Preventing Physician Suicide, Depression, Burnout →

Turn off your cell phone. Get off the grid. Take a deep breath and say, “Ah . . .” You are invited to Live Your Dream: Revolutionize Your Medical Practice, a healing retreat for physicians at Breitenbush Hot Springs.

Take refuge with like-minded colleagues who realize that healing health care begins within. Reclaim your vision, and then liberate yourself to practice medicine in alignment with your values—and the values of your community. Rest, replenish, and retreat with kindred spirits while learning to engage community, thrill patients and staff—even slash overhead and increase your income! Learn effective practice models, cures for common office irritants, medical marketing, media and more.

Soak, sauna, and soothe your soul while mastering the business, leadership, and community organizing skills you never learned in medical school so you can launch your own ideal clinic (or love your current practice). Breitenbush Retreat and Conference Center is a worker-owned cooperative and intentional community on 154 acres of wildlife sanctuary in the Willamette National Forest of the Oregon Cascades.

The Breitenbush mission is to provide a safe and potent environment where people can renew and evolve in ways they never imagined. Enjoy snow-capped mountain vistas overlooking the Breitenbush River while soaking in the hot springs with your new physician friends from all over the country (and Canada!). Hike ancient forest trails and walk the labyrinth. Savor three bountiful, organic vegetarian meals daily with vegan and gluten-free options. Sleep peacefully (and uninterrupted) in cozy, geothermally heated cabins.  Breitenbush is a healing vortex and sanctuary that allows busy clinicians to take a break from technology and focus on personal goals and dreams.

Live Your Dream: Revolutionize Your Practice is offered biannually. The next retreat will be April 23-26, 2013. Mark your calendar!  Plan to stay an extra day or two before or after the workshop if you like. Optional massage and bodywork is available onsite for an additional fee. The event is open to doctors, medical students, nurse practitioners, and other health care professionals. Scholarships are available to medical students and others in financial need. Live Your Dream is offered by Pamela Wible, M.D., a Eugene-based physician who pioneered the first community-designed ideal clinic in America. Her model is now taught in medical schools. She trains physicians nationwide, has been interviewed by CNN, ABC, CBS, and is a frequent guest on NPR.  

She has expertise in preventing physician suicide, depression, and burnout. Co-facilitator is Kassy Daggett, a highly skilled coach and therapist. Learn more: www.IdealMedicalCare.org. For rapid registration: Please email Dr. Wible through her website with your contact information. Space is limited. Register now to secure your spot.

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My Love Affair with Medical Waste →

I’m an obsessive-compulsive collector. So is my dad.

Raised in a morgue, I worked alongside Dad, the city medical examiner. Over fifty years, he amassed a huge collection of medical artifacts. My siblings don’t want any of it. So now I’m the curator of the collection.

Dad carefully ships the specimens to me. Today, I open my mailbox and discover a bag full of pacemakers and pessaries, a priority package of bullets—all retrieved from human bodies.

Physician family heirlooms. Some see only medical waste. But I see marvel and mystery, beauty and art, and mostly my love of medicine–a love I share with my dad.

I don’t believe in throwing away people or parts of people or parts of people’s stories. I can’t discard the device that saved a woman’s life or the bullet that took a man’s breath away.

And so my bedroom is a museum of medical art, a morgue of half-lived lives, of hopes and dreams, lost and found–all in a one-of-a-kind collection of pacemakers and pessaries, bullets and bones that live near my necklaces and nightgowns.

I’m a doctor and a storyteller. One day, I shall tell the untold stories of unnamed people I’ve never met. And I shall bring their medical waste back to life.

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Yes, Men Need Pap Smears Too! →

Go ahead and laugh, but it’s true. Men get Pap smears too.

Not all men. Just high-risk men who have sex with men.

The female Pap smear is a screening test for cervical cancer, which is a sexually-induced cancer caused by the Human Papillomavirus. The Human Papillomavirus is also easily transmitted to the anus in men who have sex with men. Anal Pap smears screen for abnormal anal cells that may lead to anal cancer.

But don’t worry guys. You won’t need a large vaginal speculum for your exam. Just a small, friendly swab about the size of a Q-tip.

Now watch a LIVE Pap smear demo here:

Pamela Wible, M.D. is a family physician and author of Pet Goats & Pap Smears.

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Love Is Medicine →

It’s Valentine’s Day 1997. I’m at Sacred Heart Hospital admitting a colleague’s patient—an elderly man dying of heart disease. On oxygen, gasping for life, he exchanges no words. His wife—unable to bear the pain of watching him die—leaves the room. So it’s just the two of us this Valentine’s Eve. A blind date. No champagne. No candlelit dinner. I could leave too, but it doesn’t seem right to let this guy die alone on this romantic day. So I sit with him, hold his hand, and cry.

A cardiologist looks in. Startled by my emotion, he says, “You must be a new doctor,” then disappears down the hall.

Maybe old doctors don’t cry, but I don’t want to close my heart to the wounded. I don’t believe in professional distance. I believe in professional closeness. And I believe in loving my patients.

During my pediatric rotation in medical school I used to stay up late at night in the hospital holding sick and dying children. I’d lift them from their cribs and sing to them, rocking them back and forth. One day the head of the department gave me a compliment I’ll never forget. He said that I was a doctor when my patients needed a doctor and a mother when they needed a mother.

A few years ago I visited the foster home where my nephew lived before he moved in with me. I spent the weekend with a dozen teenage boys, all on psychiatric medications. An autistic child had just moved into the home that day. As it got dark, he begged me to tuck him into bed. That night I tucked all 12 boys into bed and kissed them goodnight. When the foster mom found out she said, “You crazy. Them boys hasn’t been kissed in years!”

Some patients don’t need a pill. They need a kiss.

Photo by Spark Boemi

Pamela Wible, M.D., is a family physician in Eugene, Oregon. She is author of Pet Goats & Pap Smears: 101 Medical Adventures to Open Your Heart & Mind.

 

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Tribute to a Cowboy Doctor →

Cowboy-Doctor1

After two decades of formal education, today I’m finally set loose with real patients. It’s the actual moment I’ve been waiting for my entire life.

We’re each assigned to a family doc for the month. I scroll down the list of third-year medical students, place my right index finger beside my name, slide it across the page, then read aloud: E. Sinks McLarty, Jr., M.D., III.

The next morning I find his office—a small nondescript building with his name on the side—and enter the waiting room, which features 1970s-style wood paneling, faded and covered with the grime of decades of cigarette smoke. Centrally located is a large oil portrait of E. Sinks McLarty, Sr., M.D., who opened the place nearly 100 years ago. I pass rows of empty chairs to the front desk, where I meet three bouncy women—all relatives of Dr. McLarty. I introduce myself to the friendly, frenzied group of chatty chart finders, then the garrulous gang scurries me down a narrow, smoke-filled hallway where I meet Dr. McLarty’s nurse, affectionately nicknamed “Olive Oyl.”

A friendly, slender, snappy-tongued woman with a gravelly voice, Olive Oyl chain-smokes at her desk. Her deep red lipstick and nail polish are the color of freshly clotted blood. She escorts me into a dimly lit room where I’m not at all sure I’m safe. There, on the couch, I meet Dr. McLarty—a seventy-year-old cowboy eating Metamucil wafers while puffing on a pipe. He wears Wrangler corduroys and sports a crew cut with some gray hairs shooting through. With his thick Texas twang, he slurs his words together around southern slangisms and medical anecdotes.

With pen, paper, and stethoscope, I follow Dr. McLarty around to see what I can glean from him. I’m immediately struck by his speech with patients. He calls all the men “pahdna” and all the women “shuga.” Isn’t that sexual harassment?

Dr. McLarty has no tolerance for big-government rules. When a patient needs a triplicate form signed, he snaps, “Well, now, shuga, that’s a bunch of horseshit!” or “I don’t give a ram dam or a rat’s butt!” While cursing, he signs the forms, gives one to the patient, and throws the other two across the room in a wad. “Hell, I’ll make toilet paper out of it one day,” he rambles as he tramps out of the room.

Dr. McLarty makes even the common cold an event to remember. “Okay, now, pahdna, let’s look in that there snoot. Ah, a little redness, nothing to say grace over. Let’s listen to your ticker while I gotcha here.” Slamming down the chart, he exclaims, “You’ve prob’ly got some of that damn crud we’ve seen going around!”

In the next room, an elderly woman complains of joint pain. His diagnosis: “You’ve got arthritis! Well, hell, you can see that. No need to pay for that, shuga. Now hold that cane in your left hand and tell Byron to give ya a damn golf ball to carry around in the right.” He didn’t cure her arthritis, but she looked like an avid golfer when she left.

After seeing a few patients in the morning, Dr. McLarty closes down for a two-hour lunch. We all squeeze into his office on the couch to watch soap operas. During a romantic interracial scene, they shake their heads in unison. “Oh, no! We don’t believe in that!”

So I offer the clan some of my chocolate soy ice cream and one gal gasps, “Oh, no! My husband wouldn’t like that!” Dr. McLarty puts down his Metamucil wafer and grabs a spoonful. “That’s pretty darn good!”

After lunch we’re getting ready to see a man named “Sunshine.” Before entering the exam room, Dr. McLarty pulls me aside and says, “This family’s been shot in the damn butt with bad luck!”

“What’s going on?” I ask.

“He got cancer. I’ve known a week, but gonna break it to him now.”

“Why didn’t you tell him last week?” I ask.

“If he lived by himself, I’d a told ’im right away this is how the cow ate the cabbage, but his wife, Lordy, ya couldn’t scrape her off the wall last night,” he rants as he trudges down the hall.

I gathered that Sunshine’s wife was extremely anxious.

We enter the room. Doc pats the old fellow on the shoulder and says, “Sunshine, now I ain’t gonna pull any punches by tellin’ ya we got a drug.” After a few cryptic sentences, he asks, “Ya get what I’m sayin’?”

Sunshine replies, “Yep! Lights out.”

That was the entire office visit.

Most of Doc McLarty’s patients are old white guys who have aged right alongside him. But this afternoon, we jump into Doc’s old pickup to see a young gal in the hospital. On exam, he notices her breast implants and asks, “Hey now, shuga, how long ya had these damn things blown up that way?” She answers politely and the interview continues without a hitch.

We only saw one kid that month. As the boy raced around the exam room, Dr. McLarty quickly warned, “Hey now, pahdna, get back up there on that there table. We don’t want ya to bust your gazoo!”

I’ll always savor my month with E. Sinks McLarty, Jr., M.D., III. I didn’t learn much about diagnosing or treating disease, but I learned a lot about human relationships and the art of medical practice.

I sure miss him.

So, after fifteen years, I track him down to thank him.

He answers on the first ring.

With my heart pounding, I ask, “Is this really Dr. McLarty?”

“Yep, this is Doctor McLarty. Who the hell is this?” he shouts.

“I’m a medical student you mentored long ago, and I just want to say thank you.”

“Well, thank you, sweetie, but I got cancer of the bladder and just had therapy today, and I’m bleedin’ like hell!” Before I can express my sympathy, he quickly blurts out, “What comes around goes around. Thanks for calling on me, but I gotta go pee again!”

He hangs up on me.

That’s it.

I never even tell him my name—not sure he would have remembered me—but I do get to thank him before lights out.

Chapter 66 from Pet Goats & Pap Smears,  Dr. Wible’s best 101 patient stories from 20 years of medical practice.

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