Always choosing your own adventure: the life of a rural GP

Ever since I was a child I have been drawn to the idea of adventures. The excitement of heading out from your safe haven into the unknown, meeting a variety of colourful characters along the way, relying on your wits to get out of sticky situations and of course learning invaluable life lessons as you go – who wouldn’t want a part of that! Fortunately for me, my medical training and early career as a rural GP has given me the chance to experience my very own adventures.

One type of story I particularly loved was a ‘choose your own adventure’ novel. If you were to read the story of my rural GP adventure, perhaps it would go something like this…

Journey to the Forest of Januvia
Page 1
Driving into the small town that will be your home for the next 12 months, you park outside the local bakery. After stretching your legs you enter the bakery and notice the variety of locals going about their day. You spot a young child at the counter pointing at a colourful cupcake. Glancing around the tables you see an elderly couple enjoying a cappuccino and overhear them talking about their upcoming bridge tournament. Lastly, you turn to find a stocky middle aged tradie heading to the fridge to pick up a bottle of iced coffee.
 
You order a flat white and a pasty. Just as you are about to sit down to enjoy them, the elderly lady has clearly become too excited and has collapsed.

Simultaneously you notice the young child’s mother panicking as the youngster begins to choke and splutter.

You have to think quickly: what will you do?

If you decide to tell the bakery staff that you are a new doctor who has just arrived in town and you offer assistance to the elderly lady, turn to page 27…

If you decide to attend to the child who seems to be choking on a lolly, turn to page 79…

If you decide that nobody in town knows that you are a doctor and choose to sneak quietly out the front door, turn to page 161…
 
The reality of daily rural GP life
Ok, so perhaps this scenario is a little unrealistic and I may have added some poetic license. For me though, having moved to a rural town in the Riverland of South Australia, more realistic scenarios of the medicine you can experience on every day would read like this:

Page 102
The tradie you noticed earlier presents at your clinic concerned about a recent episode of chest pain. You discover his father had a heart attack at age 52 and he is anxious about his own cardiovascular risk. You discuss modifiable risk factors, organise some baseline blood tests and make another appointment to address his keenness to stop smoking.

Page 72
A 52-year-old woman presents to you for her annual health check. You measure her blood pressure, organise blood tests and discuss the pros and cons of each test. You chat about how long she has been in the town and what she enjoys doing. On the next visit to get the results of her tests, she brings in a huge bag of home grown peaches for you to enjoy.

Page 146
You have just finished a busy day of consulting and are on-call overnight at the small local hospital. You are alerted that one of your in-patients, a 78-year-old man with new onset atrial fibrillation, is becoming more breathless and wheezy so you quickly walk to the ward to investigate. Your patient has severely increased difficulty breathing. You call for help from several of your senior doctors and bring the patient to the hospital’s resuscitation room. Over the next few hours you work as a team to stabilise the patient with a glyceryl trinitrate infusion for chest pain, CPAP mask to keep his airways open, urinary catheter, and intravenous access. The emergency retrieval service is on the way to transfer the patient to a larger central hospital where he can get more complex care.

I already think that a career as a general practitioner is extremely rewarding and the diversity of medicine you will encounter can be found in any practice. However, being a rural GP has its extra challenges and advantages that simply enhance and enrich this experience.

Becoming a rural GP is the best way to start your very own adventure today!

Dr Lachlan Mackinnon is Registrar Liaison Officer at GPEx, the South Australian general practice training organisation.