August on Bald Head Island

My brother told me a story when he was in medical school. He said he was standing in the operating room suite, watching the charge nurse write on the board the operating room schedules for the month of August. He told the nurse Dr. Glenn was on vacation the last two weeks of August and she had written him in to do a gall bladder the last week, when he'd be gone. 
"Oh," she laughed. "He never lasts more than a week at that cabin in the Adirondacks. He'll be back with frozen trout for everybody. He'll be here."
My brother just shook his head. He had tried to tell her; if the patient arrived for surgery and no surgeon, well, he had tried. 
The nurse knew of what she spoke. Dr. Glenn turned up  in the operating room on the appointed day, just as she had said, and there was trout in the freezer in the break room.

When I was a college student, I could never imagine not being able to stay away from work. I was already brooding over the coming time when there would be no more summer vacations, when I'd be working July and August and that seemed like a very bleak prospect. 

Now I understand. After 30 years of never having more than nine days in a row off--two weekends and five day work week, I am facing 14 days off.  Actually, I had a similar 14 day holiday when I first moved to New Hampshire seven years ago and I did not last. After a week I just popped over to the office to clear away the paper work and charts I knew were building up. 



Two weeks is a long time.  It requires substantial preparation, arrangements for house sitters, lawn mowing, mail, newspaper delivery.  Friends tell me the first week is all decompression, and the second week is the actual vacation.

We usually fly down, but this year we're driving. We are bringing the dog and renting a house because the kids are joining us, this time with their wives.  One or another of my brother's sons may show up with family in tow.


This is supposed to be a trip back in time.  If it goes as planned it will be the first time in more than a decade when the whole family will reunite on the island where we vacationed when the kids were still in grade school.  Starting around high school, the kids had other commitments.  

In the days when the family was not separated for holidays, we would all gather at my brother's place on Cape Fear, now called "Bald Head Island" and memories were incubated. 

Some things became family touchstones. During a board game our younger son answered a Scattergories question to name a mountain animal with "walrus," and derision rained down heavily upon his head.  He never lived it down. Any time walruses came up he knew someone would mention that they lived in the mountains. A couple of years ago, there was a news item about a walrus or some similar mammal, having been found on the coastal Route1 in California; it was newsworthy because he had  apparently scaled the cliffs to get there and everyone was very surprised so large and ungainly a mammal could make it all the way up to Route 1. Of course, we all got the email from the boy with links to the story and a triumphal blast from the utterly vindicated son. "I TOLD you!"

Bald Head vacations were the last time my brother's sons and my own sons spent significant time together. The older cousins used my sons as "chick magnets" to meet girls on the island, apparently quite effectively, so many bonds were formed, but now the cousins have families of their own and rarely make it back to Bald Head.

Bald Head is hot in August. The ocean is warm, and the beaches, while not empty, are very spacious.  

Days on the island have their own routine:  They start with a roller blade excursion, from one end of the island to the other, which is a great way to start the day. It takes almost two hours and I'm exhausted when I finally get back.  The roads are paved but  there are no cars, only golf carts, and you wind up looking out from a cliff over  Frying Pan Shoals, where the cross currents churn the surf white, where pirate ships went down in the eighteenth century and in the nineteenth century, Confederate blockade runners got chased down by Union war ships and sunk.  The island had a Confederate outpost, and from South Beach you can see ocean tankers headed up the Cape Fear River toward Wilmington. The battle for Wilmington had been epic and desperate and was the final nail in the coffin for secession. Wilmington was the last port through which war supplies could reach the Confederacy. 

 I roller blade past these relics and once home, remove my skates and go plunge into the ocean.  There have been lots of sharks this year, and 9 attacks, so I'll make that a brief plunge this season.

Then I go out on the under porch, in the shade, for the time I really look forward to. My brother sits in one rocking chair and I in another and we talk without a clock ticking. We call each other every weekend, but this is face time. He is retired now, but he ran an academic department in the medical school for thirty years and his take on the evolution of medical care in this country comes from another perspective, but it is entirely consonant with my own.

Work can be stripped down to it's essential tasks. You read X rays, issue reports and that is the work. You sit in the room with the patient and write prescriptions and arrange for tests and follow up, and that is the work. Each task nowadays has a number code for billing. 

But that part of the job of medicine is not why you went into medicine and not why you stay in it, at least not for us.  

For many doctors now, the job is just a job, a means to an income.  Doctors are no longer working until they die. They get out as soon as they can afford to retire, and many of those are opting out in their  early fifties, even sooner if they can afford it. These people did their jobs, billed, got compensated with money, but they never really got into the job. 

The fun part, the part that keeps you juiced,  is the patients, or your coworkers, or just getting a system running well so it serves everyone's needs and problems get solved.  I'm not saying you need to be every patient's new best friend, but, ultimately, no matter how frustrated you might be with your electronic medical record or with the hospital admissions office or anything else, patients are looking to you for help and being able to provide that, being able to solve the problem, is what keeps you coming back. 

The man limps in with back pain radiating down to his heel and leaves the hospital walking pain free.  The patient who was driving her family crazy because her hyperthyroidism made her so irritable, returns with her husband, who draws you aside and says, "Thanks for giving me my wife back. She's herself again."  The woman comes in in booming labor and goes out with a new baby. The man in the emergency room frothing over in pulmonary edema is breathing comfortably within the hour. 

There's no high in the world better than what medicine has to offer. 

And we talk about all that on the porch and look out at the Atlantic. Our father used to join us down there.  Our mother never lived to see it. But, much as I have reservations about the Confederacy, the heat, the torpor, the sharks, Bald Head has history for our family--in one sense, it's home.