As a board-certified general surgeon, I ended up practicing in a rural area in northwest Kansas in a small town called Hill City. I have written in the past about my experience here and continue to reflect on it.
Because I was practicing in a rural community, I had to practice family medicine as well. During my practice of more than 40 years, I came across a few unusual cases—and I want to share some of them in this column.
Can I Get a Refill?
One day I was driving out of my garage to go to the hospital when a neighbor, who was also my patient, waved at me to stop. I rolled down my car window, and he said he had run out of medication and asked if he could get a refill. I told him to call the clinic and ask my nurse. Only in a small town would a patient stop you in the driveway for prescription refill.
Saw Your Car in the Parking Lot
At our clinic, patients park their cars in the front and at the side, whereas physicians and nurses park behind it. We usually see patients until around 5:00 pm, and the front door is closed around 6:00 pm. The doctors and nurses stay late to finish paperwork and leave through the back door.
One day a patient showed up in front of my office around 6:30 pm. I asked him how he got into the building. He said, “I saw your car behind the clinic in the parking lot. I thought you must still be here, and I entered through the back door.” He wanted refills on his medication. I took care of it. Only in a small town would patients recognize your car and enter the clinic through the back door.
Taking the Patient Home
I performed dilation and curettage (D&C) on a patient around 8:00 am. A few hours later, when her condition was stable, I dismissed her. Usually, I return to the hospital in the evening to check on other patients who had a cholecystectomy or other procedures. When I went back that evening to see other patients, the patient who had D&C in the morning was still in her hospital room. I was surprised and asked her why she hadn’t gone home. She said she was waiting for her husband to pick her up because he was at a board meeting. Because she was a neighbor, I offered to take her home. She thanked me, and I thought, only in a small town would you drop off patient at her home.
I did obstetrics-gynecology (ob-gyn) also in my practice because we did not have a specialist in our town. One day, I examined a patient in my office. She was 9 months pregnant and having some contractions. I did pelvic examination, and her cervix was 8 cm dilated. I told her she needed to go to the hospital, and I would deliver the baby there. She said her neighbor dropped her at the clinic and left to go shopping, leaving her with no way to get to the hospital. I decided to drive her myself and deliver the baby. I told my nurse what I was going to do. She called the hospital and helped the patient get into my car. When we reached the hospital, a nurse was waiting with a wheelchair in the parking lot. She took the patient to the delivery room, and I delivered the baby. Only in a small town would the physician take the patient to the hospital and deliver the baby.
Delivering Your Own Child
When my wife was pregnant with our youngest child, she was going to the ob-gyn in a town that is 55 miles away. She went by herself during the first and second trimesters for regular checkups. During her third trimester, I took her for checkups.
One day, around 4:30 am, she woke me saying she was having some pain in her belly. I did not know whether she was having contractions or just a bellyache. The only way to tell was by doing a pelvic exam. I called the hospital and told the nurse that I was bringing my wife in for a pelvic exam. The nurse was waiting in the parking lot with a wheelchair. She took my wife to the delivery room where I examined her. Her cervix was 8–9 cm dilated. I didn’t know whether I should take her to her ob-gyn or deliver the baby at our local hospital. The ob-gyn was an hour away. I didn’t want her to deliver on the highway. I decided to deliver the baby myself—a baby boy. Thankfully, everything went well. Only in a small town would you deliver your own baby.
Not a Moment to Spare
One day I was in the delivery room preparing to deliver a baby. A nurse came in saying that another woman was in labor in the next room. I delivered one baby in the delivery room, handed the baby to the nurse, and left the placenta inside. Then I went to the next room, changed gloves, and delivered the baby. I handed the baby to the nurse and left the placenta inside. Then I went back to the first room, changed gloves, and delivered the placenta. Then I went back to the second room, changed gloves, and delivered the placenta.
These things can happen when you are the only physician in town delivering babies. My career as a rural surgeon has been diverse, and I have appreciated every moment of it.