"If you want to build a ship, don't drum up the men to gather wood, divide the work and give orders. Instead, teach them to yearn for the vast and endless sea." [Antoine de St. Exupery]
"To study medicine without books is to sail an uncharted sea, while to study medicine only from books is not to go to sea at all." Sir William Osler
From RCB: As much as we would want, we cannot be successful in changing the mechanics and environments to get more rural doctors, we must focus on the vast and endless sea of rural life and practice. At a recent visit to Chadron to be a part of a career fair involving 250 rural high school students from 4 states, I was able to visit the Mari Sandoz Museum, newly opened at Chadron State. Mari's writings beautifully captured the transition of the American frontier. On the wall of the museum I found this quote regarding the vast plains region of the nation:
"Some saw it as a great sea caught and held forever in a spell and were afraid. Yet here and there were a few sensitive to the tans and mauves of the strange rhythmic hills that crowded away into the hazy horizon." Mari Sandoz
For me personally, no one captures the scope of the Vast and Endless Sea of rural practice better than Robert Boyer, M.D. Bob was the first AAFP Doctor of the Year. He has made countless contributions to Kingman Kansas, health care in the region, and medical education in Kansas and across the nation. It was my privilege to work with him at AAFP Student Resident meetings. No speaker could ever exceed his evaluations because he received perfect scores for his talks and an excessive number of positive comments. My favorite comments almost yearly were from family practice residents who noted how his talk helped them remember why they wanted to become physicians - a great compliment, but a sad commentary regarding their medical education. Even thinking about his stories brings tears to my eyes and a thrill to my bones.
I hope that you are one of those that are "sensitive" to the beauty and depth of rural practice, or whatever area of health care that you choose. I challenge you to join Bob and others, who continue to challenge the vast and endless sea of rural practice.
"Built within our traditional medical systems are roadblocks. I find many of these to be irrelevant or myths. I try to spend my time getting by these to deliver the best care that I can." Robert Boyer, MD, Kingman, KS. First AAFP doctor of the year 1993
Bob Boyer at this link for his story The Blizzard, or his streaming video.
http://www.unmc.edu/Community/ruralmeded/facil/research/authors/boyer_links_and_presentations.htm
In reflection, it seems that now that we think we have spanned the frontiers of the land, and sea, and space, we humans think that we are all powerful. Yet few of us ever span human dimensions, such as the gap between rich and poor. Those in our world who are rich, are likely to be poor in spirit. Those in our world who are truly poor, are likely to be rich in spirit. In fact it may be all that they have and all that keeps them going, just as Jesus said he had food that His disciples was not aware of. If only it were possible to be rich and truly generous, now that is a challenge to overcome. - Robert C. Bowman, 2002
Hobbs and Rural Visits - what uncharted depth is involved in rural practice, especially the teaching and service component.
Spurgeon Evening December 18
"And there was no more sea." - Revelation 21:1
Scarcely could we rejoice at the thought of losing the glorious
old ocean: the new heavens and the new earth are none the fairer
to our imagination, if, indeed, literally there is to be no great
and wide sea, with its gleaming waves and shelly shores. Is not
the text to be read as a metaphor, tinged with the prejudice with
which the Oriental mind universally regarded the sea in the olden
times? A real physical world without a sea it is mournful to
imagine, it would be an iron ring without the sapphire which made
it precious. There must be a spiritual meaning here.
In the new dispensation there will be no division-the sea
separates nations and sunders peoples from each other. To John in
Patmos the deep waters were like prison walls, shutting him out
from his brethren and his work: there shall be no such barriers
in the world to come. Leagues of rolling billows lie between us
and many a kinsman whom to-night we prayerfully remember, but in
the bright world to which we go there shall be unbroken
fellowship for all the redeemed family.
In this sense there shall be no more sea. The sea is the emblem
of change; with its ebbs and flows, its glassy smoothness and its
mountainous billows, its gentle murmurs and its tumultuous
roarings, it is never long the same. Slave of the fickle winds
and the changeful moon, its instability is proverbial.
In this mortal state we have too much of this; earth is constant
only in her inconstancy, but in the heavenly state all mournful
change shall be unknown, and with it all fear of storm to wreck
our hopes and drown our joys. The sea of glass glows with a glory
unbroken by a wave. No tempest howls along the peaceful shores of
paradise.
Soon shall we reach that happy land where partings, and changes,
and storms shall be ended! Jesus will waft us there. Are we in
him or not? This is the grand question.
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Mari also wrote a book about a female plains doctor. The book is Miss Morissa, Doctor of the Gold Trail. published in 1955 and just got a copy so it is available. The book was dedicated to three such female physicians who served settlers and natives in the plains.
More from her quote regarding the Sandhills region: "the country was aloof, austere, forbidding; the wind sucking their courage as it sucked the green from the grass by mid-June. Some saw it as a great sea caught and held forever in a spell, and were afraid. Yet, here and there were a few sensitive to the constantly changing tans and mauves of the strange, rhythmical hills that crowded away into the hazy horizon. They heard the undying wind rattle the seed pods of the yuccas against the sky, sing its thin flute song over the tall, sparse grasses of the slopes. They smelled the strange odors of marsh and mint rising from the wet valleys at dusk, saw spring run its sudden fire of yellow blossoms over the low knolls [and] give way to deep blue. Then that too was gone as though no flower had been [there] until August brought the long graceful white phlox blossoms and the reddening bunch grass turned to russet waves under the stern caress of the chill fall wind" (Sandoz, 1962).
Sandhills life today described: http://csd.unl.edu/csd/illustrations/ra5a/introduction.html