Stories from the Summer: The Flag

Twice a day everything  on Fort Sam slowed to a halt. Cars would stop driving and pull over to the side, people would stop running, and each soldier would turn to the south, stand at attention, and salute the flag. The procedure for this was outlined very specific with specific bugle calls. I am sure there were some that found this an annoyance, but for me it was a time to remember who I was, why I was there, and those who had come before me.


"The Soldiers Creed"

I am an American Soldier.

I am a Warrior and a member of a team. I serve the people of the United States and live the Army Values.

I will always place the mission first.

I will never accept defeat.

I will never quit.

I will never leave a fallen comrade.

I am disciplined, physically and mentally tough, trained and proficient in my warrior tasks and drills. I always maintain my arms, my equipment and myself.

I am an expert and I am a professional.

I stand ready to deploy, engage, and destroy the enemies of the United States of America in close combat.

I am a guardian of freedom and the American way of life.

I am an American Soldier.

Back from a Whirl Wind Summer

blackhawks come bringing patients

My last summer off has ended, if you could even call it a summer off. I spent 6 weeks training with the military in the art of being a soldier as well as what it means to be a doctor in the military. Then I spent my final two weeks in Peru hiking the Inca trail t Machu Picchu, horseback riding in the sacred valley, and sleeping on the Uros Islands in Lake Titicacca.

There is too much to share in on blog post. The military was both exciting and exhausting with temperatures ranging from 80 to 85 in the morning and 90 to 110 degrees in the afternoon, I was out of my comfortable climate in the north, but I learned to cope. The first three weeks were fairly uneventful and dull, learning the ins and outs of army protocol for everything from "what do you do if you get arrested," to "this is how the hospital works."
The next three weeks were much more exciting. We practiced convoys, shooting M16s and M9s, land navigation, and finally the combat hospital system.

Peru was a welcome change of climate. to cool, dry, and high. Cusco is about 3300 meters above sea level and on the inca trail we reached 4,215 meters on the second day. There was no sensation of the wind getting sucked out of me or even a feeling of light headedness, just a being a little winded when I walked a few flights of stairs.

My brother and I sitting of Machu Picchu

Now I am back, a second year, and continuing the medical education with late nights and cold pots of coffee.

On "Pathologies of Power" by Paul Farmer

Paul Farmer is an author of numerous books, both anthropologist and physician, and a promoter of social justice. Recently, I have just read his book "Pathologies of Power" about the health, human rights, and the war against the poor for my IPJH student elective.

Paul Farmer speaks from a passion that can only come from a changed heart. It is an uncommon phenomenon that one who has been witness to such suffering, poverty, and the evils of the world emerges un-jaded and unwavering in his mission. Standing amidst hopelessness he seeks hope, continually marching onward and fighting against an apathetic nation. His words penetrate as one who has lived and experienced as the poor do, not that he understands completely, but he has an empathetic heart and not of a sympathetic pride.

Why is someone who has the ability and knowledge to anything in this world choose to enter into relationships with those who are often viewed as the dregs of society? I would like to think it comes from both a profound understanding of who man is, and the simplest of revelations: because it is right.

This is a dangerous statement, because if there is a right way then it follows by laws of reason and logic there must also be a wrong. It is easy to define the right even if it is not easily accomplished. The wrong is not so, not because the answer is elusive, but because the inevitable reality frightens us. We work against it lest our conscience be tainted or guilt over take us and are then forced to adopt the logical eventuality that it is apathy and selfishness that rules over us, myself included.

If the opposite of work is to rest, the opposite of to go is to stay, and the opposite of selfishness is selflessness, then it follows that if the correct course is action the incorrect course is inaction. If it is right to help the poor then it flows that it is wrong to ignore them. The biggest enemy in the fight against poverty, justice, and health is not those force working against us, but the apathy of those who can rectify these injustices that exist.

We must be careful because of the evil of a sympathetic arrogance lurks in shadows. Instead we must be driven by empathy (see link for more on this subject).

Can we, those in a position to help, save the world? I do not believe we can. However, it does not change what is right:

"but what does the Lord require of us, but to do justice, to love mercy, and to walk humbly with your God." Micah 6:8

If Only I Could Become and Ant!

Recently, I was having a conversation with a few of my classmates, and we stumbled across an interesting aspect of a physician. We were discussing living situations and our plans for next year. I was thinking out loud as a I often do that I was considering living in "Over the Rhine" a particular bad neighborhood in cincinnati with numerous homeless shelters.

"but it isn't safe, and you could have your car broken into, or have things stolen. And you don't know what unsafe neighborhood is really like," my roommate replied.

"But if I want to work more with the homeless, how can identify with them at any level when I live far away in a nice suburban and 'safe' neighborhood," I countered.

"You can always travel and give them care while living elsewhere, and that will do just as much good." 

I could see now that there was no point in explaining that the safest place was where I was doing the Lord's will, or that our goals in medicine were at all the same. To him affecting change was to change the physical manifestations of a set of diseases.

I remembered a very important sermon illustration I heard from my dad several times, in several different sermons:

There once was a boy who was watching an ant hill with all of its ants coming and going working very diligently not at all concerned with the boy. Suddenly a few sprinklers came on in a yard close by and the boy watch as a flood of water was coming straight for the ants. So he tried directing the ants away from the flood, but they continued around him. He then tried chasing them and scaring them, but it was to no avail. The ants simply would not listen. Finally, the boy cried out in his frustration, "Oh! If only I could become and ANT! then I could tell them of the flood and save them all!"

Now this was used to illustrate one reason in which Christ became a man, but it may also be applied to physicians. How are we to tell people of the impending flood health problems if we live away from the injured and cannot understand our patients. We must become one of them; simply put, we must be human as they are human. 

As a final note, if you haven't been watching Jamie Oliver's Food Revolution, Start! He is exemplifying this quality for the health of people, meeting them at their level and trying to change their lives.

Medical Liability or Asset?

It has been a few months since I last wrote, which may tell you something about the mid year schedule of a medical student. With snow days, postponed exams, and the completion of the ischioanal fossa in gross lab, I am at my breaking point, but maybe that is overly dramatic.

There has been several national disasters recently. First the devastating earthquake to Haiti an already devastated country and then the worst earthquake to hit Chili in recent history. I had the good fortune of being able to visit haiti when I was in high school. I remember thinking two things, "Where did all the trees go?" and "Where can I buy a machete?" Now that I have matured slightly and seen a more small parts of the world, my eyes have begun to defog, and I am more able to learn from past experiences that were previously forgotten. These two recent events have me thinking about a new question posed to my class by a physician of wilderness medicine, "Will you be a medical asset or a Liability?"

When people are sent into disaster zones initially it is search and rescue effort and basic medical help. Doctors, nurses, EMTs, and other medical professionals are some of the first to enter into the scene. Yesterday, at a lunch talk about wilderness medicine this question was proposed, "Will you be a medical asset or a hinderance?" I pondered this for a while. What classifies a physician or even a person as an asset. The first thing I though of was humility.

My dad constantly told me, "Approach others with humility and you will go far." Hearing this as a teenager, I never believed him. To my teenage self I knew for a fact that putting yourself behind others is no way to win at anything. I think the words of Green Day's song 'Nice Guys Finish Last' echoed a little louder in my head than my dad's words. But on the field if there is a truck that needs unloading or dishes that need to be cleaned, does it matter that you are a pediatric vascular surgeon specializing in neurovascular trauma? NO!

Being a medical asset has little to do with how well I preform on my next biochemistry test or even my class rank, but to remember the task at hand, understand what the team is working towards, and by whatever means necessary achieve the common objective.