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Everybody’s a Doctor in the Back of Beyond

Essay by Rebecca Clarren

Rural Life – February 2001 – Colorado Central Magazine

I NEVER WANTED to be a nurse. I never dressed up like Florence Nightingale for Halloween. I never even took care of my dolls — my idea of tender loving care was washing Barbie’s hair with turpentine.

But I live in a small town on the Western slope of Colorado. The nearest hospital that honors many locals’ insurance is 70 miles and another county away. That’s a long distance phone call and a long trip to the doctor — even at break-neck speed. So when a friend recently had knee surgery, I had no choice. Just call me Flo.

Nursing in the rural West is a far cry from what my mother had to contend with in the metropolitan city where I grew up. While she could run to the 24-hour pharmacy for ice packs and Tylenol, the local drugstore here closes at 6. Since I am not the most organized person, I usually get to the drugstore right after it closes and then scurry around collecting extra ice trays from friends in order to fill used grocery bags with ice.

While Mom could crank up the electric heat and pop frozen dinners in the microwave, I am relegated to an ax and a cord of wood to shovel into the stove. When my “patient” runs out of medication, its an hour long drive to the hospital, down windy back roads with him moaning in the back saying something like, “Just cut it off. I’d rather be dead.”

Understandably, people here do just about anything to avoid getting sick. It is not an uncommon sight to see grown men swilling apple cider vinegar and young mothers sucking on garlic cloves.

Acupuncturists and massage therapists populate this small valley in hordes and it’s hard to get an appointment. My neighbors built an addition to their house in order to store the numerous trays of wheatgrass they’ve started growing.

Each morning they take a handful of the green stuff and squeeze it into a shot glass. According to them, a glass of the grass increases energy and prevents cancer and headaches. Personally, I’ll stick to evil-incarnate Advil; I think wheatgrass tastes like, well, grass.

But my medical opinion doesn’t really matter — everyone seems to have a favorite cure and no one is afraid to tell you how to get better.

“Really, in order to heal you need to offer yourself up to that pain and let it take you on a journey.”

“It’s all about biofeedback sister. It saved my life.”

Recently when a friend got breast cancer, well-meaning locals told her it was because she hadn’t been eating enough organic food.

BUT I HAVE TO ADMIT — I’m not that big of a believer. My Dad’s a doctor and I grew up on a healthy diet of antibiotics and Robitussin. I am not afraid of the doctor’s office. I can say stethoscope three times fast and I still believe in IVs and spinal taps. Lucky for me, it turns out help may be on the way.

According to a recent article by AP, there are national and state efforts encouraging medical students to work in rural communities. One program gives graduates from foreign medical schools a Visa to work here as long as they work in rural communities.

In Idaho this past year, the state started the Rural Health Care Access Fund to help recruit doctors to underserved areas and even pay up to $35,000 in salary. The National Health Service Corps, TK-based foundation, offers medical students scholarships if these poor students agree to work two years in small communities like mine. I can just imagine the brochures: “Don’t join the Peace Corp — who needs Africa? Come to the rural West and have a real cultural experience.”

Although I laud this effort, just supplying doctors doesn’t mean these white coats come with a hospital. It’s been nearly two months now since my foray into the world of nursing. My friend’s knee surgery didn’t go so well the first time, and because we live so far from a hospital, it took four weeks before his doctor realized that ice, organic food and acupuncture wasn’t going to help him heal. Instead, he went in for extra surgery. He’s still not as good as gold, and I’m still wearing my white nursing hat.

Until there are emergency rooms in more small towns, women will deliver babies in cars en route to the hospital and people will die of cardiac arrest in the back of ambulances. And while I’ll always worry about being the next victim of a long trip to the hospital, I don’t plan on moving. City dwellers die in ambulances stuck in traffic jams. Here, at least, the view is heart-stopping.

In the meantime I’m putting my money on Robutussin and my trust in my newfound skills as a nurse.

Rebecca Clarren is a contributor to Writers on the Range, a service of High Country News (, where she is assisant editor.