Emmett Chappelle

Emmett Chappelle on his time in Custer

Week One:

I arrived in Custer the Thursday before REHPS started and got moved into where I’d be living for the next few weeks. When Monday rolled along I met with my partner and we were introduced to Greg Swanson who is the Clinic Director for Custer Regional Hospital. He gave us a tour of the facility and informed us on the services they are able to provide in this rural setting and the challenges that come along with it. After the tour we drove down the street to Custer’s Chamber of Commerce and spoke with Fred about all the things to do in Custer and around Custer. We broke for lunch and met up at the clinic around 1:00 PM and went to tour the local YMCA. It’s a cool looking log cabin-esque building. Later on we had supper with Greg and Mark Schmidt at the Bugling Bull. Mark Schmidt is the CEO of the Custer Regional Hospital and is splitting his time between Custer and the Lead/Deadwood area. The food was great and it was a full day activities.

Tuesday morning I shadowed Dr. Lisa Brown and worked alongside a Nurse Practitioner student. The NP student and myself would interview the patients and present to Dr. Brown on what we found out and what we would recommend for the treatment plan. As a medical student finishing up my first year, I did not know nearly as much as I would have liked. Nevertheless, Dr. Brown was great in giving me important information to look up and also gave me the opportunity to take my first History of Present Illness from a patient of hers (I was pretty nervous). In the afternoon, I went to the Custer Regional Senior Care center and was given a tour of their facility by Becky Hove. She explained the services they provide and the challenges they have to overcome. A great experience overall. Later that day I decided to tackle the big hill south of town. I quickly realized how out of shape I am. But making it to the top was definitely worth the view!

Wednesday I shadowed Dr. Heith Waddell. A great physician who understands the current climate of medicine and the changes that should be made in order to improve the outcome of his patients and the community as a whole. He was very active in teaching me important practical information that will be useful later on down the road. It’s difficult to translate lecture material into clinical application because the method in which they are presented and the environment in which you use them are extremely different. However, Dr. Waddell gave me an opportunity to bridge the gap and have experiences to tie lecture material to clinical application. I was very appreciative of the time he took to teach me information from a practicing physician standpoint.

Thursday my partner and I left for Rapid City for the day. We spent 3 hours in the lab at Rapid City Regional and saw how the lab functioned as a unit. They cover a multitude of different tests and services from microbiology to blood blanking. Afterwards we went to the main pharmacy and met with Dana Darger who is the Rapid City Regional Hospital Pharmacy Director. He provided an immense amount of insight into the innerworkings of a hospital pharmacy and how the pharmacy as a whole functions under the Regional network. I also found out that he had lived in Pierre (my hometown) for over two decades. An incredible experience that will undoubtedly help my understanding of how different disciplines have to work together to provide quality care for their community.

Friday was an extremely busy day for myself as I was following Dr. Brandy Tarap. She was covering the Walk-In clinic and the ED simultaneously. I arrived at 7:45AM and met with Dr. Tarap and there were already 12 people ready to be seen. We saw as many patients as possible while taking the time to address their concerns and to implement a treatment plan. However, the ED started to receive multiple patients and we were called up. We saw a multitude of different cases in the ED and it was incredibly interesting. By 12:30PM we had a trauma enter the ED and I was able to see how all the departments come together to provide efficient care in an urgent setting. I was able to assist in some aspects which I am incredibly grateful for. I can definitely see why some individuals are drawn to emergency medicine. I left the hospital with a sore back and burning knees because I made the mistake of wearing dress shoes for an 8 hour shift in the ED. It was definitely worth it.

Over the weekend I hiked Little Devil’s Tower and visited Poet’s Table. Its great being able to easily remove yourself from the intense healthcare setting and to just walk through hills and trees with no one around (except my dog). Custer has been a unique and great experience for the first week.

Week Two:

Monday (6/12/17) we went to McDonald Chiropractic here in Custer and spent the morning with Dr. McDonald. We learned about the role chiropractors play in healthcare in a community like Custer. A great guy overall. Afterwards we had the rest of the day to relax and I did just that. Took my dog for a walk out west of town and enjoyed the nice weather.

Tuesday (6/13/17) we were able to spend some time in the Radiology department at the hospital which provided some valuable insight into what imaging exams were available in Custer. They explained to us the challenges they face such as not being able to perform certain exams and how they addressed those issues. My previous experience as a Radiology Technical Assistant gave me a reference point to compare their department to. Afterwards we met with their Clinic Dietician Lacy Burrell, she explained her role as a dietician here in Custer. Her main responsibility is diabetes education because a significant portion of their patient base are new adult onset Type II diabetics.

Wednesday (6/14/17) morning we met Greg Swanson in Hill City and toured their clinic which was recently renovated. A gorgeous clinic that makes you feel like you’re in a nice log cabin. We left Hill City and I toured their Rehabilitation Center. Jim Simons spoke with me about the services they are able to provide and the role PTs and OTs play in the management of chronic conditions. Afterwards I met back up with Greg and Brett and we headed down to Hot Springs. Ate at the China Buffet there and definitely ate too much. Met with Dr. Pruess at their Hot Springs clinic and toured the facility. We then left and went to Dr. Steele’s practice and toured his clinic. We left and headed back to Custer to relax and enjoy the weather.

Thursday (6/15/17) Brett and I left for Rapid City and met up with their Hospice team. I went to a couple hospice house calls with one of the hospice nurses. A valuable experience to have in order to understand healthcare from beginning to end. After the two appointments, we rounded with their in-house hospice team. We then headed back to Custer.
Friday (6/16/17) morning Brett and I went to Destination Dentistry in Custer. We spent the morning talking with the hygienists and dentist about the services they offered and challenges they face in a small community such as Custer. They are definitely staying at the forefront of technology and the new services dentists can provide for their patients. Afterwards, I spent the remainder of the day with Dr. Brandy Tarap as she covered the ED and the Walk-In Clinic.

Week Three:

Monday, Tuesday, and Wednesday Brett and I worked on our community project for the Custer site.

On Thursday I met with Dr. Nathan Wiederholt who is the optometrist at Premier Eye Care here in Custer. We spoke for a little while about how his scope of practice interacts with the physicians here in Custer and the common challenges he faces working in a rural community. In the afternoon, I spent time with John at Carson Drug downtown. We spoke about owning and running a pharmacy as a small business owner and the complexities that come with it. It’s great to see a locally owned pharmacy because they are becoming more and more rare as time goes on.

Friday I shadowed Dr. Tarap as she covered the walk-in clinic and the ER.

Week Four: