PART TWO
Ma and Pa Kettle: The Rural Years
Ch-ch-ch-ch-changes
In the fall of 1990 my good friend Barb the hairdresser announced she had found the perfect girl for me.
“Yeah, right, Barb,” I replied dryly. I’d witnessed some of her previous matchmaking attempts. Not good.
“No, trust me, you’ll like this girl! She’s really cute and she’s got a great sense of humour!”
“Okay, if you say so. What does she look like?”
“Five-foot-four with light brown hair and greenish eyes.”
“What does she do?”
“She’s an elementary school teacher.”
“Sounds promising. What’s her name?”
“Janet.”
After a few phone calls, Jan and I scheduled a blind date at a nearby Perkins restaurant. The day before we were to meet she came down with a wicked flu. She considered cancelling, but ultimately curiosity got the best of her and she decided to proceed. Aside from her having shaking chills (plus Barb and my buddy Raj unexpectedly sliding into our booth halfway through the meal to mooch some fries and inquire how the date was going), everything went pretty well. We agreed to continue seeing each other.
Meanwhile, back at the ranch, I had come to the conclusion that although I enjoyed working as an ER physician in Winnipeg, I wanted to see what life was like on the other side of the urban/rural divide. Several telephone calls and reconnaissance trips later I accepted a position as a family doctor in a small town in northern Ontario. I shipped a few moving boxes, loaded up my MR2 and headed east in July of 1991.
Making an abrupt transition from a city with a population of 600,000 to a remote hamlet of 6,000 is much like doing the legendary Polar Bear Dip – extremely shocking at first (what do you mean there’s no Starbucks here?), but then you quickly grow accustomed to it. Then you die of hypothermia. Kidding!
My new gig was a bona fide cradle-to-grave family practice. Technically it was a solo practice, but I shared ER call and hospital responsibilities with a congenial group of four other family doctors plus a general surgeon. On a typical weekday I would do rounds on my hospital inpatients early in the morning, perform a couple of minor procedures in the emergency department, and then go to my office for a full day of scheduled appointments. When the office wrapped up I would usually return to the hospital briefly to check on my inpatients’ progress and review the results of any tests I had ordered earlier. On weekends I’d do my regular hospital rounds first and then spend some time at the local nursing home.
Being responsible for my own inpatients was a deeply rewarding experience, but I won’t pretend it was all rainbows and lollipops. For one thing, it meant visiting the hospital 365 days a year unless I happened to be out of town. In addition to commanding a significant chunk of my time, it paid poorly. Despite these drawbacks, there was one very big plus: it allowed me to care for my patients when they needed me most, i.e., when they were sick enough to warrant hospital admission.
Every Wednesday and some weekend days I’d be on call for the ER for 24 consecutive hours. In order to accommodate my ER obligations, my receptionist always booked a lighter office on Wednesdays. This allowed me time to shuttle back and forth between my clinic and the emergency department. The ER tended to be reasonably quiet between 6:00 and 8:00 p.m., so most evenings I’d be able to sneak back to my apartment for supper and a power nap. After that I’d return to the ER and see outpatients until midnight. The void between midnight and 8:00 a.m. was highly unpredictable and ran the gamut from wonderful to bloody awful. On a good night there’d be no outpatient visits after midnight and I’d be able to get a solid six or seven hours of shut-eye. More often than not, though, people would continue trickling into the department well into the wee hours and my sleep would get hopelessly fragmented. Once in a while I’d get no sleep at all. That gets old very fast. It’s hard to face the new day when it feels like your head is screwed on backwards.
Aside from missing the action at my old ER in Winnipeg, I was pretty much hooked on my new job right from Day One. There was something immensely satisfying about sending an acutely ill patient from my office to the ER, meeting them there to start treatment, admitting them to the medical ward, rounding on them daily until they recovered and then having them follow up with me back at the office. It was like being an office-based practitioner, an ER physician and a hospitalist all rolled into one. Of course, it’s not like I invented that particular enterprise. Most rural (and some urban) generalists have been playing endless variations on that theme ever since Og fell off the first stone wheel and got rushed to the Healing Cave back in 20,000 BC.
Jan and I conducted a long-distance relationship during my first year in Ontario. In July of 1992 we tied the knot and she joined me in my northern adventure.
Devolution
For the first few months after we got married, whenever I was telephoned at home in the middle of the night to go see patients in the emergency department Jan was the epitome of concern. The instant I hung up she would ask me if I had to go in. I’d fill her in on the details as I stumbled around in the dark looking for my clothes. Before I left she’d always say she hoped it wouldn’t be long before I was back. When I eventually returned home and crawled under the covers she’d wake up and murmur something appropriately sympathetic in my ear. Ah, those were the days.
As time passed she gradually stopped asking what I was being hauled out of bed to go and see, but she never failed to say, “Do you have to go in, honey? That’s too bad.” It became a comforting little ritual.
One night I answered the phone at 3:00 a.m. and glumly listened to the ER nurse explain that she needed me to come see some intoxicated yo-yo who was going to require a truckload of stitches. When I hung up Jan rolled over and said, “Do you have to go in, honey? That’s too…zzzzzzzzzz… .” As I lumbered out the door I thought, “Uh-oh. Things are definitely slipping.”
After that she completely quit waking up for those maddening nocturnal phone calls. I can’t really say I blame her – it’s probably a sanity-preserving defence mechanism. It certainly preserves her sleep! You could nuke the house next to ours and she’d snore right through it, guaranteed. Some nights I’m recalled to the emergency department three or four times after midnight. Our alarm clock invariably goes off 20 minutes after I’ve limped into bed for the final time. Jan usually sits up, stretches luxuriously and announces, “What a great night! You didn’t get called once!”
“Great night,” I croak incoherently.
A few days ago our prehistoric bedroom telephone finally gave up the ghost, so we replaced it. The new phone rings like a klaxon from hell. Last night I was on call. This morning Jan didn’t look quite as well-rested as she usually does.
“I don’t like that new telephone,” she complained. “It woke me up!”
I had to work hard to keep the grin off my face.
The Big Smoke
Not long after we moved to northern Ontario, Jan and I decided to spend a romantic weekend in Toronto. We planned to fly out after work on a Friday evening and attend The Phantom of the Opera, then spend the next day shopping. Saturday night we’d have supper at a cozy restaurant. On Sunday afternoon we’d pack up and fly home.
First we made our flight and hotel arrangements. Next we phoned the theatre to purchase tickets. They cost a small fortune, but we’d heard so many wildly enthusiastic reviews about the show we would have gladly paid double the asking price.