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If you're going to live in the middle of nowhere, it's best to have your own ER doc on call at all times.

"Audrey! Audrey!"

Alarmed by the urgency of Bill's summons, I made my way downstairs as fast as I could without tumbling headfirst into the kitchen. From the kitchen I could see Bill staggering around the porch, holding one arm underneath his elbow as blood flowed profusely from an injury in the area of his wrist. My first reaction to the gory spectacle was frantic concern that he'd slashed an artery.

"Oh shit! I have no idea what to do about a severed artery! He's going to bleed to death before I figure that out. Would it be better to grab the first aid manual or should I try calling Jill right away?" I wondered as I dashed out to the porch.

Thankfully, it wasn't an artery. Before attempting to install a new belt on the dryer, Bill unplugged it and then stuck his hand in to remove the old belt. Unfortunately, he'd gotten his cords mixed up and had unplugged the washing machine instead. This miscalculation resulted in the dryer delivering a powerful jolt of electricity to his intrusive hand. The shock caused him to yank his hand out of the dryer with such force that it caught on something sharp on its way out, slicing open a huge flap of flesh at the base of his thumb.

Well, okay, compared to a severed artery, a big chunk of flapping flesh was something I could deal with, with some help from Jill, one of my very best friends who just happens to be an emergency room physician. It seems that whenever we really need her, Jill is waiting right there on her end of the phone.

At that time, the only communication we had with the world past our gate was a cell phone on speakerphone perched on a driftwood stand. If we touched the phone our feeble signal would disappear. I called Jill and described the wound to her. She told me to get the suturing supplies from the first aid kit our other ER doctor friend Steve had brought down to us. I informed Jill that I had no experience sewing up body parts and I didn't think this particular injury was a good one to practice on. She assured me I could do it and said she'd coach me along, since she was conveniently on speakerphone anyway. I assured her it was too big a job for my first time sewing a person. She told me it was easy. I told her it wasn't if you'd never done it before.

During our discussion, the skin on the big flap began to shrivel. Underneath the sizable chunk of lower thumb we could see a fair amount of tendon. Bill had sheared the meat off directly along the tendon without cutting it. What luck! After I informed Jill about the shrinking skin she asked me to send her a picture. I tried to send a photo of the gore but the signal wasn't strong enough. Once Jill realized what type of cut I was talking about, she let me off the hook and told me to bring Bill to Nicoya, two hours away. Without her advice to keep the wound moist until we could get it sewn up, we would have run into a lot more trouble.

At the clinic in Nicoya, I beamed with relief watching the doctor sew Bill back together instead of having to attempt it myself. The total stitch count was 23. The picture on my phone never did send, but for as long as I had that phone, every time I went to call Jill it popped up as her profile photo. Gross. That phone died and I no longer have the picture, but here's what the scar looks like to give you an idea of the configuration of the big boo boo:

We gratefully paid our bill of $91 for the visit, the stitches, and three prescriptions, and headed home.

A week later, Bill discovered why he should have given his thumb more time to heal before he got it all sweaty and sawdusty. It got infected. When we returned to the clinic, the doctor told us Bill would need a shot of antibiotics for the following three days. We told him we lived two hours away and we didn't have a medical facility nearby. He insisted we must have a clinic where we could get a nurse to give Bill the injections. We informed him that we only have a clinic on Monday morning in one direction and on Thursday morning in the other direction, and since it was Monday we were out of luck. Up until that point we'd been butchering the Spanish language but getting our point across, but when we told the doctor we had no medical personel at all in our area, he brought in a translator. The translator told the doctor that yes, we had understood him, but no, we didn't have anyone to administer the shots. The doctor shook his head incredulously. Even two hours away they think we're nuts for living way out here. It was decided the bartender from Pueblo Nuevo, whose other job is driving around on his motorcyle giving vaccines to babies, was the man for us. The next day as the sun dropped low in the sky, I told Bill he'd better get going to Pueblo Nuevo before the bar got busy. He flatly refused to go ask the bartender to give him a shot in the butt. "Most guys who go to a bar and ask for a shot and a beer don't mean that," he whined. I had to agree. There was nothing to do but go into my Audrey Obremski, Frontier Housewife routine. We called Nurse Friend Kim and put her on speaker phone. Bill dropped his trou on the front porch and I administered my first injection bathed in the slanting sunbeams of late afternoon. It was really quite simple.

We've had other more serious medical events (like the time Jill and Kim literally saved Bill's life over the phone) since then, but with each episode we learn something new. Since we moved, Bill has quit drinking and lost 50 pounds, and neither of us take blood pressure medicine anymore. Given a choice between living near a hospital in case we get sick or living a wonderfully healthy lifestyle in paradise, I'll take paradise.

Hopefully, someday soon we can have both.

Stay healthy! Eat your greens!

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