My week as a country doctor

Just got done with a week as camp doctor at a resident camp for children in Central California. I started volunteering as camp doc last summer, not just so I could clandestinely keep an eye on my own kids and take their pictures on the sly - but as a personal dare to see if I could do one of the most challenging yet rewarding jobs in medicine, being a country doctor.

At camp, I focus on keeping children healthy, and provide basic medical care wherever campers and staff need it - at our infirmary, by the lake, at the ropes course, or at lunch tables. I triage who should go to the emergency room 40 minutes away, or who needs some extra TLC for homesickness. I work with a camp nurse who dispenses prescription and over-the-counter medications four times a day. The camp doctor has office hours twice a day at the infirmary for sick campers and staff.

Being out here in the foot hills of the Sierras with a tightly knit community of about 300 children and 150 counselors and staff reminds me of why I went into primary care pediatrics. I don’t
have to deal with mounds of documentation, billing and coding, or prior authorizations from health insurance companies. Here, I just focus on keeping my little community healthy. So I thought that I should share some tips for others contemplating a stint as a camp doctor.

Ten tips from a camp doctor to future camp doctors:

1. Homesickness can manifest in startling ways: Homesickness may show up as all sorts of physical symptoms - headache, sleeplessness, poor appetite, bellyache, nausea, vomiting, diarrhea, dizziness, anxiety, or panic attacks. The wise Nurse Giggles helped me realize that sometimes my physician’s instincts may need to defer to my parental instincts. All children may need is your reassurance that they are okay. As much as you might want to help, remember to let your campers’ counselors handle homesickness. It is fine to give the child hugs at mealtimes if you like, but if the camper ends up bonding with the doctor or nurse more than their counselors or bunkmates, they will just want to hang out all day in the infirmary and participate even less in activities and making new friends.

2. Have a back-up plan for backups: Kids will revert to what their parents don’t want them to eat. The typical plate model they will follow at camp may consists of half a plate of corn dogs and half a plate of bread. You will find yourself surreptitiously looking at your campers’ plates at mealtimes and predicting which kids you will see next in the infirmary for stool softeners, a cup of chamomile tea, and a motivational interviewing session on eating their fruits and veggies.

3. Bees like juicy kids: Know where all the epinephrine auto-injectors are at camp. Children are stung by bees more often than adults. Perhaps because they tend to spend more time outdoors, or because they wear bright and patterned clothes, or because they like walking barefoot. Most bee stings are mild, but in about a fifth of stings you will see a large local reaction that can look astonishing scary. A whole forearm can swell up and turn red for days and can be mistaken for an infection. An ice pack, antihistamines, a painkiller, and corticosteroid cream usually do the trick. Just remember not to squeeze the stinger out or use tweezers. Just scrape the stinger out gently.

4. Prepare to provide full spectrum care: I had naively assumed before I went to camp that I would be working as a pediatrician - until counselors and staff starting walking/limping in. Generally not used to seeing many individuals over 5 feet tall in my practice, I had to quickly get used to 6 ½ foot tall Australian surfers towering over me as I took care of their lacerations and splinters.

5. Stay alert to issues that can spread like wildfire: The majority of your time will be spent taking care of strains, sprains, stings, swimmer's ear, conjunctivitis, cuts, allergies, and asthma. However, some issues need to be nipped in the bud so that they don’t get out of hand. Impetigo, gastroenteritis and head lice come to mind. Also, campers spreading the word among their bunk mates that the infirmary freezer stocks ice pops.

6. Enjoy the privilege of the time you get to spend with your campers: I work in a busy clinic during my regular life, where I frequently have limited time to spend with each patient. At camp I am fully able to learn about the whole child and appreciate what life is like for a child with a chronic condition 24/7. Campers teach me about their everyday challenges, from having to give themselves insulin shots to how they handle dietary restrictions and allergies.

7. Love your local EMS: Find out how to contact local emergency medical services, response times, training level of emergency service providers, and available services. Find out if there are dentists or orthodontists in the area willing to treat dental emergencies.

8. You will need to pick a camp name, and you may have this name for life: Perhaps the most challenging part of this job. I landed on Dr. Aqua after going through at least 15 names that were already taken by other counselors and staff, or that my family vetoed. The name worked well given my childhood by the sea. Chances are that you will end up keeping your camp name for a while, so choose it responsibly!

9. If this is not a medical home, then what is?: My campers have immediate access to high quality clinicians who like their jobs enough to actually take vacation to work. My campers get same-day appointments and house calls with a smile. In return, they write me sweet notes and give me high-fives and hugs when they see me out and about at camp. Take this opportunity to see how rewarding the life of a country doctor can be.

10. Have fun with your campers!: Clearing up my schedule to be a camp doctor for a week was not all work - it was a great deal of fun and a growth experience. Between infirmary office hours I took some time to enjoy camp activities – canoeing, basketball, horseback riding, and archery. Even the sidesplitting “Beyoncé Tour” run by a high-energy counselor from England with the apt camp name of Nitro. 

I left camp with more than I arrived with. An enormous appreciation and respect for camp staff, a renewed interest in pediatrics, and some cool dance moves. All in all, a uniquely rewarding and energizing experience.

- Ulfat Shaikh

Nurse Honey Bear, Megatron and Dr. Aqua at the camp infirmary