While I began this endeavor of a daily blog on a whim, the more I write, the more I find myself committed to continuing. So if you have happened on to these pages by accident or you have been invited here by myself or someone that you know, today, I am going to share some of my purpose for writing.
My goal is to spend an hour each morning, Monday through Saturday writing. While I have kept journals before, I have never had any discipline or routine. You, my audience, will give me what I have never had before which is accountability.
My primary purpose is to share what life is and has been like for me as "the Local MD." Using the letters that my medical degree permits me to add after my name will not limit these pages to the moments of my life in which I am practicing medicine. The title does mean that being a physician is so much a part of who I am that it now colors ever other aspect of my existence. I do not always find this beneficial.
As human beings I am confident that more aspects of our lives join us than issues we encounter divide us. There is much that we as human beings hold in common. For me, growing up in small town Texas, reading was my first glimpse outside my own sphere. The many books that I read in my youth not only entertained me but they informed me about a world much greater and very different from my own. In some part my desire to write comes from an appreciation for those who have written so that I might read.
As a group, I have found physicians very reticent to share their deepest thoughts. When physicians blog it is usually about research or to complain about some aspect of the insurance industry. Those are worthy topics but not as interesting for me as more personal aspects of practicing medicine.
For the past several years I have been inspired by some in the religious community. Within this group of mainline clergy, many younger than myself, I have found a refreshing honesty with each other and with those outside their vocation. This has challenged me to take a step back and look with as much critical vision as I can muster at who I am and what I do. I find this not only essential in my caring for patients but in caring for myself as well.
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Musings of a physician in private practice for 24 years, now teaching in a residency program and working as an ob-gyn hospitalist in a large metropolitan hospital.
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The Local MD
Having now been a physician in private practice for twenty-one years, twenty-six days and about an hour and twenty minutes, it occurs to me that I have become what in medical school was often a derogatory term, the local MD.The presentation on rounds often went something like: "This 45 year old Caucasian male was seen last week by his LMD, and diagnosed with a viral upper respiratory infection..." At that point everyone knew that the LMD had missed the diagnosis. Otherwise the poor patient would not have ended up in a tertiary medical center with three consulting specialist, a fellow, a resident and four medical students at his bedside.What we, the medical students, the resident, the fellow and even the attending hospital physicians did not realize is that we would never know John Smith as well as the LMD. We would never speak to his wife using her first name. We would never be able to recall the names of all his children and know where they were in the world. We would never remember his favorite hobby let alone joke with him about it. Nor would we shed a heart felt tear when we gave him the diagnosis of the aggressive small cell carcinoma of the lung that had landed him in our midst and would kill him in less than three months despite our aggressive treatment that was the best medical science has to offer.At that point in my life I was very proud to be even the lowest ranking person on the team that was on the cutting edge of the diagnosis and the treatment of the gravest of conditions that plagued mankind. I felt so very lucky that I was being initiated in to this sacred fraternity. That I would soon be able to write "MD" after my name. I am still proud of my vocation yet I believe there is a wisdom that has only come with those twenty-years of practice.Today I realize what people want most of their physician is that he or she is someone who cares.Yes, we all want "everything medical science has to offer." Yet, what most of patients need is someone who will listen with their heart as well as with their head. Physician eyes are important, not only for seeing signs of disease in the body but for making contact with the patient's eyes where we are often allowed to see into their soul. All of the technology in the world will not replace a warm clasp of the hand or sitting at the bedside to share a few moments of the day along with the test results.So, I have created this blog. In large part it is a place for me to put my feelings. My hope is that at least some of these posts will resonate with others out there. Not just physicians, but others in caregiving vocations and even those for whom we care. If we are not here for each other then why are we here?
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