twas the night before christmas

Twas the night before Christmas, when all across the atoll,

The PA was roaming, he was out for a stroll.

The volunteer bird counters, had been bandaged with care,

In hopes that tomorrow’s half-day counting they could bear.


The albatross were nestled, all snug in their nests,

While bonin petrels, danced over their heads.

Monk seals on the beach, and sea turtles by the bay,

Had all come ashore, to soak up the evening’s last ray.


I stopped at the clinic, to see if anything was the matter,

Swinging my bright beam, I watched the geckos scatter.

Into the pharmacy, I flew like a flash,

Unlocked the door, and flipped open the latch.


The light on the shelf, cast nary a shadow

There weren’t many meds, a few IV and a few more PO.

When what to my wandering eyes should appear,

A narcotics safe, but inside only nalbuphine, oh dear.


“Now, labetalol! now, lorazepam!, now morphine! now, vasopressin!

On, vecuronium! on, ketamine! on, etomidate! on, nitroglycerin!

Fill up my crash cart and the holes on the wall,

Come on the next flight, come one and come all.


The trauma bay is not state of the art,

But it’s reasonably lit, and there’s a crash cart.

Any patient on this stretcher is a medevac for sure,

Assuming I can keep them alive, with a pharmacy so poor.


I fixed the vent, you see there was a hole in the circuit,

It seems corrugated tubing is tasty, mice like to chew it.

While CPAP would be a luxury, here in this tiny encampment,

With limited O2, a mixed gas vent should be standard equipment.


What here, a working laryngoscope, a mac three and a four,

And ET tubes 5.5-8.0, all arranged in the drawer.

For difficult intubations, a four miller would complete my set,

But wisely this PA brought a his own bougie, to hedge his bet.


Though expired the ET tubes are plenty and still new in their box,

When I found two copper stylets, I was knocked right out off my socks.

It was sure reassuring after finding nothing but flimsy green wire,

I wonder what other surprises I’ll find in this mire.


Moving on to circulation, and for whatever odd reason,

There are TQs galore, and on the NWR there’s no hunting season.

I don’t worry about access even with a difficult stick,

Believe it or not I have an IO and that should do the trick.


The IV pump works great, I gave it a test,

Believe it or not, I have matching drip sets.

First it told me “distal occlusion” and “air in the line”,

But now I can set a rate, and bolus just fine.


For diagnostics there’s a microscope but it needs a torch,

And the X-ray machine I may figure out by March.

There’s tons of old not very useful equipment on the shelf,

And I laughed when I saw it, in spite of myself!


A corneal foreign body presents another fine problem,

Even though I have a Wood’s lamp, and drops to numb them.

You see, the slit lamp has rusted beyond repair,

And the fluoro strips have been ruined, by the sea air.


Most the Americans have Framingham scores greater than 53%

If one busts a plaque, in their widow maker, they’re spent.

There are only two other guys, airport firefighters to be sure,

Who would grab an AED, when that coronary hits the floor.


I have a 4×4 Mule, outfitted in all of the latest antiquated kit,

She’s stubborn to start, she’ll sputter and spit.

I might get there in time, but then to transport a patient,

There’s a van marked ambulance, but it’s derelict and vacant.


Lucky for all I plan for just such a contingency,

And minus the drugs, have all I need for the A,B and C.

Just remember this tale, next time you try to pack light.

“Happy Christmas to all, and to all a good-night!”