Introduction
What exactly is a country doctor? More than someone who lives outside big-city limits? A mythic figure to quell fear when it rides the land? An embodiment of strength and wisdom? A person, above all. Ready at hand, compassionate when callous nature strikes. A companion who knows the way to one’s home. One whose black satchel carries healing and hope.
A friend.
Those colleagues whom I regard most warmly are fellow country doctors. Similar challenges forge bonds. The endless necessity to keep up on medical advances. The strain of endless emergency call. The endless anxieties that go with practicing in a remote area, where a person with devastating injury or illness can arrive in the office or emergency room. The endless tasks of balancing family responsibilities with demands of medicine!
That rural America needs improved access to health care is evident. Recognition of the fact underlies the recent formation of a division within the Minnesota Department of Health, The Office of Rural Health and Primary Care.
I have heard history described as being of two main streams: top-down or bottom-up. If one considers top-down history as being textbook material, presidents and wars and epochal events, then one can view bottom-up history as events seen through the eyes of an individual. In a diary, a memoir. This collection of stories, of memories, is of the latter variety. It has its own claim to validity; the stories reflect real incidents from ordinary lives.
Still, is any life ordinary?
Confidentiality is a keystone to a professional relationship. How, then, to share the courage, resourcefulness, the humor(!) of my patients within such constrictions was an ever-present challenge. To alter names was obvious, but in a small community not always enough. I changed the locations of my practice towns, dubbing them Northpine. (It is on no map.) When possible, I secured permission from the patient/friend involved to use his or her story. I smudged non-essential details in order to preserve the heart of a person’s experience. I pray that I offend no one and that others can learn from the joys and fortitude of my neighbors.
That health care sails troubled seas these days is front-page news. Need exceeds availability. A specter of financial disaster caused by unexpected illness looms over all but the most affluent. We are increasingly locked into a delivery system based on tiers, those with insurance... comprehensive care... and those without, where yawning flaws in the system can prevent a person’s receiving even minimal attention. The profession of medicine squirms on the dilemma of whether it provides a service (guaranteeing access for all) or is primarily a business (with profit the decision-maker). Is it not obvious that pharmacy flounders in a similar quagmire of crossed purpose?
I consider myself fortunate. At mid-twentieth century, when my practice years began, such questions barely rumbled on a far horizon.
A small-town practice is so personal. Patients become friends, and friends become patients. One earns esteem; it is not conferred by small print on a diploma.
The life I led as a rural physician was not unique. A number of friends, other country doctors, have submitted accounts of events from their own practices to be herein included. I am grateful to these colleagues for sharing of the wealth from their lives.
The following friends and colleagues have contributed stories to this journal:
Dr. Kenneth Carter, M.D.
Dr. Joseph P. Connolly, M.D.
Dr. Norman Hagberg, M.D.
Dr. “Jack”, M.D.
Dr. C. Paul Martin, M.D.
Dr. Michael McCarthy, M.D.
Dr. Robert P. Meyer, M.D.
Dr. Robert Nelson, M.D.
Dr. Robert H. Nelson, M.D.
Dr. Vern Olmanson, M.D.
Dr. Ricard Puumala, M.D.
Dr. Thomas Stolee, M.D.
Dr. John Watkins, M.D.
Unless otherwise indicated, opinions expressed within these pages are those of the author.
Time treats past events indifferently when memory becomes less than dust. We whose stories are here included offer tribute to some of our old friends, in hopes they will be remembered a while longer.
—Roger A. MacDonald, M.D.