Locums for a Small World Blog

Locum dreams really can come true in Southern California. If you're immune to the magic of Disneyland, or just prefer your excursions without wall-to-wall people then here are some lesser-known, yet worthy spots to indulge your California dreamin'.

Ahh, September, the most wonderful time of the year. Cool breezes and changing leaves signal the start of autumn while caravans of SUVs haul the kiddies off to school, much to the delight of parents everywhere. Weekends devoted to raking endless piles of leaves are interrupted by high-fives and belly-bumps as the clock is reset for America’s favorite past time – and we’re not talking about baseball.

It may take a bit to acclimatize to the altitude in Colorado, but once your locum feet are firmly on terra firma, look up. It's a bird...it's a plane...it's 450 avian species who all call Colorado home. In fact, that renowned Rocky Mountain high has a lot to do with the sport of birding.

Now, don't go "tsk-ing" your tongue. Birders are no longer khaki or tweed-wearing geeks or binocular-toting Miss Jane Hathaways; they come from every walk of life and there are over 50 million of them in the United States alone. Some birders travel the world to add another "lifer" to their list. Others sit quietly in the woods, certain that one day a black-capped chickadee will look them straight in the eye. Still others take locum assignments in Colorado.

That's right, countless locum doctors are also birders (you could say they travel with binoculars and an MD), and as they take to the rivers and trails of Colorado, they also take to the "sights": falcons sharing the sky with droves of tiny white-throated swifts; owls snoozing inside hollow trees; and prairie chickens strutting across vast stretches of golden short grass.

Slip on your environmentally friendly Crocs^TM and wander Colorado's Kingbird Trail, nestled among the Black Forest of Ponderosa Pines that tower proudly over the region. This eponymous trail is home to the flying "tyrants" - their genus name and a richly deserved moniker (Kingbirds are known to guard their breeding territories aggressively, often chasing away much larger birds). They're also known to wait on an exposed perch for food or trespassers, though birders need not be concerned - unless they forget their wide-brimmed hats!

This land of birds is also home to some of the most beautiful grasslands along the fruited plain, where the buffalo roam and the deer and the antelope play. Spend some time in the high country above the tree line and you'll sight rosy-finches, grouse and woodpeckers. You'll also discover golden eagles, mountain plovers, belted kingfishers, jays and bluebirds.

Scenery freak? Get on over to America's Mountain, the great Pikes Peak, where the landscapes change as often as the weather. Spruce-fir forests, sagebrush hills and short grass prairies are home to green-tailed and spotted towhee, woodpeckers, hummingbirds and pygmy owls. Other notable wildlife includes bighorn sheep, pika (a small, chinchilla-like animal), mule deer and bobcats - the latter of which we advise you to avoid whenever possible.

Along a gravel road in the Sutter Butte mountain range of Northern California, nestled between an arching hillside and a babbling brook, stands a sign that reads, "Time to Slow Down."

It's no surprise that the Oregon Trail ends at Willamette Valley in Oregon. The abundant land, idyllic beauty, and ample resources that early explorers discovered there gave them no reason to continue on. This heart of Oregon argiculture has a cool climate and gently rolling hills that are home to some of the best grapes in the world, not to mention a flourishing wine industry. Two exceptional favorites, Pinot Noir and Pinot Gris, hail from the Valley.

During the growing season, the Valley enjoys warm days and cool nights. A daytime temperature swing allows the wine grapes to develop their flavor and complexity while retaining their natural acidity (translation: great grapes make for great wine). Take a designated driver along on the road from Eugene to Portland, as you're bound to stop at one or two of the hundreds of wineries.

This is also the home of Nike, where "Just do it!" is as a lifestyle as much as a slogan. The abundance of rivers, lakes and waterfalls, partnered with the mild year round temperatures, make it an excellent spot for outdoor enthusiasts. Camp or hike the Trail of Ten Falls through Silver Falls State Park, or climb to the summit of Mary's Peak - the highest point in the Coast Range. With it's spectacular views that extend to the Pacific Ocean, you'll think you're on top of the world. Descend and take to the waters in a canoe or kayak, or set sail on the
oh-so-blue Waldo Lake.

The Lord of the Rings Trilogy, Sir Edmund Hillary, Rugby, the America's Cup - all great things that have come out of New Zealand over the years. More recently, however, the country introduced something that really takes the cake: Zorbing.

An outdoor adventure sport, Zorbers climb into the hollow center of a giant transparent ball (brand named ZORB®), then hurl themselves off a ledge, rolling and bouncing at speeds of more than 35 MPH down a steep hill. It's all grass, sky, and limbs - punctuated by screams.

First developed in Auckland, the ZORB was designed to entertain bungy-jumping-fanatics-turned-bored (though we believe the ZORB was first developed in the early 70's and was called a hampster ball). Whichever the case, a couple of guys in New Zealand thought it would be a terrific idea to make a 12-foot plastic sphere, then put a human inside for the thrill of it. They did; it worked; business spread across the country; and a downhill revolution began. In fact, Zorbing (or globe riding) is one of the first things our locum tenens put on their list of things to do Down Under.

Now, the revolution has rolled (pardon the pun) into the state of Tennessee, where it has found a fanatic following. In Pigeon Forge, riders can take a tumble down a grassy slope inside a specially designed ZORB that offers a choice of a being strapped to a seat or tumbling head-over-heels in a sphere filled with water. "It's like water-water rafting without the rocks," says CEO Craig Horrocks.

Since Tennessee has claimed the distinction of having the only official ZORB course in America, people have been pouring in from all over to take a turn at this crazy New Zealand import. And while the folks in Pigeon Forge proudly advertise their course right alongside other popular Smoky Mountain attractions like Dollywood and the Elvis Museum, ZORB zealots say nothing can compete with their hillside thrillride.

On the edge of the eastern plains of New Mexico, at the foot of the Sangre de Cristo Mountains, sits a little town said to have been the worst of the biggest, baddest Old West Towns. A key stop on the Santa Fe Trail, the town hosted the likes of Billy the Kid and Wyatt Earp; Doc Holliday kept his dental office here; and the Rough Riders first met in the saloon of the Plaza Hotel here (you can still get a shot of tequila at the saloon). This historic area is surrounded by recreation and wilderness experiences, including Hermit Peak's summit. Try the long trail hike with a strenuous series of switchbacks up the cliffs and you're rewarded by great views to the south and east. And if you prefer the movie screen to nature's background, look around - this town is the filming location for numerous movies including No Country for Old Men, Wyatt Earp and the landmark counterculture film Easy Rider. Move over, Dennis Hopper and Peter Fonda. What locum tenens represents is freedom...

Written by Carville Tolson, MD

G'day, y'all!

There's an interesting greeting—it reminds me of where I am and where I'm from.
 
Anyway, I've been here in Australia 'beyond the black stump' (far out in the bush) for a month now. It really is a nice place. Not flashy or fancy, mind you, but it's a real nice place. Quiet, too...for the most part. It's a long way from anything, to be sure—that MUST have something to do with the quietness.

Clinic practice is good. One has to be a bit innovative at times because we don't have all the medicines in stock, which are sometimes indicated or required. But that doesn't happen very often, and we can get them in about a week or less.

One man has COAD (that's COPD or chronic obstructive pulmonary disease in the States) and he was barely holding his own with his current treatments. I don't consider that I'm a high-powered doc, but I knew a medicine which could help, and though it had already prescribed, I learned that he wasn't taking it. Compliance is a big problem among Aboriginals (and elsewhere), and usually GP's here just shrug their shoulders and say, "Well, what can you do?" I wasn't satisfied with that.

I explained to this man how I had seen amazing benefits with the use of Spiriva for my patients with the same problems back in the USA. I explained that it may not help much in the first few days or even in the first week, but that long-term it would probably help a lot. Don't you know, he started to use it every day and two weeks later he looked much better and admitted he felt better! I guess us GP blokes from the USA can do some good after all.

Compliance issues were introduced as a factor in deciding on the treatment plan. When kids come in with head sores, usually I would just tell them to wash the head daily, give an oral antibiotic, perhaps a cream, and have them come back to check them in a week. But not so, I quickly learned (from the GP who was soon to leave) that parents seldom give oral meds to their kids beyond the first day or two; mandatory washing of the hair is unlikely to happen at all; and parents forget to come back in a week.

So, the best way to treat this is to give the kid an injection of LA Bacillin, which is a long-acting antibiotic, but which also is no fun to get. And yep! It goes in the bum. With my mobility problems, I rely on the parents to catch the little kids, and into the butt it goes!! This is NOT the part that I enjoy - giving shots to kids. But the medicine works!! The next time they come in, though, the child stands in a corner and eyes me suspiciously, even if he or she isn't the patient. But they do warm up to me (it seems) when they hear that brother or sister or cousin is going to get a shot. Then they come right over to me...and help with holding down the next "victim" for his shot. They're such a big help. Of course, all the children present get an "icy popsicle" treat—which is pretty much like frozen Gatorade.

Of the patients who come in, 90% (+) wear no shoes. A young boy, about 5 years of age, had injured his foot which had the potential to get infected, but it only needed a Band-Aid to cover it. When I told his mum and dad that he needed to wear shoes for the next week you would have thought I was giving him a shot! He cried and cried and cried. Okay, so GP docs from the USA can be terribly mean.

Right now the weather is very mild. It does get down to 40 or 45 degrees Fahrenheit, but that's only at night. During the daytime, it gets up to 75 or 80. So, you can see it's really great.

About 10 days ago, the temporary nurse working here offered to take me out on a road trip. We went up to see Devil's Marbles and The Policeman's Waterhole. It was a great day. Weather was perfect. I rode with my window down most of the way. We each took hundreds of pictures—thank you digital technology.

We traveled 600-700 km (375-430 mi) that day. No big deal, but remember, the roads were all dirt roads. At the start I thought, "How primitive this is." After we had finished making the circuit (12+ hrs), coming through a mountain range toward the end, crossing several dry creek beds, passing through narrow openings in the rocks, riding on washboard-textured roads, averaging 20-30 km/hr (15-20 mph) over 160 km (100 mi), and then coming back to the part of the road where we had started, I then realized how GREAT the starting road really was! It was like a grand highway. I just needed a bit of a better perspective, is all.

At the end, a lady looked at me and said, "You look tired." No kidding. "And your hair is red on the left." What?!!! Sure enough, I looked in the mirror and it was. When I washed my hair, there was red muddy water from all the dust. I hadn't realized I had been exposed to that much dust. Hmmm. Wonder if it helps the hair? Might be therapeutic.

I'm really glad to be working here. The people are good people and they have needs. I try to teach them about preventive measures, how to keep from getting sick, and how to treat some problems simply. I've purchased some vitamins and give these to them with good success. They appreciate what is done. It makes me glad to be here.

Dr. Carville Tolson is a GP from North Carolina, USA, who's taken a few locum assignments with Global Medical. He's enjoying his experience in Australia's Northern Territory so much he may never return to the states!