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- เผยแพร่เมื่อ 30 ส.ค. 2023
- Dr. Glaucomflecken's rural medicine doctor has seen a lot while on shift, but the medical student is still new to the concept of the farmer's pain scale. As a resident doctor working on a rural medicine rotation right now, I'll just start off by saying that this depiction is unfortunately WAY too accurate sometimes. Here's everything you need to know about what it's REALLY like working in rural medicine right now.
#drglaucomflecken #medicine #medicalschool
Bio:
Hi everyone, its nice to meet you 🤙 My name Is Gianluca and I'm a second year family medicine resident physician at McMaster University in Ontario, Canada. I'm just trying to document my experiences throughout my medical training and beyond to hopefully help inspire/guide some other students... and make things more fun for myself :) I post a new video once per week.
Feel free to contact me on TH-cam or Instagram if you have any questions.
📬 Follow Me On Social Media
Instagram - @NXTgenMD
(That's all... medical residency and TH-cam keep me busy enough 😅)
🎹 Music
All music comes from Epidemic sound.
🎥 Stock Footage
Via Pexels.com
Just a (not so) fun fact that I forgot to include in the video: Farming is actually the most dangerous industry in all of the United States (and Canada) according to statistics
extension.missouri.edu/news/farming-the-most-dangerous-job-in-the-u.s.-5785
Much respect to all the farmers out there and stay safe
Augers are mysterious and mercurial.
Hell, when I worked at a potato processing plant (roughly 3 years total), I think two workers died over a period of like 3 years at nearby potato farms.
Yup. They grow/raise our food. Protect at all costs
I thought being president of the US was, since 8.7% of them was murdered..
IIRC being elected president of the US has a higher rate of job related death (~10%), but that has such a small sample size as to be statistically insignificant.
A relative of mine (rather distant relative) was a licensed MD and had to deal with some lawyer for some stuff. The lawyer tried the "you stick to medicine, I'll stick to law" line. The relative got annoyed and decided to prove being a lawyer isn't that big a deal and passed the bar (he might have also gotten his JD?) and ended up being both a practicing lawyer and doctor at the same time. "I'll help write your will and tell you how urgent it is to get it done."
I can see my older brother doing something like that!
A great revenge arc.
You have to get a JD to sit for th bar, so yeah, your relative definitely got his JD
@@nancydrewfan7890 I'd have to check, but it might have been pre 1920, so things might have been different back then.
@@benjaminshropshire2900 OH wow, damn. You might right then. Shit was much easier back then.
My Dr's office (local VA) has begun asking male patients a final question: "Now, is there anything else that your wife/girlfriend told you to ask about?"
That is fantastic 😂
YES
Spouse (who is sane about everything else that ISN'T medical related) for years assumed that if the was anything to be worried about, that the doctor would inquire---and that I was too high maintenance because I would ask lots of questions.
::headdesk::
Things are much better now.
I'm a nurse, we have Dr. G's farmer's pain scale tacked up on our bulletin board 😂
I remember a story about a rural community doctor performing heart surgery for the husband, dental surgery for the wife, followed by a quick treatment to their dog! Completely nuts!
I once evaluated a dog's x-ray in an ER. Nothing was broken. LOL.
I’ve also seen x ray films from a puppy that needed to use an emerg X ray machine… easily the cutest X-ray films I’ve ever seen
I worked in a remote logging community, so not rural, just dMn remote. It was a hospital with ER, and inpatient and OR. Major cases we'd call for air ambulances. Anyway, the hospital allowed the one ancient Dr who'd faithfully worked there for years to use the xray for animals after midnight 2 nights a week. He'd leave complicated ones up for the surgeon to look at In the morning. As a Nurse from Toronto arriving there I was shocked my first months coming upon pet xrays.
@@nxtgenmd At my work we have had a few cases that we had to send off to the zoo and twice to an ED for various reasons. On the flip side, I've also seen my coworker's xray's after she dropped a bucket of cleaner onto her foot and wanted to know if it was worth it to go to the ER (we are an animal shelter with a surgery suite and clinic in alabama).
Dr Glaucomflecken is my hero. I'm glad us Dr G fans got a chance to meet a real life rural doc! Many thanks to you for being a lifeline to these fortunate people.
Thank you Mike, I appreciate it :)
Gonna leave this here in the off chance that it ever happens one day, but I'd love to have him on the channel sometime for an interview - who knows 💪
Hey Mike… do you run a fan boat out of the back of a Texaco?
In the US, you can lose your vet’s license for working on any people (other than yourself or your kids, or if the Good Sam law would apply, like for CPR). So if you’re thinking of telling the story of the vet that helped you out, don’t. They took a risk for you.
The stories come out long after the statute of limitations has passed... No one is giving up the name of their Vet because Large Animal Vets are in such short supply too... You get a farmer to even say which vet clinic they're using you're doing good...
Just don't give thier names
I’m assuming that most cases where this happens is in an emergency where there aren’t any other options so the Good Samaritan law should apply
@@kevinsiggins623*Laughs in American* You'd think so...but you'd be wrong.
If you're not in immediate risk of dying...no dice. Go feed the machine of the for-profit "healthcare" business. Because it's exactly that, a business.
You have a six inch long gash on your arm due to your dangerous farm equipment? Well did you hit an artery? No? Then stop the bleeding and see your gp when you get the chance. You said you didn't hit an artery, so you're obviously not going to bleed out before tomorrow or the day after right? Wash it, keep it clean, and just forget about those chores! Your farm will survive for a few days without you, right?"
It is illegal here in Poland, too, but many veterinarians admit pretty freely to having stiched up people or removed stiches. I guess no one gets ever prosecuted for it because nobody ever complains.
My Dad is this farmer! Years back he cut off 3 fingers with his table saw down at his shop, wrapped them in a shop rag, watcked 100 yards to the house and told my mom, "I need you to drive me to the ER," with absolute control. Fortunately, the regional hand surgeon was teaching at a medical conference in the area. He patched him up, and after a couple extra rounds of antibiotics for infection, my dad got most of his hand function back.
I'm a rural ontario resident. When my wife had one of our daughters, she had a severe case of mastitis. While we were on the way to see a doctor about it, we ran into a female vet from a nearby community. She gave my wife a pile of very sound advice that saved us a visit to the doctor immedieately and told a story that weaned her off of breastfeeding. Apparently, her child had broken throught their top and bottom front teeth at the same time. While breastfeeding. And had almost completely severed her nipple. Apparetly she just got her kit and SEWED HER OWN NIPPLE BACK ON. She said she thought it was shock that let her do it, but she did a good job. Tough people up here.
Cow broke my dad's nose (could have killed him because cows) and he set it himself and kept working. My mom made him get a CT and the doctor complimented his handywork.
@@vainblack9643 Farmers are just built different. My great uncle got a pitchfork through the hand (his wife's fault), just wrapped it and kept working. Also rolled a tractor on himself, breaking all ribs in one side. Got back on the tractor a week later, on the same hill he rolled on.
@@feraynironmane8101 that reminds me of the time my dad was driving a tractor and then suddenly he was standing in the road. Tractor had gone into a hole he hadn't seen and it was a really old tractor with no cabin so he got thrown free and landed on his feet and his brain just deleted the transition.
Took him a minute to find the tractor because it was behind him.
@feraynironmane8101 my grandpa lost finger to the feed mixer and then milked all the cows granted this was his second finger he lost so he might have gotten use to it at that point
I worked with ranchers for a while. The only time I saw one go to the emergency room was when he was hit by some heavy equipment and fractured most of his vertebrae and ribs. The dude got up and tried to walk after the collision. He would have driven himself to the ER too but I don't think he could lift his arms above his waist anymore.
My grandfather was in a roll over and he walked back home. Turned out his neck was broken but they didn't find out until a month later when he was forced to go to the hospital when a tractor carrying hay dumped several bales on him. Never met him but my parents said I am just like him. First time I was told that I whined "but I don't want to have a beard" (8 year old girly girl)
Dr G did residency at University of Iowa. The step off to rural is 10 minutes, so he undoubtedly saw many rural residents.
He's also from rural Texas, and Lady G is from even more rural Texas!
I have chronic illnesses, notably chronic pain, and I'm from a family of farmers, truckers, and dairy workers. Real hard working people. "Is a bone sticking out? No? You're fine." (Family motto) I will ignore a pain, injury, or illness until I'm ready to gnaw on the doors or hurt something else to distract myself. That's considered a valid treatment for a bothersome pain; just cause a smaller pain elsewhere to distract from the big pain. I've been to the ER and been asked, "So how long have you been experiencing this pain?" "Uhhh...a couple weeks?" "WEEKS?! Why didn't you come in sooner?!" "Because it wasn't that bad? It's only been really bothersome for the past few days, and bad for the past day or two, so I figured I should finally get it checked out. My gp couldn't see me until next month and I was kinda just hoping it would go away."
When you have widespread chronic pain then you just assume any pain is related to that and will clear up on its own eventually, so why jump to waste time and resources that could be used on someone else? My doctors all say that I have an abnormally high pain tolerance too. 🤷🏼♀️
Triage nurses get super frustrated with me. 😅
The problem with ignoring pain is that it can cascade into something that will take a tremendous amount of pain killing meds to get it back under control. A lot of times you'll need to be admitted into the hospital so they can give you adequate amounts of controlled substances to numb the pain.
I, too have an unusually high tolerance for pain. I fractured my spine as a kid and thought I just broke my tailbone! I was in excruciating pain every time I had to sit down or stand up for a YEAR! I still didn't tell my parents as they would've been pissed! It was the 1970's and things were different then plus my mom had stage 3 breast cancer. I didn't find out until my 40's that I fractured L5-S1 and should've been in a body cast for a year! My suggestion to "help" your pain is to take Turmeric 2x a day, and I also take SAM-e. Of course, you have to look to see if there is any contraindications with what your taking already but both are game changers! Also MEGARED krill oil for JOINTS! This a huge game changer especially for people who can't tolerate the STATINS prescribed for high cholesterol! It'll bring your cholesterol down and the hyaluronic acid in it hydrates your joints!
Also...I stopped taking prescription pain meds (not easy to do but worth it) as I found that I was getting rebound pain when they started wearing off! They were making my chronic pain WORSE instead of better!
And EVERYBODY SHOULD BE GETTING THEIR VITAMIN D3 LEVELS CHECKED! 50% of the population has insufficient VITAMIN D3 which causes all kinds of issues including bone & muscle pain, lack of energy and anger issues (mostly in men)!
8:52 interesting 🤔
In my husband’s veterinary school class, there was a man who had been to medical school (because he didn’t get accepted into veterinary school when he first applied).
Dr B completed medical school, worked I think 5 years as an MD on a Indian Reservation in the Dakotas … after which the US government forgave his federal student loans. He paid for veterinary school by working as the on-site MD at rural urgency care clinics. Where he occupied most of his time sleeping and studying veterinary textbooks.
The other classmate with a notably interesting background was the other Dr B who left his work as a garbage truck mechanic in NYC to become a veterinarian.
Closest I had to that was a med student the year above me, who had worked as an EMT/ paramedic, gone to pharmacy school, worked at his parents' pharmacy for awhile, and then went to med school. He had a decent side-gig tutoring pharmacology to struggling classmates 😂
My cousin once worked in a rural emergency medical center. One story she had was of a man who came in with a gangrenous toe that had to be amputated. He must have paid attention to the amputation process because he removed the next gangrenous toe himself. Apparently, he did a really clean job that impressed the doctor, although of course the doctor would have preferred he came in to the clinic.
When you've got a jug of betadine, a 100mL bottle of doxycycline, and a vial of dexamethasone for the ewes, things gotta be pretty bad for an emergency room to be worth it
Haha! Yes! And during covid I bet the Ivermectin got used too. 😀😄
Super accurate. 😂 I’m prepped and ready to handle the majority of issues, for both people and livestock.
@@CrankyGrandmaif the farmers even got sick from the thing, i think i got it and felt like crap (like a bad cold and headache) for mabey a day, then i was better.
the only reason i think i had it is cuz my wife was in the hospital for a gal bladder and had to get tested, she was positive but no symptoms.
i don't think koof would be enough for any farmer to even worry about unless they were already on deaths door.
Oh god, I HATE doxycycline. I had to take it once for an infection. I was always nauseous and once I threw up because of it. I had to take it for a month. I always tell doctors to please not put me on it.
@@ARockRaiderMost of the population was like that... But hospitals were also fudging results because they got money for every reported case.
I know I magically tested positive back in October when I had to go into the hospital due to a Crohns issue (large intestine almost popped like a balloon)
My 70 year old grandma went through a hay tedder and lived to take the tale. She went to the hospital via ambulance! That was huge for them. Usually they treated themselves with various prescriptions they had laying around the house. They use a LOT of vet meds. They took good care of their cows. Not so good care of themselves.
When my son broke his wrist at age 14 I asked him what his pain level was (it looked pretty bad). He said it was a “7” because he knew when we touched it the pain would be worse and he didn’t want us to touch it. I was so impressed with his interpretation of pain scales, I used it as an example for my patients.
It was the first rural med video that got me hooked on dr G. My kids showed sheep, hogs, and Beef in 4h for years. One of my kids sent it to me. It’s absolutely true. Re: pain scale. I could never figure out what it meant. Best chart I saw matched each number to how difficult it was to work. It’s the pain nagging, but you can still work, is it a little distracting, is it hard to focus, etc.
That’s actually a great way to phrase it 🤙 I might give that a try sometime :)
@@nxtgenmdthe pain scale used to just show pictures of faces, now the ones used at Mayo health System has short descriptors (as described above) under the faces as well.
I have a lot of trouble with the pain scale because I've had chronic pain from childhood. I need that Farmers pain scale you are talking about!
@@jeanjaz How it was phrased to me is rather than "how much does it hurt" its "how much does it affect your ability to function". Wife has chronic pain and so a "most pain vs least pain" makes no sense. "can you get a glass of water" vs "can you get out of bed today" is a better scale for her
@BrandonJohnson-ud4lx I texted my doctor a screen shot of the post, she had always been aware of my problem. She said, unfortunately, the medical system is built around that pain scale, so a modified one would have to match up.
For instance, when I was in the hospital and knew I needed a pain pill, they asked what my pain # was and I said 2 or 3. They said they couldn't give a pain pill unless they could put a #4 in the computer system.
Anyway, we thought of this as a working model that might map to the regular pain scale system.
1 Noticeable,
2 annoying,
3 distracting,
4 Fatiguing
5 disrupts routine (minor)
6 disabling
7 De-socializing
8 nauseating/tears
9 Silence
10 "leave me alone"
I live in a rural community and I have no medical expertise but I’ve been shopping on Craigslist for a fan boat and maybe an MRI machine.
In the Dr G universe, rural medicine is the doctor, mailman and was the mayor (until he was unfortunately beaten out by a goat)
Darn 🐐
A friend was badly bitten by a dog. She went to her friend the vet and got cleaned up and "Fluffy" got scripts for pain and antibiotics. "Fluffy" wasn't the dog. My own vet taught me how to use a bladder cath on my male dog when he had TCC of the prostate. That skill came in handy years later with another male dog.
And our local rural human doc brought his dog to the clinic over the weekend to stitch up a wound
This was 20 years ago, I've moved back home and I he's back to being my doc
Vets are great, doctors ship you off to some specialist you have to wait a month to see 100 miles away who is as likely to send you to yet another specialist as to treat you himself, vets will just take care of the problem regardless of what it is. I don't know what it is about their training and education, but medical schools need to be remodeled on veterinary schools.
@@costakeith9048they need to know the biology of more than one specie XD
I live in a rural area and grew up in another. This strikes so true. My first summer job was on a farm an when we got cuts we’d wipe them down with antiseptic, bandage, and get back to work. No one wanted to have to deal with going to the doctor.
My great-uncle was a farmer and probably never owned a bottle of sunscreen. He got a "sore" on his nose that he (unsuccessfully) treated with black salve until it was obstructing his breathing. When he finally saw a doctor it was diagnosed as advanced skin cancer. He needed an extensive resection and the surgeon said he'd refer him to a prosthetics provider. He refused to get a prosthetic when the doctor said it wasn't needed "structurally" but because it was grossly disfiguring. "If people don't like how it look, then they can look elsewhere!"
I live in the rural USA. The population keeps going up and our doctors are all retiring. You have to drive an hour or more if you’re a new patient because the local doctors aren’t accepting new patients. And don’t get me started on the quality of care now….
We lost our lvl 3 trauma several years ago.
I enjoyed your video!
So right re pain scale. Pain scale is just for insurance coverage. I am old nurse. A good bedside nurse looks for physical and mental signs of pain to assess the patient.
Pain is subjective. That's why I always ask next what's the worst pain you've ever felt. It's not perfect but does help get some ideas of where they're at.
That’s a really good idea, very useful for someone’s own perspective. I’ll remember that one- What’s the worst pain you’ve ever felt, and how does this compare? Also we have to take into account the distress caused by pain, or the length of time the pain goes on, because chronic pain can be more distressing and fatiguing, and disproportionate to the original cause.
@@rachelartis4433 I learned that in my Medic Training back in 1998. Started noticing that wasn't being asked in the mid 2000's. Most ask duration, type( chronic vs new)and quality of pain( sharp, burning, pressure). Those are still taught.
Wise. I've heard it said that the pain scale is only helpful the second time you ask as a way to see if it's getting worse or not. Culture, personality, lived experience etc makes the first number way too unreliable to be of much use. Your way sounds smart because it gives you a baseline.
This is so true. I had bad post surgical pain, and I told the Dr my pain was at 8.5. My husband then added that this is surgery #34.
My partner was delivered by a doctor who worked as a veterinarian and MD in a very rural town in Missouri late 1950's .
God, these are so accurate, it's uncanny. Have I seen a vet deal with human things? Oh yes, seen a vet stitch up humans before and they do a great job because this is one of the few times a patient is willingly staying still for them. We have vets at equine sporting events like horse shows to large planned rides, not doctors. Unless it's a rodeo there is not a doctor around.
"I'm here aint I?" that one, that one hits hard... yea, I live rural, seven miles from the nearest town, less than 10K population.
It is getting worse. Mayo is closing smaller hospital maternity wards, expecting mothers now have 30+ miles to drive to give birth in a hospital.
30+ miles is definitely something that we see too unfortunately - there are also instances where expectant mothers in isolated rural communities need to be flown out to cities with hospitals ahead of their due date so they have somewhere to deliver
My youngest daughter’s pregnancy was monitored by maternal fetal medicine at Mayo after the 20 week ultrasound found abnormalities at one of the Mayo Health System clinics that still does deliveries.
Between the diagnosis for my grandchild and the fact that my daughter had excess amniotic fluid, the doctor strongly recommended being induced, because he didn’t want my daughter riding 40 miles to the hospital while in labor.
I live in the county seat of Wyoming Co PA. They closed our hospital 2yrs ago, and then also closed the ER fully 1yr ago. The next closest hospitals in each direction are 3@ 18mi to the east, 2@ 22mi south, 19mi north, or 47mi west. Let me tell you, kidney stones on any road with any cracks in it is not fun. See you in a half hour.
Where I live the nearest hospital is almost 20 miles away. One neighbor gave birth to 16 kids. Only half of them were born in the hospital. The others in the ambulance or still at home.
I think you might end up in rural medicine once you finish your rotations. Great personality, solid knowledge base. Who knows?
Thank you very much :) I definitely won't be ending up in a big city - that much is for sure. I really enjoy the ability to practice full scope medicine and that really doesn't get to happen when you're by a big academic center. But yes, for now anyways, who knows 💪
Doc locally always asks "Did you finish the X?" I would say yes or no. When I said yes, he would be like, well then it can't be that bad.
My grandfather from rural, upstate NY chopped off the tip of his pointer finger as a kid and my great-grandmother sewed it back on. The tip of his finger was crooked for the rest of his life but no sepsis or other complications. I remind my children of this often when they complain about a scratch.
A scratch can open up to sepsis. Been through that hell with my father a few times. Deal with the scratches properly.
My Dad's first aid kit consisted of rubbing alcohol. As a kid I learned to tolerate a lot and that meant I did not have to experience Dad's application of medicine.
I was taken to our doctor for a broken arm. Not the ER.
I'm old enough to remember murcurochrome. We prayed for rubbing alcohol or peroxide instead of that stuff, and breathed a huge sigh of relief not only when it was taken off the market, but everyone finally ran out of it.
I worked with a rural ED doc who told us when a farmer comes in, usually wearing overalls, work boots and a sweat stained cap, and tells you "I feel like I'm about to die", get ready to catch him, because he is! We called it the Positive Overall Sign.
I'd love to imagine the culture shock any rural community would have if their local rural medical practice had a competent budget, staffing, and support from bigger networks.
I’m a paramedic and safety officer on offshore oil rigs in the Gulf of Mexico. The amount of pride people have in NOT taking care of themselves is ridiculous. I can’t begin to count the times I’ve heard “I’m healthy-I haven’t seen a doctor in X years!”
From a place with a population of 5k people
The car ticket person is also our dog catcher.
People just generally have multiple roles in smaller communities
As a person living in the USA without health insurance, most of this applies even though I'm not in a rural area.
I just finished putting about 100 stitches in the leg of a farmer who patted his old bull on the head to move him out of the way of a gate, but didn't;t notice that a spring cow was mooing on the other side of the fence. The bull dropped his head and dug his horn into old mates leg as he tossed him up and over. Farmer was unfazed.
The Doc is not wrong about finishing the fence.
I love Dr G.
I wonder if the admitting staff ask them questions like "Did you finish the blah blah blah". My mom grew up on a farm and yes, they are tough people
Sometimes doctors do things to push their patients away and to not see them when they should. They are jaded or gaslighting. They don't get that people can have severe White Coat Syndrome
Thanks for sharing :) They are tough people - sometimes to a fault but I don't blame them. Most docs are trying their best, many are burned out but there's always improvements to be had. Have a great week!
Thanks for another great Dr. G reaction! I think your last one was what brought me to your channel. The more I learn about rural med, the more I know I want to do a rural residency one day, if I make it that far lol. All my life I've been involved in human and animal med in one informal/indirect way or another, and now I'm an unhoused student and I do first aid for my peers in the homeless community (and help with their pets, and with medical resource navigation, etc) ... so I just LOVE the versatility/flexibility/resourcefulness that rural med requires, and especially the challenges presented by stubborn resilient self-sufficient populations! I really think the people furthest outside the usual reach of the "system" have a ton in common, no matter where they live. And communicating with those sorts of hardened and often reluctant people, whether about healthcare education or resource referrals or anything in between, is something I just love and seem to have a knack for (I think it's the candor lol, I'm good with people who appreciate a straightforward "That s**t'll kill ya!", plus I know what it's like to be proud of rigging the best solutions you can with what you have and then deal with contempt from/for people who are rigid about "you should have done that in XYZ unrealistic ideal way", so I think people can sense that respect/peer experience). So I really want to apply that where it's most useful, and I'm convinced that there's a ton I can learn from rural med experience and bring back to help underserved urban populations. This ramble got long lol, but point is, videos like yours just confirm more and more for me that my public health passions call me toward a rural residency, and really help motivate me to work hard to try to get there! Love your content, thanks for all the work you put into sharing your experience with us!
Wow, I thought I was a struggling college student, but you have me beat. That's cool that you are helping your fellow people in the unhoused community.
You NEED to talk about volunteers fireman paramedics!
These volunteers are go to life savers.
Talk about coming a little too late.
Working on the farm i put a wire through my finger joint,
Had my tetanus shots, so no worry,
Next day my hand was a balloon,
drove into Wingham emerg,
found piece of the wire inside, I was put on IV.
"And what did we learn?"
"Don't try to rewire my hand."
firemen, paramedics, police officers, nurses - there are many different people that actively hold up healthcare and help people out in rural communities 💪 I had a chance to talk to a lot of retired paramedics from the area who told me some amazing stories from when they were still working and they should definitely be commended. Unfortunately I can't speak about them from a first person perspective though.
Your story happens quite a bit unfortunately - not always with wire, I've also seen shrapnel from saw blades and pieces of a rusty old nail. Stay well and all the best :)
@nxtgenmd I mentioned volunteer fireman paramedics because after a young neighbour died, they became paramedics. In rural Canada I memorize the local volunteer fireman phone number because I know they will arrive fastest.
my late granddad was an Aussie farmer. Farmed eggs, wheat and wool. He was also a hobby beekeeper and had personal vege garden on top of all his farmwork just because he liked making honey and growing veges. Any visit he'd give us home grown veges and honey to take home. He worked well into his late 70s. He only retired because he fell off his tractor and broke his ribs. But he got back up and finished the paddock before he went home! He was so tough and very generous. Miss him and my nanna a lot.
Yes, we get good antibiotics at Tractor Supply or online at Valley Vet. Ya gotta do what ya gotta do.
From Canada Newfoundland here, I'm mid 30's, my parents and all their siblings and my in-laws were born at home via travelling mid-wife. So when the hospitals become available via train and new highways people were hesitant to use them. My husbands grandmother gave birth to her 5 kids at home, she almost bleed to death birthing her 5th and final child, they say the midwife managed to stop the bleeding by stuffing her full of teabags - don't try that at home. When his grandmother fell in the shower in her late 60's and found it extremely difficult to walk her granddaughter convinced her to go to the hospital for the 1st time in her life, the ER doctor dismissed her saying it can't be that bad because she's walking alittle, and complaining about how she's needs to hurry home and tend to her Homestead. The granddaughter insisted they do x-rays, they did - both hips broken badly, - replacement hips needed - the young doctor didn't understand how she wasn't crying and screaming on the floor in agony, - having spent her life tending to an Homestead to survive she had built up her pain tolerance.
"Farmer pain scale," I already know where this is going -_-
I have always thought that the pain scale concept as we use it is broken. One person’s 10 might be when they broke their arm in third grade while another’s may be getting a gunshot to the abdomen.
Whenever I or my spouse are asked to rate our pain, we typically add what our 10 level is so they can better appreciate how we use the scale. My 10 is when I was off of pain medication right after a major rectal surgery and his is waking up from a classic Roux-en-Y gastric bypass on no pain medicine whatsoever.
Dr G is a. genius,. Pure genius. I've spent years in and out of hospitals with 2 very ill husbands, plus my own cancer and broken legs. I've picked up on many of these different physician personality traits. Dr G points them out effectively but with gentle affection.. I also tend to have a bit of the rural farmer in me because I tend to downplay my pain and symptoms; but when my son accompanied me he told the doctors that I'm stoic and they should add points to whatever scale I claim
We lived in a rural area and my stepdad cut his hand. The vet tech was our closest neighbor and she stitched him up.
As someone who has always lived within about an hour of a city, this is culture shock. For me, it feels almost dystopian. I know doctors who go on medical missions to other countries, but there is equally a need in the rural areas of the USA and Canada.
That video of Dr. G rings so true. There's no medical record of my dad and I getting struck by lightning despite many witnesses because I (7 years old at the time) "wasn't unconscious long enough to call the 7 digit phone number to the paramedic. It would have taken over half an hour to get to the ER anyways and what's a doctor going to do about it?“
You just came up in my feed, probably because I'm a fan of Dr. Glaucomflecken. He's great! I keep trying to determine where you might be practicing rural medicine and hoping it's Nova Scotia, where I'm located. We need doctors and nurses and medical personnel in general! I've been without a doctor for almost four years here, and nurse practitioners keep quitting. I have a heart condition and can't get a doctor, let alone a specialist. It's a sad state of affairs in NS. Anyway, I'm enjoying your take on rural medicine because it kinda hits home. 🙂Edit: if I had watched a bit more I'd know you're in the Niagara region.
My cousins and I laugh about our grandfather treating our "owies" with gentian violet (mecurichrome if it was small).
We are now in our 50s & 60s, married with grandkids of our own.
You looked at life and pain differently in those days and especially if you were raised in a farming/ logging community.
Gentian Violet still used amongst nursing mothers for thrush! But usually upon treatment they close themselves indoors, baby's got a purple mouth and mom's got purple nips LOL
*Midwife
My Grandpa was a firm believer in Sulfathiazole. (hope I spelled that right)
In the Pacific durring WW2, he was what the US Navy/Marines call a Corpsman today.
I still remember being asked, "Do you want me to fix this, or go in town?" more than a few times.
Will miss him until we meet again.
That is awesome what you do! Good luck to you in all your rotations! Do have idea what you want to do specially after your rotations are done?Thanks for all do we need kind and caring doctors out here in big city's or small communities that care.
My late uncle (a bachelor) was a farmer, and one day he woke up with some chest pain. He decided to do some chores and see if it got better. It didn't. He realized maybe he was having a heart attack. He puttered around the farm for a while, finishing chores, and DROVE HIMSELF to the hospital, where it was discovered that he WAS, in fact, having a heart attack 😬
3:50 I live in the US, so it's really cool to see how other countries triage! Out of curiosity, what level would a patient be if they come in super sleepy + high fever, & their primary doc suspects either a gallbladder infection or appendicitis? I feel like, from visual appearance alone, it might be a Level 4 (if the patient is comfortable enough to fall asleep, it can't be THAT serious, right?) -- but with their doc's suspicions, it might be a Level 3 or 2?
(Asking bc I recently had emergency surgery to remove my necrotic gallbladder & I was admitted so quick (like
My great grandfather was a rural doctor in southern Indiana from around 1900 to 1930s. He had a room for people to come to his house, but mostly it was house calls. He had so few drugs to work with, and mainly he had his observational skills to do any good. Good for those who help the folks in rural areas.
Working as nurse in a rural ED with a significant Amish population, if the patient was Amish, default acuity was at least a "3". If it was a kid, automatically a "2".
When I was between 18 and 23 yrs old, we had a traveling vet who worked on small and large animals, farm animals, and pets, and if anything was mildly wrong, you could request that he leave medication in his "drop box" (yes, it was literally a box) by a shed on his property. My mom used those meds to treat anything that was mildly wrong with the animals we owned and with us, too.
🤧🧐😷
As a Canadian that worked at a Vet Clinic, I had my Veterinarian boss remove my stitches rather than take the time to go to a doctor to get them removed. So yeah, this happens in more rural areas of Canada.
Most military Docs are trained as vets first before human medical training. The idea is that in the field you don’t get much input from the patient so you need to evaluate based on observation not answers to questions.
7-10 hour wait time is a system failure
The system is put the doctors/staff in the cities and pay them better than the rural hospitals to the point that rural hospitals can't compete because all of the staff have to pay off crazy amounts of student loans plus afford to live (Tuition reimbursement to work in rural/blight communities still doesn't stop the monthly payments that they've got to come up with..)..
my grandparents were menontie farmers. And this behaviour carried over into the entire family even though we haven't been farmers for 2 generations now. I'm trying to train myself out of it.
Shortly after watching the farmer pain scale video, I had a female farmer check in to the ER. Later, an african american male checked in with chest pain and an elevated troponin. He looked very uncomfortable. When asked what his pain was on the scale of 1-10, he replied "Oh Jesus."
I'm an RN, trained in the UK in a big teaching hospital, working in The North of Canada to experience a small community hospital of 50 beds covering anything that comes in. Fellow ~ 40 who had been taking a tree down comes in with a 3" diameter tree branch imbedded 6" into his chest, having entered just above the clavicle (collar bone). He was sat up in bed, fully awake and aware and calm as a cucumber. Down to surgery, tree parts removed, no damage to any major structures found, back to the ward and had to be persuaded to stay overnight as he just wanted to get on with the job. Had a great sleep, next noon, eating a full lunch and insisted he felt good and demanded to go home. No big deal for him but it was eye-popping for everybody else ... except for his wife!
What kind of specialties are needed out in rural areas the most, in your opinion? I'm hoping to get into medicine next year (got a couple of interviews here in Australia) and am hoping to make a difference in these communities.
Good stuff Simon :) the short answer is “all of them” but it’s a bit more nuanced than that. Rural communities still need surgeons or radiologists, but these specialists won’t be able to work out of a lot of the centres that currently exist because they don’t have the ORs, CT scanners or MRIs to do the job they trained to do. On a population level, the opioid crisis, diabetes, alcoholism, depression and obesity are the most pressing concerns because they affect so many people. We also need people who can run an emerg. I had a mentor this summer tell me that “you alone can’t fix the healthcare system.” Find something that you want to and like to do and then try to get into a community that you like being in and that you can help out.
All the best
I live in an area that counts a rural, but is also not terribly far from a highly renowned medical center. (About an hour away)
We had an amazing Family Practice MD. He was no longer delivering babies by the time we moved here, but he still did everything from pediatrics to geriatrics. Well respected by patients and colleagues alike.
On the other hand, my spouse had an patch of skin cancer a few years ago. The easily burned off and removed kind, thankfully, but now needs an annual skin check by a dermatologist. The dermatologist in our area retired, and the famous entity that owns our local hospital and clinic has not been able to find a replacement. Farmers and ranchers spend a lot of time out doors.
Knew an awesome lady while i was on my mission who had started as a vet, become a paramedic, and then became a chiropractor. Shes actually the one who figured out i had a gall bladder issue before any of the doctors i saw, and it was because she was helping with chiropractor stuff
Dr G went to Dartmouth for Medical School,🎉 which is in Hanover, New Hampshire in the middle of nowhere. I worked in a tiny rural town about 45 minutes north of there. Dartmouth was our nearest tertiary, and if anything was really wrong with you, the 45-minute drive or alive Flight helicopter ride was your best chance for survival (though we had a tiny hospital with a sketchy ED that sometimes kept people alive, sort of). We had a FQHC where we had medical students from Dartmouth at our FQHC all the time.
Good job Doc. Way to go. Keep up the good work. God bless you!🙏
Thank you very much my friend - I appreciate the message and the super chat. God bless you as well 🙏
@@nxtgenmd Glad to run across your video and hear of your work. The way I see it, it demands more love and dedication than a lot of careers do. Blessings!
Thank you for making me laugh. I am laying here recovering from a broken femur and broken Total Knee Replacement ( was replaced during this surgery).
I work in a large teaching hospital and this hits home. 😂
I know a farmer that removed his chest staples after heart bypass surgery with a pliers from the garage..... that he boiled. All to avoid the round trip to get them out.....
Where I grew up the closest rural hospital was 30 minutes away, so just going at all was already a huge deal, let alone seeking specialist care.
I was very blessed to rarely need anything. I mostly only went for yearly physicals for sports.
The only ‘real’ things I went in for were a tetanus shot after stepping on a nail at work (but only after my foot had swelled like a balloon the next day and I couldn’t put my shoe on), to get five stitches on my forehead, and to clean my ears because my mom noticed I wasn’t hearing her well (I had noticed the problem months prior).
Living in these communities you learn to just live with whatever you’ve got.
Oh, and the doctor that cleaned my ear when I was a teenager was _same_ the doctor that delivered me as a baby. And my bishop at church for many years.
I'm from Yuma Az. The Docs here in Ohio ask weird questions like, “What do you mean you popped it back into place using a garden hose”?
Have you tried using the veterans pain scale with your farmers (well, really, any of your patients, it's such a better system than the 1-10 perception scale)
Ahhh!! I work with that doctor in Niagara who was a veterinarian and now an emergency doctor!!
Dr. B is amazing 🔥
Rural medicine is a challenge never know what will come through the door, farmer pain scale is real
As Dave Barry put it when referring to guys and never going to the ER: "Maybe if we put Bob's head back on with duct tape he can play a couple more innings."
The general store in the rural town I grew up in stocked fish antibiotics that came in capsule form. I don’t think they went to very many fish.
I’ve joked with my family if I need stitches and we can’t get to hospital due to weather …Call the Vet down the street.
My uncle would get cuts that clearly needed stitches, duct tape them until he finished his work, and then go inside to the first aid kid to patch it up himself 🤦🏻♀️ he didn't die tho so I guess it works
My mom drew the line at minor surgery and broken bones. Plus she blamed the vet for why i needed stitches in the first place. Wasn’t his fault a rock hit me while i was mowing the lawn. I was game for it, but she said no.
Our first aid kit said for use on dogs and cats only. And more than one time we didn't need to go to the ER or hospital.
Thank you very much for attending to people and for these fantastic fun reaction videos. Sometimes life has to be hilarious, cause otherwise it'd be devastating! But I sometimes wonder if someday ppl will look back at you "ancestors" ("you", cause definitely not me, not directly anyway X'D) and wonder why the hell we failed to do sth. about this. Cause in that future, it's no longer a thing and ppl actually priorize societal structures systemically!
Haha I actually saw my friends story with the red Sauble Beach sign and I was like "I've seen that before!?!?" 😅 Are you going to be placed in an urban setting in the coming year?
That Sauble sign is iconic 🇨🇦 and yes... kind of. I'll be on OB and ICU at the St. Catharines hospital. St. Catharines as a city is definitely urban (pop 140,000), but not large as New York or Toronto or another large major city. It works out nicely though, because when I'm on a service, I'm the only resident there on any particular shift. This means that when I'm on ICU for example, I'm the only "ICU resident" there. I love this model because it means that I get first dibs on central lines and all other procedures 💪
@nxtgenmd just avoid Niagara General! I preferred St Catherine's as a patient when I lived and worked in the region. I worked in the Niagara on the Lake hospital for a summer during my Masters degree in Nursing at Western. Try northern Ontario for real remote rural medicine. ..like Geraldton!
Hahahahaah im from NS , fell in the woods once and walked a mile out on a broken leg to the nearest phone. Friends from away asked me why i did that lol. I said well it was either walk out or wait for the critters 😂
From the other side, as a man with a tendency not to go to doctors or otherwise seek help, part of the issue is that doctors assume contextual knowledge that I know I, at least, simply do not have. When doctors ask about symptoms, for instance, this assumes that the patient knows how their own experiences relate to the doctor's social norms and expectations. That's often a silly assumption, and it's not a gap I can bridge unilaterally.
(Personally, I've also had doctors be dismissive. Recently had one tell me what amounts to, "Come back if the pain becomes intolerable." That's a really stupid thing to say to someone you met five minutes ago and whose pain tolerances are entirely unknown to you...)
Great videos.
Thank you Frank!
We had a person bring their dog to the VA hospital for treatment. He looked up "vet hospitals" and thought we treat animals. I can't confirm or deny if the pet was treated.
"If you're here, it means you couldn't handle it at home." YES. I've always been baffled hearing about doctors just brushing things off, even in smaller places. Heck, when I was in high school, my mom almost died from meningitis after she was initially diagnosed with just a flu and sent back home (was minimum half hour drive through the mountains to the nearest city with a medical facility besides the local volunteer EMT building, btw, and I'm not sure if we were able to use one there or if my dad had to take her to an even further facility in the middle of the night).
Confession time, I have gone to the barn more than once to get veterinary supplies to doctor my own injury.
Friend drove himself to the urgent care. He had an ear infection, or so he thought.
Drove up the hill, slight air pressure change. His Ear Drum burst.
He passed out, almost crashed. Then drove another 20 minutes to urgent care.
On
To keep him from working we just about had to tie him to a tree or a huge rock
Rural guy here. I have to be dying or forced to go in to get medical treatment.
I have done my own I&Ds before, foreign budy removals. I also have that massive pain tolerance.
I have my own surgery kit that i know how to sterilize. I never let anything get as bad as that picture we saw in the video. I alwzys say, "i have enough medical knowledge to get myself killed." Mostly because my mother, brother, and sister work in the medical field, and i do to as of this year.
There is a bit of that pride in not "bothering the hospitol" with my problems, but also i think i fall under the "doctors make the worst patients" situation.
I’m sending your videos to my family
9:15 A veterinarian saved my step fathers life because they were out of the farm having the dog put down, and he had a massive heart attack. Did CPR for 20 minutes.
Please cover more of his stuff like this
I spent a lot of my growing up years on my uncle's farm, I still use the farmers' pain scale...
gangrenous, necrotic gallbladder that exploded when they tried to cut it out in surgery? "It's not very comfortable and next door called an ambulance because they think I looked a funny colour."
On discovering three breaks in my feet, all different ages, "I've never broken my foot, bruised them badly couple of times but they didn't hurt that much."
6 inches of surgery stitches undo themselves 3 days after surgery, "If you're too busy I've got some thick thread at home. Could you recommend something to wash it out with, please, I'm not sure contact lens solution is quite the right thing."
Hit by a car going 60mph in a 30 limit? Get up, pick up my broken glasses and call the driver enough curses to make a sailor blush. I only went to the hospital because the police were quite insistent about it and drove me there.
All said completely in earnest, genuinely had no pain real pain in any of those cases... at least nothing serious enough to make me stop chopping a tree down, know anything about the breaks or look at the stitches before I changed the dressing on the incision.
The hit by car incident I had a tiny blood clot in my arm which we couldn't find a week later and my neck crunches every so often... but that was over 30 years ago, so I'm probably good.
I used to work in a/evin a rural area in uk. If a farmer came in,you usually assigned them to resus immediately. If in lambing season, yoi knew there was a massive problem!
You think a farmer is going to sit around and wait for 5-7 hrs because their injury isn't going to kill them? Not during choring hours or planting/harvest time. Risking their crop yield, and therefore income, due to something that's not going to kill them? Not happening. They're usually just about breaking even, and missing a day's worth of chores could be very costly.
Silvadine is part of the layman's medical kit too. For burns, and better than Neosporin on cuts.