Oct. 12 -- Any rural family doctor is expected to take on a lot.
Not all of them can top Dr. Mark Bjorklund's story of how he popped his own shoulder out of its socket while delivering a baby and soldiered on anyway.
It wasn't fully an obstetrics-inflicted injury, said Bjorklund, now 70, who retired in recent weeks from a decadeslong career with El Centro Family Health, a federally subsidized health center that offers care in clinics and schools in a dozen Northern New Mexico communities.
Bjorklund had tripped while running in Los Alamos in shoes with long loops of lace and dislocated his shoulder. Helping with the baby delivery just caused it to pop back out again.
"I was kind of sitting there trying to get it back in," Bjorklund recalled, laughing.
Eventually he succeeded and completed the delivery -- but not before the laboring mother figured out all was not right.
"I think everybody knew what was going on," he said.
It was just one of many adventures Bjorklund had in his more than three decades practicing medicine in Northern New Mexico, including at clinics in Española and Truchas, where he often cared for multiple members of the same family over time.
Bjorklund, who most recently held the role of chief clinical officer for El Centro, planned to retire earlier this year but initially hoped to continue seeing patients on a limited basis. However, the emergence of a serious illness put a stop to that plan, he told The New Mexican.
Now a resident of White Rock, Bjorklund was born and raised in Los Alamos, the son of a lab chemist. After graduating from Los Alamos High School in 1972, he attended the University of New Mexico, where he ran cross-country and double-majored in biology and chemistry. He later attended Penn State's College of Medicine.
Bjorklund knew from the beginning he had the heart of a generalist.
"I wanted to learn a little bit about everything," he said. "I chose family medicine for that, not fully understanding just what that meant."
He took a detour into emergency medicine, eventually spending eight years at a hospital in Carlisle, Pa., before landing back in his home state in 1994.
Bjorklund was married to his wife, Heidi, by that point, a nurse who had also grown up in Los Alamos.
Being back near family was a draw, but Bjorklund said returning to Northern New Mexico also was the fulfillment of a longtime desire to help the region.
Growing up in the relative wealth and privilege of Los Alamos, he had an awareness that things were quite different in the surrounding communities, he said.
"I'd grown up with just a pretty easy course, and I felt a need to serve," he said. "I wanted to give back to New Mexico."
After a refresher course in obstetrics, he began practicing medicine at Health Centers of Northern New Mexico, as El Centro was known at the time, taking care of entire families, from birth until death.
He always viewed obstetrics as "just the miracle of the whole thing," Bjorklund said, but he found it could be terrifying, too. Once, he said, a woman came into the organization's Coyote clinic while she was already in labor. El Centro doctors always delivered babies in a hospital setting, but this woman was too far along to make it to a hospital in time.
Bjorklund wasn't there in person, but he helped with the delivery as best he could, offering support to the practitioner over the phone. It was, he said, "a unique experience."
He and his wife raised four children in the area over the years. Two of the couple's daughters died as young adults, one in a car crash and the other after being struck by a train. Their oldest is now a pediatrician, while their youngest works as paramedic in Albuquerque.
Bjorklund said he got to observe from a doctor's eye view a number of sociological changes Northern New Mexico has undergone during the last three decades.
When he first arrived, for example, he spoke enough Spanish "to get myself in trouble."
"But the elder folks who, when I was first there, they spoke ... some of the original, like, Castilian Spanish, from when people first came and settled that area," Bjorklund recalled.
That dialect "sort of has gone away" with the subsequent generations, he said, although El Centro sees a number of migrant patients who still speak only Spanish, but of a Central or South American variety.
He also saw the drug crisis come in and take hold particularly hard in Rio Arriba County, where alcohol addiction, an issue that persists, had always been the main substance problem. Opioid addiction was already starting to rear its head in the area by the time Bjorklund returned in the 1990s.
"My understanding was ... they pushed a lot of the dealers out of the metropolitan areas," he said. "You ended up with multigenerational drug problems. ... It hit all communities."
Rio Arriba County for years was one of the areas that led the nation in fatal heroin overdoses. When the opioid treatment drug Suboxone was introduced following its 2002 approval from the U.S. Food and Drug Organization, it helped stem the death toll, Bjorklund said. "That made a difference because it was a little bit safer, and it reduces the death rate."
Seeing how the opioid crisis had ravaged the region, Bjorklund said he and fellow El Centro veteran Dr. Leslie Hayes helped develop a treatment program.
"Our philosophy was, we weren't addiction specialists, but it was part of primary care," he said.
The notion, Bjorklund said, echoed his core philosophy about what it meant to be a family physician or a primary care provider: "When we took people as patients, we took them on as a whole patient."
Bjorklund said he's deeply concerned about the shortage of primary care and what it means for Northern New Mexico.
"In terms of family physicians, there's less of us," he said. "They cannot be produced fast enough."