Life is an accumulation of memories. Memories of experiences amassed throughout years of work and play. Some, life changing and profound, others, whimsical and fanciful. All said and done, though, often it is the small and minor incidents in life that leave a lasting impression.

Lake Powell is a large man-made lake along the Colorado River, in the hot dry deserts of Southern Utah and Northern Arizona. Rainfall is rare and far between. A few years ago, we rented a houseboat and spent a week exploring and sightseeing the many canyons and gorges, filled with the water of the lake and accessible only by boat. It was late summer and we were expecting a hot trip down the lake. However, we were pleasantly surprised when a rare summer storm gave us cloud cover and a much welcoming rain. The many magnificent waterfalls fed by the downpour, over the precipitous canyon walls, was a treat.  The boisterous waters of the lake added to the memories of the day. We have made many trips down that lake in the years, since, yet that summer trip is the one with a lasting impression.

On another occasion, while camping on the shores of the Gulf of California, by the town of Topolobampo, Mexico, during the Christmas Holidays, we were surprised at sunrise on Christmas Day, by a Mexican fishing boat, who precariously approached us on the shallow waters and made us a generous gift of freshly caught shrimp.
"Feliz Navidad," they shouted with a smile. We ate fresh shrimp for breakfast, lunch and dinner for the rest of our stay there.

And a colleague working on an Indian Reservation tells the story of a time, when his patient was an adorable boy of four who was there for a checkup. For the exam, he needed the child to disrobe, which he did but refused to take his shoes off. His mother talked to him in their native tongue but to no avail. She finally informed my colleague that there was a hole in one of his socks and he was embarrassed to show it. My colleague says; I laughed heartily and sheepishly took my own shoe off and showed him a hole in my sock. The child beamed gloriously, and we became good friends to the delight of his mother.

Here is to those junctures of life. We find them in the narrow crevasses and detours, often experienced in places far from annoying crowds and busy practices. Look for them and build lasting Little Great Memories.

Practicing From the Heart in the Age of Technology tells of many occasions where the humane interactions have left undeniable memories, making the practice of medicine joyful and magical.

We’re on the far side of school
A new life awaiting and soon
All efforts to get paid
Song of the future serenade.
 
A dream has been fulfilled
And a perfect life to build
Yet outstretched hands await
To steal the future at the gate.
 
Bundles of money to entice
And show a false paradise
Of luxury and wealth
But a real façade is dealt.
 
For one morning, all is clear
The hoped for future has not appeared
As it was stolen at the gate
All is not lost though, wait.
 
There is a rich world that is yours
Past the luring hands at the doors
To show the true magic of
What can be done with skill and love.
 
Just look past the ruse
To see the real needs to choose
The hardest job you’ll love
With rewards far and above
A shining future to speak of.

Reza Ghadimi

Thank you, Dr. Waters, and The DO (Journal of the American Osteopathic Association), for reviewing this book.

Dr. Waters’ observation of the core message of this book is a testament to its importance, especially for our students.
You can read the full review in this week’s The DO.  As Dr. Waters thoughtfully puts it:
“…(Ghadimi) provides dozens of heartfelt reflections on what is central to everything we do – the simple act of caring for another person.
I was struck by the unique voice of each one (vignette, essay) even though the subjects are many and varied. …They’re all personal observations, steeped in the experience of a long career in patient care.”
             (Daniel J. Waters, DO, MA, FACOS-D, FACS – The DO)

This, along with other reviews by leaders of our profession, reveals the need to address the increasing disparities in patient care in our country and around the world. I appreciate their support and hope that all in healthcare read this book.
Reza Ghadimi
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Here is the full text of Dr. Waters' review:
(Re-Printed with permission from 'The DO')

“Practicing From the Heart (In the Age of Technology),” Reza Ghadimi (Foreword by Humayun (Hank) Chaudhry, DO, MACP), ThPulse/PAPulse, LLC (2021) 264pp.
By Daniel J. Waters, DO, MA

This enjoyable, self-published volume arrived in the mail on the very same day I first saw something about ChatGPT®. It took me awhile to read the collection of essays and reminisces. By the time I was done, Bard® (Google) had arrived and, as of this writing, there are a half dozen or so more on the way. As a New Jersey native, I’m a diehard fan of Bruce Springsteen, but we might have to tweak one of his lyrics to, “Is that me, baby, or just some brilliant A.I.?”
Now, I don’t think a chatbot, even on a good day, could do what Ghadimi has done. He has organized his musings (vignettes might be a better word) in 12 chapters headed by the calendar months, although the stories told are not in chronological order. He’s been a practicing physician assistant for decades, and even though he’s not a physician, his close professional association to physicians provides a unique observational perspective on where we are and, just maybe, where we’re heading. We’re all prone to parallax, and so a take from another angle can be illuminating.
Ghadimi does not rail against technology or progress, instead he readily admits to using one of the first home computers (from Radio Shack!) to write. He provides dozens of heartfelt reflections on what is central to everything we do — the simple act of caring for another person.Some of the stories are less than a page, others are much longer. I was struck by the unique voice of each one even though the subjects are many and varied. This would be a good book to keep in your office and maybe read a bit between cases or patients.
Skip around the story selections if you’d like — short or long, each is a stand-alone piece. They’re all personal observations, steeped in the experience of a long career in patient care. Perhaps, in the end, what will separate us from purely programmable authors is our ability to contextualize. I certainly hope so.

“I am going to venture that the man who sat on the ground in his tipi meditating on life and its meaning, accepting the kinship of all creatures, and acknowledging unity with the universe of things was infusing into his being the true essence of civilization.”
Luther Standing Bear (1868? - 1939)
Oglala Sioux chief

I find it fascinating that such enlightenment filled the mind of many scholars, philosophers, thinkers and intellectuals throughout history. But I don’t think that any of them envisioned that all that thinking and philosophizing would bring us to the world of today.  Not Aristotle, nor Confucius, Epicurus, Lao-Tzu, Socrates, or the Indian in his tipi, for that matter, ever foresaw that the 21st century man will be fighting wars, poverty, famine, inequality and suffering from diseases, epidemics, and …

How did we come to this?  Was it an instance in history that set us astray? Or was it that we really never did become civilized? Despite all the scientific and technological advances, we allow our ego, self-righteousness, prejudices, hypocrisy, and unrealistic expectations control our very existence. Maybe it’s time we retreat back into the tipi and meditate some more. For we have forgotten the kinship of all creatures and the unity with the universe of things. Or perhaps we never did learn it to begin with.

As music is a universal healer
Of all that ails us, our troublers
Of all that weighs down our spirit
And makes the heart heavy with pain.
 
No matter what the affliction
Or what wind blows it in
All can get stopped by a note
Played on the strings of the soul
Or drums of the heart.
 
Though the pain of the deprived
And the tears of a hungry child
Can shout out with anger
The melody of a tune
Can shine a light and lift the spirit.
 
And if one thing is sure in life
Is that the sky is darkest before dawn
Through all the cruelty and despair, shine
Comes from hope, and hope always rises
As the crescendo of a song.
 
And all that trouble can get sung away.
So, bring it on, oh whisperers of melodies and hope,
Make it sing. Make it sing for us all.

Reza Ghadimi
March 2023

It was late in the evening on a miserable night with a very thick fog covering everything. I was stationed at the USAF Hospital in Lakenheath, England, and working the ER that night. We were dealing with the victims of a bad head on collision, on the notoriously narrow English country roads.
What made this night different enough that, fifty years later I still remember it, was the circumstances surrounding it. It was Spring equinox, which occurred on the weekend. I was looking forward to traveling to London for the equinox celebrations with family members. Imagine my disappointment when I found my name on the roster to cover the ER that weekend. So, I bribed a colleague to switch days with me, but was told that he could work the weekend but not Friday. Still, I agreed, planning to drive to London after work that night. But everything seemed to work against me, as the exceptionally thick fog rolled in, making it impossible to drive the long distance. The injured from the accident had arrived late, and by regulation I had to remain at my post until patients from my shift were taken care of, admitted or discharged. So, I gave up and surrendered to faith that I was going to miss the festivities.
As it happened, I later learned that the fog was even worse in London, and the British police had closed a big section of the road due to ice that night. The colleague, with whom I had made the arrangement to work for me, could not make it back, and I ended working the entire weekend after all.
The weekend turned out one of the busiest in the history of our hospital. The inclement weather kept many home, forcing those of us already on duty to remain there. Several more accidents of all kinds, brought an unusually large number of patients to our door. I, then, remembered a similar incident several years earlier, when during the great power blackout in New York City, many of our colleagues couldn’t get to work, as subways were out of order. Many accidents and injuries brought a large number to our ER, necessitating the setup of an emergency triage area. I mentioned that to the doctor in charge of our military ER and he agreed, asking me to set it up.
It worked well and we survived the onslaught better than any of us hoped for. I received a letter of commendation for that weekend - actually we all did. That letter was instrumental for my promotion, next time the promotion board met – and paid off nicely. Once again proving – to me at least – the value of experience.

My life in medicine started as a young boy.  I was brought up by my grandmother, who was a powerful curandera. Though she was practically illiterate, her knowledge of home remedies, botany, and common-sense healthcare was well known and she was highly respected. Growing in her care, I learned much just by watching and often helping her.
As many who have read my book: Practicing From the Heart in the Age of Technology can attest, I have high respect for women of medicine. Many stories in my book are of experiences working with them around the world. It gave me a perspective on healthcare which otherwise would not have been possible:
A wonderful nun and nurse with whom I had the privilege of working in Southern Colorado, would often drive many miles on mountainous and dangerous roads of the area to deliver care to people who - due to mental disabilities - were not even aware of her presence. I learned a lot from that lady, particularly obstetrics, as I helped her home-deliver several babies. Some under extremely trying conditions, as many families lived in primitive conditions without electricity or plumbing.
Dr. Helen Rodriguez-Trias, practiced at Lincoln Hospital in South Bronx, NY, when I was in my residency at that hospital.  The programs she started and the way she practiced medicine, touched many of us. She said: “We need health, but above all we need to create a grounding for healthy public policy that redresses and salvages the growing inequities. We cannot achieve a healthier us without achieving a healthier, more equitable health care system, and ultimately, a more equitable society.”
And my favorite, Dr. Angela Ramirez, a female Puerto Rican physician. She was a surgical resident at Elmhurst Hospital in NY when I was a nineteen-year-old tech working in the ER. When she learned of my background of working in surgery back in my home country, she took special interest in teaching me, and encouraging me to pursue medicine.
Another lady I have the honor of knowing is Doctor Regina Benjamin.  Her history is most fascinating and enlightening.  Born in Mobile, Alabama, to a poor family, she was the first from her family to receive an M.D.
Dr. Benjamin was the first African-American female physician appointed the U.S. Surgeon General in 2009 — appointed by President Barack Obama. 
I have had the opportunity to meet and work with many people like them in my years of medical work.  I learned more from them than all the schooling I received otherwise.  Perhaps the greatest and most important lesson has been how to be compassionate in the face of adversity, care for everyone even when they themselves stop caring.  How to teach while learning and learn while teaching.  As Maya Angelou once said; “People will forget what you said, people will forget what you did, but people will never forget how you made them feel.”  

In the vastness of the West
Among the standing sentinels of rock and stone
Numerous arches, carved by wind and water
Through eons of time, have built gateways
To eternities of space and time itself.
 
The view to far away, from within
Seem to warp and deviate from that of without
And tells of dimensions, only thinking minds
Can decipher and wisdomed eyes can see.
 
Look at my expanse, they decree
Oh seekers of truth, and learn
That these stones are a part of the living me
Their sculptured face, testament to all that is shaped
By the very creator of you as well as me
Be kind to all that you see and don’t see
As our destiny is entwined by land and sea
Wind and water and watched over by stars!
 
Reza Ghadimi
February 2023

Of smoky skies and shaken land
Such is the destiny at hand

For all, who wonder of our faith
Of today, tomorrow, and life's prospect

For what awaits us is uncertain
Yet here it is, a future to ascertain

From the natural world and man
In hope of a better life and chance

Healthcare providers are on the frontline of this war on uncertainty. For no matter what turmoil, nature, society, politics, pandemics, wars, man's instinctive desires and selfishness create, to our tabernacles of healthcare, the effected come for solace. But the demands are overwhelming and help is needed. Join them and experience the true magic of medicine. Promise is made that you will be tired and exhausted beyond belief. It will seem that you work thirty hours a day, ten days a week, but LOVE every minute of it.

There is nothing more terrifying than a man’s sanctuary becoming his tomb in an instant. This week’s earthquake in Türkiye and Syria is a fearsome example of nature’s wrath. 
In a world full of calamities; whether crime, war, climate change, economic perils, or natural disasters such as this earthquake, we are hit by so much news of misfortune, that its effect can quickly be replaced.  Therefore, it is essential to help in any way we can right away while its mark is in front of us. As healthcare providers, we can do much more than just send money.  Our help and knowledge is more valuable than any monetary donation. Contributions usually help organizations and governments, not the poor and afflicted. Your presence will help the truly needy. Please consider volunteering your services for a few weeks or months.  Not only will your work be greatly valued, but you will return richer with wisdom. 
World Health Organization (WHO), Doctors Without Border, International Red Cross and Red Crescent, Project Hope and many other organizations are seeking volunteers. Let’s help them.