I grew up in a household and family of teachers. There are 18 educators or school administrators in my relatively immediate family. Prior to high school, I had never even considered being a physician, but, as with many teens I aspired to do something totally different than others in my family. What I have learned is that sometimes, no matter what path you take, you can’t change who you are.
The first time I taught was in college at UC Berkeley. Berkeley had a “democratic education at Cal” series, student taught and student run. Over college I taught in Integrative Medicine and Women’s Health. In Osteopathic medical school, I was selected as the first “pre-doctoral teaching fellow”.
My role as a student faculty member in the department of Osteopathic manipulation was a great adventure, leading me into clinical research doing osteopathic treatments on women in labor in the Dominican Republic and mentoring medical students to learn the art of manual treatments.
Residency training is another form of physician apprenticeship and after internship year I was always teaching as well as learning. My final year I was elected chief resident, a leadership role again rooted in teaching.
Every day now, in clinical practice, I realize what I learned as a medical anthropology major, that the root word of doctor in Latin is “docere” which means “to teach”. My favorite part of doctoring is sharing the knowledge I have amassed from books, studies and experiences with patients up against a health challenge.
While I enjoy shedding light on the path of using medications, supplements and lifestyle changes, my favorite part is figuring out how to tailor recommendations to where someone is at right now. Teaching always starts with learning what your students know and finding out how to support their growth and change.
Those of you that come into the clinic in the next few months will see the next phase of my teaching path. I have students from Rocky Vista University College of Osteopathic Medicine in Parker rotating with me now. I teach in the department of Osteopathic manipulation at Rocky Vista on Thursdays and several months of the year I act as a clinical professor taking fourth year students in their final months before their residency.
I strongly believe that if I do not demonstrate the true art and science of being an Osteopathic physician with these students, they will not come to respect the simple benefits and unique attributes of our profession. Every day as I teach the treatment techniques to 1st and 2nd year medical students they say, “you actually use this?”. I smile and I say, “yes—every day”.
I give great thanks to all the teachers and mentors I have had along my path. Many of them have been and continue to be my own patients. Thank you for letting my students listen in, try out their doctoring skills and learn from you too. As Thanksgiving approaches, I am in humble gratitude to you all.
I was raised in rural America. Born in on the south shore of Lake Tahoe, my family moved to a town of 150 people in the eastern sierra when I was 10. I thought my life was over. It was just about to begin.
Our town shared the county with another small village of 250 and a Native American reservation of the Washoe tribe with a population of 400. Yes these are numbers in the hundreds, not the thousands. The other side of the county was even smaller and inaccessible in winter months because of snowy mountain passes. It is one of the largest counties in California by land mass and literally the smallest by population, Alpine county.
My grade school was predominately Native American and by the time I was in 8th grade I was the only other Caucasian female in a class of 8 people. For high school, I bussed to Nevada and within four years I was valedictorian of my class of 400 people. Months after that, I sat in a calculus class at UC Berkeley with 150 peers. I had gone from a big fish in a little sea to ever enlarging oceans. The San Francisco Bay Area amazed me and the diversity was astounding. I was shocked that I could get a pizza at 2 am and that a small part of the Berkeley hills had a park with signs to the “nature area”.
As a child, I wanted to be a veterinarian. It wasn’t until I was in high school chemistry class that my teacher mentioned I was “smart enough to be a doctor’. I had never considered such a thing. But my chemistry teacher was married to the town vet and I listened when she suggested doctoring humans instead of animals. At the time, an only child, I had three cats, three dogs and three frogs. I realized, humans needed more help than animals, and I set off to find the path that would bring me to the evolving physician I am today.
I didn’t know what an osteopath was until I started a club at Berkeley called “Students for Integrative Medicine”. Selfishly exploring my own career options, I invited three women to a panel discussion I called “The Future of Integrative Medicine”. This was 1999 and the term Integrative Medicine, meaning the weaving together of western and alternative medicine had just been coined by Andrew Weil M.D.. I brought together a naturopath, a medical doctor with a holistic focus and an osteopath.
I recall a few distinct things about that night. All women worked about the same amount and made the same income. All studied each other’s modalities and there was a lot of overlap in their practices. I realized I could do whatever I wanted to do, but it was my foundation that mattered. Struck by the osteopath, I made an appointment with her, Runa Basu D.O.. I walked out of the treatment and was so amazed at the changes I felt that I called my dad and said, “Dad, I know what I am going to do. I am going to be an Osteopath”. For the next six months, I took the bus from Berkeley to San Francisco to volunteer and observe Dr Basu.
My best friends come from the town that I grew up in. One of them lost her step father within a few short months when I was a second year medical student. He died from malignant melanoma which had been on his fore head, a prominent lesion I can now recall. If he had ever visited a medical doctor for prevention, it would have been easily identified. I became motivated at that time to pursue family medicine, to be on the front lines of the healthcare system.
Over the next few weeks, as I give thanks for this path that has led me to opening my own direct primary care practice I will share with you my journey. It is a reflection for me and a sharing and opening for you. When I asked the first doctor I met who was practicing direct primary care he said to me that it was “like being the village doctor again”. This resonated with me. I love living in Denver, but creating the village of families that I care for within this big city was a step back to my roots. I am so thankful for those who are joining me. To be continued….
I started waiting tables when I was 11. I worked in a family owned restaurant in a town of 150 people in the Sierras. By the time I was 15 I had my official working permit and I could work at the fine dining restaurant, a step up in responsibility and tips.
I remember my best friend’s dad, my boss, taught me the art of multitasking. He taught me that every time I was “on the floor” to watch for tables that needed clearing, a family looking for water, a check that needed to be delivered. No trip in or out of the kitchen was without multitasking. Amazingly, this was probably the first step toward becoming a family doctor though I never would have guessed.
Multitasking has dominated my experience as a young person and now as a mom and physician it is no different. I am not alone. It is a skill and a distraction from what is. When it comes to mindfulness, unlearning this skill is a challenge.
Multitasking is an essential part of becoming a physician. I remember being on call, actively managing more than 30 patients with various acute health, some of whom were actively dying. You would get called about medication changes, delirious patients, unstable vitals. Then a new patient would be admitted from the emergency room, next on your list of thing to do. Then labor and delivery calls and its time to catch a baby, the emergency room admission got basic orders, nurses were to get started but a fill history now had to wait. A baby was born. Sometimes a life was saved, sometimes it was time for a life to end. All in a 28 hour shift.
Being a mom challenges my multitasking ability every day. There are toys to pick up, laundry to do and chores are never ending. But my children need more than that. They need a mom to listen and play. To read and explore. All the while the tasks must get done too.
As a mom and a doctor, the multitasking can become unending. I am a perfectionist and like many characteristics we see in ourselves, this is a good thing in many situations even if challenging in others.
When I am doing a circumcision with a medical student or a resident, I teach them my perfectionism because it is a time and place where this is adaptive and important. When it comes my 2 and a 4 year old, perfectionism about cleaning the floor only makes us all crazy and distracts from the importance of being together at this precious time in their lives.
I am in tune with my body and mind and notice small changes easily. When I was pregnant my brain didn’t multitask as well. As a physician I know that as we get older, our brains don’t multi-task as well. We might think of this as a bad thing, but really, there is an art to single tasking.
As I have learned mindfulness, the practice of consciously single tasking in yoga or meditation or parenting has been a welcome challenge. As we bring our busy minds to one focus, it is easy to see the monkey mind dancing around a variety of thoughts. As in meditation, you can label these thoughts and gently bring your mind back to the present. Like training a puppy, over and over reminding yourself to come back to the present.
In the day and age of email, social media, internet and texting it is easy to feel that we are always in the middle of something, but never really here. It’s a practice, single tasking, and perhaps an ever more important one as our lives speed up and our brains slow down.
To practice, put your phone or computer to bed at 8 PM for a week. You’ll sleep better and your brain will thank you. (science says so).
The great thing about direct primary care is that I can reserve a whole hour for patients as I get to know them. I can actually focus on the history that you bring to the table. We can make a good plan together. We can dive deeper as we weave the web of the doctor and patient relationship.
I hope that my own practice of single tasking will be apparent the next time we meet. As a doctor and a mom part of me might always be multitasking. But switching between the two modes and being present in the one you are in while you are there—that is the art. Come in for a visit if you haven’t already. Isn’t it time for a little focus on you?
More on multitasking here: