Dr. Ryan Pfannenstein DPM is a phenomenal human being. Although I met Dr. Pfannenstein on one of the last days of my hospitalization, I didn’t know of his generosity until my follow-up appointments with him. Dr. Pfannenstein is knowledgeable, capable, and professional. He has such an enthusiasm for his profession. He is so generous with his time. No appointment is hurried. No question is unanswered. No fear belittled. No ignorance uneducated. All of his attributes are the cornerstones of a fantastic physician.

Yet Dr. Pfannenstein has something far more precious than these attributes. Once during an examination I had taken off my shoe and my sock and placed them on the floor. While talking to me Dr. Pfannenstein casually reached down and rolled my sock into a proper ball, placed it inside my shoe, and placed shoe and sock on a chair. This attention to detail seems superfluous but it is indicative of his manner. Dr. Pfannenstein reminded me of my innate dignity. I feel confident in his abilities. I feel assured of his compassion. I feel surety in his judgments. He has a fundamental decency that is exceedingly rare. Dr. Pfannenstein is the finest physician I’ve ever met. I am blessed to be his patient.

Whenever I feel the stress of life or the pressure of perseverance and I’m tempted to smoke - I remember Dr. Pfannenstein. It would be so unjust to waste all his work.

February 16, 2007

 

I’ve received a request to be available as a resource for my observations and my experiences of the medical residents at Regions Hospital in Saint Paul. And although I welcome the invitation, I’m cognizant that my reflections will be reduced to a soundbite or a phrase.

There are four great components of the human spirit: the heart, the soul, the mind, and the body. Others may be argued but these four are deemed most essential. The heart is nurtured by our loves and our loved. The clergy tends for our souls. The educators instruct our minds. The healthcare professionals heal our wounds and our wounded. These disciplines often have disciples yet rarely receive adequate accolades. The least heralded remains the physician. Often criticized, always second-guessed, and infrequently emulated, their work is disparagingly labeled a practice. Yet their work remains imperative, demanding, and consuming.

I consider it a privilege to be at the inception of so many careers and of so many fulfillments of so many ambitions. I’ve glimpsed their foundation. I’ve viewed their formation. I’ve cheered their fruition. The grandest part of volunteering is meeting the residents and hearing their descriptions of the joys and the sorrows of residency and listening to their hopes and their aspirations. I’ve watched as they shed tears. I’ve spied as they shared smiles. I’ve heard as they stifled yawns.

As we begin a new political cycle, we’ll once again hear the clamoring for healthcare reform. We’ll hear a litany of its ills. We’ll hear the expectations of its evolution. Yet I’ll remain a steadfast advocate. I’ve seen the future of healthcare in America.

And he’s honorable. And he’s principled. And he’s noble.

Michael Reid, DPM
Kevin Broder, MD
Mark Connelly, MD
A. Duncan McBean, MD
Matthew Lehnert, MD
Joseph Dolan, MD
Chris Hilton, MD
Gabriel Dersam, MD
Heather Sutherland, MD

February 17, 2007

I was in Regions Hospital Gift Shop and an elderly man in a hospital gown sat in a wheelchair holding a pack of cigarettes in one hand and buying a candy bar with the other. The cashier asked him if he was supposed to eat the candy and the man looked up at her and replied, “I’m an old man. I can do whatever I damn well want.” As a middle-aged man I listened and thought he was right.

And then I walked out of the gift shop. As I walked to the front entrance I passed doctors in their lab coats, the staff in their scrubs, and the nurses in their smocks. And I had a moment of clarity. Yes; he can do whatever he wants. Yet while he does, he’s wasting all those people’s time. And although he has that right as an American, he isn’t right. And what of the rights of the healthcare providers? Do they have the right to expect a certain degree of participation from the patient?

February 20, 2007

The last couple of years I’ve had a series of health problems. Now I’m well and I’m healed. I’ve lost weight and I’ve quit smoking. I’m often asked how I found the courage and the fortitude and the endurance (Ok actually the exact question is: How’d ya do it?) And I’ve always replied: I’ve rediscovered discipline. I’ve remembered what was important. And I’ve remembered there’s an order of importance. And I’ve made myself adhere to that ordinance.

I’ve spent a great deal of time in waiting rooms and I’ve made a few observations while sitting there. I’ve met people. I’ve talked to people. I’ve listened to people. And I’ve learned from people. Most people don’t want to get well. Most people don’t want to heal. Most people are afraid.

As a man grows older, he says goodbye to more things more often. His circles of friends and relatives diminish because of death or because of migrations. And in direct proportion so does his circle of concern. Everything becomes more about him. He has more to be concerned about but fewer who share his concerns. When coupled with the fact that as he ages his body starts to decay, he needs more attention but finds fewer places to receive that attention. On the street he is unnoticed. On a street he’s not greeted. On a street no one knows his name.

Yet he is able to receive attention at a doctor’s appointment. At a clinic, it’s about him. At a clinic, they listen to him. At a clinic, they care for him and care about him. They look at him. They speak to him. They greet him by his name. Now as he heals, that access reduces. And then it’s back to the place where he was before. That place that held those bad habits. That place where he was alone.

Transversely as the health problems increase, so does the access to that care. And as trauma is approached, the circle of those who are concerned about the patient increases. He has more influential people caring about him in greater numbers until finally, the patient is the center of attention. I’ve heard so many people list a litany of their prescriptions as if they were battle commendations. They say that fame is more addictive than narcotics. Sometimes I worry that the healthcare crisis in America is more sociological than physical or financial. Perhaps laughter isn’t the best medicine; kindness is. And that shouldn’t be solely required from the healthcare field. It is required from society.

If you want to bring down the costs of healthcare in America – smile. Greet. Engage. You’re carrying a telephone everywhere you go. Call your parents and inquire how they are. Visit them. While waiting for a bus, or walking down a path, or shopping in a store - say hello to someone for Christ’s sake. Quit looking past them as if they don’t exist or staring at the sidewalk so you don’t have to meet their eyes. Put down your cell phone and talk to the human being who is standing beside you. You’re not standing beside just anyone. That’s someone. Say hello. It’s not too much to give. How much loneliness did you expect him to take?

February 27, 2007

I had a conversation the other day with a medical resident about the nature of trauma from a patient’s point of view. I think the mingling of shock & symptom comes as no surprise to anyone who treats or experiences trauma. And although I’ve never treated trauma and have only experienced it, I was surprised I felt both quite acutely and astounded that I felt an equally intense degree of shame & humiliation.

I think when one is facing an emergency room doctor and is required to explain the habitual behavior or the humiliating experience or the accidental occurrence that resulted in the visit, the complete lack of control coupled with the acute sense of shame that the patient feels is stunning to his senses. And that’s why recovery and rehabilitation takes so much effort. I had to heal myself physically and change habitually concurrently rediscovering dignity and reincorporating self-respect. And this isn’t an endorsement of holistic medicine. I’m an advocate of conventional medicine. Nothing heals the body with more entirety. The heart and the soul and the mind aren’t its responsibility. It’s ours.

* I offered this ad as an intellectual endowment to HealthPartners. They began an expansion and the ad addressed the issue of the relocation of the emergency room entrance. They passed. I don’t know why. It’s definitive.

March 4, 2007
I recently offered gratitude to a doctor for his assistance and his support. He deflected my praise with the statement: “Well I didn’t do anything except what I was supposed to do.” And that’s exactly my point. Most people never do what they are supposed to do. They only do what they have to do. They do the minimum of what is required for completion of the task. And they only do that minimum so that an adverse consequence isn’t the result. And that’s called successful. “He did what he had to do” and the result was a successful outcome. A certain degree was met in order for the completion of the task but nothing more than that basic criterion was fulfilled.

We excuse the one who performed less than he should have performed with the sentence “He did as much as he could do” which justifies that gap between the best the task could have been done and the degree the task was actually done. This suggests he was incapable of doing more than he did and incapable of doing the most that could have been done. And although he was judged incapable, we’re satisfied he did as much as his capabilities. So he gave effort even though he wasn’t the most effective. And since the end result was a completed task without adverse consequences, it is good enough. And although the implication is that another man could have done more, we’re satisfied that the task was completed.

But doing what one is supposed to do is heroic. It means that one has not only met the lowest denominator of expectation for the task to be considered completed, but has accomplished the task to the degree in which the task should be completed under perfect circumstances. So, having the task completed is the goal and that deserves our gratitude. But it doesn’t deserve praise. Praise should be reserved for a raising of prayer in thanksgiving. Pray + raise = praise. Therefore when you find someone who accomplishes the deed in the manner it should be accomplished, you should praise him for exceeding that goal. 

So I offer my genuine gratitude and my heartfelt admiration to Dr. Michael A. Reid, DPM. He is a constant reminder of the kind of men we’re supposed to become. It’s rare to meet a man who steps up to the bar when it’s required. Yet it’s phenomenal when a man not only steps up to that bar, he actually raises it. And it is in those moments that we must bend our knees and bow our heads and offer our thanksgiving.

March 8, 2007

I offered this as an intellectual endowment to the HealthPartners Otolaryngology Department because I think Derek J. Schmidt, MD is one of the greatest guys.

March 10, 2007

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