Notes on life, philosophy, and medicine

This was the moment I thought I'd been waiting for...the moment where life crystalizes and becomes clear but this year, I must have jinxed it: Put all the weight on it from the moment I opened my eyes this morning.  If I spend too long, I suppose I could cry for what has passed this season...what remains, and the uncertainty that is beyond.  But rather, and probably like always, better to focus on the light, that tonight, shines doubly bright against the glass windows.   So that's it, if I failed this last year, I'll double my efforts to stay present in 2024. In reading bedtime stories until James falls asleep, or in my surroundings while driving :), present with the people and places I encounter by chance and most certainly by intention and choice.  God, may my heart seek you above all else, to be truly good without asking or wanting anything in return but to hear your quiet voice when decisions need to be swift so that I may guard my heart. 

Our young country  At times taken and probably lesser known shared among those before us  - The indigenous people of this land - We rose to be a great nation.  Envy of many.  A field of dreams.  We had a system and a structure that supported dreams  for some.  Not just then -but in and along with the cycle of man - human nature in its unintentional ways -  saw it fit to reach for more, power grab, greed and subjugation.  By nature of change Hindsight 20/20 unintentional consequences  we failed to teach our children how to live  reading, writing, arithmetic...fine but without the hows of living there is little use we will end up fighting one another again  implode.  so we build up systems to catch our fallen  rather than deconstruct  the errors of our ways highlight growth  admit fault  we turn a blind eye  or perhaps we have not yet seen  the full consequences of our choices.  It is not to say no progress was made  but progress too was undone  because so simple  to overlook  our very b

There's a tendency for people in positions of power to concentrate power, which leads to increasing levels of bureaucracy. It's natural and something I've spoken about in the past from personal experience. The challenge is without careful monitoring, it seems to get us farther away from actually providing the help that is needed.  And that is my response to this idea of a physician or health care provider shortage. Yes, expert care and specialty care has its place. We have medicines and procedures now that save lives, but I do not believe we actually have a significant shortage of primary care providers; I believe we have unknowingly continuously and gradually taken away the power of individuals and communities to heal and serve one another well through this concentration of power.  We have also provided major corporations with an uncanny ability to expand unhealthy practices - fast food, personal motor vehicles, less green space, suburban homes, the list goes on.  So, we w

Today and maybe 10 -14 decades of life - that's what we have -  What are the terms we need to live by?  What has happened over the last few generations has resulted in our ability to not live life as the precious adventure that it is?  Two/Single parent working households?  No connection to nature/earth. Lack of understanding of where and how food comes from and our role in it.  No idea how to operate in a different economy, e.g gift economy.  There's a lot we can't change, right now, but we have to make some decisions about how we proceed in life and to figure out what we need to do to align our life with the values we believe in.  What does that look like for you? 

Trong bối cảnh ngành y tế tiếp tục phát triển, một mô hình đang thu hút sự chú ý là Chăm sóc Trực tiếp từ Bác sĩ Gia đình (DPC). DPC cung cấp một phương pháp tiếp cận thay thế cho việc chăm sóc y tế truyền thống dựa trên việc trả phí dịch vụ, tập trung vào chăm sóc cá nhân hóa, dễ tiếp cận và hiệu quả về chi phí. Mô hình tập trung vào bệnh nhân này đang được chú ý vì khả năng cải thiện mối quan hệ bác sĩ-bệnh nhân, nâng cao chất lượng chăm sóc và tăng cường sự hài lòng chung của bệnh nhân. Cơ bản về Chăm sóc Trực tiếp từ Bác sĩ Gia đình Chăm sóc Trực tiếp từ Bác sĩ Gia đình là mô hình chăm sóc y tế hoạt động trên cơ sở hệ thống thành viên. Bệnh nhân trả một khoản phí hàng tháng hoặc hàng năm cho bác sĩ gia đình mà họ lựa chọn, giúp họ tiếp cận không hạn chế các dịch vụ y tế. Khác với mô hình trả phí dịch vụ truyền thống, DPC loại bỏ nhu cầu gửi yêu cầu bồi thường bảo hiểm và thanh toán đồng trả cho các cuộc thăm khám thường xuyên. Mối quan hệ trực tiếp giữa bệnh nhân và bác sĩ gia đình

You know what happens when you "work" less, stay at home more, yes aside from the incredible ability to find the perfect novel and the perfect bingeworthy television show, it means you can pull your child away from the screen-sitter aka television especially if it is youtube (thank goodness we banned it except for "educational/instructional videos"  You get to be there for a neighbor when their cat needs sitting, or another neighbor when they need their packages picked up and house watered or to pick up their child on an odd scheduling day. It might mean you get to take care of your ailing parent.  It is not the responsibility of the government to find ways to pay for all of this, it may be the responsibility of the government to set the vision and help make it so that living is affordable enough SO WE CAN do what we need to do for our families and our communities...and robbing peter to pay paul might not be the answer. Just a thought. 

  Summer of 2011  A year after my dad passed away, I went in search of the me that belonged to my dad or for more parts of my dad that I never learned about. I went to Can Tho, Vietnam. I traveled on streets I imagined my dad had been on as a child; I asked to see him from life beyond. And there, the dragonflies descended and something inside of me said that this was for me. This was his way of telling me he wasn't very far away. So I carry his spirit on, through Pay What You Can Primary Care. From coping with the winds of change, to the steadiness of its presence, this dragon fly is a tribute to all who came before me and now works through me to offer healing. 

A bit tongue in cheek but I think 🤔 there is a genuine truth in this…Did the problem with our society start when we decided that some people don’t have to clean their own toilet bowl? We should all be able to that or at least know how. 

How does one find peace and joy in the midst of suffering or trouble?  Does the recognition and acceptance of trouble and suffering as a part of life allow it to be embraced?  In happy times and in sad/distraught times, still we can exert JOY?  These dichotomous ideas  Neither good nor bad  But it must be rooted in our ancestors, rooted in our connectedness and loving embrace of something bigger than ourselves, something that loves us infinitely and is stable without fail.  It must be acknowledged that it exists presently.  The sun that we breathe in and is a part of us as much as we a part of it, the water that flows through us not for our own selfish sake but for the sake of this greater being that is in us and moves through us. The ground beneath us that is solid.  This is our reckoning. This is what we must recognize...to hold within our hearts both the suffering and the joy.  We must trust that we can lay it down on solid ground and embrace the gift of our day.   

What does health look like? And how do we "get" healthy?  I became an osteopathic physician because I believe fundamentally in a body that was created with an inordinate amount of built-in healing mechanisms.  It is my job to help it along, to guide it when it has moved too far in one direction.  But it's not only my job, because healthy to me, looks like an entire community working together to enjoy, and to build on this life we were given.  And I believe we have spent the last couple of generations moving farther and farther away from our ability to do this for ourselves and for each other.  So, what do we do now?  Focus on food: how do we make it, where does it come from, how do we get it, how do we grow it? how do we cook it? where are all the herbs? FOOD IS MEDICINE.  Focus on community - the people involved from the farmer to the miller to the baker.  Focus on earth and all her many gifts. 

My mind is in a state of constant dull numbness, I can’t tell if I’m supposed to be asleep or awake; but I can’t seem to do either. There’s a rolling list of things to do and I’m not quite sure how or in what order to do them without losing the state of present mindfulness. Trying to work out the details of what happened in Viet Nam and how to clarify the questions I had hoped to answer about health and well-being and of being a service to others while understanding the roots of my past and present future…

I live in a world, relatively free from financial struggles, my home is tucked away, and I can see and unsee the world if I want to. I wonder how I got here. I miss the family I grew up with every day, but most especially when the family I have here, that I fell into, breaks me; or I let it break me. I don't know.  I think about our taxation system, our government, our "citizens," brothers and sisters spending nights on the streets, and I think how far we have gotten from one another. I wonder how we got here.  How the power we have to give of ourselves has been stripped or overpowered by this great darkness - to only do and exchange our gifts and talents for money. Perhaps it is because the government sees it is within their duty to take from one to give to another despite their neutral distance and what they think they see, blinds them to the embitterment they have created.  There is no power great enough to care for and teach every one of our children; that power comes

The movies and shows that made me: Patch Adams, Dangerous Minds, Pay It Forward, Boondocks Saints, & more recently, New Amsterdam, sprinkled with TGIF Boy Meets World and I can't quite remember the others, but I realized today that these are the shows that spoke to my soul. I didn't really get a handle on reading and comprehension until sometime in high school and I struggled in my undergraduate years.  Was it nature? Or nurture?  Why did those movies speak to me?  I've lost my train of thought, will have to try to pick this one up another day...  but excited to publish this little list, because I think out of this combination lies a part of me and my vision, and the work that lies ahead.  @chuckjamison, put in a good word for me with the guy upstairs, I'm doing my best here, but nowhere near as obediently as you! 

Ask me 10 years ago why I went into medicine…although not entirely different, I have a whole new regard for the role of physician in society, another level of humility in wanting to save a life, having lost so many.  And this renewed drive is driven in part by a Netflix series about the dreams of doctors (eg healthy foods in hospitals, no wait ER, offering a frequent flyer a home, finding a home for a lost and broken child though unconventional ways, standing up for our own health care needs, working as a team - all the good stuff) personified in the medical director of a large public hospital New Amsterdam!  So, @NewAmsterdam, thanks for the inspiration. Looking forward to the work still to be done. 

with little to no connection to its (our own) history and its roots  floating somewhere between present and this effervescent world created (social media)  pulled by the forces of those who have governed with limited foresight  who failed to recognize the forces of human nature  when left without accountability to the very land and people they are surrounded by  believing that some bureaucratic polity could right the wrongs  the ongoing taxation without representation  a policy too detached from one another  that the only winners are those who do the taking  prized is every individual  yet deprived of the dignity to work for his own fellow man  in the only way in which man feels purpose  for one another  these distant products  global forces  one surely must appreciate  but how to reign in  in the end only some idealistic geographic boundary  but a land always of many  voices to be heard and heeded  easy enough to only think of ONE  despite the many  when we live in a world without acc

This is it, the day and night I usually get to reflect on the year that has come and gone, and to look toward what lies just ahead. A set word to guide me, a quiet night just me, the dark of night and the twinkle of Christmas lights on our 3 foot Christmas tree… This one, is just a bit different. I’m under a knitted blanket in my sister’s entry room living space on her couch and Luna, our now 7 almost 8 month old puppy is at my feet. Our flight home 2 days ago from San Diego to Seattle was cancelled. And my mother’s flight from Raleigh to San Diego was cancelled.  While most of the country is under snow and ice in a historic winter storm, I’ve gotten to enjoy the warmth of Southern California’s sun.  But beyond all of that and the hub hub of commercialized Christmas - aka I’ve spent way too much - I got to see my son watch a Christmas movie and bake cookies for Santa with his cousins! And in less than 24 hours, I’ll get to spend this very special day with all of my siblings, which is s

I'm a physician; a family physician...I spend my days talking to patients about healthy lifestyle and healthy food choices. The food we choose is either helping our bodies or it is not BUT this is my blood sugar right now and it's climbing... And you know what I did when I saw this, I reached for the bag of cheesy puffs that my son left on the kitchen counter. FOREHEAD SLAP EMOJI. I've been having headaches, I feel tingles in my body, I'm bloated, uncomfortable, but I haven't stopped. We the one solitary human has been battling the machine of food industry - science of chemical combinations - and it's supposed to be on us to win?  Meh. Can I readjust my recent binge eating habits I call "holiday hibernation"? It's cold here. But seriously, I'm not too keen on feeling this way for too much longer. I did grab a piece of thanksgiving turkey leftover to try to slow the rise in my blood sugars. My point is with sugars going up as high as they do, I

Ah it was fantastic. The way one can write your soul and speak to you. The way a writer can detail the inner workings of someone’s mind even more than the person themselves. Mine is definitely not so astute; but this book just gave me all my wishy ideals in writing, all the romantic feels, all the deep knowing of a great love.  All the soundings of hopeful aspirations that inspire… I’m in my happy place after reading it. Thank you @BookLover 

It’s not the poetry The beauty with words The art and sounds  Poured out  It is the soul That speaks That unifies personhood Human, creature, life It is the sharing of stories That bind us Elevate us So we write But not until we hear A resonating voice Does the words  Put on paper Speak to us.  Share with me Your soul I invite you. 

After 2.5 years of shifting how we do medicine and finding health and healing in a period of unrest - I think we need even more power behind reimagining how we care for our patients; to collectively rethink how we offer that care and the kind of care we should be offering.  That said, we need to start with us. As physicians, to rediscover what it means to be a physician, serving our patients and not corporate policy or a fragmented health system. We need the space to discover what brings us deep satisfaction; To pursue a life and lifestyle that is commensurate with living out the healthy lifestyle we wish for our patients. This year, I made a major request of my employer, I asked to reduce my clinic hours even further, negotiating the opportunity to work from home to incorporate telehealth visits and to work on community-based projects that bring me joy but also, I believe undoubtedly will increase the health of my community.  With this increase flexibility, I feel an incredible weight