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My nonvacation with the Boy Scouts

Serving as camp doctor to 50 kids didn’t quite get this FP the relaxing week he’d hoped for. But he came home with a new appreciation for his line of work.

By Erik C. Walker, MD
Family Physician/Oviedo, FL

Imagine abandoning hot, humid, bug-infested central Florida in July for a week in crisp, cool North Carolina. Picture leaving a high-volume medical practice for a trout-stocked lake and mountain hiking trails. It sounded fabulous to me, so when my son’s Boy Scout troop asked me to serve as the doctor at its summer camp, I quickly accepted.

My task was to handle the medical needs of 50 boys ages 11 to 16, and 18 adults. "How hard could that be?" I thought. "This will be a vacation."

A few weeks prior to our departure, the troop leaders met with the campers’ parents. I joined them to answer questions and collect health questionnaires and forms. I’d assumed that parents would give me brief summaries of their sons’ conditions and medication needs, but many provided detailed histories and instructions–how much congestion one boy should have before he’d need his oral antihistamine, when another boy might need his ADHD medicine, and so on. I took extensive notes and wondered what I’d gotten into.

At the next meeting, our final one before camp, parents and some older Scouts brought me medications to dispense during the week. I soon had a travel bag filled with medicine bottles, inhalers, creams, and nebulizers.

As we began our 13-hour bus ride to North Carolina, I realized that eight kids needed various medical regimens throughout the day, and each one assumed I knew all of his meds and how he took them. I made out a cheat sheet, noting which kids required meds at breakfast, lunch, dinner, and bedtime. After every meal, I glanced at my list, then grabbed the appropriate boys and told them it was time for their pills. This proved to be no easy task. I spent a fair amount of time dragging kids off the shooting range, down from the climbing wall, and out of the lake.

Actually, those were among my more peaceful moments. One afternoon early in the week, for example, I was relaxing under a large tree next to a babbling brook with a book I’d wanted to read for two years. It was heavenly, until a boy ran up to me screaming, "We need the doc right now!" As I learned, two Scouts had been fishing when one of them tripped on his pole and hooked himself with a lure. The other quickly said, "You sit here and I’ll get help."

When I arrived 10 minutes later to remove the lure, I was astonished to find the injured boy sitting quietly, without fear or panic, with the fishhook in his hand. The calmness and maturity of these two youths, who were only first-year Scouts, reminded me of just how well Scouts are trained to handle emergencies.

My "vacation" didn’t get much more relaxing in the wake of that incident. Another afternoon, while I was with a group of Scouts and adults climbing a 40-foot-high rock wall, an adult from another troop told me that the nurse needed me at the Health Lodge. When I got there, she explained that a 25-year-old camp counselor had a 24-hour history of diffuse midabdominal pain. Over the preceding few hours, the pain had moved to the right lower quadrant, and eating or standing caused discomfort. The nurse had encouraged her to go 40 miles into town and be checked at the hospital, but the young woman had refused.

I asked the patient the standard acute-abdomen questions and learned that she’d had a normal period two weeks earlier. When I examined her, I found that she had tenderness at McBurney’s point. Holding her hand, I told her that she might have acute appendicitis and needed a complete workup right away at the local hospital. The nurse’s face lit up when the patient agreed to be transferred to town.

A CT scan subsequently showed a ruptured ovarian cyst, and the patient returned to the Health Lodge that evening with antibiotics and pain medicines. After I went home, I got a thank-you note from the nurse, who reported that the patient was doing fine.

Although my week wasn’t quite as uneventful as I’d anticipated, we didn’t just head from crisis to crisis. In fact, the Scouts and their leaders had few problems that Band-Aids, bacitracin, or Imodium A-D wouldn’t help, so I had many hours to talk with the other adult leaders about our lives, work, and children. We discussed why time with family is important to us, whether it be in scouting, sports, church, or even at dinner each night. We also had long, leisurely talks about cholesterol and fad diets, why you need a rectal exam even with PSA testing, and why health costs are so high in America yet our health remains bad. I enjoyed answering their questions about health issues, and they were eager for information. I imagined how wonderful it would be to have this kind of time with my patients, who I’m sure have many questions of their own.

All in all, it was a great week–partly because it reminded me why I love being a doctor. Sure, managed care and medicine in general involve a lot of problems. But there’s nothing like caring for sick and injured people who really need your help–and being respected and appreciated for doing so.

Erik Walker. My nonvacation with the Boy Scouts.

Medical Economics

2002;2.