You could say that being a doctor was in my blood. My father is a small town family physician in Fergus Falls, Minnesota. I watched him take care of patients and families from before birth to after death. He did inpatient and outpatient care, seeing patients in clinic, admitting them to the hospital, and following them after discharge. He maintained close connections to his patients, which I admired, and around the holidays there were often gifts of various home-canned treats. Growing up, the two things that emerged for me were a love of science and a love of helping others. It sounds cheesy, but this is what I said in my med school application, and they believed me (or at least let me in on other grounds).
In my second year of med school I hatched a plan to delay graduation to study abroad. With a vague notion of wanting to “make a difference,” I left for a semester working at St. John’s Medical College in India, followed by working at a missionary hospital in rural Zimbabwe. These experiences realigned my priorities, with global health now being at the top. It seemed unfair that my background of relative privilege and comfort was so different from that of the patients I cared for dying of HIV, TB, malaria, advanced cancers, and other illnesses far less common or less advanced in the U.S. Coming home, I realized further that the global is in fact local. I didn’t have to look very far to see health care disparities amongst different patients even in our residency or care systems.
After graduating from the University of Minnesota (UMN) med/peds residency, I became a hospitalist at Regions Hospital in St. Paul, Minnesota. I have branched out into inpatient palliative care, as well as continuing internal medicine and tropical and travel medicine in our outpatient clinic. I co-direct our UMN Department of Medicine Global Health Course and work with medical students and residents to encourage them to do clinical rotations and research abroad. Global Health, palliative care, tropical medicine, and hospital medicine may seem like an unlikely combination, but for me they are tied together by the goal of reducing suffering and health disparities both at home and abroad by creating connections, improving knowledge base (both for providers and patients), and caring for people when they are unwell. Clinically, I am most energized by teaching med students and residents and connecting with my patients. I love a good story and getting to know my patients on a more personal level is something I treasure.
With the combination of work with our teaching program, hospitalist group, global health, and clinical duties, I exemplify the over-committed physician struggling to also be a good spouse and father. Life has funny ways of reminding us that we are indeed mortal. This past June, I was diagnosed with Chronic Lymphocytic Leukemia (CLL) – a game-changer in terms of further planning that has demanded a rebalancing of work, life, and health.
The upside of my CLL diagnosis is that it has allowed me to be more empathetic with my patients. Thus far my counts are stable (and I hope to keep them that way for a very long time), but like my patients I am living with some of the same uncertainty that they face when they are admitted with a new diagnosis or a flare of a chronic one. While I would rather not have CLL, I can at least be grateful to have this connection to how my patients may be feeling and the vulnerability that comes with a diagnosis of any disease. I think this empathy will make me a better physician.
I am excited to have the opportunity to blog for SHM. I hope to delve into themes of the impact of culture and cultural differences on care, global health and health disparities, and empathy and how we connect and care for our patients. I also plan to explore how we balance competing demands on our time and energy, like family, work and taking care of ourselves, particularly when life reminds us of our own mortality.