Monthly Archives: August 2012

Final entry

In the last year we’ve highlighted many of the poems and stories in The Country Doctor Revisited. We’ve examined the joys of rural practice — the beauty of the wide open spaces, the close relationships with staff and patients, the benefits of less red tape. We’ve considered the challenges  modern health care poses in rural settings — how to provide the latest high tech care, how to install electronic health records with limited dollars, how to welcome more ethnically diverse populations and serve them in culturally competent ways. We’ve learned that big city problems are also problems in small towns — alcohol abuse, domestic violence, suicide and violent shootings. In rural areas the resources are more limited, so health care professionals are often more innovative.  Please review these pages and share them with your colleagues who are exploring rural practice as a career.

Check out the web site. http://thecountrydoctorrevisited.com/

Look at the contributors and their new work.

Consider starting a book discussion group to learn more about rural health and access the discussion questions on the web site.

Above all celebrate the importance of having a well trained rural workforce to care for the 20% of the US population who live rural.

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Blog: Rural Mississippi—Aftermath of Hurricane Katrina

–Shailendra Prasad

August 2005. I planned on flying back to New Orleans after a conference in Arizona. My wife and son had accompanied me. We watched Katrina grow like a weird reality show—a petulant child gaining weight, becoming unruly. There was talk about this being bigger than Ivan from the year before, even bigger than Camille from 1969. “No,” my friends and patients in Mississippi told me, “nothing gets bigger than Camille.”

Our flights home were canceled. Then we learned our neighborhood was under mandatory evacuation. Evacuation was not foreign to us. We’d participated in four drills during our seven years in Mississippi. “Hurricane parties,” we called them. We’d lock the shutters on the house, secure the garage door, and remove the yard implements that could become missiles in the sixty plus mile-per-hour winds. Then along with our two satchels filled with a change of clothes, our son’s favorite toys, and copies of our important documents we would drive to a safe home, a friend whose home was not in the path of the storm. We’d spend the night playing cards, talking, and waiting out the squall. Usually we could go home the following morning.

We hoped this, too, would pass and called a friend who had a spare key to our house.

“Sounds like a bad one,” our friend said.

“Can you get our hurricane satchels? There are two of them, in the closet in the master bedroom.”

“Sure. I’ll lock up the house too. Anything else?”

“Yeah, put the birdfeeders in the garage. The birdbath too.”

“Of course. Be safe. I’ll be in touch.”

That night in Phoenix I watched the television. Reporters talked about the rain and wind in surrounding areas. Counties in both Mississippi and Louisiana were evacuated. I called every number in my cell phone. No answer at the hospital, the clinic. My practice partner did not respond at his home phone or cell. I could not reach our neighbors or local friends.

Our county, Pearl River, and our town, Picayune, were orange on the weather map. The Internet news pages said nothing more. I could not eat dinner. I continued to make calls. I phoned my dozen sickest patients whose numbers I kept just in case they needed me. No one answered. I worried about my three-year old patient waiting for a renal transplant at Tulane. He’d just gotten a match.

What would happen now? No answer. And there was complicated Mr. Shirley who I just referred to the neurologic unit in Birmingham, Alabama. Would he get there for his appointment? When was that appointment? No answer. Then there was my dialysis patient. Where would she go? No answer. Feeling restless and helpless I walked down to the business center and opened this blog:

Pearl River County Katrina Survivors

This is my attempt to help in the aftermath of Katrina. I work in the Picayune area and have very dear friends in the area. The only precondition to this blog is this—respect your fellow bloggers.

Please blog away to add on to the information on Picayune/Pearl River County,Mississippi.

posted by sprasad @ 8/30/2005 07:54:00PM

By midnight there were thirty posts. I am looking for . . . I am trying to reach. . . does anyone have any information on . . .

 (Excerpted and used with the permission of the author, published in The Country Doctor Revisited, KSU, 2010)

Dr. Prasad felt an obligation to his patients during Hurricane Katrina. Medicine is rarely something you can walk away from when you leave the hospital or office. Often you carry patients with you – think about them, worry about them, pray for them. In a small town you often see  patients as you run errands at the hardware or grocery stores. This raises the issue about how one sets boundaries. How one cares for his/herself.

Talk with your preceptors and other staff in you clinical setting and see how they manage these challenges. 

Trends in Medicine

–Tom Bibey

We’ve been around long enough to see the trends come and go. I’ve seen Aldactone fall in and out of favor three times now as the latest “hip” drug. When I see some young fellow tout the latest study on the merits of the drug as some new thing, I ache from his lack of wisdom.

(Excerpted and used with the permission of the author, published in The Country Doctor Revisited, KSU, 2010)

 Dr. Bibey, who has some gray hair, gives us perspective on the changing knowledge of medicine. We have embraced Evidence Based Medicine (EBM), but the evidence changes. We once encouraged menopausal women to take hormones to protect their hearts, then learned that was not helpful. We encouraged anti-oxidants, then learned that did not make a difference. Talk with your preceptor and explore the other trends that have come and gone as our knowledge and science has grown.