FIFA or the World Cup is usually held in the summer.  But due to the location of the event - this year in Qatar - it was moved to December. Qatar is on the south side of the Persian Gulf and the northeast side of the Arabian Peninsula where it is known as ‘God’s Anvil,’ as was said in the movie: Lawrence of Arabia.  The formidable winds from North Africa, further heat up as they cross this scorching barren land.  Even though FIFA is being held in December, the games are played after sunset, to protect the players from heatstroke.
 
The games have been a good distraction from an otherwise very difficult year. Like millions of people around the world, I’ve been glued to the TV for the past weeks. Yesterday’s match between France and Morocco was a nail biter. Even though France won, Morocco sure gave them a run. The first African nation to make it to the semi-final and play so well. The final game between Argentina and France will be on Sunday (Dec. 18) 8 AM mountain time. It will be another exciting game.
 
How I wish we could get this excited about our healthcare. Even a little excitement would add to the well-being of us all, and with all the technology available to us, it would be at a fraction of the cost of establishing, providing and participating in these international pastimes. Of course, I realize that it is the teamwork and competitiveness of sports that make them so exciting and healthcare is not a competitive sport. But it does require and demand teamwork. That teamwork could be built upon. As healthcare providers, we can assure that the service we provide is to the best of our ability. And showing a little enthusiasm in providing it, well, could be contagious.
 
Let us hope and pray for a better year full of contagious enthusiasm ahead.

With the cold weather, we limit our exposure and shelter in, isolating ourselves from the elements. As we celebrate this holiday season of customs and beliefs, let’s not overlook the nature around us.

On an unusually warm day awhile back, my wife and I were hiking a mountain trail behind our house. Even the blue jays and chipmunks seemed dumbfounded by the heat. I was leaning on my walking staff, lost in the magic of the day. My wife, walking a few passes ahead, suddenly stopped, turned and whispered; "We are not alone!" pointing to the side of the trail.

I turned to see a rather large rattlesnake coiled up, soaking the sun on a massive bolder by the side of the trail. Seeing us, it slowly raised its head and darted its slit tongue in and out a few times in gesture of greeting. It raised its tail and lazily swung its rattler a couple of times before resting back on the warm rock. Not feeling a threat, it did not seem alarmed.

Just then, an unnatural sound silenced the nature around us. Disturbed, I reached into my pocket and retrieved my cell phone. It was our daughter, wanting to know of our whereabouts. I answered her, and shutting the confounded thing, placed it back into my pocket. Turning around, I noticed that the snake had slithered away and was gliding under the rock and out of sight. I cursed the annoying phone, and we continued on our hike.

Having lost my line of thought, I focused on the fantastic tools at our disposal. I grew up studying by a kerosene lamp. Out of town communication was by telegram and we took horse and buggy to school. Though we were bundled against the cold, we could still experience the world around us.  The horse’s heavy and steamy breathing, the cracklings of its hooves on the icy earth, and the bite of the cold air in our face. Winter was present and experienced – even in the city.

In my lifetime, we invented jet aircraft, color television, went to the moon and back, computers, the internet and the blasted cell phone. So that we can be found and contacted miles away in the wilderness. This technology, I fear has severed our relationship with our nature, with dire consequences.

The world, however, is still a wonderful place. Let's slow down a bit, talk softly, listen more attentively. Hear the blue jays, coyotes, chipmunks, and the crows. Say hello to the sleepy snakes, lizards and the frogs. Let’s not forget that down below our buildings and vehicles, there is a planet that our very existence depends on.

While we are at it, let’s be more tolerant listening to our patients. The good Lord has given us two ears and one mouth. If we listen twice as much as we talk, we will understand them better and avoid mistreating each other. Let us wish everyone a wonderful and joyous season and thank mother nature for all the blessings bestowed on us.

When I was appointed to the NM Medical Board, it was winter and my first attendance was the December meeting.  A cold front and an associated early winter snow storm the previous night, caused havoc for my morning 65-mile drive to the state capital for the meeting.   I ashamedly arrived an hour late for my first board meeting. To my relief, I learned that two other board members making the same trip had not arrived yet either. This is significant for this article, as the member’s tardiness allowed a lengthy discussion by the members present about a complaint received by the Board on a particular practitioner – apparently well known to them.  The entire incident was memorable enough for me to still recall it today.
The particular practitioner – I will call him Dr. T. (for trouble) – became a regular at our Board meetings for the entire seven years, I served on the board.  Dr. T. was an intelligent and good medical practitioner.  The repeated complaints were not about his knowledge or practice of medicine. Mostly, they were not even from patients, rather, they were from his colleagues or co-workers on his abusive conduct.  What made this case particularly difficult for us, was his level of intellect and astute arguments he presented.  Of course, he was placed on probation multiple times, even referred for psychiatric evaluation.  But even the psychiatrists seem to have trouble identifying his behavior.  He was diagnosed with narcissistic vs bipolar vs anger management, etc. type of conduct.  Our inability to deal with him adequately, compelled us to ask the governor to appoint a psychiatrist to the board when a vacancy became available.

At one point, we were pleased to hear that he left for a position with the federal government in a neighboring state.  But since the federales did not require him to be licensed by that state, he practiced under his NM license.  And it wasn’t long before we received a complaint on him, forwarded to us by the Medical Board of our neighboring state. 
If there was one thing that I learned about such cases, was how such behaviors were common in highly intelligent, educated practitioners.  I also came to appreciate that trying to change such behaviors, seldom works. Sometimes, I feel that a real jolt or as the old saying goes a kick in their attitude works best.  There are, of course, other ways to deliver such a jar than an actual physical contact.
A young member of our family got involved with gangs in his school, and a close friend of his was killed in an altercation with the rival gang.  The incident had a profound effect on him and as his mother said, “totally messed up his mind.”  To a point that the family was worried that he might do something drastic, and asked if he could spend sometime with us and away from his toxic environment.  I agreed, but soon after his arrival realized that I had a real problem on my hands, as we were not even on the same level of communication.  He looked at me as an older person and repeatedly said: oh, you just can’t understand what is going on these days. All my efforts failed, and I was feeling helpless. Then I noticed a pamphlet I had received in the mail about a medical conference (CME) happening soon, in a resort city of a developing country in Central America.  An idea came to me and I told him that I was going to the conference and would like him to come with me, and that it would be a good break from it all. He agreed eagerly.
We flew to the capital city. From there I opted to take the train to the Resort City. I purchased a couple of coach tickets on the overnight train.  On the ride, the average citizenry got on and off throughout the night. Often carrying their children, belongings and goods of all kind. Even occasionally their livestock like chickens, goats, sheep, etc. my young relative’s eyes widened and he was totally fascinated by all he witnessed.
At the resort, I checked in at the conference which was held at a 4-star hotel on the beach, but then checked in at a hotel in town, close to the marketplace – making cost, an excuse. The vendors, arrived at five in the morning, carrying their goods for the day.  The commotion woke us and despite his objection, I made him get up and go to the market. Again, the seemingly primitive layout of the market engrossed him.  Of particular interest was the meat market. We watched with fascination as butchers, expertly cut the meat from the hanging carcasses for the customers, as they swatted the flies (no refrigeration here.)  To catch a ride to the conference, we had to walk through the meat market, which added to the effect. When we returned at the end of the day, the marketplace was dark and empty. Even the flies seemed to have gone home.
I can’t believe these people live like this; he commented once. To which I pointed out that I was glad he noticed, as 90% of the world population live thus. As a matter of fact, I said, many places would consider this a luxury.
I was especially pleased when, on the last day of the conference, he decided to remain behind at the hotel and do some souvenir shopping. Later, he couldn’t stop talking about other fascinating discoveries of his. We flew home the next day. His mother could not believe the changes she saw in him.
Now just think of the possibility of our Boards requiring our unruly practitioners to spend a couple of months practicing at a rural clinic or hospital in a Third World country.  I am willing to bet that much of such recidivism would resolve.

Reza Ghadimi