone is here. Egolessness abounds in Baker; it's truly lovely. And as I mentioned earlier, I appreciate the connectedness and community. I think back to my anthropology classes at Notre Dame and our discussions about how the happiest individuals are those who live in a supportive community and have meaningful connections with others. Baker brings this concept to life.
Tomorrow Dr. Schott and 10 others head to Honduras for an annual medical service trip. I'll miss working with him, but I know that his Honduran patients will really appreciate his visit! He sees some of the same people year after year, and not surprisingly, several patients count down the days each year for the day that they'll get to see him again! What an amazing privilege it is to be a healer!
One of Dr. Schott's patient rooms decorated with artwork and other treasures from Honduras. He said they serve as a daily reminder of living a life in service. :)
(Side note on Dr. Schott. Such a humble man who is such a clinic and community leader. He co-founded EOMA, started Pine Eagle Clinic, birthed the annual Honduras service trip, and is starting a new clinic in North Powder. In addition, he is the main physician of Pathways Hospice, head of the Baker County Health Department, and founder (I think) of a child abuse group. And I'm sure there's more. When I asked him, "What hat were you wearing for this meeting (hospital utilization meeting)?" He wisely replied, "I don't really wear 'hats.' It's all a part of what I do. It's all a part of being a family physician." This comment really speaks to the role a family physician can play in a clinic, hospital, and community. I'm quite astounded by all that he does. He makes things happen, a lot of things happen. And he doesn't come off as a workaholic. He works incredibly hard, but he still seems to be able to live a life in balance.)
I'll be working with several of the other EOMA physicians tomorrow and next week, which I'm sure will be really fun too. I've worked with each of them now at least once, and each one of them has been great. They teach OHSU students on a voluntary basis, and I continue to be thankful for all the time and effort they take to teach me! Thank you, OHSU, for this amazing opportunity and immersion experience. I've realized that one of my favorite things in life is being exposed to different cultures, meeting new people, and experiencing new places. I love exploring. Each experience shapes who we are, and I know my time in Baker will certainly have an impact on me. It already has. Who we are in each moment is a culmination of all our past experiences, and I am so thankful to be here experiencing life in beautiful Baker City.
I had a chance to meet a cardiologist who I will join tomorrow when she does the first stress echo at EOMA. Echos are done every Thursday, and this will be the first time ever that the stress test component is included.
Snow-covered lakes are such a treat to see. Beautiful, pristine open spaces that are surrounded by trees are what we commonly see. We imagine what the lake looks like in the summer, and it tickles us that we can walk on it with our snowshoes in the winter. 
After our snowshoeing adventure, we stopped briefly at the Anthony Lakes Ski Resort lodge for some comfort food. :) Clam chowder, cornbread, and hot chocolate hit the spot. Turns out Anthony Lakes' motto is "Where powder is reality," and I've heard a number of people comment on the excellent snow there. I can't wait to go boarding! It'll also be fun to go since Cindy, the EOMA practice manager, is a snowboard instructor. Very cool lady. :) 
After Anthony Lakes, Mike and I visisted with Jacque Cobb, one of EOMA's nurses and care managers. Her husband (Josh), brother, father, and she have a huuuuuuge potato farm. It's so big that it's considered a corporate farm! Josh and Jacque kindly invited us to their farm and let us check out one of their massive potato silos. The one we visited held 22,000 sacks of potatoes, and each sack = 100 lbs! That's a lot of taters. :) And this is one of their smaller silos! I've never seen such a sight. Jackie and Josh explained a lot about the potato-growing process; it truly is both an art and a science. 
The temperature of the silo is kept around 45 degrees F; any colder and the potatoes could freeze, any warmer and they could get moldy. They have a wind tunnel along one side of the silo to cool down the potatoes. "Since they are living beings, they give off heat," Jacque described. It's clear that she and Josh work incredibly hard year-round. Their farm is definitely something to be proud of!
Dr. Kal Kelley
Vanessa and Michelle 
The drive was gorgeous. The gradual rise of the sun unveiled beautiful stretches of snow-covered mountains extending to what seemed to be infinity. Halfway is located 55 miles northeast of Baker near Whitman National Forest.
