MD? Who cares about that? The virtues of doctoring in a small town.


I had spent medical school and the better part of my adult life in another state by the time I matched into a medical internship back home. Such an opportunity allowed me the opportunity to enjoy a more familiar setting complete with the more bucolic and relaxing lifestyle I had missed for so long. Though not quite in my rural hometown, my intern year stationed me on the outskirts of the quiet farmland I had grown up on and undoubtedly served as the referral center for the typical agricultural accident or trauma more than a hundred miles away. Indeed, our trauma bay was once inhabited by a patient with the complaint of “Bobcat incident,” and we were unsure of whether he had encountered an angry wild feline creature or had simply overturned a piece of farm equipment, as both would be equally likely in our hospital.

It didn’t take long before I bumped into a familiar face. I was working in the emergency department one day when an elderly gentleman leaned forward, squinted at my name tag, and said, “You’re that little turd who used to hit my door with the newspaper.”

A little bit surprised, I responded with a puzzled gaze before flipping to the back of his chart where his personal information confirmed his contention. His home address was down the street from where I grew up, and not only was I once a newsboy, but his descriptor was probably accurate in characterizing the younger version of myself.

Our conversation soon shifted to the events of years past and the current state of our hometown. Unfortunately, his health had taken a turn for the worse over the preceding months, and he’d needed care that required transfer to my facility. He needed a procedure that I had never performed independently at the time. I offered to get him someone more experienced, but his wife insisted that I at least try first. The reason, she suggested, is that I was Ray’s boy (my father’s first name being Ray), and that was worth more than having some stranger involved.

Let this be a lesson for those unfamiliar with rural America. In the small town, your last name and handshake are typically worth more than your social status or income. Even if you are wealthy, why does that matter if there are few places to spend your money anyway? It doesn’t, and that is why family and morality trump financial measures of success. That’s why being Ray’s boy carries more weight than a diploma on the wall.

The lesson recurred time and time again over the course of my training. The heritage that I carried as the descendant of hardworking German farmers earned me a badge of trust among those patients of simple means and upbringing. This is where the ability to truly relate to people enhances communication to the fullest and dissolves barriers to understanding, and this is how you enter a realm in which the patient buys into your recommendation and takes ownership of his or her own health.

In reflection on my upbringing as a person of simple means myself, I try to carry with me the values and traits of my ancestors, otherwise I would be doing a great disservice to the name on my badge and to the patients who would expect nothing less. In honor of the Father’s Day that has just past, I cannot emphasize enough how the values instilled in me as a youngster by my father has served as a catalyst in the way I approach my career.

MD? Who cares about that? I’m Ray’s boy and proud of it.

As for the gentleman I met in the emergency department that day, I’d like to think that my conversation helped in his decision to stop smoking. Many doctors had tried to convince him to kick that habit, but he just needed to hear it from that little turd who used to hit his door with the newspaper.

Cory Michael is a radiologist.

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