[Part Three in a series.  Click here for Part One and Part Two.]

As I have been reflecting on my great-grandfather’s losing battle with the rising Arkansas River in 1943, I realized that as a now ‘city boy’ (according to my redneck brother) I don’t naturally think in acres.  Blocks, neighborhoods, interstate exits – these are my geographic frames of reference.  Acres are not as natural for me as they should be for someone with farming roots.

In that flood, 450 acres forever disappeared underwater as the river changed course.  My 24-home typical suburban neighborhood sits on about 10 acres, so 45 of those.  A square mile covers 640 acres, so about 70% of that.

Gone.

Forever.

Here is where we get to the really hard part of the coronavirus reality.  Not the part about short-term pain or inconvenience or the challenges in restarting, but the part where we stare hard at the situation and ask, ‘Is it gone forever?’

Last weekend I was happy to plop down in the booth at our favorite Mexican restaurant for an enchilada and a margarita. But in about 30 seconds you realize that despite their best efforts, the math just doesn’t work.

I flew for the first time yesterday and while I enjoyed having a row, or seven, to myself with room to spread out, the same math was easy to do.  As it was at the hotel. And many other places you see.

Many just won’t make it.

Their business is, or is sliding toward, the bottom of the river.

Surely this can’t happen to physician practices, right?  I mean, we’re talking doctors here, superheroes in white lab coats.  Wasn’t there some implied and unspoken promise for surviving med school?

Devastating floods and microscopic killers are indiscriminate.

The prognostications on physician practices that will close shop, particularly small practices and especially primary care, are blaring everywhere.  That has not yet happened at a doomsday level and maybe the soothsayers got a little carried away.  Or maybe PPP loans and Medicare advance payments propped up some dead practices that just haven’t fallen over yet.

I recently spoke with some folks who work with a lot of small practices and they are optimistic.  Maybe it was their unique market, maybe it was more hope than realism.  I’ll hang on to their take as we all want some good news.

But the math of business applies to physician practices, too.  Take enough volume out for long enough and it ends up under 25 feet of water.

Well, that was cheery, wasn’t it?

Dan Dan might tell us there are two options: quit farming and move on, or you better work the land you have and maybe go find some more.

This is where we’ll be focusing in the weeks to come.  You’re going to hear things you’ve heard from me before, only with more urgency.  You’ll hear some new thoughts based on our new reality.  But I assume you still want to keep farming, keep practicing medicine and taking care of patients.

So, let’s get after it.

I never met my great grandfather, but the stories are legendary.  Some are apocryphal I am sure, some enhanced with a little entertaining hyperbole, some details grown a little fuzzy over time.

Dan Dan, a hardscrabble Scottish farmer, settled into the Indian Territory not long before Oklahoma became the 46^th state.  His land was nestled there where the Arkansas River turns north a bit before leaving Oklahoma and heading across its namesake state to join the Mississippi.

He was notable for his interminable will, penchant for the alcohol of his ancestry, and a fiery temper that was probably inflamed by the Scotch. He went to town and bought his Buicks two at a time.  He’d drive one like a bat of hell across the fields and when it would finally conk out, a hired hand would haul it back to the dealer for repair as he hopped in the second one without slowing down.

He parked his car astraddle the railroad tracks one day, forcing the engineer to slam on the brakes to bring the train to a screeching stop.  The day before the train took too long switching over and it blocked his driveway, delaying him by 15 minutes from getting back to work after lunch. In his view, Kansas City Southern would have to wait the same amount of time to square things up. Yes, he pulled a pistol from under the seat of the Buick when the engineer approached the car and ordered him to move.  It was persuasive.   The train waited.

He may or may not have killed a man. Some guy over in Arkansas was abusing his wife, a sin that Dan Dan would not tolerate. A strongly worded conversation led to some form of frontier justice; the details of the punishment are a little fuzzy, but the judge appreciated the matter being handled directly and swiftly, dismissing the charges in a matter of minutes.

I share those stories to share this one.

As I mentioned, Dan Dan’s farm was low against the river.  Regular floods were a good thing, but 1943 was different.  In mid-May, the river crested at 38 feet above normal, wrecking devastation across both Oklahoma and Arkansas.

One field was right on the river.  Somehow Dan Dan had secured one of the few bulldozers that was not in Europe supporting the war.  He had used the dozer to build a levy around the perimeter of the field.  There were crops in the field and crops were cash.

As the river continued to rise, the levy was threatened. Frantically, a worker used the dozer to shore up the levy.  Inevitably, the river broke through and water begin to pour into the field.  My great grandfather ordered the man to drive the dozer into the crumbling hole in a desperate attempt to save the field.  Hesitation at the command brought out the aforementioned pistol and the dozer was plunged into gap, of course to no avail.  38 feet of river would not be held back, even by a determined farmer with a bulldozer and a gun.

The crops in field were lost in that flood.  But that was not the biggest loss.  The field itself disappeared, even when the water receded.  The flood changed the flow of the river and that 450 acres of dirt was, and still is, out in the middle of the river somewhere.

The flood brought short-term loss, massive clean-up, long-term loss and property boundaries changed forever.

Sound familiar?  Next time let’s start unpacking the parallels.