Saturday, May 25, 2013

I had the opportunity to work side by side with another doc (gently "older" than me) the other day.  I was doing a physical on an Air Marshall and he wanted to sit in.  (These physicals are like "executive physicals" from the 80's that encompassed everything short of a colonoscopy- we have to make sure these government employees are ready for anything and fit to perform.  As I was reviewing the Marshal's chart, I didn't see much of a problem short of the usual extra 30 lbs, scant scalp hair and few screening test abnormalities but I started asking my salvo of questions to make sure past and family history were devoid of risks for a premature departure from the job of crime fighter.  I  brought up the few abnormalities and along the way threw in a few fun fact suggestions for nose congestion, reflux, hearing problems.....  He seemed to resonate with a few and started asking questions seemed to be interested in my few comments so I would give him more info then move onto the next body part......then more I could see he was hungry for info/guidance.  In fact, what started as a simple review of tests and updating chart notes soon became counseling on using omega 3 oil and turmeric for the early arthritis in his ears (yes the 3 bones in there get arthritic from shooting a firearm for years) and cutting back on alcohol and considering stopping since he had some signs in his life of dependence.  Then he opened up to both of us about chest pain for the last few months!!  I appreciated his candor and took it that he was subconsciously concerned but at the same time he was always aware we were the doctors licensed by the government to flag Marshals unfit for duty.  I am used to this as when I interview someone past 10-15 minutes, they usually open up and I find the juicy information that would have been missed on standard medical history taking.  This is the info that helps shape the personal lifestyle change I create.  I figure if we take extra time to figure how they got to this mess/at this decade of life, we can plan around addressing the cause of disease and not just treat it. 

The other doc was perplexed as to why he was giving so much information.  My colleague kept on saying that was very odd.  (I was just snickering to myself, "that is the way you do it doc!")  Truthfully I saw a man that wanted to get some help for drinking and was having problems controlling his teenage daughter-the hearing wasn't a concern, neither was the chest pain.  Well, I sent him to an Ear Nose Throat specialist and got him to the hospital for a stress test. 

I don't always have the luxury of extra time with patients but I can always continue next time.  This is the trick I learned from Medicare.  We are supposed to tell the patient after the first or second complaint that they have to follow up for guidance of the next few complaints at a later time since I only have time to address 2 major symptoms.  (...and this is your grandpa who has 10 pills twice a day from 3 different specialists and may questions about the side effects to a few of the expensive pre-approved drugs.  If I have to, I will guide my patient to concentrate on the major issues we in the medical community would be concerned with to continue functioning independently while we let go of any low grade nuisance symptoms. 

So even some of the established docs don't have the right idea about how to really empower people to change the cause and not just address the symptoms.  Shop wisely!

Tuesday, May 7, 2013

Fork in the Road

I am awestruck with how the Universe shows itself every time I stop resisting.  It's like hiking a path at night, I know the journey is out there but I can only see what my lamp illuminates.   The forces I fight are not "the dark side" luring me to play, they are my feable attepts to try and control for every variable for the future.  Lamenting in the past can cause depression, worrying about the future can cause anxiety.  It takes effort to maintain but I try to live in the present. 

I did this in 2005 when I was sick of a new hospital administration stringing me along and saying its going to be alright as long as you sign a very legally binding contract for 5 years and you keep up with a some MGMA statistic (info pools of large medical practices and how many patients you are supposed to see to be average)   If I worried about the future, I would not have been able to leave and start this journey to present day.  No question it was hard work to survive the finger pointing from established docs and job interviews with newbie graduates, but I let that stuff go and just grabbed onto any solid step that was placed in my path.  Herb Benson from Harvard, Deepak Chopra, Andrew Weil all were part of the universes plan for me to give back.  I can confidently say a career of being a medical doctor was just a stepping stone to my true calling of healer.  I am honored to have met these world leaders and take bits and pieces of their practice philosophy to evolve mine.  I consider myself a neophyte but wonder if I too am supposed to be influencing those that I come in contact with. 

Had some free time before another hospital orientation so I stopped by Whole Foods Market.  Saw a young premed student I spoke with briefly in the recent past.  She congradulated me on getting an appointment to teach at the University of Illinois Medical School.  (have to chuckle that after years of being ridiculed as a foreign medical school graduate from the Philippines, now I am being asked to teach by the same people who pushed my application to the bottom of the pile)  Last time I spoke with her, she was deciding on which school to pick-UofI or Uof WI Madison.  Immediately I started rattling off about Madison WI.  Richie Davidson -founder of the Center for Investigating Healthy Minds (most famous subjects include Matthiew Ricard and The Dalai Lama) is a huge proponent to mind-body medicine "the new Herb Benson" of the millenium, built his multi million dollar facility there along with Dave Rakel -previous fellow of Andy Weil, now Director of the UW Integrative Medicine Fellowship.  Something special about this place-poised for being a center of healing.  I leaned a little to UofI since I am now an appointed teacher/tutor there but considering the fact that she knows so much about nutritional supplements (employee of WFM) she already has a step above all medical school candidates-she understands how food can heal.   I was so happy to hear she made a choice to move and continue premed in Madison!  I saw the reservation in her face about the stress of moving.  I then reflected on where I am now and wondered if I had the same look back in 2005.   I've moved my family into 2 states, 3 different houses, applied to a new hospital every 3 years.  The difference is the career keeps me appealing to hospitals that want experienced docs (for standard pay) so there is always a job.  The difference is the calling brings me to a more beautiful vista with every move forward.  It seems like a logarithmic unfolding of some master plan the universe has in mind.  It's daunting to know that while I consider myself a student, I will have to start teaching my style of healing and help others get to this point.  My courage is fueled by the fact that even now, someones application is being placed at the bottom of the pile and that person may be responsible for my family, my patients, my community.