ONE YEAR AGO TODAY, I had my first virtually caffeine-free day in longer than I could remember. By “caffeine,” I mean three Diet Cokes or cups of coffee each weekday, and easily double that on some weekends. From these jittery heights I pared back to a mere 8 ounces of home-brewed green tea per day as the liquid base of my post-gym smoothies, which remains my current dose. Compared to my earlier intake, that’s abstinence.

To many freelancers, parting ways with caffeine, and especially the black blood of the bean, might seem an unforgivable heresy and warrant that I surrender my work slippers. But shortly after I opened my freelance writing, editing, and proofreading business, I noticed unexplained physical symptoms recurrent and serious enough for me to record them daily to discern a pattern. A spot of Google fu placed the blame on caffeine intake, which I realized had expanded considerably. With nobody to watch me go to the company fridge for a new can of Diet Coke, or to click their tongues as I took yet another bathroom break, my three-a-day habit had grown. Adding coffee to the morning mix further boosted my daily dose until, by my estimate, I was reaching well into a few hundred milligrams of caffeine. No wonder I was filling a notebook with things like “nervous,” “rapid heartbeat,” “difficulty concentrating,” and “irritable”!

When these symptoms recurred in 2010 after I’d relegated coffee to weekends and enforced my three-cans Diet Coke policy, I began investigating ways to kick the aggressive alkaloid to the curb for good. Thus armed, I began my program on September 27, using these tips and tricks:

• Tapering vs. cold turkey: All of the more credible guides said that cold turkey was a jagged slide to Hell. Instead, I bought bottles of Caffeine-Free Diet Coke, and replaced one third of each 12-oz. serving every couple of days. This is where freelancing helped; measuring out precise dosages of cola from a pair of bottles every few hours at a full-time job would have made me look, at minimum, like a displaced soda jerk mixing a phosphate for some Coolidge-era sharp in a straw boater. Or, more likely, a nut.

• Kicking Diet Coke immediately: To break me of the taste of my main drug at once, I swapped out Diet Coke for Coke Zero as my caffeine vehicle of chose these final few weeks. I wanted to end the thrice-daily sensory experience of it immediately, and I find Coke Zero vile (apologies to John Scalzi).

• Public accountability. At the risk of boring my Facebook friends to death, I posted each day’s progress, any new lower dose, and anything else related to the experience, so I could get some fans for the effort.

The dreaded caffeine headaches were far briefer and less intense owing to the tapering strategy; my previous attempts at swapping 100% decaf for hard stuff failed for this very reason. I found myself having oddly detailed, vivid dreams early in the process, perhaps because the residual caffeine, Nutrasweet, and other chemicals were finally draining from my system. I also began waking up earlier than my alarm and the sun, and found a definite drowsiness setting in earlier in the evenings, once I reduced my dosage past 2 servings per day.

One challenge came early: What to order at restaurants? I’d been so predictably a Diet Coke man that friends would order it for me if they arrived early to a bar or were seated while I was still parking. I had to stop myself from reflexively reaching for the bottomless sodas and refills that some places served. Instead, I learned to order water or, eventually, seltzer, which at least added bubbles and some flavor if I remembered to ask for lime.

But the awkwardness passed as the supply of Coke Zero in my fridge dwindled. By mid-October, I’d reached the days of a single, 4-oz. dose along with the caffeine-free soda. My last serving was on October 16, and before posting that I was at last free, I poured the rest of the Coke Zero down the sink.

And again, “free” is a relative term. I do still add a cup of cold green tea to the berries, ice, banana, and protein powder I down each morning after gym trips. The caffeine is negligible—no headaches on those few days when I’ve had to skip the smoothie—and the benefits of the antioxidants outweigh whatever the lingering stimulant effect might be (if it’s even discernible when I’m waddling around the apartment swilling straight from the blender pitcher after doing squats).

Two big benefits of the switch away from Diet Coke in particular. First, I’m hauling out a lot less garbage. Twelve empties every four days, plus the odd brace of drained 2-liter bottles if those happened to be on sale for a cheaper per-ounce cost than cans (I had a junkie’s sense of where the cheapest deals could be had at any given supermarket chain, scanning circulars and making rounds to stores like William Burroughs scrounging heroin across 1940s New York City), made for many trips to the Dumpster each week. Second, with the end of the recyclables, my bank account gained: I estimated that between sodas consumed at home and on the road, coffee beans, and mealtime caffeine at restaurants, I was spending over $400 per year on the stuff. Believe me, a starting freelancer can find far better uses for four spare C-notes than the Coca-Cola Corporation.

I don’t miss Diet Coke, but I do miss coffee. I miss the scent, lingering for hours after I’ve made a pot of java. I miss the ritual, buying a brimming bag of fresh beans from Whole Foods, spooning them into the grinder, and smelling the grounds before sifting them into the filter. I felt the same sort of gap in my day as someone quitting a far more harsh substance, like nicotine or worse, might struggle to fill. In my considerably less serious case, however, the gap was quickly filled.

By sleep, in fact. I now have a definite fence around my day, as sleep—no longer driven further into the night by extra cans or cups of caffeine—taps me on the shoulder on a more consistent and urgent basis. It’s forced me to plan out my freelance days, placing detail work like proofreading earlier in any given day so my eyes and mind are freshest and least weighted down by fatigue. My mid-2000s poker nights would be impossible now, as are the day (and night) trips to Atlantic City, during which the return trips were buttressed by stops at Dunkin’ Donuts or a last call to the poker room cocktail waitress for a cup of joe to travel.

My last Diet Coke purchase was in March 2011. I was volunteering in Jersey City on the final night of the WFMU Fundraising Marathon, a stint that would have me in the hallowed halls of America’s finest freeform radio station well past midnight. I snagged the 20-oz. bottle while driving down to the station, for medicinal purposes in case I found myself too tired to drive safely. In this one case, I told myself, if I had to crack the seal, to keep myself from nodding off and putting my car through the front of a Home Depot or into the Hackensack River, it would be justifiable, like amoxicillin for a sinus infection.

That bottle, still sealed, sits in my apartment today. I’d be lying if I said I wasn’t tempted to down the bottle to mark today’s occasion if only to see what the effects would be. Or instead, to buy a coffee from one of our better indie joints and enjoy the flavor while grabbing hold of something solid as the buzz hit. But I declined. Instead, the bottle stands as a testimony to a minor triumph of behavior, one small success while I was radically revising many other aspects of my work and life.

Healthcare travelers are privy to scores of hospital warning signs in careers marked by new places, but few are as singular as the one John Rigby, RN, noticed recently that was posted on the closed door of a patient’s room in Tuba City, Ariz. “It’s the first place that I’ve been where they have a sign that says, ‘DO NOT ENTER: CEREMONY IN PROGRESS.’”

The note, while simple, reflects how the beliefs of the Navajo Nation permeate the environment of the clinics and hospital that make up the U.S. Indian Health Service system. And, it’s one of the aspects of tribal culture that Rigby and his travel partner and fiancée, Christine Ott, RN, have come to appreciate and respect while living among their patients.

Sharp-eyed observers of this blog will note this isn’t the first time I’ve written about mobile healthcare professionals caring for Native American populations. In May 2010, I wrote about locum tenens physicians who have visited IHS facilities in HT‘s sister publication, Locum Life, in “On the Reservation: Providing Locum Tenens to Native Americans.” In this newer article, I was able to speak with two nurses who visited a different part of the vast Navajo reservation than the Northen Navajo Medical Center in the Shiprock area mentioned in my earlier work. But do check out the LL article as well, especially for the tale of Dr. Greenlee, who serves the tiny Havasupai Nation from the bottom of a canyon accessible only by foot, helicopter, or mule.

You can read many other articles I’ve written about mobile healthcare careers here. And if you’re looking for a writer who can transport your readers to the raw beauty of the American Southwest or anywhere else, drop me a line!

How did she become a ray of light for neglected and abused animals? Quite unexpectedly:

When she purchased 22 acres in Silverton, Ore., Sophie Dojacques, MD, didn’t foresee the animal-rescue operation and community resource it would become. But the goats had other plans.

“I bought the property in 2005 with the plan to rescue horses, but the first goats came in 2006,” she says of 46 poorly kept and malnourished animals from a nearby farm. “That’s when things just headed off running.”

It was plainly evident in communicating with her and my three other physician sources that they had arranged their careers to support their interests, and not the other way around. Whether boating across the seven seas, surfing off the Australia or New Zealand coasts, or exploring the seemingly barren wastes of northern Alaska, they had configured their professional lives around their core interests—a fantastic example for all of us, no matter how we earn a living.

This article had me half out the door with my laptop looking to become a wandering writer, to follow these docs’ example. My next article is no exception; I spoke with several travel nurses who have been working on the road for a combined 40+ years. You don’t enjoy such a long career without deeply digging what you do and where you do it, and in this upcoming Healthcare Traveler article, I’ll share these nurses’ tips for staying engaged with one’s work and not only surviving on the road, but thriving.

And as always, if you have a story that needs to be told—llamas or no llamas—I’d love to be the one to deliver it to your readers. Contact me here and we’ll discuss!

“Nurses and Physicians: The Art of Communication and Collaboration”

An informative introduction will open a dialogue with your doctors and launch strong clinical partnerships at each travel nursing assignment.

“Going Beyond the Handshake: Collaborating Effectively on Locum Contracts”

Each interaction with your colleagues is a chance to demonstrate respect, share knowledge, and improve your patient care.

Because I’m often new to the worlds I explore in my writing, I like to cast my articles as introductions, crafted for readers entering these worlds for the first time too. I’m neither a doctor nor a nurse, but I can gather the informed opinions, experience, and enthusiasm of professionals from these realms to educate those who may be considering a mobile healthcare career.

I researched and wrote these stories in this spirit. The former, which appears in the October 2010 Healthcare Traveler, is similar in introduction to the latter, the cover feature of October 2010′s Locum Life. But they ended up being quite distinct. I hope they help staff/hospital nurses or physicians with enough information to make their start and head out on the road. Plus you can’t beat the locales they often visit: Australia, New Zealand, the Caribbean, or across the varied tableau of America.

“Crisis Nursing in Haiti: One Traveler’s Tale”

Eleven days in a Port-au-Prince tent hospital renewed travel nurse VJ Gibbins’ dedication to patient care.

Some travel, though, is less for tourism and profit than for dire need and charity. I had the privilege of interviewing VJ Gibbins, RN, a travel nurse with the Clinical One agency, about his volunteer mission after the January 2010 earthquake. He’d been a great source on a previous story, and when the agency asked me if I might want to speak with him after he returned from his trip, I leaped at the chance.

VJ was kind enough to grant me a long interview after he’d recovered from the ordeal; in an unused quote from our discussion, he acknowledged, “I wasn’t prepared for this level of badness.” Kimberlee Hodges, my contact at Clinical One, also arranged a chat with Cynthia Kinnas, the head of their national healthcare division, who described how they made the decision to assist Gibbins in his quest:

“We’d come to know him pretty well,” Kinnas says. “We knew that he’s a really strong clinician. But we also knew that he had a lot of integrity, that he’s reliable, and that he had a true passion for relief work.” Kinnas and her colleagues were also moved by Gibbins’ sustained interest in Haiti even after news of the earthquake subsided. “And VJ’s just one of those people who embodies what we all might dream nursing to be,” she adds.

This was one of my most challenging assignments, primarily because I didn’t know if I could do justice to the entire narrative in 2000 words, or even 2400 (after I asked the editor for a larger word count!). But I think I was able to craft a flowing narrative while accurately portraying the conditions Gibbins encountered, the ways he circumvented the shortages of personnel and modern equipment, and the toll his labors took on him.

This was my most rewarding assignment so far, and if you only read one of the articles linked above, do check out VJ’s tale here. I am of course available to discuss any future writing assignments, so please drop me a line here if you’d like to work with me. And do leave a comment if you enjoyed any of the articles!

Each emergency department has its own unique culture and rhythm, but the transition from your home ED to others around the country might be easier than you’d imagine. By exposing you to diverse patient populations, novel patient care techniques, and the fertile minds of other caregivers, each new assignment is like a miniature nursing school. And don’t forget the chance to visit and absorb the local attractions of countless new communities to a degree you’d never achieve over a fleeting week’s vacation.

Although veteran travel nurses will say there’s no bad time to start your mobile career, there’s definitely a best way. To help you find it, we’ve tapped the wisdom of several travel nursing recruiters and ED travelers for an overview of the current market and their suggestions for securing and acing your first assignment. Once you sample the travel world, you may wonder why you waited so long!

Similar to my July 2010 HT article, “Ten Dont’s: Steer Clear of These Travel Nursing Pitfalls,” this one’s sort of a round table format, calling upon the input of several recruiters and ED travelers to form a picture of the industry and what nurses should keep in mind while beginning their first assignments.

This was also one of those stories where using a sidebar greatly improved the readability of the final draft. I had originally integrated the first-timer’s advice into the story itself, but it made the main narrative much lumpier.

As sometimes happens, while mulling the problem during the morning shower, the solution presented itself. I’ve learned to keep a pad and pen close to the bed for those ideas that sneak in across the hazy borders of sleep, but I know of no such option for shower-inspired thoughts . . . short of either writing it in steam on the mirror, or streaking to the keyboard in some 21st-century version of Archimedes’ “Eureka!” moment. Which, hey, nobody wants to see.

Check here for a full list of articles on nursing topics. October’s HT will be a big month for me, because I wrote both feature articles. The first, as mentioned earlier, is the story of a pediatric travel nurse who spent 11 days in an intensive-care hospital tent in earthquake-ravaged Port-au-Prince. The second is another round-table-style article on the best ways to communicate and forge partnerships with the physicians that travel nurses will meet while roving the healthcare settings of America.

I’m always looking for ideas that need someone to shepherd them from germ to gem. (See, all I’ll need to do is delete an r. Simple!) If you’re interested in recruiting a regular writer for your blog, magazine, or other periodical—whether in the healthcare, temporary work, personnel recruiting, or other areas—please contact me!

Are you the owner of a slightly rusty set of pipes that hasn’t been raised in song since medical school? Does hearing classical music on your office stereo remind you of a favorite Mozart or Beethoven piece you used to strike up on the piano? Has that battered guitar case in your basement been urging you to get the band back together?

It’s never too late for a comeback. Full waiting rooms, burgeoning paperwork, and ever-expanding hospital shifts can be detrimental to a doctor’s free time, but the flexible nature of locum tenens practice can change your tune. And the benefits can be more than artistic. Playing an instrument can help you make new friends around your contract location, awaken your creative energies, or even form the basis of a well-rounded retirement. Learn how three physicians have harmonized their musical talents with locum tenens careers.

This story was a lot of fun to write. I was able to speak with:

• A family practitioner who travels all across Alaska with her violin and viola, and who manages to find groups and symphonies to play with at her assignment locations;
• An OB/GYN working at an Indian Health Service hospital who composes original piano works while on the road; and
• The director of the Los Angeles Doctors Symphony Orchestra, a surgeon who has played oboe for years and manages to balance small-town locums work with leadership of an all-medical-professional orchestra.

Musical passions and medical proficiency struck me as a natural pairing when I was assigned the article, and their testimony—the clear love for music I could hear in their voices—bore this out. Plus it boosts the mind as you near retirement:

Locum tenens work has been a strategic part of Dr. Shulman’s shift into retirement. As a means of transition from full-time practice, he notes, it gives physicians a chance to step back and explore those interests that will most engage them after they leave medicine.

“The reality is that none of us should or can practice medicine forever. Certainly not in the surgical specialties,” he observes. “We’ve been productive all our lives,” he says of his fellow locum tenens doctors, “and we want to stay productive.” Dr. Shulman therefore urges physicians not just to plan their retirement from medicine, but to have an activity or career to retire to, as well. “We all need to prepare ourselves for that eventuality,” he says. “Music for me is not a hobby; it’s another vocation.”

That’s a lesson for everyone, no matter what their career may be. We’re all hopefully going to spend a couple of decades in retirement. Why not cultivate those proficiencies and passions that engage us now, at the height of our cognitive powers, so we have these interests to pursue as treasured friends once we hang up whatever career hats we wear?

As for me, the hat I donned after completing this article was that of the author of a Healthcare Traveler piece on entering the world of emergency department travel nursing, which you can read more about here. Should you happen to have a story that needs telling, whether in the healthcare field or elsewhere, please don’t hesitate to contact me and let me help you bring the words to light!

My dilemma for such articles is always that the opportunity to speak with so many passionate, thoughtful nurses and travel company recruiters and executives naturally produces many more ideas than I can fit into two thousand words. I included the most popular don’ts the nurses and recruiters described, but sadly had to cut such stories as the one about a travel nurse who drove from Kentucky to California with a smashed-up car after a collision minutes into her journey to an assignment knocked her bumper off!

You can check out the other articles I’ve written on nursing issues here. The next piece of mine to hit the streets will be a Locum Life piece on physicians with musical talents, and today I handed in a piece for HT I’m very much looking forward to seeing in print, about a pediatric travel nurse who spent 11 days working in the pediatric and neonatal ICUs of a tent hospital in earthquake-stricken Haiti. Following that, I’ll be writing another HT article on how to get started as an emergency room travel nurse. Busy busy!

But not too busy to discuss new writing or editing projects you might have in the works. If I can fit those needs, please contact me!

If you’re seeking a locum tenens opportunity that combines humanitarian aid, public health medicine, and breathtaking terrain, the Indian Health Service (IHS) offers it all. Through the IHS, the U.S. government provides medical care to 47 percent of the nation’s 3.3 million American Indians and Alaska Natives. With a history of neglect, persistent poverty, and inadequate preventive education, reservation residents also endure high rates of alcoholism, depression, diabetes, and obesity. And staffing shortfalls worsen these problems by limiting access to skilled medical professionals.

Locum tenens physicians have never been more crucial to filling these openings. Positions are plentiful, streamlined government licensing requirements can get you started quickly, and your new colleagues will teach you how Indian traditions will influence your medical practice. Learn how an IHS contract can reconnect you with the spiritual aspect of patient care.

I’m especially pleased with the look of this piece. A number of the doctors I spoke with had taken IHS assignments in the American Southwest, and the opening spread of the article depicts a lush, wildflower-filled valley set against the rust-red sandstones of the region. Even more impressively, the sidebar on working at the remote Supai Clinic—set at the bottom of a tributary of the Grand Canyon—is accompanied by an overhead shot of the Havasupai Village that the clinic serves.

I’ve just submitted a new Healthcare Traveler article, this one with 10 points of advice on what not to do as a travel nurse, from researching assignments to dealing with negative coworkers and staying safe while alone. Plus I’ve got a new Locum Life article in the works. They should hit the street and the Web in July and August, respectively; keep an eye on this space for descriptions and links. And do contact me if you’re looking for a writer in the healthcare, recruiting, or medical staffing industries!

Has the prospect of being distant from your family kept you from venturing forth on your first locum tenens assignment? Are you concerned that you won’t be able to return home for emergencies? Worried that your children may grow apart from you, one text message at a time?

If so, don’t postpone your dream of practicing in a new location any longer. Locum tenens agencies have a wealth of experience in helping providers to arrange their home lives and embrace technology to deepen, rather than diminish, their family ties. Read on to learn how recruiters prepare their clients to discuss their aspirations with family, lay the groundwork for their first departure, and reduce the effect of emergencies on their remote practice.

I’ve actually written a piece on the pressures of leaving home for temporary medical work before. For the February 2010 Healthcare Traveler (Locum Life’s sister publication for travel nurses), I wrote “Relationships on the Road: Managing Family Ties While on Assignment.” Although both articles mention the reliance of today’s traveling caregiver on things like texting, Facebook, and Twitter to stay close to home, this one differs due to the nature of locum contracts versus those of travel nurses. Those seem almost uniformly 13 weeks in length at minimum, whereas those of the locum physicians can vary depending on the nature of the assignment, the needs of the doctor, and so forth.

I’ve also completed and submitted the LL article for May 2010 article that I mentioned in my last post. That’ll probably hit the Web in 30 days. My editor was kind enough to offer me the chance to write a new Healthcare Traveler piece, this one for July’s issue. As those go live, I’ll link them up here. As always, if you’re seeking a writer for your healthcare, staffing/recruiting, or nursing topic of interest, email me today!

Fishing, hiking, tourism and, of course, golf—the activities often cited as the benefits of a locum tenens lifestyle might seem like the stuff of a dream retirement. Locum tenens work definitely allows mobile providers to schedule these and other interests while developing their careers, pursuing their passion for caregiving, and even touring the country to try out prospective retirement locales.

Whether you’re new to locum tenens and need ideas for your days off, or a veteran traveler whose assignments are crowding your spare time, there are many unique ways to complement your medical practice above and beyond the aforementioned stereotypes: becoming an entrepreneur, pursuing an artistic dream, or even volunteering. And workaholics take note: Your recruiter actually wants you to take some time for yourself. It engenders safer medical practice, helps you avoid burnout, and can increase your long-term job satisfaction.

This one also appears in LL‘s March 2010 print edition, which you can see in digital form here. I’d written two articles for Locum Life‘s companion publication on the travel nursing industry, Healthcare Traveler, so this breaks some new ground for me in the temporary medical-staffing field. I interviewed working locum tenens physicians and recruiters from the locum placement industry to get a sense of how doctors found time to breathe—and what their recruiters did to ensure their docs actually did so from time to time. One of the most surprising findings was that locum work’s flexible scheduling actually granted one physician who took contracts out of state more contact with his family than he had enjoyed while working in a local hospital!

I actually just submitted an article for LL‘s April 2010 issue, and I was fortunate enough to be assigned a story for May’s LL as well. Watch this space for links. And if you’re looking for a writer with some recent research and contacts in the healthcare staffing and recruiting industry, drop me an email!