Healthcare in the Rural North: the Hospital

For a town of only 1,900 people, we have a remarkable variety of public amenities and services. There are five parks, a baseball field, a soccer field, a go-cart course with functional go-carts, 63 holes of park golf, a giant outdoor driving range, an assortment of outdoor jungle gyms, an indoor pool, two community gymnasiums, a library, dojo, museum, ski hill, hot springs, two mountain hiking trails, and a camp ground. We also have an excellent retirement facility, because where else would 70% of the population live.

Yet despite this plethora of fine, well-serviced facilities available for people to be active and maintain their health, the quality of options available for health treatment pales somewhat in comparison. Our hospital for instance, is populated mostly with the dead, the dying, and occasionally a doctor who usually quits after a few months of giving out the exact same diagnosis.

“Doctor, how is he?”

“Well, I’m afraid he is dead.”

“Oh thank you doctor. It’s a relief to know for sure.”

“Yes, well you can rely on me. Now here’s a document I’ve stamped that proves the point unequivocally.”

Sometimes patients arrive who are not dead. In this exciting case they are given a room and a bed and a few days of hospital food, and that usually does the trick. However, there is the occasional tough case, which hospital food would simply not ameliorate. But at times like these, the doctor has a secret weapon at his disposal, an ambulance.

“Doctor, how is he?”

“He’s not dead. ”

“Oh my. It is serious?”

“I’m afraid so. We’re unable to treat this sort of condition here. Better call the ambulance. ”

“The ambulance? Oh there’s no need for that. We can take him.”

“Don’t be ridiculous. How else would I justify my salary?”

And so, driven by two giddy paramedics who have just spent the last two weeks of their life working full time in the fire station repetitively sanitizing the CPR dummy and charging defibrillator batteries, the ambulance arrives with great fanfare and the patient is thrust inside so he can be poked and probed and ultimately die at some other hospital, the nearest of which is an hour and a half away.

Thus, in short, the doctor here usually will diagnose you as one of the following: dead, soon to be dead, and go die someplace else. Yet there is one other, albeit rare diagnosis, the ambiguous “you’re perfectly fine, take these drugs and go home” diagnosis. Perhaps most frightening of all the scenarios, it is essentially the same as “go die someplace else” but lacks in evidence to justify sending you to that someplace in an ambulance. Thus, you are sent home until you are either cured, or you meet the criterion for the first three diagnoses.

Such was the case with me one fine autumn afternoon when my collar bone decided to separate from my shoulder after falling awkwardly during a game of tag with some boys at the junior high school. Of course, at the time, I didn’t know the exact nature of my injuries. All I knew was that I heard a loud pop, and that my shoulder hurt like hell.

Naturally, my first instinct was to seek medical attention. If a bone was broken, it needed to be reset. If my shoulder was out of its socket, it needed to be put back in. However leery I may have been towards the care available at our local hospital, the urgency of these needs compelled me to go in spite of any misgivings. Besides, there was no other alternative, aside from the local chiropractor/electric-shock therapist. Though, as it turned out in the end, he was far more knowledgeable and helpful. But what did I know? Surely, I thought, a hospital in a first world country employing modern medical techniques using modern medical equipment could handle a shoulder injury.

To be fair, I had not broken a bone. I had torn ligaments in my shoulder, and ligaments are not detectable via x-ray. However, the injury should have been obvious through a simple range of motion examination that the doctor personally performed. But, I was not dead, nor dying, nor did I have any ailment that could justify the use of the ambulance. So I was given enough pain medication to tranquilize a herd of elephants and told to go home.

Not satisfied with this diagnosis, I sought a second opinion from the chiropractor/shock therapist, who also happens to be the local judo instructor. I gave a brief description of the injury and he took one look at it and knew exactly what it was. He then shocked the crap out of me and I was able to feel nothing out of that side of my body for a good twelve hours.

Needless to say, I’ve not revisited either establishment, except for one occasion, when a tick decided to implant itself on my back in precisely the small circumference of skin that I cannot reach with either arm. My wife was too terrified to cut it out. So, I went to the hospital, where it took four nurses, three stitches and a two centimeter long incision in order to remove a puny insect attached by a one millimeter wide mouth.

But you know things could be worse. I could go to the dentist.

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Jared Boasen

Singer/songwriter; paragliding, kung fu, and private English instructor, living and playing in northern Hokkaido.