Tuesday, June 11, 2013

La Posada

After the previous night's unnecessarily-harrowing drive, I was ready for something a bit more relaxed. And there are few better places to have a relaxed breakfast than Winslow's La Posada Inn. It's a relic of the Romantic West's golden era, where Fred Harvey's trains carried people from one luxury hotel/train depot to another.

Conveniently, La Posada is at the intersection of major rail lines and Route 66, so as rail travel made way to the Great American road trip, La Posada stayed just as busy. It's one of the only operations of that era to still be in business. The turn of the century adobe construction is breathtaking, and the food is even better. Certainly worth a stop if you're in the neighborhood.


With that, Aimee and Judy headed back to Tucson, and made the long, open drive back to the reservation for my last week of work there.

There is such a unique, stark beauty running through this area, and the work is absolutely incredible. I'm sure I'll be back.

































Monday, June 10, 2013

It looked paved on the map

With tired legs and a belly full of ice cream from the Bryce Canyon lodge, we headed back home to the reservation. I wanted to show Aimee and Judy a different view on the way back, and I saw a route on the map that looked promising.

Before we left, I had heard that this particular route was kind of touch and go. The road wasn't great, and it occasionally got washed out altogether. But the people I talked with at the health center said that it wasn't too bad these days, so I decided to go for it. If this were a story about a calm, pleasant drive home, it wouldn't be on the blog.

The first stop of the drive was Lake Powell. It was something like 140 degrees outside, so it was kind of hard to imagine myself having a relaxing afternoon on the boat. But there were certainly people out there enjoying their Bud Lights and inevitable sunburns. I suppose that in AZ we don't get to be too choosy about our recreational waterways. And you can see from the photo, the scenery was stark and stunning.


After Lake Powell, and Page, the city adjacent to it, we entered the west side of the Navajo reservation. It was one of the more rural sections of an entirely rural reservation, but there was a huge set of power lines next to the freeway. We followed the road (and the power lines) all the way to the 1960s. Well, it was actually a coal mine, but nothing around there appeared to have changed in the last 50 years. Signs were written in faded mid-century fonts, and there wasn't a soul on the road that day. If I didn't know the back story of the mine, I would have easily assumed that mine dried out and the area was abandoned years ago.


But that's not actually the case. It's a small, active, and controversial mine that provides the fuel for the area's power plants. The irony certainly isn't lost on the Navajo tribe that their options for electricity and modern life come from either coal or uranium. Both come from the reservation, and both provide their own unique environmental challenges. But they also provide the electricity that their community needs, and one of the few solid employment bases of the region. It's not an easy decision.

The area is known as Black Mesa, and it's not hard to figure out why.


But I didn't have much time to enjoy the scenery or ponder the ethics of bringing electricity to a community, and then requiring them to mine their own land to support it. The sun was going down fast, and every few miles, the road degraded a bit more. By dusk, we were on a winding, signless dirt road without a single person in sight, and no cell service.


The map that I brought with me didn't have much detail on that road, but it didn't matter much. The road had been washed out so many times that it was almost indistinguishable from the desert around it. Aimee was being a good sport, and Judy was sleeping, but I was trying to figure out how I was going to spin the story about how I got everyone lost overnight in Indian Country.

After about an hour of driving in pitch blackness, I saw a handpainted sign showing "Ganado" with an arrow. I couldn't show how relieved I was, because that would have betrayed my considerable internal worry. But with the tiny town of Ganado as our new landmark, I new I'd get us home.

The rest of the drive was more pitch blackness punctuated by the occasional road sign or coyote. But we made it back without incident, and I slept like a baby.

Bryce Canyon

Heading out of Kanab, we knew where we were going, but we didn't know anything about it.  Before we left the Hopi reservation, we looked through my housemate's rather impressive guidebook collection.  And while we're talking about it, there are few factors that convinced Aimee and me that a job on the Hopi reservation might be worth exploring more than his collection of at least 150 guidebooks.  About half of them discussed the Four Corners region, and the other half covered places as far away as Cambodia, Siberia, and Belize.

All of the books had bent corners and ragged covers, and the local ones had check marks alongside each hike in the table of contents.  We knew that the books were well used, and we thought that any job that allows for this much adventure can't be half bad.  Or any bad.

But back to this trip.  We found a guidebook for hikes in Southern Utah, and knew that one of the area's five National Parks would be where we were heading.  We didn't know much about any of them, but we picked Bryce Canyon based and a fun-looking hike description and a photo of Navajo Wall Street (we'll get to that in a second).  The other options were Arches, Canyonlands, Capitol Reef, or Zion National Parks, but those would have to wait for another trip.

I took this photo with my phone, so that I would have a copy of it when we were in the canyon (without having to lug the whole guidebook), but this seems like a good place to drop it in.


Pulling into Bryce, the park looked pretty, but not necessarily National.  You see the horse corrals for the guided tours, and a fake western town for the international travelers.



But then we hopped on the National Parks Service shuttle, and got dropped off at the trail head.  Ah, that's why it's a National Park.


I can't overstate how striking that was.  The shuttle bus drove through a wooded area that blocked any sort of canyon view.  Then we walked over a small hill to get to the lookout point and were completely floored.

The park encompassed two neighboring canyons (the first one spans the photo above).  Our hike was going to take us down into both, which of course meant that we'd have to climb out of both.  My aunt wasn't particularly excited about that part, but we knew she would be fine.  And if not, there was always the NPS Search and Rescue helicopter.

Aimee and Judy heading down:


The hike began by taking us though Navajo Wall Street.  The name makes sense.


The view from the bottom:


I love slot canyons, and this was one of the most striking ones that I've been through.  It was also remarkably approachable.  The trail was well maintained, and there were handrails for the steeper sections.  The National Parks Service really deserves some kudos for how they manage Bryce (and really, every other park that I've been to).  The approachable trail, shuttle bus, well-made maps and free guidebooks really opened this park up to people who may not otherwise be inclined (or able) to see this sort of scenery.  Which really is the purpose of the National Parks Service, to showcase our shared environmental and cultural heritage.  This park was a perfect example.  Well done, NPS.

At the bottom of the slot canyon, most of the park's visitors completed the small loop to head back up to the trail head.  But the three of us turned off down a side trail to explore the rest of the park.  This took us through the Peekaboo Loop (map above) to explore the other canyon.  The main canyon has the red rocks and striking hoodoos (rock spires) that makes the park famous.  The south canyon was equally beautiful, but looked like it was in another state entirely.  The geology was completely different, and there was quite a bit more vegetation.  It's amazing how much a slightly different sun and wind pattern can completely change the landscape.





By this point, we had already climbed out of one canyon, and were at the bottom of the second one. We had plenty of water, and Judy was probably in better shape than I was.  But around this point, she began openly asking me why I took her on this never-ending death march.   I reminded her that we had already climbed out of a canyon once, and that the scenery was more than a sufficient distraction.  But Judy struck up a conversation with a passing hiker (actually every passing hiker), and they just had to mention that our end point was actually 500 feet higher than where we started.  Judy took this as irrefutable proof of our impending demise.

Of course, I wasn't immune to looking-upitis.  See that little black speck on the top of the cliff?


That's a person standing where our trail ends.


There was absolutely no chance that I was going to tell Judy that little fun fact.

But we kept going up...


And up...


And up.


An hour or two later, we very proudly reached the top (for the second time).  Judy said, non-ironically, "Hey, that wasn't so bad."


It was an absolutely stunning hike, and we all agreed that it was one of the best that we'd ever been on. The ups and downs got us a bit more exercise than we were planning on, but it was more than worth it. Plus, it gave us a great excuse to grab some ice cream in the guest center on the way out.  The National Parks Service really did think of everything.

Sunday, June 09, 2013

The Hollywood of the West. East of Hollywood.

Kanab, Utah is a strange little town.

We needed to spend the night in Southern Utah, so that we could get an early start on hiking the next day.  I picked Kanab because it was on the way to Bryce Canyon, but I really didn't know much about the town.  I only knew that its dot on the map was bigger than the one for Fredonia, and smaller than the one for St. George.

After leaving the dance at Hotevilla, we got back in the car and headed north.  We hit Tuba City on the Navajo reservation after about 20 minutes in the car, but that was far too soon to stop. Unfortunately, there is absolutely bupkis between Tuba City and Arizona's northern border.  So everybody held their bladders and we enjoyed the uneventful--but very pretty--drive.

Fredonia is the small town on the Arizona side of the border with Utah.  But "small town" is probably too generous of a term.  "Large dust pile" seems more appropriate.  So you can imagine our surprise to travel about a hundred yards north to the green grass and white picket fences of Kanab, Utah.

The change is beyond striking.  It's like the town has absolutely no idea that it's smack-dab in the middle of the high desert.





My aunt, spending most of her adult life in water-conscious Tucson, was apoplectic.

We pulled into the Roadway Inn around five or six, and we checked in with the living entity at the desk. I'm almost entirely sure that she was a human being.  She came out of a back room when we entered the lobby, and she nearly evaporated when the sun hit her ashen skin.  She barely said five words as we checked in.  I'm telling you, this is one of the strangest cities that I've ever visited.  Aimee asked if we stumbled into the Truman Show.

Against my better instincts, I attempted to make friendly conversation, and I asked if she had been to the one restaurant I knew in Kanab.  My housemate had recommended the place, saying, "It's good.  Well...it's not bad for Utah."

In response to my question, the sentient being at the check in counter said, "How should I know?  I never get out of here."  I assumed that meant it was a fancier restaurant, perhaps on the opposite side of town.  It was a cafe, quite literally across the street.  And it wasn't half bad.

We walked around for a bit after dinner, and we noticed a series of placards along the main drag.  They featured golden era Hollywood stars, and the posters for several mid-century Western epics.  Kanab is apparently known as The Hollywood of the West.  There were quite a few movies filmed in Kanab during the 50s and 60s, which explains why the entire town felt like a film set.  But nothing has really changed.  They don't get out much.

The next morning, I stopped at a Sinclair gas station on the way out of town.  My aunt exclaimed that she hadn't seen a Sinclair since she was a kid, which seemed appropriate for the town.  I walked into the attached convenience store to pay for my gas (there wasn't a card reader on the pump).  The two octogenarian customers at the counter looked up from their coffees as the septuagenarian employee smiled and said, "Son, you pay me after you fill up."  This certainly wasn't Tucson.  It took me a minute to figure out the pump, and when I went back in to pay, I heard the customers talking about shifts at the plant.  I half-expected them to take out tin lunch boxes and warn me about the Soviets.

Kanab, Utah is a strange little town.

Saturday, June 08, 2013

Family vacation

Since the Hopi reservation is effectively the epicenter of the Desert Southwest, most of the health center staff block their work days into 10-12 day chunks.  That allows them to take long weekends to explore the area without it counting towards their vacation time (which they also use to explore the area).  My schedule was no different.  I've been working most weekends since I got here, so that I could take a few days to explore the region.

By no coincidence, this was also the weekend that Aimee and my aunt were coming up to the reservation.  They arrived Saturday afternoon, and we walked right over to the health center.  We were going to explore the area north of the reservation for most of the weekend, but I wanted them to see the hospital first.  Dinner was at the Hopi Cultural Center, which the tribe runs to help preserve and display their cultural history.  The Cultural Center is made up of a small museum, an attached hotel, and a little restaurant that features Hopi cuisine.  But since it's one of the only restuarants on the reservation, it's also frequented by Hopis looking for a nice dinner out.  And since they don't need people to cook tradtional Hopi food for them, the other half of the menu consists of the usual fare that you would expect to see at any other rest stop along Route 66.  So when you look around, you see white people eating Hopi food, and Hopi people eating white food.  It's a little surreal, but the food is tasty.  Besides, after five weeks of cooking my own bowls of cereal, I would have eaten anywhere.

We had a nice treat in store for Sunday morning.  Denise, one of the clerks in the Emergency Department, had invited us to her village (Hotevilla) to see a traditional dance.  Traditional Hopi dances are a cultural spectacle, and they're normally closed to outsiders.  Needless to say, it was a huge honor, and we were all looking forward to witnessing it.

Hotevilla is about 30 minutes west of the health center, and we pulled into the village around lunch time.  There is one major road that runs across the entire reservation, and most of the roads leading off of it degrade into various stages of Jeep trail.  But it wasn't too hard to follow the line of cars from the "modern" village center to the historic village center where the dance was.  The "modern" center in most Hopi villages is usually a Bureau of Indian Affairs building that acts as a recreation center, event venue, and municipal headquarters.  But the villages also have a historic gathering space that is just an open town square in the center of densely built stone and brick houses.  Some houses were made of historic adobe, and others were pieced together with cinder blocks and 2x4s.

Hotevilla's simplicity was reminiscent of the Nicaraguan village that Aimee lived in during her time in the Peace Corps.  But it wasn't run-down by any stretch of the imagination.  The homes were simple, and there were no roads or other symbols of modernity, but you could tell that the people that lived there took pride in their community and it worked well for them.

The town square was barely fifty feet across, but it was packed with shirtless men chanting and dancing in a circle.  The Hopi have never been a warrior tribe, so these dances weren't intended to intimidate or rally anybody.  They evolved for several reasons (this particular one was to bring the summer rains), but it seems like their alternate purpose is to bring the village together for a common celebration.  And that's probably why the dances have survived relatively unchanged from their ancient origins.  That function is timeless.  Children ran around and played in front of houses, adults drove in from their jobs in Flagstaff (and Tucson, we overheard), and the elders sat back and let us other suckers bring them water and snacks.

Speaking of suckers, I had been carrying around a large fruit pastry that Aimee and my aunt picked up on their way to the reservation.  We were going to give it to Denise's family to thank them for their hospitality.  But we had arrived before Denise, so I wandered around (essentially door to door) looking for her family.  I had forgotten her last name, so all I could ask was "Does Denise live here?"

Everyone was very friendly, but most people looked at me with the amusement that the situation warranted.  But I was very sensitive about not wanting to stand out.  I don't know if I thought they'ed think I was the Great White Hopi if I could just blend in, but the giant tart that I was carrying around the village didn't help my cause.

I finally found someone who seemed to know who Denise was.  He suggested "Denise Namingha?", and that sounded right.  Of course, Namingha is a very popular name on the reservation, so it really didn't narrow things down much.  But he pointed me towards a house and said, "I think her Grandmother lives there."  I was so anxious to lose the tart that I wasn't going to ask many questions.

I walked up to the house that I assumed was the right one, and asked if Denise lived there.  The person that answered the door was just a neighbor, but he pointed to a few elders sitting around a table and said that he thought that one of them was her grandma.  Elder Hopis (like most Native American elders) don't speak much English, and really don't speak much at all.  But I asked her if "Denise from the health center" lived here.  She nodded and smiled.  I said that we were early, but she would be meeting us.  She nodded and smiled.  I asked if I should leave the tart on the counter.  She nodded and smiled.  We thanked them and said that we would be right outside, watching the dance.  I think my aunt said "Gracias."  We were a mess.

A few minutes later, Denise found us watching the dance.  She was as friendly as ever, and we told her that there was a pastry waiting for her at her grandmother's house.  She looked confused, and said that she had just come from her grandmother's house on the other side of the village.  Oh boy.

So I'm still not sure what transpired in that house, but I'm pretty sure the elderly woman heard something along the lines of: "Hello, I am a well-dressed white person.  Can I walk into your home and leave this delicious-looking pastry on your counter?"  I would have nodded and smiled, too.

This is not the culturally-sensitive anecdote that I will be submitting to the State Department if I ever decide to work there.

But the dance was really a treat to see, and we were very lucky to witness it.  We stayed for about an hour, before succumbing to the heat.  We also had to make it up to Utah by nightfall.

As we walked out, we came across a family selling Sno-cones.  Ice and syrup had never tasted so refreshing.

Since there are no photos allowed of the dance (or inside the village) this was the only one I took that afternoon.  But it sums things up nicely.


We fit right in.

Friday, June 07, 2013

Clinical potpourri

I'm long overdue for another clinic post. It's been a busy week.

There was, of course, the obligatory rectal exam. I was looking for intestinal bleeding in an elderly man who had recently lost a lot of weight. Small amounts of blood in the stool is one of the most sensitive test for colon cancer. So get those colonoscopies every ten years. It beats the hell out of a med student poking around up there. He turned out fine, by the way.

Another patient that sticks out in my head was an elderly woman who was here for a diabetes check up. As you probably know, getting a person with diabetes to change the habits that gave them diabetes in the first place is one of the hardest tasks in medicine. I'd even go so far as to say that it's harder than brain surgery. Granted, I'm biased, but I'm pretty serious about that.

This particular patient was in her 70s, and she was getting tired of all the medications that we were giving her. She was taking about 6 or 7 drugs to keep her diabetes and high blood pressure at bay. It's easy to write her off and label her as "non-compliant", but we had a really nice chat about what goes on in her life after she leaves the clinic. First of all, her children seem very supportive, but they had to move off the reservation to find good jobs (very common). And as friendly as her neighbors are, most of them are elders who are also struggling just to take care of themselves. So here we have a woman in her mid 70s living alone and getting endless piles of mail and forms to fill out. Some forms are heath care related, some aren't. She can barely read what's on the paper ("They just keep using smaller and smaller print on these things"), and when she can make out what it says, she barely understands what they're asking. We can't really expect her to know the difference between glipizide and glyburide. Hell, I can barely remember, and I go to school for this.

Her memory is also fading. That's not helped by the diabetes, but it does make it harder for her to remember the medications that she uses to treat it. The pill bottles are hard to open, and the pills are the size of golf balls. She says that every few weeks, she just throws in the towel and says that she's just going to let her body take it's natural course. You really can't blame her.

Now, as you know, the medications that we're giving her aren't for the sake of passing out pills. They'll protect her memory and vision, and they'll prevent even more serious complications. They may not make her live longer, but they will help her enjoy the years that she has left. Of course, if they're a hassle to take, and if she doesn't connect real benefits to why she's taking them, she's going to dump them down the drain. With all this going on, writing her off as "non-compliant" is almost malpractice.

At this point, I was ready to go to her home and sort through her pill bottles one by one. But then the doctor that I was working with reminded me that we actually have people who can do that! One of the nicest perks to a system as unified as the Indian Health Service is that we can provide services that may not fit into the usual doctor/hospital/nurse/insurance company model. One of those services is public health nursing. These are fully licensed nurses that drive around the reservation in an off-road jeep and provide services in patients' own homes. They can provide wound management, home safety checks, school vaccinations, newborn exams, and other services that don't really require patients to come into the clinic. From a public health standpoint, it's a wonderful service that has a clear benefit for the community. And from a cost-efficiency standpoint, it's also a no-brainer. If people can't come in to the clinic, they let small problems become big problems (which are obviously more expensive to treat). And for quick check ups, it's far more efficient to send out one nurse than it is to mobilize the entire clinic apparatus, including doctors, nurses, registration clerks, medical assistants, etc.

Public Health Nursing is another clear advantage of an all-in-one health system like IHS. For the rest of us, the same type of program is much harder to achieve. When a person gets discharged from the hospital, who sends the nurse out? The hospital? The primary care doc? These questions get a lot easier to answer when multiple health care players are all under the same umbrella.

But before I go off on too much of a tangent, I'll round out the post with a couple of the more unique cases out here. The first was an elderly woman who had a chronic cough. She mentioned that her husband worked at the uranium mine for many years, and she asked if that could play any role in her illness. Yep, uranium. There's a working uranium mine on the Navajo reservation (which seems wrong on so many levels), and quite a few of the tribe members either work there or know people who do.

The last case is a 17 year old boy who had a pretty bad laceration on his hand. He got kicked by a horse. I don't see a lot of that in Tucson.

America's Health Responders

That's the tagline for the Commissioned Corps of the United States Public Health Service. They're the people that you see in military uniforms (often in addition to the actual military) at hurricanes and other disaster sites. They are deployed to relief sites across the country whenever they are needed, and maintain regular day jobs with various federal agencies during the rest of the year. The Indian Health Service employs a significant amount of them, since providing efficient, resource-conscious health care in high-need areas overlaps nicely with both agencies. The doctor that I am staying with up here is a member of the Commissioned Corps, and he invited me to a road clean up with the other officers after work last week.


Coincidentally, he got called back to the hospital right before this photo was taken, but these are some of the nurses, pharmacists, physical therapists and other health professionals that are members of the Corps, and based on the Hopi reservation.

It's easy to forget that the second word in Surgeon General is General, and she has an important role in overseeing the public health responses to national emergencies.  She has the power to deploy her officers to disaster sites, just like a general in the Army does.

In addition to the Army, Navy, Coast Guard, Marines, and Air Force, the United States has two other uniformed services that most people aren't familiar with: the Commissioned Corps of the USPHS and the National Oceanography and Atmospheric Administration. They perform a crucial, but often less-than-glamorous jobs for our country, and the overseeing agencies need to know that they have a cadre of trained professionals that they can send around the country as needed. 

 In the case of the Public Health Service, the role is obvious. Doctors, nurses, and other health professionals are needed at a minute's notice for many different types of public health emergencies. The NOAA officers are deployed to survey extreme weather events and monitor our coastlines. In both cases, the officers wear a military-style uniform and are eligible to be mobilized to anywhere in the country where there is a need for their services.

The Commissioned Corps of the USPHS got its start in the early 1800s, providing care in marine hospitals along the coasts and major waterways. They provided health services to commercial fishers and the US Navy at the time. Their location next to major seaports put them in an ideal position to provide TB screening and other health services to disembarking immigrants coming off the ships. Their role expanded to providing care for other marginalized populations and controlling the infections that were rampant at the time. Those roots set up the modern Public Health Service. They continue to provide safety net medical care for people across the country, oversee biomedical and infectious disease research, and respond to all types of public health emergencies.

In return for being "on-call" for the country, the officers receive generous time off benefits, and other military perks like tax-free housing and VA health care after retirement. All in all, it's a pretty sweet gig, especially since the deployments are generally in areas with a real need, and in situations that would be very gratifying to help out with. I could definitely see myself doing something like this in a few years.

Tuesday, June 04, 2013

Keams Canyon

There's an interesting little anachronism on the far east side of the Hopi Reservation.  It's Keams canyon, and it's where all of the Bureau of Indian Affairs services were located (including the health center, police department, and employee housing).


The reason it was selected was that it wasn't actually on the reservation.  The canyon is names after an early American trader and homesteader.  He lived in the canyon before the reservation was even an idea, so when it was formed, his land was carved out so that he could continue to live there.  And it remains a little pocket of private land surrounded by the Hopi reservation, which is, of course, surrounded by the Navajo reservation.  Land issues get pretty complicated up here.

I talked about this a bit more during my last trip, but the well-intentioned BIA had more of an assimilation mentality than an assistance mentality.  They intentionally tried to upset the Hopi peoples' regular daily life, and encouraged them to come down off the mesas as often as possible.  They wanted to eventually make them a part of mainstream American culture.  Although I'm sure it seemed like the right move at the time, it's pretty easy to see how that policy was pretty misguided.

In the 70s and 80s, the BIA started to see the err in their ways, and gradually integrated services into the  Hopi community.  That's why the health center is right next to Second Mesa, and there are community centers and post offices right up at the top of most mesas.

But until recently, that wasn't the case.  All of the Federal and State services were located in this little pocket of land 17 miles east of the reservation.  There's still some activity there now, but it has a distinctly out of place, ghost town feel to it.






It's a fun little look back in time, but it definitely doesn't represent the finest period in the BIA's history. I'm glad to see how well integrated the services are now.  The clinic is in the heart of the reservation, the police officers are all Hopi, and the tribe is much more in control of its own resources.

Saturday, June 01, 2013

A day in the life

It's Saturday, and I'm at work.  But on the reservation, that's actually a pretty sweet gig.

First of all, days of the week don't really have much meaning out here.  Many people farm their own food, and get the rest of their support from the tribe.  So the Monday through Friday work week doesn't mean much.  The pace is also a lot slower on the reservation, and it's not like taking a Tuesday off to go hiking is any different that taking a Sunday off to go hiking.

But at the clinic, it's a different story.  Most people here actually do have a traditional work week.  So on the weekends, it's just the Emergency Department staff and a few nurses taking care of the admitted patients.

To compound the deserted feeling of the place, we had an exceptionally small patient load.  We had maybe three or four people come in to the ED today, which is about a tenth of the usual flow around here.  We saw the usual bumps and bruises, and a few curveballs that required a larger workup.  But all in all, it was a pretty sleepy day.

Early on, the ED clerk suggested that we all do something nice for lunch.  Of course, there are zero delivery options around here, and the closest restaurant requires an hour drive.  So we were clearly going to have to cook.

There's a small barbecue outside of the hospital, so everyone picked up a few things to grill from their houses over the lunch break.  The paramedics would do the cooking, since when there weren't any 911 calls coming in (which there weren't) they didn't have much to do.

Here's Randy, one of the career paramedics, working on lunch in the ambulance bay.


While Randy was cooking, I used the chance to snap a few photos of the facility.  Here are two of the four emergency bays.


And one of many of the routine exam rooms.


But that's not the most interesting part of the facility.  The hallways and building entryway are actually pretty striking.




And, of course, it's got one of the best views of any health clinic in the world.


All in all, not a bad way to spend a Saturday.