Joseph Bretschneider
First Week at Philip
I awoke early on Monday morning, crawled out from the homey basement of our generous host mother, stepped out onto the porch and took in a deep breath of some fresh Philip air. This would be the start of my rural medicine experience and needless to say, I was beyond excited. My partner for this excursion, Mr. Nate Smith and I would not have to wander aimlessly for long, as we were greeted with a sign at the entrance of the hospital welcoming us to the facility.

We spent the first day getting a formal tour of both the Philip Health facilities as well as the town. After enjoying lunch at the Steakhouse Lounge, Dr. Klopper pulled us into the ER and put us to work thinking critically on some interesting cases he had encountered on just our first day. The next couple days were filled bouncing back and forth between the clinic and the ER. We felt like part of the team right away. Part of this teamwork included a very important task of making a staff treat run to Ginny’s (a locally owned and operated coffee shop) for fresh fruit smoothies and gourmet coffee. It was easy to see why morale was high amongst the staff after just three days in town.

I spent Thursday afternoon in the Kadoka clinic (a Philip Health affiliate about 20 miles south) with Dr. Holman. On Thursday evening, we were invited to play in a local men’s slow pitch softball league. This was a great opportunity to not only meet new people outside of the healthcare setting, but also as a way to showcase our mad skills on the diamond. Friday was spent at the Dakota Country pharmacy, which gave me my first experience behind the scenes of a retail pharmacy. On Friday evening, we participated in “Grill your own steak” night at the 73 Saloon in town. The combination of a large cut of prime beef and my marginal grilling skills actually made for an excellent meal. Although we missed out on Scotty Philip Days last weekend, we did not miss out on Kadoka Reunion Weekend. I’m eager to see what week two will bring.

Week Two

The second week in Philip found me much more comfortable and settled into town. For this weeks blog I wanted to use this opportunity not to talk about the things I did, but the people I’ve met. At this point in my experience, I know much of the clinic/hospital staff on a first name basis.  You might think that Philip, SD is just an ordinary rural midwestern community, but there is certain uniqueness about it.

From Rapid City to the Missouri River, there is a 200-mile stretch of Interstate 90 with essentially one hospital in between. This means that thousands of people traveling east and west every day have but one place to go should a medical emergency arise on that stretch of road—The Hans P. Peterson Memorial Hospital emergency department. I’ve had the pleasure of being able to help people from all over the country already in times of great need a long ways from home. One could say that the little facility in Philip is a diamond in the rough. I’ve been so impressed by the larger than life hospitality provided by the healthcare providers and residents of Philip to travelers.

With a task this tall, it’s not surprising the hospital staff is so knowledgeable, prepared, and experienced. Dr. David Holman, Dr. Coen Klopper, and PAs Terry Henrie and Janell Gerberding have all been in practice here from 9 to well over 16 years. I can honestly say that each of these 4 providers is among the best and most thorough providers I’ve had the pleasure of working with. Combine that with an excellent and personable staff of nurses, laboratory services, imaging technicians, and other ancillary services and you’ve got yourself a healthcare unit capable of almost anything.

I’ve learned so much in two weeks here and have actually been having fun doing it. I’ve been taking call with Dr. Holman in the ED all weekend, which might not sound like most exciting thing to do over a Forth of July holiday weekend, however Waggoner Lake is close to town and the city of Philip puts on a excellent fireworks show with all the good stuff…not just snakes and sparklers.

Week Three
I can’t believe three weeks has past here in Philip already. This week started off with a Monday holiday, but we certainly didn’t take the day to relax. The Badlands National Park is just a hop, skip, and a jump from town and was begging to be explored on Independence Day. Nate, his girlfriend Madicen, and I hiked 8 miles through the majestic neatness-infested unknown surviving the threat of hungry prairie dogs, rattlesnakes, pesky big-horned sheep, and sunburn. This adventure was definitely an invigorating way to start the week.

Joe, Madicen and Nate hike the badlands over the 4th.

We spent Tuesday in the radiology department learning how to capture the crucial images necessary for proper medical diagnoses. Wednesday was spent at the Courthouse. No we didn’t get arrested, but we learned an awful lot about community health there. Heidi Burns is the nurse that oversees the region and she does an excellent job not only getting people resources that have difficulty affording healthcare, but also in promoting health and disease prevention for everyone in the region. We had a great discussion on vaccinations and used Burns as a resource to brainstorm ways to increase HPV vaccination rates in Haakon County as part of our community project.

The end of the week allowed me to spend more time in clinic learning how to better myself as a Physician Assistant. I was able to spend a few hours with Black Hills Orthopedics as they were doing outreach in the clinic as well. Saturday gave me a chance to get away again, so I spent the afternoon hiking through Spearfish Canyon. We wrapped up this week back in town with a Sunday Matinee at the Gem Theatre. The final week in Philip will definitely be a little bittersweet and I’m going to promise myself that I won’t cry.

Week Four
Our final week in Philip got off to a great start as we spent Monday morning at Silverleaf Assisted Living. It was interesting visiting with the residents and I’m still not sure who enjoyed the time we spent there more, them or us. Stemming from that, we were able to partake in some house calls on Tuesday and Wednesday mornings with the home health nurses. It really was an eye opening experience to see what it takes to follow through with the medical therapies that we prescribe for patients once they leave the hospital or clinic. It was so cool to me just how much the nurses here sincerely care about their home health patients and the lengths they will go to in order to ensure that these patients get what they need.

Thursday was our presentation day. We had been advertising all over town inviting people to come, but were really unsure what kind of turn out we’d get. To my surprise, we had over 30 people attend between hospital/clinic staff and towns people. The support was overwhelming and I feel blessed to have been put into such a warm and compassionate community.

Although week four would not mark the end of my time here in Philip, it would mark the end of my experience with the REHPS program. I have a few more days left to fulfill my obligation to my PA program, but leaving town will not be easy. I’ve learned so much over the last month. Not only was I able to make great gains in my pursuit to become a Physician Assistant, but I was also reminded of what is most important to us as individuals. That is community. We can be great if we surround ourselves with good people and a positive environment, and that is exactly what Philip, SD provides. Thank you to everyone that has helped make these experiences possible.