The unexpected…but good!

About 2 months into my hand fellowship, the group that I was going to join called and told me that one of their older partners had a heart attack and was not expected to return to work ever to full duty, and that they were going to recruit another orthopedic surgeon for his spot. This changed their plans, and they felt that 2 new orthopedists in the group was more than the group wanted to economically sustain and they thought I needed to know.   Basically, this is a notice to me that  my services were no longer needed in that community and I was out of a job I never started.  Here I am, starting a hand fellowship that will last a year and now I am looking for a job.

A couple of months later, I had the good fortune to meet up with the hospital administrator and his team from a new hospital being built in a community about 30 miles from this same large metropolitan area (instead of 80). They were in desperate need of another orthopedic surgeon. Putting it all together, the physician who was the orthopedic surgeon at that time everyone basically thought was a jerk. He would send folks out of town rather than take care of them at the local hospital. He also was reportedly abusive and argumentative about his emergency room responsibility for coverage and  would not be available on weekends or at night!!  Not being one to set too high a bar for myself to achieve, I certainly thought my deportment was better than that, and least at the outset, I thought I could be available.

The saying in orthopedics and medicine (and in most professions) is that physicians need to have 3 qualities. These are Availability, Affability, and Ability, and IN THAT ORDER!!!!  The rationale behind this is that most patients cannot judge the quality of your work but only whether you are nice to them and seem to care, whether you can  be reached anytime and will show up to care for them when they call in their time of need.

I sent my wife to this new potential practice location, since I thought professionally it was good for me, but it also needed to be good for her. She looked over the community and the schools and after carefully assessing the location, we signed up to come to this town for the beginning of my professional career. I did not know from the outset whether or not this would be a long term deal and did not commit to any long term housing for the first six months. We moved into a very nice rental house. I set my first office up in a very nice double wide trailer parked in the parking lot of the old hospital which had been built with funds in the 1960’s.

The old hospital had  been built as a one level like an old VA hospital.  The NEW hospital was a state of the art 80 bed facility with all the latest in technology and built expressly for the purpose of maintaining medical care locally.  There was a larger community another 30 miles further northwest that had been siphoning off a good bit of the medical care and  a number of people who still felt like they needed to go to the large city for care.   The philosophy behind this New Hospital and bringing in a number of specialists (I was one of Five) was to increase the quality of care at the local hospital, elevate the perception of local medical care in the minds of the community and build a world class medical facility.

Unknown to me, one of the other physicians recruited was an medical school classmate of mine, a general surgeon who was on his second wife when he came to this community, having married one of our classmates when he was in his fellowship training for vascular surgery.  That marriage didn’t work, and he divorced and married a nurse before he came to join the medical staff.

The local community’s perception of the OLD hospital was that is where you went to find out whether you needed a doctor or needed to be in the hospital and then were transferred out to either the “BIG CITY” hospital or the hospital a few miles to the west. Our goal was to change all that. We did.  My practice took off from the very beginning and grew until my retirement. The hospital has done well and continued to grow undergoing many expansions. The medical staff has grown with many specialists and is a first class place to work.

I get some satisfaction from knowing that all this has occurred on my watch. Most of my satisfaction in my practice, however, has been predominantly from the patients that I have had the privilege to treat  and the situations in which I have been involved in professionally.

I have learned a lot about life, people, human judgment, religion, God, the IRS, other physicians, hospital administration, corporate medicine, insurance companies, workman’s comp, cocaine, meth, alcohol and sports medicine. (In no particular order LOL!!)

I’m going to try to bring you some stories as we progress along so you can get a better understanding of what we do , why we do it, and maybe where we are going with this….. stay tuned……..chapter 2

 

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and some about residency….

After medical school……

I was able to get into a good residency program at the same hospital and started looking for positions to pursue.  Unfortunately, there is no plan for one’s life after one leaves their residency. In this profession as in most professions, there is a fairly rigid prescribed regimen of school work, grades, and requirements for graduation and hurdles to leap over to reach the next step. In high school you are required to get into a good college, in college you are required to make good test scores and do well on your grades so that you can get into a good medial school. In medical school you were required to either decide to be an operating or non operating doctor and pursue a residency. Once you finish your residency, however, there is no blueprint. there are no roads to follow. To someone who spent all their life in school up to this point its a very disconcerting feeling. All of the sudden you have to have to examine the unknowns as such as where  my wife wants to live?  Where does the field of orthopedics need my services?  How far is too far from home?  Will I be able to make a living?  How much “call” and time away from home will I have to take and what will  my quality of life be?  At times the variables  can be overwhelming.

I talked to several orthopedic groups in the area of the state I wanted to live. I wanted to live close to home but not too far away. My wife and I fortunately shared a number of common desires as most couples have. Ideals such as good schools, a good place to grow up, fairly decent standard of living, low crime etc.  We felt we found a community about 80 miles away from a large city where we both had family.  One of this orthopedic groups requirements was that the new associate be fellowship trained  in hand surgery.  There was nothing on paper, but I explained to the group that I would be more than happy to pursue this because I had some leanings in this direction. I enjoyed hand surgery and the little mechanical things that happen in the hand were interesting to me. On that basis, I entered a hand fellowship and put off the ultimate move  for another year, anticipating that I would be joining that group…. but it was not to be…….more coming………

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number three…part one

Work…….On the other hand, once I got to medical school, the first two years seemed like work. My first two years were predominantly two  more years of schooling. We performed  our clinical experience in the last two years of our four year medical school.  On that basis, the first two years felt more like really hard college. The main difference was that I was no longer grouped with a bunch of wannabe pre-med majors at the state university where, although the competition was difficult, it wasn’t spectacular.  In our group in medical school, you were now amongst the folks that were chosen to be the best of the best and it was indeed a challenge to keep up with the crowd.  Overall, I think I did well. I was not in the top of the class but in the upper one third, albeit right at the border of the lower 2/3 and the upper 1/3, but happy to be there. There was a tremendous amount of information to be processed those first two years and the purpose of it I could not see  for about three or four years subsequent to medical school.

The start of the clinical years, however, made a lot of sense to me.  I worked in a hospital in high school for four years and then while I was in college in the operating room and was very comfortable in the hospital environment. I knew how to get things done. Here I could shine above my classmates.  I knew how the system worked and was very comfortable scooting about, finding labs that need to be found, x-rays that were lost, getting soft goods and other items from purchasing without truly having a purchase order , etc.  A large institutional hospital is very much like the military. There is usually a corporal or some other lower ranked enlisted person who really runs the show and if you can befriend these  people, all the rest is easy. The clinical years were enjoyable, and although it was the first time that I really started to do what I wanted to do, there are still some decisions to be made as to what part of medicine to pursue.

Medicine can be divided into operating and non operating doctors. That is, there is a portion of doctors who like to do things to and for people in the mechanical or invasive sense and these I would call the “operating” doctors.  The “Non operating” doctors would be those who like to examine patients and think about the possible diseases and  do tests etc, but not truly invade the human body to “fix” something.  I had always been involved with repairing things around the house , putting radio kits together and  I was very enamored of doing things with my hands.

I had a good friend in medical school who also had a similar skill set in the mechanical realm. He loved to work on cars etc. I shared his automotive interest. I asked him one day what part of medicine he was thing about. Without a moment of doubt, the answer came back “orthopedic surgery”.   When I pursued further, he said that when the patients came in with an injury, they needed help immediately, he could usually take an x-ray or CT and assign a picture or mechanical problem with a solution to that patient. Then you could repair the afflicted mechanical problem, and the patient would be helped.

At the time, this reasoning appealed to me. To think that one could mechanically fix a problem , as a task oriented person, this was much more appealing to me.  Rather than asking someone if they had taken their high blood pressure pill or cholesterol or kidney medicine and deal with the myriad of excuses , as if the medicine had a mind of its own and destined by the cosmos not to be used as directed.  The idea of also mechanically using my hands and fixing something “hands on” was appealing……more later…….

 

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…more of one….

The ER is  like a 24 hour night club. the lights are always on, the people usually have not been deprived of sleep in that, they’re working an eight or 10 hour shift and they see numerous afflictions and ailments at all times of the night. My patient is just one more patient to process and move on to the operating room or the floor as needed.

Why do we do this, this activity of relief of human suffering or our feeble attempts to do so?  I really believe it is a calling. I really believe that it is not like many other jobs on earth. I believe also that it is not fully understood by anyone except for those people who do this service.  There are a number of people out there with ideas about health care and its delivery and how the problems we have in Medicare, Medicaid, Third party pay, Obama care etc., would all be alleviated if they would just have people acting and seeking medical care in a certain way.  One of our bigger problems is that we are dealing with people and patients and not making widgets or lawn furniture.

That, to me, is one of the most fascinating portion of this profession. We can do different surgeries on different people with different outcomes. Almost inevitably, however, we will have different results.  Some people will be crushed by the injuries and experience and dealing with the medical situation, and some people will be strengthened, and some people it wont make any difference either way.

I was an orthopedic surgeon in a suburban practice in a small town outside a large metropolitan area in the southeast. I  trained in the southeast and grew up in the southeast. I went to a relatively well-to-do high school in a relatively well-to-do community.  I attended the state university with good grades, played in the band where I met my lovely wife. I attended medical school at a state university and continued there with my internship in a residency in orthopedic surgery.

When I went into this business I knew (I thought) that I wanted to be a physician.  This was a life long childhood dream and probably about as mature. I knew at about age eight I knew I wanted to be a doctor probably because I was enamored of my childhood pediatrician. He seemed to be a kind, gentle, loving man who would minister to our family and our medical needs as necessary and seemed to evoke a calming effect on not only myself, but something, that was probably more apparent subconsciously than consciously, a calming affect on my parents in times of crisis.

My mother’s father was a physician and had a very successful career and practice in a large metropolitan area, so the fact that I wanted to be a physician seemed acceptable to her, although to her credit, she did not push me at any point in time in my career to be a physician.  She was a very thoughtful, pragmatic and honest woman. She only felt that you needed to be the best at whatever you chose as a profession . One of the main caveats was to “do one thing and do it well “and thereby lay success and the road to prosperity.

My father, from a long line of family in the manufacturing business, was a “born executive” i.e. His dad was the boss!!   His father had gone to work at a manufacturing facility by his father and indeed my father never thought about doing anything else but continuing in the long line of the manufacturing business. Somehow, this had no appeal to me.  The idea of making items for consumption at the cheapest cost thru the manufacturing process  having too deal with labor union and “federal regulations” seemed too much like work to me…..more to come…..

 

 

 

 

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Part one…

I’m putting down some thoughts I have had for a LONG time. Bits and pieces of my years in practice as an orthopedic surgeon.  Maybe it might interest some….

The phone rings and I get out of bed for the hundredth time in a number of years. My wife, who is immune now to the sound of the phone after she goes to bed from years of living with me and this family doesn’t even change her sleep cycle.  I usually get the phone on the first ring except for the unusual occasions where I usually answer the clock radio (oops).   Its the Emergency Room with less than a totally detailed oriented ER physician/nurse with another orthopedic injury that requires attention.

These injuries range from a 12 year old jumping off the bunk bed in the middle of the night to a rodeo rider having been thrown with an injury or a young adult or adolescent, usually intoxicated, definitely doing something dumb in the middle of the night , in most cases involving an automobile, but sometimes a jealous girlfriend or angry spouse and a back door or a front door window.

Half awake but awakening as the time passes, I stumble to the bathroom, splash some water on my face and then reach for my clothes as I took them off only about 4 hours ago, lying by the bedside, as one would find a fireman’s boots and fire suit, belt in the loops, keys in the pockets, ready to go at a moments notice.

In the dark, I will walk the hallway past the two bedrooms of my two boys, now both almost bigger than me, asleep in their own unaware slumber.  Finally, at the bottom of the stairs I can turn on enough light to find my shoes and the back door.  The dog, also accustomed to occasional nighttime sojourn, casts an eye in my direction but barely lifts her head.  Out the back door and down to the garage with the automatic lights lighting the way.   I cross the carefully laid brick walk to the last car, a gray Ford, bought at the request of my wife when it was apparent to her that we did not have a car that had four doors and a trunk. I affectionately  refer to this as my “doctor’s” car I that its very middle of the road and sedate. Not old, not flashy, but not boring. It ,however, not like some of my other cars, it is very serviceable and starts every time.

The trip to the hospital takes about 10 minutes but allows me to get my thoughts strait. Sometimes if the individual was known to be intoxicated my fury at the stupidity of their acts requires some moments for reflection before I finally encounter these individuals. I know these are God’s creatures and that they require my help and my assistance in a non-judgmental way and that my job and my duty and this moment is to do the best that I can as an orthopedic surgeon to minister to these individuals.      … to be continued……

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Music is a wonderful …something.

I sit here having returned from a gig at the Southern Museum of Music http://www.westsideartscenter.com/

in Atlanta and am overwhelmed with how blessed I am. The band was killer, composed of all the best players in town and some of the best guys I know. http://www.bigband.band/

All had a great time doing such fun stuff performing for a TV crew who films a video every 2 weeks and puts it on a Internet channel that probably only gets views in foreign countries!!!WATCH_TV47_29764257

Yet we had a great time and played great music. In the audience were movers and shakers of the music scene in town and some local celebrities including “Officer Don” and Art Farmer. http://www.southernmuseumofmusic.com/about.php

 

I am very thankful I am allowed to play with these folks. In addition Bob and Libbie came and sang  3 tunes for the show.  Im coming off playing last nite with a local concert band who put on a Gaelic themed concert.

The group I played with today has been booked to play every two weeks at a local hangout with a money guarantee!!cosomo live 3-30 The EJS is playing a concert on the 16th of this month.EJS poster

Also, I get to play for a local senior facility and then play for a benefit for the Children’s Make a Wish network. Senior centerThe month of April finishes up with another couple of concerts with the EJS and the DCO. Life is good.

Here are a couple of videos from our Strand Concert!!!

Strand Concert ONE!!!

Strand Concert TWO!!!

 

 

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Nothing in Feb? How can that be?

Wow. What a busy month. Started on Feb 1 at Channel 11 with Douglas Cameron and several members of the band. We played for a promo for the Feb 12th Concert at the Strand Theater. I put together some arrangements for the small group and I actually got some TV Face time!!!  http://archive.11alive.com/atlanta_and_company_story.aspx?storyid=328253

channel 11 pic

Channel 11 TV

Did a radio spot and interview on  the next day at WYXC for the promotion of the EJS BIG BAND Concert on Sunday Feb 14th Matinee at the Grand Theater. Then a couple of days later another on WBHF.

Played “solo” with the karaoke stuff for the Fellowship of Christian Athletes on Thursday of the same week. Friday, I worked at Career Day for the HS  kids of the county at Ga Highlands College all day. Next day had a HOA meeting in Jasper for our “mountain community” house and then a Birthday party for all the February birthdays in the family.  Sunday, was the rehearsal with the BBC and Douglas and Ashley Rivera   who sang with us on the 12th at the Strand.

Monday was a production meeting for the Grand Theater and Tuesday we had another grandson!!!  ROY CARLTON JONES!  Needless to say, that occupied most of the spare time that we would have had for a while!!! CONGRATS!!!

Meeting with Etowah Share a Song (https://www.facebook.com/etowahshareasong/?fref=ts) on Wednesday nite and made some future plans for gigs and organization.Etowah Share a Song

Thursday, played in Rome with the small group Im part of (some how hooked up with the Georgia Highlands and Sam Balzer) at a church.

Friday nite, the 12th, Played the STRAND in Marietta on the Square and had a blast. Great time and great music!!!!  (https://vimeo.com/156788072   is the link and the PASSWORD is STRAND)  The full DVD is out and available (contact Douglas at http://dcameronmusic.com/)

 

Then we played Sunday Matinee with the EJS at the Grand Theater.

So kind of a whirlwind month.  Coming up we have gigs for EJS on April 16th, 30th and May 21st, and for the DCO, March 30th and others scheduled. We have a video taping for the BBC on April 3rd  at a studio in Atlanta.  Sooooooo, kinda busy. Stay tuned. Life is good!

Douglas Cameron and the DCO BIG BAND at

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