The Real Rural World

Joseph-Sedillo-banner“This is the true story of seven strangers picked to live in a duplex, work together and have their lives interlinked, to find out what happens when health students leave PDX…and start getting rural.”

Okay, so it’s not QUITE the salacious prologue to a hit MTV series, but it doesn’t make it any less valid for those involved. In truth, most of us (three PA students, three med students, one dental student – and one PharmD student who we didn’t live with but worked with) did not know each other before we started this adventure. The idea* seemed simple enough: bring OHSU students from myriad fields of medicine, assign them to a community project, and see what happens. And while there were many program goals to be met, it was what happened behind the scenes that really made a difference.

Week One was like the beginning of any other clinical rotation. Trying to get a feel of what your preceptor is like, what their expectations are, having moments of, “How did I miss that massive systolic murmur in a patient with aortic stenosis?!” And of course, getting to know a new town, voicing frustrations that they don’t have your favorite brand of hummus, and missing your boyfriend, your friends, and your creature comforts – #privilege.

But then came the weekend. You go crabbing on a boat, fraternize with other students, see some local events, and get a little taste of the culture surrounding you. You take a breather, put your game face on, and recognize that it’s not about you, it’s about the experience. And most importantly, it’s about being exposed to a different patient population, and that’s when everything started to sink in.

crabbingWeek Two left me in kind of a rut. I saw so many patients in such dire straits. Internal medicine is not for the thin-skinned provider. You see people that society has failed to protect. Poverty is infiltrating every corner of your patient panel and sometimes you don’t know where to start. But last rotation a wise classmate told me, “It’s not about curing people, it’s about helping people live the best life possible with the circumstances given.” It got a little bit easier after that, like chipping away at a rock until you started to see the statue ensconced beneath it the entire time.

By Week Three, all of us had shared stories, commiserated about the plights of our personal/professional journeys, and bonded over busywork. But more importantly, we all got a different glimpse into the lives of patients living in this small community. Maybe we saw how we grew up, or how we didn’t. Perhaps we thought, “Are we so different?” I can’t speak for everyone, but I would guess that we all had struggles getting to where we are. It is futile to contemplate who sacrificed more, because in the end, hardship is hardship, and we all needed support at some point.

And now it’s Week Four. Patients with 40+ active problems don’t scare me anymore. I know the ins and outs of hyperlipitensabetes (not a real condition) and have a more robust understanding of the woes and wonders of a small coastal town. I realize we won’t address all the issues facing this rural community, just as we haven’t fixed our broken healthcare system…yet. But with one week left to go, I can say with confidence that the rural world is the real world, whether you’re living in it or not. A part of me came from someone that sacrificed something, somewhere, so that I could have a better chance at success in life. And I hope that by Week Five, I can give something back.

*Joseph is part of the first cohort of students in OHSU’s Campus for Rural Health, an initiative which aims to build the pipeline of future physicians, pharmacists, dentists and other health care providers for rural Oregon communities. Learn more on OregonLive.

10 responses to “The Real Rural World

  1. Fantastic, Joseph! So great to hear about the experiences you and your student colleagues are having. It sounds wonderful, enriching, and humbling.

  2. Great perspective! I plan to quote you and use that term – “hyperlipitensabetes”
    And I hope we can bring you to Klamath sometime!

  3. What an wonderful story! I am new to OHSU, and when I hear a story such as this, it fills me with such gratefulness to be part of an organization that is doing such amazing things to reach those that are in need. Thank you for sharing your experience Joseph, and I wish you continued success!

  4. Thank you for an honest reflection of your experience and thank you for caring for our rural communities.

  5. Joseph – your eloquent description of your experiences with the rural community and interprofessional teams moved me. You are a wonderful ambassador for meeting patients where they are, and recognizing that while we can’t “fix” everything, we can do our best to make things better. Thanks for sharing this!

  6. I would love to hear about any of your experiences with pediatric patients, if any, and also any strengths or assets you noted in the community.

  7. Thank you all for the comments! I appreciate the feedback and accolades. But really, all the thanks should go to the providers to the providers who are out there in the community. There are a lot of caring people out in Coos Bay and other communities and they definitely made us feel welcomed and appreciated. A note for Tami: I didn’t see any pediatric patients as my rotation was in internal medicine but Dr. McKelvey or Dr. Deleon would be good resources from North Bend Medical Center to talk to about pediatric rural health. All the best, ~Joseph

  8. Hi Joseph,

    Great post…reading it has made me want to attend OHSU even more. I am really inspired by the university’s commitment to serving rural/disadvantaged communities.

    I’m a prospective PA student and was wondering if you would be able to tell me about the selection process for the rural campuses. I recently applied for the SHOI scholarship-are selections based on recipients or are the two unrelated?

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