Louisville Medicine Volume 64, Issue 2 | Página 21

PRACTICING AND LIFE MEMBER CATEGORY WINNER
2016 RICHARD SPEAR, MD, MEMORIAL ESSAY CONTEST

so I thought….
I felt my entire life change in Ethiopia. I had never experienced
such peace, and even though I loved the practice of cardiology, it
was nothing compared to treating patients on the side of a mountain in western Ethiopia. Before I knew it I was back in Louisville,
at the next monthly meeting of our group. I told them I would
stop being practice manager at the end of the year, and quit the
full-time practice of cardiology in five years. Even though I would
practice part-time office cardiology the next 12 years, the days of
interventional cardiology would be over very soon.
In Ethiopia, I realized that the practice of medicine was exactly
what the Hippocratic Oath stated. “I will apply, for the benefit of the
sick, all measures [that] are required…I will remember that there is
art to medicine as well as science, and that warmth, sympathy and
understanding may outweigh the surgeon's knife or the chemist's
drug. I will not be ashamed to say ‘I know not.’ ”
My heightened awareness of the essence of the doctor-patient
relationship deepened with every short-term trip to rural outposts
worldwide. What began as one trip to western Ethiopia was the
beginning of dozens of short-term trips all over the world: Gabon, India, China, Romania, Guatemala, and more. Each trip had
medically interesting cases. For example, there was the snake bite
in Gabon treated with anti-venom and then epinephrine back-andforth until the patient stabilized. In northern China, I practiced
alongside a Chinese doctor. I would give him my diagnosis and
suggest treatment; then he would take the yin-yang of the patient
and give me his own diagnosis. But no matter the location, especially
in the many villages hundreds of miles from any other help, there
were repeatedly the disastrous stories with no treatment available.
Over and over, I would tell patients I had nothing to treat their
problem but prayer, and there would be hugs and tears while the
family profusely thanked me. I was amazed. This aspect of remote
clinical medical practice profoundly changed me. I began to wonder
if I could experience the same feeling closer to home.
After 17 years of short-term trips around the world, I attended a
meeting in West Louisville where statistics for the rates of cancer,
hypertension and diabetes were more than double those where I
lived, only 13 miles away. Starting in 2006, a 10 year journey began
to build a clinic in West Louisville, specifically the Shawnee neighborhood, where no primary care practice existed for over 17,000

people. Having gone from interventional cardiology, an area I felt
tremendous expertise, to voluntary CEO of our clinic, an area where
I felt lacking every day, I felt just as much angst as when I practiced
primary medicine overseas. Having no idea how to be an effective
CEO, I started attending local, state and national meetings. I received
help on writing grants, met with neighborhood representatives, and
watched the clinic concept grow until we opened on a dime-store
budget in 2011. Fearing constant bankruptcy on a day-to-day basis,
our team persevered until August 13, 2015, when Shawnee Christian
Healthcare Center (SCHC) received a fully funded 330e FQHC
grant. SCHC can now look forward to long-term sustainability
and turn our attention to transforming the neighborhood using
our human and health care assets to create the transformation.
Perseverance paid off.
How has medicine changed me? - beyond my wildest expectations.
Being the first in our family to attend college, my essay on “What
I Want to Be” in high school was titled, The Three M’s - Medicine,
Min