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I was holding the pressure and he had a better angle to sew. In the process he also got my finger. I was just glad the bleeding stopped. I was ready to sew my hand in if it would just stop the bleeding." Part of the community's fabric Doug and Shelly coach youth football, basketball, and soccer teams, participate in 4-H with their kids and stay active in their church. Shelly helped start an annual 5K race that kicked off fundraising for the Castle Rock Wellness Center on Quinter's Main Street. The Gruenbachers have hosted several medical students from the Wichita campus doing their rural rotations, including Kyle and Amanda Miller, a married couple from Derby. After spending a month in Quinter, the Millers sounded hooked on finding a similar set-up. "I like that they get to do a lot more. And the atmosphere is just different," Kyle remarked. Shelly concurs, "You don't 'settle' for family medicine," she said. "Family medicine is one of the biggest challenges." Dr. Cayle Goertzen was working his first weekend emergency room shift at Republic County Hospital when a deadly two-vehicle accident on Highway 81 drove home the reality of his new situation. The crash killed two people instantly. A third was airlifted to Lincoln, Neb., with injuries that would leave him paralyzed from the waist down. "The great realization that hit me that weekend was how isolated we are from trauma care," Goertzen said. "You'd better be sharp in stabilizing those patients and making sure they can make it to the next level of care." Goertzen, who finished his studies at the University of Kansas School of Medicine–Wichita, has taken several steps to improve trauma care at Republic since his arrival in 2007. He pushed for the hospital to get Level IV trauma certification from the state of Kansas, helped reorganize the hospital's trauma room, and currently serves as director of the six-county North Central Regional Trauma Council. "We've really worked on this end of the hospital," he says of Republic's trauma room. "From birth through death" But for Goertzen, the real appeal of practicing family medicine in a rural small-town setting is that he isn't focused exclusively on providing trauma care or any other single thing. "Family medicine gives me the chance to treat patients from birth through death and everything in between." A typical day might see him giving a newborn his one-week checkup, stitching up a lacerated finger in the emergency room, doing what he can for coughs and colds in his clinic, and removing a gall bladder. Belleville is a town of about 2,000 people that sits just south of Nebraska. Although primarily an agricultural center, it draws crowds throughout the summer to the High Banks racetrack. "It was once touted as the world's fastest half-mile dirt racetrack," Goertzen said. Goertzen, 40, took a somewhat untradi- tional route to medical school. A native of Johnson in southwestern Kansas, Goertzen graduated from Tabor College in Hillsboro with a degree in biology, and earned another degree in medical technology from KU. He worked as a medical technician in a hospital lab for three years before deciding to go to medical school. "It's known that at the KU Wichita campus the medical education you get is hands-on," he said of his decision to attend there. Realities of small-town medicine Goertzen is one of four physicians and three nurse practitioners or physician assistants in Republic County. That puts the county just above the level of an underserved area, according to government criteria. But Goertzen said the larger region served by the hospital – including Thayer County in Nebraska and Jewel, Cloud, and Washington counties in Kansas – would qualify as underserved if the same criteria were used. Goertzen usually sees patients in the 26-bed hospital in the morning, then walks across the parking lot to his office in the Medical Arts Building, where he finishes paperwork and sees patients the rest of the day. He staffs the ER one night a week and one weekend a month, and performs minor surgeries such as tonsillectomies, colonoscopies, and appendectomies four or five times a week. Goertzen said he once had to wait for a surgeon to travel to Hillsboro to have his own appendix removed. "Historically, a family doctor doing a minor surgical procedure has been discontinued in many small communi- ties," he said. "In this town, it's been important to hold on to that tradition." He and his wife, Nikki, who works as an occupational therapist in Concordia, have two daughters. He enjoys deer hunting and golf and the occasional outing to High Banks racetrack. "Growing up in a small town, I always knew I wanted to go back to a small town," he says. As for practicing medicine in one? "Actually it's more than I could have hoped for." Dr. Cayle Goertzen, Republic County Hospital "Kansas Gayfeathers" by Rachael Barr, Flint Hills 10 11