call to serve, Feed My Starving Children, Haiti, health care, hunger, mission work, sorghum making, Uncategorized

Why Haiti? Part III

Len Demert founder

Schools4Haiti Founder, Len Demert

Day 2 of the mission trip with Schools4Haiti:

One of the very first things that was apparent upon arriving in Port au Prince (my first exposure to Haitian people) is how boorish or verbally aggressive they are.  It is classic id run amok–no filter.  If they think it, they tend to say it. “Hey pretty lady!” they call out to some of the ladies in our group.  Wow, put a sock in it, Ace! I think to myself. Yet somehow, they are also polite and quick to smile.  Their default expression is one forged out of lifelong hardship, however.

Haitian elder

She’s younger than you think…

Unless you are from Haiti or used to driving in Haiti, it’s best to hire a driver who can double as an interpreter–especially if you are not fluent in Creole.  One truck was not enough for our team and our luggage.  The trip organizer, Penny Demert-Neal of Schools4Haiti left our company to get another truck rented from Avis.  The standing joke of how many people can you fit on a Haitian truck (one more) did not hold for our team. We needed two trucks. Driving in PAP streets is harrowing, crowded, choked with traffic, and very minimal traffic laws are observed.  Our host would later tell us stories of drivers who have hit others in the street who were then pulled from the vehicle and stoned by villagers–judge, jury, and executioners all rolled into one frenzied group.

haitian streets

driving in Haitian streets

We began our northward ascent toward Mirebalais and the New Life International compound and our hosts, Brian and Jamie Rauschenberger. Soon we were climbing Mt. Cabrit (goat) and were seeing what appeared to be wild goats, donkeys, and horses.  Our driver soon corrected me on this issue and said that although each animal appeared to be wild, every Haitian knew exactly who this horse belonged to or that goat, even that stray chicken scampering about. I was pleasantly surprised by the beauty of the countryside that followed the despair, crowds, and litter so rampant in PAP. Cacti of varying types speckled the mountainside, while animals scurried about. On the way up Mt. Cabrit, those of us in the back of the truck got caught in our first monsoon, taking care to hold the blue tarp over us and at least limit the impact of the big drops of rain that were pelting us.

IMGP0532

Our New Life Int’l hosts, the Rauschenburgers

After arriving at New Life International at meeting our hosts, we grabbed our bags and checked out our new dorm rooms.  Each of us men had a single bed, three in our room.  One of the docs roomed with his sister, a high school French teacher.  The rest of the ladies in our group shared a larger dorm room with two single beds and two bunk beds.  The dorms, recently completed, looked more like bunkers than dorms as the interior was unpainted cement that was not yet finished sweating–and would not be painted until time passed and the sweating had run its course.

inside NLI dorm

inside dorm room at New Life Int’l

Our host, Brian, explained that the air conditioning was freshly installed but the daylight hours had slipped away before the electrical connections could be completed.  Therefore, our first night we would have no AC but each subsequent night we would.  This was a huge bonus, as the nighttime air brought open windows, mosquitoes, and security risk.  Outside were two armed guards who kept patrol while we slept.  New Life International in Mirebalais sat on 40 acres of the prettiest jungle in Haiti.  Enormous cane stalks bordered the lane and the property and made me recall the memories of my grandfather Ever who grew cane and pressed sorghum for 47 years until he died in 1983.

Wanting to appease the curiosity of my foodie wife Sara (of thesisterslice.com), I took care to carefully catalog the different foods that we ate while in Haiti.  Brian’s wife Jamie served us spaghetti with fish, rice & beans, an iceberg salad, and ranch chicken drumsticks with lime-aid to wash it all down with.  Brian assured us that the lime-aid was made with purified water from his own system.

Haitian water purifying system at Pastor Paul’s orphanage

** Watch for Why Haiti, part IV soon! Please remember to like and follow the blog.

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health care, HIPAA, patient privacy laws

Crying Wolf? Hippocratic or just hypocrite?

miltonwolf

Dr. Milton Wolf, radiologist and candidate for U.S. Senate

A Kansas physician, Dr. Milton Wolf, has come under fire for posting “grisly images” on FB, images of patients he has served as a radiologist over the years—those of gunshot fatalities and medical injuries. The headlines draw us in at the very hint that a physician, America’s closest thing to royalty, may be guilty of impropriety or even poor judgment. Society likes to place physicians on a pedestal and too easily forgets that these folks are people first, physicians second. They are just as prone to making mistakes as the rest of us, except society seems held in delight and awe of their fall from grace, compared to regular folks.

MD on a pedestal

Society puts physicians on a pedestal

What those who do not work in health care fail to understand is that we need dark humor, behind closed doors, in order to cope with the burden of what we see and hear every day—human beings doing stupid things and then reacting with even greater stupidity. Worse, when stupidity is revealed, people don’t want to have any consequences from it or let the mistake be known.  Too often, the results are tragic and health care professionals use dark humor to cope, to survive. We wrap dark humor around us like a protective cloak, to keep the ugly off of us so we can live to treat others yet another day.

cloaked

cloaked in dark humor

However, judicious care must be taken when making private images public, regardless of the intent. If Dr. Wolf simply posts an x-ray of a shotgun blast to the chest, with no identifying markers, then arguably the x-ray could be anyone who has ever suffered a shotgun blast to the chest. However, for argument’s sake, let’s say it is circa 1993 and a radiographic image of a severed penis is posted publicly to the internet. How many men suffered amputation of their penis that year? Any such image that might surface that year, even void of identifying markers, would be presumed to be that of John Wayne Bobbit—even if it was not. Could it be argued that patient John Wayne Bobbit’s rights have been violated, even if the image of the severed penis did not, in fact, belong to Mr. Bobbit, given the media frenzy that followed the event? In the end, Mr. Bobbit’s reattachment was successful, but if it had not been, would he have become so well known or go on to star in adult films?

Using another example, I once cared for a hemicorpectomy patient—yes, a patient who had been traumatically cleaved in half. If I were to post radiographic images of this, it might narrow down the possibilities to one of fifty people each year in the US. However, if any additional details of this case were shared, like which year this occurred in or what city, I would no doubt violate HIPAA laws and risk inciting perturbed family members to respond in litigious ways. HIPAA is an acronym for Health Insurance Portability and Accountability Act.  According to hhs.gov, the privacy component of the HIPAA law  states that the major goal of the Privacy Rule is to assure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high quality health care and to protect the public’s health and well-being.

My point of this post is that I am far from perfect, but I believe it is always best to behave in a way that will not necessitate an apology later. Dr. Wolf, U.S. Senate candidate, has publicly apologized for posting these images in question. At best, his actions were a lapse in judgment. At worst, they were a violation of the patients’ rights and possible courtroom fodder. As gaffes go for those who aspire to or are elected to public office, this is no blue dress or defining what “it” is, or inspiring second graders across the fruited plain to ask their parents what oral sex is.  But it also is something I would not have done under any circumstance. In a time of ever-increasing healthcare regulation, who really wants to thumb their nose at the HIPAA laws and risk being made an example of in the national spotlight?

lewinskydress

Bubba fancied The Blue Dress!

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call to serve, Feed My Starving Children, Haiti, health care, higher education, hunger, mission work, Uncategorized

Why Haiti? Part II

I decided I would keep a journal before heading to Haiti.  I wanted to look back on my experiences, Haitian cuisine, the orphans, and my team. Haiti would be the 19th country in my passport, except mine had expired and was in need of renewal.  The postmaster in the Mount Horeb, WI post office discouraged me from expediting the renewal, certain that the new one would return within 5 weeks.  She was right.  I paid my $116.50 in total passport costs and merely waited.  A scrub top for the photo–perfect.  I looked the part of a medical missionary.

Eriks passport photo001

my passport pic, wearing a scrub top

Our flight was leaving O’Hare about 0730 with a connection in Fort Lauterdale, FL, so nearly all of the team wanted to meet at a Quality Inn there, dine, and organize the materials we were taking along. Day 1 of this excursion happened to be July 2nd, my 8th wedding anniversary with Sara.  I came home after a 12-hour night shift in the emergency department, napped 3 hours, and headed to the farm.  My wife is an excellent planner and had most of my clothes and accessories gathered already. I made a point of not taking anything that I could live without, worried about the risk of it getting stolen or ruined in some fashion.  By 3 pm we were leaving my brother’s farm and we arrived at the Quality Inn O’Hare by 1730.

Soon we were having dinner at Bella Sera in the Hotel.  I ordered the seafood ravioli and remember that I wanted to lick the plate–it was so incredibly good!  Those who know me well know that I am a foodie, married to a foodie: Sara, 1/3rd of thesisterslice.com Topping off my dinner was tiramisu and a Castle Rock pinot noir.

tiramisu

tiramisu!

I knew it was not likely I would eat this well in a third world nation for the next 10 days. I don’t believe we had any teetotalers among the group, which made organizing and re-packing all the medical supplies that much more fun. By 2230 we were in bed, brother Adam and I in our room, and I awoke at 0200–mind a flurry of activity, so I decided to go use the hotel’s business computer to log some work on my doctorate.

airport security

airport security

I was asleep maybe another hour when the alarm went off and we were up. We were on the shuttle headed for the airport by 0430–strong work on the part of the QI staff and drivers.  It was no easy task to get all of the team and our 12 bags into the shuttle. It was an easy traverse through security and then to an Americanized breakfast of McDonald’s hot cakes and a venti Mocha latte.  I couldn’t imagine there would be a McDonald’s on every street like in the U.S.; but then again, I was surprised to find one in Zermatt, Switzerland and Foix, France too. A couple of hours later we were dining in the Ft. Lauterdale airport before catching our 90 minute flight to Port au Prince.  A nice, hot plate of spaghetti and meatballs in my belly helped get me psyched up for culinary conditions unknown once we landed in Haiti.  How do you get psyched up for intractable diarrhea in a 3rd world nation?

mcdonalds zermatt

McDonalds, in the shadow of the Matterhorn!

We knew when we were flying over the Bahamas, a series of islands surrounded by some of the brightest aqua-blue colored water I have ever seen.  Minutes later we were touching down in PAP and I thought “We’re not in Wisconsin any more, Toto.”  We were greeted by throngs, oceans of Haitians everywhere.

crowds of haitians

Haitian crowds like the one at the PAP airport

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health care, hip resurfacing, orthopedic surgery, surgery, Uncategorized

Humbled by Mortality

Today…I bought a cane.  A cane!  I am 46 years old. I am only 46!  I have inherited some bad genes.  Genes for coronary artery disease (CAD), genes for diabetes (which I have dodged so far), and genes for osteoarthritis (OA).  About one year ago I stopped taking the statins, those wretched, wretched drugs that are supposed to be wonder drugs that will bring naughty lipid profiles up to toe the line.  I predict Hupy & Abraham 1-800-BAD-DRUG commercials in the near future, featuring statins. I had started aching–my legs, arms, even the spinal erector muscles ached.  An endocrinologist in Monroe, WI named Dr. Bekx tweaked my regimen with CoEnzyme Q10, Niaspan, the water-soluble Crestor that had been touted as “the best of the best of the best” in that class of drugs.  Dr. Bekx is a brilliant man, and even among physicians he stands out.  Tweak as he may, the myalgias (muscle aches) persisted to the point I could not stand taking even the tiniest dose.  I began to list them as an intolerance.

pill bottles

Mr. Polypharmacy!

By July I thought the statins should be long gone from my system and the pain should therefore also be gone…but it wasn’t.  My primary doc set a referral to a rheumatologist, Dr. Wilson.  A reputation of being difficult to work with preceded her, but I found her to be delightfully candid with a fast, dry wit.  Upon exam, she brought each of my legs up to my chest and I nearly came off the table in pain!  After reviewing the family history and getting an anterior-posterior x-ray of my hip joints, she told me I had osteoarthritis in both hips.  Mine was so bad that I had bone on bone, grinding, in each hip.  Worse, I had bone spurs that had been laid down as part of the body’s response after it received a chemical signal that something was bad in each hip.

OA hip

Arthritic hip; both of mine are bone-on-bone

Next was a referral to the orthopedic surgeon, Dr. Wolff.  From Madison, WI, he has a stellar reputation and a great surgical history.  Better, he was well-liked.  I cared little about that part because I would rather have a sound, gifted surgeon than one who simply made me feel good about some gaffe that occurred intraoperatively.  Surgery was originally scheduled for early December, but I just couldn’t wrap my mind around the notion of a total hip replacement on each side–not at age 46!  Sure, just lop off the proximal end of each femur and shove some hardware down in the center of the remaining leg bone!  No way, not for me, not at 46.

total hip hardware

The more common “total hip” replacement

A salty mare of a charge nurse that we love and work with in the emergency department suggested I look into the program at Sauk Memorial Hospital.  So I did, and I realized they offered hip resurfacing–new titanium alloy surfaces covering the head of the femur and the corresponding cup that is attached to the hip bone in the acetabulum.  Touted as the ideal surgery option for a male in his 40s or 50s with OA who plans to return to a vigorous lifestyle of running and skiing, this sounded like my perfect solution.  I would not likely run marathons again, but I do plan to ski with my sons.  By choosing this option, I get to keep my bones but I just get new surfaces so my bones are no longer grinding together–the titanium parts are!  Now that sounded like a capital idea!  When I met and spoke with Dr. Arnold Rosenthal, I liked him immediately.  He confided that he had the hip resurfacing done years ago himself and has loved the outcome.  Suddenly the man had street cred with me…like a mom-to-be taking suggestions from her doc who had already had a baby herself.

hip resurfacing hardware

This is hip resurfacing hardware; generally titanium alloy

Having never been cut on and placed under a general anesthetic, I am scared witless about this surgery.  I have decided to have both hips resurfaced and the closest the surgeon will do them is 6 weeks apart.  So, six weeks it is.  I will be on FMLA from work for 12 weeks.  Since osteoarthritis is a degenerative process, my hips will never be better than they are today–they will only get worse.  I cannot continue to gobble up the tramadol, naproxen, acetaminophen, and motrin as I have been for months or my kidneys will begin to fail.  My physician even added hydrocodone recently to help manage the pain all the other times that I am not at work.  Ibuprofen causes my ANA or anti-nuclear antibodies to spike and then I begin to feel pretty cruddy, so I reserve that stuff for breakthrough pain while at work. I cannot imagine a day where I don’t have to take something to manage pain, but that is the ideal I strive for by committing to these two surgeries.  Living with chronic pain is pure hell.

chronic hip pain

Living with chronic pain

**Please like and follow the blog!  Thanks!

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Do-It-Yourself, health care, higher education, hunger, Uncategorized, Weight Loss

No Weigh! 6 Simple Ways to Trim Bad Habits & Your Waistline!

Hansons are big people.  Not so much in height as in girth.  Grandma was always heavy, grandpa was built like a utility truck.  Dad was morbidly obese and mom was plump.  What a nice word, plump.  “Fat” sounds so judgmental.  Plump sounds cozy, like when I was a small boy and just wanted to snuggle into grandma’s soft, round, plump belly and fall asleep. Growing into men, grandma was concerned that we would go out in the world and settle for skinny Minnies who we “couldn’t find under the sheets.”  Instead, she suggested we find good eaters for our mates. God forbid, I once brought a girlfriend around who had the nerve to pick around at the dinner in front of her.  After grandma saw this, that woman had to go!

reubenesque

For many years I was a runner.  I ran because I liked it…and maybe because I knew where my genes would take me if I let them.  I ran my last marathon on my 38th birthday in St. Paul, Minnesota.  Just prior to the Med City Marathon I had met Sara, a 6′ 2″ German gal who I had decided would be a great partner to raise three boys with.  Although grandma would be pleased that I knew how to locate my mate, the trouble was that Sara is a mighty fine cook.  I stopped running and starting eating.  Before I knew what happened, I was packing 282 lbs. onto a 5’9″ frame and feeling pretty lousy about it.  As it turns out, I made a miserable fat guy.  I got winded walking up two flights of stairs.  I would feel sciatica shoot down my leg from my back.  I sweated on relatively cool days. I had to wear BIPAP when I slept so I did not stop breathing for long periods of time.

Erik Med City Marathon 38th BD001

Hamming it up at the Med City Marathon, my 38th birthday

To make matters worse, in July of 2013 I saw a rheumatologist who diagnosed me with osteoarthritis in both hips.  I began to pay attention to the hip x-rays put on the PACS screen at work in the emergency department.  There were 91 year old women with healthier hip joints than I had.  I was referred to an orthopedic surgeon who popped up the AP film of my hips and said “Your hips are shot!  At 46–what in the hell did you do to your hips?”  I ran for many years, I have been in health care all my adult life, and I love to ski–all had taken a toll on my hip joints.  “Big guys like you aren’t suppose to run!” the ortho guy exclaimed.  “Save that for those wispy-chested Nigerians who are built for distance running.”

marathoner

marathoner

Now that I was grinding bone on bone in each hip, my choices to lose weight were suddenly quite limited.  Cutting out my tongue seemed too extreme so I took a long look at the habits I had formed to get me to 282 pounds.  I hate the word ‘diet’–implicit in that word is an ebb and flow I am not comfortable with.  Or maybe, that’s what the word has come to include in our society.  Inevitably the wane of dieting is followed by the wax of gaining all the weight back the moment behavior resorts back to what is was before. Options limited, I had to achieve weight loss in the most basic way possible:  fewer calories in, compared to calories burned throughout the day.  No longer could I just go out and increase my running to burn off weight gain.

debility

debility

1.  I stopped eating out of boredom.  If I wasn’t hungry, I didn’t eat.  I’m not sure when I started eating due to boredom, but I had somewhere along the line.

eating when bored

1) don’t eat when bored

2. I started cutting down on my portion size and asking my wife to do the same when she served my plate.  Although I grew up with a scarcity of food and leftovers were something we never had, it became okay to push my plate away when I had enough.  I had to reassure my wife there was nothing wrong with supper, it was just that I had enough.

push food away

2) No need to belong to the Clean Plate Club!

3. I stopped using social gatherings like birthdays, holidays, big games, deer hunting season, and other celebrations as an excuse to pig out.  Instead, I would try a single bite-size of something I really liked just for a taste, then quit.  This takes tremendous will power.

buffet line

3) No pigging out at social functions!

4.  I stopped eating a big meal right before bed.  I have been a night shift worker for 28 years so my bed time is variable, depending upon my work schedule.  No matter when I was going to bed, 10 p.m. or 10 a.m., I would have a simple sandwich or apple–just so my stomach didn’t growl while trying to fall asleep.

healthy snacks

4) Healthy snacks only before bed, if you must

5. I began to curb my intake of red wine.  I love a nice chianti or sangiovese on my night off, but at 7 kcals per gram, the weight gain from alcohol adds up fast.  Drinking my calories was no different than eating a big meal right before laying down.

chianti

5) In moderation only!

6. I started drinking a lot more water–the recommended eight 8 oz. glasses per day. In doing so, I replaced my usual diet Coke with water–the caffeine being an appetite stimulant and in its absence, I was not as hungry any more.

water bottles

6) Drink more water, less soda!

I had also moved from the float pool as an RN to the emergency room.  ER nurses run their butts off, as a rule.  By contrast, when I was in the float pool I often enjoyed a banker’s lunch.  In the ER, I was lucky to have two minutes to wolf down a PB & J.  This is a very unhealthy eating practice, but at least I was burning calories in my new role.  Say what you will, but a year and a half after moving to the ER, I am down from 282 lbs. to 232 lbs–A fifty pounds weight loss by using ONLY these 6 easy steps!

skinny in fat jeans

Happy losing!

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health care, religion, spiritual journey, Uncategorized

Spiritual Darwinism

Yellowstone Church

Yellowstone Lutheran Church

I remember church being something foisted upon us by our parents at the behest of Grandma Hanson, mostly so we would not later “burn in a lake of fire.”  Wow.  That sounds like a hateful way to go.  If all I have to do is attend church once a week on Sundays, then yeah, I would happily opt to avoid such a tragic and preventable end.  Of course, Grandma was talking about my spiritual self, not just my here-and-now mortal self. Perhaps she was a believer, perhaps she knew that this mortal life is but a precursor to an eternity with Jesus.  Mostly, I think she just wanted us children to stop cursing so much.  Ah, the sequelae of a mother who could swear to make a sailor blush.  Maybe Grandma believed that if we got a little Jesus on us that she could use shame effectively whenever we let loose on an expletive tirade.  Her strategy worked.

burn in lake of fire

Burning in a Lake of Fire

In my teen years I would take confirmation classes and be confirmed in that church.

Erik at confirmation age 14001

Confirmation at Yellowstone Lutheran, age 14

But so what?  Who wants to belong to a group of so-called Christians who would bad-mouth my father right within the church walls and in front of me?  Although my kin had been buried in that cemetery since Ole Elgstuen got off the boat from Norway 140+ years ago, I dismissed the current Yellowstone Church congregation as a bunch of pseudo-Christian occupiers.

pseudo-religious

The pseudo-religious

During my college years I was too busy defining and discovering myself, drinking beer and chasing girls to be concerned with eternity. My only religious experience to date was dealing with those sanctimonious, opinionated Lutherans back in Argyle.  I dated a troubled young lady from the Latter Day Saints when I was working in Payson, AZ.  I witnessed a LDS baptism and saw the outside of the Mormon Temple in Mesa, AZ.  I learned enough and witnessed enough to not want to drink that Kool-Aid.  Growing up excluded, I had learned to reflexively back away from any group, religious or not, that valued exclusivity above nearly all else.

exclusive club

Exclusive Club

A vast amount of time passed before I was married and ready to start a family.  Sara grew up Baptist and I grew up Lutheran so we sought a nice happy medium for a church, which we found in Community Heights Alliance Church in Newton, IA.  I got into church league softball and got to know our pastor a bit more.  We felt strongly that children need structure, the more of it the better, and without it…they begin to unravel.  Soon Sara and I realized that this was the ONE hour of each week that we could sit and hold hands and be just Erik and Sara–not “mom! dad! mom! dad! MOM! DAD!”  Simultaneously, I was growing closer to God, coming home.  I began to listen to pastor Cory’s sermons and take in the message, take it to heart. I began to pray, silently, in my bedroom, in my car.  I didn’t want things, material things from God.  I had a physician’s income as a nurse–I had all the things I wanted and needed. I wanted God’s love and guidance.  I wanted to feel Him with me, in my heart and mind.

presence of God

In God’s presence

In late March of 2008 I started to have chest pain–nothing terrible but nagging pain at the left sternal border. I decided to be seen in the ER and my cardiac enzyme troponin was slightly bumped and there were non-specific changes on my 12 lead ekg.  As soon as I mentioned that my father had an out-of-hospital arrest at age 39 (I was 41 at the time), they whisked me right to the heart catheterization lab.  I prayed.  I had conversations with God and felt his presence.  Many hours later Dr. Ianone, the cardiologist, was sitting in my room, post-cath, and explaining that my coronary vessels were “pristine.”  What had caused this then, I asked?  Likely it was a bout of pleurisy, he said.  It was an $18,000 day just to learn that I need to take motrin every six hours until the bottle was gone.

heart cath

Heart catheterization

Pastor Cory visited me at home in the days that followed this scare.  I remember his line of questioning growing too personal, too invasive for my comfort–and I told him so.  I explained that my relationship with God was mine.  It was personal, not to be questioned or dissected by any mortal being, pastor or not.  Honestly, I resented his intrusion.  I explained that I think of faith and religion like I do a tooth-brush.  My tooth-brush is mine, not yours and just like I expected pastor Cory not to use my toothbrush, nor would I ask to use his.  My tooth-brush works for me–it will not work for him or vice versa.

toothbrush

In October of 2012 Sara and I began scoping out Hidden Valley Community Church in Dodgeville, WI.  We made a plan to get in, get out, and leave no trace or identifying marks–just in case the church smacked of kookiness or our cult alarms went berserk.  We had just moved to rural Hollandale and were thrilled to find a church akin to CHAC in Newton. Never before had I felt so at ease.  We both took to HVCC quickly and easily.  By August of 2013, I was baptized in Cox Hollow Lake at Governor Dodge as Jesus had been by John the Baptist in the River Jordan.  I felt honored to be baptized as Jesus had been, rather than simply the sprinkle of water upon my forehead as a baby.

Baptism of Jesus

Jesus being baptized

There are many in the scientific community who believe that science and religion are mutually exclusive, that the two cannot be reconciled.  A truly inspiring book by Dr. Eben Alexander called Proof of Heaven addresses how scientific minds can also be believers, and shares this physicians’ spiritual journey through e. Coli meningitis back to good health as a neurologist. In the words of Dr. Alexander, “my experience showed me that the death of the body and the brain are not the end of consciousness, that human experience continues beyond the grave. More important, it continues under the gaze of a God who loves and cares for each one of us and about where the universe itself and all the beings within it are ultimately going” (Alexander, 2012).

Alexander, E. (2012). Proof of Heaven. New York: Simon and Schuster.

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health care, higher education, medical school

“C” Equals MD, but “D” = Door

KU med

Certain jokes are thrown around in med school to help ease those things that you cannot control–like failing an exam that you studied so hard for.  “C” = MD is one such saying, and “what do they call the person who graduates lowest in his MD class?  Answer:  Doctor!”  In 2003, 15 physicians met in a little room and decided my fate in medical school. I was suspicious that they were heavily influenced by the Dean of Student Affairs–a tiny-handed, effeminate man who governed through the Marquis du Sade playbook.  Sometimes tiny gloves just mean tiny hands, but he seemed to have something to prove and worse, seemed to delight in student attrition from the program. It is not accurate to say that I failed med school. I failed one class–medical biochemistry! I missed a passing grade by 5 questions on the final.  My younger MD brother with a photographic memory would later say “had I failed one more question on my biochem final, I would have failed also.” His words meant to soothe, to ease the heartache, but I still felt hollow in the center of my chest. Heck, I still feel hollow in the center of my chest when I think of that terrible day now. Ten years later, I have a new wife, 3 sons by her, am back to being a nurse, have finished a 4.0 masters in health administration and have a perfect start in my doctorate of health care leadership and organizational behavior.  I will lead a health care organization soon. I haven’t had a grade other than an “A” in ten years–but then, nor have I had to endure a standardized multiple choice test either. I write my way to academic perfection lately.

newton house

In 2006, we bought a lovely home–a 1916 one and a half story arts & crafts style bungalow–in the original Maytag town of Newton, Iowa. How could we have known that Whirlpool would buy the plant and then shut it down when union bosses failed to concede $5 per employee, per paycheck, for their own health insurance coverage. 1,800 jobs soon left a town of 16,000 people. Then the house of cards that was Fannie Mae and Freddie Mac collapsed, mere weeks after my wife and I bought our first ‘flip’ house. Our flip house was lovely when we were done and the Altoona, IA city council said that we single-handedly took the town’s most unsightly home and made it one of the most enviable. We spent $25,000 in 17 weeks and sold it for a loss of $7,400. At least we had our pride to hang our hats on–the house was gorgeous, sandstone vinyl siding with black and white trim.

altoona house

before pic of Altoona house

In 2010, Sara and I began to think our Newton IA home had been built upon an ancient burial ground–my job was changing and not for the better and Sara was silently enduring yet another miscarriage. The Wisconsin grass seemed greener, so we packed up and moved that May. I wanted to rent in a nearby small town, but Sara insisted our kids should play with my brother’s kids on the farm. “Hey–didn’t Adam once have a mobile home parked on the farm? Wouldn’t the septic and utilities still be in place?”

a cabin

the “cabin”

 Although the impetus for the move was to escape the heartache of Newton, the prospect of a job put the move in motion. I quickly got a lesson in how poisonous some healthcare organizations could be. I was given an opportunity to bail and I did. Debt deepened. The ‘cabin’ as we not-so-affectionately referred to it was overrun by mice and even a floor-breaching “ugly cat” or o’possum. The fiberboard floor would become wet, sag, and then put life and limb in jeopardy until I fixed it. What a hateful chore that was! The pipes froze in the winter, often, and I actually set a mouse trap once and before I was out of the tiny bedroom–it snapped with a freshly-dead mouse in it! Meanwhile, it seemed that our professional indoor paint job in the Newton home did little to bait any prospective buyers. We let an associate pastor and his new wife stay there for $1 a month–just to have the utilities paid, the grass mowed, or the sidewalks shoveled. Then a land-contract buyer sought us out, a hard-luck story ensued, and we were hooked. Hey–at least I would not be hemorrhaging around $1500 per month any longer.

academic failure

In 2004, still reeling from the sting of a failed run at med school, I started down the nurse practitioner tract through the University of South Alabama.  Although my first course, pathophysiology, was an “A,” my next term included a course in nursing theory.  While I love being a nurse and the life it has given me, I loathe nursing theory.  It is an entire ‘language’ thought up by nursing academia to justify their own existence.  The argument is that nursing theory promotes the professionalism of nursing. What hogwash! I am of the opinion that this nonsense denigrates the profession. I submitted my first work for the nursing theory course and was graded 3 out of the 15 possible points.  Wow.  Here I am in a sham course, then draw an instructor who thinks she is God’s gift to technical writing…she would not budge.  I lodged a formal complaint with the university and withdrew from the program. Note to self: be something more than lukewarm about a career path before starting in that direction again.

academic success

In the summer of 2010, Sara and I and two boys were living on Adam’s farm when it was as though a switch was flipped on.  I wanted to return to school, earn my masters, and ascend the health care hierarchy.  A career nurse, I feared my knees or my back would fail me and I had better have something else to fall back on.  I looked into A.T. Still University, home of the original doctor of osteopathy program–the same program my maternal great-grandfather Franklin VanNess De Vinney graduated from in 1917.  Great grandpa De Vinney was the first physician in our family, either on mom or dad’s side.  Although A.T. Still had been weakened by a stroke in 1914, I often wonder if my great-grandfather knew the founder of the American School of Osteopathy, as it was known then.

early doctor]

I started my masters in July of 2010 with one class called U.S. Healthcare Systems.  I realized the pace was fine and thought I would be able to handle more, so I doubled up the next term.  I spanked those two courses as handily as I had the first one.  At last, I was on the right track.  Two years and one month after starting, I stood on stage in Kirksville, MO with Upsilon Phi Delta honors after earning a 4.0 Master’s in Health Administration! My wife and sons where there to witness my achievement. I remember thinking that this is how a bride must feel on her wedding day, except I was prancing around campus sporting a mortar board with my gown.  Oh, the irony, this juxtaposed with the crash-and-burn at KU.  What a tragedy that I chose that wretched, unfriendly place to attempt an MD.

Masters ceremony ATSU

ATSU Master’s Ceremony
Me, bottom right

I have roughly completed my first year of three in the doctorate in health sciences program with an emphasis in leadership and organizational behavior.  When I am done, I will be primed to head a healthcare organization.  As an ATSU alum I drew a 20% tuition discount for my doctorate whereas the U. of Phoenix wanted to charge nearly $60,000 for the doctorate in health administration.  I will pay $26,000 for this degree and with my work subsidizing the degree, the net cost to me will be a paltry $14,000! I remember drawing all kinds of criticism when I was starting medical school about how costly the tuition would be.  Usually this was mentioned by folks who hadn’t bothered to go to college at all–a point that really had me scratching my head.  Had I stayed in Argyle, WI and recycled automobile parts for the remainder of my life at $8 per hour–how expensive would that ignorance have been? Imagine the income lost, had I stayed, and compare that to the career I have provided myself and my family. Ignorance may be bliss, but it is far more expensive than a good education!

cost of ignorance

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