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The Country Doctor Revisited: A Twenty-First Century Reader

The Country Doctor Revisited: A Twenty-First Century Reader Edited by Therese Zink 191 pp, $32 Kent, OH, Kent State University Press, 2010 ISBN-13: 978-1-60635-061-4 Rural medicine is quite unlike that depicted in the painting hanging on the wall of the South Dakota community hospital where I practice. In that painting, a country doctor's horse and buggy stand outside a warmly lit farmhouse. Next to the house is an idyllic pond, with a formation of wild geese framing the sunset, and the viewer can easily imagine that the physician is inside delivering the perfect baby. This false picture of rural medicine is rubbed out as the reader progresses through the diverse museum of short stories, essays, and poems captured within the pages of The Country Doctor Revisited: A Twenty-First Century Reader. Like a fine-arts master, editor Therese Zink brings experiences and viewpoints from the folks living, surviving, and providing health care in less populated areas of this country. Forty years ago, my teachers at the University of South Dakota School of Medicine promoted a humble rural point of view: to learn the art of medicine in this rural state, one must understand how to provide the highest-level, most complex and technical modern health care as well as minimalist medicine when resources are scarce. But this Twenty-First Century Reader shows that there is something more about practicing the art of medicine in rural America. That “something more” is sculpted by Kullnat in the first essay, “Boundaries” . Writing after her rural rotation in Oregon, she describes the inescapable dual relationships that occur for physicians from small towns as they provide health care to their friends and neighbors. Kullnat relates that “[d]uring my rural rotation, I witnessed physicians who hunt and fish with their patients. . . . ” She summarizes, “[such] relationships may challenge the sterile guidelines made by medical associations but are nonetheless fruitful. So fruitful in fact, that patients praise their physicians with a loyalty that has become rare in medicine.” That something more is painted in a poem by rural Massachusetts psychiatrist Berlin: . . . Right now I’m a hundred and fifty miles from the waste of your broad muddy fields, the end of a day with dementia and AIDS, headed home to redefine the objects in my world— raw knuckles of red rhubarb breaking the earth's clay crust, sawed-off apple limbs expecting fire, sticky-swollen horse chestnut buds, tips sharpened to stingers aimed at the sky, all around, the grass a rumor of green. That something more is chiseled by Bibby (pseudonym of a family physician from rural North Carolina) when he writes, “You don't have to ask the family history if you were there.” That something more is feeling connected to the cows on Beaver Simmons' farm, writes Loxterkamp, a family physician from rural Maine. To his question, “What are cows for?” he replies, “cows can bring us joy and beauty, provide companionship, inspire the next generation of farmers. . . . ” Loxterkamp thus speaks to the value of practicing rural medicine and realizing the deeper meaning that comes with connectedness. That something more is drawn on the rural New Hampshire experience of family physician Kollisch, as he describes the dying of his elderly farmer patient: “(Elwin) pictured himself on the John Deere, cutting wide swaths in a dense hayfield, the fallen grass lying thick and green and pungent behind him. And when the last grain (of the hourglass) ran through, he closed his eyes, the tractor stopped, and he slept.” A few authors, such as Abraham Verghese, David Loxterkamp, Richard Berlin, and William Orem, are well known. But most who contributed to this compilation are practicing physicians, students, and clinicians given the joyful opportunity for the creative and expressive process. Not all parts of this collage are of the same quality, yet that is a token price to pay for this museum tour of eclectic points of view in rural medicine which, while not always complimentary, are always intriguing. The Country Doctor Revisited enlightens like a museum of artwork from myriad perspectives, colors, and textures. Then the observer may have a truer picture of what it is like to impart health care in rural America. To know rural medicine is to understand the highest-level, most complex and technical of modern health care, as well as minimalist medicine. And that is something more. Back to top Article Information Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

The Country Doctor Revisited: A Twenty-First Century Reader

Holm, Richard P.
JAMA , Volume 305 (19) – May 18, 2011
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Publisher
American Medical Association
Copyright
Copyright © 2011 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2011.648
Publisher site
See Article on Publisher Site

Abstract

Edited by Therese Zink 191 pp, $32 Kent, OH, Kent State University Press, 2010 ISBN-13: 978-1-60635-061-4 Rural medicine is quite unlike that depicted in the painting hanging on the wall of the South Dakota community hospital where I practice. In that painting, a country doctor's horse and buggy stand outside a warmly lit farmhouse. Next to the house is an idyllic pond, with a formation of wild geese framing the sunset, and the viewer can easily imagine that the physician is inside delivering the perfect baby. This false picture of rural medicine is rubbed out as the reader progresses through the diverse museum of short stories, essays, and poems captured within the pages of The Country Doctor Revisited: A Twenty-First Century Reader. Like a fine-arts master, editor Therese Zink brings experiences and viewpoints from the folks living, surviving, and providing health care in less populated areas of this country. Forty years ago, my teachers at the University of South Dakota School of Medicine promoted a humble rural point of view: to learn the art of medicine in this rural state, one must understand how to provide the highest-level, most complex and technical modern health care as well as minimalist medicine when resources are scarce. But this Twenty-First Century Reader shows that there is something more about practicing the art of medicine in rural America. That “something more” is sculpted by Kullnat in the first essay, “Boundaries” . Writing after her rural rotation in Oregon, she describes the inescapable dual relationships that occur for physicians from small towns as they provide health care to their friends and neighbors. Kullnat relates that “[d]uring my rural rotation, I witnessed physicians who hunt and fish with their patients. . . . ” She summarizes, “[such] relationships may challenge the sterile guidelines made by medical associations but are nonetheless fruitful. So fruitful in fact, that patients praise their physicians with a loyalty that has become rare in medicine.” That something more is painted in a poem by rural Massachusetts psychiatrist Berlin: . . . Right now I’m a hundred and fifty miles from the waste of your broad muddy fields, the end of a day with dementia and AIDS, headed home to redefine the objects in my world— raw knuckles of red rhubarb breaking the earth's clay crust, sawed-off apple limbs expecting fire, sticky-swollen horse chestnut buds, tips sharpened to stingers aimed at the sky, all around, the grass a rumor of green. That something more is chiseled by Bibby (pseudonym of a family physician from rural North Carolina) when he writes, “You don't have to ask the family history if you were there.” That something more is feeling connected to the cows on Beaver Simmons' farm, writes Loxterkamp, a family physician from rural Maine. To his question, “What are cows for?” he replies, “cows can bring us joy and beauty, provide companionship, inspire the next generation of farmers. . . . ” Loxterkamp thus speaks to the value of practicing rural medicine and realizing the deeper meaning that comes with connectedness. That something more is drawn on the rural New Hampshire experience of family physician Kollisch, as he describes the dying of his elderly farmer patient: “(Elwin) pictured himself on the John Deere, cutting wide swaths in a dense hayfield, the fallen grass lying thick and green and pungent behind him. And when the last grain (of the hourglass) ran through, he closed his eyes, the tractor stopped, and he slept.” A few authors, such as Abraham Verghese, David Loxterkamp, Richard Berlin, and William Orem, are well known. But most who contributed to this compilation are practicing physicians, students, and clinicians given the joyful opportunity for the creative and expressive process. Not all parts of this collage are of the same quality, yet that is a token price to pay for this museum tour of eclectic points of view in rural medicine which, while not always complimentary, are always intriguing. The Country Doctor Revisited enlightens like a museum of artwork from myriad perspectives, colors, and textures. Then the observer may have a truer picture of what it is like to impart health care in rural America. To know rural medicine is to understand the highest-level, most complex and technical of modern health care, as well as minimalist medicine. And that is something more. Back to top Article Information Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Journal

JAMA – American Medical Association

Published: May 18, 2011

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