First Day of Rural Medicine

Anybody know where to get possum anti-venom?

[michaelcollins]

This isn’t an exaggeration. When I was working in Alaska, I met a PA who’s business card identified him as the mayor, postmaster, and chief medical officer of his town.

[j_skye]

Reminds me of my time in medical school when I treated a rural Appalachian grandma who got a snake bite. She drove the 2 miles to her nearest neighbors (her nephews) and they got on an ATV to kill the snake then drove her to the ED. We asked her if she was sure it was a copperhead and she said "yep" and pulled the head out of her purse. Resourcefulness is on another level out there.

[tabeechey]

Good lord do I relate to this. Hometown was a massive scattering of houses, pop 3, 000 across a valley, and we were one of the bigger municipalities in the area. My sister had heart failure and ultimately succumbed to it at 4. Four years later my brother had heart failure, and transplants had just started to see success, so when we got the midnight call for a match in another state (nearest equipped hospital was 6 hours away by car), mom dropped me (4) a toddler at a neighbor's she had only ever talked to on the phone so they could catch a prop plane that would take them on a dedicated flight.

Our rural hospital docs were champions. They identified a rare congenital heart defect, navigated us through the transplant process and recovery in 1990, successfully treated my aunt when the same defect hit her, and screened the rest of the family. They banked our samples in a research lab in Texas and about 20 years later, tracked us down to let us know when the genetic defect was identified (TNNT2 mutation). They successfully treated my mom when she later had heart failure, and shared records seamlessly when I had heart failure last year and was lucky enough to live right by an internationally known cardiac hospital.

They also managed every broken leg, diabetic crisis, heart attack, fall, and stroke in a three county area. Rural docs are remarkable - and as I said, we aren't even THAT rural. The folks out in Montana, Alaska, the Colorado mountains, the deserts of the SW... they are brilliantly diverse, innovative, and compassionate!

[VeryFairygirl]

The rural doctor in my area was the only clinic within two hundred miles who would see patients without insurance. She had patients drive in to see her from 4-5 hours away. Walk in clinic so always a waiting room full of people waiting for hours. Whole families being seen at the same time. From babies go the elderly. She found a tumor in my dad from a physical exam. Treated my mom’s depression/anxiety. Treated my bronchitis. I don’t know what we would have done without her. God bless her.

[gryphonennis]

Loved this vid! I'm a rural veterinarian and this rings true for us as well. Once I had a man come in with his dog- dog had a fish hook embedded deep into the face. I got it out and he said he'd be back to pay me later in the week. A few hours later he came back. I said "wow! that was fast! Fish not biting?" He said "Uh, well, I didnt come to pay you. I was hoping you could help me get the fish hook out of my son." I laughed, thinking he was kidding, but then his kid took his baseball cap off. Yep. Fish hook in the head. Also, had a pet rat come in. Needed surgery. I had no clue how to do it. But where else can the owner go? I watched a few you tube videos on rat surgery that night, and performed the surgery the next day. Rat went home happy and owner was happy. Country medicine is great! and scary. One must have inner confidence.

[Sveccha]

Texaco Mike's DWI caught my hemorrhagic stroke early and saved my life. I'll never forget the sound and sensation of his mighty propellor as he drifted away effortlessly, like the apotheosis of a newly minted deity. This is why, if elected, I plan to build him a new clinic and award him an honorary radiology license. I'm the goat, and I approve this message.

[docweaver]

I’m a rural medicine doctor- Family Practice. I’ve done just about everything short of open heart and orthopedic surgery. During COVID, that increased exponentially! Love your videos. Thanks for making one about us. We didn’t have a possum with venom, but we did have a pet raccoon for years that slept with my son.

[hotforhoya]

The farmer part got me! My partner had a grandpa that grew up and lived on a farm his entire life. He had hemophilia and, being on a farm, was prone to cuts and bruises all the time. His go-to solution was to cauterize it. The man would find a piece of metal, burn it hot and then cauterize the bleed. And did so for decades. The hospital staff were constantly astounded by the fact that he made it well into his 80s doing this when ever he came for a visit.

[Pedram_k]

It's funny how this is relatable on an international level. In Iran we have to do 2 years mandatory service in rural areas when we're done with medical school. The first few months is nightmare! the patients are not shy to express dissatisfaction when they see a rookie who doesn't know shit about the endemic diseases or stitching a half detached finger!
But gradually you earn a lot of precious experience lasting for the rest of your life.
Like when two patients come to the emergency room, one is making a scene and requests attention and the other one is quiet and looks at you with wide open eyes, it's probably the quiet one who needs immediate attention, not the loud one

[_Kyprioth_]

Our tiny rural town has had the same family doctor for the last 40 years.
I swear, that man could manage just about anything.
He used his own funds last year to build the town it’s first medical centre. Brand new equipment and everything.
Rural doctors are something else!

[valerianaranjocruz]

I don't know about other countries, but in Peru doctors are obligated to do one year of rural service after graduation. My dad told me about that one time during his rural service a man came in carrying his wife and his newborn, the woman bleeding like an open faucet. They had nothing to make the uterus contract, so what does my dad do to stop the bleeding while the ambulance takes them to a bigger hospital? He took his fist and put it inside the woman, putting pressure on the cervix, and stayed there for the whole 3 hours it took to get there. Woman survived and my dad earned the respect of the community. I love that man ❤.

[sarahw]

Yep, I did all of my clinical rotations in a rural hospital. My favorite was when an Amish kid sawed his thumb off (yes, with a handsaw, no I have no idea how) and the general surgeon was YouTube-ing different repairs before operating on him. The kid was denied general anesthesia by the elder accompanying him, but we were allowed to give him heavy duty pain meds. So this Amish teenager is stoned out of his mind on Dilaudid and is flirting with the nurse about the cows on her family's farm all while the surgeon is repairing his mangled thumb and I'm trying so hard to be professional and not giggle like an idiot. It was amazing. Rural med is awesome.

[stephanieburgess]

Oh my gosh so I grew up in a farming community and this is 100% accurate. You know how many farmers do their own stitches or family members. I once heard a Dr tell a story of a farmer who came cause he lost his thumb farming and he just wanted the Dr to stick the wound closed. The Dr was like let me call orthopedics at the nearest hospital for emergency surgery and the farmer responded no just stitch it closed cause I need to get back out there and keep working.. so so true.

[DieNextInLINE]

The absolute hilarity and truth of the farmer saying "Okay." And then going home to do it himself is just beyond words.

[veevee]

I'm a nurse at a tiny, underfunded inner city hospital that still gets GSWs, stabbings, and any manner of whatever that comes through our door. We may have a Level 1 trauma center 15 miles away, but it might as well be another world. We take whatever, we do whatever, and most of our population is homeless so we're social services too. Sometimes we don't even have blankets, but we still give excellent holistic care.

We totally relate to rural medicine!

[hiltonian_]

My grandfather was a small town doctor in upstate NY. He had a special pair of pliers for removing fish hooks from little boys’ ears. He hated field hockey season because they played for keeps in upstate. They would bring in teenage girls unconscious with their scalps laid open. By necessity he would sometimes barter. He knew the community so well that he could diagnose people as they walked in the door.

It’s family medicine but the whole town is your family.

[tommiegirl]

This is my rural Montana childhood in a nutshell. There was very little that our rural doctor couldn't handle. And if you were mortally ill or hurt, he stabilized you the best he could, and the HELP helicopter came and hauled you off to the nearest hospital, 150 miles away. Some didn't survive the trip... but most did. Shout out to old Doc Jay, and to all the rural medicine heroes - they don't do it for the money and they don't need your respect. But they've damn sure earned it.

[Marmalard]

I was once working ER in a rural community, and a guy came in for a nose bleed. He'd gotten kicked by a horse in the face. Took a while but finally got the bleeding under control. I said he should stay the night to make sure it's settled, and he was like "nah I gotta tend to my horses".

Another guy had his barbecue blow up in his face, and he was all singed. I asked him if he smokes, said no. Asked him if he smokes marijuana. He said yes. I asked when the last time was, and he goes "right after my barbecue blew up."

[colinmartin]

As a medic in a really large area, we worked with a mildly rural hospital in the mountains (nearest major hospital was a 45 minute priority ambulance drive) and I was always amazed at how the doctors handled everything. There was one trauma 3 center on the way, about 25 minutes, but they wouldn't TOUCH a lot of patients. They'd refuse and force you to drive the hour to the larger trauma center if the pt fell more than 3 stairs.

But this little 5 bed ER in the mountains would take EVERYTHING. Absolutely no refusals. I was talking with one of the docs one day and he said the most obviously sensible thing: "We can do a lot more than can be done in the field, and while we do it, can have a helicopter on the way." Over the years, I learned so much more from the rural docs than the ones at the trauma 1 hospital. Some seriously impressive improvisation.

That's honestly the exact kind of medicine I want to get into. Cut my teeth on major trauma in an ER and then go rural. Hoping that desire, a decent MCAT (plus my 10+ years as a medic) are what gets me into med school.

I also intercepted a lot of air evacs to the major Seattle trauma hospital from places like Alaska and Montana, and those stories just blew my mind. Patient had a tractor roll over on him, he crawled two miles to the farmhouse, family drove him 2 hours to the clinic, local doc dropped two chest tubes and intubated, stabilized him for transport before the plane even had its flight plan ready.

[sarahhavillamelooliveira]

My dad is a family doctor in a rural area while I am a med student in a bigger city. Man do I see some odd things that I quite sure wouldn't happened elsewhere. The deliver a baby thing is absolutely chefs kiss. My aunt is also a rural med and let me tell you: she takes car, boat and animal pulled transport before even reaching her post. Beeing a rural doc is almost too much adventure.

Edit: Oh yeah, and about mental counseling... docs are more often than not invited to the burring ceremonies and it's usually expected from the doc to give counseling to the family and tell them they did all they could, that its fine to grieve and that they can look for him if things feel out of grasp. I seen one of such instances and is amazing how relieved people seem with some words even if its obvious they are suffering. Never underestimate the power a docs word hold.