Born in Havre

November 24, 2021

I was born in Havre Montana located sixty miles east of Chester on US Highway 2. My hometown Chester’s population hovered around 1000 from the year of my birth until my high school graduation in 1966. Havre, with a population of about 5,000, was the nearest town that had a hospital in 1948. Over my 73 years I have learned that bald population statistics do not clearly convey the particulars of my formative years. I try to further describe my hometown by noting that our city streets were not paved and we made daily trips to the post office to collect our mail. The post office was just a short walk from our house. Two of my classmates lived over 50 miles apart. I had been in nearly every house in town and I knew where almost everyone lived.

Despite its size, the town was not the cultural desert that many people assume. High school graduation rates were high and a majority of graduates sought and achieved higher degrees. Farm owning residents were mostly Republican, but a vigorous minority of Democrats sustained themselves. A small but resourceful number of art lovers organized and sponsored concerts, plays and visual exhibits. Hunters and fisherman were common, but the area also harbored birdwatchers, musicians, historians and amateur archeologists. There was minimal racial diversity but a few Plains Indian descendants sporadically sought refuge in the unwelcoming town. Religious diversity was limited to Roman Catholics or Protestants. Homosexuality was not openly recognized.

After I left Chester, I lived in larger towns. I practiced medicine in a town of 7,000 for ten years, and I still consider it a large town. Despite some obvious limitations of smaller towns, I remain sentimental to rural living. Some of the most intriguing people that I have ever met were from my motherland. Many of my better friends and family members still reside in or near Chester Montana. When I visit, I find diversity of opinion discussions generally respectful. I observe demonstrated values that are not detectable in my more populous current home. I regret that stereotyping small towns and rural residents is common, often denigrating and mostly inaccurate.

I hasten to add that rural denigration is probably from ignorance rather than malice. Media outlets are currently urging parents to consult their Pediatricians or (rarely) their nurse practitioners for advice about COVID vaccinations. On the surface, this may sound innocuous. But residents in small towns do not have Pediatricians. Likewise, women in small towns don’t have Obstetricians and men do not have Internists. In small towns residents of all ages and genders are served by Family Doctors if they are fortunate. Although I doubt that reporters intend to demean Family Doctors, the inference is there. If you do not see a limited medical specialist, you are not getting the advantage that is available to most Americans. To be fair, many rural residents do not feel insulted by this biased message. They are used to not having everything that city folks have and many chose to live in smaller communities because of other benefits.

But such national slights have unintended impacts. One impact is that Family Medicine is ignored and unappreciated by a large percentage of American citizens. Students who want to be medical doctors rarely say that Family Practice is their goal.   When I introduce myself as a retired Family Doctor people usually respond, “Oh you were a GP?” I often answer, “No I was never a GP because the specialty named Family Practice replaced General Practice in 1968 before I entered medical school”. I submit that more than 50 years is a long while for Americans to remain uninformed. I realize that many people think that GPs and FPs are synonymous, but that is a false assumption. I maintain that Family Practice is a solution to many of America’s healthcare problems despite the specialty’s virtual invisibility. I will attempt to make that case in some detail next week.

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