Commentary: The locum tenens ‘itch’ strikes again

Dec. 1 : Flying north from San Diego to Reno, Nev., along the spine of the Sierra Nevada Mountains, the plane crossed over Lake Tahoe, just before landing in Reno. The mountains surrounding the lake were white. The trees were grey-green; and the lake itself, black, in shadow from the mountains, just before sundown. I looked down upon a California-Nevada chiaroscuro. I was on my way to a locum tenens psychiatric outpatient assignment northwest of Reno, in the eastern foothills of the Sierras, in Timberton, Calif.

Locum tenens is Latin for “holding a place.” Because of staff departures from hospitals, clinics, or private practice, temporary replacement doctors (or nurses or dentists) are needed until permanent staff members can be hired. In essence, a locum tenens is a “rent-a-doc.”

Dr. Neal A. Kline

Landing in Reno, I left the main terminal lobby with its silver sculpture of a downhill skier and picked up my rental car. (For a locum tenens, the plane, the car, lodging, malpractice insurance, and the contracted hourly fee-for-service are included in the locum tenens agency’s monetary province. Not food and not gas.)

Driving north on the interstate, the car skidded a bit on a patch of black ice. Even though the car skidded only “a bit,” still, that was enough to focus my attention. (Oh! That’s what black ice is all about. Slow down, Hopalong!)

My destination was close now, and I pulled off the highway onto Main Street, Timberton.

Two blocks off Main Street was my bed and breakfast: a pale green Victorian house decorated for Christmas with white mini-lights hung as icicles from the porch roof’s eaves. The home was storybook-immaculate; the innkeepers, extraordinarily gracious. Neatness and kindliness count.

Outside, 2 or 3 inches of snow accumulated, and a snow plow “chingled” up the street, pushing the snow aside. For the rest of the evening, no sounds disturbed the winter’s silent night.

The next morning, on route to my worksite, I passed the once-upon-a time Timberton railroad station. Nearby, California Bigleaf Maple trees – their autumn hues so strikingly similar to the color palette of Eastern sugar maples in the fall – were nearly bare. A few leaves – vivid reds and yellows – were hanging on for dear life, trying to maintain the glory of the Crayola-colored fall, just passed. Eventually, however, for the leaves – and all else – time and seasons move on, waiting for no one and no thing.

In days gone by, this railroad depot bustled with passenger traffic. And lines of timber-laden freight cars with both cut logs and milled boards rolled through, supplying lumber for a growing nation. History matters.

At the clinic, my first patient asked, “Will you be my new doctor?” “Will you be here for a short time or a long time?” “ I’ve already had four doctors since I’ve been coming here.”

My night times were filled with reading:

“Of Human Bondage,” by W. Somerset Maugham, the story of a crippled atheistic English lad, attending a London medical school, seeking the meaning of life … and a square meal. [Or is that redundant?]