Reflections Of A Country Doctor

This book contains my reflections upon my 26 years as an "old time" generalist family physician in rural America. It is merely a collection of stories that depict some of my many experiences over the years. The stories mirror those of many of my generalist colleagues who have experienced "the trenches" of rural primary care. My stories span the breadth and depth of the discipline of rural family medicine. Stories range from assisting mothers giving birth to caring for and comforting those at the end of life, from performing surgery to becoming involved in one's community, and from making house calls to providing emergency room care. Some are silly, some are sad, some are funny, and some may make you mad. JIMMIE ASHCRAFT, M.D. Doctor Ashcraft is a graduate of the University of Oregon Medical School. He was a member of the clinical staff of the University of Washington Medical School for 30 years. Doctor Ashcraft and his wife, Kay, live in Montana. They have three grown children and six grandchildren.

Meet Barry Ladd. He is a family physician who practiced medicine for thirty years in a small country town, forty miles south of a major city. He calls it "Our Town", because the residents, including himself, so personally identified with the community. In the thirty years that Ladd practiced in "Our Town", he delivered fifteen hundred babies and had one hundred and eighty thousand office visits. He delivered the babies of the babies, and took care of four generations in the same family. During that time, there was an explosion of technology and scientific information. The practice of medicine shifted from being more of an art to being more of a science. During this time, Ladd was a participant and observer. He saw how personal events and decisions played out over time. He tells his readers what he saw, heard, and felt. These are all true stories. Some are composites of several people. The names have been changed.

I have been most gratified with the positive response to my first book, Reflections of a Country Doctor. Many readers encouraged me to write another book that told the rest of my story. This book contains some of my experiences during my premedical and medical training years and more of my experiences during my twenty-six years as an "old time" family physician in rural America. Stories range from assisting mothers giving birth to caring for and comforting those at the end of life, from experiencing the joys of pediatrics to the frustrations of medical errors, from performing surgery to becoming involved in one's community, and from making routine home visits to providing life-ordeath emergency care. In keeping with the format of Reflections of a Country Doctor, some of the stories are silly, some are sad, some are funny, and some may make you mad. Doctor Ashcraft grew up as one of four brothers in a poor family in Montana. Despite a difficult childhood, he managed to work his way through college. He was the first graduate from Eastern Montana College to graduate from a medical school. He graduated from the University of Oregon Medical School. After his medical training he served in the National Health Service Corps. Doctor Ashcraft practiced as a family physician in Sidney, Montana, for twenty-five years. Afterward, he was a member of the faculty of the Montana Family Medicine Residency, a program that he helped to develop. Doctor Ashcraft was a member of the clinical faculty of the University of Washington Medical School for thirty years. He is a Lifetime Fellow of the American Academy of Family Physicians. Doctor Ashcraft and his wife Kay still live in Montana. They have three children and six grandchildren.

I have been most gratified with the positive response to my first book, Reflections of a Country Doctor. Many readers encouraged me to write another book that told the rest of my story. This book contains some of my experiences during my premedical and medical training years and more of my experiences during my twenty-six years as an "old time" family physician in rural America. Stories range from assisting mothers giving birth to caring for and comforting those at the end of life, from experiencing the joys of pediatrics to the frustrations of medical errors, from performing surgery to becoming involved in one's community, and from making routine home visits to providing life-ordeath emergency care. In keeping with the format of Reflections of a Country Doctor, some of the stories are silly, some are sad, some are funny, and some may make you mad. Doctor Ashcraft grew up as one of four brothers in a poor family in Montana. Despite a difficult childhood, he managed to work his way through college. He was the first graduate from Eastern Montana College to graduate from a medical school. He graduated from the University of Oregon Medical School. After his medical training he served in the National Health Service Corps. Doctor Ashcraft practiced as a family physician in Sidney, Montana, for twenty-five years. Afterward, he was a member of the faculty of the Montana Family Medicine Residency, a program that he helped to develop. Doctor Ashcraft was a member of the clinical faculty of the University of Washington Medical School for thirty years. He is a Lifetime Fellow of the American Academy of Family Physicians. Doctor Ashcraft and his wife Kay still live in Montana. They have three children and six grandchildren.

An African proverb says, "It takes an entire village to raise a child". The same can be said of physicians. No one traverses the journey through medical training and private practice by themselves because "the stars are aligned just right". The journey demands a considerable supportive effort from a village of many or perhaps many villages.This book contains my reflections upon my 26 years as an "old time" generalist family physician in rural America. It is merely a collection of stories that depict some of my experiences over the years. The stories mirror those of many of my generalist colleagues who have experienced "the trenches" of rural primary care. In fact, on occasion, I introduced myself as nothing more than a full time "trenchologist".My stories span the breadth and depth of the discipline of rural family medicine. Stories range from assisting mothers giving birth to caring for and comforting those at the end of life and from performing surgery to becoming involved in one's community. Some are silly, some are sad, some are funny, and some may make you mad.

This book contains my reflections upon my 26 years as an "old time" generalist family physician in rural America. It is merely a collection of stories that depict some of my many experiences over the years. The stories mirror those of many of my generalist colleagues who have experienced "the trenches" of rural primary care. My stories span the breadth and depth of the discipline of rural family medicine. Stories range from assisting mothers giving birth to caring for and comforting those at the end of life, from performing surgery to becoming involved in one's community, and from making house calls to providing emergency room care. Some are silly, some are sad, some are funny, and some may make you mad. JIMMIE ASHCRAFT, M.D. Doctor Ashcraft is a graduate of the University of Oregon Medical School. He was a member of the clinical staff of the University of Washington Medical School for 30 years. Doctor Ashcraft and his wife, Kay, live in Montana. They have three grown children and six grandchildren.

In turn heartbreaking, irreverent, moving—and at times raucously humorous—one of the nation's leading pediatric researchers recounts his first years as a newly minted, stuggling, and insecure doctor at Massachusetts General Hospital in Boston. A graduate of a state university medical school, Scott Rivkees was competing with elite students from some of the most prestigious schools in the country. Nervous and uncertain, he worked unholy hours with patients ranging from indigent street people to celebrity guests drawn to the reputation and care offered by Mass General. Along the way he learned what medical school textbooks don't teach: how to deal with immense pressure, exhaustion, unruly patients, mysterious conditions, the joy of saving a life, and the wrenching suddenness of losing a patient, more often than not a young child. His resident education did not prevent him from losing his sense of irony and humor as he recounts bleary nights on the town, the allure of young nurses, substandard housing, and the value of pricking an inflated ego.

In the years after the Second World War, a young doctor took up his post in one of the most remote regions of northern Minnesota. His term of service turned into a lifetime of caring for the people who made this isolated and often lonely place their home. The story of this remarkable adventure in frontline medicine forms the heart of this wonderful book. As a storyteller, MacDonald shows us the beauty of this remote region and the charm of those who make their lives there. With respect, affection, and humility, MacDonald relates his experiences with those who placed their well being in his hands. The result is a warm and warm-hearted tale of the life of a north country doctor.

An anthology that addresses the changing nature of rural medicine in the United States "These authors courageously document the emotional and literally physical vulnerabilities they experience while delivering care in rural communities. ... This book exquisitely illustrates the complexity of 'dual relationships' and boundary issues in rural practice."--Family Medicine Over the past thirty years, rural health care in the United States has changed dramatically. The stereotypical white-haired doctor with his black bag of instruments and his predominantly white, small-town clientele has imploded: the global age has reached rural America. Independently owned clinics have given way to a massive system of hospitals; new technology now brings specialists right to the patient's bedside; and an increasingly diverse clientele has sparked the need for doctors and nurses with an equally diverse assortment of skills. The Country Doctor Revisited is a fascinating collection of essays, poems, and short stories written by rural health care professionals on the experiences of doctors and nurses practicing medicine in rural environments, such as farms, reservations, and migrant camps. The pieces explore the benefits and burdens of new technology, the dilemmas in making ethically sound decisions, and the trials of caring for patients in a broken system. Alternately compelling, thought provoking, and moving, they speak of the diversity of rural health care providers, the range of patients served in rural communities, the variety of settings that comprise the rural United States, and the resources and challenges health care providers and patients face today.