The Art of Medicine

http://www.youtube.com/watch?v=5cvHgGM-cRI

Actually, I could have called this blog "Dr. Pamela Wible MD", and it would have been just as accurate.

Dr. Wible is a general family physician practicing in Oregon, who, along with her TED talk, has also written a book called 'Pet Goats and Pap Smears'.

Every physician must read this book, for their own health and humanity.

Every patient must read this book, so that they can give it to their own physicians.

Pamela is the extremely feminine version of a cross between Patch Adams, Bernie Siegel and Seinfeld's Kramer.  She is an incredible mix of zany, hilarious, beyond loving, and real;  I mean really real.  Her unique authenticity is unparalleled in any health practitioner I have ever come across in person or in written word.

This book is worth getting just for reading the section alone, entitled "My favourite phone message".  When I reread it even now, I still laugh.

The true stories in this book are filled with compassion, laughter, sadness and most of all, loving authenticity.  As I watched the TED talk and read her book, it was so very clear to me that the relationship Pamela has with her patients and the physicians she supports, is built on profound trust and love.  The flavour of the medicine she delivers to her patients, and the lifeline she extends to her colleagues, comes with the added bonus of this slightly altered 1 Corninthians 13 verse:  Love is patient, love is kind, it does not envy, it does not boast, it is not proud, it does not dishonour others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs, it rejoices with the truth, it always protects, always trusts, always hopes, always perseveres, never fails, - and is creatively zany.

I remember going through naturopathic medical school, and a classmate verbosely marveled at how there was such an incredible creativity to the art and practice of medicine.  Frankly, back then, I didn't see it at all.  Twenty-five years later, I still didn't see it, until I saw and read Pamela Wible in action.  From the gift-basket offerings she gives out if she is late for patient appointments, - to balloons and lipstick kisses just-because, - to pap smear parties, - and to even the contemplation of a clinic pet goat, - after learning about her, I had a change of heart in the way I saw the possibilities for creativity in the practice of medicine.

While I can't say that I have ever brought any profound creativity in my approach to medicine over the years, I am blessed that there have been many patients who have trusted me enough to have brought their own brand of creativity and laughter to my practice.

Many years back, I was almost rolling on the clinic floor with laughter.  So the story goes:  I'm administering intravenous therapies to a room full of patients.  While I'm taking the blood pressure of an older gentleman, he whispers to me in a serious tone, "Kathy, I think you'd better go and check your bathroom".  With a concerned look on my face, I quickly make my way to the bathroom.  There, I see a huge pile of poo on the floor beside the toilet.  My brain is racing a million miles an hour.  OMG.  Which patient did that?  Is he or she that sick and missed the toilet?  I quickly do an internal mental scan:  everyone's vitals are good, everyone's level of consciousness is good, no one has any disconcerting symptoms.  Who the heck did that?  I am worried sick and I quietly remain in the bathroom trying to figure this out.  I decide to clean the mess up before I head back to the treatment room.  Donning my latex gloves, I proceed to pick up the poo with paper towels.  Immediately upon lifting the feces, I realize that it's a realistic plastic dog poo replica.  The joke is on me, and when I start to laugh, the entire treatment room breaks out in laughter.  The older gentleman says that when he saw the plastic replica on his trip to Las Vegas the month before, he thought of me.  As funny as that sounds, I saw this as an incredible compliment to how comfortable he felt with me in order to have played his practical joke.  All of the other patients, after their raucous laughter and being in on the joke, were feeling exceptionally well.  I'm sure that it had little to do with what was infusing in their IV bags that day.

Creativity isn't the only reason I am enamoured with Dr. Wilbe's work.  Her authenticity is mesmerizing.  In Pet Goats & Pap Smears, there is a section called "The Raw Truth".  In it, Pamela queries why she is a doctor.  These are the most honest and profound words I have ever read, coming from a healthcare practitioner.  Buy the book and read it.  You will be amazed.

In trying to answer for myself the question of why I am a doctor, I wonder if I will ever come close to expressing a fraction of the authenticity exuded by Dr. Pamela in "The Raw Truth".  Beyond my reasoning for having entered the field of naturopathic medicine in the first place, I suppose I would say that I continue to practice medicine because of my belief in the best quality of life for all people, including myself.  I'm pretty much a bottom line person, focused on patient outcomes, wellness, well-being and the success or failure of those, no matter the type of treatment administered.  I am not married to a particular medical philosophy, science-based, or otherwise.  I am married to the idea of the best quality and longevity of life possible, that any type of medicine can offer.  Failure of treatment is what initially led me to explore naturopathic medicine, after having been steeped in conventional modalities for a decade previous to that.  And later on, failure (and lack) of treatment for my mom who died of ALS, at times, still breaks my heart to this very day.  And now, failure of treatment in the occasional patient who has sought out every form of medicine on the planet to no avail, and then has landed on my doorstep with hopes that I cannot fulfill, leaves me empty.  I am a doctor who has not yet realized what Dr. Pamela Wilbe knows to be true:  that medicine and healing are a journey and not endpoints.  She has learned, preached and written about, what I long to learn in medicine:  that sometimes love is enough.  People die, people become ill, people are in pain, and occasionally, there is nothing anyone can do about it.  In these cases, love has to be enough.  I'm not there yet.  I'm still traveling that road.

I can't leave this blog without mentioning the section in her book called "Bambi Syndrome".  As a new born-again dog lover, I cried while reading this chapter.  To my 2 friends who are the most stellar dog owners in the entire universe, Pamela rivals your commitment to man's best friend.  You both have to get this book just to read this chapter!

For me, Pamela serves as a model for the practice of medicine.  While I have no pet goats, I do have a very cute goldendoodle that looks like a sheep and comes with me to the office each time I'm there.  And I stopped doing PAP smears decades ago when I realized that it was more affordable for patients to let the Canadian government pay for this type of screening done by MDs than to pay an out of pocket expense to me.  I do however, ensure that all women are up to date with their PAPs, and for those women who "do not believe in PAPs", I counsel them for up to an hour at times;  - some women have a change of heart and some do not.

Medicine is replete with science and necessarily so.  Medicine can also be replete with humanity.

If there was a Nobel Prize for Loving Authenticity in Medicine, Dr. Pamela Wible MD would be a shoe in.