A small town is a complex system

There are stories, and then there are tales

There are successes, then there are fails

I can say how it went

After the event

But I cannot disclose the details.

Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, traveled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I went back to traveling and adventures in temporary positions. Assignments in Alaska, rural Iowa, suburban Pennsylvania and western Nebraska have followed.  I finished my most recent assignment in Clarinda on May 18.  Right now I’m in northern British Columbia, getting a first-hand look at the Canadian system. Any identifiable patient information has been included with permission.


I don’t like big cities, I never have. I grew up in Denver, and I can remember thinking at age 8 that city held too many people for my comfort.  After I left home I kept moving to smaller and smaller towns until Bethany and I found ourselves on the Acoma Reservation in New Mexico, in a settlement of about 75, attached to the hospital.  Seeing a stranger would come up as a topic of conversation for a week.

When we moved to Sioux City we found ourselves inside a city limits holding 5 small towns with pockets of wilderness that contained deer, turkey, and mountain lions. The nearest buffalo herd roamed a river bottom 30 miles away, and once a wayward moose wandered through the county.

So I really enjoy this small town. It has a good grocery store and a wonderful recreation center.  Everyone knows everyone.  The first graders walk themselves to school.  Drivers on the highway, like most Canadian drivers, stop to let pedestrians cross.

Wilderness lives hard by civilization here. Enough black bear try to sort through garbage that dumpsters lock, and have signs proclaiming A FED BEAR IS A DEAD BEAR.  I believe the story (though I haven’t verified it) that when the fence around the dump got electrified, 50 grizzlies came into town and had to be relocated.

This town qualifies as a complex system in the mathematical sense of the word: the diverse components connect, interact, and can adapt.  A person could spend an academic career studying complex systems, or even one complex system, but, in brief, everything is connected to everything.  Changing one element changes every other element in a non-linear fashion.

I can’t talk about details of the case, but at the end it involved neighbors, friends, colleagues, and my wife. In many ways a test, with drama and irony it introduced Bethany and me to the community.

The aftereffects still ripple through the social fabric here. People recognize Bethany through a friend of a friend.  People introduce themselves as friends or relatives of those with close involvement.

But the real health impact on the community will come 21 days after the event itself. For some it will bring healing, for others, illness.


2 Responses to “A small town is a complex system”

  1. CytoP Says:

    I am grateful to you doc, for suggesting the Cytomel. I’ve been noticing significant positive changes from day 1 on it. I am very hopeful for continued improvement over these first 6 weeks! I read some of your blog. I’m happy you’re in this part of the world and hope it continues to be good to and for you so that you stay a while…. 🙂

  2. M Says:

    Intriguing 🙂

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