Past HUGS Stories
- Sonal Sacdev - Cowra
- Claire Lawley - Moree
- Jess Bispham - Uralla
- Laura Kindt - Dungog
- Nicole Hall - Grafton
- Rosa Sacca - Walgett
- Dev Nathani - Narrabri
- Monisha Dharmi - Ballina
- Mervyn Poh - Dungog
Cowra by Sonal Sacdev
Born and raised in the city, I had relatively little experience of life in a country town, so when the opportunity arose to spend a week in Cowra in Central Western NSW, I was on board without a second thought.
Despite my slight apprehension at being in a place I had never even previously heard of, my hosts, Jen Richmond and her husband Dr Dave Richmond, made me feel instantly at home. I spent the days learning more than I have in two years of medical school sitting in with the doctors at the local practice, and my free time at home with Jen and her daughters, Grace and Phillipa and getting to know Cowra.
The week taught me so much, first and foremost, about the incredible efforts of doctors working in rural areas. Treating everything from skin infections to gastrointestinal or heart problems, diagnosing fractures, delivering babies … the list just went on and on. This incredible diversity of cases also gave me the best clinical experience of my time as a medical student so far, as well as demonstrating how varied an interesting life as a rural GP can be.
I was also very lucky to spend two days in Cowra Hospital, where I witnessed my first colonoscopies, gastroscopies and a pregnancy termination. This experience would not be afforded to me for at least another year here in Sydney, and was in fact the first time I have ever worn operating theatre scrubs. In the hospital, I was also exposed to the administrative side of medicine – sitting in on the staff’s preparation for the hospital’s next M & M (Morbidity and Mortality) meeting.
One of the issues that repeatedly came up during my visit was dealing with emergencies or critically ill patients. Though Cowra does have an ambulance service, the hospital is very small and is often forced to send patients to the larger Base hospital in Orange (about an hour’s drive away). Dealing with problems like this, which would never come up somewhere like Sydney, is something that rural doctors do every day, and the ingenuity with which they solved some of the unique challenges of practicing medicine in a rural setting was incredible to see.
Having had this experience, I can hardly understand why there is a shortage of rural doctors. The support and encouragement I received from the staff at the Medical Centre was extraordinary, and the doctors were eager to help me learn. The people in the community clearly knew their doctors well, and vice versa, and consultations often went far beyond simply the presenting complaint. People were keen to share their stories and allow me to take pulses, blood pressures and often perform the examination. The experience has developed my clinical skills immensely, and taught me much about life in the country –feeding the chooks and watering the veggies in the shade house gave me a chance to get my hands dirty.
I would like to thank the Richmonds for an amazing week, as well as all the doctors and staff at both the Medical Centre and Cowra Hospital, for making me feel so welcome and teaching me so much. Thanks also to Liz Wragge for organising the HUGS placements – it gives students and particularly city-dwellers an invaluable opportunity to experience life in a rural area. I urge every medical student to give HUGS a try – it completely changes your perception of rural medicine, and I will certainly be back.
Moree by Claire Lawley
As someone who had lived in Sydney, having never been further west than Tamworth (and that was only for three days!) or in heat above 35 degrees, I was not sure what to expect during my placement in Moree this January. I had an amazing, eye-opening (and not too hot) time and have taken so much away in terms of what rural medicine and life is like and where I might fit into it.
I was placed with Dr Ethel Gilbert, staying with her young family and attending the practice at which she worked. Here I was given insight into how the day of a GP runs. Watching doctor-patient interactions not only contextualised my clinical skills but communication techniques as well. It was great chatting to patients about their lives in and around Moree and what they did on a day to day basis. I’d also not been exposed to the diversity of conditions and patients we saw.
I was constantly reminded how truly multidisciplinary health care is. Dr Gilbert not only made use of her skills but enlisted numerous other individuals and groups to ensure optimal patient care. This also highlighted to me that it’s not doctors that are needed in rural Australia but also allied health professionals. It was interesting to note that certain pathology tests were actually sent to St Vincent’s Hospital in Darlinghurst, my usual base hospital. For anything out of the ordinary, waiting lists or travel to places such as Tamworth, Newcastle, Sydney and Brisbane (or both!) was almost expected by patients. Some of these had already travelled over an hour and a half for a consultation. While we learn about the shortages in health services and professionals at University, I was still confronted by this aspect of rural practice.
During my time in Moree, I was fortunate enough to spend a day at the Pius X Aboriginal Medical Service. Having heard so much about Indigenous health, particularly in the media recently, I felt privileged to actually see what goes on in these types of organisations. The chance to meet and chat with some of the patients was an invaluable opportunity. It was interesting to note facilities at the AMS that could give patients almost instant feedback about their diabetes management (Glycosylated Haemoglobin-HbA1c-testing) and lipid profiles (looking for high cholesterol particularly). This meant that patients could have tests performed, receive the results, see a Doctor with these and be issued with a management plan, including any required medications, all in a single visit. I was impressed with this as a way of addressing poor patient re-presentation levels contributing to the shocking Indigenous health statistics in Australia.
It seems like this type of service would be great to implement more widely.Time in the operating theatre at Moree District Hospital and the procedure room at the practice where I was placed exposed me to surgery which I would not normally see until later in my degree. I doubt I will meet surgical teams who perform such a range of procedures in succession-a rare occurrence in city and metropolitan Australia. A tonsillectomy, hernia repair and endoscopy was all part of a single morning’s work. The team tackled these completely different procedures with apparent ease. In the practice procedure room I learnt for the first time how to draw up needles and chat with patients during local anaesthetics. This gave me an insight into patient anxiety and the role health professionals play in addressing it.
The chance to just be part of life in Moree, including spending time with Dr Gilbert’s family, was something I really appreciated. During my “HUGS” experience I went to the art gallery, saw the council buildings, had lunch on the main street in town and even got to go to the “famous” Artesian hot springs. It was great staying with a family and just being part of their normal day. This meant getting to take the kids to day-care, picking up the mail and running into friends on trips absolutely anywhere in town. The people I met in Moree were a key part of making this experience so memorable. This included patients from a whole host of different backgrounds, the ever-giving health professionals of rural medicine and especially Dr Gilbert and her family.
I’d like to especially thank Dr Ethel Gilbert, Nick, John, Jacob and Tom for being so welcoming and sharing their experiences with me, including time in the Northern Territory with the Royal Flying Doctors Service. Also, a big thanks to Liz Wragge, for all her work coordinating and organising this experience. This “holiday” has encouraged me to continue my interest in rural medicine. In the future I hope I will be able to find a way to practice in communities such as Moree, rural health being such a large area of need in Australia. I’d urge anyone considering taking a student for a “HUGS” placement to do so, it’s really been a high point of my medical career to date.
Uralla by Jess Bispham
For 10 days in my September break, I was lucky enough to be hosted by Dr Phillip & Lorraine Brownlie on their lovely 3000 acre property ‘Matoni’ near Uralla. During the week I accompanied Phillip to the group practice where he works in Glenn Innes, about 150km away from Matoni. The 1 ½ hour drives to and from work provided a great opportunity to get to know Phillip, to chat about life on a farm and to soak up the view.
I thoroughly enjoyed watching Phillip at work, and was struck by the rapport he had with his patients. It was plain to see that this had been built as a result of the time he invested in talking to them about everything from their medical concerns to sheep and the possibility of rain.
I found that medicine truly is about lifelong learning, and was impressed by Phillip’s continuing involvement in seminars and the numerous postgraduate certificates he had achieved. At the practice I saw and participated in a great deal which I hadn’t had the opportunity to see on clinical visits at uni – including pap smears, hernias, a dislocated finger and skin lesion removals. Many of the people Phillip saw would have presented to the emergency department had they lived in the city. Phillip’s wide range of skills and versatility were a great asset in these situations!
I found being a rural GP definately isn’t all about medicine. Life on the farm kept everyone busy - between checking the heifers, riding the quad bike, exploring the farm and playing with the dogs, there was never a dull moment. I was fortunate enough to see two calves pulled during my stay.
One thing I’ll never forget was the scrumptious cooked breakfasts and the dinners Lorraine had a knack for having ready just as we arrived home. It inspired me to brush up on my cooking skills!
Phillip & Lorraine, thank you so much for your hospitality and for the lengths you went to to include me in the family during my stay! I had an unforgettable time, and hope to be able to visit again someday. Thanks also to Liz Wragge without whom the trip wouldn’t have been possible!
Dungog – A small town with a big personality
By Laura Kindt
In early December I had the pleasure of spending a week, for my HUGS placement, with Dr Phil Jeffrey and his family in the small town of Dungog, which is in the Hunter region of New South Wales. I spent a couple of hours on the train from Sydney, and the last few showed beautiful scenery – everything was very green from all the rain in that area, and I was fascinated by some of the smaller stations for which the platforms were just 5 metres long! I was met at Dungog station by Phil’s wife Tess, and her daughter Britta, who provided lots of entertainment throughout the week.
I went to work each day with Dr Jeffrey, who spends time at Dungog and Clarencetown surgeries, and accompanied him to Dungog hospital and nursing home, and also on a home visit. During this time, I was very excited to gain practical experience helping out in consultations; taking blood pressures, burning off warts, taking blood and giving immunisations. I also observed close up some procedures such as stitches and excision of skin cancers. It was very enriching for me to see in practice so many things that I have been learning about over the past two years; this often inspired me to revise these topics! Sitting through consultations made me realise how diverse the field of general practice can be, involving anything from counselling to minor surgical procedures. After practicing in Dungog for many years, Dr Jeffrey knows and understands his patients, and this is integral in his provision of their care. This is a key difference I observed between rural and urban practice.
Spending time in the community was also very enriching; in Dungog, everyone seems to know each other. During the week I attended the primary school music concert and the local dance concert in which Britta performed, and these events embodied a strong sense of community, which is also not as common in the city. It was fun to see a cattle sale in Dungog, another important social event; I had never been to a cattle sale and it was also a learning experience! I loved spending time in the country – the scenery is just beautiful and it was common to see kangaroos or koalas while driving home.
I had a lovely time getting to know Phil, Tess and Britta and their town, and learnt lots about rural medicine during my time in Dungog. Many thanks go to the Jeffrey’s for their kind hospitality, and to Liz Wragge from HUGS for her time spent organising the week.
Grafton - Jan 2007
By Nicole Hall
Being a city girl born and bred, I had little idea of what to expect when arriving in Grafton. I had never even heard of it before I realised I was going to spend a week there!
My hosts, Dr Paul and Faye Fowler, and made me feel very at home during my stay in their lovely home, and were keen to show me around the local area and ensure I got the most out of my time in Grafton.
After a plane and bus trip on which I was introduced to the famous ‘bendy bridge’, I found myself on the gorgeous main street of Grafton in the heat.
My work started nice and early on Saturday morning, with hospital rounds, as Dr Fowler was on call for the weekend. This was a great chance to see the hospital- it was very different and much more relaxed to what I was used to at St George Hospital in Sydney where I complete my clinical placements. The staff were all lovely and keen to show me around- I felt very welcome!
Indeed, this combination of hospital visits, working in the private practice, home visits and nursing home visits was a great way for me to encounter many aspects of health care, and I believe this would be a great advantage of being a General practitioner in a rural area. Also, the 5-10 minute trip to work each day was also a great bonus I’m sure very few in the city would have!
Even in my short time, I felt I got to know quite a few patients well. This is a clear advantage of being in rural practice, and indeed is one of my major motivations for wanting to practice in a rural area at the completion of my degree. I was surprised at and very appreciative of the way patients were keen to share their experiences with me.
I had some memorable experiences with Dr Fowler and one of the practice nurses, Therese Terry. As both were very keen for me to gain some practical skills, I had much practice at taking blood pressures, spirometry, reading urine dipsticks, assisting in the excision of a BCC and even suturing! I realised from this how impossible it is to put sterile surgical gloves on without contaminating them!
I was lucky enough to meet some lovely people from the town at Dinner parties; playing tennis with some locals on a tennis court where the thermometer showed the temperature to be in excess of 50C was an experience I will not forget! Grafton itself is a lovely town, and very flat, as I discovered whilst exploring.
I was also lucky enough to be given a tour of one of the local industries, Boral Timber mill. Jeff, my tour guide was very informative, I was amazed at the machinery and the size of the saws! The workers were all very happy to pose for photos, even taking me to the top of the storage tank for saw dust so that I could get the best view!
I enjoyed my time of Grafton immensely, and would have loved to stay longer! The fowlers were fantastic hosts, and I value the opportunity to get to know them. This trip was a great motivator for me to work in a rural area. I would encourage anyone interested to give it a go!
Walgett - December 2006
By Rosa Sacca
Being a city girl pretty much all of my life with few rural connections, I found it a curious thing that I became so passionate about rural health so early in my degree. At the time of my Working Hugs visit I had just finished my 1st year of Medicine at the Univerity of Sydney and was extremely eager to get more raw clinical exposure. From the 4-18 December I was invited by the lovely Dr Barbara Allan to stay with her in a little town called Walgett.
Walgett is located about 640km from Sydney in the north-west of NSW, about 1.5 hours drive from the Queensland border. It has a population of about 3000 people, 60% of which are of Aboriginal heritage. Walgett has a small hospital and two medical centres, one of which is Walgett Aboriginal Medical Service (WAMS). Dr Allan and WAMS hosted my experience in Walgett and I spent my time split between visiting the community with the health workers and observing the doctors within the practice.
Staying in an Aboriginal community and spending time listening to residents really illustrates the hard truths of life more than any well-meaning university lecture can. Although my stay was quite brief (2 weeks) I was there long enough to get a feel for the kind of hardships people in these communities face as well as the challenges that I will face as a medical professional. The broad range of issues that I was exposed to was not limited to health and included alcohol and drug abuse, domestic violence, unemployment and teenage pregnancy. Despite this Walgett itself is quite a resourceful, resilient town and due to the hard work of WAMS and other community workers it is not only facing up to its challenges but making significant progress in many areas.
My clinical experience included exposure to some of the many outreach activities run by the health workers for the community. There was White Ribbon Day, promoting an end to violence against women; the Grawin Clinic, a day visit by the GP to the remote opal fields; and an Aboriginal Elders Meeting, helping to eduate elders about health issues so they may pass the information on to the community. In addition to this I sat in on consultations with the locum GP and saw more medicine in practice than I had in my entire 1st year at university. The many procedures I witnessed ranged from drug and alcohol counselling to vaccination and from antenatal examination to the obscure Dix-Hall Pike manoeuvre.
As with any adventure it is the people that can really make or break the experience for you. My time in Walgett was highlighted by the support and help of many wonderful people. My host, the commendable Dr Allan and fellow housemates Debbie and David made my stay extremely comfortable and entertaining. Almost every night was filled with socialising, a delicious dinner, good wine and great conversation. I am also indebted to the locum GPs Geoff and Vivienne who taught me a lot about clinical practice and who I deeply admire not just for their bedside manner but for their perspective on life and humanitarian natures. The many health workers who I had the privilege of working beside included Philip, TJ, Courtney, Kelly, Justine and of course, the radiant practice manager Jessie. Without these people and many others my experience wouldn't have been the exciting and informative time it was and I'm very grateful to them all for their hospitality.
Overall my Working Hugs adventure was an extremely positive experience. I've learned a lot about rural Aboriginal communities and the challenges they face whether it be social, financial, legal or medical. Having been able to spend some time in such a community I am even more enthusiastic about rural health than I was before and can say that it would be a pleasure to return one day in a more professional capacity.
I would like to extend many thanks to Liz Wragge and Working Hugs for making this visit possible for me.
Narrabri - June 2006
By Dev Nathani
Fate threw into my hands the wonderful opportunity to visit a rural town in NSW and observe the operation of the healthcare system. This happened when I was fretting over my mid semester holiday schedule, noticing a gaping 1 week with nothing planned and an observing friend suggested the Working Hugs program organised by the NSW Rural Doctors Network. I checked the website and got in touch with Liz Wragge, the coordinator of the program who then painstakingly searched for hosts available specifically in that 1 week window. After some weeks, the decision was made for me to go to Narrabri. Being an avid traveller and an international student, the concept of visiting a rural town was exciting but I had no idea what to expect.
I was put in touch with my host, Sally Urquhart, a speech pathologist by profession and the Assistant CEO of the Barwon Division of GPs. The latter credential proved to be useful as her various connections allowed me to experience the entire range of healthcare systems in Narrabri.
Upon arriving at Narrabri Station by train, I noticed as Sally drove me to her place how different Narrabri was from my preconceived notions of a rural town. Narrabri appeared to be much more developed than I had expected it to be. There was an obvious absence of multi-storyed buildings but technology wise, I saw little difference. The agriculture and service industries seemed to dominate the economy.
I was indeed very lucky to have such a wondeful host who together wih her husband Hugh took great care to ensure I was comfortable. Over the next 6 days, each different from the previous, I experienced Narrabri and its populace in the best way possible. I was brought to social events to mingle with the residents. These were the opening of a new restaurant in town, a seminar on costume design and a dinner with doctors from the Barwon Division of GPs to welcome new additions to the Division. Each event exposed me to a colourful range of personalities present in such a small population. For the last event held in Moree, I had the luck of being flown over for dinner and back in a 6 seater aircraft piloted by a doctor himself. Now, how often does that happen?
Hugh brought me out to the farms surrounding Narrabri for a day to show me the agricultural industry. The trip was well worth it for I saw first hand how massive the farms were and appreciated the country landscape. I was lucky enought to get my first sightings of wild emus racing across the farmland.
Lest I give the impression that all was fun and play, let me get on to the main purpose behind my visit to Narrabri. The aim of sending city medical students into rural NSW is to let them experience how the healthcare system works in rural areas. Many city students I have conversed with seem uncomfortable or even averse to the notion of long term practice in the country. To demonstrate the realities of life as a rural doctor, I was attached to 2 physicians (Dr Sanjay Verma and Dr Michael Ling) who have been practicing in Narrabri for several years. The demographic differences between the population of Narrabri and the population of doctors were glaring. It was obvious that while the residents were predominantly Caucasian, the doctors were more likely to be international as overseas doctors are placed into areas of need ie: rural and remote areas.
Interactions with doctors in Narrabri and Moree proved to be invaluable as they helped to put my thought of rural practice into perspective.
Observing the doctors in Narrabri made me realise that doctors have to work much harder in rural areas primarily due to the shortage of doctors and a lack of specialists. This works as a double edged sword as rural doctors were much more experienced than their city counterparts and were capable of performing several procedures that their city counterparts would just refer to specialists. Also, living in a rural area means no traffic problems and the workplace is no more than 5-10 minutes away. Another advantage as pointed out by Dr Verma is how close the doctors get to the population. Often entire generations grow up with the same doctor. This greatly facilitiates communication and understanding between the doctor and patient.
I also had the opportunity to visit the community health service where I had the chance to observe a podiatrist as she attended to her patient, a mental health worker as she interviewed and counselled her patients and a nurse as she conduted tests on a baby to assess his overall health and his mother to ensure she was coping well.
Perhaps to give me a completely different perspective to healthcare, I was scheduled to spend half a day at the local veterinary surgery. Besides observing feline castrations, vaccinations and general visits, there was little else that I learnt but it was significant perhaps as it was the first time in my life that I had ever touched a cat or dog.
I spent most of the rest of my time walking around Narrabri admiring her simple beauty and contemplating on my options for the future. I have decided that I am certainly going to return to explore rural Australia and consider having some of my rotations here.
To all those who assisted in one way or another to make my trip wonderful and worthwhile, a big thank you from the bottom of my heart and to all starting medical students, do consider the Working Hugs program to clarify any misgivings you may have about rural practice. There is nothing to lose and everything to gain.
Ballina - December 2006
By Monisha Dharmi
I could hardly believe my luck when I learned of my HUGS destination: the beautiful town of Ballina, on the NSW north coast. Although I'd heard much about it, I was little prepared for the reality of what awaited me in what was to be one of the most enjoyable and rewarding weeks I've had.
I was greeted at Ballina airport on a balmy Sunday afternoon by my hosts, Dr Chris McKenzie and his wife Merryn. After having lunch in Chris and Merryn's hometown of Lennox Head, I was open-mouthed as I was driven around some of the seemingly endless beaches and picturesque headlands of the area.
My anticipation built as Chris told me about what was planned for me during the week (activities which held the promise of excitment for an otherwise sheltered first-year student!).
Early mornings were spent with Chris, doing the inpatient rounds at Ballina Hospital, and by 8am I was off to various specialists from whom I learned so much - I discovered that no matter how much reading you do, nothing beats practical experience for making information stick! Monday morning was spent with gastroenterologist Dr Howard Hope as he performed colonoscopies and gastroscopies. I've always been a firm believer in my strong stomach, but this belief was challenged when, upon being confronted with images of bowels on the screen before me, I promptly fainted and had to have a break before I could re-enter. Dr Hope re-assured me: "Don't worry Monisha - once you've fainted, you probably won't do it again". Here's hoping!
Most of my afternoons were spend at Chris's home-away-from-home, the fantastic Ballina Family Medical Centre. I had such a great time at the practice; not only because of all the things I was able to see and help with, but because of how amazingly welcoming and warm the staff were. From the super-efficient ladies at reception, to the four hard-working GPs, to the nurses, Di and Katie, who let me help them with things I would never normally have the chance to see, the atmosphere ensured that I couldn't help but feel at ease.
Tuesday morning was spent with Dr. Pam Weir, an ophthalmologist, as she flew through a series of cataract removals. For the first time, I was able to follow a patient from the process of admission, through anaesthesia and the operation itself, into recovery.
Wednesday is Chris's day off, so he treated me to my "cultural experience" for the week; a swim at beautiful Boulders Beach in Lennox Head, followed by a bushwalk over the headlands. I was gobsmacked at the untouched beauty of the landscape - a far cry from the congestion of the cities where I spend most of my time.
The afternoon was spent in Emergency at Ballina Hospital, and on Thursday morning I headed into theatre with Vascular surgeon Dr John Graham, where I witnessed the easy banter (on everything from politics to music) that lightens the mood in the operating room.
On Friday afternoon, to round out the week, Merryn and I headed into Byron Bay to do some shopping and see the famous sights. I can't wait to go back and spend some time enjoying the beaches!
I learned a great deal during my HUGS week, but the one thing which I know will stay with me is the welcoming nature and camaraderie which I witnessed as a defining feature of rural medical teams. Despite my inexperience, everyone was more than willing to let me into their worlds, teaching me so much as they went about their work. Perhaps this attitude can be attributed to the laid-back lifestyle of the area, but whatever the reason, it's definitely something that I'd like to be a part of.
I'm incredible grateful to have had the chance to be a part of HUGS. I was so lucky to end up in such a breathtakingly beautiful area, with a host family who I got along so well with. A huge thanks must go to Liz Wragge and the RMFN, and especially to Chris and Merryn for welcoming me so warmly into their lives for a week. This was certainly a week which won't be soon forgotten!
Dungog - September 2006
By Mervyn Poh
Having lived in a city throughout my life in Singapore, I had no idea what the countryside was like in Australia and I thought to myself, probably the HUGS program was the key to this door of opportunity. With no idea of what the program would be like, I decided to sign up for it since I would never get to experience new things till I get myself exposed to the 'uncertainty'.
Arriving at Dungog came to me as a surprise with only me alighting from the train station and one person waiting patiently at the train station who was my host for the program - Phili. She was the person who helped me arrange my schedule for my stay, along with Tess who is the wife of Dr Phil Jeffrey. Furthermore, the hospitality that she has showered on me throughout my stay was beyond my expectation.
During my stay in Dungog, I had the privilege to visit more of the healthcare services. I was introduced to the hospital, various doctor's practices, ambulance service, nursing home, neighbourcare services and even the veterinary hospital in scone. Amongst these visits, the most interesting place to be is at the doctor's practice. Not only did I learn some diseases through the explanation by the doctor but also get to have hands on experience of practising my blood pressure measuring skills and history taking skills. Of these practice sessions, the most daunting task was to draw a syringe of blood from a patient. Although I was not taught how to draw blood at this stage of my education, the proper guidance provided by Dr Duncan has definitely boosted my confidence.
The most meaningful part of my visit would have been the time I spent in the nursing home where I got to spend my time chatting with the elderly and understanding their concerns and needs. However, the ambulance service came to me as a disappointment because during my full day attachment at the station, there were absolutely no calls. On the whole, the visit has given me a better understanding of the healthcare system in Dungog.
Besides visiting the healthcare services, the HUGS program has given me a chance to explore the countryside. Some of the significant ones are cow milking, watching a polo game (never knew what polo was) and going to the Chichester dam which is responsible for supplying water to those staying in Newcastle. From a small and hectic country like Singapore, I would never have been able to be exposed to such experiences and this program has successfully provided me a difference perspective to life in the country.
Lastly, something that really touches me is the people of Dungog. There is this sense of familiarity and belonging when you walk down the town of Dungog. The friendliness and trust that the people of Dungog possess make you feel that you are part of the big family. I feel that the relationships are really valuable and hard to come by. My guess is probably that is what makes country people unique.
The HUGS program is really useful in providing us with a greater insight of the medical practice in rural areas and granting us with an awesome experience of life in the country. It is a program that I would strongly recommend to all urban dwellers.