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Monday Jan 30, 2017

Keep Calm and Carry On … Being a Family Physician

I almost hit a whale -- two, actually.

As I type these words, the entire experience comes back to me in a rush.

We were coming in from halibut fishing on a friend's boat. It was an agile and fast surplus Coast Guard patrol boat that was painted to look like a killer whale. I was driving much faster than I'm accustomed to, out in the open, miles from shore, when roughly 40 tons of humpback whale -- mother and calf -- surfaced right in front of us. You can imagine the feeling of approaching more than 60 feet of whale at 28 mph. The mother more than filled the span of the boat's windshield.

I've written before about my encounters with large wild animals, but none as large as these.  

Fortunately, we were in a boat intended for young Coast Guardsmen. The owner said even they couldn't make it roll over. I remembered this quite distinctly as I cranked the wheel hard, laying the boat over on its side. The boat has rails that bite into the water just like the edges on skis, which is exactly what it felt like as we approximated a right-angle turn, passing within grabbing distance of the mother whale's flukes.

I corrected and cut the power, and we all sat there recovering, boat, humans and whales. The whales were just as surprised as we were. I couldn't help but think about the karmic implications of hitting a baby whale.

We took some pictures. They took a few breaths, and then sounded. We were alone again as if they had never been there.

There is a moment of intense clarity during an emergency. I know this mental state well because for more than 20 years, I have had my own family medicine clinic and covered the ER in a rural hospital in Valdez, Alaska.

This was one of those moments. Yet it paled in comparison to the intensity I have felt as a small-town family physician. We here live at the intersection of big mountains, snow and ocean. Some of our cases have led to serious adrenaline rushes, and we have made some amazing saves, including resuscitating people who had been caught in avalanches and glacial crevasses; delivering twins during an intense snowstorm; bringing patients back from strokes and heart attacks; and ensuring fertility in one young woman stricken with an ectopic pregnancy, later delivering her healthy baby and watching that child grow.

I can't talk specifically about these cases because of HIPAA regulations -- and also because this is a small town. However, you can extrapolate something about family medicine from these examples, which were more intense and more interesting than a high-speed near-miss with a mother and baby whale in a surplus Coast Guard boat painted like an orca -- and much more satisfying.

John Cullen, M.D., is a member of the AAFP Board of Directors.

Posted at 03:32PM Jan 30, 2017 by John Cullen, M.D.

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