The adventures of a sleepaway camp doctor

“Med staff — callback.”
“This is Dr. Jim, med staff, go ahead.”
“We need med staff to Cabin #1 immediately.”
“On my way. What’s going on?”
“We think one of the campers may have lice.”

That was the call that came in over my medical staff radio at 2330 on Friday night as I completed my final night on-call as a volunteer physician at a sleepaway camp along Virginia’s remote eastern shore. Sure enough, it was an infestation of lice among the campers in Cabin #1. Not the typical emergency call that I am accustomed to, but at youth sleepaway camp, lice get the attention of everyone. 

Volunteering for the week as a youth camp physician turned out to be one of the most rewarding experiences of my professional career. I have been practicing as a pediatric emergency physician at a tertiary referral children’s hospital for the majority of my career and have also had the opportunity to work at the children’s hospital in Port-au-Prince, Haiti. However, this was my first time working as a volunteer physician at a youth sleepaway camp. Working in resource-limited and austere environments often afford the opportunity to use osteopathic manipulative treatment and my osteopathic training, and working as a camp doctor was no exception.

Settling in

Arriving the previous Saturday afternoon, I was greeted by an empty, tranquil camp between sessions. A few counselors and staff did laundry while others relaxed by the seashore watching the sunset over Chesapeake Bay. I met my team: two obstetrics nurses with a ton of street credibility and experience who have been volunteering at this camp for years, along with a surgical nurse, who, like me, was new to sleepaway camp medicine.

They gave me walkie-talkie #24 and told me to stay on Channel 8. The three nurses would rotate first call, and then call me if anything was amiss. I instructed them to feel free to call me with any questions, and they assured me they would not hesitate, if necessary.

After settling into my cabin, which was tucked along a stretch of sparkling silver beach on the shores of the Chesapeake, my wife and I strolled along the water’s edge, swinging our 3-year-old son between us while balancing mugs of iced coffee in our other hands. He would spend the week in our cabin while our older kids, middle school and high school aged, would spend the week as campers. This would be their first, and possibly their last, overnight camp experience. We were all game for the adventure that awaited.

We woke up late on Sunday morning and explored the still-quiet camp. Breakfast consisted of Corn Flakes and Lucky Charms with a side of buzzing flies. The camp coffee was weak and lukewarm at best, which made me even happier that I’d packed a small two-cup coffee maker for our cabin.

Meeting the kids

At 1500 sharp, the gates opened and the cars lining the access road began to file in with their cargo of 200+ eager campers, aged 8 to 16 years old. The two OB nurses set up a table and took the campers’ medications, labeled as breakfast, lunch, dinner, nighttime and PRN medications, filling out the MAR. If required, an EpiPen was to be taped to the camper’s bunk, unless it was for a known food allergy, in which case Med Staff would bring the EpiPen to each meal.

I was set up at the next station with the lifeguards. We were on lice check, having each camper peek their head out of the car window as we examined behind their ears and scalp, looking for nits and creepy crawlers. It is evident to me now, in retrospect, that a few critters made it past our checkpoint, hiding among the countless follicles and braids. 

This week-long session was no ordinary session at camp though: this week was for the children of Special Ops military families—a week dedicated to giving back to our soldiers’ families for their sacrifice. I jokingly told my kids before leaving home that the other campers would certainly be much better at archery, riflery and swimming than they were. In fact, these Special Ops kids were just like every other kid at camp—they got homesick, they laughed and cried, they loved to sing, make bracelets and roast marshmallows by the campfire.

Most of them are marginal at archery, though the majority were outstanding swimmers. Some of them are survivors, having lost a parent in battle when they were still toddlers. For them, in addition to having fun, camp is an opportunity to build relationships and find support among peers who truly understand. It’s a chance to be a kid, to learn new things, to gaze at the stars, learn to sail, waterski, climb and explore nature in a wonderful camp environment. These kids were all absolutely incredible, and caring for them was extraordinary.

Caring for the campers

During the week, our medical staff was radioed often from 0600 to midnight and all through the night. Our team was strong, and we bonded at breakfast, lunch and dinner as we distributed medications for epilepsy, allergies, depression, ADHD, otitis externa and bowel regimens, among other ailments, all while a camp counselor DJ spun the tunes, and counselors and campers alike stood atop cafeteria tables singing at the top of their lungs. Kids who, I imagine, would otherwise be shy and timid, were dancing in the aisles at every meal. It was magical, deafening and absurd. I loved every minute at mealtime. We all did.   

After meals, we took sick call in the medical clinic. Many of the campers were coming by for stomachaches, with my primary objective to differentiate the generalized abdominal pain and nausea as either appendicitis, pancreatitis, cholelithiasis, constipation, functional or simple somatic and related to being homesick, as was often the case.

In contrast to the emergency department, where I spend my professional life, at camp I was able to spend a lot more time watching and waiting: following the progression of the illness over hours or even days and checking on the campers throughout the day before jumping straight to diagnostic tests. I would frequently call up parents after reading the camper’s medical chart and discuss the camper’s complaint. I found that I was their eyes and ears and noted that the parents truly appreciated my calls and follow-up.

Supporting teammates 

The sickest of my patients were not the campers, but the counselors, who ranged in age from 18 to 30 years old and hailed from all over the world including Hong Kong, Germany, Sweden, England, the Dominican Republic, Mexico, Malaysia, India, Australia and beyond. These young international counselors had been working at camp for a few months and were now exhausted. 

COVID was running through the ranks along with some other symptoms of fatigue. Despite their discomfort, they all remained upbeat. I relied on my history and physical exam and was pleased, if a bit surprised, to find how closely volunteering as a camp physician paralleled my work in Haiti, where I have only a limited arsenal of diagnostic tests while practicing in an austere environment.

By the end of the week, I had cared for a few concussions, lots of dehydration, a pair of broken ankles sustained by two separate campers during the same play at beach volleyball, a couple of facial lacerations, lots of URIs, coughs, some head lice, muscle strains, broken braces, swimmers’ ear and homesickness. Ultimately, my week as a volunteer camp physician was exhausting and rejuvenating all at once. I came back to my overnight shifts in the ED recharged and with a new perspective.

Heading home – and looking ahead  

Signing out my walkie-talkie to the next camp doc, we headed for home. My kids reflected on their week at sleepaway camp while I reflected on mine. To my delight, my kids were eager to return the following summer and so I signed on to volunteer again next year. We were all exhausted, salty, sun-kissed and itchy behind our ears.

Whether you have already had the opportunity to volunteer as a camp physician or medical staff as an osteopathic medical student, or this is the first time you are hearing about this type of experience, I wholeheartedly recommend it. The cafeteria food is terrible. The cabin is stuffy. The beds are uncomfortable. And the radio is with you for 168 hours straight without a break.

But once you help that first camper, you will realize that it is all worth it. You will have the opportunity to use OMT and your osteopathic training to treat acute alignments while watching out for young campers who are living away from home. It is guaranteed to be one of the most rewarding, and fun, experiences of your life. It certainly has been for me. I am already looking forward to next summer’s camp adventure.

Related reading:

Working as a camp doctor during my pediatrics residency

Child abuse pediatrics: Who we are and where we are going