Preview of Coming Attractions

Matha's Vineyahd

The Cape and Islands

So much to talk about. There is a lot going on in our world right now. The normal hecticness of finishing up the assignment and end of ski season parties has been compounded by actually knowing where we are going in May. Usually at this time of year, as the winter season wraps up in Colorado, we’re discussing where we would like to go for the spring and just starting to get some leads from our recruiters. But, this year, we locked down our May to November assignment in March, a true luxury. Normally, 2-4 weeks ahead of an assignment is good lead time to get everything set for the next assignment, but we have been graced with a full 2 months to get ready for our summer doing home care on Martha’s Vineyard. There seems to be a lot of confusion about exactly what and where Martha’s Vineyard is.

I grew up nearby around the Boston area, so I do know that Martha’s Vineyard is an island off the coast of Cape Cod – Nantucket’s next door neighbor. There once was a man from Nantucket…. um, nevermind. Anyways, Martha’s Vineyard is an island, there is no actual vineyard that I am aware of. I’ve only ever been there for one day as a kid – I seem to remember it being a fall day with pretty lousy weather – Kate has never been there. An unknown adventure awaits!

Housing is coming together pretty well for us despite running into a few challenges along the way. We originally were looking into houseboats for the summer, but there’s a lot of logistical challenges to how long you can stay in one harbor, what to do when a storm comes, and whether you are actually allowed to live on your boat at all in certain places. Basically, if you plan on working a 5-day-per-week job on land, it gets really challenging logistically to live on a boat. So, we shifted our focus to finding an apartment. At first glance on Craigslist, apartments looked very reasonable for rent – unfortunately, all the rent rates I was seeing were weekly rates. It quickly became clear that finding a reasonable place to live without having half a dozen other roommates was going to be a real challenge.

Dear Champ, Hey there Champ, Kate and I need to talk to you about something. We had some great times out there on the road - some of our more memorable times in all our years of traveling. But, well, it's time for us to move on and get another camper - something newer, something sleeker, something a little more "liveable." I know you'll understand, we'll think of you often. - James

Hey there Champ, Kate and I need to talk to you about something. We had some great times with you out there on the open road – some of our more memorable times in all our years of traveling. But, well, it’s time for us to move on and get another camper – something newer, something sleeker, something a little more “liveable.” I know you’ll understand, we’ll think of you often. – James

Kate and I have long dreamed about living in a camper since riding around in our old RV “Champ” every weekend during our assignment several years back in Anchorage, AK. It turns out that Martha’s Vineyard has one campground and we have locked down a campsite for the summer. The only problem is, we don’t own a camper yet. Our main logistical problems will be 1. Finding a camper small enough for our SUV to tow, but big enough to live in for 6 months. 2. Reserving a spot on the ferry to the island not knowing the exact size of our camper yet. 3. Figuring out how to watch as many Red Sox games as possible without cable!

I’m really looking forward to the adventure of living in a camper this summer. At some point we’ll have to make a decision whether to sell the camper at the end of the summer or keep the adventure going. I guess whether we keep or sell the camper depends on how much we like it. In the meantime, the end-of-season parties are wrapping up here in Colorado. Work parties, ski mountain parties, and just party parties will keep us busy over the next 3 weeks before starting the road trip back “home” to New England. The first leg of the trip going back East will be to head West for a dry needling course in Salt Lake City! After that, I hope to grab a couple baseball games in random stadiums along to route and couch-surf with a few old friends from the road.

Stay tuned! Lots of adventure and fun ahead!

White Christmas

This quick entry is specifically inspired by my friend Ry. He has requested I send him a picture of myself at work some day, because he doesn’t believe that I actually work. I can’t blame him, I really try not to work, but it is a necessity.

If I have to work, I like to have a view of a ski area. :-) Loving it.

If I have to work, I like to have a direct view of a ski area.  Loving it.

As a traveler, you sometimes have to do the grunt work. You might work weekends, you’re likely going to be working hard during the hours you are at work, you might even work Christmas, but hopefully you’re doing it in an awesome place.

Here in Aspen, the place Kate and I return to every winter for work, I know the drill. I’m going to work Saturdays, I’m going to work Christmas and New Years. I have come to grips with this schedule and actually have come to like it. Someone suggested a possibility of no working Saturdays, and I realized I actually like working Saturdays because it’s low-key and I get to be off an extra weekday off.

If I have to work (and I do have to work), I’m going to do it in a place I love and that will make my hours outside of work so very much better. Living here in a touristy paradise there are many, many benefits. Working Christmas Day is a small sacrifice. It’s a White Christmas today, which means it’s a powder day tomorrow (when I’m off) 🙂

Christmas Day, at work. Merry Christmas all!

Christmas Day, at work. Merry Christmas all! It’s not so bad.

When I’m off work in a few hours, Kate and I will host our annual Christmas Party for many of our co-workers and few of the new travelers here who don’t know many people yet. If you’re in the Aspen area, drop on by. We’ve come to celebrate our Christmas in an unorthodox way, but it’s one part of great life through being traveling therapists.

Happy Holidays, Happy New Year, See you on the slopes. See, Ry, I do work…. sometimes. 🙂

Jack of All Trades

On my very first travel assignment, almost 8 years ago, I quickly started appreciating parts of PT that I never thought I would be working in or ever need to recall from the most doodled-on pages of my college notes. But, there I was, 6 months into my career – that I had originally intended to be as a professional sports PT – and I was standing by a whirl pool doing debridement on a homeless guy. Alex, an experienced PTA with a crazy amount of passion for Physical Therapy, had recently taught me the ins-and-outs of the simple wound care we were performing and why we were doing what we were doing. On this first travel assignment, I was also baptized into the world of prosthetics. Alex taught me about shrinking the stump and different techniques for wrapping and making simple adjustments to the prosthesis itself. Alex was a neat guy who took a “non-traditional” path to being a PTA and was one of my best early mentors. Along with Alex, there was a handful of PTs with varying degrees of experience who were all willing to help me through my first travel assignment. Me, Non-Traditional PTA Alex, and a few other PTs were conquering all the issues of the good blue collar people of Lowell, Massachusetts – and were definitely not doing professional sports PT. The funny thing is, I enjoyed it. Prosthetics was a cool field. Wound care wasn’t anything I cared for, but it was different and new. I even got some early ER experience and found some excitement in the mayhem I would find every time I walked through those doors – cops, crooks, drunks, and broken parts of all kinds. I ended up spending 10 months in Lowell getting some quality mentoring and all kinds of experience in a wide spectrum of PT. This was the first place I experienced the kind of place where you treat “whatever walks in the door” (or rolls in the door), it certainly would not be the last. After a few contract extensions, I triumphantly left that assignment, nearing a year and a half of PT experience under my belt – I knew it all, nothing could surprise me now!

[Just something to listen to while you read – enjoy! About Kaunakakai, where we currently live.]

I’m somewhere around 20 travel assignments now – I’ve worked in about 30 clinics. It amazes me that I have learned something significant and useful on every single assignment. My new knowledge on each assignment comes from both the things my bosses and co-workers are doing well and the things that could be done better. Much of the time, I’m learning something positive directly from colleagues who have become specialists in their own unique mixture of whatever walks in their door. Often my education is purely experiential in working with a new population, a new culture, or in a new setting – home care, inpatient rehab, private practice, acute care, hospital outpatient, ER. There is just so much variety of what you can do with PT and how you can deliver it. At the end of every assignment I make a note of what I may have learned and confidently think, “Now I’ve seen it all, I can’t possibly see something at my next assignment that I haven’t seen before.” I’m being a little sarcastic here, but seriously, after a while, there can’t be too many surprises left… right!?

I knew on this current assignment I would have to be a true generalist and pull from many different parts of my skill-set. On this island, there’s no OTs, no SLPs, no nothing other than one other PT working at a community health center up the road. To really up the anti, there’s just absolutely no where else to find any specialists, there is open ocean between us and anybody else – referring out to someone more equipped for a particular job isn’t an option. We are essentially the only option for whatever ailment you can dream up. I took a phone call last week from a case manager in the large hospital system we are a part of. The main hub of this system is over in Honolulu, and there are many smaller community hospitals throughout the islands that are a part of this health system – although, I can’t imagine any one of these small community hospitals being any smaller or more isolated than Molokai General Hospital (MGH). Anyways, this case manager in Honolulu was wanting to send a Molokai resident back home but wanted to make sure we had both PT and OT for her referral. I explained to her that we do not have an OT here at the hospital and there are absolutely no OTs on the entire island, but that we are used to filling many roles and can handle the patient. The case-manager seemed unimpressed with a reply of, “OK. Thank you,” and hung up. After the call, I realized that in a way, I am fulfilling a very Molokai role. Nobody expects to have every resource available on Molokai, but many people fill multiple roles and help the community as best they can by wearing many hats. Many employees in the hospital have their main role, but then serve an adjunct role as the as infectious disease coordinator, or employee health director, or any other job title you can picture being a full-time position in most hospitals. A funny sidenote: I was talking with someone who was one of 3 employees of the local paper, a transplant to Molokai. She described how word got out that she was decent with computers, and people (mostly older people) started showing up with their computer issues at the newspaper office for her to help. People here don’t expect to have every amenity or service, but they help each other out however they can.

Kate and I have enough years experience behind us in enough different settings that we are able to confidently carry out the vast majority of our responsibilities. At MGH we cover inpatient, outpatient, ER, and SNF (14 beds in the hospital – 7 rooms). We are serving as hand therapists, neuro PTs, the Ortho Specialists that we actually are, and essentially work in the role of rehab specialist on every condition from the age of 1 to 100 with only modest resources. We have a surprisingly great clinic, gym, and staff, but are routinely having patients order equipment they need online – there is a local pharmacy, but it’s pretty limited in the DME department. Kate has taken on the wound care, and while I appreciate having learned some about wound care in the ol’ days with Alex, I’ll pass, thank you. My learning experience on this assignment was revealed to me early on when I realized all the additional roles I would be filling:

Social worker – Kate and I both worked our butts off last week to get 2 SNF patients discharged. We called family members, called outside services, and essentially fully arranged and negotiated these patients’ discharges. Kate even went to her patient’s house to help her transfer out of her car and into her home. Not what you would call billable hours, but good work that achieved great results.We are also a part of a team that is charged with delivering a decision on whether or not to admit SNF patients. The list of variables to consider is huge, since to even get here as a SNF patient, you are typically flying commercial on a puddle jumper. Also, you have to be thinking discharge ahead of admission – there’s no home therapy services, there’s no long-term nursing home, there’s no assisted living. If a person can’t ride a commercial flight with a nurse or be expected to discharge home – they shouldn’t be admitted in the first place.

There are no surgeons. When someone cannot or will not go off island for an Orthopaedic or other surgical consult, we are the next best thing. The PCPs, many of whom we have gotten to know well in a short time, are quick to refer anybody with an ache, pain, or movement dysfunction to us for more specific diagnosis and treatment. We are determining weight bearing status for acute fractures, managing follow-up appointments, and suggesting when someone might need additional imaging. It’s a unique experience to be working with a patient that you know should have surgery, but that off-island surgery is just not a realistic option in his world. I could write another entire blog about performing PT in reality – treating within people’s financial limits, having realistic/sustainable goals for patients, knowing when someone has reached their own individual ceiling of health. When a guy shows up needing a metal plate in his ankle, but that metal plate is a plane ride away that he’s not going to take, that’s when some real-world PT is needed and when we need to decide what the best conservative treatment option is for the patient.

I do feel well equipped for this assignment that requires a wide range of skills and a certain depth of knowledge. I would not recommend this assignment for anyone without a few years experience across a few settings. It’s nice to be in an environment where we get to use a full range of our skills as PTs. Most of the time PTs will work in a setting that sees only a very small slice of the full scope of practice. Sports and ortho is still my bread-and-butter, but I have gained a lot of skills and knowledge in other areas over the years. When I am back in Colorado in the winters, I work for a hospital that practices orthopaedics at a very high level. The patients with various sprains, strains, and fractures are handed down from a team of Orthopods and ER docs that absolutely nail their diagnoses. It’s a nice luxury, but to be honest, my diagnostic skills atrophy severely in the winter from disuse. As I’m bending and straightening joints all day, patients ask , “You had to go to school for 7 years for this?” I defensively explain how making their knee bend is only a very small part of what I learned in school and that PTs are trained across a large variety of diseases and dysfunctions. But, back here, I’m using every last bit of those diagnostic skills and every ounce of my education across a very broad spectrum of pathologies. The health community here may not have specialists or surgeons, but to be as comprehensive as possible, everyone else must work their role to its limits. It’s fun, challenging at times, and definitely a new learning experience.

Red light. Green light.

Here is a Hawaiian Monk Seal. Only 1,100 of these endangered guys left on Earth. We did not almost trip over this one like we did the one mentioned in the last blog - but there he was, just laying on the beach enjoying the sun... just like us.

Here is a Hawaiian Monk Seal. Only 1,100 of these endangered guys left on Earth. We did not almost trip over this one like we did the one mentioned in the last blog – but there he was, just laying on the beach enjoying the sun… just like us.

I feel like we’ve graduated tiers of traveling on this assignment. We’ve reached a realm with only the other wild-ones. On this small, 8,000 person, 1 hospital island the two traveling nurses we’ve met are doing their work the rest of the year in places like West Sudan and St. Thomas. We have arrived. It’s just us and the other nuts who cannot fathom the inhumanity of a 9 to 5 in Pleasantville, USA. We have traveled far to the remote, quiet, pristine island of Molokai… only to continue working the 9 to 5.

In our first 2 weeks here, I have already found this island to be a place that will broaden my view on life and how life can and should be lived. Earlier this week, while out hiking, I said to Kate, “I think this assignment is going to be life changing.” She asked me why, and I quickly back peddled. OK, “life changing” may be a little dramatic, but this is a different place, and for 13 weeks I’m living a different life than I have ever known. It’s slower here, there are few people, much of the land is pristine – this is how the rest of Hawaii used to be. Last weekend, as we were walking from the local farmers’ market that takes over the center of town each Saturday, I had my arms full of local papaya, tomatoes, and avocadoes. I took a look around at the people and buildings – and the scenery – and knew that this place is very different from anywhere I’ve been before.

Up on our hike in the Forest Preserve. A beautiful jungle protected just behind the cliffs of the North shore.

Up on our hike in the Forest Preserve. A beautiful jungle protected just behind the cliffs of the North shore.

This past weekend, we headed up to large forest reserve. Between off road driving from sea level, then mountain biking, and then hiking to an overlook at 4,300 ft, we covered 16 miles one way (pretty good on an island that is 38 miles end-to-end). We saw one group of hunters while we were on the roads. On the bike and hiking trail we saw no one at all and on Labor Day weekend! The lookout at the top was socked in with clouds, but we had heard that if we waited a bit, a hole would usually clear. As Kate and I waited, we talked about Molokai. We’ve done travel assignments in a lot of places and hiked to a lot of far-off summits, but decided we have never been in a more remote place than where we stood at that moment. The clouds later parted, and we were treated to one of the best views anywhere.

Somehow, through all this quaintness, the 14-bed hospital remains a part of the 21st century. People show up on time for appointments, the days are busy, and JCAHO and their misguided standards reign supreme. I find myself rushing through the hallways to patient rooms, back to scheduled appointments, off to grab equipment. It’s a great place to work and is full of extremely friendly people (the “Friendly Isle,” after all), but it’s a busy hospital like any other. The dichotomy of the two lives I’m living in and out of work were displayed for me full force the other day as I headed out for a quick errand at lunchtime. I had the time, but needed to move quickly to be back for my 1 PM patient. I zoomed out of the hospital parking lot and briskly down into town where the speed limit is 20. As I hit the first stop sign*, a man driving 7 mph pulled out in front. SEVEN. This guy was driving 7 miles an hour. On the weekends, or after work, I behave. I’ll drive slow, walk slow, pop into little shops, and have exceedingly long conversations with strangers. But, I had to get back to work for a patient, and this guy was driving 7 miles per hour.

Our view once the clouds parted. Likely, there isn't a single person in that valley.

Our view once the clouds parted. Likely, there isn’t a single person in that valley and the ocean beyond stretches uninterupted to the Aleutian Islands of Alaska

This life here is definitely going to change some perspectives for me because of its simplicity and the slow pace. To really make things interesting, we are going without TV altogether, and because of weak cell signals Netflix is really hard to stream. (Now, no cable, that’s life changing. I’ve already decided to put the hospital-supplied cable box away when we get back to Colorado… except for football… or hockey playoffs… or…) Despite the slow pace, the roosters waking me in the morning, the empty hikes, and the empty beaches, a hospital is still a hospital and there is work to be done. In fact, here, there is work to be done 6 days per week (yeah, more on that later). We’re working hard while at work and trying everyday to slip back into lazy island life within minutes of walking out the hospital doors – It’s pretty awesome.

More soon. I have some great blog topics coming, but getting them written down takes some time. Stay tuned, and get out on the road! As travelers, we are given an awesome opportunity to see the many different sides of this country and world – Enjoy it!

*They call it a one stop sign island – However, I have counted several. There are no traffic lights at all.

How Should I be Paid?

With any job, there are a number of different ways you can be paid. There’s straight-forward salary, hourly, or some sort of productivity-based pay. Of course, when considering pay for a typical job, there are things to consider besides just the money – health care, retirement, life insurance, employment-related discounts, and the list goes on. In traveling physical therapy, the list gets a little bit longer and more complicated. A traveling therapist has more say in how he or she would like to be paid and needs to determine how much he would like to weight his taxed versus untaxed wages. There are IRS limits on how much you can take tax free in each zip code, but I have been told that taking those upper limits with low taxed pay can be a red-flag for an audit. So, I typically take $20-$30 hourly (taxed) and get the rest of the pay as stipends/reimbursements. I know a lot of travelers think hourly should be near the normal hourly amount a perm PT makes with the reimbursements being in addition to normal pay, but that’s just not the way it works. A more adventurous travel assignment can have some perks that can make the math of take home pay a bit more complicated: a loaner car from a boss, employee housing, a coworker’s mother-in-law apartment, or other non-monetary compensations.
Productivity arrangements in healthcare can get iffy real fast, think anti-kickback laws. I am not a fan of pay-per-code or percentage of billing situations. These can quickly turn an honest therapist nasty. It’s just too tempting to bill an extra modality or therex that may not be necessary when you know your own bottom line is linked to it – I don’t like it one bit. I’ve seen a number of positions, particularly for therapists in management, where bonuses (boni?) are paid for meeting certain productivity thresholds – number of patient visits or units billed. I occasionally see pay-per-visit systems go awry with a therapist seeing many patients at once, episodes of care dragging on, care extenders over-reaching their scopes of practice, patients getting less attention, and therapists getting burnt out. But, I can’t speak too harshly about pay-per-visit, since it is how I’m getting paid right now. Luckily I’m in a practice where all treatments are provided by PTs 1-on-1 for an hour. With the focus of 1-on-1 patient care, I find the arrangement ethically acceptable, but it’s definitely got its pros and cons. I’m well paid for my hour with a patient, but there is nothing worse than an initial evaluation that no-shows and leaves me unpaid with nothing to do for a full hour. I would encourage anyone considering a pay-per-visit position to first strongly scrutinize the care patients are receiving, and secondly, to ask for a little more money than you normally would, because the chances of batting 1.000 for attendance in any given week are slim.

Advance Healthcare Network

From Advance – Click to access their full report

New travelers are always asking me what they should get paid – I don’t know. Pay varies so much regionally and even town to town. It can be real tough to know if you’re making all you can of if a recruiter is taking you to the cleaner’s. Just find a recruiter you trust and get as much as you can out of each contract. I may try to establish a database where travelers can anonymously input how much they got paid on assignment. It would likely be a small sample size, but may provide all of us some information about what other traveling PTs are getting paid in each state. As I mull over that idea, here’s a nice piece that Advance puts out each year based on their survey results of PT pay. I just stumbled across the APTA Workforce Data page, not as sexy or user friendly as the Advance survey, but lots of good info in there if you click around (APTA Members only).

Some advice for the new traveler: Remember that your recruiter is working on commission and doesn’t get paid if you don’t get hired- it is in their best interest to get you on board even if it lowers their own bottom line. You are a temporary worker for a facility that needs help immediately, you are willing to pick up your life and move to that job to fill a position they desperately need filled – this has big value to it. With all these things working in your favor for higher pay, the costs of travel, furnished apartments, and miscellaneous other will likely cancel out a big chunk of the extra moolah. But, traveling PT can be an exceptional lifestyle that is worth so much in personal experience and growth – so get what you can financially out of a contract, but more importantly, just get out and see some more of this world.

In other news, a series of conversations this week have lead me to believe that the travel PT market is rebounding from a couple of more difficult years, I’m finishing up my SCUBA certification with four dives off the coast of the Big Island this weekend, and (in a crazy out of this world experience that only traveling PT could provide) a hospital has bought Kate and I plane tickets to fly out to interview for a possible once-in-a-lifetime travel assignment this fall – we shall see and more on this later.

Keep living the dream 13 weeks at a time!

Just Go With It

I’ve returned to my natural state. Everything I own is in a bag. The rear-end of the car is dragging on the tires from the weight of stuff that will ultimately end up in a storage container. Kate just got home from her last day of work with a bottle of wine. The corkscrew is packed away at the bottom of a box, but at least my camping gear is coming on the trip, so my Swiss Army knife is available. We’re each wearing different white Red Sox shirts as I twist the corkscrew portion of the Swiss Army knife into the cork and pull like hell while hoping not to splash red wine on either of us. Success! It’s going to be a good week off.

Map of lava flow hazard zones for Island of Hawai`i

The USGS’ Lava-flow Hazard Zone Map. I guess we’re supposed consider this when looking for housing? It’s going to be an adventure.

It’s been a wild ride to get this next assignment’s contracts in place. Actually, they aren’t really in place, I’m just going in on blind faith with fingers crossed. Kate got an assignment set in Kona, HI through a recruiter. We thought long and hard about whether Kona was where we wanted to go and what our other options were. When it became apparent that there were some more jobs around Kona and a couple opportunities for independent contracts presented themselves, we committed to Hawaii.

People ask me about independent contracts a lot. Let’s be clear, I am no expert on independent contracts, but I do have a little experience. Whatever I’ve done this time around is not the way independent contracts should be done. I’ve verbally accepted two PRN jobs with no idea what the pay is.

It all started well. I have had two different interviews at places that would like me to work for them. Seems simple enough from there, right? Let’s sign the contracts and get started with work. Unfortunately, neither of the jobs has 40 hours for me, but they both say they have 20-30 hours for me. We have talked pay, but I have no commitment from either job on exactly what the pay will be. I supposedly have a job offer in the mail from the private practice, and the hospital I have spoken with has cautioned me that they are run by the state, so “it can be quite a process to set-up a contract.” I’m antsy to have a contract in hand, but Kate keeps reminding me about “Aloha time.” Aloha time is the Hawaiian equivalent of “Don’t worry, be happy.”

The start of the Ironman Kona swim is right around the corner from my job. The locals call it “The Pier,” and I cannot wait to go get some open water swimming in.

Kate’s right, things are going to go fine, we always land on our feet. I have two places in Kona that want me to work for them and want me to start in under 10 days – that’s a pretty good situation. It’s Hawaii, they’re relaxed, and I should be too. No one else is worried, they expect me to show up on the 19th and start work. Nothing left to do but knock on wood, hop on the plane, and hope someone has scheduled me some patients when I get out there.

Remember, don’t do this. Be more business savvy than I have been. When talking finances of a contract, be clear, be confident. Because I have not been clear or confident when talking about the business parts of my independent contracts, there’s nothing left for me to do but wait and start working on my transition into Aloha time. Patience is a virtue, don’t worry brah.

To Be Continued...

Island Dreaming

Just a quick entry for you folks today. Thought I would give an update on my current job search and some of the obstacles I’m running into.

Regular readers know my wife, Kate, and I are both PTs who travel together and know that this sometimes presents some unique challenges. Mainly, we need two PT jobs when we travel instead of just one.

Island of Hawai‘i, Hawaii

Kona coffee every morning.

Our hope this summer is to return to Hawaii. We worked in Waikiki a few years back and after a couple consecutive years of assignments in the more Northern reaches of our country, we’re ready for some sun and water. This time, we’d like to try to avoid the city and check out an island other than Oahu.

I try not to rant on here too much, but I really wish we could have some more reciprocity between states with our licenses, like the nurses do. It took almost three months to reinstate our Hawaii licenses – a process which should have been easy, but dragged on mostly because of mistakes by state board staff in several different states. Anyhow, we now have our Hawaii licenses current and even have a possible job on the big island (Hawaii).

Normally, we would be psyched to have a lead on a job in Hawaii this far out from our start date (4 weeks), but our situation got a little bit spicier this week. Two jobs on Nantucket materialized and got us thinking a bit more Easterly.

Nantucket, MA

Nantucket – 30 miles off the coast of Cape Cod. Very expensive.

Nantucket sounds like a great time – but, it comes with a few challenges: 1. We’d really like to be in Hawaii. 2. Housing prices are ridiculous. The only Nantucket posting on airbnb.com right now is a house available for rent at $40,000 per month! There’s no camping on Nantucket, so a trailer or RV are out. I’m trying to wrap my head around how living in a house boat for 3 months would go. (I think it would go pretty awesome!) If these Nantucket gigs work out, I think we’re going to have to ask for higher pay to help buffer the cost of living.

That’s all for now, just a quick update and I hope to have more to share soon.

A Little Ketchup

One of the many beautiful sunsets this fall from our apartment looking back on Boston.

One of the many beautiful sunsets this fall from our apartment looking back on Boston.

Another travel assignment has flown by and I again have written far less frequently than I intended. I have a short list of meaningful topics I’ve been wanting to get to, but today you’ll have to settle for just an update on the travel life.

It’s been a great autumn in the Boston area. Kate and I got a killer apartment on the coast just north of the city and have made up for a lot of lost time with old friends. Lots of fun, a few shenanigans, nice cold evening sunsets, and being here for another World Series championship have made it a great fall! It’s raining right now, but its probably one of less than 7 days it has rained during our 3 months here. It’s been a fantastic fall… but, man, am I ready to get out of here and head to Colorful Colorado!

Highland Bowl

Highland Bowl, one more reason to get out and get acclimated… that bowl ain’t gonna hike itself!

This will be our 6th year working seasonal positions out in Colorado. I have worked for the same hospital out there for 5 years now – I am so excited to get to the mountains, see good friends and co-workers, start up the low-stress life of a professionally employed ski bum, and most importantly,get to laying down some powder turns. After a delay in finding a job for the fall, this contract is running a little later in the year than I’d like it to, and some weeks of the ski season are slipping by. I’m also losing out on some precious time for altitude acclimation that makes a huge difference for some mountain races later this winter – and just trying to keep up with the other locals around town – and not being out of breath sitting at my desk at work.

 

Accord

The ol’ Accord road tripping in all its glory.

I think part of my extreme anxiousness to get out there lies in a newly fine-tuned proficiency for getting ready to move. I have no bags packed, but I feel like I have been preparing to move for 3 weeks now. Just a few drawers of clothes to shove in bags and we’ll be packed up. To add to the ease of moving this time around, we have upgraded to an SUV. I sold my old Honda Accord that I had put 120,000 great miles on (plus 70,000 miles from its original owner). It drove some of the great roads in North America – made the trip up the Alcan Highway to Alaska, drove East through Canada to Prince Edward Island, and touched the Southern and Northern tips of Rt 1. But, for two people routinely moving cross-country multiple times each year, I can’t believe it took us this long to get a bigger car. I sold the Accord this weekend on Craigslist and I am driving a rental for my last week working in home care – 4 more days on this contract – head down, nose to the grindstone. Short-Timer Syndrome be damned!

I, of course, will be updating on the Facebook and Twitter (@hobohealth) pages all along the road trip, but this trip will be less of a meander out west than some of our previous trips. We will get to catch up with some friends in Chicago along the way, but otherwise this trip is going to be a straight-shot westward in just a couple long days of driving. Expect updates soon and travel safe! -James