Foreword to “Practicing from the Heart” by Reza Ghadimi
By Humayun J. Chaudhry, DO
By Humayun J. Chaudhry, DO
Reza Ghadimi is at least two decades older than me but I have known him for more than a decade and we share much in common.
We both immigrated to the United States in our youth (Reza at age 17, me at age 5), we both completed our health professions education here (Reza became a physician assistant, I became a general internist), we both did part of our training in New York’s South Bronx (Reza at Lincoln Hospital, me at St. Barnabas Hospital), we both served in the United States Air Force (Reza as a medic, me as a flight surgeon in the reserves), and we both enjoy writing.
As he vividly recalls in his insightful memoir, “Practicing from the Heart,” Reza has seen much of the world over the last 75 years, giving him an opportunity to observe and reflect on matters as varied as astronomy, religion, philosophy, sociology, psychology, and poetry, to name just a few disciplines. His collection of short articles in this laudable book covers these topics and more but his primary focus, as he also writes on his blog (The HealthCare PULSE, at www.thpulse.com), is to always be an “advocate of the poor and the homeless everywhere.”
Reza learns in his teenage years from a friend of the family who is a doctor that the practice of medicine first and foremost involves the “art of listening, sensing, looking, and finally examining.” The words echo those of Sir William Osler, the father of modern medicine, who famously said, “The whole art of medicine is in observation… but to educate the eye to see, the ear to hear and the finger to feel takes time, and to make a beginning, to start a man on the right path, is all that you can do.” That same point is reinforced for Reza by a brusque nurse he encounters who says, “The most important thing is to listen to the patient.”
Particularly poignant in this book are the stories Reza shares of weaknesses and failures, and of challenges and inadequacies, in our health care system for those who lack health insurance, for those who are undocumented, or for those with cultural backgrounds that are not always understood or appreciated. The story of an asthmatic mother of three who dies because she is unable to get the care that she needs on a timely basis is a reminder of what we still lack in health care, despite incredible advances over the last five decades in diagnostics and therapeutics. Reza admits he doesn’t have specific solutions to all of these dilemmas, though he suggests technology and better communication will be critical factors that will enable improvement. While acknowledging that “legal minds” and “bean counters” will also need to figure some of these problems out, Reza’s compassion is fully on display as he repeatedly suggests a sense of urgency to do something sooner rather than later to improve humanity.
The people he writes about or quotes in his short stories tell us a lot about Reza’s own humanity and character. He mentions being inspired by luminaries like Pulitzer Prize-winning poet Maya Angelou, with whom he has a memorable conversation. But he also admiringly mentions a young man he meets early in life named Ibrahim, a surgical assistant he meets overseas who appears to lack a formal education (despite his work in the hospital) but always prays for the patients he helps manage. “The human body is sacred,” Ibrahim tells Reza. “The very breath of God has given it life, treat it with reverence and respect and it will repay you by living well.”
Reza demonstrates an exceptional curiosity about mankind and its place in the cosmos. When Halley’s Comet makes its pass in 1986, many of us in North America were unable to see it well on terra firma because of where we were, due to bad weather or just too many city lights. Reza, too, had difficulty seeing it from the ground but that did not stop him. He did something many of us did not or could not do, hopping onto a Cessna plane (Reza is a licensed pilot) to get a closer view for himself at nightfall. He also marvels and talks about the lunar eclipse of the sun he witnesses and what it means to him.
Now retired from clinical practice, Reza is thinking a great deal about what is happening on the ground and what is in store for the future of medicine, especially with the COVID-19 pandemic all around us. He recognizes that, especially in the United States, we still have far to go to address inequities in health care, to improve the lot of tens of millions of individuals who lack health insurance, and provide broadband internet access across many more parts of the country, especially in rural areas. This latter point is of special interest to Reza, who has lived and worked in New Mexico for many years and has been active with the American Telemedicine Association (ATA). Reza even manages to mention, in passing, the future role that advances as 3-D printing, robotics and artificial (or augmented) intelligence may play to advance telemedicine and telehealth.
Having served on the New Mexico Medical Board for many years, Reza smartly reflects on what medical regulators may be able to do to advance the practice of medicine in the years ahead. He applauds efforts by state medical boards to support medical licensure portability, such as with the Interstate Medical Licensure Compact that has been promoted by the Federation of State Medical Boards and has thus far been passed into law by 29 states and two U.S. territories (including the District of Columbia). He notes that all health care providers need to do a better job in communicating with their patients, accurately observing that many of the complaints that state medical boards receive about inadequate or poor care by physicians and physician assistants could have been avoided through better communication between provider and patient.
Midway through his collection of stories, Reza waxes philosophically to consider a famous question attributed to the poet Cicero. “What greater or better gift can we offer the Republic,” the Roman statesman asked more than two millennia ago, “than to teach our youth?” Reza’s book does a splendid job, his gift to us, of teaching what matters most (humanity, fairness, tolerance, compassion, education, understanding, and technology) as we consider our future.
Humayun J. Chaudhry, DO, MACP, FRCP
President and CEO
Federation of State Medical Boards
June 26, 2020