This Rural Mission: Bravery

Young professionals today are super brave. We move across cities, states, and even oceans

- [Julia] This rural mission is brought to you by Michigan State University College of Human Medicine Leadership and Rural Medicine programs. The podcast is funded in part by a generous grant provided by the Herbert H. and Grace A. Dow Foundation. To learn more about the Leadership in Rural Medicine programs, please visit www.msururalhealth.chm.msu.edu. I'm your host, Julia Terhune, and stay tuned for more from this Rural Mission.

(bluegrass music)

-[Julia] Hello, and welcome back to another episode of this Rural Mission, brought to you by Michigan State University College of Human Medicine. Today we're going to take a little bit of a different route. Today we're going to talk about what it means to be brave. That might seem like a really different topic. Typically we talk about rural health disparities or we talk about social issues in rural America and now we're going to talk about bravery? Well, hear me out for a second We do a lot of brave things in our lives. Some of us move overseas, some of us go out of state to a brand new place to get an education or change jobs and all of those things, every single one of them is extremely brave and courageous, but there's something else that's just as brave and that's going back. Going back to that small town that you grew up in, going back to the place you said you would never return to.

(electric guitar music)

We're going to talk to a number of people today. Some of the people that we talk to are planning to return to their small town after they graduate. Some are already returning to their small town to get an education, and some swore they would never, ever return but have made a career out of their small town. I encourage you to stay tuned and hear more from this Rural Mission. We've got an interesting road ahead and I'm excited for you to see how brave you really have to be to go back. Daniel Drake, soon to be Dr. Daniel Drake, is a Rural Community Health Program student at the Midland Regional campus.

- [Daniel] I mean, I grew up in Caro and Caro is a relatively small town. And so I went up to the UP and I was at Michigan Tech. No one in my family is a physician, no one had gone to a four-year university at all. So I was kind of figuring it all out on my own and when I was at Tech, I heard about an early assurance program that Michigan state did and you took your MCAT early and applied early and so I think I found out it was 2012 when I found out that I was going to go to Michigan State for my medical school.

- [Paula] So I'm Paula Klose and I am a family physician, I'm a graduate of Michigan State College of Human Medicine and I trained in the Upper Peninsula campus for my clinical years.

- [Daniel] I have always kind of known that I wanted to do rural health, that was always my big thing. Being from a small town, going to undergrad in a small town where I knew I wanted to practice rurally.

- [Paula] I wanted to work in a rural community, I wanted to live in a log cabin that I built by hand (laughs). And so when I was applying to medical schools, I chose Michigan State College of Medicine because of the Upper Peninsula medical education program.

- [Daniel] With R-CHP, the rural community health program, Midland has a site for that in Pigeon.

- [Paula] For the past, let's see, six years, I have been involved with Michigan State again and was asked to be the community assistant dean for the Midland Regional campus.

- [Daniel] In Pigeon, it is near the tip of the thumb and Huron County, not far from my hometown at all and it was a place that I was familiar with. I was like, it would be really exiting to go back and just be able to actually practice clinical medicine up there.

- [Julia] You grew up here too, didn't you?

- [Paula] Yes, yeah. I wasn't born here, but my dad worked for Dow Chemical and never thought I would end up back here again. Pictured myself living in the UP, practicing. And so I was going to use the Midland family medicine residency as a practice interview. So I came down, interviewed with the program, actually learned more about the program than I had known and loved it and so ended up ranking them first and matched (laughs). And so, the rest of the story.

- [Daniel] For me, if you would have asked me three years ago or four years ago before I started, I would have told you I will never go back to the farm. I would have said I don't want to go back.

- [Paula] So I was not going to live in Midland, Michigan. I was going to live in that little community (laughs), but loved my partners, and my practice, and my patients and it's really an excellent hospital system to work in, so I ended up staying here raising my kids.

- [Daniel] As I've gone through this, the training, as I've had kids, it's really dawned on me the importance of community and family. But here in a city, there can still be some anonymity with how you're treating patients, right? Like, you blend into the crowd of a couple other. Couple other. A huge group of doctors. A rural area, if you go back, you might be the only doctor in that town.

- [Paula] As I started residency and I had a panel of patients, all the sudden my panel was full of nurses I worked with, friends, friends' parents, colleagues of my father (laughs). So you get into this role that has all these multifaceted dimensions, right? I was also the first female primary care physician in Midland and I had overwhelming interest in being part of my practice.

- [Daniel] so your reputation is really on the line and I think that to go into a situation like that, I think that takes bravery.

- [Paula] As a woman in medicine in a smaller community, you're already a leader of sorts, so some of that came with the position and the same thing with my position as community assistant dean, you know, that's what I am and I represent the health system as well as the college, so that's challenges. I wouldn't say that it was bravery, but it was a challenge.

- [Daniel] I honestly look forward to it though. I think that's also one of the strongest things about practicing rural medicine and one of the biggest benefits about it is the fact that you can really carry a community and help them out and I don't know, I just love that idea.

 

(acoustic guitar music)

- [Julia] The voices that you're hearing in this segment

are of Ali Hoppy, Elana Rosmussen, and Kala Yob. All three are premed undergraduate students from Michigan. All three of them have something else in common. They all participated in Michigan State University's Rural Premedical Internship Program in the summer of 2016. I'll be telling you more about the Rural Premedical Internship Program or the RPIP program I just a bit, but before I do, let's talk a little bit about what it means to be brave. Ali, Elana, and Kala talk a little bit about that. All three of them have spent time overseas.

- [Ali] I went to Ghana the summer of 2015, so after my freshman year of college.

- [Julia] So you were 19?

- [Ali] Yes, 19.

- [Elana] I went to Australia for six weeks.

- [Kala] I studied abroad in Segovia, Spain.

- [Julia] And how long were you there?

- [Kala] For two months.

(acoustic guitar music)

- [Ali] Ghana more picked me. I grew up in a very small town in the thumb. Rural Michigan. My senior year in high school, unfortunately got a phone call one morning that my oldest brother Josh has been killed in a car accident. My brother, he was a high school teacher. He left a legacy through a lot of people in the way he lived his life. I heard of this trip to Ghana and I just wanted to go. I didn't have any real reason behind it. I just wanted to go and touch as many lives. I saw how short how lives can be but how much you can do in that short time. I just hopped on the plane and went to Ghana.

- [Julia] Yet when I ask them what they would rather do, get on a plane and go back to those foreign lands or apply to medical school, I wasn't surprised with the answers that I received.

When you think about hopping on a plane and going back to Spain or applying to medical school, which scares you more?

- [Kala] Applying to medical school (laughs).

- [Ali] Ghana, jumping on a plane, going to Ghana, was hands down less terrifying than filling out a medical school application.

 

- [Elana] I know that I can do it, but I have a hard time with that, getting from there to expressing that to somebody else, I have a hard time with. So I have a really big concern for that part as far as applying for medical school, but I know that once I get in, I'm really excited for that next step, but I'm excited to actually be there and be with the people that have that same feeling that I have a hard time explaining (laughs).

- [Kala] I just noticed through this whole process how much of a well-rounded person you need to be and I guess in a small town it's like, that's not the focus. It's just kind of survive, get through, and do your best and then in a small town, it's easy to stand out (laughs) because there's less people and then once you get to the medical school process, you need to know how to stand out, you need to know how to be different.

(acoustic guitar music)

- [Julia] Dr. Mower is the assistant dean of admissions at Michigan State University College of Human Medicine. Michigan State University College of Human Medicine has had a significant devotion to underserved populations since its foundation in 1964. We were the very first community-based medical education program and we're pretty proud of that. Dr. Mower is responsible for making sure that we are not only admitting the best potential doctors, but that we are also admitting students who are diverse and have altruistic reasons for going into medicine. We want students to return to underserved communities, specifically rural communities, and Dr. Mower has some real concerns about how students get their medical education and where they go when they're done practicing because that's also very important.

(piano music)

- [Dr. Mower] I think we're a medical school that takes its mission seriously. I think we bring a lot of people in who have a lot of ideals and hopes, and ideas of how they want to serve in the medical field. And so, I mean, I just think that there has to be more, I mean if we're going to be serious about this, I think we have to figure out a way to capture these kids before they show up on our doorstep and we have to figure out a way to continue to monitor and mentor them once they walk away, particularly if it's a student who has identified him or herself as having a strong interest in serving an underserved area, whether that be rural, whether that be intercity, urban, whether that be migrant healthcare, LGBT health care, international developing country health care. I mean, we need to figure out a way to continue to follow and mentor these graduates, even though they are under the direct tutelage of perhaps somebody else right now.

- [Julia] Dr. Mower's concern for having a place for rural students before medical school, during medical school, and after medical school is a significant concern and something that should be taken very seriously and we have. Dr. Andrea Wendling has been running the rural premedical Internship Program for several years now. It's a place, a place for rural students to learn more about getting into medical school and to help them feel more confident and prepared. And Dr. Wendling is reaching her goals for this program. Let's just return for one moment back to Elana, Ali, and Kala. Hear what they have to say about returning to their rural community, even though they have gone on to do amazing things both in the state of Michigan and abroad.

- [Julia] Why, why rural? I know you said that there's a need, but I mean, you're living in East Lansing, you lived in all these big cities, I mean, why go back?

- [Elana] It's the whole package that is really appealing to me. I like the idea of going home. I belong there, I don't belong here in East Lansing. It's just a feeling, I know it.

- [Ali] I love my rural community, but for people that have grown up rural, you know when you're there that you're ready to go see something new because you don't know the uniqueness and the specialness of the place you live until you leave it. Going to Grand Valley was amazing for me because it really taught me how much I had back home and how unique and special those small communities are.

- [Kala] So yeah, I'm really excited to come here and to practice one day and to be that extra resource for people. And not only to help them, but to have known where they come from.

- [Ali] And I was so excited to learn that that's something that you can actually specifically pursue and there's people out there that can help you make that happen and know how to make that happen because when I came into this and I've known that I wanted to go to medical school for a long time, but when I came into it, I thought that I was going to have to establish myself in an urban area to gain the training and stuff. I didn't realize that there was an option to directly go to the rural setting and just learn there, start there, and continue on there.

(piano music)

- [Julia] I get it, we all want to make an impact, we all want to do really brave and courageous things that last a lifetime and even longer. That's the reason why we go to school, that's the reason why we move places, that's the reason why we work. We want to do great things in the time that we have and I'm not saying that going overseas and going to a new land, or starting over in a brand new place isn't brave or courageous or impactful. I think that there are lots of people that have done amazing things by stepping way out of their comfort zone. What I'm actually saying is that going back is just as courageous. Go back and work at your local hospital making sure that hiring processes are up to federal standards for diversity and inclusion. Go become a teacher back at your hometown, go serve the geriatric community as a doctor, a nurse, or a physical therapist. Go back, do great things with the time that you have in a community that you know and love. In my opinion, that's just as brave. Normally, I end with some music, but today I'm going to end with a poem.

In Defense of Small Towns

by Oliver De La Paz.

When I look at it, it's simple, really.

I hated life there.

 

September, once filled with animal deaths

and toughened hay.

And the smells of fall were

boiled-down beets and potatoes

or the farmhands' breeches

smeared with oil and diesel

as they rode into town, dusty and pissed.

The radio station split time

between metal and Tejano,

and the only action

happened on Friday nights

where the high school football team

gave everyone a chance at forgiveness.

The town left no room

for novelty or change.

The sheriff knew everyone's

son and despite that,

we'd cruise up and down the

avenues, switching between

brake and gearshift.

We'd fight and spit

chew into Big Gulp cups

and have our hearts broken nightly.

In that town I learned

to fire a shotgun at nine

and wring a chicken's neck

with one hand by twirling the bird

and whipping it straight like a towel.

But I loved the place once.

Everything was blonde and cracked

and the irrigation ditches stretched

to the end of the earth.

You could ride on a

bicycle and see clearly

the outline of every leaf

or catch on the streets each

word of a neighbor's argument.

Nothing could happen

there and if I willed it,

the place would have me

slipping over its rocks

into the river with

the sugar plant's steam

or signing papers at a

storefront army desk,

buttoned up with

medallions and a crew cut,

eyeing the next recruits.

If I've learned anything,

it's that I could be anywhere,

staring at a hunk of asphalt or listening

to the clap of billiard balls

against each other in

a bar and hear my name.

Indifference now?

Some.

I shook loose, but that

isn't the whole story.

The fact is I'm still in love.

And when I wake up, I watch my son yawn,

and my mind turns his

upswept hair into cornstalks

at the edge of a field.

Stillness is an acre,

and his body idles, deep

like heavy machinery.

I want to take him back there,

to the small town of my youth and hold

the book of wildflowers

open for him, and look.

I want him to know the colors of horses,

to run with a cattail in his

hand and watch as its seeds

fly weightless as though

nothing mattered, as though

the little things we tell ourselves

about our pasts stay there,

rising slightly and just out of reach.

Oliver De La Paz is an associate professor of English at College of the Holy Cross in Worcester, Massachusetts. I want to thank him sincerely for letting us read his poem on this Rural Mission. You can find more of his poems at www.oliverdelapaz.com.

(acoustic guitar music)

♫ When I turn to little town

Thank you again for listening to this Rural Mission. It's an honor and a privilege to get to produce this podcast. Each topic is more interesting and I get to interview some of the most intelligent and intriguing people. I want to thank some of those people. I want to thank Dr. Mower and Dr. Klose for taking time out of their schedules to speak with me. I also want to thank Dan Drake. Dan Drake is a fourth-year medical student and will be graduating in May. I'm really proud of the things that he's accomplished and he's been an outstanding student and a fantastic person to get to know. I want to thank three student-to-be doctors if everything. I want to thank the three R-PIPe students that I spoke to today, Ali Hoppy, Elana Rosmussen, and Kala Yob. It was great to get to work with them this summer and it was even more fun to get to know them a little bit more through this interview. As always, a sincere thanks to Dr. Andrea Wendling, the Director of Rural Community Health at Michigan State University College of Human Medicine. This podcast would not be possible without her and she is a physician who also moved away and went back. She didn't go back to her hometown, but she went back to her husband's hometown and has worked as a rural family medicine doctor for a number of years. Her contribution to rural medicine, again, is also clinical and academic, much like Dr. Klose's and she does fantastic things to make sure that rural medical students are represented in medical education, specifically at MSU. Thank you to everyone and I hope you join us again next time for more from this Rural Mission.

♫ Picking up the pieces

♫ Of where I should have been

♫ And if you see

Michigan State University has been devoted to recruiting, training, and retaining doctors in rural communities for over 40 years. We started in 1974 with the Rural Physicians Program up in Marquette, Michigan and we've expanded with the Rural Community Health Program down into the Lower Peninsula through the Midland Regional Campus and the Traverse City Regional campus. For several years now, Dr. Andrea Wending has been running the Rural Premedical Internship Program or the RPIP program. This program works with undergraduate students who are interested in pursuing medicine as their career. The program preference is premed undergraduate students who are from a rural community or have a significant devotion to a rural community. We run the program every summer and students are accepted through an application process. If you are interested in the Rural Premedical Internship Program, please visit our website at www.msururalhealth.chm.msu.edu. There you can find out more about the program, its requirements, and even apply.

♫ When I close my eyes and pray

♫ The song's rapt hold and wouldn't let go

♫ Until we went our separate ways

♫ Oh little town oh town

♫ I'm on your streets again

♫ Picking up the pieces

♫ Of where I should have been

♫ And if you see the side of me

♫ That brings me to your door

♫ Then hold me little town

♫ And if you see the side of me

♫ That brings me to your door

♫ Then hold me little town

Please visit our website at www.msururalhealth.chm.msu.edu. By joining our website, you could connect to us on Facebook, Instagram, and Twitter. You can also find out more about our musician. Music today was provided by Horton Creek and Bryan Eggers, a local musician and Michigan native. We hope you tune in next time to hear more from this Rural Mission.

to live up to our potential and make a positive impact on our world. Moving back to that small town that you swore you would never return to can also be a very brave thing to do. Think about it... Make a name for yourself in a completely new city? Or try to convince your high school English teacher that you are capable of managing their healthcare? For the students and doctors we are talking to on this episode, that is exactly what they've done! We also highlight a program that has been helping rural undergraduate premedical students matriculate into medical school and live out these brave, brave career choices.