What the heck are these guys doing?

Matthew, Weston and Nathan are first year medical students with a passion for community health and biking. Along with Daphne, a first year Veterinary student, the 4 companions will embark on a five-week trip through 1,000 miles of rural Oregon wonder. Along the way they will be working in conjunction with the Oregon Academy of Family Physicians to facilitate community discussions on improving local healthcare options. See our photo album

Sunday, July 31, 2011

Family, Friends and Eastern Oregon

It's been an eventful end of July for the crew.  Matt, Daphne and Wes agreed to take a few layover days at my family cattle ranch in Sumpter Valley.  The ranch has been in my family for over 100 years and is nestled between in the Elkhorn Mountains between John Day and Baker City.  I love sharing the ranch with visitors and could not have had better guests.  Matt and Daphne jumped right into work and moved cattle like seasoned ranch hands with the help of our trusty collie Roy.  Wes was no slouch and made short work of morning chores.  My sister, brother, mother, father and grandfather were all busy putting up hay but took the time to feed us and put us up.  Thanks family!  A special thanks goes to my Grandpa John for a dynamite send-off breakfast.

Mom, Dad and the Cyclists in Sumpter Valley

After stopping in to see the family we gave two presentations in Baker City, where I attended high school.  It felt like a real homecoming to be presenting to familiar faces at the Lion's Club and Baker City Democrats meetings.  The current Baker City Lion's Club president Chris Knoll is the clinic manager at St. Luke's Eastern Oregon Medical Associates in Baker City and kindly offered to give us a tour of their new facilities.  We were impressed by the quality of the clinic and the services they were able to offer to their patients.  Thanks for the tour Chris!

After the stop on my home turf we headed north towards La Grande.  The ride was just a tiny bit windy as we cruised under some of Oregon's newest wind turbines into Union, just a few miles before La Grande.  On our way through town Dr. Kim Montee flagged us down in the middle of the street.  Dr. Montee had heard we were riding through town and fortunately was looking at the right time to stop us for an unplanned visit.  Not only is Dr. Montee a family physician but he is also an avid cyclist, so we had plenty to talk about.   He showed us around the Union Community Clinic and a brand new mobile clinic that will be visiting schools in the small communities of Cove, Union and North Powder.  Dr. Montee then directed us to Papa's, his favorite local eatery.  We were all impressed by the BLT marketed as having over a pound of bacon.  I was the only one brave enough to give it a shot.

Matt Ponders the Windmills Outside of Union

Loaded down with a hefty lunch we finished the remaining miles to La Grande in time for a BBQ and an evening presentation.  My friend Nella Parks at Oregon Rural Action and Jillian Currey with the Oregon Rural Practice Based Research Network hosted the presentation.  It was really fun and a dedicated crowd.  They have been putting this up this weekend and treating us like royalty.  Thanks Nella and Jillian!

Daphne's Special Peach Pie
Tomorrow we leave at 7am from Mountain Works in downtown La Grande if anyone wants to join us.  Next stop, Wallowa Lake.

Wednesday, July 27, 2011

The Rose Colored Hills of John Day

We descended from the summit south of John Day, and then crossed the valley and climbed an 11% grade to the home of Dr. Bob Holland and his wife Karin Holland. Why do all these doctors live on top of mountains? :)

They very graciously invited us into their home, but then Wes and Nathan reciprocated by inviting Dr. Holland and his rotating 4th year medical student, Gabe, to a friendly game of golf at the local golf course. Little did the boys know that they were up against a very experienced golfer. After Dr. Bob easily took the game, they came back to the house for a party hosted by the Hollands. We were able to meet many of the physicians that work in the community, and it seemed like each had a medical student or resident in tow.

Right now the John Day community has a relative plentitude of physicians. Dr. Holland has his own family practice, and in addition to that there is another family practice that now has six providers. Their goal is to be able to see patients the same day they call in for an appointment or the next day, and for the most part, they have been able to do that.

We gave the presentation to a group mostly comprised of participants in the John Day Chamber of Commerce. They were a very interested crowd with lots of good insights and questions. One topic we discussed was the need for the community to both actively recruit and retain medical providers but to also support the local public school system. Many physicians and other professionals move to rural Oregon with their families, and so their children are going to be students in the local school system. One of their priorities is a healthy education for their children. This means that without a strong local school, physicians will not move to or stay in that community. This is just one more example we have found of the network of support necessary for a strong rural community.

The next day, we rode from John Day to Nathan's parent's ranch in Sumpter Valley. It was a beautiful ride - about 57 miles with three mountain passes all over 5,000 ft. The weather was perfect. We had a cool, overcast morning of cycling, and arrived to the ranch in time for lunch! Now we are slated for some work with the cattle and a presentation in Baker City tomorrow. We hope to see you there!

Sunday, July 24, 2011

Hot Hot Hot

We've found the heat now, there's no escaping it. The freezing rain of the Cascades is nothing but a distant memory. From Paulina we climbed long sweaty miles up through the Malheur National Forest to a high camp at Starr Campground. Initially we had hoped for a delicious stop in Izee, but were disappointed to learn that there was nothing there except an abandoned school house. Our hopes of a general store stocked with cold soda vanquished, we made due with a scrap of shade beneath a juniper tree on the side of the road.

This day would turn our to be our most isolated. We passed a few scenic ranches, but otherwise found our route civilization free. We left the sage and juniper behind as we climbed up into the Pine of Malheur - the shade much appreciated. It was our longest day yet, pushing up against 70 miles for the day and taking us over 700 for the trip so far.

In camp we made the acquaintance of a a very interesting gentleman. Jim Jenson is a 91 year old, retired anesthesiologist. He pulled into the campground late in the evening, and we all got to chatting. He related his story about starting out in medicine in 40's as a GP, then moving to anesthesiology in the 60's. We he started, they were still using ether! Now he's traveling around in his one of a kind RV, moving between California, Montana, and Idaho. Sounds like he's been through many adventures, and still manages to be a hit with the ladies! I think all of us dream to be as healthy and active as he is at 91.

Today's ride was fast downhill 16 miles to the residence of Dr. Holland in John Day. We're thrilled to be here, take showers, and enjoy the hospitality of the Holland family. Tomorrow we present to the John Day Lions Club. See you there!

Friday, July 22, 2011

Thunder Over the Ochoco

Trip Log: Day 18

We bid farewell to Prineville this morning and set our sights eastward. Some friendly bikers we crossed paths with a ways back pointed us towards route 380 in lieu of the less scenic and more traveled 26. The friendly advice paid off and we enjoyed a day of beautiful riding through the high dessert. Much of the road followed a branch of the Crooked River that provided us with several great blue heron sightings (GBH!!). We also spotted our third bald ealge of the trip!

Daphne lead the majority of our 60 mile day, earning her major steam donkey points. Flash Back: On our first day of the trip we stopped at the Tillamook Forest Interpretive Center and learned about an old mechanical beast of bourden that pulled giant logs down the hillside, a.k.a. the steam donkey. From that point on we have developed the custom of bestowing steam donkey points upon an individual who distinguishes themselves through feats of strength, endurance and gusto.  In other words, it's our trip's equivalent of getting a gold star in kindergarten.

The trek along 380 has been smooth and hot. The miles were melting away at a good clip as was our water supply. Luckily there were two towns on our way that proved to be perfect pit stops.  We pulled into the general (and only) store of Post, Oregon around noon and took an extended lunch break. Nathan and I indulged in the daily special, the meatloaf sandwich, while Daphne and Matt strategically supplemented their lunch with ice cream and coffee.  Slightly heavier and much happier, we continued to push east.

A few hours of riding later we arrived to the small hamlet of Paulina. Here again, the general store was the (only) pace to be. We met the owner, Rose, and got the word that we could sleep for free at the local rodeo grounds. That was all we needed to hear. We changed into our evening wear, kicked our feet up on the front porch of the store and delved into stories and laughs with a small group of locals. The unofficial mayor of Paulina, Greg, was even kind enough to share some of his famous barbecue chicken! After thanking the welcoming committee for their hospitality we pushed off for the home of the annual Paulina Amateur Rodeo.

The rodeo grounds are a perfect campsite - picnic tables, flat grassy areas for the tents and even an outlet to charge our beloved computer! After settling in we decided to host our own rodeo. The links below will usher you to videos of a few of our better attempts to last eight seconds on the wild bucking Kona Jake. We have all had a few cracks at her and so far Nathan holds the record at seven seconds... tomorrow's another day. Yeehaa!

It sounds like it's going to be even hotter tomorrow. We're hoping to hit the road extra early to take advantage of the cooler morning temperatures. That means it's bed time. Even bicycle cowboys and cowgirls need their beauty rest.

Buenos noches.


Eastward Ho! Over the Cascades We Go!

We last posted from the summit of the Cascade mountain range. It's all been downhill from there. We coasted from Willamette Pass onto the Cascade Lakes Highway where we spent a night at the beautiful but rugged Little Lava Lake. Wes burned us up some delicious burritos for dinner and we went for a twilight walk around the lake to spook up some deer. An added bonus was the view of South Sister, Broken Top and Mt. Bachelor.

We woke the next morning to a nasty Central Oregon rain storm. It was only a 40 mile ride to Bend but it felt much longer fighting through the wet and the cold. By the time we got there, we were frozen through. Luckily, we had a place to stop and warm up. Wes' parents and younger brother live in Bend and were kind enough to put us up for a few days as we recovered. We spent our R&R time soaking in the hot tub, eating too many cookies, reading, and watching the new Harry Potter movie. Matt thought it was probably the scariest one yet. Once the weather improved we took advantage of Central Oregon's natural amenities - I went climbing with my good friend Mary out at Smith Rock State Park while Daphne, Matt and Wes tested the water by floating down the Little Deschutes.

Yesterday we thanked our hosts and reluctantly departed. It did not take long to enjoy being back on the bikes. We were on the road to Prineville to meet with a community health advocacy organization called the Rimrock Health Alliance. We have been hearing great things about what Rimrock has accomplished in Prineville so it was a welcome chance to see for ourselves. Sharon Vail is the Executive Director of the organization and had invited us to join her and local medical providers for a discussion over pizza and beer. We soon learned that Rimrock Health Alliance was making a big difference in Prineville. As a non-profit health care advocacy group, they have been able to recruit family physicians, mental health workers, dentists and other providers. They take an active role in retaining these providers and making sure they are a good fit for the community. Yet their mission expands far beyond recruiting providers. They are improving the health care of their community while decreasing overall cost. One of my favorite examples was what the emergency department at the local hospital was doing to address dental pain. Prineville emergency room doctors had noticed that the number one reason for a visit was because of untreated dental pain. Not only is a visit to the emergency room much more expensive than a visit to the dentists office, but patients receive more effective care at the dentist than they can in an urgent care office. The physicians took this problem to the Rimrock Health Alliance to see if they could help figure out a solution. Rimrock helped bring in another dentist to town and increase the access to primary dental care. The emergency department started referring more patients to local dentists and the number of E.R. visits for dental pain is going down. This saves the patient and hospital money and provides better care. A real win-win project that seems so simple in retrospect.

We're finding that small communities are able to be much more mobile than their larger counterparts. It is really inspiring to see what big changes can be made in rural communities. For more about Rimrock, check out their website at www.rimrockha.org.

We now depart for John Day. We're taking the back roads from Prineville through Post, Paulina and Izee. A real adventure awaits!

Sunday, July 17, 2011

The Misty Mountains

We have entered a stretch of the trip that will be full of long days on the road and the beautiful high lakes of the Cascades. Upon the recommendation of Reedsport native, Brian Swift, we departed the coast along the Smith River.  It would be hard to ask for better biking. The soft rolling hills of the Smith River road treated us to two days of nearly car-free amazingness. For most of this section we were able to ride four-wide as we took in the incredible riparian scenery. At one point our relaxing roll was interrupted by three giant birds that tore across a break in the canopy. As they looped overhead it was hard to mistake the distinct feather patterns of two bald eagles chasing an osprey through the sky.  This was just one of many reminders that we were cutting through section of Oregon's wild landscape.

We emerged from the Smith River and stopped in on our gracious classmate and class Vice President Carrie Litchman for a night in Eugene. As has been the case along our journey, we were spoiled with hospitality at the Litchman house. After a full night's rest we were treated to a home-made french toast breakfast courtesy of Dr. Mark Litchman. Bellies full, we returned to the road for our first day of riding in the rain.

Despite a leisurely start to the day, we decided shoot for McCredie hotsprings in foothills of the Cascades. 60 miles and a few repairs later our weary muscles were enjoying a well-deserved soak in the hot waters along Salt Creek. Again, we benefited from some local knowledge and found our way to a hidden campground near a lesser-used part of the hot springs.

Today was all about the climb. We are currently eating lunch at Willamette Pass after gaining over 3000 feet this morning. After a calorie recharge and some stretching we will head for the Cascade Lakes Highway and find a lake to cozy up to for the evening. Tomorrow we will stop in Bend to say hello to my family and prepare for the next round of presentations.

Friday, July 15, 2011

My impressions of rural Oregon

For the past week I have been the photographer for the boys as they give all their presentations. As you have probably read, we have visited many little towns along the coast, and we have given presentations in Lincoln City, Florence and Reedsport. As we go along, they have been able to do quite a bit of networking, learning about being a physician in a rural place and meeting community members. That seems to be very rewarding for them. For me it has been a little different experience.

A little about me: I grew up in a rural town in Virginia and have moved around quite a bit, always to more and more urban communities. I was sure that I would be happiest in a city, but I am not sure that I knew why. It could be because city life is still new to me, or maybe because I feel good being anonymous, or maybe because of all the amenities cities have to offer. Regardless, I didn't see myself becoming going into rural veterinary practice even though I liked to think that it was still on my radar.

Travelling to these rural communities has changed my outlook. People we have visited have consistently said that the thing they like most about living in their communities is the close-knit relationships they have with their neighbors, friends and families, relationships that would not be as strong if they lived in the big city. The community feel that they are talking about is pretty infectious. We stayed in Reedsport for less than 48 hours, but we met most of the people actively involved in civic clubs and boards, and by the end of our stay, I felt like we had integrated ourselves into Reedsport pretty well. People knew us by the last presentation, and as we rolled out yesterday, it felt like we were leaving good friends behind.

It felt pretty good to be so integrated in a community like we were, and that is what has changed my mind about rural practice in the future. Even though I have been in the background of this trip, it has been transformative for my future practice plans. With that being said, I still haven't decided on a career path, but rural practice is officially in the running.

From Jul 15, 2011

Wednesday, July 13, 2011

Inspiration from Reedsport

View of the Umpqua Jetty

We're in Reedsport, home to the Dunes Family Medicine Clinic and Dr. Robert Law, our gracious host. We're spending three days here and blanketing the community with presentations to seven different community groups! We've already spoken to the local Toastmasters (and yes, we got evaluated just like all of their normal speakers), the Lower Umpqua Economic Development Forum, the weekly hospital MedStaff meeting, and the Hospital Foundation meeting. Tonight we present to the Lions Club, and tomorrow we'll be speaking to the Rotary Club and the Chamber of Commerce.

The presentations have gone well, especially thanks to the Toastmasters for their critiques and suggestions. But what I'd really like to talk about is the inspiring experience of this community. The Reedsport I've gotten to know over the last two days is an incredibly kind and service oriented town. It seems like every person we meet here not only holds down a day job, but has a second volunteer position in the school, at the hospital, or elsewhere. As Dr. Law puts it, everyone in this town wears multiple hats. Reedsport, to us, seems to be an example of a community that works because people are invested in it, invested in making it work, and in changing to keep up with changing social and economic climates. Reedsport is undergoing a massive demographic shift as the mills have closed and logging has dried up. And yet, although the economic climate has gotten worse, people are dedicated to living here and maintaining the lifestyle they love so much.

Presenting to the Coast Toasties
At the end of each presentation we ask the group what "the best thing about living and working" in their community is. Consistently we have heard from folks here that one of Reedsport's strongest aspects is its service ethic. A great example of this is the partnership between the Lower Umpqua Hospital and the local High School. Tara, the Director of Nursing at the hospital, has led the charge to create a series of college credit courses for high school students introducing them to different careers in health care. So far they offer two courses: and introduction to health careers and a medical terminology course. They are hoping soon to offer CNA, First Responder, and medical coder training. The hope is to inspire students to pursue careers in healthcare, and give them immediate skills (like a phlebotomist) that might let them pursue summer employment outside of McDonalds.

Inside the Umpqua Lighthouse
And its not just big organizations like the hospital that have impressed us. A local civic booster, Joe Coyne, has provided us housing during our stay. This isn't something he was pressed into doing by Dr. Law. It's something he does almost every week. As soon as he heard we were coming into town, he got in touch with Dr. Law to volunteer his place.  Last week he hosted a tsunami disaster expert who was in town to work on tsunami preparedness measures. After us he's housing an Oregon Coastal Trail activist while he's in town. It's just something he does because it's good for the community.

And I would be remiss not to mention Dr. Robbie Law himself. He's been in this community for 20 years, still maintains a busy clinic, call schedule and ER coverage. And yet he finds that time to volunteer in the schools, participate in multiple boards throughout town, host 3rd year medical students, and put together all the logistical work for our visit. In a lot of ways I think Dr. Law is perfect for this community -- committed to service and committed to keeping Reedsport an ideal place to raise kids and call home.

Monday, July 11, 2011

The Central Oregon Coast - Oh My!

With the exception of our dash across route 26, every mile of this trip has been beautiful. That said, I think we all agreed that today's section from Cape Perpetua to Florence takes the cake for breath-taking scenery. On top of the rugged coastline, this stretch is also studded with a number of amazing bridges courtesy of our main man Conde McCullough (check the classy photo!).

Yesterday we stopped in on Newport for a cup of jo, some cookies and a look at the Hatfield Marine Science Center. We parked under one of Mr. McCullough's bridges for lunch. Our appetites have been building steam along with the trip but fortunately the culinary skills of the group have been up to the challenge. So mom, if you're reading this, don't worry. We got a little fancy last night and whipped up some stuffed peppers. Ooo-la-la!

Later in the afternoon we set up camp in Cape Perpetua State Park and checked out some of the local splendor including Devil's Churn and a whale-of-a sitka spruce tree. We met an amazing family who were in the midst of a 13 month bike tour of the world. Julie (moma) and Martin (papa) were on the road with their four sons - Moses, Caspar, Turis and Herbie. All four youngins are are under the age of 5 = INCREDIBLE!! Check them out.

Today began with our first flat - Nathan of course. After a quick tube switch, it was smooth sailing on the rolling hills of 101. We treated ourselves to pizza and ice cream for lunch in Florence (we deserved it). From there it was a short trip south to our nesting ground, Jesse M. Honeyman State Park. I'm writing this post from a picnic table at the hiker/biker campsite. There are a bunch of other bikers here and it has been fun getting everyone's story.

Presentation two and three are on deck tomorrow. Nathan will take stage in Florence followed by Matt's late show in Reedsport. Our first double header! We are definitely looking forward to sinking our teeth into more presentations! There should be a lot to talk about tomorrow. Thanks for following.

Sunday, July 10, 2011

Coastal Update

Greetings from Newport! We're having a relaxing rest day in the city, eating cinnamon rolls at the Cafe Stephanie and enjoying life. Yesterday the Thompson's and their church members helped us depart Lincoln City by preparing a waffle send-off breakfast. Three varieties of waffle were prepared, my favorite was the sourdough but the rest of the crew favored the vegan oatmeal waffle. Their palates aren't quite as refined...

On our way south with the wind at our backs we made a stop in Depoe Bay to watch the charter boats shoot the inlet to the Bay. For those One Flew Over the Cuckoo's Nest movie fans, Depoe Bay was the location where McMurphy led the renegade fishing trip. I imagined myself in McMurphy's shoes, leading a group of escaped mental patients along the Oregon Coast. I don't believe that Wes, Daphne and Matt found the comparison appealing.

The cuckoos and I stopped for the night at Beverley Beach State Park last night in time to witness this -

They do sunsets pretty well out here.

This afternoon we sprint towards Cape Perpetua, so I must sign off. Thanks again to the hospitality of Lincoln City! Stay tuned for updates on our Tuesday Florence presentation.

Friday, July 8, 2011

The First Presentation

Today we had our first presentation here in the community of Lincoln City. We were hosted by Drs. Albert and Myra Thompson of the Bayshore Family Medicine Clinic. Early in the afternoon we had met Dr. Thompson, a Lincoln County family physician of nearly 29 years, and took a tour of his very nice Pacific City clinic. We stopped at Dr. Thompson's house on the way to the Community Center to freshen up, where we treated to a delicious dinner prepared by his wife and fellow Bayshore Practitioner Myra. And it wasn't just us she hosted! It turns out she had invited in friends, family and other colleagues, and the table was set for twelve. We could hardly believe her generosity as homemade cream of tomato soup and fresh made bread were served all around. Feeling refreshed and well fed, we then traveled onward to the center for our inaugural presentation.

We had spent the night before rehearsing, and were all feeling pretty confident as we walked into the Community Center. However, this was our first presentation, and there were bound to be a few kinks. Wes, as master of ceremonies, performed admirably under pressure when it became apparent that our beloved netbook which contained our presentation video might have given up the ghost at the most inopportune moment. He rearranged the presentation on the fly while Nate and I scrambled desperately in the background to find a new laptop and and figure out how to download the video. I would like to say that we responded to the crisis with such fluidity the no one in the audience was the wiser, but alas, this was not the case. Our supportive audience did not seem to mind the occasional delays.

Although the audience was small, they were all actively engaged. Several members of the Bayshore Clinic attended. Also in attendance were Allyson Longueira, the editor in chief of the Lincoln City News Guard, Linda Armstrong, a well spoken citizen from Depoe Bay, and Michelle Thomas from the Oregon Rural Practice Network. There was a lively question and answer session following the presentation, with a lot of discussion about how to expose more medical students to the pleasures of working in rural Oregon.

Other highlights of the day included a relaxed afternoon playing on the dunes of Pacific City, watching the dories race onto the beach, and a perfect ride along the gorgeous old highway 101 from Pacific City to Lincoln City led by Dr. Thompson and his son, Sydney Thompson. We are currently enjoying the hospitality of the Thompson family.  Thanks so much for putting us up!

Wednesday, July 6, 2011

Oregon Coastal Range: Check

I'm writing from the beautiful Tillamook Bay tonight. Yes, we have made it across the coastal range, in style I might add.

Our trip started with a bang yesterday morning. A great crowd saw us off from the alma mater, OHSU. Several of our classmates, faculty, organizers and well wishers were there to send us off. Thanks to all those who made it, we sure did appreciate the support and it added an extra boost to our days ride! The following photo is courtesy of friend Hanna Blake.
Out of the gate we were eager to log a healthy chunk of miles. Speed prevailed over scenery and we traded grimaces with the truckers down route 26. We made great time and were soon to the Wilson River Highway, Route 6. This section proved to be a much more beautiful and friendly. We settled down for lunch along Gales Creek before summiting the coastal range. Notice Nathan here, fresh as a daisy after a our first big climb.
From here it was a short coast downhill to our first night's camping spot along the Wilson River. We got into camp early afternoon and were quick to sit back and enjoy the summer afternoon. Matt and Daphne whipped up a delicious meal of couscous to recharge us for the next day's ride After an evening dip in the Wilson, we settled in for the night.

Our second day on the road comprised of an easy 22 miles ride to Tillamook. The scent of dairy farms grew stronger as we neared Oregon's cheese Mecca. We made a quick stop in town for groceries and then made the short trip to the Fuhrman family house overlooking the bay. After an adventurous trek around the property we cooked up some dinner and are currently settling down with the maps to scout the road ahead.

We're hoping to camp at Cape Lookout tomorrow and then have our first presentation in Lincoln City the following evening. We'll keep posting as long as often as we have i-net access. Thanks for checking in!

Monday, July 4, 2011

One More Day

Tomorrow is the big day! We're all busy making last minute adjustments to our bikes, packing gear, and shopping for food. At 9:30am tomorrow the ride begins!

I must admit that I have a few butterflies in my stomach. More than a few unknowns lie ahead. Beyond the usual "What have I forgotten?" type worries, I hope that our presentations are well received. We've practiced a couple of times, but you never know how it will work out until you're in front of an audience. More than that though, I just hope people show up!

Saturday, July 2, 2011

Home from Canada

Daphne and I just finished our Canadian pre-tour. We spent an amazing couple of weeks riding up the Sunshine Coast of British Columbia and down the eastern coast of Vancouver Island. Looking back at our pictures the theme was definitely B.C. ferries, gravel beaches and night time rain showers.

It was a great opportunity to get our systems down before we start the five week Oregon tour. We were really excited that despite the rain showers every night we stayed dry and warm. We definitely took too much stuff, and it will be nice to know what to pare down to make sure we're running as light as possible for the big hills of the Cascades.