Grand Rounds
Johns Hopkins University School of Medicine
Department of Obstetrics and Gynecology
19 February 2004
A few months ago, our youngest daughter – thirteen years old – asked, “Dad, how should I answer when my friends ask me, ‘Morgan, what does your dad do?’” I could have recounted for her a dinner conversation in New Orleans with a thoracic surgeon friend from Northwestern. I described for him my various roles inside the medical education and practice environments. I detailed my role at that time as coordinator for a large inner-city Ob/Gyn residency program with responsibilities to keep the rotation schedule untangled, construct the didactic sessions, interview prospective residents, moderate the resident evaluation committee, attend morbidity/mortality conferences, visit the anatomy lab, pore over resident statistics, co-chair the research committee, wrestle with the national accrediting organization. At one point, my friend interjected, “Doug, you are like an anthropologist who is studying a previously unknown population. He (or she) pitches camp on the edge of the village. The villagers gradually come to trust the anthropologist who finally moves into the village.” Instead, I suggested to my daughter, “Just tell them your dad is an irrigation ditch.” By the end of the conversation, she seemed to understand the metaphor. For the past twenty-plus years, I have been privileged to work closely with medical students, residents, academic physicians, and practicing physicians who remain resolved to be humane toward their patients and to exercise a strong social conscience in the practice of medicine.
Four physicians have created ways for me to be imbedded in the medical education and practice settings since the early 1980s – (1) Tom Elkins, an internationally respected pelvic-floor surgeon who died of heart failure August 1998 at age 48 just as he was establishing himself here at Johns Hopkins as director of this department’s gynecologic specialties; (2) Sheldon Korones, founder in 1968 and still director of the University of Tennessee Memphis Neonatal Intensive Care Unit who has welcomed me to spend hundreds of hours with him in and out the unit gaining insight into the complexities associated with intensive care for critically-ill newborns; (3) Emmalee Bandstra, a neonatologist at the University of Miami who invited me to work with her and her staff for four years as she led two federally funded intervention projects in the 1990s that targeted cocaine-abusing women who were delivering -- prematurely – cocaine-exposed babies; (4) David McRay, a family physician who has spent the years since he completed residency in 1989 leading the efforts of a non-profit community health center in the Appalachia Mountains of East Tennessee to make primary medical care – including surgical obstetrics – accessible to uninsured patients (and where I have worked as a member of the executive leadership team for the past seven years).
Any insight in my comments today I owe to the resolve of these four physicians (and a circle of like-minded colleagues) to keep alive the vision of genuinely caring for patients to the point of the fatigue and the edge of cynicism implicit in the question – “Do I care . . . really?”
Johns Hopkins University School of Medicine
Department of Obstetrics and Gynecology
19 February 2004
A few months ago, our youngest daughter – thirteen years old – asked, “Dad, how should I answer when my friends ask me, ‘Morgan, what does your dad do?’” I could have recounted for her a dinner conversation in New Orleans with a thoracic surgeon friend from Northwestern. I described for him my various roles inside the medical education and practice environments. I detailed my role at that time as coordinator for a large inner-city Ob/Gyn residency program with responsibilities to keep the rotation schedule untangled, construct the didactic sessions, interview prospective residents, moderate the resident evaluation committee, attend morbidity/mortality conferences, visit the anatomy lab, pore over resident statistics, co-chair the research committee, wrestle with the national accrediting organization. At one point, my friend interjected, “Doug, you are like an anthropologist who is studying a previously unknown population. He (or she) pitches camp on the edge of the village. The villagers gradually come to trust the anthropologist who finally moves into the village.” Instead, I suggested to my daughter, “Just tell them your dad is an irrigation ditch.” By the end of the conversation, she seemed to understand the metaphor. For the past twenty-plus years, I have been privileged to work closely with medical students, residents, academic physicians, and practicing physicians who remain resolved to be humane toward their patients and to exercise a strong social conscience in the practice of medicine.
Four physicians have created ways for me to be imbedded in the medical education and practice settings since the early 1980s – (1) Tom Elkins, an internationally respected pelvic-floor surgeon who died of heart failure August 1998 at age 48 just as he was establishing himself here at Johns Hopkins as director of this department’s gynecologic specialties; (2) Sheldon Korones, founder in 1968 and still director of the University of Tennessee Memphis Neonatal Intensive Care Unit who has welcomed me to spend hundreds of hours with him in and out the unit gaining insight into the complexities associated with intensive care for critically-ill newborns; (3) Emmalee Bandstra, a neonatologist at the University of Miami who invited me to work with her and her staff for four years as she led two federally funded intervention projects in the 1990s that targeted cocaine-abusing women who were delivering -- prematurely – cocaine-exposed babies; (4) David McRay, a family physician who has spent the years since he completed residency in 1989 leading the efforts of a non-profit community health center in the Appalachia Mountains of East Tennessee to make primary medical care – including surgical obstetrics – accessible to uninsured patients (and where I have worked as a member of the executive leadership team for the past seven years).
Any insight in my comments today I owe to the resolve of these four physicians (and a circle of like-minded colleagues) to keep alive the vision of genuinely caring for patients to the point of the fatigue and the edge of cynicism implicit in the question – “Do I care . . . really?”
