Hard hearts and horse-drawn carts

The signs are what first caught my attention: “Welcome to Chesley — Population: 5000. Don't park here — Horse Drawn Carts only.”

I am in Chesley, Ontario, for Discovery Week — a program organized by the medical school at The University of Western Ontario, in which first-year medical students are sent to rural communities across southwestern Ontario for week-long clinical electives. For many of us, this is our first experience in a small town, let alone learning how to practise medicine in one.

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Rural Ontario signs surprise medical student. Image by: Jonathan Cook / iStockphoto.com

My supervisor is a family physician. As one of the only doctors in Chesley, her medical responsibilities are many — from emergency medicine to palliative care. She enjoys the variety in her work, but the flip side to having such a broad-based practice is the overwhelming volume of patients she sees each day. Rural family physicians, she points out to me, are some of the most overworked in the nation.

While seeing patients at the local emergency department, I try to get a sense of what they think is satisfying and frustrating about the health care they receive. Almost invariably, these patients say they are most frustrated about not having access to a family physician. In communities across southwestern Ontario, small and large alike, there are long lists of patients waiting to sign up with family physicians. Chesley, it seems, is no exception to the rule.

Near midnight, a teenager enters the emergency room with blood smeared all over his T-shirt. He was sharpening a hunting knife and accidentally cut his finger on the blade. As my supervisor gets ready to suture his wound, she tells me about the special needs of rural patients. Farming-related injuries are commonplace.

A lot of patients ask me whether I will return to work here as a doctor someday.

It would take a really hard heart to say no to them.

Recently, my anatomy professor was demonstrating the pericardial membrane. “Notice the thickness of the membrane — a very hard-hearted man indeed,” he jokes.

As for me, I will not be caught dead accused of hard heartedness.