June 2013 Archives

Posted on behalf of Eric Bomberg, MP3 resident.

This last week has been busy as usual. I helped deliver a baby for the first time since medical school, and then being the pediatrician that I am, was first in line for newborn assessment and resuscitation. I have really enjoyed working at the Shawano Medical Center, and have had the opportunity to care for many adults and children here. 

We had one patient come in during my last call with a history of anoxic brain injury who was having fevers and possible seizure activity. As we do not have many specialists around, we had to transfer to another hospital. These experiences really show me how much of a luxury it is to be at a large academic center with specialists that can come 24 hours a day.  And they have taught me a great deal about the challenges of working in a hospital where the resources are limited in this respect. There are specialists that we are able to call for consults but most of them are only around on a very limited basis.

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Photo of the clinic

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View on the Menominee Tribal Reservation

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Driving on the reservation

I finally got my car back from the shop. I hit a deer on the freeway about 2 and a half weeks ago and it took this long to repair. This is extremely common in Shawano County and most people have experienced this at least once. Happy that is finally taken care of. Green Bay is the closest major city to us, which is about 45 minutes away.

This last weekend I spent one day kayaking on the Wolf River which I have never done before and then spent spent some time looking exploring Green Bay.  I visited Lambeau Field and got to explore the shoreline of Lake Michigan a bit.

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Lake Michigan shoreline

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Lambeau Field

I have really enjoyed being able to explore the reservation and have now been around most of the area by this point. The land is beautiful, full of forests and lakes. Much of the housing looks similar as most of it was built through HUD housing projects in the 1970s.

Heading back to the Twin Cities in the next couple of days. This whole experience has been unreal.

3rd Yr MP Resident Bomberg Tours the Menominee Reservation

Posted on behalf of Eric Bomberg, 3rd year MedPeds Resident

Yesterday, I had a tour of the Menominee Reservation. The reservation is beautiful and is covered with trees. There is a powwow site and twice a year they have 3 day powwow events where the Menominee come from all over the country to attend. The Menominee people used to own over 9,000,000 acres covering much of the state of Wisconsin, from up here all the way down to Milwaukee. Due to repeated treaties, the land size has been cut down to around 265,000 acres. Each time a treaty was signed, they were given a smaller area of land in exchange for such supplies as food and money. However, with each newly-signed treaty, what was promised from the previous treaty was made null and void, and as such the Menominee people each time did not get what they were promised from the government. This has lead to a land size much smaller than they originally owned, as well as a general mistrust of the government. On one such occasion, the government passed a treaty in which only 5% of the Menominee people agreed to, many of whom did not understand the English language. This has all leads to a concept called "historical trauma," which I will talk about more in a later post and which underlies a lot of the challenges faced within the community. Overall, Menominee County is the 13th poorest county in the nation.  The main industries on the reservation are the logging company, which employs about 200 people (most of whom are native), and the casino, which also employs a large amount of workers as well.

I had the day off on Sunday and went up to Door County, which was incredible. It is located right on the peninsula in Wisconsin. Up there, they have multiple state parks, wineries, restaurants, and shopping. I went for a 7 mile hike right on the shores of Lake Michigan!

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MP Resident Bomberg brushes up on OB and NRP Skills

Posted on behalf of MP3 Resident, Eric Bomberg

This has definitely been a crazy week. I drove back to the Cities for graduation events, which was great!  However, on the way back, about 20 miles outside of Shawano, my car hit a deer on the freeway.  Apparently, this happens to almost everyone at some point in Shawano.  In fact, car insurance rates in the county are about $400 dollars a year higher than surrounding areas due to the extensive deer population and the fact this happens so much. Had to get the car towed to Green Bay, where it will be for the next 2 weeks as they fix the extensive damage.

This continues to be a fantastic experience. I am on call tonight, and there was a young mother with type I diabetes who presented with preterm labor at 30 weeks gestation. The heart tones were not fully reassuring. 

My heart was racing a bit as I thought about the possibility of having to resuscitate this 30 week child that would be born to a diabetic mother. There is no NICU here, and no neonatalogist in the near vicinity.

I quickly read up on my neonatal resuscitation and got ready to go. Fortunately, the heart tones stabilized, and we were able to transfer the mother to an acute care hospital with NICU capabilities, as we do not have this here.  The alternative would be to have stabilized the baby and transfer out when available . . . such is life in a rural setting.

Although my residency does not train me to do OB, this whole experience was definitely a great refresher, and definitely got me to read up on my NRP skills!

Plans for later in the week are going on Thursday to see patients in the jail on the reservation.  More updates coming soon!

Posted on behalf of 3rd Year MedPeds Resident Eric Bomberg

Hello all! Eric Bomberg here, just finishing up my first week in Shawano, Wisconsin at the Menominee Tribal Reservation.

The experience here has been fantastic! I work as a Medicine/Pediatric hospitalist in the morning, seeing patients from the Menominee tribe who were admitted.  In the afternoon I go to work at the Menominee Tribal Clinic, where I have my own schedule of patients.

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The picture above was taken looking out from the balcony at the home where I am staying.  We're close to the river at home and at the hospital!  We have wireless internet, cable TV, a full kitchen, a laundry machine, and weekly house cleaning services.  They take good care of us here

At the hospital, all of my meals are covered and they even pack me a bag lunch to take with me when I go to clinic.  Because the hospital is small, everyone there knows who you are and they know my food preferences!

The hospital has 25 beds and we take care of everything from newborns to trauma. The patients at the hospital are not all from the Menominee tribe, and there are many other providers there as well.  We admit our own patients from clinic and almost exclusively follow tribal patients while there.

The major things I have taken away so far is what is means to practice in a rural setting (Shawano is the largest town around here with a population of approximately 9,000).  It's not uncommon to see a patient in clinic and then follow them in the hospital.  The experience of practicing medicine in a rural setting first hand is so valuable and I've already learned so much in one week. 

More to come!!! Eric