I am a Fly Fishers International Certified Fly-Casting Instructor. I teach fly casting in lakes or rivers. Additionally, I teach salt water casting techniques. This blog will be dedicated to fly fishing and fly casting. I will also write about rods and reels and whatever takes my fancy in the fly-fishing universe.
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https://everyjonahhasawhale.com/wp-content/uploads/2016/10/Fort-Pickens-1.-nov-2009-068.jpg15842376Jonas MagnussonJonas Magnusson2016-09-29 01:28:482023-05-26 12:44:06Every Jonah Has a Whale - You cannot buy a cast!
I enjoy observing various forms of wildlife where I live. I have touched upon some of the aquatic species in Pensacola Bay and in the Gulf. Now I want to do the avian part some justice. I recently took my dogs on our daily one-hour walk, starting from my house, and saw the birds I cover here. To spot all these birds during an hour’s walk within a small town is amazing. The spotting part is easy – these are big birds (except for the Kestrel), but if you don’t pay attention you will not see them.
The first bird is the great blue heron, and it’s ubiquitous around here. The heron and I have at least one thing in common, and that is fishing. However, the heron does not cast any fly, instead stalks the shoreline, and uses its sharp beak to spear its prey. The stunned prey is then just summarily swallowed.
The red-tailed hawk lives and hunts around our recreational center – in the middle of town. There are several wide open fields, and it can view the menu from various vantage points. I absolutely wouldn’t want to be a rabbit crossing those fields. This hawk is quite the poseur, and is not nervous around people at all. I encounter him on my walks at least once a week.
For the Icelandic readers, our language has two words for its falcons – fálki and haukur (fálki i.e. gyrfalcon). Haukur is the same word as hawk. In USA there are numerous hawks, but they are not in the falcon family. The red-tailed hawks are quite a bit bigger and chunkier than the Icelandic gyrfalcons. I must say that I find the table manners of the gyrfalcon more refined, than those of the red-tailed hawks. The gyrfalcon will sever the spine of its prey before dining, but the hawk does not observe such niceties, and just starts eating its prey. The prey might be dead from the impaling talons, but often it’s not.
Then I noticed two bald eagles soaring – too far up to photograph (I use an old photo for this blog). They are unmistakable with their white heads and tails. Their number seems to be growing, but that might just as well be due to my powers of observation. The fishing prowess of the bald eagles is legendary and known to all. Their table manners, however, are appalling.
The ospreys are everywhere here in the coastal areas. They are superb hunters and eat preferably live fish. They cruise over the water and then dive down, hitting the water with their talons first. They can become totally submerged, then pop up again and take flight with a fish in their talons. I have noticed when they fly off with their fish, the fish’s head always faces forward. Whether it has to do with aerodynamics, or the osprey is just being nice with a scenic flight is unknown. Then the osprey tears the fish apart and that is that.
I think they have a sense of humor, or at least one of them has. One day I went fishing and was catching Spanish mackerel left and right, and releasing all the fish I caught. When I came home an osprey flew over and dropped a mackerel on my driveway!
The kestrel is North America’s smallest falcon [weighs ca 4.1oz (120g)] and is similar in size to a mourning dove. I once noticed a smallish bird sitting on top of the uprights of an American football goal at the recreational center’s grounds. Those uprights are really high. By sneaking in and using my longest tele (approx. 640mm – handheld – sometimes you just get lucky), I got this shot of the kestrel surveying its hunting fields. The big hawk and the small kestrel can coexist because the kestrel goes for insects, invertebrates, and the small fare. So each bird occupies a different niche. Judging by the droppings (the white stuff) on the pole, it is clear that this is a well-used vantage point for the kestrel. I find the kestrel to be a beautiful bird.
Now for my biggest surprise of the dog walk. I noticed some movement in an abandoned eagle nest. This huge nest sits very high from the ground in a dead tree. In order to be able to see over the top of the edge you need to be far away. First I spot the “horns” and then I see the unmistakable owl face. Then I spot the owl chick. I had never seen this owl before. The great horned owl is a huge bird (22” or 55cm high) and an apex predator. Only the great gray owl is bigger here in USA, but the gray owl is a resident of the north part of the US. The great horned owl is found all over Canada and the States. The owl kills its prey by squeezing it if it survives the initial impact. Those talons are able to exert 500 pounds of pressure per square inch (30psi is your car tire pressure)!
After I posted this I got this e-mail and correction from Lucy Duncan.
Your blog was certainly interesting. I would make only one correction, and that is of the nest in which the Great Horned Owl nests. It is not an abandoned eagle’s nest. The trail is called the Eagle’s Nest Trail because there used to an eagle’s nest there 70 years ago when my husband was a boy here. That tree and nest had long been forgotten by any eagles by the time I moved here in 1966, but in the 1970s or early ‘80s, a tornado took that tree down and the nest with it. The nest you now see is an Osprey’s nest. Or, I should say it was an osprey’s nest! The owl nests much earlier than the osprey, and when the owls leave that nest, an osprey could move in. If there were a competition for the nest, the owl would certainly win.
So, Every Jonah has a Whale….. and you have woven quite a delightful tale of your own.
Thank you for sharing.
Thanks Lucy – I opted to place the whole e-mail here to prove that someone does indeed read my blog!
Also please have a look at Capt. Baz’s comment after the blog entry.
https://everyjonahhasawhale.com/wp-content/uploads/2020/02/IMG_1256-scaled.jpg17072560Jonas MagnussonJonas Magnusson2020-03-02 18:35:142023-10-16 12:52:35A great blue heron and five raptors - my neighbors
The frigate birds nest on Seymour, both the great frigate bird and the magnificent one. The magnificentfrigate is a bit larger, but they look very much alike. The way to tell the males apart is by the color sheen of the feathers on the back of the birds. The magnificent has a purple sheen – the great has a greenish sheen. The femalegreat frigate has a red eye ring and the female magnificent frigate sports a blue eye ring. The frigates have the largest wingspan compared to body size of all birds. They spend most of their time soaring effortlessly over the oceans months on end. They can even sleep when they are airborne and seem to have the ability to rest one brain hemisphere at the time. However, they can’t land on water – feathers get wet and heavy. Previously I have seen them several times but never up close. The frigates like to follow ships on their journeys. The males have a scarlet throat pouch which they inflate to impress the females. The female birds have a white throat.
Waking around the path we came upon a booby in love. The series of pictures are priceless where he dances around – picks up his stick – shows it to the love of his life – more dancing – alas she was not interested and scorned him while we were there. Let’s hope he can win her over someday.
Diving at Seymour Norte was great and I managed to snap a picture of a parrot fish that is more or less focused – getting better at that. During the snorkeling I saw a Galapagos shark glide by – a turtle – and a whole host of colorful fish.
We started the day on Isla Santa Fe. A modest climb up the lava edges led us to a plateau. The soil was bone dry and cacti littered the landscape. No leaves yet on the palo santo trees, but soon it will start to rain. We did not spot any porpoises but they have been reintroduced to the island.
Land iguanas were cooperative and we spotted several of those guys. One of them even smiled to us. Could have been gas though. However, this is a smile only a mother would love – sorry iguana.
I must post some more iguana photos – they are just so cool.
On returning to our boat in the dinghy we saw a sea lion that had just given birth. The hawks were monitoring the situation and momma sea lion was nervous. She decided to head for the beach with the pup in her mouth. Immediately the hawks swooped down on the afterbirth, and then it was total mayhem. The “Nature red in tooth and claw” comes to mind. Usually attributed to Tennyson’s In Memoriam.
Next stop was the tiny Isla Plaza Sur – just east of of the much bigger Isla Santa Cruz. The scenery there was just stunning as you can see in the picture below. This is one of the most amazing places I have been to. We witnessed restoration project i.e. the small cacti have to be protected until they reach a certain hight. The iguanas are vegetarian. The lava rocks someplace were turning white – called Galapagos marble the guide joked. The bird droppings will have their effect.
Next on the menu for us was to observe the swallow tailed gull. Note how big those eyes are – it’s a night-feeder and the end of its bill is florescent. For Icelandic readers – lundi (Puffin) also has a florescent beak.
https://everyjonahhasawhale.com/wp-content/uploads/2019/11/0BA31D89-FFC2-4112-B37F-372C5DD9DB56_1_105_c.jpeg7461054Jonas MagnussonJonas Magnusson2019-11-13 13:14:292019-11-13 15:52:31Isla Santa Fe - Isla Plaza Sur
Punta Cormorant was our first destination. There is a brackish lagoon there with a Flamengo sighting possibility. Two coves are accessible on each side of the Punta with a short hike through the Palo Santo forest. The Palo Santo trees were bare, waiting for the rainy season. We were lucky with our sightings – flamingos – green turtle – nursing sea lion – penguin – plus the usual suspects! We sure ticked all the boxes for that location.
We spotted a Green turtle ambling up onto the beach. The turtle will crawl above the high-water mark and dig a hole there whereupon the eggs are deposited. The eggs are covered with sand and the turtle makes its way to the ocean again. Curiously the sex of the turtle is temperature dependent – over 31 centigrade in the nest will produce females – under 28 Centigrade males and in between a mix. I have seen news that there are now more female turtles hatched. https://oceanservice.noaa.gov/facts/temperature-dependent.html
On the brackish lake there were indeed flamingos snacking with their heads upside down finding their food in the mud. The Palo Santo trees are waiting for the rains to start. The hillside will turn green and conditions will become more tropical. https://animalcorner.co.uk/animals/galapagos-flamingo/
On our way to the ship we had a stroke of luck and spotted a Galapagospenguin. This little guy was cleaning up on a lava outcropping and our guide spotted him. The Galapagos Penguin is of the banded variety (relatives in Patagonia and South Africa), and the only penguin to venture north of the equator.
From Punta Cormorant we sailed to Corona Diablo, that is a volcanic crater half submerged. This turned out to be a fantastic snorkeling experience. However, my skills at shooting underwater photos is limited, but the wet suit sure is dressy.
On to Post Office Bay. Whalers started the tradition of leaving letters in a barrel in Post Office Bay. When it was time to return home they stopped by the collective post office and took letters heading for the same destination and hand delivered them to the addressees. – https://www.galapagosislands.com/blog/post-office-bay/
The usual suspects.
The Mangroves are vital for coastline ecology. This tree has adapted to saline environment and excretes salt on the underside of their leaves. If you do not believe me lick a mangrove leaf. Their importance will increase with rising sea levels. Let’s hope this shoot will make it. https://en.wikipedia.org/wiki/Mangrove
Isla Espanola is a volcanic island, as are the other Galapagos islands. The islands sit on the so-called Galapagos microplate, which in its turn sits at the junction of the Cocos – Pacific – Nazca tectonic plates.
At tectonic plate junctions there will be volcanic activity. I am used to lavas coming from Iceland. The lavas and the craters are familiar, but decidedly not the flora and fauna. The igneous rock is softer than the metamorphic one. The Pacific ocean pounds away relentlessly, thus the Galapagos have been formed and eroded in cycles over the eons.
These photos are from Punta Suarez. The hawk and the sea lion from Bahia Gardner.
This is the island to visit to see the waved (Galapagos)albatross and the only island they nest on. When an albatross pairs up for egg discussion and nest building, they dance. They extend their necks then lower their beaks. Then there will some beak “fencing”. The following video show some great moves. Now if the dance is accepted, they pair and nest and raise their chick. After that they leave the island and each other and stay away and apart for 2 years flying wast distances over open seas. When it is time again for nesting the male birds will arrive first. Then female birds come back one after the other and the only way the pair can find each other is to do their signature dance.
Here is a gallery of the smaller birds. I can’t identify the finches, so I lump them into “Darwin’s finches.” These finches are famous for the work Darwin did when he visited the islands, and led him to the theory of evolution
Now for the lizards. Lava is porous and water just seeps through the top layer and disappears, that fact has important repercussions for all life on the islands. We can imagine a long drought – land iguanas going hungry – an enterprising individual starts foraging in the wrack on the beach, and little by little over a long time we have marine iguanas
The boobies are are in the same family (Sulidae – https://en.wikipedia.org/wiki/Sulidae -) as the northern gannet (ísl. súla) which Icelanders know from their shores. These birds are magnificent and their dives into the sea are spectacular. At PuntaSuarez there are breeding colonies of both species.
The Galapagos archipelago is a fantastic place to visit. The trip generated many good and some great photos. I have chosen to simplify the presentation by recounting each day with the corresponding pictures as we sail along.
We arrived in Isla San Cristobal in the afternoon for our Galapagos adventure. We flew in from Quito with a stopover in Guayaquil. Isla San Cristobal has a small town, and where there are people there will be cats and rats. After arrival the group was promptly rounded up by our crew and our guide. Tourists live aboard boats during their visit, and some boats are bigger than others. We were quartered on a boat for 16 tourists. The boat then sails between the various islands. Inflatable dinghies are used to get ashore. The boat is anchored further out. The small islands we visited were all regulated in number of visitors each day. There were marked paths we were allowed to take, and the guide was vigilant in herding us and making sure we were not transgressing. You can’t come closer to an animal than six feet, but generally they show no fear of humans.
The guide system.
No one is allowed to visit the islands without a guide. After meeting the guide, he was with us at all times. Our guide was a fantastically knowledgeable naturalist Fabian Sanchez. His website is http://galapagossealife.com He has profound respect for the fauna and flora, and was able to convey the facts, but also able to convey his respect and love for life forms in the Galapagos. All the guides working with tourists are employed by the national park. The park collects 100$ from each tourist visiting. https://www.galapagos.org
I am older than 18 “anos” for sure (but for some reason I am getting ads for hearing aids – shame Google. Unripe fruit is still ok – I think).
For my Icelandic readers – Icelandic has only one word “skjaldbaka” but English has two words, one for the land animal i.e. tortoise, and one for sea animal i.e. turtle. In San Cristobal we had some time to visit a tortoise hatchery where work is being done to conserve and reintroduce the Galapagos giant tortoise. https://www.galapagos.org/conservation/our-work/tortoise-restoration/ for instance on Isla Santa Fe. Small tortoises can’t make it where there are rats. Now they are nursed until they become four years old and then they are released into the wild. Efforts are also being made to rid some of the islands of vermin and cats. The afternoon we were visiting it was rather cold. Consequently, the tortoises were seeking shelters and burrowing, thus it was difficult to get a good picture of them. You can believe me when I tell you “they are big.” Notice how the carapace has an upward notch – the tortoise munches on plants and this way can reach higher. Their necks are long (see below). The Galapagos islands sit on the equator but are colder than you would expect. The culprit is the cold Humboldt current – https://en.wikipedia.org/wiki/Humboldt_Current – that sweeps up alongside South America’s coast.
The islands and ocean around are a national park. The waters around the islands are protected from fishing, and visible in the harbor the Coastguard had rounded up some sinners and confiscated the boats – then they will be auctioned off I was told.
This list of natural wonders is in itself enough to keep anyone full of awe and profound respect for the forces of nature.
In Zion I spotted some vultures soaring in their familiar fashion. I suddenly noticed a much bigger black bird cruising in the canyon. I immediately thought “it’s a condor” but nay – they are so rare. Probably the rarest extant bird in the world. My wife got in two shots with her 200 mm lens (you need more, but it will have to do) and when we blew up the image the case was settled. The white coloring on the wings’ underside clinched the diagnosis. A condor it was, and we were suitably impressed and thankful for getting to witness this majestic bird cruise effortlessly in Zion canyon.
Humans are capable of immense destruction of nature. We are in a period of extinction of animals and moving towards a climate catastrophe. However, humans are also capable of immense feats when we choose to. When we understand that we are a part of nature – not its outside masters – it is possible that we can solve the environmental problems we have created and survive and even thrive. On my positive days I am a pessimist and I do not harbor much hope that we as a species will come to our senses. However, the condor story gives me hope. I choose to recount my condor story because it is positively amazing, and it underlines what we are capable of when we set our minds to it.
The Condor Project
1987 Californian condors were nearing extinction. The US government funded an ambitious and expensive plan to breed and then reintroduce the condors. All extant Californian condors were caught and brought to participating zoos. The Condors will lay one egg every other year. If that egg is promptly removed, they will double clutch (i.e. lay another egg). The chicks were hand reared and little by little the stock increased. Now, to make certain that the condors could survive when released, two female Andean condors were released in South California, and they did fine, thereby proving the point. Subsequently those two Andean condors were caught and returned to South America. Now, condors have been released in South California, in the Grand Canyon Arizona, Zion National Park, and North Mexico. In short, the birds are making a slow comeback. Now their biggest threat in the wild is lead poisoning, acquired by eating animal carcasses peppered with lead shot. Hunters in condor areas are now supposed to use lead-free shot.
When running an inpatient surgical ward there is a constant struggle to get the patients home after operations. There is, of course, some reasonable length of stay needed for serious matters etc. However, from my point of view some of my patients could go home sooner than they themselves wanted. There were all kinds of ploys used to hasten their discharge, but the opposition had some tricks up its sleeve, too. For instance, when I would do the rounds on Monday, I expected that someone would be able to go home on Wednesday. So, I would suggest discharge on a Tuesday. Then when the patient began to balk I would suggest: „Well ok Wednesday then,” and everybody was happy. The hospital had a library and the patients used it in their convalescent period (Icelanders are a literate bunch). Then I had the following rule to lighten the atmosphere in the wards where there were a number of patients together. Of course, the patients preferred the romantic genre of books, for example, the Red Series (Fabian bare chested, etc.). The rule: Whenever a book like that was spotted on a patient’s nightstand, they would be unceremoniously discharged (or an attempt would be made on the basis of the evidence). If you can read that stuff you are ready to go home, right? And It would happen that this did not go over too well.
At that time, we had a Surgeon General of Iceland Ólafur Ólafsson, who was and still is a crusty old guy. He sported bushy white hair, and his equally bushy eyebrows were in the Santa Claus class. He was at the tail end of his career at that time. His voice was deep and gravely, and had he been an American he would have been reading the voice overs in the Whiskey and Cigarette commercials. He probably would have put James Earl Jones out of the voice work. As Surgeon General he has a great sense of humor and the ability to see the absurd and funny in just about any setting. He was always a champion for the patients and their rights, and was never a tame tool for the politicians – he was a very unconventional civil servant. He gave me invaluable advice: “Jonas, just be yourself.”
Contrast him with the Suits and apparatchiki that we have met through our lives.
Author‘s addition to the definitions: A Suit – a civil servant totally devoid of any charm, humor or even a face.
Ólafur could be a handful, especially when he called in the middle of the night (he is a night owl) to discuss some pressing issue. You are fast asleep in some happy dream and then “It is Ólafur” and you began thinking – it must be some damn volcanic eruption. When he was still working, his offices were next to the square where the homeless and unfortunate souls of Reykjavik congregated. To his credit, he always kept a protective eye on his neighbors and tended to their needs. When he retired he palmed them off to another humanist doctor. I just love this guy for lots of reasons.
Now, one of my patients got offended by my Red Series comment and made a formal complaint to the surgeon general. Such a matter needed to be resolved and resolved it was.
I got a formal reprimand letter from the Surgeon General’s Office stating (loosely translated):
https://everyjonahhasawhale.com/wp-content/uploads/2018/04/Screen-Shot-2018-04-18-at-18.51.12.png465546Jonas MagnussonJonas Magnusson2018-04-26 17:52:512021-01-01 09:54:16Reprimanded by the Surgeon General
That was when the russkies were naughty (they still are), and when they wanted to mess with Europe they just squeezed its balls, i.e. Berlin. To get vital supplies to Berlin after the roads and railways were closed (by the russkies), the Allies resorted to a massive airlift to keep the city running. I found this utterly fascinating and subsequently had a brief obsession with airplanes. One of my casting students (a retired pilot) actually flew on those missions via that corridor [via one of the three permitted air corridors]. But I am just rambling, so I will get on with it.
During the tail end of my Med School days, I got the opportunity to do a locum (relieve some doctor who needed a break) in general practice out in the sticks. This was very welcomed since we med students got paid, and it was a learning opportunity for us. What the patients thought of it is not clear, but I guess they thought it better to have someone manning the shop, albeit an inexperienced medical student. It was deemed prudent by the authorities to send two med students to relieve one experienced doctor. So off we (I and my colleague) went and wound up in the farthest district from Reykjavik on the shores of the Arctic Ocean.
That month turned out to become very eventful, and we were very busy. At this stage in your journey as a doctor everything is just so damn interesting and stimulating. We for instance had a patient who developed a sudden onset of pain in one eye! What the heck can that be? So, dive into books (remember no internet), and if we needed more, a corded telephone was our best ally. We treated cardiac arrhythmia, overdose, urinary retention and even plucked shot gun pellets from the derriere of the local police officer. Plus, all the other more routine ailments. It turned out that the organ specialists in Akureyri (closest big town) and Reykjavik, whom we repeatedly had to consult, were very helpful. They probably remembered their own bygone locums, so the system worked – if you had the sense to ask for help. We both were keenly aware off our limitations, and relatively free of hubris (that came later) – but when I reflect on that period I realize that we were so ignorant of all the ways things can go caput [go to hell in a handbasket] in medicine, that we just happily forged on with our trusted ally, the telephone. When I gained more experience I never encountered a situation that I could not make substantially worse by untimely intervention or the wrong one. So, make sure your indications for doing anything in medicine are solid before proceeding.
To give you a glimpse of the Zeitgeist I can share the following story. We got a call from a farmer who had some pain in his chest. “A stick fell on my back” was the story. “Can you come out here and have a look?” When we arrived at the farm, we met the family, and then we were invited to a meal. There was no examining until after. After that and conversations about our family trees (yup, that was the social norm) we got to have a look at the farmer. This was the typical attitude of those people in those days. Tradition dictates a certain decorum, and it is to be observed even if you had a “stick” fall on your back.
As it turned out, the “stick” was in fact a large driftwood log. This farm owned a stretch of beach where you could harvest these logs. Such logs drift from Siberia to Iceland’s shores and were through the ages extremely valuable as there were no big trees in Iceland for construction purposes.
Transpolar current bringing driftwood to Iceland
Furthermore, they were salt impregnated after their journey in the ocean and thus rot resistant. The farmer had his ribs on one side broken with air under the skin (subcutaneous air). When you encounter such air, it feels like the crunch of newly fallen snow under your fingers. The lung was punctured, but the farmer was stable so we sent him off via airplane to the nearest hospital in Akureyri.
During the Cold War the Americans had built a radar station on the top of a nearby mountain and ran it from 1954 to 1968.
Driftwood and the mountain
To service it there was a small airfield on the shore running from east to west. To be able to land there, a radio beacon had to be turned on. The airfield manager (and only personnel) turned the beacon on after receiving a call from Keflavik. ”Can you turn the beacon on Mr. X?” to which the answer was “Whiskey?” “No damn it – no whiskey.” “No whiskey no beacon.” They could get by with few words. If the negotiations were successful, the beacon got turned on, and the airfield manager was happy. The way alcohol is sold in Iceland is through state monopoly shops. Sweden has the same system, for instance, and it is rumored that the people living on the Faroe Islands only get to buy their liquor if their taxes are paid. The state shops in Iceland are called “Der Reich” (The state) and exist only in the bigger towns. The population with no “Der Reich” makes a phone call, and the merchandise is delivered with the next post delivered by flight. It was thus imperative to receive the post on a Friday. On Friday the airfield manager had radioed in the local weather conditions on which the pilot made his decision to fly or not. The “terminal” at our local airfield was the bridge cut off from a decommissioned trawler. Yet it functioned well. We were in the terminal once waiting for some medical supplies when we witnessed another interesting exchange on Friday afternoon: “You reported the local weather – visibility unlimited – calm – no clouds” came the voice of the pilot from the radio. Then we could hear the drone of a plane from above, but it was totally overcast (clouds 600 feet), wind from the north 10 mph (crosswind). “Yes – it is amazing how the weather on the arctic ocean can change in a heartbeat,” answered the airfield manager tongue in cheek. Now the calm voice of the pilot was heard – “I am going to kill you Mr. X.” “Well, you have to land to do that” was the logical answer. The bush pilots are very good, so nothing untoward happened despite dicey weather. We got our supplies, and the village its vital necessities.
“Hi doctor X! You’ve got free air in your abdomen.” Doctor X is a pediatrician, rotund and florid. He is rather excitable and has a vivid imagination. You often expect him to have a cerebral hemorrhage during a conversation (blow a gasket). He is a great story teller with artistic tendencies, and has good rapport with children and their parents. A bit unorthodox perhaps, but never boring. “I can sell this darling on the internet for you,” he said once when some parents were complaining about their son’s stomach. Well, the doctor had been seen by the surgeon on call, because of an abdominal pain, who had promptly ordered a CT scan because of his abdominal pain. After the examination he&the patient somehow got through the cracks and just went home. The surgeon on call came across the CT later in the day and there it was — free air in the abdominal cavity (which means there is a hole in a bowel somewhere). The surgeon immediately contacted Doctor X and ordered him to come post haste to the hospital. Understandably Doctor X got really scared, and with his imagination racing, thought his days were numbered. He was expected to return within the hour, but time dragged on, and finally he shows up obviously freshly shaven and sporting a new haircut! “Where the hell have you been?” was the first question. “I am certain that I am not going to make it,” came the retort — “that´s why I went to have a haircut and a shave.” Now the surgeon is incredulous “we fix this all the time you idiot” (is that how you talk to a pediatrician?). “No, I am a goner,” he continues, “to be on the safe side I also had my portrait taken by a professional photographer – in black and white for effect. Something for my family to remember me by.”
His treatment was uneventful, and he recovered. Since that time, he has a new found respect for surgeons and thinks we are miracle workers, nothing less. Doctors are a very difficult group to deal with as patients. Especially those who are cynical and meddle in their treatment plans. The only group that is worse is probably the clergy. “It is all in His hand” type of reasoning can get you to a boiling point. “Perhaps He put us here to take care of you” reasoning does not seem to enter their minds.
Neskirkja í Aðaldal
At the end of my training I used my vacation to do locum work at my first surgical department. I was a newly minted surgeon (licensed and all), and it was common for new specialists to do locum work in Iceland instead of taking a vacation. The family got to go home to all the relatives, and we got some brownie points for relieving the staff doctors. It was a bit like a dress rehearsal, where we could show just how good we were and also get a feel for working there for the future.
The atmosphere at the surgical department was jovial, and the morale good. The rhythm of the day was to present new patients at the morning meeting. The emergency patients were discussed, and any problems incurring during the last 24 hours were recounted. I had been on call, and we had admitted an old lady with a distended abdomen in the morning hours. She was emancipated and in dire straits, and the bowels were obstructed. What to do? Well, first off you discuss that with your patient. She understood that an operation was very risky, but by doing nothing she was going to die. She still enjoyed life she told me, and we decided on an operation as our only option. The staff surgeons were very negative about this endeavor. One of them of the “It is none of your damn business” fame (see my blog, https://everyjonahhasawhale.com/?p=1811) thought me mad. “Are you going to operate on that mummy?” He went on and on about it. Then there were the anesthetists! “The electrolytes are terrible, the kidney function impaired and my god that heart.” Well, I honestly love anesthetists and I understand their plight. First, they have to anesthetize such a person, and then they have to deal with the surgeon – at the same time. So, the discussion with the anesthetists on the merits of such an operation, and the risks involved could be interesting. My central argument was always simple. The primary disease process causing all those abnormalities in the electrolytes, etc. was perhaps, and quite likely something that could be reversed. Our philosophy is, if the primary process can be fixed, the secondary problems have a chance of getting better. So, the patient will only survive the operation that fixes the primary problem. We must be very focused on that, and actually try to simplify things (some might call it tunnel vision). If you do not do that you will become mired in minutiae, and you can not do anything at all because it is all so terrible and rapidly getting worse. My arguments carried the day, and the anesthetists got the old lady ready for an operation. I was about to open her abdomen when the door of the operating room banged open, and the surgeon with his walrus mustache barged in.
Dánarvottorð – Death certificate
He was in fine spirits and was holding a pen in one hand and a death certificate in the other hand (those forms were the only ones we used on yellow paper.) Then he bellows – “When you start cutting – I will start writing!” He really was a lovable scoundrel.
There you go – what an auspicious start to an operation. By that time, I was getting to know him and I suspected that he was only “weighing my cojones,” so I did not get too rattled. All this black humor is a coping mechanism in a stressful environment. The operation was easy, and I found the suspected incarcerated femoral hernia, which was easy to fix. This lady recovered nicely and was duly discharged.
I sit here alone on the banks of the river
The lonesome wind blows and water runs high
I can hear a voice call from out there in the darkness
But I sit here alone too lonesome to cry
The Lonesome River – Bob Dylan
For doctors the river is constantly there. Our lives are lived on the banks of the river. Sometimes our toil is to prevent early departures and sometimes it is to help people to navigate across. We might as well fish it while we are at it!