INNOVATION AND CHANGE
Still Changing
This article is in response to an article previously published in Louisville Medicine in 2010 by the same author . The original article can be found on page 14 .
by MARTIN HUECKER , MD
Reading this essay from 2010 reminds me that the only constant in life is change . It ’ s easier to observe what has stayed the same . All the emergency medicine physicians are still around ; most continue to teach residents and students . I still have a hard time calling some of them by their first names . They continue to impress me , perhaps more now with their depth of knowledge than breadth . As both specialists and generalists , we strive to be well-rounded , “ I-shaped ” individuals the way Flexner 1 intended . I am grateful for my fun , creative , tireless wife ; my bright , inquisitive and hilarious children ; and the rest of our families who have supported us as we made sacrifices for careers in medicine .
What has changed ? Lots . Paul Rychwalski moved to the United Arab Emirates as a faculty member for the Cleveland Clinic . Many times , I have repeated that “ busy person ” quote from his email signature , but I misremembered it . I have been saying “ If you want anything done , ask a busy person to do it .” I like the 2010 version better . Rahul Bhola , who took over the pediatric practice from Paul , operated on my son , twice . He moved on to UC Irvine . Regarding that eyelid lac repair on my friend ( that healed nicely ), I found out sad news years ago . After a winding route to a career in medicine , Eric Schweitz practiced in California until a tragic motor vehicle accident . He died 2 in 2009 , but I hadn ’ t heard the news .
The UofL emergency room has also changed in many ways . We have a new chair , Jeremy Thomas , who picks up weekend and holiday shifts and believes in old school autonomy for residents and faculty . Dan Danzl is now chair emeritus and continues to be a cool dude . 3 Our program has expanded by hiring several uniquely skilled new faculty members . But we have been fortunate to retain the ones who know they better not retire yet . The ER is still my favorite place in medicine , but I have branched into other directions . I led didactics and spent a few years as assistant program director , but now focus on research and wellness . We run a wellness journal and plan to offer a wellness fellowship next year . Each member of our three-person research “ wolfpack ” intrinsically enjoys the work and the many hats we wear . We recently secured grant funding to continue studying an innovative technology 4 that determines ejection fraction , fetal heart rate , COPD and more with a standard cell phone .
Since 2021 , I have treated patients in an integrative medicine practice . 5 Its geographic and metaphorical distance from EM demands a massive amount of studying . The patient-doctor relationship looks quite different with regular patients of my own . Now I understand what you all have been talking about ! I used to claim that no person in Louisville called me their doctor : untethered , but maybe dislocated . Now I feel proud and grateful to hear their stories and partner with them as they seek optimal health . When considering new professional opportunities , I still consider how far this thing will take me from the bedside , from working on a team to help a vulnerable human patient .
Another constant since 2010 is a gravitational pull back to writing . I love the engaging flow experience , but writing is often the most challenging and humbling part of the job ( especially when that manuscript comes back from reviewers ). Perhaps most striking about the 2010 essay is how clearly a different person wrote it . Heraclitus wrote that “ No man ever steps in the same river twice , for it ’ s not the same river and he ’ s not the same man .” It is fascinating to review not just what our past selves thought , but how they thought . Looking back for narrative anchors in these rapidly passing 13 years , I see squandered opportunities for reflection because I don ’ t keep a journal . I am lucky enough to follow a trail of periodic essays and a few years of monthly newsletters 6 intended to help colleagues escape the tunnel vision of medicine . But these lampposts would be so illuminating if I wrote more . Do you feel the same way ?
ER docs notoriously lack patient continuity , but we do have continuity with residents , nurses , coworkers and other physicians . GLMS remains a glue for the broad network of doctors in town . I am still excited for each new issue of Louisville Medicine , to see what our colleagues are going through . We write about the great fortune of finding true vocations that focus on healing people instead of managing stocks , bonds , cars or politics . But we also write about our constantly changing selves . We share the stories that shape us and the important people in our lives , people that medicine tries to pull us way from if we aren ’ t careful .
References
1 https :// www . ncbi . nlm . nih . gov / pmc / articles / PMC7253148 /
2 https :// www . legacy . com / us / obituaries / louisville / name / eric-schwietz-obituary ? id = 23873580
3 https :// pubmed . ncbi . nlm . nih . gov / 32336381 /
4 https :// www . tele-stethoscope . com /
5 https :// www . ihsmed . net /
6 https :// practiceofwellness . com /
( original article on page 14 ) December 2023 13