I love living in a small town in a rural area. So I love my day job, trying to recruit and retain medical professionals to the region. It’s a little like being a social worker for doctors: “You’ll love doing a one-month residency here. Let me introduce you to some people. Here’s a list of great places to eat, and the times of our local farmers’ markets. Have you visited the winery? Yes, there is a bookstore; my husband and I run it!”
And it’s a lot like being a hard-ass cynical lobbyist, hanging with policy makers and program implementers who think civilization stops at Roanoke, and southwest of that is a sign reading, “HERE BE DRAGONS.”
Remarks from a planning meeting for a statewide conference on rural health–to be held in Charlottesville: “Oh, since we’re discussing rural areas we should serve fried baloney on white bread for lunch? What a cute joke! And you’re the president of the board? Oh, how lucky we are to have your leadership!”
Being an advocate for what Stephen Colbert called “the last ethnic group it is socially acceptable to make fun of” is tricky. Advocacy always is. On the one hand, you’re begging for help, a very undignified position. “Invest in our infrastructure; stop colonizing our resources; ask us what we need instead of offering us what you’re prepared to give.” On the other, we need to stand on our own collective two feet. ‘Twas ever thus for any group coping with institutional AND individual discrimination, and with their own sense of responsibility.
Recently I got asked to speak about the cultural elements of Violence and Injury in rural Virginia. We covered from the clan to Christianity to substance abuse to coal mining incomes to educational attainment. And by the time I’d finished, they were staring at me with their arms crossed and anger in their eyes.
Why did you ask the question if you didn’t want to know?
Then a man stood and explained that he was from rural Virginia, and he had educated himself and gotten out of there, and this was the key to the future. I thanked him for his comment and suggested that a fine line divided “blame the victim” from “invest in our infrastructure.” And that a 15% annual drop in population in the 18-24 demographic, coupled with extraction-without-investment, was a heavy burden for any people group to bear and still be expected to “live like you do.” And that the attitude “Thank God the leak is at the other end of the boat” was as shortsided as it was unhumanitarian.
They uncrossed their arms. They blinked. They started asking questions.
As my friend Susan says, “People don’t ask questions if they think they know all the answers.” Did the world change yesterday? No. Did a couple of seeds land in some good soil? Yes. Also, that man came up and shook my hand and wished us well “down there.”
Hey, it’s a start.