Why Rural Family Medicine

Why Rural family medicine?

I was sitting on my couch mulling it over and looking outside wistfully. I have been recovering from a distal fibula fracture suffered 5 weeks ago while skiing and this has curtailed my outdoor adventures for the last few weeks. I broke it up on Thompson pass, an uncontrolled backcountry area with the best snow in the world, while skiing with my sons. There are no ski patrols. Getting back to the car was an adventure.

As I sat on the couch looking at the spectacular mountains and slopes, marred only by streamers of wind blown snow, I could not stand it anymore and hobbled down to my cross-country ski boots. It was a tight fit, but the boots provided great support. The cross- country trail runs in front of my house and I quickly geared up and headed out. It was beautiful with clear skies and the peaks towering above, but it was gusting 40 mph with wind blown snow at times blocking vision completely. At one point I looked down at my leg and then up at the next onrushing gust of wind and yelled, "What in the world am I doing? " The answer came almost immediately. Living a life of adventure!

 The last fifteen years have been the biggest adventure any one person could have. I have been practicing medicine in a community with the most perverse and extreme weather of anywhere on the planet. We are periodically isolated completely, from avalanches, volcanoes, or storms. We have learned how to be self-sufficient and to stabilize anything. We perform a lot of procedures because we have to. And it hasn't always been fun. I have earned every one of my grey hairs. Webster*s Dictionary defines adventure as, *a bold undertaking, in which hazards are to be encountered, and the issue is staked upon unforeseen events.* I have sat by a bedside of a young woman with an ectopic pregnancy for several days waiting for the weather to clear, along with the rest of an impromptu surgical team in case she started bleeding. I served as the doctor for the World Extreme Ski Championships and for several snowboard championships, learning how to care for injuries on the side of a mountain. Once I even started an external jugular IV on a young skier with a liver laceration while crammed into the nose of a helicopter Threading its way through Keystone canyon.

My family has been able to have big adventures. We sailed from Seattle to Valdez. We climb glaciers and ski down them. We catch big halibut and enough salmon to feed us for the winter. My children have learned how to handle emergencies. My sons helped me get off the mountain that day. The truth is that I have loved being a Family Physician, even with the parts that have not been particularly fun. I also hope to start downhill skiing again in a couple of weeks. Breaking a leg is a small price to pay for the freedom of backcountry skiing. Practicing medicine without backup is a small price to pay for the closeness of physician patient relationships, the scope of practice, and the lifestyle for my family.

Posted at 08:51PM Jul 19, 2009 by John Cullen, M.D.  |  Comments[4]