My Change of Jobs

In the summer of 2007, I was approached by individuals from the hospital where I had done my residency. The main faculty that supervised and ran the Family Practice Residency were having some changes in their situation, and were going to be unable to maintain that relationship. My former program director knew that I had an interest in medical education, and so convinced the hospital to recruit me to maintain the program.

I was not unhappy at my job at the Arrowhead Clinic. In fact, I loved it, and to this day think it is one of the best places to work as a Family Physician. But opportunities to enter medical education, especially after only two years of practice, and even more as an assistant program director, come by very rarely, and it was an opportunity that I couldn’t pass up.

The negotiations resulted in significant sacrifices on both sides, but at the time, the financial sacrifices seemed worth it to me to get my foot in the door of medical education. Unfortunately, the specifics of the contract, the promises and visions of the original discussions, and the realities of the hospital and practice situation on the ground never quite aligned.

The hospital is going through another consolidation, and although I firmly feel that the hospital is now firmly on the path of stability and growth, the uncertainty, combined with a general decreased interest in Family Practice and questions over faculty staffing, resulted in there being no new residents.

In September of 2007, I became the sole attending physician of the residency clinic, thus providing temporary stability to allow the current residents to complete the year. At the end of June, the senior resident graduated, and the second year resident decided to complete her last year under the supervision of the original faculty that she had signed on with in their private practice. Thus, right now I am the only physician seeing patients at the residency clinic. Occasionally there are students or first year surgical residents, but no family practice residents. Not exactly what I left a great practice in Newcomerstown for.

The intensity of a clinic population, that is very heavy laden with complex internal medicine patients, non-compliance, and economic barriers to the care I have been trained to offer, is taking its toll on me. Ideally, I would like to have my own private practice part time, and rotate with other teaching faculty into the teaching clinic. I think the stability of the hospital combined with a diverse and committed teaching faculty would allow the hospital to successfully recruit new residents.

The practice has a new Practice Manager, and the consolidation will be completed early this month. The administration is working on making the necessary investments, recruitment, and changes necessary to successfully rebuild the residency program. I remain hopeful that my move to my current job will bring forth great fruit.

A Forced (but needed) Respite

It has been way too long in writing. I have needed to write, not just to update a little-read blog, or even to update the few friends that read this blog. No, I have needed to write as a process of digestion of what has occurred in the last several months.

As I start writing this, I am in the Atlanta airport, waiting for a connecting flight from Akron to Phoenix. It has been nearly one year since I have been back in Phoenix. That was a relaxing week spent with my family in the White Mountains of Arizona, and I think fondly on that week. Due to a variety of circumstances which I hope to elucidate in the next several posts, I have not had the vacation time nor the money to travel much in the last year, much less get back to Phoenix. I would not be making this trip now to spend over a week in Phoenix if it were not for the fact that my dad is having his hip replaced on Wednesday, September 3, and he paid for me to come out to be with the family during this anticipated rough week.

So, this was an unexpected respite, but one that is greatly needed. There is not a whole lot planned for much of the week, and I hope to spend much of my needed down time blogging about the last year. Topics I hope to touch on, if ever so briefly, include:

1. My best friend’s theo-philosophical journey
2. A huge job change and transition
3. A fun “business” trip to Denver with two great friends
4. My relationship with my wonderful girlfriend, Carey
5. The attempt at selling my house and future plans
6. Provoking thoughts about regarding theology provoked by a history book
7. My philosophical wranglings with atheism
8. The state of my spiritual journey and exciting trajectories
9. Thoughts about Obama and Palin in the current presidential races

This is an ambitious list, and I’m not likely to get to all of these, but by listing them, it provides a goal. Hopefully, this exercise will provide some clarity on some of these issues, for me if not anyone else.

Time of Reflection: Part 3

Cacophony Number Two: Event Horizon Fugue
(written December 2007 by Tony H.)

SOPRANO

He looks into the pleading eyes
Of a man. But barely.
The North Star is only a faint
Flicker - among many.
Though, without a ship, it matters
Little. Did it ever?
What do you plead for? Answer me!
Faith? Hope? Love? A forever?
His anxious silence - maddening.
His cause - captivating.

His voiceless mouth and screaming eyes
Peer back from the mirror.

ALTO

Silent tears fall, the world he knows-
Explicitly therapeutic?
Emotion, manifest sorrows?
Excretions, the eye's sole tonic?
Expected, a behavior learned?
Expression of a soul just turned?
Preposterous!

TENOR

The sands of Time could not erase
the clawing hands, much less the face.
A monument to guard the Nile,
a figure of hubristic wile.
Though sand did hide, the past - forgot;
it waited there to be resought.

In holy zeal for the Great Disc -
or shrewd scheming in politics -
A city birthed upon the Nile,
soon razed to earth with jealous bile.
Amarna's fate for years unknown -
now naught but dust where once it shone.

A mountain tomb for all to see,
a monument of vanity -
Though once the home to king, and gold,
expected peace as they grew old,
The great facade is empty now;
a hope destroyed, a pointless vow.

Though young compared to all the rest,
it may have been the nation's best.
Its hallowed walls upon the sea
encompassed all Humanity.
But all it took was one small flame,
and Man's grand trove was gone in shame.

My query should apparent be,
of all of these, which one are we?

BASS

a trust a knowing deep inside
a faith somewhere within me hides

a future landscape far and wide
a hope somewhere within me hides

a warm embrace where peace resides
a love somewhere within me hides

experience the flow of blood

an unseen force to walk beside
somewhere spirit within me hides

two friends by choice pneumas entwined
somewhere friendship within me hides

one soul by choice bodies entwined
somewhere marriage within me hides

experience the flow of blood

Time of Reflection: Part 2

Cacophony Number One: Heart Song
(written somewhere between 1993-1995 by Tony H.)

SOPRANO

no one understands
how could they?

yet how is it that we
are able to hide
the Sun?

are we that blind?
or have we just learned
to shame the
Great Wall?

one was brave
taking up his chisel
a chip from
the Wall

but with his one blow
a breech was born
a glimpse of the mountain that
reigns beyond

will we just place
another brick in
the Wall?

ALTO

isn't it frustrating?
do they see can they hear

the roaring waterfall

springing from the mountain

rushing to offer itself

only to be damned by
the Wall?

TENOR

the Passion burns within
and yet only flickers are seen
a silly laugh a common meal
words shared...barely
hug and holy kiss...rarely
we await the hour
when the Lord in His day
fans the flickers into flames
an unhidden passion that will incinerate
the Walls
as we share in the love
the Perfect
Love of God.

BASS

i can't always say it
i don't always try
i thank my brother
for saying it so well
the Passion i have
i through Christ have for you

You my brother

You my sister

all my beloved

and though we may be apart
in body or spirit
know that we are
One
in Him.

CHORUS

the most harlotted word
the most sacred word
i share all its holiness
with you

I Love You.

Time of Reflection: Part 1 - READ FIRST

Although I am an emotional guy, I, like many MBTI Thinkers, have problems comprehending and understanding these emotions, much less expressing them. Occasionally, I have used the process of writing to sort through these emotions, and in the end, to express them. Recently, I have been going through a lot of inner reflection (hence the relative quiet on the blog).

In the process of churning through some of the emotions, I went back and read some old writings, and came across a couple that I will share. One is a short reflection that I will share in a later post. The other was a poem written years ago that inspired the form of my most recent emotional exploration.

I share these humbly, knowing that I am no poet (nor a good editor).

My head hurts... (A poly-rant)

I think it is from too much thinking. Or, perhaps, from too much deconstructing. There has not been one area of my life that I have not been analyzing, struggling with, or learning from. The constant challenges at work, the uncertainty of work and healthcare in general, relationships, church, spirituality.... all of these things have kept my mind spinning. So, I thought I would share a few random rants and thoughts... to give a taste of my thoughts lately.

... Stark County (and Ohio in gereral most likely) is very parochial, and if it is going to be successful, the hospital of Western Stark county must understand this and play into that. Even if it is owned by some corporate "outsider" monolith, that doesn't mean that it can bring outside "expert" help and get positive results. "All politics are local" is a famous truism... so it is with healthcare. I need to be on a guidance board... ;-)

...When you have a paradigm shift, it is truly like Alice in Wonderland (or the Matrix, if you prefer): Once you have taken the red pill, there's no going back. So, as I look at what Jesus says, I'm struck more and more by the fact that I've had it wrong all along. When Paul says, "There's no other name in which you are saved," I now wonder if he meant that in the literal, immediate since which the context seems to demand. When Rome invaded Judea, historically, no Christians were killed, because they all believed in Jesus and his message, and fled, allowing utter destruction to come upon the Jews (unfaithful Israel) alone. What does such a statement in such a context mean for me, today? (Lest any flip out, I do think that there are important ways such messages speak to us today, but I no longer look at it in the direct way that I used to.)

...I love curriculum development, educational planning, and assessment models. If I had the resources and unlimited reign... (since most of you who know me are cringing at the thought, I will not dwell on that blessed (or cursed) state of affairs!)

...Why do people hate change??? I'll never get it. No matter how fast or slow it is presented, there are always gripers. If something doesn't work, then change it. If that doesn't work, change it again. Oy. What's the big deal?

...Why do relationships have to be so difficult? Why did I have to be born in a generation that has watched our parents' marriages fall apart, and in fact watched many of our generation endure divorce? Can I, and others, be blamed for our "gun shy" attitudes about marriage? Why do I have such a hard time opening myself up... to joy, but also hurt? (There's the answer, eh?)

...How can I sustain my singleness much longer, when I am increasingly feeling "traditionless?" Though I have the best friends and circle of spiritual family that a person could want, I nevertheless am not integrated into any one family unit's tradtions. One family has a tradition of getting a tree, decorating it, and watching a certain movie together the day after Thanksgiving. My best friend did something similar with just he and his wife. That is a very exciting, and warming, tradition, one that don't have any share in. I actually nearly broke down on Sunday while singing, because I suddenly realized that the holidays make people feel lonely not because you don't have someone, but because you don't have any one to share traditions with. I have been struggling with whether or not to put up a tree this year. I struggle each year... the last two years I have put up a "blessing tree" where I decorate it with "blessing ornaments" from years past. But I have no one to put it up with, no one to share the past blessings with, no one to enjoy the warm feelings that the glow of a tree at night produces. While thinking about all that, I thought of my grandma, whom I love dearly. Every year, she decorates here little apartment with lots of Christmas decorations, and puts a little ceramic Christmas tree up. No one shares in that, at least no one person or group of people in a regular way. She's be a widow for decades... the loneliness of it all, and the fact for the first time I could relate, nearly brought me to tears.


...I currently have asthmatic bronchitis... I have never really wheezed before, and it is a vulnerable feeling, the physician being a patient. Plus migraines... oy vay. (which, as I recently discovered thanks to Carey and her "Joy of Yiddish" book, literally means, "Oh the pain!".)

That's enough. I have ranted long enough. Indeed, my head hurts.