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Small-town physician feels at home in St. Francis

Brown works at the Cheyenne County Hospital and Cheyenne County Clinic. St. Francis sits about 15 miles from Nebraska and Colorado. The town has about 1,300 residents and the county another 1,000. The hospital serves patients from adjoining counties and states as well.

"Physician, heal thyself" is more than a proverb to Dr. Megan Brown. Earlier this year, she was the only medical provider around this small town in the far northwest corner of Kansas. And she was sick with the same bug many townspeople had.

"I couldn't keep anything down," she said. "I ordered some IV fluids for myself and some medication so I could keep working."  

That's one of the challenges of being a small-town physician, and Brown wouldn't have it any other way. She had been practicing here about six months when she suddenly became the only doctor in town thanks to another physician's retirement.  

Brown didn't panic. The responsibility is exactly why she became a family physician.  

"I really liked the feel of the practice," Brown said. "It lets me do everything I wanted to do, everything I was trained to do."  

As she talked, Brown was expecting to do one of her favorite procedures - delivering a baby - later that day. She has delivered about 50 in her two years here.   Brown works at the Cheyenne County Hospital and Cheyenne County Clinic. St. Francis sits about 15 miles from Nebraska and Colorado. The town has about 1,300 residents and the county another 1,000. The hospital serves patients from adjoining counties and states as well.  

Brown, who grew up in Hutchinson, says she knew early on she wanted to be a physician. Her best friend's dad was a doctor and her own father switched careers from selling cars to become a nurse. "I think I told my mom when I was four I was going to be a doctor."  

Brown earned a biology degree from Lawrence University in Appleton, Wisconsin. She spent four years working in medical research for KU in Kansas City before being accepted into medical school. "I enjoyed it, but definitely would not have been happy doing anything else" other than practicing medicine, she said.  

She spent two years on the Kansas City campus and six months on the Wichita one before completing her degree in Salina as part of the rural physician track program. She also completed her residency at Smoky Hill Family Medicine in Salina.  

Brown met her predecessors in St. Francis - Dr. Rebecca Allard and Dr. Mary Beth Miller - while doing her rural and advanced family care rotations there. Allard moved to Nebraska before she arrived, and Miller left for California six months after Brown started. Brown said Miller told her of her plans beforehand. Following that came the retirement of the town's only other doctor.  

Brown knew she'd have company before much longer. A fellow KU School of Medicine grad, Dr. Dallas Walz, arrived about six months later. Brown knew Walz from medical school and residency in Salina. "We knew we worked well together."  

The two see patients in the clinic, hospital and area nursing homes. They alternate being on call in the hospital emergency room and also staff an outreach clinic in Bird City, a town of 500 about 15 miles away, at least twice a month.  

Brown sees a lot of children and mothers, while Walz focuses more on elderly patients. "We really get to know our patients here," Brown said. "I like that connection."  

The ER sees its share of serious cases. Brown said she treated seven young victims of vehicle rollover accidents in one week, caused by reckless driving and crops obscuring vision on country roads. Oil field and farming mishaps are common, as are some chronic illnesses such as COPD, diabetes and depression.

"Farming is a tough job," she said. Brown said she has patients who refuse to be transferred to a larger medical facility. "They say 'Take care of me here. If I die, I die.'"  

When she does transfer patients, it's usually to Denver, Hays or Kearney, Nebraska, and it's not always easy. One medical transport plane was grounded on the runway in Denver for several hours while a premature baby awaited. "Weather is a challenge," she said.  

In that case, Brown said, she telephoned an emergency room physician in Denver, who agreed that she needed to perform a needle decompression of the chest.

She's encountered other challenges related to practicing in a small town, such as finding masks small enough to fit babies' eyes when treating them with sunlamps for jaundice.  

The hospital typically keeps only about four to six units of blood on hand, although Brown said surrounding medical facilities are good about sharing in an emergency. And even though the town's number of medical providers is limited to herself, Walz and three physicians assistants, she said, "You'd be surprised who shows up" in an emergency.  

The area has what Brown calls a significant illegal drug problem. For that and depression, Brown often recommends that patients get mental health counseling.   Brown tries to practice proactive care, too, talking to senior citizens about their health and measuring blood pressure at a senior citizens' center, and giving away bicycle helmets to children during a recent fair.  

The town's population nearly doubled this spring when cyclists with Bike Across Kansas arrived. Brown and other providers offered a $25 walk-in clinic for participants. She treated one cyclist after an accident in which she broke her arm.  

Taken altogether, she said working here "is the kind of practice I was looking for. I was really looking for somewhere to stay."    


KU School of Medicine-Wichita