THIS LITTLE VILLAGE
There has been a complex story here since I cam in 1999. Dr. Robert Clary DO is key to understanding the Marias Health Center, as he has been a founder and leader.. This newspaper article explains a bit.
In the eary 2000’s, when trouble with Dr. Clary began, I was on unemployment and asked to apply for the job of ward clerk at the Marias Center, which specialized\ in older patients. some with dementia.. The clerk at the time was Mary Maxwell, a former lab technician and crackerjack ward clerk. She had worked so hard that she began to have symptoms and her doc asked her to take leave for a while. That was me. Before Maxwell they had never had a really good clerk and I was only marginally good enough. In Montana it is legal to fire someone at 6 months with no reason, so they did so that Mary Maxwell could come back. I agreed with this.
One entered through the nurses’s break room and Mary always cleaned up and restored order when she came in. No nurses did this. One wall was a big blackboard. In addition to formal records, Mary would record new patients in a circle on the blackboard that included their needs. The nurses went by these circles, but I could see no order. or system so people felt I was doing the wrorng things. On the time I was there, new software programs were acquired but none were easy to use. This continues. One failed experiment ws to seal all meds as prescribed into plastic bubbles. Nurses simply used scissors to borrow meds as needed when doctors weren’t there. Management kept thinking there would be make everything safe.
In those days the border was not closed and many nurses were “travel nurses” from Alberta. Someone had given the hospital a house where these women could stay. They were bonded friends. In addition were local women who sometimes served the nearby prison. Janet, the pharmacist, was high quality, fair-minded, alert. In addition to her was a specialist working on the claims indicated by medical coding. This was risky enough in terms of law suits that she kept a lawyer on retainer all the time. Both have retired.
Community secerts included an instance where a little circle of renegades shared drug needles, bodies, and booze. Effective treatment for Hep C was just starting but never caught up. These people had a super-mutation of Hep C. One had a “bad cold” and within weeks they were all dead. This is all “nurse gossip” — no media, motivated by the unpredicted small disease episodes.. Shelby is a port city with a highway running north-south and massive traffic flow east-west on highways, river and railroad.
Some nurses were exceptional. The Center was built in a closed circle do so one day Maggie Nutter, who was also a rancher, brought a calf and let it play all day in the yard where the old former ranchers could enjoy watching.. She has left nursing and does ag politics now. It’s hard to realize that so much has changed in a decade or so.
Dr. Clary had been instrumental in forming the county hospital in the first place. He was a DO rather than an MD and not just old=fashioned, but a bit of a throwback. One friendship circle of important men in the town backed him with total trust. Others found him out-of-date and objected. This is probably a common pattern in small local hospitals. Finally the state intervened and questioned the whole setup. There was so much trouble that Dr. Clary simply moved his practice to Cut Bank and continued. He practices in his own cliinic. Now that Logan has taken over so much, Glacier Community Health Center persists as independent in Cut Bank. Some doctors followed Clary. Other whole groups left. The situation is complicated by the demographics on both sides of the rez border. The tribal people have an Indian Health Service hospital but do not trust it.
Pondera County Hospital has a similar situation to Glacier and Marias. Logan dominates them. The rival is Benefis, 80 miles away and very different in culture than Kalispell where Logan management is centered. It is harder to cross Marias Pass from the high line towns in winter through the Rocky Mountains than it is to drive a long way to Benefis. At the moment there are 5 cases of Covid in Pondera County. (3,000 peeople) Marias rates are going up again. Great Falls, Bozeman and the Flathead valley have been and remain hot spots with over hundred cases daily.
(Pondera has an aging, rural conservative citizenry but an ncreasing number of people moving in who are more right-wing. A core of responsible, still-coooperating people remain.
It’s very hard to have sciatica, as I do at the moment, because I can’t drive and almost everything here is dependent on driving, almost like California. UPS brings my cat food. No one removes the results. There is no social worker interface who checks on people. City people have no notion of all this.
I”m just noting — I have no impact and can only wait for my sciatica to abate. There is no real treatment.
