FACULTY & STORYTELLERS

…and Personal Statements

I have always been fascinated by people. Even as a child I was interested in how people talked to each other, what made relationships work, and what didn’t. We are social creatures, yet we live in a time of growing opposition that’s splitting our human connections. This is our collective blind spot. We are under the illusion that thinking and feeling are separate functions that can be compartmentalized. We are not machines. Today’s profit-driven healthcare behemoth relies on this split. It functions from a paradigm that hurts clinicians and patients. As Einstein said, “We can’t solve problems by using the same kind of thinking we used when we created them.” After two decades of research, study and practice, I believe a new paradigm is emerging. It’s one in which the condition of being well starts with being in ‘right order’ in relation to self and others as part of a greater whole. It’s indeed possible to lead from one’s humanity, rather than in spite of it, and we can have fun doing it! Let’s turn the problem on its head, and discover how the very opposition that separates us, can also energize us and lead to greater levels of consciousness, compassion, and agency.

How does one remain passionate about healthcare, especially in such a fragmented and broken system?
We see individuals at their most vulnerable; when they are sick and seeking help.  How we – as physicians and nurses – care for people at those incredibly vulnerable moments makes all the difference. And when I say care, I mean more than treatment. It is about seeing and hearing them, both in our professional capacity but as a caring human being, too.

So how do we, as trusted clinicians, retain our sanity as we do this work?  My story—from being a ‘pregnant orthopedic intern who quit orthopedics’ to now, as Chief Medical Officer of the University of New Mexico Hospital—is filled with many anecdotes. There have been exhilarating moments when I felt I had reached the top of a mountain, to real lows when I felt in free fall heading to the valley floor below. From my roller coaster ride, I have gained perspective and discovered insights.
My answer to the question above is simple—but not always easy.  We must remember what compassion means…for our patients, for ourselves, and for each other.
I hope that sharing my personal experiences will provide an opportunity for those who see and touch patients to reflect on how we all can fulfill our commitment to help and serve our patients even when we think we have given all we can.

As an artist who also works with and in healthcare, I have experienced something fundamental at the nexus of creativity and illness; a conscious engagement with the unknown. It has been a personal reflective practice deepening my understanding of self, but also has allowed for an empathetic connection to those who have collaborated with me while reflecting on their own relationship to illness.  For me, the creative act, lays bare our vulnerability but also elevates that which makes us human.  This engagement has resulted in a collection of drawings and stories that illustrate the tender, ambiguous nature of illness in our culture.

The practice of medicine has never been more overwhelmingly complicated and stressful. As physicians we have achieved much using our intellectual thinking minds. The intellect is a powerful tool. Yet it falls short in times like this because it fails to properly recognize and honor suffering. In fact, the thinking mind will minimize, rationalize, victimize, or radicalize the experience of suffering. If we stay here, we suffer more. An over-reliance on the thinking mind to solve all of our problems leaves us feeling empty, frustrated, and disappointed. The intellectual thinking mind is the wrong place to relate rightly to our own experience of change and suffering. There is a deeper intelligence that can help us. The skill of compassion allows us to unite our intellect with the intelligence of our open, warm space of awareness. In this union, positive qualities like compassion, love, equanimity, and joy naturally emerge. As we discover the compassion we need for ourselves to meet these challenging times we will discover a most incredible gift…the gift of genuine unconditional love and compassion for others and maybe joy along the way.

Many health care professionals aren’t attentive to personal finance: as a group, we are generally uninterested in running a business, and often ignore dollars and cents. As such, we are easy prey for Wall Street and other financial professionals. However, like it or not, we have a second job: CFO of our own lives. Compared to residency training, learning money management is relatively simple…but as I often say, like dieting, it’s not always easy. A small investment of time to learn financial basics can pay tremendous dividends! Tending to personal finance allows us to focus on patient care, and other life passions. Over the years, I have become educated about financial health, and I enjoy sharing my knowledge with colleagues. I view it as my contribution to helping others achieve well-being, at least in this area of life.

I decided to become a physician because I wanted a concrete skill that I could use to make a contribution to humankind. Medicine worked very well for me. I always had a clearly defined role that I was good at. I made a difference in both individual lives and the community. I always found joy in the work, the relationships, the problem-solving skills and in the new knowledge I gained every day. I didn’t ever burn out on medicine, but it was intense work, and I knew I would one day need to transition out of Emergency Medicine. As I age and evolve, I know that certain aspects of the way I think and react will always reflect my identity as “an ER doc.” But what else will I become? I am more than 2 words. How else can I heal and contribute?

Practicing medicine, particularly in the face of a very broken “health care system” (which is more appropriately called a profit-driven health care market), can of course be terribly frustrating.  But it can also be wonderfully rewarding … if only we can reestablish control of what we do, and remember why we do it.  That – rather than complaining about or even “fixing” all the bureaucratic intrusions upon humane practice – is the secret not only to overcoming these many frustrations, but also the only possible way to remake this system into one that actually serves both us and our patients.

My nursing career has spanned 33 years, always in a hospital-based, patient care setting. Sprinkled in have been three overseas volunteer medical missions to Haiti and Peru, sponsored by two different groups. Each time, those respites provided the nourishment my soul needed. I continually tell my colleagues, if you want to recharge your batteries—and remember why you chose nursing—go to an underserved country and care for patients there. It’s remarkable how many sick people you can see in one day without the ever-lurking computer in the room (or hut) with you. I draw on those experiences frequently (they are my mental ‘oases in the desert’) when I have typed in my name and password for the umpteenth time during a shift. I actually think those experiences have made it possible for me to still love what I do after three decades at the bedside.

I consider myself a ‘High Efficiency Foodie’ having been inspired by military mass food preparation, studying the civilian counterpart, as well as Epicurean philosophy. As the Endorphin Power Company (the nonprofit Sam Slishman founded in Albuquerque 15+ years ago) developed, so did our ability to cook and direct feasts. Our finest culinary hour was ‘Grandma’s Beans,’ a week-long event of simple family dinners open to anyone in the EPC neighborhood and community. ‘Money not required, nor was anyone required to bring food, cook or clean…’ (But they did, nonetheless.) Grandma’s Beans became the metaphor for a group of acquaintances that became a community that felt like a ‘family.’ What better way to begin each Osler Symposium than a Grandma’s Beans dinner! I imagine the group of strangers that sit down to dinner on August 23rd will feel like family by the time we all say good-bye. Soup’s on!

After my first medical mission I was hooked. Traveling thru northern Guatemala by bus, canoe and jungle trails to work in an isolated clinic with Guatemalan doctors. That was 3 decades ago but I can still see the fruit bats the size of vultures flying overhead. I still remember the anxiety of the army patrol entering the small village. But most of all, I remember the people. A Mayan culture deeply rooted in Mesoamerica. A people who would travel a day and a half just to see a doctor.
My soul was nourished by these humble people. I learned so much from the Guatemalan doctors. I came home a different person. What a privilege it has been to travel the world in medical service to others. From a Gypsy camp in Romania to an Operating Theater in Swaziland, I have been encouraged and challenged by amazing people.
Making medical missions a part of my professional life has anchored me. Remembering that in serving others I am benefited more than anyone else. Coming alongside medical professionals from other cultures, learning from resourceful physicians, and recognizing their unselfish contributions to the people they care for. This is why I became a physician.

When I was 19, I remember asking Dr. Rudolph (my first boss at the University of Rochester School of Medicine) if he got the chills every time he signed ‘MD’ after his name. His sweet smile acknowledged my innocence and he shook his head ‘no’. Fifty years later, I still think that credential is something sacred and worthy of goose bumps. My career in CME—and now The Osler Symposia—has allowed me to serve those I revere by making their wellbeing the focus of my lifelong work. This has given my life purpose and meaning. Dr. George Sheehan, an early mentor who became a treasured friend, once ended a talk by saying: “The Rx for a good life can fit on a 3 x 5 index card. ‘Be fit. Have a sense of humor. Love what you do and the people you do it with.'” These are words I live by.

I have long been motivated by one burning passion: focus on the patient relationship and its potential for healing. I knew I wanted to be a nurse at the age of 5 when I was hospitalized for a month. That was 1940. As a sick, scared child whose relationship to home, family, and life changed dramatically, the care I received by a nurse named Florence Marie Fisher, who sat at my bedside and colored in my coloring book, changed my life.

Bringing my whole self to nursing and to life has resulted in both a rich academic and entrepreneurial life. Who I am is as much a result of the challenges I have faced as well as the successes and accolades, and they are not separate from the work I have done with health care executives and clinicians alike. Having entered a more reflective stage of life, I find my colleagues and clients continue to seek my counsel, wisdom, and experience which is an important part of human caring. (For more information – Marie Manthey – Wikipedia)

Although all good physicians are grounded in the teachings of science, the practice of medicine remains magical for me. It is the mystery, the wonder, the complexity, the uncertainty and even the occasional vexation that make it endlessly enriching; the opportunity for dedication and service to our fellow travelers through life that make it a joy. I was accepted to medical school 40 years ago and believed myself to be the luckiest person in the world. Today I am more certain than ever that I am.

Med students are like bright-eyed stems cells, with application essays focused on the ‘I just want to help people’ theme. We differentiate in the four-year grinder and choose whom we might want to help. We differentiate further through residency and some of us emerge energetic, empathetic, and altruistic. Others emerge angry, resentful, ‘malignant.’ Some can barely wake up for work. I’ve been all of these. The Osler Symposia are social stem cell research conferences, to help us rediscover our bright-eyed days.

“Dad, I’m applying for medical school” was the one thing my college-aged children said to me that gave me both the most hesitation and introspection in my life.  They each lived through my own medical school, residency and ER career so knew firsthand what it entailed and saw how frustrating it became as the times changed.  But at the same time they understood the pride I had in being a Doctor and the things it allowed me to do across the globe.  I’ve been lucky enough to have had a variety of careers in my life, but medicine and being a doctor is what’s defined me for most of them.  And as I told my kids looking for advice, it’s not what it used to be, not what you think it is, and will frustrate the heck out of you, but it’s also something I’d do again in a heartbeat.