Wednesday, June 06, 2012

A brief interlude - my story

I will give a *brief* history of how I started in this profession and what has influenced me over the years...just so you know a little about me.

My first memory from my childhood that made a lasting impression, of all things, was listening to the music of the Beatles. Their music was special and enchanting. I also remembered the assassination of John Lennon when I was in Kindergarten - I got to know much about John Lennon and what his music meant to many people as I was a young kid in elementary school; "Imagine" was the song that epitomizes what I think John really felt about humanity and the world. As a child and adolescent, it made a whole lot of sense to me...even now.

As I was learning about the Beatles and their influences, I recalled their discovery period when they visited India and that was where I became aware of Mahatma Gandhi. Also, the movie starring Ben Kingsley got me interested in this mysterious figure who happened to promote change through non-violence. Then I read about Martin Luther King, Jr who practiced Gandhi's concepts. Again, I thought that was such a cool idea; the concept of change and non-violence was my guidepost to what I did in life.
It was too bad that all the individuals I admired so far, they were all assassinated at their prime. In some ways, I was unusually fascinated with the concept of martyrdom as a child.

I grew up in a family that worshiped Buddhism. I also attended Sunday School at the local church and they all seemed like good ideas with the exception of the idea of organized religion (for both) - I also began to have an inkling of what group mentality was and that it wasn't such a great idea when it went too far. I was influenced by a book I read in junior high, The Wave, by Todd Strasser which talked about how powerful group pressure can be. There was a time I was agnostic and not committed to any type of religion.

I was enamoured by Albert Einstiein, both as a scientist and as a person. Not only could he think of great physics concepts to explain the ways of the world, he was a great violinist too! I got into computers very early on. Commodore 64, Apple II, Atari 2600, IBM...I knew the ins and outs of 1's and 0's. I created a video game out of machine language.  I also played the violin (I started playing before I knew that Mr. Einstein did himself) and played in a variety of string orchestras and jazz ensembles (Jazz with the violin??  See the Turtle Island String Quartet).

High school was in some ways challenging for me. I couldn't get hired by the local grocery store as a bagger. I couldn't get hired by McDonald's...pretty pathetic for looking at a part time job. Then I got hired on by a local bakery/cafe in St. Louis called the St. Louis Bread Company and I sold bakery goods and made soups and sandwiches which at the time was a fledgling anti-fast-food phenomenon. Just when I was graduating from high school and offered my resignation, the company was bought out by a California group of investors. People will know this local company by it's now corporate name, Panera Bread. But back then, I realized the importance of a local economy and how important I was, even as the lowest member of the totem pole, in this local company. I even saw how computerization of certain repetitive tasks (touch screen cash registers that was called the Micros system) made operations efficient, less error-prone, and made statistical analysis of items that sold well versus others that didn' was cool, even back then.

As this was going on, I was following the footsteps of my father as an engineer. And then...

A near-life-threatening scooter accident right after high school graduation in Taiwan started me truly thinking about what was important to me in my life. It makes you take stock of who you are as a person, what you can contribute to society, and how you can make a positive difference in even on person's life...all from this pivotal event.

I realized I only had one chance in this life to do what I really want to do; I had the choice to make and only I could make it once. I could no longer imagine myself sitting in a cubicle looking at diagrams all day long. I needed more to fill my urge to help the people around me. It had to be personal for me. But yet, I still had the scientific side that I appeared to excelled at. Thus, I chose my path to be in medicine.

I was influenced by a family doctor (too bad I didn't know his name) that spoke at one of the seminars for pre-med students at the University of Illinois where I went to college. I remembered how passionate he was about taking care of the whole person, not just the specific body part or medicines they prescribe to "fix" people. I read into this concept and put it into my letter to admissions when I was applying to medical school. And then I got in to the University of Missouri.

Medical school was like going through military training. I was poor. I lived in a cockroach infested apartment with a broken air conditioner in the sweltering heat. I ate at McDonald's nearly all the time and I felt icky all day long (see Super Size Me and you'll know what I mean). During this period of turmoil, I read a book that happened to be lying on the table at the school library called "Small Is Beautiful - Economics as if People Mattered" by E.F. Schumacher. First of all, I wasn't even remotely interested in the theory of economics (didn't take it college, any financial topic was gibberish to me, didn't know the meaning of debit and credit...), but somehow the title grabbed me.  It talked about how the theory of modern economics is irrational in that there was not an infinite amount of consumption and that humans have to know what is "enough" - the concept of "enoughness" and NOT "bigger is better" and "greed is good". The concept of Buddhism Economics was from this book and it propelled me to read more about Buddhism (specifically Zen Buddhism) as more as a philosophy and a way of life, rather than organized religion. During medical school, I also managed to fulfill a dream of mine to be in a rock band.  I got to play a whole bunch of songs from the Cure, U2, Eric Clapton, Kiss, The Eagles, and The Police (but sadly, never the Beatles).  Through that outlet, I got to let out the steam and frustration of being in school.

I also felt like I took a time space warp when I entered medical school. Everything was still documented by pen and paper. Charts upon charts - "can't find the chart" - and the obligatory hand cramps. It's crazy that this still existed when I saw how the St. Louis Bread Company could use a touch screen ordering system 8 years before?! Being a self-professed computer nerd, I was totally flabbergasted and perplexed that this was the new reality.

Looking at residency programs after medical school, I got to visit Seattle for the first time after living in the Midwest all my life. I happened to be staying at a local youth hostel (no hotel rooms were available because of the WTO conference that year). This youth hostel also was Ground Zero for social activists who were protesting at the WTO conference that ended up in violence with sound grenades, curfew, tanks and smashed windows at the Bon Marche department store. I was getting all kinds of education about fair trade not being free trade, the pros and cons of the North American Free Trade Agreement, local and sustainable practices for the economy, ecology, and the environment.  It opened my eyes to a whole new way of thinking about society, people, and the impacts we have from small to large.

After all that traveling, I ended up doing my residency in family practice in Minneapolis, Minnesota. I thrived there, taking care of the indigent population that consisted primarily of immigrant and Hispanic/Latino families. I also delivered quite a few babies during that time. I also learned more about complementary and alternative medicine. I also helped the hospital acquire an new electronic medical record system (finally!). It was everything I considered family practice to be. I also became quite aware of the problem of economic and political forces that steered students into specialty practices rather than primary care. I recognized then that family practice clinics and physicians were slowly being steamrolled into this larger byzantine system that encouraged increased procedures, increased overhead, increased patient numbers, but less time with patients, less quality of care, less connectedness to the people we serve. Everything was getting bigger and the family doctors were becoming cornered into a wall. It was as if we had no choice but to follow the status quo. Talk about peer pressure (ie The Wave).

And when I finished residency; I made a choice to take the road less traveled. I took the approach of what was small was beautiful. I centered my practice after the whole concept of whole person/whole family care. After a false start and a broken promise after 8 months, and then making a decision to fully go it alone, I have finally made my dream come true...a micro-practice that I built along with my wife. I was fully utilizing computer systems to help me streamline my operations so I can still do all of the things that computers cannot do - like diagnosing an illness, healing hands, the art of medicine, making agreements with my patients; it was recognizing the limits and ultimately creating a unique but natural balance with the way things work. Granted, it was still hard work and I didn't get paid much, but in my own way, it was the most gratifying type of work I can imagine for myself.

Now...back to the the perfect storm...


Amber said...

You've made such a difference for our whole family.
We will sorely miss you (and just when we're moving back to town, too).

Jonathan said...

This is a wonderful blog. I have read a few posts here and there and I really can't tell you how impressed I am. It is a shame that chances are, we will never meet.

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