Tuesday, May 8, 2007

Rural medicine


At the Cascade Medical Center, there is an Emergency Room where we see a lot of male Idahoans come in, because for one reason or another, they make a habit out of packing lots of sharp objects into their bags, downing multiple beers, and then hopping onto the back of a four wheeler. Men are known to be dumb, but when you give them the freedom to combine alcohol with the limitless outdoor pursuits of the provincial lifestyle, they become recklessly dumb. If we're not seeing the bloody man from the fourwheeler accident, then we're seeing the dude with the fishhook embedded deeply in his toe, who claims he has no idea why his toe hurts or looks so nasty and swollen, and reports that he has not been fishing for over 2 weeks. And then we see the unfortunately young tree loggers that come in with 10 inch lacerations from their backfiring chainsaws, asking if there is a Doctor that can "sew up my little cut." In just my short stay here, I have witnessed some hilariously dumb folks deep from the woods of Idaho, albeit hardy and tough. These guys present to the office looking awfully grimy and just plain down and dirty, with their clothing soiled and body all banged up, but they are grateful as hell, and smile reverently up at you as their miracle healer when you patch up their wounds.

Practicing primary care medicine in a rural community can be challenging, as the availability of resources for referal and access to high tech diagnostic tests and acute emergency care can be severely limiting. Sometimes, just getting the basic utility needs can present as a challenge. Dr. Bedell, the family doc I'm working with, performs scheduled upper GI endoscopies and colonoscopys every Thursday morning. As one of the only physicians in town, he pretty much does it all, just shy of major surgery. Last week, during the middle of his colonoscopy procedure, the power suddenly goes out through the entire hospital/clinic, leaving us to stand there in the silent dark, staring at a blank tv screen, holding what remained left of the four feet long black tube inserted 3/4 of the way up this dudes ass. I could only chuckle inwardly, meanwhile pondering the irony and likelihood ratio of something like this happening. I followed the lead of the attending physician and maintained my cool composure. Luckily for the patient, we were able to locate an alternative power source with the aid of an extension cord, thereby allowing us to finish the procedure and safely withdrawing the endoscope. And fortunately for us, the guy was not the least bit aware of our electrical malfunction, as he snoozed deeply through what was supposedly only a small dose of "conscious sedation." Now thats what I call rural medicine.

1 comment:

Nissa said...

Good for people to know.