Home visits and feet

Home visits on Ramah Navajo reservation today. Was incredible. I kept trying to take pictures with my mind. Remember this, I'd say to myself. Huge sprays of wildflowers, incredible rock formations. It was hard work. Long drives down inhospitable roads, into rocky cliffs and onto farms dotted with sheep. Some of these people lived in areas so remote it took 30 minutes down a barely-there road before their house even came into view. At one point I napped in the van as the interpreter drove, the sun warming me as my hand held a stack of medication in place in the seat beside me. I learned some Navajo - hello, goodbye and pain or hurt. Saw a variety of patients. A tennis-loving quadriplegic was one of the more interesting. He was also fluent in English so it was easier to talk to him. We saw our patients in living rooms, kitchens, bedrooms, and outside on a stoop. Most were elderly, some disabled. Two patients in their 90s. A brother and sister who were blind. We had boxes of medication in our truck - day-to-day pillboxes to switch out for those on chronic meds. Bottles of refills. Other supplies like cough syrup, creams, Tylenol, things that might be needed. The blind woman received bottles of pills. She could recognize all by feel.

Reservation dogs were everywhere. The man I went on visits with warned me that they could be dangerous. A tall thin white man with a long, gray beard, he would make these hissing sounds to scurry them away from us. I feel I can get a good read on dogs and none of them seemed aggressive. Most were simply passive and not even that scared. Certainly hungry. One looked like a Catahoula. Another was certainly part Sharpei. One woman had a tiny toy dog - definitely not a typical reservation dog as it was inside the house and wore a collar. It was a yappy thing, one of those longhaired black dachounds. It jumped up on the arm of the couch the woman was sitting on and demanded I pet it through most of the interview.

The translator was pretty good however she would engage in lengthy conversation with the patients and not relay what they had talked about. The interpretation went pretty much exactly as we learned not to do in medical school. We would address our questions to the translator, not the patient (if we asked the patient directly the translator didn't understand that we wanted her to translate).

Podiatry clinic was in the afternoon. Ragged vasculopathic and diabetic toenails, cracked feet, ulcers, heel spurs and more. We removed a soggy cast from a woman who was post-op for a fascial release (the podiatrists have surgery privileges at Fort Defiance, a relatively close hospital). The smell after the cast removal stayed with me the rest of the evening. The podiatrist scraped off calluses with a scalpel. Looked so satisfying, I wanted to do it but here schedule was packed and didn’t allow for medstudent experimentation (a patient every 15 minutes all afternoon). During the day we talked about her home of St. Thomas island. Why feet? I asked her. It was a love she developed in college shadowing a podiatrist father of a roommate. No calls and no emergencies - the life of a podiatrist, she said, is very good. She did her podiatry residency in Detroit. Later, she invited me to bible study at her house Friday night. I had other plans so had to refuse. But we ended up talking about religion and Grandpa Willoughby and liberal Christianity a little waiting for our 4:30 who was late.

It’s my first night house-sitting but I spent most of it moving my clothes and food over from the trailer so haven’t enjoyed the place much – did notice they had the DVD Water (Deepa Mehta’s movie) so I’m planning on watching that at some point!