No, this is not some diatribe or opinionated piece on religion. If you are here to talk about churches, then you are thinking about the House of God not the house of god (HOG). This is an irreverant look at medicine as a system, a practice, the good, the bad, and the ugly. Medicine like the economy is in foreclosure. It seems to be falling apart at the seems and every effort that is made to fix it seems to just tear it further. This foreclosure affects the patients, public, staff, doctors, nurses, family — EVERYONE.
The house of god is an immortal book written by Samuel Shem in 1978 about the medical culture. Many of it attitudes and wisdom still hold true today. It sheds a light on the difficulties that can only be experienced when waist deep in it. This is going to be my humble attempt to pick up where the book left off looking at modern medicine.
Now to introduce who I am and why I feel that I am a permanent tenant in the house of god. I am a board certified Emergency Medicine physician. Board certified means that I have actually been trained specifically to work in the Emergency Room (ER) and see/treat the unique patients that come to the ER — just like a cardiologist has specifically been trained to treat hearts. I am trained to take care of emergency medical conditions. But the definition of emergency conditions is left up to each patient so there are different ideas on what an emergency is. It can range from a stroke or heart attack to a stubbed toe or “I need a work note”.
I was born and raised in the HOG. Both of my parents are ER docs. So dinner conversation was always interesting and graphic. I knew I wanted to be an ER doc since the 2nd grade. Why the 2nd grade?? That is a story for another time. While in college, I was an ER tech (the bottom of the medical totem pole). After college, I went to an Osteopathic medical school. From there, I completed my residency in Emergency Medicine at a large community hospital where we were the one and only hospital in the area (there was another hospital close but it was known as the “band-aide hut”). We saw it all – all the trauma, all the cardiac, all the neuro, all the pediatrics, etc… It was a great place to train and a great place to establish my permanent residence in the HOG. I finished residency as chief resident. From there, I went to work for the federal government. The federal government paid for my medical school – year for year. So I owed them 4 years of my life. Here I am still with 409 days remaining. I also work extra (moonlight) at 2 other private hospitals – one is a rural community hospital and the other is the county hospital. Just to get another perspective, I also work at a medspa doing cosmetic medicine. With all this, I get to see socialized medicine, private insurance based medicine, and cash based medicine. Each has it own floor in the HOG. Some floors are larger than others. Soon their sizes will change. In my “free time” while applying for entrance to the HOG, I made multiple trips to Central America. It is there where I experienced a different version of the HOG, a more pure and basic HOG made of wood with dirt floors. While it was not as advanced or pretty, it was much more fulfilling.
There you have it. I hope you want to come along on the tour of this beaten down, much in need of repair, overcrowded, leaky, smelly, maze of a building. I look forward to guiding the tour from my perspective and particular views. I am not claiming to be right in all my opinions, but they have been shaped by my experiences and my convictions. Hopefully this tour will also be therapy for me and further clarify things in my mind. We better get started soon before the bank repo’s the HOG and chains the doors before we can get in.