There are a few pieces in this issue of the Journal that wander into the vernacular of Eastern North Carolina, and they hit their mark, touching both head and heart.
It's been just about 40 years since I traveled into rural Eastern North Carolina to moonlight two days a week at a Rural and Migrant Health Clinic while studying for a master's in public health at the University of North Carolina. I'd just finished three years of a National Health Service Corps commitment in the mountains of eastern Kentucky. Both communities were a far cry from where I grew up outside of New York City.
Articles in this issue show I was a poor pick for the UNC School of Medicine if they wanted someone to practice in rural North Carolina, which I did not ultimately do. Forty years has gone by and most of the reasons people better suited than me still don't stay haven't been remedied either. Though, as you will read in the following pages, we're trying, and it's getting better. Some.
I bought my first personal computer—an Apple II+—when I was in rural practice, but there was no internet there then, and there is little broadband now. The schools were poor, we drove miles to a grocery store, there was no cable, little entertainment, employment for spouses was sparse, and though I wasn't in solo practice in Kentucky or Eastern North Carolina, I was the only pediatrician for miles and miles. This meant that I saw adults as well as children, practicing at times well “over my head.” The social and professional isolation was—and these articles suggest, still may be—real.
But back to that vernacular. During my time in the rural South, plain speech evoked home and welcome and hospitality. People spoke straight and meant what they said, and they expected the same from me. They were kind and generous. Knowingly or not, they taught me to be a better doctor. I learned how to listen and how to hear. I learned how to earn their respect and be heard. They worked hard, earned less, and deserved better. The lessons I left with seemed like more than I gave. They sparked my career in public and community health and advocacy, and I try each day to live up to their expectations.
This issue of the Journal points to many ways we have, can, and are doing things better for rural North Carolinians. There is so much more to do to really get it right.
- ©2018 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.