Category Archives: Wyoming

Jackson, WY

Christmas in Jackson, WY
Christmas in Jackson, WY

I spent December and a portion of January in Jackson, Wyoming working with Dennis Butcher.  It was an incredible experience.  The clinic staff were warm and welcoming.  We saw a range of patients, including my first horse wreck.  The hospital is small, but friendly.  The strength of this site is the preceptors and the patients.  It’s a glimpse into real primary care.  The town of Jackson itself is fun and full of activities.  I skied, did some ice-climbing and learned how to two-step.  Please feel free to contact me with any questions.

Jackson

I spent a beautiful October in Jackson last year. The internists spend most of their time seeing patients in clinic, but there is a little hospital medicine mixed in. I gained experience in everything from palliative care to acute cardiac care, but it’s the primary care medicine that makes this rotation special. The docs in Jackson are committed to providing top-notch care accross the board.  Their patients view them as trusted members of the community. You’ll see everyone from ski bums to cowboys who ride into town on their horses (practically).

There was plenty of free time, as well, and I spent most of it running and hiking the long trails in the National Elk Refuge in the shadow of the Grand Tetons. It’s an easy drive to Teton National Park and just a little further to Yellowstone.  I saw tons of wildlife, and this place is a photographer’s dream. If you like to ski — I personally don’t like going downhill fast, except that I love roller coasters… go figure — anyway, if you like to ski, I’m sure you’ll love Jackson in the winter.

Jackson, Wyoming

Doing a WWAMI rotation in Jackson truly enhanced my medicine residency experience!  During this rotation I was precepted by Dr. Martha Stern, and I had the opportunity to take care of patients in the outpatient setting, on the medicine wards, in the ER and the ICU.  I value this experience because I was able to focus on continuity of care by taking care of the same patients in clinic and in the hospital.  The radiologists, surgeons, and emergency room physicians were a delight as well, and they often went out of their way to provide teaching.  I appreciated the sense of community and collaborative work amongst the physicians working in Jackson. 

Being in this amazing town speaks for itself, and of course I had plenty of free time to ski, hike, and trail run.  I hiked in Yellowstone National Park with my preceptor, and we even waded in the natural hot springs while being watched by a group of buffalo!  I woke-up every morning with an amazing view of the Grand Tetons, and met people from all walks of life in this small town.

A month in Jackson was not enough…

Doing it all in Jackson

sam.jpgLooking at residency, it’s Jackson where the breach between what I knew and what I felt I needed to know was widest. I’d wake up to a patient in the ICU and a few more on the wards, and expect to be a nephrologist of sorts, the critical care person, a medicine consultant for local family doctors. After one of those days, my preceptor Mike Menolascino had me make a house call on a rancher with wide-open mitral regurg and Staph endocarditis. His wife wanted to stop the IV antibiotics. Mike said I should stay until they were finished asking questions, and then stay a halfhour more. Having grown up in Idaho, I know that rural places are places of extreme weather, where you get resistance from the environment. People have to struggle a little bit to live and over their dead body they’re going to a specialist in Salt Lake City. So it’s a tribute to the vitality of ranchers that we stopped the antibiotics and he’s still alive today … People in Jackson possess a strong sense of place. After being in the Tetons, I’d talk about moose spotted on trails, wind scouring the range from the west, spring slough slides. When you come back from the mountains, everybody knows exactly what you’re talking about.

Career plans in Cody

doug.jpgCody at sunrise after camping on the Shoshone River the night before and my first thoughts were how beautiful the country is in the early morning and that I could definitely live there. Cody is a town of hard working blue-collar people, a lot of ranchers, and of course people were very friendly. It was fun being geographically isolated, getting to practice true general medicine and take care of things specialists would take care of in bigger cities. We got the sickest patients in town. Every week, we spent a half-day in even smaller places – Powell, Meeteetse, Grable – and people appreciated us. I was already 100% interested in small town general medicine before Cody, because of rural rotations I did as a student at Colorado. In Cody, I learned I want to practice in a place with an established medical community, where internists work together and share call. I look forward to being in Soldotna in the spring, to see a medical practice with a reputation of being well run.