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