Observations from an Island Transplant


First off, I need to say how much of a pleasure it has been to work in the Emergency Department at Big Sky Medical Center. The staff has been outstanding and the community has fully embraced us.

I moved here from Hilo on the big island of Hawaii, where I had worked in Emergency Medicine for the past 17 years. Although I enjoyed Hawaii and my position there, it was time for a change, time for something new and different. Montana–and Big Sky in particular–have not disappointed. It is a wonderful outdoor playground and a vibrant community. It’s been an exciting place to live and a very enjoyable place to work.

I have had a fair amount of cultural adjustments to make however. For one thing I had to buy a lot of clothes. It gets really cold here and I’m told this was a mild winter. Also, I’ve had to learn to nod and say howdy, instead of my old greeting with a shaka and howzit. When, by habit, I gave a shaka to someone, they just gave me a blank stare. I guess they didn’t know it’s just a Hawaiian style wave!

At my old ER job in Hawaii, most of the trauma we saw was from motor vehicle accidents, with an occasional surfer or bike accident. With a trauma case, we often cut clothes off to expose the injured body part. In Hawaii it was simply a T-shirt and board shorts and that was it.
After my first week working at Big Sky Medical Center, I had to go out and buy some heavier duty trauma shears because the ones I had weren’t doing the job on three to five layers of thick winter clothing.

One of my patients this ski season had a dislocated/fractured shoulder, which made it very difficult to remove her clothing. We had to cut off her four layers of expensive ski clothes to examine her arm and shoulder, after several unsuccessfulattempts to remove them without cutting. Of course, I apologized and asked permission. The patient’s husband was not happy, but agreed. The patient herself, however, seemed to be pleased, stating that now she would get to go shopping!

As I sat by my fire watching it snow the first week of April, my mind randomly wondered. I was told by long time Big Sky residents that we would have another couple months of winter, although it sure felt like spring. I wondered how soon I could take off my snow tires. I wondered what type of injuries we will have this summer. I imagined kayakers’ injury patterns from smacking rocks in the river will be very similar to surfers smacking the reef. The fishhooks we remove from various body parts probably will be much smaller.

I think I am adjusting to the culture pretty well. I saw a herd of elk on the way to work this morning. I wonder if I’ll feel like shooting one by next fall.

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