Can you go to a city? I have dealt with the rural area crap too and just gave up and avoid getting care here. My primary dr used to be near here but moved an hour away and I still see him. My therapist is 75 minutes away. My pdoc 2 1/2 hours. And if I have an emergency I do my very best to get to the hospital where my pdoc works. Even if you go to a city (preferably a teaching hospital) ER they'll probably pay more attention to you and less to the little notation that you have bipolar. Chest pain should be taken seriously after all.....no matter what.