Rural Doctoring

My patient population here in New Zealand is mainly farmers and blue-collar workers. Blue collar workers are familiar to me from the US, but I’ve never worked with farmers before. I don’t know much about farming or about livestock, and this hampers me a little, in my doctoring. A patient will come in and say that their elbow hurts, and then explain that the day before they spent an hour holding up a feed hose. Rather than nodding and moving on to diagnosis, I have to pause and ask, “What’s a feed hose? Is it heavy?”

“Yes,” the patient will say, looking at me dubiously.

Or, I’ll have a patient who sprained their ankle. “You have to go easy for the next few weeks,” I’ll say. “Use crutches for the next few days at least, and try not to put much weight on it.”

“But who will feed the deer?” the patient will ask. “I own a deer farm, and I have to feed them every day. There is no one else who can help me. I can’t let them starve.”

I’ll be momentarily silent, trying to picture a farm full of deer, imagining how one would go about feeding them. Were they like other domesticated animals, and come right up to you? Or were they skittish like wild deer? Did you scatter the food around or put it all in one place? But these are not questions that one can ask, when there are only 15 minutes per patient. So I try to find a workable solution. “Could someone come help you out for a little while? Just for the next week or so?”

“It’s just me out there. I can’t afford to pay someone to work for me,” they’ll say.

If I knew more about the day-to-day details of deer farming, maybe I could come up with a clever answer, but I don’t. I can talk about ankles, but I haven’t the faintest idea how farms work, so my suggestions are not usually very helpful.

Another time, I’ll have a patient with a history of gout, and I’ll give them a handout about things to avoid eating if you have gout. One of the things on the list is wild game – venison, etc. “But I’m a hunter,” the patient will tell me. “I can’t stop eating wild game. That’s what I eat.” At least I have an answer for this one – “then you’re going to have to go on the gout medication, whether you like it or not.”

I’ve had a few patients tell me they are shepherds. In a land full of sheep, it is, of course, perfectly natural that many people would work as shepherds. But I like the word choice “shepherd” rather than “sheep-farmer” or something equally prosaic. The word itself has such an old, Biblical sound to it; there is an old-world romance in it. I’ve never met a self-professed shepherd back home in Connecticut. I know there is no romance in the day-to-day business of herding sheep; these men are not trekking mountains in their tunics and shepherds’ crooks. I still love the choice of word. The other day I was attempting to get to the bottom of a shepherd’s foot problem, and in the course of his history he told me that the problem wasn’t because his shoes were too tight. He explained that he knew this because he went barefoot most of the time. A barefoot shepherd. You just wouldn’t meet a barefoot shepherd in Connecticut.

Right now it is calving season, which (from what I can gather) is a very busy time for the farmers. The calves and the lambs are popping out right, left, and centre, and they are keeping everyone on their toes, not to mention butting the farmers’ legs and causing no end of knee problems. From what I can glean, international kids – maybe looking for an adventure over the summer break from  college; I don’t know – come over and work on the farms during calving season. They come in to see me too, for their carpal tunnel or their STDs. 

It’s sometimes embarrassing how little I know about farming in New Zealand. I actually only just recently found out why there are so many sheep in New Zealand. I had assumed it was to make hardy, warm, woollen sweaters that could be sold at exorbitant rates to tourists.

“We have self-shedding sheep,” a colleague of mine told me, when describing her own little farm. “It’s too much work to use the wool. You have to treat it or it gets yucky.” She then went on to explain that many farmers chose the same types of sheep, and pointed out that New Zealand lamb is sought after all over the world. She didn’t personally sell her lambs for meat, but rather slaughtered them herself, for food. She and her family were close to self-sufficient, on their farm.

I had no idea. I had been picturing idyllic farmyards, with little lambs frolicking happily around, anticipating their growth into sheephood with many happy years ahead of them, during which time they would be standing around eating grass, and periodically getting shorn to make an expensive sweater. It made me a little sad to picture all those knee-butting lambs getting turned into stew, although I suppose that if you compare it to what we do to animals in the US, it doesn’t hold a candle.


I am getting better about understanding the colloquial expressions here, although I haven’t gotten to the point of using them easily. When doing a pap smear, I have a wee sheet to give to ladies to put over themselves after they undress, but try as I might, I just can’t say “wee sheet” in a plausible manner. I’ve tried to say it in a casual, offhand manner, sandwiched between other things – “Take off everything from the waist down, and here’s a wee sheet to put over yourself, then you can get up on the table.” But I can’t pull it off and sound natural. Another word I can’t say is “pottle” which is (I think) a tiny pot. When you give a urine sample, you pee into a pottle. I can’t say “pottle” with a straight face. I have tried. I am never brave enough to say it in front of a patient, only the nurses or receptionists.

Some other New Zealand expressions that my patients use all the time (but I don’t, yet):

“Feeling crook” – that means they don’t feel well.

“Feeling flash” – that means they DO feel well. Usually my patients are “not feeling flash”.

“Good as gold” – that means they are satisfied with the plan, or at least, they want me to stop talking so they can leave my office.

“Back passage” as in “I’m having trouble with the back passage” – this refers to the lower part of the digestive system. I think.

“Cool bananas” – I only heard one patient say this, but I liked it so much I had to share it. I believe it is self-explanatory. You can’t say it with an American accent – you have to use a New Zealand or a British-type accent, “ba-nah-nas”


The only thing that I have felt particularly knowledgeable about, when talking with my colleagues, has been Lyme disease. I was at a get-together with some of the other young, female doctors in this part of the country, when (mysteriously) one of the other doctors brought up Lyme disease. I guess she had had a patient with it. He had traveled to New Zealand from Europe. She hadn’t known anything about the disease and had some reading material with her. The other ladies knew nothing at all about it, and wanted to learn more. Finally, something I knew something about! There are no ticks in New Zealand, just like there are no snakes, or crocodiles, or poisonous spiders, or mammals at all – except the ones that the Australians brought over. And so I taught the ladies all about the symptoms of Lyme disease, and how the lab test works, and how you treat it. I felt so proud, telling them that the town that was the namesake of the disease was only 30 minutes from my home in the States!

1 thought on “Rural Doctoring”

  1. Love it! Great stories, Mary Beth. Now you come into sharp focus, as did your dynamic girls in Toy Library and Disney on Ice. Hope you keep writing. What wonderful tales of an incredible year and the 4 formidable characters engaged in it!

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