Doctor Dagger Carves Up and Serves the Benefits of Rural EM Practice
An Interview with Edwin Leap, MD, Featured Speaker at 2010 Scientific Assembly Rural Section Meeting

Randolph Knight, MD
July 21, 2010

The alternating rise and fall of the bellows, steady airflow of a hand-cranked blower and sudden metallic clangs do not mean that this rural Emergency Medicine physician is using steam-engine technology to ventilate a critical patient.

Dr. Edwin Leap is just having fun with his children, in a way that only a small-town practice could provide.  In his free time away from a full-time position at Oconee Medical Center in Seneca, South Carolina, Leap enjoys blacksmithing in the forge he has erected on his 60-acre farm.  He lives on the farm with his wife Jan and four children and a number of hound dogs, including Ajax, who keeps watch while we talk this week.

“This is one of the reasons you do rural practice,” Leap reasons.  “You do things you couldn’t do closer to town, like have your own shooting range.  You have a freedom of lifestyle that will be wonderful.  If you enjoy activities like whitewater rafting or hunting, don’t travel for four hours to get there . . . go live there!”

Dr. Leap has shared his experiences in rural EM practice and rural living with his colleagues for the past 10 years in his monthly column for EM News.  He will now take center stage in front of ACEP’s Rural Section at this year’s annual meeting.  He will talk on Tuesday, September 29, in the Mandalay Bay Resort, Las Vegas, Nevada.  The first 190 attendees will enjoy a seated lunch sponsored by EmCare and The MedicAlert Foundation (see accompanying article).

“I’m thrilled to come to this year’s meeting,” Leap says. “I love meeting people with similar stories and look forward to making new friends.  I am also concerned about the plight of our specialty in rural areas.”

Leap plans to share his insights into what makes practicing Emergency Medicine in a rural setting special and challenging.

“Things out here aren’t the way the books said they would be,” Leap advises.  “When the chips are down you are on your own, the only doctor in the hospital.   For example, during one of the few times we’ve had snow down here, we had a fellow with a head injury in a snow sliding accident.  There was no helicopter and no ambulance.  We had to hyperventilate the patient all night long until we could evacuate him in the morning.”

“You have to be willing to learn from people who live here.  Don’t think people with Southern accents aren’t as smart as you are. If you do, they’ll smoke ya!”

ACEP members who attend the luncheon will get to enjoy the wit and wisdom of a West Virginia native who grew up “roaming the woods” and then planned to be a journalist, but who wound up veering into Emergency Medicine in the Blue Ridge Mountain foothills of South Carolina.

“I did not intend to become a physician.  I intended to be a columnist for a newspaper,” Leap recounts. “But my mother, who was a nurse, recommended I go into medicine.”

Leap had his career shift occur while still an undergrad at Marshall University.  After getting the hang of premedical science, he went on to West Virginia University for medical school and then a 3-year Emergency Medicine residency at Methodist Hospital in Indianapolis, Indiana.

He moved with his wife to South Carolina in 1993, where they have lived ever since.  Leap credits Dr. Bill Childs, who preceded him by a year in training, with luring him to his current post.  He also fondly recalls the influence of Dr. Jack Warren – a grandfather figure to the young Dr. Leap – who asked the essential question that helped make his rural EM practice successful: “Is this life going to make your wife happy?”

Leap had concern that first summer when his spouse said “You have moved me to the Hell! This is the hottest place to live in the entire world!”

One of the keys to happiness for his family has been their life on the farm which he describes as their “refuge.”

Dr. Leap’s mother couldn’t have predicted that Leap’s ambition to write for an audience would not be thwarted but would be enhanced by his role as a doctor.

Leap for the past 15 years has also written a bi-weekly column for the Greenville (SC) News, a Gannett newspaper.

Leap says topics for the two columns emerge from his life as a husband, father and doctor living in the rural South.  But the focus of the newspaper column is more on family events and regional culture. Readers particularly enjoy his annual Vacation Column for its gentle humor.

“When you take four kids to the beach or up into the mountains, funny stuff happens,” Leap says.

Yet when he describes a run-in between himself and a rattlesnake – an encounter that left one of them minus its head – his interest in medicine is apparent.  He sets up an instant dissection clinic with his kids where they explore the anatomy of the still-writhing creature.

His column for EM News, however, deals with issues of more interest to Emergency Medicine specialists.  He probes the social, economic and political challenges that shape his patients’ lives and responses to illness.  He can be startling frank about attitudes and behavior he sees at work.

“You really can’t write about how patients act in the local newspaper,” Leap says.  Yet he explores these themes in his EM News column, with the spin that only a rural practice can bring to his hospital work.  His rattlesnake story for this column would more likely cite the case of the snakebite pet owner who cleared out 36 vials of antivenin one day.

Leap says his wife and his children have different reactions to his side job in column writing.

“My wife is used to it, but I can’t say she enjoys it.  She knows it’s going to happen, though,” he explains. “My children love it.  They feel like it makes them famous.  Readers feel like they know my family.”

An old box of family pictures, from his boyhood in West Virginia, spurred him to write, Leap says.  He was shocked to realize he didn’t know the stories that accompanied the pictures of people in his family. So his own efforts remedy this by giving his children the stories of their own lives.

He also derives inspiration from writers such as C.S. Lewis and G.K Chesterton.

“These writers address the realities of the human heart with intellectual vigor and also with love,” Leap states. “The great writers show how people get to be where they are. Their stories contain Truth and Love and Mystery . . . and deal with matters of Faith and how the Universe works.”

Other inspirations come from modern authors such as Mark Helprin, Edgar Lee Masters and the modern poet Luci Shaw.

Leap says a particular literary form he loves is the Children’s Story.  He and his wife have enshrined the bedtime story in their family culture.  As his children move from early childhood into their teens, the stories include more and more science fiction.  Because all four children are homeschooled, Leap says, they have filled their hours with good books and their own writing, particularly when the summertime heat, hornets and wasps make exploring the woods near their home an unpleasant proposition.  When the first freeze hits, however, it’s time to get out into the woods as a family.

And that means deer hunting.

Not that the deer should worry TOO much.

“I enjoy hunting but I’m really bad at it.  I’m not claiming to be a “mighty hunter, fine figure of a man.” But it is just as much fun whether you’re bad or good because hunting gets you out of the house with your child to feel the cold wind in your face,” Leap shares.  To help his kids appreciate where they come from, he has them trying to chip spear points from the native quartz in imitation of the arrowheads they find lying around.

“Our ancestors were amazing people,” Leap recalls.  “They were able to survive by dint of their hunting.  And my kids and I have learned that working quartz, even when you have metal tools, is really hard.”

So don’t be surprised if the next time you try to chase down Dr. Leap, he isn’t off forging arrowhead chipping tools with his children.

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