An investigation of the dangers the nation faces from runaway health care…
The Providers
- Description
- Reviews
- Citation
- Cataloging
- Transcript
Set against the backdrop of the physician shortage and opioid epidemic in rural America, THE PROVIDERS follows three healthcare providers in northern New Mexico. They work at El Centro, a group of safety-net clinics that offer care to all who walk through the doors, regardless of ability to pay. Amidst personal struggles that reflect those of their patients, the journeys of the providers unfold as they work to reach rural Americans who would otherwise be left out of the healthcare system. With intimate access, the documentary shows the transformative power of providers' relationships with marginalized patients.
'This film could be renamed The Heroes. We are so proud of the work of thousands of clinicians across the country who have dedicated their lives to those who need their help the most. This film perfectly exemplifies the challenges and hope for those living in underserved communities. The challenges are real, personal, and pervasive - but improving people's lives is truly rewarding. The Providers is authentic and shows that providers are heroes in their communities every day.' Craig Kennedy, Executive Director, Association of Clinicians for the Underserved
'A very concrete and tangible example of how imperative rural providers are to the health and wellbeing of a community...This excellent film can be utilized in classroom and community settings to not only illustrate the need for rural provider recruitment and retention, but to also illustrate rural models of care where the rural provider treats the whole patient and sees the whole person. These providers offer care for substance misuse without judgement while also addressing social determinants of health, including food insecurity, poverty, insurance status, health literacy, adverse childhood events, and childhood trauma.' Shawnda Schroeder, Associate Professor, Center for Rural Health, University of North Dakota
'A compelling portrayal of the individuals - physicians, physician assistants and nurse practitioners - who deliver care under very difficult circumstances. I enjoyed the film.' Bill Finerfrock, Executive Director, National Association of Rural Health Clinics
'The Providers shows humanity at its neediest and at its most admirable.' The Boston Globe
'The Providers delivers a deeply moving portrait of selflessness and dedication that feels particularly timely in this era of division between the red and blue states.' The Hollywood Reporter
'Beautifully-composed doc, which immerses us in the lives of three unsung heroes quietly making a difference on the margins' Filmmaker Magazine
'A heart-warming, soul-affirming documentary [which] provides a deep insight into small-town America while confronting the challenges of keeping those in poor, rural communities safe.' Hollywood Glee
'Your community needs you...This inspiring movie finds that, for some young professionals, vocations start where they are most needed-at home.' Washington City Paper
'Deeply touching from beginning to end, The Providers tells stories of triumph and tragedy, of heroes and their travails.' cineSOURCE Magazine
'Our own inadequate medical system is given a merciless treatment in The Providers, Anna Moot-Levin and Laura Green's clear-eyed but encouraging look at a collapsed community.' The Flip Side Reviews
'With intimate access, the film shows the transformative power of healthcare providers' relationships with marginalized patients.' Selina Chignall, Realscreen
'A hot-button topic.' Adrian Gomez, Albuquerque Journal
'A complex portrait emerges of small-town America. This absorbing documentary is a quiet yet urgent reminder that the country's heartland is in trouble, and that the very nature of general practice medicine needs to be rethought to address a devastating epidemic.' American Film Institute
'Inspiring...A heartfelt, life-affirming watch...The heart of the documentary is its focus on relationships, particularly on the trust the healthcare professionals have built over their long-term engagement with their patients.' Michael Abatemarco, Santa Fe New Mexican
'Explore[s] a critical aspect of the health-care crisis...Moving, almost elegiac.' This Week In New York
'There clearly are many places like Las Vegas, New Mexico, where the simple day-to-day basics already feel tenuous. It's frustrating to everyone that in a country and at a time when medicine has never been more sophisticated or more effective, too many people still are kept from its benefits.' David Hinckley, TV Worth Watching
'Outstanding...Reminds you that some people join the profession out of a love of humanity rather than the dollar.' Louis Proyect, The Unrepentant Marxist
'The unique perspective being documented here is the way all three providers are constantly navigating the way addiction and their dedication to treating it is intertwined with their lives, families, and their dedication to their community.' Trisha Brown, Brightest Young Things
'The Providers is what any aspiring rural doctor or nurse practitioner should see to know if they are really cut out for the job. Against the setting of magical New Mexico landscapes is the reality of tough country living, and the personal challenges that can all too easily fall into depression and substance abuse. How then do those driven to provide medical care for these folks deal with the challenges and retain their own humanity? This film does a marvelous job in providing us with that insight.' Dr. Bill Honigman, National Outreach Lead, Progressive Democrats of America
Citation
Main credits
Moot-Levin, Anna (film director)
Moot-Levin, Anna (film producer)
Moot-Levin, Anna (screenwriter)
Moot-Levin, Anna (videographer)
Green, Laura (film director)
Green, Laura (film producer)
Green, Laura (screenwriter)
Green, Laura (videographer)
Other credits
Original music by Paul Brill; edited by Chris Brown, Laura Green, Anna Moot-Levin.
Distributor subjects
Addiction; American Studies; Anthropology; Ethics; Health; Medicine; Nursing; Opioids; Poverty; Psychology; Rural Studies; Social Justice; Social Psychology; Social Work; SociologyKeywords
healthcare providers, rural America, doctor shortage, opioid epidemic, northern new mexico, el centro family health, safety-net clinics, nurse practitioners, physicians assistants, latino community, Matt Probst, semillas de salud, mentoring high school students, medical careers, drug addiction, Leslie Hayes, Chris Ruge, healthcare system, emergency rooms, psychiatric illness, EMT program, Santa Fe Community College; "The Providers"; Bullfrog Films,doc; sociss
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THE PROVIDERS PICTURE LOCK TRANSCRIPT
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TIMECODE |
VIDEO |
AUDIO |
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01:00:00:10 |
TEXT CARD: A Stray Pony Productions Film |
Sound of driving. |
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01:00:03:20 |
Shots of CHRIS RUGE driving. |
Sound of driving. |
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01:00:14:02 |
Shots of CHRIS RUGE opening gate. |
Wind blowing, dog barking, gate opening. |
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01:00:20:06 |
CHRIS RUGE in home visit with CHERI |
CHERI: I’ve been a little sick, like my insides, they’ve still been kind of messed up and—
CHRIS RUGE: Well, you’re torn up inside pretty good. You have, uh, just a streak, uh, uh, all along your stomach where your stomach’s kind of eroded.
CHERI: I don’t want to let my kids bury me.
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01:00:49:22 |
MAIN TITLE: The Providers |
Instrumental music, wind blowing
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01:00:57:11 |
Shot of New Mexico countryside, superimposed TEXT CARD: Last year, 70,000 deaths in rural America could have been prevented with better access to care.
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Instrumental music |
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01:01:02:02 |
TEXT CARD: That’s ten times the number of Americans who died in the Afghanistan and Iraq wars combined. |
Instrumental music |
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01:01:10:04 |
Shots of Las Vegas, superimposed TEXT CARD: Las Vegas, New Mexico Population: 13,201 Per Capita Income: $15,481
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Instrumental music |
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01:01:19:04 |
Las Vegas scenics – buildings |
Instrumental music |
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01:01:27:07 |
Las Vegas scenic – town square
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MATT PROBST: I love this community. |
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01:01:30:15 |
MATT PROBST in interview |
MATT PROBST: Born and raised, and never left, and never going to leave.
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01:01:33:18 |
Las Vegas scenic chili roasting shots |
Instrumental Music |
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01:01:39:08 |
MATT PROBST walks into El Centro clinic
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MATT PROBST: For me, what I was going to do -- |
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01:01:42:14 |
Images of El Centro – sign, patients in waiting room and hallway
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MATT PROBST: was nowhere near as important as where I was going to do it. There’s so much beauty here and there is so much pain.
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01:01:52:10 |
MATT PROBST in medical appointment with patient Roy
Superimposed TEXT CARD: Matt Probst Physician Assistant |
MATT PROBST: The first thing I saw was your weight. Are you, are you eating? Are you, are you okay?
ROY: Towards the end of the month, it got sort of skinny-
MATT PROBST: Okay, so—
ROY: So, will admit that.
MATT PROBST: —food security has been an issue.
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01:02:09:02 |
DR. LESLIE HAYES in appointment with infant
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DR. LESLIE HAYES: We want to hear if she gets a fever, if she gets a lot of swelling or redness where she gets the shots, or just if you think there’s anything you’re really worried about.
Female Voice: Okay. |
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01:02:20:07 |
Interview with DR. LESLIE HAYES
Superimposed TEXT CARD: Leslie Hayes Family Physician |
DR. LESLIE HAYES: When I was eight, I read a book on the history medicine and how they got rid of small pox, and I thought that was really cool, and I decided to become a doctor –
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01:02:27:11 |
DR. LESLIE HAYES in appointment with child |
DR. LESLIE HAYES: and I really never changed my mind.
DR. LESLIE HAYES: Do you know you have kitties in your ears? Let me see if you’ve got kitties in the other one.
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01:02:34:22 |
CHRIS RUGE in appointment with DOMINIC |
DOMINIC: Sounds like the motor’s running?
CHRIS RUGE: Still, still ticking. You’re still alive.
CHRIS RUGE VO: I was born and raised in an angry little town in central Iowa.
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01:02:47:02 |
CHRIS RUGE in interview
Superimposed TEXT CARD: Chris Ruge Nurse Practitioner |
CHRIS RUGE: I took off hitchhiking the day after high school. I think I graduated on Friday, and I was gone on Saturday.
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01:02:52:12 |
Archival photo of CHRIS RUGE with truck
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CHRIS RUGE VO: Truck driving was a way to make money. But at 30, I wanted to do something –
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01:02:59:15 |
CHRIS RUGE in appointment with DOMINIC |
CHRIS RUGE VO: where I just felt a little more connected.
DOMINIC: Now I need a favor from you.
CHRIS RUGE: Mmmm-hmmmm
DOMINIC: Lend me $10.
CHRIS RUGE: Again?
DOMINIC: Yeah.
CHRIS RUGE: Oh, yeah, I don’t know, I don’t know if I want that on camera.
DOMINIC: Yeah, yeah, yeah
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01:03:17:02 |
Map of New Mexico superimposed TEXT CARD: Matt, Leslie and Chris practice at El Centro, a group of clinics that serve northern New Mexico.
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Instrumental music |
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01:03:22:11 |
Map of New Mexico superimposed TEXT CARD: El Centro covers 22,000 square miles and treats all patients regardless of insurance, condition, or ability to pay.
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Instrumental music |
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01:03:41:05 |
Ext. of El Centro clinic |
Sound of town ambience
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01:03:45:16 |
Images of El Centro, nurse with patient, nurse measuring child’s height
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Sound of clinic ambience |
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01:03:52:13 |
Image of El Centro, nurse crossing hallway |
Female Voice: Looks like a buffet of burritos, Dr. Gammon.
DR. GAMMON: I can see- |
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01:03:54:21 |
El Centro Provider Breakfast Meeting
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DR. GAMMON: -that.
Female Voice: Whatever. And here’s some salsa. I’ll get some bowls, okay?
DR. GAMMON: Okay, great.
MATT PROBST: We are on-
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01:04:05:09 |
El Centro Provider Breakfast Meeting
Superimposed TEXT CARD: Matt Probst El Centro Medical Director
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MATT PROBST: -the brink of a provider staffing shortage crisis, right? Between now and summer we’re going to end up being about eight providers short. I describe it like a bridge, and you have all these trusses, and now you’re eight short. The remaining trusses feel more weight.
We’ve been trying to our darndest to recruit, but in the meantime, we fight the good fight.
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01:04:31:01 |
MATT PROBST walking down hallway in El Centro
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Sound of clinic ambience |
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01:04:35:18 |
MATT PROBST in appointment with IGNACIO and MARIE LUCERO
Superimposed TEXT CARD: Ignacio, 90
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MATT PROBST: All right.
IGNACIO LUCERO: Hello, doc.
MATT PROBST: You walked in today—
IGNACIO LUCERO: How you doing?
MATT PROBST: —again. [unintelligible]—
MARIE LUCERO: Oh, yeah, he walked—
MATT PROBST: I’m doing good. How are you doing is the big question.
IGNACIO LUCERO: Uh, I, I can’t brag. That pain is there, and you can’t get rid of it.
MATT PROBST: Today you said your pain scale is eight. That’s a lot of pain. This is nerve pain. Your acute pain has turned chronic now with what we’re calling not shingles, but post-herpetic neuralgia, right.
IGNACIO LUCERO: Yeah, I’m just getting too anxious.
MATT PROBST: You’re not being patient.
IGNACIO LUCERO: I’m getting ready to get out there and do some work. A year ago I painted all the schools in West Las Vegas, all of them, all by myself. She painted all the doors.
MARIE LUCERO: And windows.
MATT PROBST: I know you live to, to do your work, and I know that that is what feeds you, what keeps you going probably second in the world to her, right?
IGNACIO LUCERO: Oh—
MARIE LUCERO: He better say that. [laughs]
MATT PROBST: Right? He better. So I don’t have a problem with you getting out there and doing some little things. Pace yourself -
MARIE LUCERO: [laughs]
MATT PROBST: -because it’s still a long race, or at least I hope so, okay?
IGNACIO LUCERO: [laughs]
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01:05:51:16 |
CHRIS RUGE working in his office, writing and making phone calls
Superimposed TEXT CARD: Chris Ruge ECHO Care Program |
CHRIS RUGE: Hi, George. Chris Ruge over at the clinic. I’d like touch base with you, end of the day sometime.
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01:06:10:18 |
CHRIS RUGE leaving office |
Instrumental music |
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01:06:15:14 |
Trucks driving down the highway superimposed TEXT CARD: Chris’ position at the clinic is funded by ECHO Care, a program being piloted at El Centro and five other clinics.
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Instrumental music |
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01:06:26:04 |
Trucks driving down the highway superimposed TEXT CARD: Through ECHO Care, Chris is able to offer 24-hour access to care for El Centro's sickest and most vulnerable patients, often visiting them at home. |
Instrumental music |
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01:06:37:14 |
CHRIS RUGE driving |
CHRIS RUGE VO: Project ECHO is probably the reason I came to New Mexico. The program is designed to work with patients who have significant medical issues, significant psychological issues, and chaotic social- |
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01:06:55:07 |
CHRIS RUGE walking along pathway to a house. |
CHRIS RUGE VO: -situations.
The 15-minute visit in the clinic doesn’t work with these patients.
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01:07:04:17 |
CHRIS RUGE has home appointment with GEORGE
Superimposed TEXT CARD: George, 40 |
CHRIS RUGE: Okay, go ahead and step up.
GEORGE: [Whistles]
CHRIS RUGE: So 294. So you were 287.
GEORGE: So I’m still putting on the water.
CHRIS RUGE: Yeah, so your liver is sick enough that it is not able to perform all the functions it normally performs, and that is the reason your belly filled up with water, okay. How much salt are you eating? Show me what you eat for breakfast and lunch and stuff. |
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01:07:37:10 |
CHRIS RUGE going over foods with GEORGE during home visit |
CHRIS RUGE: Let’s look at your cupboard real quick.
Let’s look at sodium. This has 1,000 milligrams of sodium. I want you to eat a total of 1,000 milligrams of sodium a day. Each hotdog has 1,100 milligrams of sodium, 200 milligrams of sodium, 800 milligrams of sodium. If you eat the high-sodium foods—
GEORGE: Mm-hm.
CHRIS RUGE: —you’re going to put on more and more and more water, so why don’t we avoid all processed meats and pizza and that—
GEORGE: Okay.
CHRIS RUGE: Are you going to survive doing that for five days?
GEORGE: Ah, yeah.
CHRIS RUGE: You ever eat breakfast cereal?
GEORGE: I just smoke a cigarette instead.
CHRIS RUGE: A cigarette breakfast?
GEORGE: [unintelligible]—
CHRIS RUGE: I don’t think, I don’t think there’s any sodium in cigarettes, so that’s, that, that fits into the low-sodium diet.
GEORGE: Yeah. |
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01:08:25:23 |
CHRIS RUGE leaves house and goes to car
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Instrumental music |
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01:08:30:14 |
GEORGE looks out window |
GEORGE VO: After my wife died, that’s when it all went to pots.
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01:08:41:11 |
Archival photo of GEORGE and his wife |
GEORGE VO: She killed herself, so I just started drinking.
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01:08:47:14 |
GEORGE watching TV |
GEORGE VO: I’ve already been to detox eight or nine times, rehab a couple of times, and just can’t straighten out. I don’t know.
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01:08:59:17 |
CHRIS RUGE driving and pumping gas in the rain |
CHRIS RUGE VO: Many of our patients have been very sick for a very long time, but occasionally, you have to have a patient that you’re just overwhelmingly positive as far as where things are going, and with George, I think he’s ready for change. I’m willing to bet the bank on him.
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01:09:25:19 |
Car driving down the road in front of New Mexico mountains
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Instrumental music |
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01:09:32:17 |
Map of New Mexico showing Las Vegas and Española
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Instrumental music |
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01:09:40:20 |
Scenics of Española, truck passes, building for lease, truck with wood for sale
Superimposed TEXT CARD: Espanola, New Mexico Population: 10,159 Per Capita Income: $19,186 |
Sound of town and road ambience |
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01:09:56:00 |
Ext. El Centro clinic
Superimposed TEXT CARD: El Centro Clinic Española |
Sound of town ambience
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01:09:59:21 |
DR. LESLIE HAYES in appointment with patient DARREN |
DR. LESLIE HAYES: Tummy tender at all?
DARREN: No.
DR. LESLIE HAYES: All right, go ahead and sit up. Okay. Any drug or alcohol use?
DARREN: Yeah, a little bit.
DR. LESLIE HAYES: Okay. Which, uh, which of them?
DARREN: Uh, drug. I was – used a little bit of, uh, heroin and cocaine.
DR. LESLIE HAYES: Okay. What was your trigger?
DARREN: Uh, well, I, uh, showed up late on Thursday.
DR. LESLIE HAYES: Okay. So it was just being out of the medications?
DARREN: Uh, basically, yeah.
DR. LESLIE HAYES: Okay. All right, any meetings or counseling?
DARREN: No.
DR. LESLIE HAYES: Any particular reason you haven’t been able to make them?
DARREN: My son was down.
DR. LESLIE HAYES: Oh, was he?
DARREN: Yeah.
DR. LESLIE HAYES: Does he look good?
DARREN: Yeah, he looks good. He’s—
DR. LESLIE HAYES: Good.
DARREN: — starting to talk more now, too.
DR. LESLIE HAYES: Really?
DARREN: Yeah.
DR. LESLIE HAYES: Wow.
DARREN: He’s cute.
DR. LESLIE HAYES: He is… And how’s Crystal doing? Are you still staying at her place?
DARREN: Uh, for the most part.
DR. LESLIE HAYES: Okay. So your pulse rate was pretty low today. You tend to run a little bit on the low side, but it was more so today than usual, but your EKG looks perfect, so—
DARREN: Okay, cool.
DR. LESLIE HAYES: —so if she ever tries to accuse you of being heartless, you can tell her, no we’ve got [unintelligible]. All right. So there’s your visit summary and your prescription.
DARREN: Okay, cool.
DR. LESLIE HAYES: Be on time for your appointment.
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01:11:26:15 |
DR. LESLIE HAYES interview |
DR. LESLIE HAYES: Many physicians don’t do, uh, treatment of substance use disorder as part of primary care, which I disagree with.
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01:11:33:05 |
DR. LESLIE HAYES walking down hallway and out to car at clinic |
DR. LESLIE HAYES VO: Physicians tell me they don’t want to see these patients in their waiting room, but sometimes it’s the patients who are struggling where really we actually make more of a difference.
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01:11:46:20 |
DR. LESLIE HAYES driving |
DR. LESLIE HAYES VO: Most years, Española is in the top five in the nation for heroin overdoses per capita, and right now, if I were to -
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01:12:00:06 |
DR. LESLIE HAYES in interview
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-retire, there’s no one who could take on my patients. |
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01:12:04:01 |
Ext. of DR. LESLIE HAYES’ house, DR. LESLIE HAYES reading newspaper
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Instrumental music |
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01:12:08:13 |
Archival photo of DR. LESLIE HAYES’ family
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Instrumental music |
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01:12:10:11 |
Footage of DR. LESLIE HAYES reading newspaper and chicken coop |
DR. LESLIE HAYES VO: I grew up in Los Alamos, New Mexico, which is the town with the highest percentage of PhDs in the country. They’re one of the few places in New Mexico that has an adequate supply of physicians, and I wanted to be someplace where physicians were really needed, so Española seemed a good fit.
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01:12:30:16 |
Sunrise over Las Vegas
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Sound of outdoor morning ambience |
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01:12:34:17 |
Ext. of MATT PROBST’s house
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Sound of outdoor morning ambience |
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01:12:39:19 |
MATT and ELIZABETH PROBST gets kids (ISAIAH, ISAAC, NOAH and MATEO) ready for school |
MATT PROBST: Time to make the donuts. Time to make the donuts. Good morning ‘Teo. Morning, Isaac.
ISAAC PROBST: Good morning.
MATT PROBST: How you feeling?
ISAAC PROBST: Tired.
MATT PROBST: Those were some nice soccer moves yesterday, dude.
ELIZABETH PROBST: Put your jacket on. And we’ll actually make it on time today.
NOAH PROBST: We’ve all got emojis inside of our heads mom
ELIZABETH PROBST: I think you’re an emoji.
MATEO PROBST: But these parts got a little messed up.
MATT PROBST: Oh, we’re off by one button. You did good, though. You did good. You buttoned them all by yourself. We just missed one button, though.
Various voices: [unintelligible]
MATT PROBST: Noah I know you’re just excited, but that excitement, if you can’t control it, is going to land up getting you in trouble at school.
NOAH PROBST: In prison.
MATT PROBST: In prison. Yeah, in prison, too.
ELIZABETH PROBST: Love you.
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01:13:47:02 |
MATT PROBST gets into car. |
Sound of getting into car.
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01:13:51:14 |
Images of driving, Entering Albuquerque sign |
MATT PROBST VO: In rural America, trying to recruit is a challenge. We just don’t have enough docs, so physician assistants, nurse practitioners, and nurse midwives serve as primary care providers.
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01:14:12:11 |
MATT PROBST in interview |
MATT PROBST: We kind of got thrown into that role because someone had to do the work. The patients were still there, the illnesses were still there.
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01:14:17:22 |
Ext. UNM Health Sciences Center
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MATT PROBST: We’re in the trenches on the front line -- |
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01:14:22:08 |
MATT PROBST talks to UNM Physician Assistant class |
MATT PROBST: and problem in underserved health care is that there’s no resources and you have to do a whole lot with like nothing.
I mean, you guys probably already know what our statistics are, right, in New Mexico? And then you get into rural New Mexico, and you see, wow, okay, well, yeah.
There’s no work here, and it’s an aging population because the educated youth, they move away.
Female Student: You created this analogy of us being on the front lines, in the trenches, and this, not saying we don’t all want to be there, you know, but then at the same time, what do you think could be a saving grace for the rural parts of New Mexico?
MATT PROBST: Health care is a relationship, so the difference maker is when you say, “This is my community now, and I want to be part of this community.” You guys chose a service field. I don’t know if you realized you did that when you did it.
You’re here now, though, so if you’re going to have a satisfying life, and career, and vocation, I think you guys got to decide now, you know, how do you want to fight, where do you want to fight. I’ll be recruiting you guys, I’ll come back for you? Yeah. Yeah.
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01:15:32:21 |
Las Vegas 4th of July parade and Fiestas |
Sounds of Robertson High School marching band and parade
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01:15:41:15 |
MATT PROBST and family watching Las Vegas 4th of July parade and Fiestas |
MATT PROBST VO: I grew up in very rural northern New Mexico, little, small towns, you know, a thousand people, and then now the big city of Las Vegas, New Mexico. [laughs]
It’s too easy to say, “Well, we’re just a statistic, or that’s just the way it is here.”
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01:16:15:07 |
Las Vegas 4th of July fireworks |
MATT PROBST VO: This community, it’s so much a part of who I am, I can’t separate myself from it.
I could have done a lot of different things besides medicine. I could make a lot of money. I could live wherever I want. But I can’t turn my back.
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01:16:45:14 |
SUV driving down dirt road |
Sound of car driving down dirt road
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01:16:51:00 |
CHRIS RUGE driving on a dirt road |
Sound of car driving down dirt road
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01:16:53:23 |
CHRIS RUGE in home visit with CHERI
Superimposed TEXT CARD: Cheri, 33 |
CHRIS RUGE: I was just looking at your upper GI again, and I, you know you have a real severe, what they call erosive gastritis, from all the alcohol. And the only treatment is, no alcohol.
CHERI: I felt like drinking so bad yesterday.
CHRIS RUGE: I know, but that’s been your fallback for how many years, you know? So it’s natural that, you know, when you’re in crisis and stuff that that’s going to come up as a, as an urge. So a classmate of yours just OD’ed?
CHERI: Yeah, he was a year younger than me. He died in front of his kids and his girlfriend. I went to his rosary, his funeral. It was so awful, his little kids putting the, on the coffin. It’s awful, awful.
CHRIS RUGE: What can I do to help you through the weekend? You sure you have the cell written somewhere?
CHERI: You want to come in, and I’ll—
CHRIS RUGE: Yeah.
CHERI: —grab a marker, and we could just put it—
CHRIS RUGE: Yeah, [look], uh, I’ll put it on the fridge, too.
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01:17:53:23 |
CHRIS RUGE puts phone number on refrigerator in Cheri’s home |
CHERI: Thank you so much for coming out. I needed that.
CHRIS RUGE: Good. Just make it through, okay?
CHERI: Okay.
CHRIS RUGE: Hang in there.
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01:18:06:11 |
CHRIS RUGE talking to CHERI’s son C.J. |
CHERI: [unintelligible]—
CHRIS RUGE: Have we met before?
C.J.: I don’t think so.
CHRIS RUGE: No?
CHERI: That’s my son C.J.
CHRIS: Hi, C.J.
CHERI: He’s the one who helps me with everything.
CHRIS RUGE: We’re trying to keep her in line. So you could help.
CHERI: Yep, he is. He’s, uh, my helper.
CHRIS RUGE: She can help keep you in line, and you can help keep her in line. Sound like a plan?
C.J.: Mm-hm.
CHRIS RUGE: Good.
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|
01:18:29:13 |
Images of driving |
CHRIS RUGE VO: The pilot program, ECHO Care, officially ends this year.
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01:18:44:06 |
Chris getting equipment out of truck, going into patient’s house.
|
CHRIS RUGE VO: So far, the insurance companies have foot the bill. The question is will they continue funding ECHO Care. |
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01:19:01:06 |
Scenics of Las Vegas landscape, cross by side of road
|
Instrumental music, church bells |
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01:19:09:01 |
Virgin Mary statue outside Immaculate Conception Church
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Sound of church bells |
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01:19:12:06 |
Exterior of Immaculate Conception Church
|
MATT PROBST: When I was your guys’ age -- |
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01:19:14:14 |
MATT PROBST giving talk to confirmation class |
MATT PROBST: I was a mess, probably a lot worse than anyone in here, I would guess, maybe not. And if not, then you can relate to my story.
I started with drugs and alcohol and all of that when I was like 12, 13, hanging out in arroyos and smoking frajos, right? So I was this little drug-dealing kid starting at being sophomore, when I was slinging coke, and had all the things that came with that, money, and girls, and power, and that was my life.
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|
01:19:46:21 |
Images of driving on a rainy/snowy day |
MATT PROBST: These arroyos right here, this was our stomping grounds.
Steve’s house. He’s in jail right now. A really good friend of mine growing up.
And there we passed Brian’s, Brian, my friend that passed away.
And then this was my road, here, into our house.
|
|
01:20:13:09 |
EXT. MATT PROBST’s childhood home |
MATT PROBST: Those two windows up there, the one on the right was my sister’s room, the one on the left was my room.
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|
01:20:20:10 |
MATT PROBST walking and talking near his childhood home |
MATT PROBST: This was my great-grandma and great-grandfather’s property from here all the way over there, all that field over there, all the way over there.
My dad’s oldest brother lives over there.
Luckily everybody else has has kept their pieces in the family, but, but, yeah, we lost our piece.
Yeah, my dad was an addict, bad, bad --
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|
01:20:44:03 |
Archival photos of GILBERT PROBST (MATT PROBST’s father) around when MATT PROBST was in high school |
MATT PROBST VO: by that time.
And my mom couldn’t pay the bills fast enough --
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01:20:49:10 |
Archival photo of MATT PROBST and his father and mother around when MATT PROBST was in high school
|
MATT PROBST VO: and we just kept falling further and further behind on the mortgage.
Then after fighting for it - |
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01:20:54:00 |
Video still of MATT PROBST’ childhood home |
MATT PROBST VO: -for so long, my mom just decided she had to let it go.
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01:20:59:04 |
Archival photo of MATT PROBST and his mother around when MATT was in high school |
MATT PROBST VO: My mom got a divorce. |
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01:21:01:17 |
Archival photo of MATT PROBST’s father on couch |
MATT PROBST VO: My dad was homeless for a while, lived in the car. One day, we came --
|
|
01:21:06:23 |
MATT PROBST walking and talking near his childhood home |
MATT PROBST: - home, and the house has been broken into, and my rifle, and the microwave, and all kinds of stuff was gone. And, uh, then we realized who the thief was. It was my dad.
And so we went looking for him, and we found him at the El Rancho bar.
My dad had an old station wagon. That’s what he was living in. And all our stuff was in the station wagon.
And, uh, that was a bad day, too. Yeah. My brothers beat the crap out of him, and I couldn’t handle even watching it, so I just took off running down the road crying, but, yeah.
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|
01:21:52:08 |
MATT PROBST walking down dirt path near childhood home |
MATT PROBST VO: Five weeks ago, my -- |
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01:21:58:03 |
Images of driving on a rainy/snowy day |
MATT PROBST VO: -- dad got really, really sick again, and all the writing on the wall was that it was opiate overdose. I made a decision to call his provider and let him know what I was seeing.
My dad called me very quickly afterwards, and he disowned me again for having made that phone call.
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01:22:21:14 |
Hummingbirds on hummingbird feeder
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Sound of instrumental music and hummingbird wings |
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01:22:30:09 |
CHRIS and ANN RUGE getting ready for work in the morning |
ANN RUGE: Were you just making that sound, or was the coffee ready?
Oooooh.
CHRIS RUGE: Here you go.
Oh, boy. [clears throat]
Seven a.m., huh?
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01:22:56:09 |
CHRIS RUGE walks into patient’s house
|
Sound of street ambience and dog barking, knocking on door. |
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01:23:04:05 |
CHRIS RUGE examines DOMINIC during a home visit |
CHRIS RUGE: How’s that mouth looking? Good.
DOMINIC: It hurts like heck, though.
|
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01:23:10:09 |
CHRIS RUGE makes notes and fills pill box during a home visit. |
CHRIS RUGE: The rotten teeth have a significant impact on a lot of your other issues, including inflammation in other parts of the body.
MARY DELL: I Need some tissue….
Some tissue.
DOMINIC: Oh you need some tissue?
|
|
01:23:23:16 |
CHRIS RUGE talks to MARY DELL during home visit
Superimposed TEXT CARD: Mary Dell, 67 |
CHRIS RUGE: Hi, there. So how long, how long were you in the hospital? Boy, you were, you’ve been gone forever.
MARY DELL: Two weeks.
CHRIS RUGE: Yeah. And how often are you going to the ER?
MARY DELL: Every other night.
CHRIS RUGE: Was that for shortness of breath, or—
MARY DELL: Mm-hm.
CHRIS RUGE: Yeah.
MARY DELL: And chest pain.
CHRIS RUGE: Yeah.
MARY DELL: And then when your doctor’s just like, oh, you know. He’s one of those that doesn’t give a damn.
CHRIS RUGE: Well, you can always change doctors, uh.
MARY DELL: To who?
CHRIS RUGE: Anybody but me.
MARY DELL: Why not you?
CHRIS RUGE: Yeah, well, I, I’d work you. [Makes noise]
MARY DELL: Well, that’ll be fine. I don’t care. That would be good.
CHRIS RUGE: Yeah?
MARY DELL: Yeah.
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01:23:59:22 |
CHRIS RUGE driving, eating apple and picking up notepad |
Music from radio |
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01:24:08:05 |
CHRIS RUGE knocking on GEORGE’s door. George opens door and let’s CHRIS in. |
CHRIS RUGE: Hello George. It’s Chris.
Hello? Doors locked.
How you doing?
GEORGE: Not good. |
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01:24:30:05 |
CHRIS RUGE talks to GEORGE during home visit. GEORGE grasps alcohol bottle. |
GEORGE: I don’t know what’s wrong with me… I’m stupid or something.
CHRIS RUGE: No, alcoholism, it’s a disease. If it was easy to stop drinking, we wouldn’t have people drinking until they die.
I know you don’t want to die, but your liver right now, is real, real, real sick. And just doing this once a week could kill you.
GEORGE: You mad at me?
CHRIS RUGE: Nope. I’m not mad at you. I’ll never get mad at you. That’s not my job. My job is to try keep you alive. Okay?
GEORGE: mmm-hmmm. Okay.
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|
01:25:11:01 |
Scenic view of New Mexico
|
Cars driving, town ambience |
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01:25:15:05 |
Ext. of the El Centro clinic |
Cars driving, town ambience |
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01:25:19:04 |
CHRIS RUGE in hallway of El Centro clinic and working in office |
Recording: When you are finished recording, you may press pound for more options. [beep]
CHRIS RUGE: Hi, George. Chris Ruge, over at the clinic. I’m just touching base. It’s Sunday. Uh, you can call directly to my office phone. I’m in here today.
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01:25:43:10 |
CHRIS RUGE answers the phone
|
CHRIS RUGE: Hello? ANN RUGE (over phone): Game on. |
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01:25:47:12 |
ANN RUGE calling CHRIS RUGE from home |
ANN RUGE: They’ve already scored.
CHRIS RUGE (over phone): Who did?
ANN RUGE: Well, you’ll have to come home and see.
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|
01:25:55:14 |
ANN RUGE at home brushing golden retriever
Superimposed TEXT CARD: Ann Ruge Chris’ Wife Nurse Midwife |
ANN RUGE VO: I graduated from midwifery school, and there was an opening at Chinle Indian Health Service Hospital. The first night there,
|
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01:26:09:04 |
ANN RUGE in interview |
ANN RUGE: they said, “Watch out for the guy in the ER. [laughs] Stay away from him.” And that, of course, was Chris.
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01:26:16:13 |
Archival photos of CHRIS RUGE with motorcycles
|
ANN RUGE VO: We had been together -- |
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01:26:21:03 |
Archival photo of CHRIS and ANN RUGE together early in their relationship
|
ANN RUGE VO: four months when I got pregnant. |
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01:26:05 |
Archival photo of ANN RUGE holding positive pregnancy test
|
Instrumental music |
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01:26:27:10 |
Archival photo of CHRIS and ANN RUGE at their wedding
|
Instrumental music
ANN RUGE VO: When our -- |
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01:26:30:19 |
Archival photo of ANN RUGE with her two children when they were very young
|
ANN RUGE VO: -- oldest was three, Chris was working down in Springfield -- |
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01:26:35:00 |
Archival photo of CHRIS RUGE driving
|
ANN RUGE VO: which is inner city, poor. He was working with the HIV population, -- |
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01:26:40:15 |
Archival photo of CHRIS RUGE reading textbook with one of his kids when they were very young
|
ANN RUGE VO: and he just starting putting in more and more hours.
|
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01:26:45:07 |
ANN RUGE with one of her kids when very young
|
ANN RUGE VO: It was like being a single parent. He’d come in -- |
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01:26:49:04 |
Ext. of RUGE house at night |
ANN RUGE VO: one, two in the morning. There came a time --
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01:26:53:20 |
ANN RUGE cuts flowers, watches the fish at night |
ANN RUGE VO: -- when I just really felt it was going to be our marriage or his job. Then he got an offer out here in New Mexico, and El Centro hired us both. When he left, I think two people took over his job, or three.
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|
01:27:13:20 |
Scenics New Mexico sunrise and cars driving
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Instrumental music |
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01:27:20:04 |
Ext. of the El Centro clinic |
MATT PROBST: Just a little bit of –
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|
01:27:23:23 |
Provider breakfast meeting at El Centro |
MATT PROBST: updates in terms of staffing. Thank you all for holding things together.
We were already short with having lost Kristen, and we were already short because in trying to meet the needs of this community that’s in dire straits and has lost yet again another primary care provider, we already had expansion positions, and those are still vacant.
I want to give thanks to Leora. She’s sought other employment, but now she’s extended to help us out, and she, so she’s going to be here. Originally, her last day was going to be January 20th, and now she’s working through the end of February.
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01:27:57:06 |
Clinic hallway |
MATT PROBST VO: It’s not uncommon for a provider to come and work a year, and then resign.
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01:28:03:02 |
MATT PROBST walking outside the clinic and driving |
MATT PROBST VO: And so that’s created a big problem. The evidence is really clear. You’re much more likely to retain someone
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01:28:12:23 |
Ext. of West Las Vegas High School
|
MATT PROBST VO: if they’re from that community.
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01:28:16:16 |
Anonymous students walking at West Las Vegas High School
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PA Announcement: [unintelligible] there is a meeting today during [lunch at the school]— |
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01:28:20:06 |
MATT PROBST and colleague set up Semillas de Salud display
|
MATT PROBST VO: So I started the Semillas de Salud program, creating health career clubs in all of our local schools. |
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01:28:26:19 |
MATT PROBST and TIFFANY ENCINIAS talk |
MATT PROBST: So if you need help with that, you know, in terms of [unintelligible], learning to go through that
TIFFANY ENCINIAS: Yeah, I talked to my teacher, and, uh, for that last week. |
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01:28:32:19 |
Anonymous students in hallway at West Las Vegas High School |
MATT PROBST: This is about phlebotomy.
|
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01:28:35:14 |
MATT PROBST at phlebotomy workshop with Semillas De Salud students |
MATT PROBST: You’re going to learn about phlebotomy, and learn about the health care field and being a laboratory technician. So that’s what we’re, uh, going to be working with today is blood.
When I was learning blood draw in school, the thing that someone said that helped me the most, it’s like shooting pool.
Phlebotomist: You got to go in real smooth, and then you’re going to pop in this one. Don’t shake, it’s okay? [laughter]
MATT PROBST: [laughter] Have a good one.
Good, and you?
Good.
|
|
01:29:10:08 |
Ext. of El Centro clinic
Superimposed TEXT CARD: El Centro Clinic Española
|
DR. LESLIE HAYES: See, have you seen our drug screens?
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|
01:29:15:05 |
DR. LESLIE HAYES shows medical student ZHONG ZHENG how randomized urine drug screens work. |
DR. LESLIE HAYES: If it’s negative, there’s two lines. If it’s a positive, there’s no line. So positive opiates, it can be codeine, it can be hydrocodone, it can be morphine, it can be heroin. Patients who are pain pills I test every six months. Patients who are buprenorphine, uh, I test them every time I see them.
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01:29:41:20 |
Clinic hallway with Superimposed TEXT CARD: Leslie went through the first training in New Mexico to treat opioid addiction within primary care.
|
Sound of clinic ambience |
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01:29:47:14 |
Clinic hallway with superimposed TEXT CARD: She prescribes Buprenorphine, a medication that reduces opioid withdrawal symptoms and cravings. |
Sound of clinic ambience |
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01:29:54:14 |
DR. LESLIE HAYES and ZHONG ZHENG have an appointment with TOMAS |
TOMAS: How are you doing, Doctor?
DR. LESLIE HAYES: I am doing well. How about you?
TOMAS: I’m doing real good.
DR. LESLIE HAYES: Good. So any particular concerns?
TOMAS: No, not at all.
DR. LESLIE HAYES: Okay. And any drug or alcohol use?
TOMAS: No.
DR. LESLIE HAYES: Okay. And buprenorphine still working well for you?
TOMAS: Mm-hm.
DR. LESLIE HAYES: And what have you been doing over the summer?
TOMAS: Driving buses.
DR. LESLIE HAYES: Yeah.
TOMAS: So I stayed busy all summer.
DR. LESLIE HAYES: Oh, I’ll bet.
TOMAS: Yeah.
DR. LESLIE HAYES: I can barely park my minivan. There’s no way I could [unintelligible] a school bus.
TOMAS: Yeah.
DR. LESLIE HAYES: All right, I’ll be back in in just a minute.
TOMAS: Okay, Doctor. Thank you.
|
|
01:30:25:05 |
Medical student ZHONG ZHENG talks with TOMAS in his appointment |
ZHONG ZHENG: What school do you work for?
TOMAS: Espanola Schools.
ZHONG ZHENG: Espanola.
TOMAS: I drive school buses for them, yeah.
ZHONG ZHENG: Okay.
TOMAS: And I’ve done a lot of physical labor, you know, uh, concrete trucks, and propane companies, and, with me, I broke my hand. I started using opiates for the pain.
Believe me, I didn’t wake up one day and said, “I want to be a drug addict.” That’s not what happened, you know. But before you know, I needed them just to get out of bed.
ZHONG ZHENG: Mm-hm.
TOMAS: But now I work every day. I go to the gym, you know. I don’t go through depression, you know. I’m happy in my family life, so, you know.
|
|
01:30:58:23 |
DR. LESLIE HAYES talks with TOMAS in his appointment |
DR. LESLIE HAYES: All right, so, uh, I will see you back in two months, sooner if you’ve—
TOMAS: Okay.
DR. LESLIE HAYES: —got any problems, and then you’re also scheduled with Miss Joy.
TOMAS: Have a good day.
DR. LESLIE HAYES: You, too.
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|
01:31:10:02 |
Interview of DR. LESLIE HAYES |
DR. LESLIE HAYES: Being exposed to alcoholism and addiction --
|
|
01:31:14:04 |
Archival photos of DR. LESLIE HAYES around when she was in medical school |
DR. LESLIE HAYES VO: uh, at a young age did a lot to lessen the stigma of it for me. |
|
01:31:19:01 |
Archival photo of DR. LESLIE HAYES’ grandfather |
DR. LESLIE HAYES VO: My grandfather, who I adored, would take me with him to AA meetings,
|
|
01:31:23:12 |
Archival photo of DR. LESLIE HAYES’ grandfather and grandmother
|
DR. LESLIE HAYES VO: and because my grandfather got sober and did so well, I always viewed addiction as a treatable disease. |
|
01:31:30:03 |
Interview of DR. LESLIE HAYES |
DR. LESLIE HAYES: For a long time in medicine, we just kind of flung up our hands and didn’t think we could do anything. But I always viewed it as something where there was hope and you know, you could get --
|
|
01:31:37:19 |
DR. LESLIE HAYES working in her office |
DR. LESLIE HAYES VO: people drug or alcohol free.
When I started prescribing buprenorphine, I was so happy to finally have something that we could do to treat these patients.
I thought when people learned about it, everybody would rush to do it --
|
|
01:31:51:02 |
Images of medical equipment in exam room, and empty exam room. |
DR. LESLIE HAYES VO: but it’s not been as many as I’d hoped. We need to dramatically increase the number of providers who are treating opioid use disorder.
|
|
01:31:59:02 |
Conference on Opioid Overdose Epidemic Panel in Santa Fe, NM. DR. LESLIE HAYES speaks on the panel.
Superimposed TEXT CARD: Opioid Overdose Epidemic Panel Santa Fe, NM |
DR. LESLIE HAYES: I work in a community that has a lot of opiate overdoses, and I must admit, my big interactions with opiate addicts, as we were calling them at the time, was the people who came into my office trying to scam me for Percocet.
And what I found is once I started offering treatment, you make a difference like nothing else you do in medicine.
I have been treating high blood pressure for 25 years now. I have never once had somebody come into my office and say, “Thank you so much for getting my blood pressure under 140 over 90. It means so much to me.” But I have people come into my office several times a month, and say, “Dr. Hayes saved my life.” |
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01:32:35:21 |
Nurse rolling equipment down El Centro hallway
|
Sound of clinic hallway |
|
01:32:39:15 |
MATT PROBST exits exam room and enters another exam room
|
Sound of clinic hallway |
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01:32:44:10 |
IGNACIO and MARIE LUCERO in medical appointment with MATT PROBST
TEXT CARD: Ignacio |
MATT PROBST: What are you up to?
IGNACIO LUCERO: No good.
MATT PROBST: No good?
IGNACIO LUCERO: You get tired of being a good guy all the time. [laughter]
Everything’s working out the way you, you planned it, the way you thought it would. I’m able to do a few things, probably not get up on a roof. I mean, I, I, I, I feel that I’m not quite ready now, but I’m getting there.
MATT PROBST: You’re the expert. Power tools, uh, uh, operating heavy equipment, if you feel impaired, you shouldn’t do that. But if you’re not feeling impaired, again, I, I trust your judgment on that.
|
|
01:33:26:08 |
IGNACIO LUCERO showing the houses on his street, and the architecture of his house |
IGNACIO LUCERO: I built all these houses you see here, plus the ones on the next street.
I make a lot of crazy things. That’s the window to match my door, and that’s another window and door up there, identical to this.
And that’s the balcony. And my wife and I sit there in the evenings.
|
|
01:34:50:01 |
IGNACIO LUCERO enters workshop and shows funeral urns he has been making |
IGNACIO LUCERO: These are the little things I was telling you about. The urns. They’re for ashes. When someone passes away. That’s something that I’m doing because of what I’m going through.
I mean, that’s not what I do all the time. |
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01:34:09:00 |
Painting of IGNACIO and MARIE LUCERO as a young couple
|
IGNACIO LUCERO: I served three years here in the States, and one in Japan. |
|
01:34:15:03 |
Interview of IGNACIO LUCERO, with his wife MARIE looking on |
IGNACIO LUCERO: I, uh, I had the opportunity of seeing what was left of Hiroshima and Nagasaki.
When I got out of the service, I asked my family, and I asked everyone else that I would talk to not to ever complain about anything. Today is one of my very worst days. I, uh, I had a hard time just getting up. But the more you stay in bed, the sicker you get.
|
|
01:34:57:20 |
Landscape with “Fire Danger Moderate” sign in a snowy field
|
Sound of plants rustling in the wind |
|
01:35:02:02 |
Dead sunflowers blowing in the wind
|
Sound of plants rustling in the wind, C.J. and Cheri talking and dogs barking |
|
01:35:06:02 |
CJ and CHERI playing with their dogs outside in a snowy landscape |
CHERI: [unintelligible] [he took off]. [dog barks]
CHERI: No. Glory.
C.J.: She likes biting your feet.
He’s really old, how old is he?
CHERI: He’s - I got him nine years ago, so he’s about nine. Hah Mambo?
Go get it!
CHERI: I got a month and four days -
|
|
01:35:32:14 |
CHERI and CHRIS RUGE at a home visit
Superimposed TEXT CARD: Cheri |
CHERI: -clean and sober today.
CHRIS RUGE: Yeah.
CHERI: But my mom, she got kicked out of her house for fighting—
CHRIS RUGE: Mm-hm.
CHERI: —drunk, and now she’s like trying to come, you know, back and—
CHRIS RUGE: Right.
CHERI: —hang out. She came around the other day, and, oh, I see her with the bottle and it’s like everything that I drink, you know—
CHRIS RUGE: Yeah.
CHERI: —and it’s still hard for me.
CHRIS RUGE: How did you stay sober? How did you stay not drinking?
CHERI: My son, I seen him, uh, playing basketball and stuff, I just stayed there
CHRIS RUGE: Mm-hm. Good. And then do you have your meds?
CHERI: Yes.
|
|
01:36:06:09 |
CHRIS RUGE and CHERI look through CHERI’s medications |
CHRIS RUGE: So I can peek at them?
CHERI: Mm-hm.
CHRIS RUGE: Where they at? Why don’t you kind of separate them and read them off to me?
CHERI: Mirtazapine.
CHRIS RUGE: Mirtazapine, yeah, [unintelligible]. Okay.
CHERI: And the Fenofibrate.
CHRIS RUGE: Yeah. Okay.
CHERI: And then the Metoprolol.
CHRIS RUGE: Yeah. Now are you taking that—
CHERI: Yes.
CHRIS RUGE: —consistently?
CHERI: Mm-hm.
CHRIS RUGE: Good. Oh, and if anything seems to bother your stomach a little bit, make sure you have something in your—
CHERI: Yeah, and—
CHRIS RUGE: —in your stomach when you take it.
CHERI: —escitalopram.
CHRIS RUGE: Yeah, that’s your, for depression.
CHERI: Yeah.
CHRIS RUGE: That’s the Lexapro, yeah.
CHERI: [Okay]. And then I’m taking, oh, these are [unintelligible]. A friend gave them to me. But I don’t take them. I—
CHRIS RUGE: Yeah, and they’ll just get you in trouble.
|
|
01:36:43:17 |
Ext. of CHERI’s house |
CHERI: And Christmas, you ready for Christmas?
|
|
01:36:47:17 |
CHERI and CJ having a conversation in the kitchen with Christmas decorations up |
CHERI: I already know what you want
CJ: Of course.
CHERI: He wants a PlayStation, but they’re expensive.
CJ: Not a four, a three.
CHERI: So I’ve been saving money out of every check to try to get him. He’s been through a lot. He’s the one who had to be the parent. When I was at my worst, he would take care of me.
CJ: When she would be laying down, I would ask her if she needed anything, and I would lay by her all night and make sure that if she needed to throw up, she had a bunch of throw-up bags inside of the bathroom. If she needed to throw up, I would run and get one, and just to keep her safe, I would keep the phone by my side and lay with her all night until I go to school.
CHERI: I put him through a lot. But I will not do that no more. I love him so much.
|
|
01:37:54:23 |
River running through frozen landscape
|
Sound of river flowing and voices. |
|
01:37:58:10 |
MATT and MAYA PROBST carrying cooler with their families |
MATT PROBST: Here you go, [bud]. I got you.
|
|
01:38:04:23 |
MATT and MAYA PROBST carrying cooler.
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MATT PROBST VO: For three years now, the first thing I think of when I wake up in the morning is my sister --
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01:38:10:12 |
MAYA PROBST puts hat on her son’s head
Superimposed TEXT CARD: Maya Probst Matt’s Sister
|
MATT PROBST VO: is she okay.
MATT PROBST VO: Maya and I grew up - |
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01:38:15:10 |
Archival photos of MATT and MAYA PROBST as children |
MATT PROBST VO: - very close. I’m the big brother, very protective big brother. In some ways, maybe a little bit of, uh, caregiver relationship, too.
|
|
01:38:25:23 |
MATT PROBST sets up grill talking to MAYA PROBST |
MAYA PROBST: Do you need help with anything here?
MATT PROBST: Mm-mm, I got it if you want to go hang out with them.
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|
01:38:33:12 |
MAYA PROBST sledding with MATT and MAYA’s kids |
MATT PROBST VO: It started when she would come around to less family things, and when she would, it was just acting funny. She did eventually let us know that she had been on meth.
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|
01:38:46:22 |
MAYA PROBST sledding with MATT and MAYA’s kids |
MAYA PROBST VO: What I have experienced the past three years was hard for all of us. I went through a separation, and so -
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|
01:39:03:04 |
MAYA PROBST interview |
MAYA PROBST: my kids, they spent the, the majority of their time right now with their father, and I want to be an active part in their lives more.
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|
01:39:12:14 |
MAYA PROBST sledding with her son
|
MAYA PROBST VO: That hope, that’s all I have.
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|
01:39:22:23 |
MATT PROBST grilling and serving food to family members, MAYA PROBST and kids eating. |
MATT PROBST: Maya, are you ready to eat?
Female Voice: [unintelligible]
MATT PROBST VO: We’d set it up for her to go to an inpatient program. And then she ended up spending time with my dad, and my dad and her kind of convinced each other that she shouldn’t do that. You know, it becomes a family disease.
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|
01:39:50:16 |
Early morning ext. of CHRIS and ANN RUGE’s house
|
Sound of coffee grinder and morning ambience |
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01:39:55:07 |
CHRIS RUGE makes coffee and drives away from house
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Sounds of making coffee and car driving away |
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01:40:14:03 |
CHRIS RUGE in home visit with MARY DELL
Superimposed TEXT CARD: Mary Dell |
MARY DELL: Mmm
CHRIS RUGE: Okay. Now just breathe normal.
MARY DELL: I have a question for you, Chris.
CHRIS RUGE: Yes.
MARY DELL: Why was it you requested, uh, some drug testing for me?
CHRIS RUGE: I do drug tests on everyone who does pain meds. Uh, it’s actually a state requirement now, every three months.
MARY DELL: That’s fine, Chris, that’s fine.
CHRIS RUGE: Yeah.
MARY DELL: You know, if it’s required, that’s fine with me.
CHRIS RUGE: Yeah.
MARY DELL: But for me to get my EOB and all this stuff is on there, I’m like—
CHRIS RUGE: Plus, uh, —
MARY DELL: —why does Chris think I’m on drugs, uh—
CHRIS RUGE: No, what, what, what—
MARY DELL: —you know, and I got very offended with that—
CHRIS RUGE: Okay.
MARY DELL: —because I don’t do drugs.
CHRIS RUGE: Yeah. So when you check for is any medicine you’re being prescribed.
MARY DELL: Mm-hm.
CHRIS RUGE: And if there’s a narcotic medicine I don’t prescribe that’s in your urine, then I can’t prescribe—
MARY DELL: What—
CHRIS RUGE: —what I’m doing.
MARY DELL: Okay.
CHRIS RUGE: So that, but that’s what that’s about, okay?
MARY DELL: Okay. And, and on the hydrocodone, Chris—
CHRIS RUGE: Yeah.
MARY DELL: —you’re only giving me three a day, and that’s not helping me. I need, I need more. I, I’m sorry—
CHRIS RUGE: Mm-hm.
MARY DELL: —but I, you know, I’m in a lot of pain.
CHRIS RUGE: Yeah.
MARY DELL: And, and I don’t exaggerate about that. I am in a lot of pain, and I definitely need more. I’m sorry.
CHRIS RUGE: Well, [uh], probably not.
MARY DELL: So if you can make it up to four a day, I’m, I’ll be fine.
CHRIS RUGE: Yeah. Yeah.
MARY DELL: Yeah, one more a day—
CHRIS RUGE: Well, the, the problem—
MARY DELL: —because I’m like—
CHRIS RUGE: Yeah. The, the problem with long-term narcotics—
MARY DELL: Mm-hm.
CHRIS RUGE: —is that it actually increases your pain.
MARY DELL: Mm-hm.
CHRIS RUGE: So the more you take, actually the more pain you feel because it, it hyper, what we call hyper-activates your pain receptors.
MARY DELL: Mm-hm.
CHRIS RUGE: So it, it could be that you would feel better for a couple weeks, or a month or two on four, uh, but then it, the, you would actually feel worse.
And then the only thing that would make you feel better is for that dose to go up. Some people put patients on pretty high narcotics, but kind of looking at you when I do visit and stuff, I don’t think you need more narcotics on board.
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|
01:42:33:18 |
CHRIS RUGE driving
|
Sound of driving |
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01:42:38:14 |
CHRIS RUGE walking down hallway at clinic
|
Sound of clinic ambience
MATT PROBST: All right, man - |
|
01:42:44:03 |
MATT PROBST doing annual performance review with CHRIS RUGE while they eat lunch |
MATT PROBST: - well, it’s the normal, uh, routine, which you have not had, I don’t know if you even remember the last time you and I had an annual performance review together.
CHRIS RUGE: Right.
MATT PROBST: But let me start with, you know, how are you? Are you taking care of yourself? Are you taking care of your family? Uh, are you balanced?
CHRIS RUGE: Of course.
MATT PROBST: Yeah?
CHRIS RUGE: Work and family [gestures, laughs]
MATT PROBST: Okay. Right. Yeah, yeah.
CHRIS RUGE: I don’t know if I’ll ever evolve out of that. I’ve never totally been able to balance family and work, but that’s just I, I’ve always sensed a lot more need on the work side of that equation.
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|
01:43:25:22 |
CHRIS RUGE dialing phone in his office |
Recording: At the tone, please record your voice message. [beep]
CHRIS RUGE: Hi, this is Chris Ruge over at the clinic. Uh, I am just trying to find, uh, Miss Cheri.
|
|
01:43:41:14 |
CHRIS RUGE dialing phone in office again
|
Sound of office ambience and phone dialing |
|
01:43:56:00 |
Ext. of CHERI’s house |
Instrumental music.
Sound of phone ringing.
CHRIS RUGE VO: When I’m unable to contact Cheri, I definitely worry.
|
|
01:44:07:10 |
CHRIS RUGE holding the phone in his office
|
CHRIS RUGE VO: When she totally disappears, |
|
01:44:13:14 |
Ext. of Cheri’s house |
CHRIS RUGE VO: it’s more likely than not that things fell apart again.
|
|
01:44:21:13 |
Storm on the horizon at dusk |
Instrumental music |
|
01:44:28:15 |
CHRIS RUGE lighting a fire at home
|
Instrumental music and fire crackling |
|
01:44:50:14 |
MATT PROBST chopping wood in his yard |
MATT PROBST VO: It’s been a very rough week for my family, a very rough week.
|
|
01:45:02:04 |
Archival news footage from KOB-4 of news anchor walking down the street
|
News Anchor: Santa Fe County deputies arrested five people for identity theft last week. |
|
01:45:06:06 |
KOB-4 news footage showing mugshots of Edward Lucero, Gino Bear Gonzales, Johnny Moreno, Danielle Schroder and Maya Probst
Superimposed TEXT CARD: Maya Matt’s Sister |
News Anchor: Edward Lucero, Gino Bear Gonzalez, Johnny Moreno, Danielle Schroder, and Maya Probst: were all arrested for identity theft. Deputies believe they worked together to steal bank statements, credit cards, and checks from people’s mailboxes.
|
|
01:45:22:21 |
MATT PROBST chopping wood in his yard |
MATT PROBST VO: Stolen goods for drugs scheme is what the media was calling it. She got out of jail, but she’s in a hole. She lost her house, lost her job, and she lost custody of the kids.
When somebody’s sick, when somebody’s dealing with addiction, you want so bad to believe that they’re okay that it’s easy to convince yourself that they are. It’s been a tough week, for sure.
|
|
01:45:57:05 |
Scenics of Las Vegas town and surrounding area at night, flags waving in the wind, trucks on the highway at night
|
Instrumental music |
|
01:46:10:23 |
Scenic of sunrise
|
Instrumental music |
|
01:46:14:01 |
DR. LESLIE HAYES in an appointment with ANONYMOUS PREGNANT PATIENT |
DR. LESLIE HAYES: Hey, how’s it going?
ANONYMOUS PREGNANT PATIENT: Good.
DR. LESLIE HAYES: Anything in particular going on, or just here for routine pre-natal?
ANONYMOUS PREGNANT PATIENT: Routine pre-natal and a refill.
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|
01:46:24:02 |
Image of clinic wall and equipment with superimposed TEXT CARD: Due to the stigma faced by pregnant women struggling with opioid use disorder, this patient appears anonymously.
|
Sound of ambience of appointment |
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01:46:29:23 |
DR. LESLIE HAYES in an appointment with ANONYMOUS PREGNANT PATIENT |
DR. LESLIE HAYES: And how’s the baby moving?
ANONYMOUS PREGNANT PATIENT: Good, a lot—
DR. LESLIE HAYES: Good.
ANONYMOUS PREGNANT PATIENT: —now.
DR. LESLIE HAYES: And I forgot. Does he have a name yet?
ANONYMOUS PREGNANT PATIENT: No.
DR. LESLIE HAYES: Okay.
ANONYMOUS PREGNANT PATIENT: Want to do a butterfly?
ANONYMOUS PATIENT’S DAUGHTER: Yes.
DR. LESLIE HAYES: And has anyone hit, kicked, or otherwise abused you?
ANONYMOUS PREGNANT PATIENT: Besides her, no. [laughter] What’s that?
ANONYMOUS PATIENT’S DAUGHTER: A baby lion.
ANONYMOUS PREGNANT PATIENT: That’s a baby lion?
DR. LESLIE HAYES: And buprenorphine is still working well for you?
ANONYMOUS PREGNANT PATIENT: Yeah.
DR. LESLIE HAYES: Okay. Any cravings?
ANONYMOUS PREGNANT PATIENT: I mean, it’s always there in the back of my mind, the pills or whatever else.
DR. LESLIE HAYES: Okay.
ANONYMOUS PREGNANT PATIENT: But knowing I’m pregnant, like I wouldn’t want to do anything to put them in jeopardy.
DR. LESLIE HAYES: All right. Are you going to push the button for me? Hey, you found it first time.
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|
01:47:17:03 |
DR. LESLIE HAYES performs ultrasound on ANONYMOUS PREGNANT PATIENT |
DR. LESLIE HAYES VO: The general media perception of women who use drugs during pregnancy is that they’re selfish, awful people who don’t care about their baby at all.
|
|
01:47:26:08 |
Interview of DR. LESLIE HAYES |
DR. LESLIE HAYES: But when you actually talk with the women, the vast majority are so desperate to get drug free so that they can take care of their baby, but they’re just overwhelmed by it.
|
|
01:47:34:08 |
DR. LESLIE HAYES performs exam on ANONYMOUS PREGNANT PATIENT
|
DR. LESLIE HAYES: And he is head down, so.
ANONYMOUS PREGNANT PATIENT: Is he? Okay.
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|
01:47:36:21 |
DR. LESLIE HAYES performs exam on ANONYMOUS PREGNANT PATIENT, ANONYMOUS PREGNANT PATIENT’S DAUGHTER measures ANONYMOUS PREGANT PATIENT’S stomach |
DR. LESLIE HAYES VO: I find if we’re giving them support and they’re getting treatment, it’s by far and away the most motivated group you will ever find.
DR. LESLIE HAYES: All right, so I will see you next week.
ANONYMOUS PREGNANT PATIENT: Okay.
|
|
01:47:48:09 |
DR. LESLIE HAYES and family go into restaurant for Mother’s Day Brunch |
Female Voice: Here’s to mother’s everywhere.
RICH HAYES: Happy Mother’s Day.
Female Voice: Happy Mother’s Day.
DR. LESLIE HAYES: Cheers.
RICH HAYES: And happy Emmy is home day.
DR. LESLIE HAYES: Yes.
Female Voice: And happy Emmy is home day.
|
|
01:47:59:09 |
DR. LESLIE HAYES having mother’s day brunch with husband DAVE RICH, children and friends |
DR. LESLIE HAYES VO: As a parent, I had some incredible role models in my patients.
Various: [unintelligible]
EMMY HAYES: [unintelligible] spoilers
Male Voice: Hello?
DR. LESLIE HAYES VO: I have seen many truly wonderful parents through the years with far fewer resources than I’ve had, and I’ve tried to emulate them.
Female Voice: Is this your new tattoo?
EMMY HAYES: Yeah.
Male Voice: [unintelligible]
EMMY HAYES: Yeah, the only one that hurt was like the one down here.
Female Voice: Mm-hm.
EMMY HAYES: Like I thought the ribs were going to hurt, but—
DR. LESLIE HAYES VO: It’s also given me some perspective. I don’t care about what hairstyle they want or tattoos, because I’ve seen parents dealing with so many more difficult things.
I think it sometimes makes the kids a little crazy. When my daughter went away to school, I insisted that she carry Narcan with her. I don’t want her to ever have someone in her dorm overdose and not be able to take care of it.
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|
01:48:46:13 |
Ext. of West Las Vegas High School
|
Instrumental music |
|
01:48:52:05 |
Wall in West Las Vegas High School with school name and “Home of the Dons” logo
|
Instrumental music |
|
01:48:55:16 |
Anonymous students entering classroom |
MATT PROBST: What you want to do in your health care career, and I think probably just in life in general, is you –
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|
01:49:00:00 |
Sign on wall that says “105, Lab Prep” |
MATT PROBST: want to create a solid foundation of knowledge.
|
|
01:49:03:22 |
MATT PROBST talking to classroom of high school students
Superimposed Text Card: Tiffany Semillas de Salud Student |
MATT PROBST: And then you start building on that solid foundation of knowledge.
Who in here butchers animals for their meat, right?
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|
01:49:15:13 |
MATT PROBST helps students dissect cats |
MATT PROBST: Okay. The best experience I had for medical procedures was being Grandpa’s assistant in, as the butcher’s assistant growing up, yeah.
Various: [unintelligible]
STUDENT’S VOICE: Ms., are you moving me?
TIFFANY ENCINIAS: Gallbladder, stomach, fat.
What’s this?
MATT PROBST: Uh, lomo.
TIFFANY ENCINIAS: Our cat’s so fat.
MATT PROBST: Your cat does have a lot of fat.
TIFFANY ENCINIAS: Our cat was so unhealthy.
MATT PROBST: It could have just been diet, but it could have had a disease process, too.
|
|
01:50:00:20 |
Ext. of West Las Vegas High School, students walking down hallway
|
School bell buzzes |
|
01:50:04:18 |
MATT PROBST talking to LOURDES ENCINIAS in her truck
Superimposed Text Card: Lourdes Tiffany’s Grandmother |
LOURDES ENCINIAS: Thank you for my—
MATT PROBST: Oh, yeah.
LOURDES ENCINIAS: —for, you know.
MATT PROBST: Well, thank her.
LOURDES ENCINIAS: [unintelligible]—
MATT PROBST: She’s amazing.
LOURDES ENCINIAS: I don’t know. She wants to go in for, uh, for—
TIFFANY ENCINIAS: EMT?
LOURDES ENCINIAS: Yeah.
MATT PROBST: Yeah.
LOURDES ENCINIAS: And I, I want her more like a nurse.
MATT PROBST: Well, I think that EMT is a good place to start because those credits apply to nursing, so you start with this one-year certificate, then you can keep going, and, uh, and you can go paramedic, or nursing, or medical. She’s going to end up being an ER physician eventually. She thinks EMT, and that’s good to start there, but she’ll probably be an ER doc.
LOURDES ENCINIAS: Okay, you need to tell her that.
MATT PROBST: I know. Anything I can do.
|
|
01:50:41:23 |
TIFFANY ENCINIAS cares for cattle at her family ranch with grandmother LOURDES ENCINIAS |
LOURDES ENCINIAS: You’re going to carry the calf.
TIFFANY ENCINIAS: Again?
LOURDES ENCINIAS: Yes.
TIFFANY ENCINIAS: Yeah. Come on, baby. Get up. I don’t want to carry you.
LOURDES ENCINIAS: He weighs at least [unintelligible].
|
|
01:51:06:17 |
TIFFANY ENCINIAS in interview |
TIFFANY ENCINIAS: I would think that growing up on the ranch is a good training to go into medicine because –
|
|
01:51:10:10 |
TIFFANY ENCINIAS cares for cattle at her family ranch with grandmother LOURDES ENCINIAS |
TIFFANY ENCINIAS VO: - you’re exposed to a lot more animals, a lot more bodies, a lot more home remedies.
I started thinking about becoming an EMT from being in the Semillas program, and over the years, that passion has just grown. In 2011, my –
|
|
01:51:32:20 |
Archival photos of TIFFANY ENCINIAS’ grandfather |
TIFFANY ENCINIAS VO: - grandfather was diagnosed with leukemia cancer. As the years progressed, it just got worse and worse. I would call the ambulance knowing it’s going to be an hour and a half before they get to our house, or even find our house.
|
|
01:51:46:19 |
TIFFANY ENCINIAS cares for cattle at her family ranch with grandmother LOURDES ENCINIAS |
TIFFANY ENCINIAS VO: So I want to go into the medical profession because this community is so far from medical help.
TIFFANY ENCINIAS: Ready to go home?
LOURDES ENCINIAS: Yeah, I’m ready to go home.
|
|
01:52:06:11 |
Storm, clouds, rain, lightning on the horizon
|
Sound of storm |
|
01:52:20:19 |
Ext. of CHRIS RUGE’s house surrounded by storm clouds
|
Female Voice: This is the nurse advice line. have, uh, George – |
|
01:52:27:03 |
CHRIS RUGE writing notes in his kitchen |
Female Voice: -that wants to talk to you, and he says that he’s, uh, fell off the wagon, and he’s been drinking a lot, he’s having lots of anxiety. I’ll just tell him that I left you a message. Thank you.
|
|
01:52:39:14 |
CHRIS RUGE in home visit with GEORGE |
CHRIS RUGE: So you didn’t have anything to drink yesterday before that?
GEORGE: Yesterday? No.
CHRIS RUGE: Yeah.
GEORGE: The day before.
CHRIS RUGE: Yeah.
GEORGE: Just, uh, you know how I get with anxiety.
CHRIS RUGE: Yeah.
GEORGE: Then I think I’m going through withdrawal, too, just like you said I was.
CHRIS RUGE: Mm-hm. Well, that’s not a surprise. So did you talk to the knee guy?
GEORGE: I sure haven’t.
CHRIS RUGE: Yeah. When you going to do that?
GEORGE: Tomorrow. Uh—
CHRIS RUGE: Do you know, do you know what days of the week they’re there?
GEORGE: Thursday.
CHRIS RUGE: So tomorrow’s Wednesday. Why don’t you call them while I’m here?
GEORGE: Okay. I don’t have a phone, though, that’s why you haven’t been able to get ahold of me.
CHRIS RUGE: Oh, are you out of minutes?
GEORGE: Yeah.
CHRIS RUGE: So what’s next?
GEORGE: Rehab.
CHRIS RUGE: Is it?
GEORGE: Like you said, yeah.
CHRIS RUGE: Have you, have you talked to anybody?
GEORGE: No, I haven’t.
CHRIS RUGE: So what do you think you want to do over the next four weeks?
GEORGE: The next four weeks I think I should start attending Rio Grande, at least. Think?
CHRIS RUGE: I’m done thinking.
GEORGE: I know.
CHRIS RUGE: I want you to start thinking. You’re not placed on the, on the earth to make me happy, right? You’re, you’re, you’re on here for, for your own purpose and your own reasons.
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|
01:54:19:07 |
CHRIS RUGE driving |
CHRIS RUGE: That was a big ouch. What’s pretty obvious is we’re not really out of the fire at all.
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|
01:54:41:15 |
CHRIS RUGE on ECHO Care video teleconference with specialists at UNM |
CHRIS RUGE: Unfortunately, what has been happening, uh, uh, over the last six to nine months is a worsening trend with liver tests.
Female Voice: Well, this patient sounds a little bit different. I guess what I would do, Chris, is [unintelligible]—
CHRIS RUGE: We’re trying to brainstorm and come up something to turn things around.
Female Voice: —the idea of taking the medication. Was there something else going on at the time—?
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|
01:55:05:00 |
Image of hallway with wheelchairs and medical equipment with superimposed TEXT CARD: The pilot phase of Chris’ program, ECHO Care, is concluding.
|
Instrumental music |
|
01:55:11:01 |
Image of hallway with wheelchairs and medical equipment with superimposed TEXT CARD: Insurance companies are considering an option not to renew its funding.
|
Instrumental music |
|
01:55:20:14 |
CHRIS RUGE on phone, getting medication from fridge at the clinic, sitting at his desk |
CHRIS RUGE VO: The news, which was a little bit of a surprise, might mean that the ECHO Care program will totally dissolve. It might mean that they changed the heavy emphasis on home visits. If it ended, it would likely lead to the early death of a lot of our patients.
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|
01:55:46:01 |
CJ and CHERI in appointment with CHRIS RUGE |
CHERI: I had a relapse, and, uh, I was scared to come back in. I’m, I messed up again.
CHRIS RUGE: So, um—
CHERI: I don’t know. I was doing so good, and then—
CHRIS RUGE: How many days were you drinking this time?
CHERI: Probably two weeks, almost three straight. Oh yeah I, I messed up bad.
CHRIS RUGE: Mm-hm. Yeah. Okay. Well, why don’t we do this one step at a time? But the first thing we need is to get you in here, well, at least every two weeks. Uh, weekly would be great, because I think then you can get things taken care of.
CHERI: I don’t have transportation.
CHRIS RUGE: Yeah. But this is the thing. If we can get things set up, and we can actually get you meaningful employment here, we can solve the other problems as they come up. But the number one thing is, is, is getting money in your pocket, okay, because if we keep on waiting to do this until this happens, and then, but we can’t do that until this other happens, then, then time flies, and, and, and you get frustrated and more stressed—
CHERI: Yeah.
CHRIS RUGE: —and then bad things happen, so, uh—
CHERI: Yeah, I haven’t had my medicine, so that’s what I said [unintelligible] it’s, it’s awful.
CHRIS RUGE: Well, let’s, let’s fix it then.
CHERI: Yeah. I’m ready. I’ve been ready.
CHRIS RUGE: I know.
|
|
01:57:28:21 |
Early morning outside the RUGE’s house, birds chirping in the trees
|
Ambience of early morning, bird sounds |
|
01:57:34:23 |
ANN RUGE in the kitchen making pies, CHRIS RUGE enters the kitchen. |
ANN RUGE: You know, this is going to be our first Christmas just with you and me.
CHRIS RUGE: It’s these rituals, the cooking rituals of holidays, we should just cook, but then just give it all away, and then go to Mexico.
|
|
01:57:51:22 |
CHRIS and ANN RUGE talk while Chris does the dishes |
ANN RUGE: Well, what is it about holidays that make you uncomfortable, Chris? I mean, why do you think you don’t like Christmas?
CHRIS RUGE: I don’t know.
ANN RUGE: Or birthdays?
CHRIS RUGE: We’ve, for 20 years, have worked the communities that when we’re, when we finish, we go home, we go home to a different reality. We escape that reality.
ANN RUGE: I mean, you, you show --
CHRIS RUGE: Well, no, I—
ANN RUGE: —a tenderness and a sacrifice for your patients that, you know, you, you don’t give to your family because I think you feel that there’s that guilt and that we have everything that they don’t.
CHRIS RUGE: It, it’s as yesterday, you know, working with a patient with such a tragic life that she’s caught up in. It’s like watching someone stuck in quicksand, and you’re on dry land, at a table, with a margarita, and saying, “God, that’s really tragic.”
ANN RUGE: Well, you’re hardly that to your patients.
CHRIS RUGE: No, I know.
ANN RUGE: How could you do more?
CHRIS RUGE: But, but, but I—
ANN RUGE: By living with them?
CHRIS RUGE: —but you walk away, I don’t know. Like if I knew in my heart of hearts that, uh, bringing my patient and her 13-year-old home for like a month would like totally put their life in another direction and totally change their reality forever, I think I’d argue for it.
ANN RUGE: Well, you’d have quite a list.
CHRIS RUGE: Yeah.
ANN RUGE: It’s really, uh, sort of flabbergasting that there’s guilt on you for, I mean, how could you work any harder?
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|
01:59:43:11 |
Snow falling in a field, and on the road
|
Instrumental music |
|
01:59:54:22 |
MATT PROBST driving in the snow, show of a rosary hanging in the window
|
Instrumental music |
|
02:00:03:02 |
MATT PROBST drinks from a paper cup
|
Instrumental music |
|
02:00:06:13 |
Clinic staff talking before Provider breakfast meeting
|
Instrumental music |
|
02:00:09:15 |
Close-up on MATT PROBST
|
Instrumental music |
|
02:00:12:22 |
Clinic staff talking before Provider breakfast meeting
|
MATT PROBST: So as you all know—
|
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02:00:16:06 |
MATT PROBST addresses clinic staff at provider breakfast meeting |
MATT PROBST: - we’re having peer reviews for opiate prescription. We’re gonna to go through that process of peer review. We’re going to learn, we’re going to revise our guidelines. Uh, with the history of opiates, there’s been a big shift, and, um, this is near and dear to me, okay? This is near and dear to me, this issue right here.
Uh, my dad died two days ago, guys, so my dad died three days ago, on Sunday, and, uh, he died most likely of an accidental overdose death. And this is something that I’ve been knowing about for a long time, that he would take it his own way, and he was his own guy, and everything he did, including how he thought it was best to take pills.
And I told him, and I told his provider, and I told everybody I could tell, but nonetheless, that, that’s what happened. And I don’t want that to happen again. I don’t want that to happen to my patients, to my family, to my community.
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02:01:15:13 |
MATT PROBST leaves meeting room, hugs LORE PEASE
|
Instrumental music |
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02:01:21:19 |
Ext. of PROBST house at night |
Instrumental music
ISAIAH PROBST: Dad, I made a timeline of him.
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02:01:26:13 |
MATT and ELIZABETH PROBST and their kids cut out and arrange photo collage boards |
MATT PROBST: You made a timeline?
ISAIAH PROBST: Yeah, look at.
ELIZABETH PROBST: I say we start—
MATT PROBST: [unintelligible]—
ELIZABETH PROBST: —laying them down, and then rearranging them.
MATT PROBST: Okay.
Your Grandpa Bibo grew up on the farm there.
|
|
02:01:41:16 |
Archival photo of GILBERT PROBST and family on the farm |
MATT PROBST: He spent a lot of time, when he was a little boy, on the farm.
MATT PROBST: This whole -
|
|
02:01:46:05 |
MATT PROBST and his sons look at old family photographs |
MATT PROBST: - farm that your great-grandpa had—
NOAH PROBST: Oh—
MATT PROBST: —is where I grew up, and all, all that whole area in the Pojoaque Valley is nothing but our relatives.
ISAAC PROBST: This one. This one, Dad.
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02:01:56:00 |
Archival photograph of young GILBERT PROBST with motorcycle |
MATT PROBST: Well, that one’s, that one’s Grandpa when he was young, mm-hm.
|
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02:02:02:04 |
ISAIAH PROBST looks at old family photographs |
ISAIAH PROBST: He had a unibrow like me—
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02:02:04:09 |
Archival photo of young GILBERT PROBST |
MATT PROBST: Huh? Like all of us, that, that’s, that’s part of the legacy is the unibrow.
|
|
02:02:10:13 |
MATT PROBST and his sons look at old family photographs |
MATEO PROBST: Daddy, I know who that is. You could recognize it’s you.
|
|
02:02:14:06 |
Archival photograph of teenage MATT PROBST |
MATT PROBST: Yeah.
ISAAC PROBST: Why did you—
MATT PROBST: Okay.
ISAAC PROBST: —used to have a mullet?
MATT PROBST: I know I had a mullet, dude. I was proud of my mullet. I wanted to be just like—
|
|
02:02:21:20 |
MATT PROBST and his sons look at old family photographs |
ISAAC PROBST: If you would have just kept your hair like that—
MATT PROBST : —Grandpa Bibo with a mullet.
MATEO PROBST: That is Auntie Maya—
ISAAC PROBST: Do this one. |
|
02:02:25:15 |
Archival photo of teenage MAYA PROBST |
MATT PROBST: That’s Auntie Maya, that’s right.
|
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02:02:29:14 |
MATT PROBST and ISAIAH look at photos while ELIZABETH PROBST carries MATEO PROBST out of the room |
ELIZABETH PROBST: [unintelligible] Go brush your teeth, and I’ll get it.
MATEO PROBST: [unintelligible]—
ELIZABETH PROBST: Let’s go get you all ready for bed
MATT PROBST: Yeah, there’s all kinds of stories.
MATT PROBST VO: It was a good thing learning responsibility as a young person.
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02:02:54:07 |
Interview of MATT PROBST |
MATT PROBST: Maybe it made me too serious.
|
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02:02:59:07 |
Archival photograph of MATT and MAYA PROBST as children with their father
|
MATT PROBST VO: You shouldn’t be working a chainsaw at 10 years old. You shouldn’t be –
|
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02:03:04:06 |
Interview of MATT PROBST |
MATT PROBST: -you know, there’s some things, [crying], you shouldn’t be selling cocaine when you’re a sophomore in high school to pay the mortgage.
|
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02:03:18:07 |
Archival photograph of teenage MATT PROBST |
MATT PROBST VO: I saw a lot of awful things. [crying] |
|
02:03:24:09 |
Interview of MATT PROBST |
MATT PROBST: [crying] And there’d be, be big fights going on, and my sister –
my sister would come crawl in bed with me, and just hold her and try and love her, you know, the way a parent should.
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|
02:03:58:02 |
MATT PROBST looks down at photo collage boards
|
Instrumental music |
|
02:04:03:15 |
Ext. of PROBST house at night |
Instrumental music
|
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02:04:08:00 |
Scenic of Las Vegas landscape at night
|
Instrumental music
CHRIS RUGE: This is the email- |
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02:04:18:16 |
CHRIS RUGE in interview reading from a piece of paper |
CHRIS RUGE: - from Project ECHO that came to the teams. Actually, it says, [reading from piece of paper] “We are sad to relay the news that the ECHO Care program will be concluding at the end of June.
Ongoing efforts to negotiate continued contracts with the insurance companies have been unsuccessful. Please accept our deepest gratitude for your commitment to the most underserved patients in our communities.”
|
|
02:04:45:14 |
CHRIS RUGE sitting in office |
CHRIS RUGE VO: So the program is –
|
|
02:04:49:12 |
CHRIS RUGE walking outside the clinic
|
CHRIS RUGE VO: kaput in three months. |
|
02:04:53:15 |
CHRIS RUGE drives down driveway to his home
|
Sound of driving |
|
02:05:02:20 |
CHRIS and ANN RUGE talking in kitchen while preparing drinks |
ANN RUGE: Or do you need to kick something?
CHRIS RUGE: Uh, no, no, no.
ANN RUGE: You can’t kick me.
CHRIS RUGE: I’m not kicking.
ANN RUGE: But you can hug me.
CHRIS RUGE: I’m not kicking.
ANN RUGE: I think I need a really nice, big glass of wine.
CHRIS RUGE: Well, Matt came in and said, said, “So big news, huh?”
ANN RUGE: Had you heard?
CHRIS RUGE: No. To which I said, “What?” He says, “Yeah, didn’t you get the email?” And so I opened up my email, and as he was talking to me, he goes, “Ding.”
ANN RUGE: What does this mean for you?
CHRIS RUGE: That’s what we have to figure out. We don’t know yet. It’s just an unknown- |
|
02:05:43:14 |
Phone rings while CHRIS and ANN are talking in kitchen |
CHRIS RUGE: Hello?
MIRIAM KOMAROMY: I just went out for - |
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02:05:47:04 |
CHRIS RUGE sits in chair talking to MIRIAM KOMAROMY on phone
Superimposed TEXT CARD: Voice of Miriam Director, ECHO Care |
MIRIAM KOMAROMY: -a beer with the ECHO Care team.
CHRIS RUGE: Mm-hm.
MIRIAM KOMAROMY: We’re sort of licking our wounds a little bit.
CHRIS RUGE: It’s frustrating and a little sad that people really didn’t get the big picture here.
MIRIAM KOMAROMY: I know. Audrey and were talking about attachment theory and that it was like—
CHRIS RUGE: Yeah.
MIRIAM KOMAROMY: —you know, a lot of the intervention has really been about persuading these patients to attach to somebody and actually experience what it feels like to be cared about —
CHRIS RUGE: Yeah.
MIRIAM KOMAROMY: —and to trust somebody.
CHRIS RUGE: Yeah. Yeah.
MIRIAM KOMAROMY: Now, of course, we’re going to pull the rug out from under them once again.
CHRIS RUGE: Again.
MIRIAM KOMAROMY: Yeah.
CHRIS RUGE: Again.
MIRIAM KOMAROMY: [unintelligible]—
CHRIS RUGE: Con, confirm, confirm their—
MIRIAM KOMAROMY: Yeah, that they were right to begin with.
CHRIS RUGE: —their fears, yeah.
|
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02:06:26:02 |
Ext. El Centro Clinic |
LORE PEASE: Okay so the next part is what are we going to –
|
|
02:06:30:11 |
LORE PEASE, MATT PROBST, CHRIS RUGE, and MARK BJORKLUND in a meeting discussing ECHO CARE |
LORE PEASE: do about ECHO Care?
CHRIS RUGE: Uh, I think it’s an obvious benefit to our patients. Our, our satisfaction surveys, our hospitalization numbers, our ER numbers are all pretty darn good.
MATT PROBST: From the taking care of humans aspect, this is working for us, this is a successful model.
LORE PEASE: That’s true. But to sustain the program, it has to be financially feasible.
CHRIS RUGE: Yeah, right.
LORE PEASE: It doesn’t have to make money. It has to just break even.
CHRIS RUGE: Right.
Male Voice: Right.
LORE PEASE: And I want to keep the program going, because I think we’re making a real positive impact into these patients’ lives.
Male Voice: Mm-hm.
LORE PEASE: But financially, it has to be feasible.
CHRIS RUGE: Right. Right.
|
|
02:07:13:15 |
Albuquerque skyline
Superimposed TEXT CARD: Albuquerque, NM |
Sound of quiet city
|
|
02:07:19:03 |
Ext. UNM Hospital |
MATT PROBST: Hey
|
|
02:07:22:10 |
MATT PROBST visits MARIE LUCERO and IGNACIO LUCERO in the hospital |
MARIE LUCERO: How are you?
MATT PROBST: Good. How are you?
MARIE LUCERO: Oh, I’m fine.
MATT PROBST: What happened? I saw you two days before he landed in the hospital—
MARIE LUCERO: I know.
MATT PROBST: —and he was doing good that day—
MARIE LUCERO: I took him in because he said he couldn’t breathe.
MATT PROBST: Uh-huh.
MARIE LUCERO: And the, the lung had already collapsed.
MATT PROBST: Okay. Well, I’m glad I could be here. I thought you were going to give the clinic a facelift and some of those nice doors like you have at your house. Our clinic needs some character. [laughs]
IGNACIO LUCERO: Well, l, I will. When I have time. because I’m, I’m backlogged, uh—
MATT PROBST: You’ve got jobs and jobs piled up.
IGNACIO LUCERO: Mmmm, all piled up.
MATT PROBST: Yeah.
MATT PROBST: Every once in a while, I have a patient that as their physical body withers, they become more alive, brighter, their light –
The one thing medicine has intrigued me is how to find that. I’m always looking for that in myself. I want to find that light. I think it’s something we’re all looking for.
IGNACIO LUCERO: Well, I’m going to make sure that you find it.
|
|
02:08:49:14 |
Tree being blown by the wind |
Wind sound
Instrumental music
|
|
02:08:57:11 |
Funeral Mass for IGNACIO LUCERO at Our Lady of Sorrows Church with MATT PROBST and MARIE LUCERO attending |
Instrumental music
Female Voice: [Prayers in Spanish] |
|
02:09:54:15 |
DR. LESLIE HAYES walking down hallway in clinic
|
Sound of clinic ambience and baby crying |
|
02:10:00:19 |
DR. LESLIE HAYES having appointment with ANONYMOUS PREGNANT PATIENT |
[baby cries]
ANONYMOUS PREGNANT PATIENT: I barely got to the hospital in time to have him. I don’t think I was there maybe 45 minutes.
DR. LESLIE HAYES: Oh, man.
ANONYMOUS PREGNANT PATIENT: And I almost had him without a doctor, too.
DR. LESLIE HAYES: Okay, so anything you’re worried about with him?
ANONYMOUS PREGNANT PATIENT: No.
DR. LESLIE HAYES: Okay, great.
Hey, handsome. [Baby sneezes]
ANONYMOUS PREGNANT PATIENT: Bless you.
DR. LESLIE HAYES: And how are you doing?
ANONYMOUS PREGNANT PATIENT: I’m doing good.
DR. LESLIE HAYES: And, um, any drug use?
ANONYMOUS PREGNANT PATIENT: No.
DR. LESLIE HAYES: Okay.
ANONYMOUS PREGNANT PATIENT: Now it’s just adjustment to have the two of them, a big adjustment.
DR. LESLIE HAYES: I was amazed how much more work two was than one, so.
ANONYMOUS PREGNANT PATIENT: It’s hard work dealing with a brand new baby and, and a toddler at the same time. It’s, it’s a lot of work, but I love it. I don’t think I would trade anything for the world for this.
|
|
02:11:05:02 |
DR. LESLIE HAYES and nurses with newborn baby in clinic hallway
|
Instrumental Music |
|
02:11:10:10 |
Scenic of sunrise over Las Vegas
|
Radio Announcer: Good morning again, folks. |
|
02:11:14:15 |
MATT PROBST, TIFFANY ENCINIAS and others recording radio program at KFUN / KLVF Las Vegas |
Radio Announcer: We have with us in the studio students from West Las Vegas, the school-based health center. Tiffany, can you share with the audience what your interest is in, in the medical field?
TIFFANY ENCINIAS: I live way out in the country with my grandparents, so I want to go into EMS and help out the rural community.
MATT PROBST: I know there’s a lot of despair, you know, how will we survive in rural America and rural New Mexico. Right now we export our most precious resource, and that’s our educated youth. They got to move away because there’s nothing here to do.
Well, you know what there’s here to do? Health care. This is the thing that I’m the most proud of, these youth, and Tiffany, in specific.
MATT PROBST VO: Our biggest recruitment-
|
|
02:11:54:00 |
El Centro nurses and providers in the clinic |
MATT PROBST VO: - recruitment success has been Semillas de Salud. Right now we have nine people lined up for interview –
|
|
02:12:01:01 |
MATT PROBST walks down hallway with MELODY MARTINEZ
|
MATT PROBST VO: and of the nine, two have already accepted. |
|
02:12:04:12 |
MATT PROBST talks to MELODY MARTINEZ in office |
MATT PROBST: You’re going to write down all your questions.
MELODY MARTINEZ: Okay.
MATT PROBST: I’ll answer them as we go.
|
|
01:12:08:21 |
MATT PROBST and MELODY MARTINEZ in appointment with young patient |
MATT PROBST: This is Melody, and she’s our new provider.
Go ahead and open, and say “ah” for me and stick out your tongue.
Young patient: Ah.
MATT PROBST: Can you put it out? Oh, we did this last time, huh? And you don’t have a sore throat today. No need to torture you. Put your head back and let me look in your nose, though.
Young patient: Okay.
MATT PROBST: I’ll show you this, too, Melody.
Yeah, so we got the ear infection.
|
|
02:12:29:17 |
CHRIS RUGE drives down dirt road
|
Sound of driving |
|
02:12:34:22 |
CHRIS in home visit with CHERI, CJ plays video games in adjoining room |
CHRIS RUGE: When was the last time you went this long?
CHERI: It’s been a while.
CHRIS RUGE: Yeah.
CHERI: This is the longest that I’ve—
CHRIS RUGE: Mm-hm.
CHERI: —been clean and, and doing, you know—
CHRIS RUGE: Mm-hm.
CHERI: —doing great, and, you know, found out I’m going to get a full-time job.
CHRIS RUGE: That’s great.
CHERI: I really want to finish school and—
CHRIS RUGE: Okay.
CHERI: —you know, study at nights—
CHRIS RUGE: We’ll figure it out. Do you have a laptop now?
CHERI: Yeah, but I don’t know how to use it.
CHRIS RUGE: Bring it out.
CHERI: Okay.
CHRIS RUGE: Turn it on.
CHERI: It’s a kind of older one, so—
CHRIS RUGE: Older? Holy cow, this is like in one of the sci-fi movies or something. …See if we can come up with something different for you.
CHERI: Yeah.
CHRIS RUGE: We’ll see.
CHERI: I’m just happy it’s going great now, and my son sees a difference, you know, everything.
CHRIS RUGE: She doing good? Yeah, keep it up—
CHERI: Thank you.
CHRIS RUGE: Okay?
CHERI: Thank you so much.
CHRIS RUGE: Yeah. Call me if anything comes up.
CHERI: Okay. Thank you.
|
|
02:13:36:22 |
MATT and ELIZABETH PROBST and three of their sons visit GILBERT PROBST’s grave |
MATEO PROBST: Hello Grandpa. How are you doing down there?
MATT PROBST: It sounds like you have a pocket full of Grandpa Bibo’s favorite things. Maybe you should leave him one.
Let’s all think of one thing we remember.
MATEO PROBST: His favorite candies?
MATT PROBST: Mm-hm. What about you, Ma?
ELIZABETH PROBST: Oh, there’s a lot of things. His big heart, and his delicious food, and how—
MATT PROBST: I was going to say chili relleno —
ELIZABETH PROBST: —kind he was—
MATT PROBST: —casserole.
ELIZAEBETH PROBST: Yes.
MATT PROBST: It’s good to get, it’s good to cry, dude.
Voice: [unintelligible]
|
|
02:14:31:16 |
GILBERT PROBST gravestone with piece of candy left on it |
MATT PROBST VO: Because of the way my dad died, left this taste of all the hurt.
|
|
02:14:39:09 |
MATT PROBST sits by side of his father’s grave |
MATT PROBST VO: As time has passed, all of that is becoming much more distant –
|
|
02:14:47:20 |
Archival photo of GILBERT PROBST with MATT and MAYA as young children |
MATT PROBST VO: and what’s becoming more clear is all the things that my dad was.
|
|
02:14:50:22 |
Archival photo of GILBERT PROBST with art |
MATT PROBST VO: My dad was an amazing artist.
|
|
02:14:53:16 |
Archival photo of GILBERT PROBST with MATT and MAYA as young children
|
MATT PROBST VO: He was charismatic –
|
|
02:14:55:21 |
Archival photo of GILBERT PROBST lying in hammock with young MAYA PROBST
|
MATT PROBST VO: and I have no doubt he loved us. |
|
02:14:59:18 |
Archival photo of GILBERT PROBST giving young ISAIAH PROBST haircut
|
MATT PROBST VO: He gave Isaiah his first haircut. |
|
02:15:02:12 |
Archival photo of MATT and ELIZABETH PROBST as a young couple
|
MATT PROBST VO: While Liz was in school, and I was taking my first physician assistant job –
|
|
02:15:05:20 |
Archival photo of GILBERT PROBST holding two of the Probst boys when very young
|
MATT PROBST VO: my dad would come all the way from Santa Fe to take care of the kids. |
|
02:15:09:21 |
Archival photo of GILBERT and MATT PROBST, and MATT’s four sons
|
Instrumental music |
|
02:15:13:17 |
MATT PROBST walking through graveyard as the sun sets |
MATT PROBST VO: There’s a story that I heard about there’s three kinds of people. There’s sheep, which always think everything’s going to be okay. And then there’s wolves that prey on the sheep. And then there’s sheepdogs that will do anything and give their life to protect the sheep.
We like to think that we’re one, but the truth is that every one of us has all three of those inside of us. My dad, he had sheepdog mode, don’t get me wrong. The one that’s going to win that battle inside of us is the one you feed the most.
|
|
02:16:06:08
|
TEXT CARD: Leslie was honored by the White House as one of the nation’s Champions of Change in fighting the opioid epidemic.
|
Instrumental music |
|
02:16:15:20 |
TEXT CARD: Leslie was honored by the White House as one of the nation’s Champions of Change in fighting the opioid epidemic.
|
DR. LESLIE HAYES: I work in Española, New Mexico –
|
|
02:16:18:06 |
DR. LESLIE HAYES speaking on panel for being one of the White House’ Champions of Change in fighting the opioid epidemic |
DR. LESLIE HAYES: which often is number one in the country for opiate overdoses. And one of things I’ve taken to saying when people tell me, “Well, I don’t want to treat those people because I don’t want them in the, in my waiting room,” is, “They’re already in your waiting room. You’re just not identifying and treating them, so.” [applause/cheers]
|
|
02:16:33:22 |
Ext. of El Centro clinic |
Instrumental music, CHRIS RUGE [singing]: Oh, what a beautiful morning.
|
|
02:16:37:11 |
CHRIS RUGE singing in his office |
CHRIS RUGE [singing]: Oh, what a beautiful day.
|
|
02:16:41:16 |
TEXT CARD: El Centro negotiated with insurance companies and secured funding to continue the ECHO model of care. |
Instrumental Music |
|
02:16:47:18 |
TEXT CARD: Of the six pilot sites, only El Centro has found a way to continue the program.
|
Instrumental Music
CHRIS RUGE VO: The job offers me the opportunity to –
|
|
02:16:54:20 |
CHRIS RUGE with patient MARY DELL in her home
|
CHRIS RUGE VO: actually be walking alongside patients, helping them find the door. |
|
02:17:00:09 |
CHRIS RUGE knocking on door of GEORGE’s home |
CHRIS RUGE VO: Some people you need to open the door just once.
CHRIS RUGE: How we doing?
GEORGE: Come in!
|
|
02:17:07:07 |
GEORGE with bruised face and wrapped foot, CHRIS looking at GEORGE |
CHRIS RUGE VO: Other people it’s months and years. If you open enough doors, they will walk through that door with you.
|
|
02:17:17:11 |
TEXT CARD: UNM’s Physician Assistant program presented Matt with the Distinguished Alumni Award.
|
Instrumental music |
|
02:17:23:14 |
TEXT CARD: The charges against his sister Maya were dropped, and she has regained partial custody of her children.
|
Instrumental music |
|
02:17:32:10 |
MAYA PROBST pushing kids on tire swing
|
Sound of kids and instrumental music |
|
02:17:36:11 |
Close-up of Matt Probst smiling |
MATT PROBST VO: My dad’s gone, but Maya is still here –
|
|
02:17:38:15 |
MAYA PROBST pushing kids on tire swing |
MATT PROBST VO: - and I’m not going to give up on her.
|
|
02:17:42:11 |
MATT and MAYA PROBST hug |
Voices: [unintelligible]
|
|
02:17:44:13 |
MATT PROBST and extended family gathered around table holding hands |
CHRISTOPHER PROBST: No matter where we’re at, we still have family, and I’m grateful and thankful for all of you for being here.
|
|
02:17:50:06 |
MATT PROBST enters clinic |
MATT PROBST VO: Every day I wake up, my first thought is, “How can I serve today?”
|
|
02:17:56:00 |
MATT PROBST in appointment with boy patient with allergies |
MATT PROBST: You have a lot of allergies.
Boy with allergies: Mm-hm.
MATT PROBST: You and me both. Look at my eyes today. I was pulling weeds too much yesterday. You been pulling weeds?
MATT PROBST VO: At the end of my days, I think I can meet my Maker, and say, “I gave it everything I have.”
MATT PROBST: All right, dude, big breaths for me.
|
|
02:18:23:19 |
CREDITS |
Instrumental Music |
Distributor: Bullfrog Films
Length: 82 minutes
Date: 2019
Genre: Expository
Language: English
Grade: 10 - 12, College, Adults
Closed Captioning: Available
Audio description: Available
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