Comment by throwaway787544 | Hacker News Reader

Comment by throwaway787544 | Hacker News Reader

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throwaway787544

I live in the outskirts of a poor rural town in NY. We have 2 bars, some restaurants, a coffee shop, a fast food chain, some dollar stores, a grocery store, hardware store, antiques, gas stations, etc, Library and a little theater, farmers market on weekends. River runs nearby with a put-in for kayaks and fishing. Biggest town/city nearby with big box stores is about 45 minutes. They have fiber internet here but it's very expensive and the 300/20 Mbps is fine for me. 5G varies by region & provider.

Honestly... It's kind of great. The people are nice, the scenery is gorgeous, it's pretty quiet, and most everything you need is right in town. Since the community is so poor, all the housing is cheap. Nearby towns are all bought up as second homes for expats. Everything outside town is an old farm.

The worst thing about the place is it's a minimum 2 hour drive to anywhere, and having a car is mandatory to get here. But if you have everything you need, there's no need to leave. There is no Uber/Lyft/Instacart/GrubHub, don't expect any startups here. Cell service outside of towns is mostly nonexistent. Also know that none of your old friends will ever visit because it's way too inconvenient.

The only things I miss are "big city" things and more people around into the same things I'm into. And an international airport would be nice, but it's not like I was flying around the world every weekend before.

I'm curious, how do you people deal with medical emergencies? I live in a city and I have 3 24x7 hospitals within walking distance. I have gone dozens of times on foot at 3 in the morning to get medicine.

"It depends."

My town actually has an E.R. and urgent care. We have a CVS in town too (my town has a lot of stuff!!). There are also medical taxis (there are no regular taxis here) and private hire ambulances that'll take you if you need a different hospital.

Typically you get the number of the closest general doc to you, and make good friends with your neighbors, so somebody can drive you to a hospital right away if you cut your leg off in the middle of the night. Could be a long way off or right around the corner, it depends.

The biggest thing I never anticipated? Car parts. My brakes went and rather than bring it to the local mechanics I tried to fix it myself. Walk into town takes about 40 minutes, getting the right parts took weeks.

Power also went in the spring due to freezing rain bringing down trees. Cell signal went, along with power and internet, and my water well's pump is electric; heat is propane but the damn heater's thermostat went, probably electric too. So being prepared to be off-grid once a year is useful.

Why did you struggle to get car parts shipped?

Stripped a bolt. Luckily our town also has an auto parts store (we have a lot of stuff!!) and they had those giant stripped bolt extracting sockets, but no replacement bolt.

Have you ever tried to find the rear brake caliper housing assembly bolt for a 2nd gen Scion xB? Not the slide pins or bracket bolts, the housing assembly that holds the whole caliper onto the wheel. Nobody sells it, you have to get it from a dealership, who's 2 hours away and ships via USPS (there is no way to get there without a car). They then screw up which part it is because nobody ever orders this bolt and the parts diagrams don't label it well. So you wait for a different part to be shipped again. All after getting the normal brake parts shipped and trying to install them which took a week on its own. So about 3+ weeks.

(If you have a second car you could maybe go around hardware stores looking for an identical bolt, but even then the steel and threads may be different, as different bolts have different torque specs due to whether that bolt's threads are supposed to stretch or not in order to bind. These bolts are very low torque even though they are for a caliper assembly)

Lots of America just deals with them poorly. The nearest hospital might be an hour away. Or more. Usually better than that in New York state, at least.

Something to think hard about before you embark on your small town life journey.

I have gone dozens of times on foot at 3 in the morning to get medicine.

For starters, the number of times that myself or either of my former or current spouses has felt the need to seek out a vendor of medications at 0300 has been...zero. That said, and I don't mean to be trite, you deal with it by living like you live 2 hours from an ER. Know your first aid, make doubly sure to keep those fingers away from that table saw (and even that won't likely kill you before you get to the ER). That, and just don't obsess over it. People have lived far away from emergency medical care for many years. Sometimes they die as a result. Sometimes people die driving to the ER that's right down the street. But me and my house, just because a hospital could be close to home doesn't mean it has to be.

(Says the guy smack in the middle of Redmond, WA within a long walk to the ER...or a five minute drive. That hasn't always been the case, however.)

He is in Srinagar, Kashmir. Probably the vendors live above their shops and will open up in an emergency.

nope. unlike your "idea", the picture you're painting must've been 20-30 years ago and definitely not now.

we have SMHS hospital which is a superspeciality/emergency, around 3 Km away is JVC hospital which also has an emergency and another 5 Km away is soura hospital which is the biggest hospital in the area, again, has emergency wards.

then we have some smaller, privately owned hospitals in the city itself so that is where people get treated.

Well my mistake then.

I'm not sure where you are, but maybe the medical system is set up a little differently?

I say that because I know when I met my wife (who was used to the Chinese medical system) she was used to a hospital being the be-all end-all of medical care and very frustrated with the level of service she received... until I introduced her to the clinics and other places she should have been going to have most things treated.

If you're taking yourself to a hospital here without some sort of referral from a doctor you're generally entering through the emergency department which is set up to treat emergencies. Things that will kill you in short order. If I go in for "medication" and it isn't a situation like "I've run out of my life-saving medication and I need a dose to get me through to morning." I'm probably just gonna spend the night sitting in the waiting room. Likely longer. It'd be like putting a P5 ticket in for a team whose responsibility is dealing with P1/P2 tickets. You're gonna be waiting a while for the other higher priority issues to slow down long enough for them to catch up and run out of things to do. If you're lucky they might sneak you in sooner just to avoid blowing the P5 SLA, but even that will only happen if they're _mostly_ caught up on P1/P2 issues.

If it's immediately life-threatening, I call an ambulance. They're about 5-10 minutes away. Not the best, but that means I can get someone with a moderate amount of medical training focused on "keeping you alive" to me in about 10 minutes. If it can't wait until morning but isn't going to kill me in the next hour, I can drive or be driven the 45 minutes to the hospital.

Anything else (like getting medication to treat a condition) I'd just wait until morning and see a normal doctor at the closer clinic. They can provide basic diagnosis and treatment, and there's a pharmacy nearby that can dispense any medications they prescribe.

> I'm curious, how do you people deal with medical emergencies?

Be healthy. Also be able to survive a 60 minute wait and ambulance ride to the nearest hospital. I'm totally serious, unfortunately. Locals tend to look healthier for a reason.

Why would someone go DOZENS of times on foot at 3am to get medicine?

And if so, why not get it from a pharmacy?

multiple times is over many years

> I live in a city and I have 3 24x7 hospitals within walking distance.

Where is that, just curious? I can't think of any place with three major hospitals within a mile or less?

In San Francisco if you start from St. Mary's: UCSF is 1.1 miles away by car, CPMC Davies is 1.5. If you start at Kaiser's Geary campus: UCSF Mt. Zion is 0.4 miles away, St. Mary's is 1.1 miles away. If you start at SF General: St Luke's and UCSF Children's Hospital are 1.5 miles away – although UCSF only takes pediatric patients and I think Sutter closed the ER at St Luke's because focusing on specialists is more profitable.

In Oakland: Kaiser and Summit ERs are about half a mile from each other and UCSF Children's Hospital is about 1.5 miles away.

Lower Manhattan: Mt Sinai Beth Israel and Bellevue are about a mile away and there's a VA hospital with an ER next to Bellevue.

In Chicago: UI and county are 0.6 miles away by car and Rush is on the other side about 0.4 miles away. UI actually calls this the "Illinois Medical District".

In Seattle: Swedish First Hill and Virginia Mason are 0.4 miles apart. Kindred's right there too but doesn't have an emergency department. UW Harborview does have an ED and is 0.4 miles in the other direction.

This is amazing analysis. Hat tip!

Did you just happen to know all of these hospitals... then you used Google Maps to show distance? You are like the Ken Jennings of hospitals!

He probably knew that there around a bunch of hospitals around the geographic center of SF (if you live in that part of town it’s hard to miss), and then did a Google search for the numbers. I used to work at UCSF and this matches my sense that there are a lot of medical facilities in town.

Yeah I know where the hospitals are in San Francisco because I lived there. Centrally located isn't as great as it may seem. For the others I just plugged "emergency room" into Apple maps and picked some points that seemed close enough together.

Atlanta, Boston, Houston, and Philadelphia all have medical center areas with 3+ hospitals within walking distance of each other.

Houston has the largest medical center in the world with ~10 including Texas Children's Hospital, the largest children's hospital in the world (or at least it was a couple of years ago).

Philly has 4+ hospitals in center city (Jefferson, Penn), 7+ in university city (Drexel, Penn, CHOP), and a smattering more all over. Baltimore had 3+ hospitals near downtown but I think most got absorbed into UMMS, so it's Hopkins and UMMS, but lots of different facilities around.

Boston's Longwood Medical area is a great example of a place you can stand and be within a mile of 4 hospitals. Brigham and Women's, Boston Children's, Beth Israel and New England Baptist.

3 of the 4 are Harvard Medical School affiliated and our outstanding hospitals.

oh, i didn't mention this isn't america, but instead a third world backwater country

Houston?

Ah, yes, a quaint, small town. :)

In northern MN often times they use helicopters for transport for major emergencies.

Are you in "upstate ny" by chance? I was going to suggest that area but read your post potentially covering that suggestion.

Central.

There are 10 regions of NY State. According to NYCers, literally the entire state outside of the Hudson Valley is "upstate" - you could live an hour from Cleveland,OH or an hour from Montreal,BC , and both are "upstate". So it helps to be more specific when suggesting a place in NY.

Sounds like Hancock. Beautiful setting but the town seems like a constant reminder of what it used to be.

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