Bring a rural doctor, my wife knew going in that it would be different than what she’s done before. When we were in Deseret, there would periodically be a patient of hers that would run into us at Walmart and immediately dive in giving Clancy an update on how whatever she was last in for turned out. When I’m in Redstone, I’ve periodically run into students or the occasional teacher at the local bookstore or Walmart. But here in Callie, it’s different.
The other day she took a vacation day off work because she had an afternoon appointment (if she just takes the morning off, she can still be double-booked to the point that she would have to work through the afternoon to get through everybody). She still had an AM morning she had to go to and when she left she went to the local coffeehouse to take care of some paperwork. While there, she ran into a colleague who had herself taken a couple vacation days to take care of hospital and clinic paperwork. There were some officey things to discuss, but as soon as she was done, she ran into a patient. They chatted for a while (about, among other things, the need for substitute teachers in Callie). Clancy came back a little regretful of not having been more productive at the coffeehouse, but it was pretty apparent that the time had done her some good. That represented the good side of working and living in such a small town.
The bad side came the next day.
Clancy and I don’t live in the best part of town. In fact, she inwardly groans when she recognizes an address being nearby ours. It often (though not always) means a problem patient of one sort or another. And so it was with a patient that came in the next day. Without going into details, it was a bad visit and authorities had to be contacted (legal and professional responsibility). And wouldn’t you know it, the patient lives on our street (I haven’t a clue who it is – don’t want to know). Anyhow, on account of this, when Clancy walks the dog, she’s going to be going out the back way for a while.
Several years ago (approaching 15… gah!), I was talking to a cop and he made a comment that he would never work in the same city where he lived. He used the metaphor of eating where you excrement. Prior to talking to this cop, most of the cops I’d gotten to know had been in the city of Phillipi. My ex-girlfriend Julianne lived there her father was a volunteer fireman, and there is a fair amount of crossover between being a cop and a volunteer fireman. Not a single Phillippi police officer I knew didn’t live in Phillippi as far as I knew. The idea of living in one community and protecting another seemed rather strange to me.
When I started substitute teaching, rather than subbing in Callie, where I live, I signed up to do so out in Redstone. There were a number of reasons for this. Redstone is the bigger district so I figured I would get called in more often. Callie gave me the run-around while Redstone asked the soonest day I could take the TB test. I had my standard question when asked about it, though: “I’ve never subbed before. I figured by substituting in Redstone, if I was lousy at it, I’d be messing up some other community’s kids. Since then, I’ve heard more than once that there is actually a pressing need in Callie. It also turns out that a teacher in Redstone knows the superintendent down here and is willing to write an email of recommendation. With the kid on the way, working closer to home makes more sense. Yet, for all of my joking about messing up Redstone’s kids, I actually have that sort of sense that it’s really not bad living in one town and working with the youth of another.
(To be clear, it’s not that. I’ve grown fond of some of the “repeat customers” I’ve had at Redstone schools. I also like the excuse to go out there sometimes. But I really do find the prospect of substituting neighborhood kids to be daunting, despite the fact that the kids here are generally better adjusted than the kids in Redstone, and kids surprisingly don’t hold a grudge against a substitute who gets them in trouble.)
Which brings me back to the medical community. There is a degree of separation between the medical community here and the broader community. Most of the doctors (of the ones I know where they live) live well outside of town in unincorporated county. There was actually a big to-do here many years ago where the doctors and other individuals essentially pulled their kids out of the local high school and took over a school a half-hour away. There’s a whole story there, but it’s a part of what I consider to be a broader detachment. Before we decided we would be sticking around, Clancy and I talked about where we might get a house and she felt pretty strongly about getting one out of town. Some of it is her introversion (oddly, my introversion is why I think getting a place out of town would be a really bad idea), though another part of it is the general eating/excrementing thing.
In an ideal world, none of this would be the case. The Phillippi model would true. I think in Redstone itself, of all places, it actually does. It’s one of the things I’ve always admired about that place. Interestingly, Redstone and Phillippi are both rather blue collar. Both tend to draw sneers from outsiders. For a variety of reasons, though, they retain a degree of community spirit that I think is healthy. I am thinking that such places are the exception as much as the rule, however. I know some places actually pass laws requiring civil servants to live in town. Not much they can do about doctors, I suppose.
Heh. I was just talking about this the other day on the way to a meeting with one of my partners.
Where I used to work, it was inevitable that I would run into people at the supermarket that I knew that I knew. I am terrrrrrrrrible with names (it is a source of constant wonder to the Better Half, who remembers everyone he ever met, ever), but I would see lots of people shopping and know that I had some connection with them. And I would usually wonder “is that a patient’s mother?” followed immediately by “is that a patient’s mother who hates me?” (Perhaps I tend to be paranoid, but it’s easy to make people mad when you’re the one saying “no” to the antibiotic demand.) And even if it was one of the moms who loved me, I’m not the kind of person who likes to chat in the grocery store. (I was well suited to life in New York City.)
Now I live 45 minutes away from the town where I practice. I looooooove the distance, for just the reason poor Clancy is dealing with in deciding where to walk the dog. (I do live in a popular vacation destination for many people who take their kids to my office, and am kind of dreading when I finally bump into one when I’m out for a run.) I can leave work behind and not fear the possibility that a dinner out or trip to the market will result in contact with someone whose status as a patient will make the situation fraught.
We had once incident at Walmart that was almost right out of the page of a TV ad. Doctor and her husband run into two of doctor’s patients. Female patient immediately starts talking about how male patient’s hemorrhoid problem is flaring back up again. Doctor’s husband and male patient exchange glances awkwardly.
All that was missing was Clancy pulling something off the shelf and saying “When my husband gets hemorrhoid flare-ups, I give him this!”
Though this doesn’t apply to the post’s anecdote, the one that worries me most is that Clancy is conservative with narcotics prescriptions. When a doctor is standing in between someone and a narc scrip, that can create a lot of animosity. Until marrying Clancy, I never realized how much of a family doc’s job (and IM, no doubt, except more so) is handling patients who think that MD stands for “medicine distributor.”
Verbal threats to her safety have been made in the past, all but one of them involving narcotics prescriptions and a patient’s inability to get them through her. At some point I may write a post on “the other war on drugs.”
Cop like that probably wants to be a bully more than he wants to protect people. Just my experience, mind.