2022 RICHARD SPEAR , MD , MEMORIAL ESSAY CONTEST
In-Training Member Category Winner
A CHANGE OF HEART by COLE DOWDY
It was time to clock out at the Have A Heart Clinic — a free cardiology clinic for Louisville ’ s underserved . Before I could leave , Dr . Imburgia had to tell a story that made his Thanksgiving . It was vintage Dr . Imburgia , full of spark . He chronicled the visit of a patient who , because of IV drug use , had developed infective endocarditis . During the appointment , he reassured her that she would face no judgement - that at Have A Heart , you have a medical home . Weeks after her visit , over Thanksgiving , Dr . Imburgia received a call : it was her . Through the phone line , she revealed something sobering : he was the only doctor she had ever met that did not belittle her for her drug use . Her interaction at Have A Heart led her to check into rehab . Dr . Imburgia was beaming .
Fascinated with the heart , I have recently assumed volunteer and leadership opportunities pertaining to cardiology . Have a Heart is but one example . With each EKG reading and patient workup I can feel the pieces coming together . For the first time I can feel myself transitioning from student to doctor . Yet common to many medical students , doubt , the joy-stealing kind , has emerged . Does medicine need another brazen cardiologist ? Why should I spend life placing stents and prescribing pills for problems that are preventable with better policies , education and lifestyle choices ?
The night I drove home for the holidays was uncharacteristically warm for Christmas Eve . The warmth was welcome : I wanted the sanitized and cold world of medicine to melt away . I permitted my mind to ease . With the windows down and the radio up , my mind drifted to the spiked eggnog awaiting me at home — my heart became warm .
I was greeted at the front door by my twin brother and parents . Medical training can be a lonely enterprise the first two years , and this has only been heightened recently . How good it was to feel some family . My grandparents came up . Many memories , laughs and gifts were shared . Later at nightfall , Grandad excused himself as he needed to go check his blood sugar levels before bedtime . Being
the budding doctor , I decided to accompany him .
My Grandad is a hilarious , loving and easy soul , a straight shooter who wears his heart on his sleeve with a Diet Mountain Dew in hand . He is 72 and recently diagnosed with Type 2 diabetes with a history of coronary artery disease and hyperlipidemia . Tragically , even those close to you begin to look like patients .
We went into the guest bedroom , and he pulled out a black bag storing his glucometer and notepad . I could just about read a scribbled record of blood sugar levels . He winced as he pricked his finger , bright red blood appearing . At that moment I felt sympathy . Diets , pills , blood drops , recording , repeat . He was careful to drop the blood on the monitor correctly … wait … beep … 88 . Not bad . He expressed contentment . After writing the number down he began putting everything away .
We moved to the kitchen for a long conversation about diabetes . I asked him when he first thought something was up . We talked about all the symptoms , presentation , complications and medications . I relished the opportunity . We must have spent 30 minutes together . For the rest of the weekend , he couldn ’ t stop talking about how much he enjoyed our conversation . The feeling was mutual . It was incredible to feel years of learning come together in such a seamless , satisfying way with someone that means so much to me .
I went to bed that night and dreamed of how I could bring that conversation to others . How many other eyes could I light up ? How many connections could I make with a community to help them manage chronic conditions ? How can I better educate others on their health ? I am not prone to welcome racing thoughts . I didn ’ t mind these . There was passion behind these .
Weeks later and I was back at Have A Heart . I got to see my favorite patient : an impeccably dressed elderly gentleman who always wears a smile . Walking back to the exam room , my eyes caught the rustic brown cowboy boots he was wearing . Owning cowboy boots myself , I took the opportunity to strike up conversation .
“ Awesome boots there ! What kind ?” “ Tecovas !”
22 LOUISVILLE MEDICINE