July 2007:
"I think you have me beat for the number of job changes
per unit of time. Something struck me as I was reading of your sojourn. But
before this, I want to share something with you. I have always seen you as one
of the best and brightest in Family Medicine. You have an incredibly broad and
deep mind and are one of the few Family Physicians I have known who can apply a
Family Medicine philosophy of care to complex medical issues in a way that blows
away the arguments of sub-specialty “experts” in open discussion.
"You may not recall one of the noon conferences in which you
participated while the residency program was still in its original home at
Hershey Medical Center. A guest speaker (I believe he was a cardiologist) was
invited to present on a clinical topic. Following his presentation, you provided
a counter presentation that offered an alternative approach to the same problem.
Your presentation addressed clinical and cost of care issues. It was a bravura
performance. You made the case, in an analytically clear manner, that a
“generalist style” approach, was really the thoughtful way to go.
"Everyone in the room was impressed, both the few faculty who
were present and all the residents. Your ability to articulate your ideas in a
“evidenced-base, scientific” fashion was powerful. Your presentation
demonstrated the value and elegance of a FM approach to medical problem solving
and care management.
"All of the FPs I know who received your newsletter told me
that they found your approach to care to be valuable because of your rigorous
and thoughtful approach to. Reading your newsletter helped them to have
intellectual confidence in a Family Medicine approach to clinical decision
making. It empowered them and supported their more instinctive approach to care.
The difference between them and you was that they believed they were “flying by
the seat of their pants” while you had a grounded and rich intellectual basis
for your approach.
"I also recall one STFM NorthEast region meeting in which you
presented a seminar or workshop that addressed a cardiovascular topic. I pay
attention to who presents and the topics presented at our meeting. Ahead of
time, I wondered who would attend your presentation. The title and the abstract
you offered in your submission made it clear that this would not be a
“touchy-feely” type of presentation. It may have mentioned Bayes Theorem. Not
the stuff that most students, residents or faculty in FM get excited about.
"During the meeting, I make my rounds checking to see which
topics and presenters are drawing an audience and which rooms are near empty. To
my complete surprise your presentation was full with medical students and
residents. They were listening with rapt attention.
"Why am I saying all of this? Because I believe that you have
an important role to play in the future of Family Medicine. You are a thinker,
writer and speaker who can articulate a FM/generalist approach to clinical
issues that has the potential to anchor, extend and sustain the future of
primary care in the US. There are many current faculty and residents who want to
be effective Family Physicians but are uncomfortable with the biopsychosocial
model and other key concepts that FM has embraced. They yearn for something
analytical and “hard” that can anchor their belief and practice.
"There is need for Family Physicians with your skill set and
perspective who can articulate to business, media and sub-specialist medical
leaders the value and efficacy of a generalist approach to clinical issues.
There is an incredible need for you to find a way to apply and extend your
approach."
LB, Dayton OH
February 2001
"I am so sad to hear you are leaving. You have been such a
grounding force and ray of hope for me. I look at you and think, "Well, Colin
can do it, so it must be possible." When I say, "it" I mean so many different
things. I have been grateful again and again for your giving voice to what I
feel and
struggle with in work, medicine, family practice, and life, but which I can
never seem to find words to express. Hearing you say what I feel so precisely
has been affirming in a way that I have great difficulty finding in medicine.
"I have never had close colleagues with whom I can share the
real trials and challenges of this work on a personal level. I have felt a
closeness and connection with you because I feel, "you really understand, AND
you're not afraid to say it." But also, you are not afraid to look closely at
what
people are doing. This, too, feels so affirming because the willingness to look
closely is inseparable from the belief that we can do better. I am grateful for
this message every time you offer it, in all the ways you have over the 3 years
I've been here: from your attempts at systematizing practice chart reviews and
giving appropriate feedback, to your inpatient service oversight role, to your
comprehensive and incredibly educational M&Ms, to your amazingly practical
didactic sessions, to your insightful (and often disarmingly simple) comments in
morning report and every other educational forum we have, and so on and so on. I
often think of what you have written (and said) about the need for courage. It
is so helpful to remember that what some would regard as stupid or reckless is
often the most courageous and healing act. I use the words you have given me
often with residents: "Be
courageous" aka "Trust your heart." I think my home birth practice epitomizes
this for me, and I love the frame you've given me through which to view it. I
get scared to death every time I await and attend a home birth, but nothing else
gives me the incredible sense of fulfilling service and closeness to the grace
of god that it does. I think that's what courage is for me. The other part of
"it" is limit setting. You are absolutely my ideal role model when it comes to
having healthy limits and remembering that to care for others you must care for
yourself, that charity begins at home... all the things I know to be true, but
have never been able to practice. I see the intense pleasure in you when you
speak of your children and your family. I remember having that once, and I catch
glimpses of it here and there, but I can't seem to reign my work in enough to
regain it with any consistency. I see how my children suffer from this, and my
marriage, and I remember when we went to the "Courage to Teach" retreat with
Parker Palmer and they asked us to finish the phrase "I am afraid I will die
before..." and I knew immediately that for me that sentence ends "...before I am
a good enough mother." And I think, "Why can't I do anything about this?" But I
know it's possible, because I see you
do it. Your presence has been a beacon for me--of all the goals I have for
myself. You are the living example that makes me know it is possible for me to
be what I want to be in all these ways. The gifts you have given me are
timeless, and I will continue to have and treasure them with you at
Stonybrook. But, I will sorely miss your presence--presence of body and presence
of mind, with all your miraculous gifts.
"They are incredibly lucky to be getting you at Stonybrook,
and we are incredibly unlucky to be losing you. But we are incredibly lucky to
have had had as long as we did, to help us make this program firmly good and
healthy in ways that you know better than anyone. You have really helped some of
the other faculty's greatest gifts grow and flourish with your prodding, your
example, and your steadfastness. I hope they appreciate at Stonybrook what a
treasure they are gaining. And, if they don't yet, I hope they are able to
perceive it once you get there, so you are fully appreciated, which I suspect
you have not been here. Quakers say, "Don't hide your light under a bushel."
"Shine on, Colin."
SN, Zionsville PA