Good Medicine

by Clay Scott
Photos by Clay Scott

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Beaverhead County, Montana
January 18, 2012

CLAY SCOTT: You’re listening to Mountain West Voices. I’m Clay Scott. If you’re in southwest Montana, and the subject of health care and doctors comes up, it’s a pretty good bet that you’ll hear the name of Ron Loge. Ron’s a doctor in Dillon, Montana, and over the last 30 years he’s probably travelled every road and visited every ranch in Beaverhead County. I was curious about what it’s like to be a rural doctor, and he invited me to visit him on his day off at his family’s cabin in the mountains. A five minute hike on snowshoes brought me to a rustic, Norwegian style building on the edge of a forest of Douglas fir. Ron was there with his family, including one of his daughters, Anna. It turns out she’s a doctor as well, and she’s just returned home to start working at Barrett Hospital alongside her dad. I got to visit with both of them about the challenges of rural medicine.

RON LOGE: There’s a very, very deep and committed relationship you develop with people in rural communities that is not at the same level as in urban areas, and that really is true in the medical practice. Because the people that you take care of you know, you see on the street, and you have to basically answer to them all the time. Not only in terms of the outcomes that you have to deliver, but also in terms of just interpersonal relationships. And these people end up becoming your friends; people that you share church choir with, book club with, committees with, campaigns with…so when you’re practicing medicine it results in an understanding of these folks, and what their needs are, what their expectations are…

SCOTT: Ron says a big difference between health care in an urban environment and a place like Dillon is that, for the most part, there are no specialists in a small community. But he doesn’t see that as a bad thing.

LOGE: To practice broad-based general medicine, means that you have to have a real grasp of the entire scope of medicine…it’s easy to become a specialist in one area and not have a sense of the bigger aspects of medicine…and I think people that practice rural medicine stay with it and love it because of that….it lets them be a complete physician
SCOTT: For a long time, Anna says she resisted the idea of becoming a doctor. When she finally did decide to apply to medical school, she didn’t even tell her parents for six months. Now she says she can’t imagine doing anything else.

ANNA LOGE: What is lacking in medicine everywhere, outside of rural communities, is the very personal and intimate nature of medicine, and that is what makes rural medicine so special. I knew that in my heart of hearts, but it has only been since I have come back to Dillon that I’ve really kind of found my love and passion for medicine again, because of that personal aspect – it is incredibly personal. I get to take care of teachers who mentored me growing up, and I got to take care of someone who used to cut my hair when I was eight years old, and I had completely forgotten about that experience until I walked into his hospital room, and introduced myself, and asked him what he did, and he told me he cuts hair, and there was this moment when I was just magically taken back to being eight years old and sitting in his barber shop, and having him cut my hair, and that was something that I had completely forgotten about for almost thirty years…but here I get to give back to someone who even did something as simple as cutting my hair, and it’s really, really wonderful to have that connection with people…

RON LOGE: It was in the Big Hole Valley in February. I had a patient who had a brain tumor, and she chose to stay in her ranch house, and spend her last days. It was a 75 mile drive one way, but I made a point of trying to see her at least once a week. She made it clear that she wanted to spend her last days in the kitchen. Because that’s where her friends were. Her friends were the moose, the chickadees, and the deer that would come and visit her front porch. So the last trip I made out it was a long, beautiful drive. The snow was falling quietly. I drove down the driveway. Large flakes. The spruce trees lining each side of the driveway were almost black against the white snow falling down. The rail fence had about three or four inches of fresh snow on it. And there was a moose that greeted me along the side of the road as I drove in. And she was in a coma then, and breathing very deeply, and quietly, and truly at peace, and not suffering at all. And this was going to be her last day. And I looked out the window, and there was a deer and moose looking in from through the woods…and there were chickadees on the window.

(SOUND OF CHICKADEES CHIRPING)

SCOTT: You’ve been listening to Doctors Ron and Anna Loge. This is Mountain West Voices. Our series is produced in association with the O’Connor Center for the Rocky Mountain West, a regional studies and public education program of the University of Montana. Additional support was provided by the Greater Montana Foundation. To see images of today’s story, and to hear dozens of archived stories from around the Rocky Mountain West, go to mountainwestvoices.org. I’m Clay Scott.