As I reached for the doorknob with my right hand, I had but one and only one impulse.
Run! Turn around and run as fast as you can!
It's fair to say that being a physician requires a certain constitution. When one deals in the currency of death, it becomes second nature to hold our heads high when others fall. How else can we view the tortured realities of existence. The average life is chocked full of suffering. People die tragically, unexpectedly. Pain rips through the tender belly of humanity leaving us raw, and yet we stand our ground.
But sometimes it's different. Sometimes the guarded armour of the physician is pierced in just the right fashion to expose the glistening skin overlying the Achilles tendon. We fall, mortally wounded but unable to close our eyes. It is in these times we learn to hurt all over again.
It is in these times, you either shield yourself, or open the door and let the pain run right through you.
I choose to open the door.
The act of writing about what hurts usually soothes me. It gives a morsel of control over that which is ultimately ephemeral.
Today, writing it is an act of submission.
As the raging
waves of the ocean crash against the shores of my insides, the waters eventually
calm and the tide recedes.
And I am empty once again
Tuesday, April 30, 2013
Friday, April 26, 2013
Do You Know?
Do you know?
I realize how I must sound. Throwing around the word futility like a game of dominoes, I slam the last piece onto the table defiantly. You glare.
She's not your mother!
I want to shake you. Of course she is. They are all my mothers, sisters, and brothers. My father who died when I was ten and my grandmother who waited for me to drive from St. Louis before drawing her last breath.
I won't escape unscathed. My birthright is to experience the allotted measure of human grief. But I'll lose your mother too, and thousands more. Sadness will be my daily companion, collateral damage from the oath I so naively took all those years ago.
Sometimes I sit in bed after being awoken by your mother's nurse. I stare at the ceiling and listen to the walls exhale deeply. I dream that when I die the spirits of my deceased patients will come to greet me. A parade of old and young, angelic and bruised. They shake their hands over their heads, and I can't discern whether they are clenching their fists in anger, or signalling affably.
I know, for better or worse, the consequences of my actions.
Do you?
Do you know?
I realize how I must sound. Throwing around the word futility like a game of dominoes, I slam the last piece onto the table defiantly. You glare.
She's not your mother!
I want to shake you. Of course she is. They are all my mothers, sisters, and brothers. My father who died when I was ten and my grandmother who waited for me to drive from St. Louis before drawing her last breath.
I won't escape unscathed. My birthright is to experience the allotted measure of human grief. But I'll lose your mother too, and thousands more. Sadness will be my daily companion, collateral damage from the oath I so naively took all those years ago.
Sometimes I sit in bed after being awoken by your mother's nurse. I stare at the ceiling and listen to the walls exhale deeply. I dream that when I die the spirits of my deceased patients will come to greet me. A parade of old and young, angelic and bruised. They shake their hands over their heads, and I can't discern whether they are clenching their fists in anger, or signalling affably.
I know, for better or worse, the consequences of my actions.
Do you?
Do you know?
Thursday, April 25, 2013
Jordan Grumet Interviews Himself, Again
I caught up with Jordan Grumet, physician, Internet entrepreneur, writer, and overall man of mystery in a secluded corner of Panera Bread Company.
Q: Jordan, this is the third in a series of self interviews over the last two years for this blog. Tell me, is anyone else (present company excluded), interested in what your doing?
A: Actually, my life story was recently presented to a distinguished group just last week.
Q: And how was it received?
A: My son's second grade teacher said he did a really stellar job!
Q: Um...OK. You recently were featured in Mike Sevilla's Family Medicine Rock's online radio show. How did it feel to be interviewed by a social media legend? And tell us about your new practice.
A: Mike is the real thing. His voice, his interview skills, it's like being on Oprah (I know you're out there O. You haven't returned my calls yet!)
I'm really excited about the upcoming changes. As of January 2014, I will no longer be seeing patients in the office. Instead, for a about a tenth of my current population (250), I'll be doing comprehensive primary care from the comfort of their own home. I'll charge members a yearly fee to allow myself to break the economic bonds forced by Medicare.
Q: What prompted you to make the change?
A: Medicare, healthcare reform, medicare, medicare, and healthcare reform
Q: Explain?
A: The delusional administrative and regulatory requirements by our governmental agencies are hampering basic medical care. We our losing sight of our patients, and spending time and energy bowing to the electronic dictates of an insatiable monster.
Becoming a master diagnostician is an ideal that takes a hundred percent commitment. Every click, form, and ridiculous constraint takes our eye off the ball.
By collecting the funds required to support myself completely outside the system, I will for once be free. Medicare can do what it wants.
C'est la vie!
Q: Is it true, that you are also starting an Internet business? CrisisMD.com?
A: Yes. What I enjoy most about being a physician is helping people make complex decisions. As most of us know, our healthcare system has been so perverted that we can no longer count on our own personal doctor to guide us through medical care. What with meaningful use, HIPAA, and completing yet another idiotic MOC (maintainence of certification requirement by the ABIM), who has time to spend hours with patients and their families making complex decisions?
CrisisMD does! We provide healthcare coaching, advocacy, and interpretation. We are not your doctor. We don't diagnose, examine, or treat. We translate.
Make no mistake. When you arrive at the doctor's office or the hospital, you are entering a foreign land. The language may sound familiar, but it's not what you speak at home!
Q: Wow! With all these balls up in the air, how do you have time to sleep?
(A crash is heard, Jordan has dozed off and fallen forward into his lukewarm bowl of broccoli cheddar soup).
Q: That's a wrap. Somebody get this poor slob a towel and clean him up.
Q: Jordan, this is the third in a series of self interviews over the last two years for this blog. Tell me, is anyone else (present company excluded), interested in what your doing?
A: Actually, my life story was recently presented to a distinguished group just last week.
Q: And how was it received?
A: My son's second grade teacher said he did a really stellar job!
Q: Um...OK. You recently were featured in Mike Sevilla's Family Medicine Rock's online radio show. How did it feel to be interviewed by a social media legend? And tell us about your new practice.
A: Mike is the real thing. His voice, his interview skills, it's like being on Oprah (I know you're out there O. You haven't returned my calls yet!)
I'm really excited about the upcoming changes. As of January 2014, I will no longer be seeing patients in the office. Instead, for a about a tenth of my current population (250), I'll be doing comprehensive primary care from the comfort of their own home. I'll charge members a yearly fee to allow myself to break the economic bonds forced by Medicare.
Q: What prompted you to make the change?
A: Medicare, healthcare reform, medicare, medicare, and healthcare reform
Q: Explain?
A: The delusional administrative and regulatory requirements by our governmental agencies are hampering basic medical care. We our losing sight of our patients, and spending time and energy bowing to the electronic dictates of an insatiable monster.
Becoming a master diagnostician is an ideal that takes a hundred percent commitment. Every click, form, and ridiculous constraint takes our eye off the ball.
By collecting the funds required to support myself completely outside the system, I will for once be free. Medicare can do what it wants.
C'est la vie!
Q: Is it true, that you are also starting an Internet business? CrisisMD.com?
A: Yes. What I enjoy most about being a physician is helping people make complex decisions. As most of us know, our healthcare system has been so perverted that we can no longer count on our own personal doctor to guide us through medical care. What with meaningful use, HIPAA, and completing yet another idiotic MOC (maintainence of certification requirement by the ABIM), who has time to spend hours with patients and their families making complex decisions?
CrisisMD does! We provide healthcare coaching, advocacy, and interpretation. We are not your doctor. We don't diagnose, examine, or treat. We translate.
Make no mistake. When you arrive at the doctor's office or the hospital, you are entering a foreign land. The language may sound familiar, but it's not what you speak at home!
Q: Wow! With all these balls up in the air, how do you have time to sleep?
(A crash is heard, Jordan has dozed off and fallen forward into his lukewarm bowl of broccoli cheddar soup).
Q: That's a wrap. Somebody get this poor slob a towel and clean him up.
Wednesday, April 24, 2013
An Open Letter To @kevinmd
I think this needs to be said.
I have been writing a long time. I have been blogging since 2005. In all this time, I've learned much about social media.
There is a problem with content. No matter how important it is, and how good you are at creating it, it all means nothing if you can't find your readers.
Content comes first, then amplification.
There are many amplifiers out there: Twitter, Facebook, etc. I have tried, succeeded, and failed at using many of them. But by far, the most effective amplifier in the health care social media world is Kevin Pho and his awe inspiring website kevinmd.com.
I have been reading Kevin since my earliest dipping of toes in Internet based self expression. I have watched his site morph from a personal blog to an open forum for today's opinion leaders to express their latest insights. Never, I repeat never, has the information been stale or dated.
Over the years, I have been lucky enough to have Kevin pick up and publish a number of my blog posts. The opportunities afforded me through his attention have lead to media interviews, publications in major periodicals, and invitations to speak in exotic places (and get paid for it).
As his website proclaims, he truly is "Social media's leading physician voice". He also appears to be a kind, down to earth, stand up sort of guy.
Kevin, you have paved the way for many of us in the heath care social media universe. You continue to deliver day after day, year after year.
From the bottom of my heart,
Thank You!
I have been writing a long time. I have been blogging since 2005. In all this time, I've learned much about social media.
There is a problem with content. No matter how important it is, and how good you are at creating it, it all means nothing if you can't find your readers.
Content comes first, then amplification.
There are many amplifiers out there: Twitter, Facebook, etc. I have tried, succeeded, and failed at using many of them. But by far, the most effective amplifier in the health care social media world is Kevin Pho and his awe inspiring website kevinmd.com.
I have been reading Kevin since my earliest dipping of toes in Internet based self expression. I have watched his site morph from a personal blog to an open forum for today's opinion leaders to express their latest insights. Never, I repeat never, has the information been stale or dated.
Over the years, I have been lucky enough to have Kevin pick up and publish a number of my blog posts. The opportunities afforded me through his attention have lead to media interviews, publications in major periodicals, and invitations to speak in exotic places (and get paid for it).
As his website proclaims, he truly is "Social media's leading physician voice". He also appears to be a kind, down to earth, stand up sort of guy.
Kevin, you have paved the way for many of us in the heath care social media universe. You continue to deliver day after day, year after year.
From the bottom of my heart,
Thank You!
Monday, April 22, 2013
CrisisMD Launches Soon: Guidance Through Uncertainty
When was the last time you were in a medical crisis?
When was the last time you had a health scare with a family member and felt you had no one to turn to?
The medical landscape is changing. Healthcare reform, economics, and the modern agrahospital system are clouding basic personal care. We no longer treat patients, we treat communities. We no longer heal our patients, we manage their insurance companies, input their data into impersonal computer systems, and spit them out of the hospital with a nonsensical set of discharge instructions. The doctor who performs your yearly physical is different from the doctor who triages you during an unplanned office visit or who oversees your hospital care.
Frankly, it's not surprising that patients and families with no medical training or experience are floundering under the weight of this awkward system. How could you not?
I proudly announce the upcoming launch of CrisisMD.
Visiting the hospital or doctor's office can feel like entering another country. The terminology is unfamiliar and the process convoluted. CrisisMD will help fill the gap. We provide healthcare coaching, advocacy, and translational services to families in need.
Please support this venture by:
Following on twitter: @CrisisMD
Liking on Facebook: https://www.facebook.com/CrisisMD
Or visiting our website that will launch in the next few weeks: www.crisismd.com
Saturday, April 20, 2013
Show Time
My daughter is surrounded by a gaggle of small girls. Half the cohort marches forward gingerly on their skates while others have learned to glide. It is the first act of a two hour ice show at the local rink. The little ones have been practicing every week for the last few months. This is their first attempt at performance.
As the show progresses, the age and the skill set of the skaters improves. Those of us in the crowd can tell fairly quickly the talent of the soloists. Some have the God given grace and bearing of performance, even though they have not yet mastered the intricate movements. Others hit the jumps cleanly, but somehow struggle with the appropriate posture.
Then, then there are the ones who have it all. We hold our breath as they speed by and effortlessly nail a series of complex moves. It's almost easy to forget that years of practice have lead to this moment. While their friends were clowning around on the weekend, these teens were in the rink sweating: before school, after school, on holidays.
As my daughter waddles off the ice to the rousing applause of the audience, I wonder what her future will hold. The same goes for my son and the violin. Will these be just passing fancies or something more?
It certainly never happened for me.
Growing up, there were no sports I excelled at, no instruments that bent nimbly under my fingers. And I regret it. I regret not becoming a gymnast or concert pianist.
But I wouldn't say I wasted my youth.
I was in the library. Locked in my bedroom, I poured over school books hour after hour. knowing I wanted to be a doctor since preschool didn't make the subjects any easier. I struggled.
While my friends in high school were cruising chicks at Northbrook Court, I was buried in algebra. I spent countless Saturday mornings in the law library while the rest of my dorm was getting drunk at the football stadium.
I remember each test, each landmark: the SATs, The MCATS, Step 1, Step 2, Step 3, and the Internal Medicine boards. How many little moments go into artistry? I stumbled through the first patient encounter. I tripped over diagnosis after diagnosis. One day I was a resident, the next a full fledged attending.
Although what I do may not always be pretty, I perform each and every office visit. This is my art.
This my triple axle.
Sometimes I nail it. Others, I fall on my rear.
Take away the computers and the annoying paperwork, it's just me and the patient sitting in the exam room.
I prepare my instrument and flex my calf muscles.
It's show time.
As the show progresses, the age and the skill set of the skaters improves. Those of us in the crowd can tell fairly quickly the talent of the soloists. Some have the God given grace and bearing of performance, even though they have not yet mastered the intricate movements. Others hit the jumps cleanly, but somehow struggle with the appropriate posture.
Then, then there are the ones who have it all. We hold our breath as they speed by and effortlessly nail a series of complex moves. It's almost easy to forget that years of practice have lead to this moment. While their friends were clowning around on the weekend, these teens were in the rink sweating: before school, after school, on holidays.
As my daughter waddles off the ice to the rousing applause of the audience, I wonder what her future will hold. The same goes for my son and the violin. Will these be just passing fancies or something more?
It certainly never happened for me.
Growing up, there were no sports I excelled at, no instruments that bent nimbly under my fingers. And I regret it. I regret not becoming a gymnast or concert pianist.
But I wouldn't say I wasted my youth.
I was in the library. Locked in my bedroom, I poured over school books hour after hour. knowing I wanted to be a doctor since preschool didn't make the subjects any easier. I struggled.
While my friends in high school were cruising chicks at Northbrook Court, I was buried in algebra. I spent countless Saturday mornings in the law library while the rest of my dorm was getting drunk at the football stadium.
I remember each test, each landmark: the SATs, The MCATS, Step 1, Step 2, Step 3, and the Internal Medicine boards. How many little moments go into artistry? I stumbled through the first patient encounter. I tripped over diagnosis after diagnosis. One day I was a resident, the next a full fledged attending.
Although what I do may not always be pretty, I perform each and every office visit. This is my art.
This my triple axle.
Sometimes I nail it. Others, I fall on my rear.
Take away the computers and the annoying paperwork, it's just me and the patient sitting in the exam room.
I prepare my instrument and flex my calf muscles.
It's show time.
Thursday, April 18, 2013
Jumping The Fence
It would be an understatement to say that things have been a little topsy-turvy.
I tossed and turned last night as the thunder cracked and sheets of rain slapped against the windowsill. My body rose out of bed by habit, minutes before the alarm released it's throaty bellow. I hunkered into my spring jacket and ducked out the door, through the backyard, and into the garage. The drips of water fell off my brow as I climbed into the car.
Visibility was poor. The entrance ramp was under a few inches of water, and my car lurched forward slowly. Thankfully, the highway was clear. Miles down the road and picking up speed, I saw the familiar line of break lights in the distance. I slowed down cautiously before coming to a complete stop. I was stuck.
At the end of a long line of cars with an impenetrable swamp obstructing my passage to the hospital, my options were sparse. I felt a sinking sense of doom. Like a caged bull, I could butt my head against the bumper in front of me, but it would be an act of self flagellation. There were patients waiting, but I couldn't get to them.
I craned my head in desperation, complete darkness. Not a single vehicle on the road barreling toward me. So I whipped into reverse, clicked on the blinkers, and drove the wrong way down the shoulder till I could exit off an entrance ramp.
Driving the wrong direction on the expressway is an odd feeling. It's like being given special glasses to look directly at the sun. Your mind can rationalize the action your body is initiating even as the muscles fight to maintain the status quo.
But at some point, you take the path that is given to you.
Many of us bulls are waiting till the door of the pen is flung open, and will run as directed into the arms of healthcare reform.
I, for one, have chosen to jump the fence.
And gallop the other way.
I tossed and turned last night as the thunder cracked and sheets of rain slapped against the windowsill. My body rose out of bed by habit, minutes before the alarm released it's throaty bellow. I hunkered into my spring jacket and ducked out the door, through the backyard, and into the garage. The drips of water fell off my brow as I climbed into the car.
Visibility was poor. The entrance ramp was under a few inches of water, and my car lurched forward slowly. Thankfully, the highway was clear. Miles down the road and picking up speed, I saw the familiar line of break lights in the distance. I slowed down cautiously before coming to a complete stop. I was stuck.
At the end of a long line of cars with an impenetrable swamp obstructing my passage to the hospital, my options were sparse. I felt a sinking sense of doom. Like a caged bull, I could butt my head against the bumper in front of me, but it would be an act of self flagellation. There were patients waiting, but I couldn't get to them.
I craned my head in desperation, complete darkness. Not a single vehicle on the road barreling toward me. So I whipped into reverse, clicked on the blinkers, and drove the wrong way down the shoulder till I could exit off an entrance ramp.
Driving the wrong direction on the expressway is an odd feeling. It's like being given special glasses to look directly at the sun. Your mind can rationalize the action your body is initiating even as the muscles fight to maintain the status quo.
But at some point, you take the path that is given to you.
Many of us bulls are waiting till the door of the pen is flung open, and will run as directed into the arms of healthcare reform.
I, for one, have chosen to jump the fence.
And gallop the other way.
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