Friday, March 16, 2012

Family Medicine: Reconciling our Wounds

"What are cows for?  To the bioengineer and corporate manager, they are machines; they are units of production."....David Loxterkamp, MD from "A Vow of Connectedness:  Views from the Road to Beaver's Farm" in The Country Doctor Revisited pp.80-86, Edited by Therese Zink, MD.  Kent State University Press 2010.

Doctor Loxterkamp eloquently expounded on the meaning of cows to the farmer, making a further point about the meaning of the Family Physician.  "the family doctor is rarely an agent of meteoric change.  But, every day and closer to the earth, we are its vehicle and eyewitness.  Doctors who remain deeply connected to their patients will know this privilege.... In modest ways, we accomplish the utterly profound, long before the prescription is filled or the blood test is taken.  We profit by the patients' periodic return and by the mutual exchange of friendship, intimacy, and trust."

I enjoy reading those words, but flinch at his lasting message about our frailty, humanity,  and vulnerability in another section of this piece:  "We realize that patient care is not portable and that the doctor who lives among his mistakes and prejudices becomes a healthier person less prone to severity in the judgment of patients or peers.  Lastly, family doctors are inevitably changed by the patients they serve.  The merely responsible physician, tempered by mercy and groomed by grace, adds to the stock of moral credibility that has sustained our profession over the milennia."

I was paused by the phrase "Lives among his MISTAKES and PREJUDICES", suddenly reflecting on, and again thankful for, the small town Family Physicians who trained me in the night clinic at Ohio State (Pete Dils, MD stands out since I later became his partner) and in my Family Medicine Residency at Hershey, PA. (Tom Leaman, MD; Hiram Wiest, MD; Doug Chervenak, DO; Bill Hakkarinen, MD).  These were sturdy Family Doctors, but with a certain, humble respect for patients and their stories.  All were willing to share stories of their humbling moments in patient care in the most genuine of ways, maybe hoping to help younger learners to avoid similar situations, but I think it's more likely they were preparing us for membership in the guild of Family Practice, where all have been wounded.

Vulnerability springs from compassion, and the wounded physician humbly carries the scars of living among their mistakes, quietly avoiding their duplication.  Over time, the wounds are reconciled into the essence of each Family Physician.  I'm comforted to know that so many of us quietly allow our reconciliation to happen, "tempered by mercy and groomed by grace, add(ing) to the stock of moral credibility that has sustained our profession..."

My deep appreciation to David Loxterkamp, MD for recording his reflections and insights so others may better light the path to reconciliation.



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