John M (Jack) Westfall is a Professor of Family Medicine and Director of the High Plains Research Network. Dr Westfall will be speaking at the forthcoming North American Primary Care Research Group (NAPCRG) annual meeting.
The High Plains of eastern Colorado have been referred to as a dwindling remnant of the “worst hard time”, reminding us of a not too distant past that included the dust bowl and westward out-migration to the West Coast. Rural Colorado has become mostly a crop-circle curiosity or a time to “put your seat into the upright and locked position” for the thousands of travelers that fly over at 30,000 feet. The small town of Last Chance, Colorado sits at the junction of 2 blue highways. It is home to just 22 residents.
Last Chance once had a Dairy King and 2 gas stations, and was for many, the last chance for food and fuel before heading east into the vast open plains of eastern Colorado. East of Last Chance is the end of Rocky Mountain vistas and purple mountains majesty. But eastern Colorado is much more than the irrigated corn circles and dusty dirt roads one sees from a 30,000 foot flyover. The vibrant life of rural community members is evident in their downtowns, coffee shops, health care, and schools. Rural communities have been discovering innovative local solutions to local problems for centuries. To experience those solutions takes time; windshield time, listening time, kitchen table time, friend time. How you spend your time is a choice. Since 1997, The High Plains Research Network’s job has been to spend time with people in eastern Colorado, engaging local residents to find solutions, and help make these solutions usual care.
John Steinbeck told the tale of families living East of Eden and reminded us of the inherent choices we make in how we live, where we live, and what we do with our lives. He brought to life the Hebrew word “timshel” that, despite various translations, finally means “thou mayest”, that is, you have a choice as to how you live your life.
And the people living east of Last Chance have made a choice to live out their days in rural Colorado, choosing to make the communities thrive, improving the education, healthcare, business, and agriculture. The Community Advisory Council of the HPRN has made the additional choice to help improve the health of their communities by full participation in the work and research of the HPRN. These farmers, ranchers, school teachers, students, and retirees identify health issues, develop programs, implement research, review and interpret results and disseminate their findings locally and nationally. They participate, create, innovate, share, see, remind, walk, dance, and work their day jobs. The people east of Last Chance choose to make eastern Colorado their home, their paradise. And the HPRN chooses to be with them and participate in their lives and work to improve the health of folks living in east of Last Chance.
Perhaps all our research is done east of Last Chance. Whether in small rural communities or urban inner cities, with diverse races and ethnicities, on clinical or translational or public health, our research faces the sweat and toil, weeds and vines that grow up around our work east of Last Chance. And that means we all have a choice how we spend our days. Our community has chosen to join us in the High Plains Research Network to strive for health. They ask us to choose to strive for health. They ask you to choose.
The North American Primary Care Research Group Annual Meeting is being held from November 12th to 16th 2016 in Colorado Springs, CO. CMAJ is a co-sponsor of the meeting.