100 plus miles from a Level I, doing your own tests, doc a few times a week.
I live in what I thought was "rural" Ohio, until I read some of your tales!!!
We are a small community hospital, only Level III in this section of Ohio.
3 OR's (actually 6 rooms, use 3 at a time usually) about 60 some beds, that varies some, and a 15 bed ED.
EMS response times can be rather long. Golden Hour??, forget it. We have one paid ambulance service and several great vol. squads.
We have a chopper 10 mins, plus or minus, away from us. Our big referring hospitals are "only" 50-75 miles away. Also some great docs living within site of the hospital, in some cases.
After reading your tales, I think I would be terrified, yet tempted to want to experience what you do. I feel I'm old school, and would also like the challenge of wearing several hats.......but, snakes and spiders...YIKE!!!