Practicing from the Heart in the age of Technology
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.
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