Rebecka B’s Blog   Back to 2013 Students

Miller, South Dakota
Week 1

11:33 AM and I am about 25 miles from Miller, SD. Right on time, well sort of, my GPS says I will arrive at my destination at 12:04 PM. My phone rings and it is a text message from Claire, the pharmacy student who I will be with and my partner in crime for the next four weeks. I pull over to the side of the road to read the message “I’m here, so what you will do is head into Miller and there will be a stop sign with a big cow statue, so you will take a right at the cow and then take your first left on 4th street then its not too far down. Also only one working radio station, 96.9, see you soon!” Claire is a godsend because I had no idea where Avera Hand County Hospital and Clinic was and since I would just be arriving in the knick of time! Her directions were perfect. I found the large cow statue, took a right, and then a left and lo and behold was the Avera Hand County Memorial Hospital and Clinic.

Teresa, the coordinator of our program in Miller, greeted me; she gave me a big smile and made me feel at home right away. She led me up the stairs where I was greeted by other staff and lots of good food! We had taco bar and a delicious home made dessert as we talked and got to know one another. It was a great first meeting and start to my Miller experience. From there Teresa gave Claire, Kassy and I a tour of the Hospital and Clinic. It was beautiful, especially the new addition. Near the entrance was a granite wall of the donors who made the new addition possible, each granite piece had the donors names engraved and would hang at the new main entrance of the hospital. The idea of having this on the wall with all who gave is beautiful and shows how each person’s contribution makes a difference. My first lesson learned at Miller, when people give together, they can accomplish the impossible.

After the tour, Teresa showed Claire and I where we would be living for the next four weeks. She led us to a cute little house near the hospital called the ‘Sleep Study House.’ The beds were amazing and definitely sleep study material.

The first week went by in a flash. I had the opportunity to do things I had never done before. One, shadow a pharmacist, two, spend the day with radiology screening women for breast cancer. Travis Anderberg, the local pharmacist, was very knowledgably about medication and it was a great experience learning this side of the health field. He knew many of the patients by first name and would have their medication ready to go right when they walked in. Because he knew his patients medical history so well, he was able to give great advice about their current prescription and debrief them on their prescriptions. As a medical student, I value the opportunity to learn about the pharmacy side of the health field because I believe that it is crucial that we develop a strong relationship with our pharmacists.

The second day was spent with radiology in the mammography truck doing breast screens. I had never had the opportunity to see this done before and it was a great learning experience. I felt very humbled to be a part of something that can be a nerve-racking experience for many women. Watching the radiograph, x-ray, image come through the screen made me realize how advanced our technology is. We are able to practice preventative care by having the technology to produce clear pictures.

I am looking forward to next week and all that I will learn! Thanks Miller, SD!

Week 2

Monday: On Monday morning I met Dr. Huber for nursing home rounds at Highmore (about a 20 minute drive from Miller). I haven’t shadowed Dr. Huber yet and was looking forward to meeting him. While we are driving, he points out the hills to the south and says they were used as burial grounds for the Natives. He then points to the clouds which are wispy and says they are called Cirrus clouds. Dr. Huber may be the smartest man I’ve ever met. We arrive at the Highmore nursing home and are greeted by the director. She has been there a little over a year and is a great director for Highmore. Dr. Huber has about six patients to see. We see the sweetest elderly woman who is working on her flexibility with the physical therapists. After making the rounds we grab a quick coffee and snack at the gas station and head to Miller’s Good Samaritan. While there we see around eight patients. Dr. Huber is a great teacher and explains the multiple medications each patient is on. I am able to listen to an elderly man with COPD, a woman with a pace maker, a man with a metal aortic stint, and see a Parkinson patient. The day has been a wonderful learning experience and we even finish before 3 p.m. so Dr. Huber is able to make his Jeopardy ritual!

Tuesday: Today is x-ray day. It’s great that they have allowed us to see all aspects of the hospital. I am able to sit in on a ultrasound of the gallbladder, liver, and kidneys. The tech explains each level and shows me the different slices and views. He describes the ‘stones’ and ‘rubble’ that is seen in the gallbladder that could become problematic. Later that day we take an image of an elderly man’s lungs with pneumonia. The x-ray slides will be sent to a radiologist in Aberdeen and the results should come tomorrow. I have never seen x-ray, ultrasounds, or cat-scans procedures done before so this is a wonderful experience.

During the evening Claire and I head over to the walk/run club held in the park. We join about 10 women and have a nice social hour with good exercise. We also hand out our flyers for next week, ‘Women’s week!’

Wednesday: This morning is my first day in the Clinic. I make rounds with Karen, she is a CNP, and is so welcoming and easy to talk to. I immediately like her. She has three young boys and is a busy mom. It was a really fun day in the Clinic and we saw patients from 17 to 88 years old.

Wednesday evening we head out to Ladies Night at the golf course. We golf with a group of women and have a great time! The evening is beautiful with hardly any wind. We finish the 9-holes around 9 p.m. and head into the golf house for a good pork loin dinner with all the ladies.

Thursday: This morning we watched Dr. Bormes from Aberdeen do cataract surgery. There are two sets of microscopes so we are able to stand right next to him and watch the entire procedure. He walks us through each cut with his diamond sharp razor as he removes the cloudy lens and places in a new man-made plastic lens. Amazing. The patients who could not see sit up with new eyes. The eye I thought that once was so intricate and delicate is remarkable strong, it can withstand being cut and flushed and suctioned.

Thursday evening is the unveiling of the donor wall. We head over the hospital at 5:45 p.m. and it is already buzzing with excitement. There are 100’s of people there, and lots of good appetizers :) . Miller always seems to have good food! Brian, the administrator, speaks and tells of how giving the community of Miller is and how proud he is of all they have accomplished. They have a beautiful hospital because of how willing they were to give and how supportive this community is. The veil comes down and on the wall is the granite donor memorial. It is beautiful, on the largest slab of granite it says: ‘Every donation is a stepping stone to heaven’, around this are small granite pieces of the donors names engraved on them. The granite used is found locally. Also throughout the hospital are pictures taken by local people, nurses, and physicians that symbolize Miller. There are pictures of farm places, breathtaking sunsets, and rows of corn fields. This is a community that is extremely generous, supports one another, and are proud of who they are.

Friday: This morning I shadowed Dr. Turner in the Clinic. She was great! I hadn’t met her before today. She was great at talking with her patients and explaining their diagnosis or answering their questions. She also had a great sense of humor and I could tell right away her patients trusted and liked her. We saw a few really neat cases of an umbilical hernia that was repaired in 2012, and a  Sarcoidosis case. I listened to some unique heart sounds, one a ‘whoosh’ sound because of a still stenotic aorta and one that threw in a few extra beats every now and then.

Saturday: Wine on Nine at the golf course! Best golf tournament ever! It was a two person scramble and was a great turnout with four teams starting on each hole. At each hole a local restaurant or bar served their special drink with an appetizer of their choice. We sampled everything from shrimp to pork wings, to banana muffins and from wine to chuck-norris. It was a great evening. Thanks Miller!

Week 3:

June 17-23
I can’t believe we are over halfway through with our Miller experience. It has gone so fast and I’ve learned so much in the past few weeks. Not only from a health care perspective but about relationships and how valuable they are to caring for the person as a whole. The people of Miller have welcomed us with open arms, whether it is a Tuesday evening ladies get-together, Sunday church, or eating steaks down at the local restaurant. Miller will always leave a lasting impression on me, not only do they have a beautiful hospital but the warmest and kindest people I’ve met. Also a plug in for the kitchen staff and the food!! All the meals have been amazing!! Jackie (one of the cooks);  I wish I could take you home with me, or maybe steal some of your recipes.

This past week was another week where each day was different and offered new experiences. I spent some time in the clinic, some in lab, some time in outpatient, and some in physical therapy. I appreciate that Teresa organized our days so that we are able to experience all aspects of the hospital and what it takes for a clinic to run smoothly; to see firsthand that it is a team approach to care. The lab was especially interesting because I had never seen how they run tests on samples. The calibration of each machine is an art in itself. Nichole, who is in charge of lab, walked me through each machine and explained the test they run, CBC, TSH, HCT, etc. She was very knowledgeable and informative.

Colonoscopies were on the schedule for Wednesday, Claire and I looked at each other, oh what fun. We arrived at 8 am, and surprisingly the general surgeon, Dr. Werth, was amazing! With each colonoscopy he took the time to explain the structures he was passing and looking for, also what polyps or cancer would look like. He was a great physician to shadow and he even said we could come to Aberdeen and shadow him anytime we would like. He does various surgeries, from mastectomies and cholecystectomies to removing melanomas.

This week I also spent time in physical therapy. Here I saw the full circle of medicine. A patient who I had seen x-rays from a week earlier was now here doing physical therapy. The dedication of the physical therapists and the patients is humbling.

Also, during the week, Claire and I held a ‘girls night’ for 13-18 year olds at the sleep study house. We made lots of treats, but sadly only had two visitors,  Shelly and her daughter Sylvia. We both thought though that it may be scary for young girls to come and with all the nightly softball games and activities, summer is a busy time. We also hosted a women’s night at the wellness center to go through the machines and show how to properly adjust and use the new machines in the recently opened wellness center. We had the cutest elderly and middle aged ladies come! Then on Saturday, at Rexall pharmacy, we took glucose screens and blood pressure of customers who came in. We were surprised at the great turnout! There was a steady stream of people who came and that kept Claire and I busy for the three hours while we were there!

The week went extremely fast.  We learned a lot, but also had fun and kept our nights busy going to “Chick Flick” at the drive-in movie theater, ladies golf night, venturing out to ‘Wille’s Restaurant’ for steak tips, and ending the week by unwrapping the Miller, SD Board Game that was given to us in our ‘Welcome to Miller bags.’

Week 4:

This week started off with “Care Camp” where we rediscovered our creative side. We learned about what Avera stands for and what C.A.R.E really means,

“C-Communication, A-Attitude, R-Responsiveness, and E-Engagement.  It was a fun morning spent with some of the new nurses and patient care technicians. Monday evening we had our last ‘Women’s Health Event’ at 6:00. Even though only one lady showed up, it was definitely worth getting to know her and talk about breast cancer awareness, osteoporosis, and hypertension. I’ve learned in Miller, it’s all about the relationships!

This week I also was able to spend some time in the clinic with Dr. Turner. Right now, here’s a shout out to Dr. Turner, she does it all. A mom, a doctor, a kind word, a cautious warning, and her patients’ biggest cheerleader. She sees cases from the rarest to the common cold and takes it all in stride. One of her patients has osteogenesis imperfecta, another a fungus in her lungs requiring removal of that lobe, and yet another a fibula fracture. After this experience, a family practice physician may be the most challenging, but one of the most rewarding professions where you are able to develop relationships with your patients.

Later during the week we had the opportunity to shadow Dr. Werth in Aberdeen. We met Dr. Werth last week when he came to do colonoscopies. He may be one of the best mentors I’ve had the chance to shadow. He explained each procedure during the surgeries and allowed us to ask questions. We saw everything from a breast mastectomy to a umbilical hernia repair.

Once again this week, Miller has exceeded my expectations! I have learned more in these past four weeks, it seems, than months at school. There is something to be said about a small town feel and the people who make a place special. Everyone has been extremely welcoming and kind. I will never forget my time in Miller and I hope to return again. Thank you to everyone who made this possible and organized this experience!!!