Rural hospitals are closing their doors. Five hundred counties in the U.S. have no hospital at all. In rural areas, access is the issue. Many communities lack a primary practitioner, a clinic, a drugstore, or an ambulance. Even those communities with a clinic, staffed by a physician's assistant, a midwife, and/or a nurse practitioner, can afford to be open only a few days or hours a week.


Rural Closedown

Jeff Norman, a botanist, lives on a mountaintop in a rural area
that stretches along 60 miles of coastline and extends inland
into 1200 acres of wilderness. One day, while working on his
house, he accidentally cut open an artery.

The local Health Center, an hour's hike down the mountain,
then a twenty minute drive away, is open 14 hours a week.
The nearest hospital is an additional hour's drive from the Center.

 

He was up on the roof when it happened,
working the cap back onto the stovepipe,
the chill, this late summer, familiar as breathing.
It was time, before full winter hit, before cold
crept the mountain, to ready his stove
for its download of lumber

He'd cleaned out the soot from the six-inch steel
stovepipe, could smell it, could taste it powder
his mouth. He'd spent hours sifting out soot ash,
and was jamming the metal cap back on the
stovepipe, when it slipped like a knife-blade into his wrist

His arm went blood wild, an artery, a death slice,
years of forestry training, his hand clamped the wound
hard, the wound three inches across and half an inch deep,
blood pounding from under his fingers, he climbed down
from the roof, the dog barking, he left red moons of his fingers
along the CB, no neighbor to drive him

Then the hour's hike down, he clamped the wound
harder, three miles downhill, thoughts of Bob years before,
on fire crew alone in remote, sliced open his arm with a
brush hook. He'd known what to do but it left him,
tried to radio for help but it left him, lost blood,
passed out and left him barely rescued in time

He wouldn't panic like Bob. He began counting
coast live oak, one two seven madrone trees,
coast redwoods, three black oak and maul oak,
arroyo willows to canyon bottom, Tin House Road
and his car

Blood on his stick shift, north to the Health Center,
twenty minutes away, he'd make it he knew it, there,
the next curve in the road, there, the windows, the roof --
Closed

- Frances Payne Adler © 1993