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Beyond Norman Rockwell

Thugs made Therese Zink turn to her journal. While she was on an aid mission to Chechnya in 2000, her boss was kidnapped. Fortunately, after a month, he was returned but the mission ended abruptly. “Needing to understand that,” says Zink, “got me writing.”

Writing again, really, as the family medicine physician had pursued an undergraduate double major in English and theology and, as a resident here at Minnesota, studied literature and poems by physicians such as William Carlos Williams with faculty member Nancy Baker. Now, however, she is writing to share with others.

When she became a faculty member involved with the Rural Physician Associate Program, she saw an opportunity to help students do similar reflective writing. RPAP students are “on their own,” she notes, not able to share stories with peers on the wards. The program set up a secure Web site where students may post experiences—such things as encountering trauma; helping a birth in an Amish home; or caring for hometown patients they’ve known since birth.

Some students touch on universal emotions such as joy and grief, the first code, or the death of a patient, Zink finds on reviewing the stories. Students who show potential to go beyond simply recording to deeply reflecting will be invited by Zink to work with her. “Some do; some don’t,” she says.

Those who do have collaborated with Zink on many articles, including 11 stories published in journals such as JAMA, Academic Medicine and Minnesota Medicine. One recent piece by former RPAP student, now physician, Cesar Emilio Ercole reflected on the profound implications of an immigrant’s accident.

“This is much more than Norman Rockwell’s doctor,” Zink says of today’s rural practice. Cultural issues, robotic doctors, and exchanging health information electronically are part of a complex mix in rural practice. She has been collecting today’s rural health stories for The Country Doctor Revisited, which will be published in 2010.

Meanwhile, she also promotes reflective writing as a tool of professionalism among her physician colleagues at conferences. And word is getting around about her skill at mentoring students in skillful writing, the kind that brings a reader into the scene and moves them emotionally. Says Zink: “I’ve been getting request from non-RPAP students to write, too.”