7 things I learned on rural family medicine

Lake that I visited close by my rural rotation

Last night I drove away from the town of just over 1,000 people where I lived the last two months. Yesterday was the last day of my rural family medicine rotation and it's hard to put into words the impact that it's had on me. I'm not going to try to put it in words now, but I am going to share 7 things I learned on rural family med (joining Jen).

1. Delivering babies will never cease to be amazing. If you've been following along at all, you probably already know that delivering babies (or being involved in a patient's pregnancy and/or birth in any way) is my favorite thing and nothing really compares to it. On family med I got to help parents hear their babies heartbeat for the first time, see women through their pregnancies, do the delivery, and then see their baby afterward in clinic for a well-baby check.

2. The value of caring for the whole family. Family doctors have a role like no other specialty since they care for the whole family. It wasn't uncommon on a clinical day for us to see a new baby and his/her mother postpartum, then that baby's siblings, grandmother, and great-grandmother. The doctors that I worked with also all grew up in the community where we worked and so they had a unique understanding of the challenges and strengths of many of the families we saw in clinic.

3. The art and importance of the physical exam. Despite my background as a nurse, I admit that I felt like I was going through the motions when I did my physical exams during first and second year (and it was not much better in the beginning of third year). The doctors I worked with on rural family medicine did a thorough exam on every.single.patient and I learned firsthand how crucial this is. During the rotation, I got to feel an abdominal aortic aneurysm and realize the necessity of a thorough abdominal exam, listen to many heart murmurs and finally feel comfortable diagnosing one, discover a mass that would never have been found without a complete physical exam, and diagnose a brain tumor that only manifested itself by a subtle change in the patient's eye movements.

4. The difference it makes when a physician truly cares for his/her patients.  The physicians I worked with on rural med were both incredibly knowledgeable and genuinely compassionate. They listened to their patients, comforted them, did everything they could to help patients in difficult situations, and treated their patients like their own family. 

5. The role of spirituality in medicine. Despite how important my Catholic faith is to me, there is a part of me that has always been afraid to mention prayer to patients. But too often there is an end to what we can do as physicians for a patient. The doctors I worked with weren't afraid to tell patients that they would pray for them or encourage them to lean on their spiritual beliefs when there was no longer anything that medicine could do. And I saw how this gave patients tremendous comfort.

6. Medicine is a vocation. Small towns don't have the luxury of having a doctor on every corner, and our clinic didn't just serve the town that we were in (we had patients frequently come from an hour away). There were some days that we would be at the hospital in the early hours of the morning to round on patients, see 30 patients in the clinic, and then go back to the hospital to admit a patient and round again. The doctors on rural med sustained this lifestyle by viewing their job as a vocation.

7. Do what you're passionate about. The doctors that I worked with during my rotation were at the top of their medical school classes and could have had a more 'glamorous' and high paying job than a small-town doctor. But they chose to become a family doctor because they wanted to return to the communities they grew up in and serve the people they knew and loved. And they're happy with their decision (in contrast to some of the highly-paid and prestigious specialists that I've met). Seeing them helped me to make my decision against going into dermatology like I'd been encouraged to do by many, many people I respected. During my rural medicine rotation, I re-discovered the importance of pursuing a specialty that I'm truly passionate about and will find meaningful for years to come.

I admit that I've looked at this picture of myself at my White Coat Ceremony the day before medical started and wished for that girl back. I was passionate about becoming a physician to help the underserved that I'd encountered in various places around the world. As I continued in medical school though, I sometimes questioned why I embarked on this journey. It's challenging, sometimes isolating, often discouraging; and I've found myself forgetting at times why I started this in the first place. But these last two months helped me remember again why God called me to be a doctor.