‘We Still Love What We Do’

A Letter to the AAFP President

We thought you’d appreciate the sentiments shared in this letter received by Wanda Filer, MD just after she was installed as the president of the American Academy of Family Physicians. The Keystone Physician staff has kept this piece in its original, unaltered, unedited form.

Dr. Filer,

Congratulations on your new appointment as AAFP president. We look forward to your representation of our specialty at all levels. As a rural family doctor with 28 years’ experience, I want to share some thoughts with you as you prepare for the Southern Governors Convention, sentiments which I am sure you likely identify with.

Family doctors are not satisfied to make a comfortable living and live in a nice house. We stay up nights delivering babies. We lay awake sorrowing over our patients. We laugh with the joys of our patients, we weep with their sorrow, we suffer with their pains.

We humbly rejoice in diagnostic and therapeutic triumphs and we carry our failures with us, vowing to learn from our mistakes. We are human beings who are transformed by human suffering into compassionate, caring professionals who see our patients as whole persons. We are the humble powerhouses of a healthcare system that can hardly be called a health- since it is based on disease; care- since it has become about profit; system- since it is a quagmire of multiple insurance and government programs whose agendas and rules and formularies are enough to make a grown man cry or find something else to do- except for this one thing.

We still love what we do. In a quiet moment sitting with a suffering human being, a mother, a scared child, a dying grandparent, an emaciated, diaphoretic heroin addict, we remember with gratitude why we chose this path. We see in every patient another chance to lift up, to provide value, to bind the wounds that cause us to suffer, to inflict grace on another human being.

We work in some of the most remote places to help the most vulnerable. We place ourselves in harm’s way here and across the globe for a chance to help someone in a refugee camp or a slum or jungle clinic whom we have called our patient. We do this for the sake of a calling, a dream to make the world a better place. We are not often recognized as heroes, but we are. Our reward is not in medical insurance form that is completed nor a meaningful use box that is checked nor in a paycheck , but in a life that is restored to humanity.

I was driving past our county jail a couple of weeks ago. From the corner of my eye I saw a young woman pushing a baby stroller. The sight of her brought a smile to my face because I know her. I first met her a year ago, on the other side of those locked jail doors. Her hair was a rat’s nest, her teeth falling out of her mouth, emaciated, tremulous, pale, sweating. She was pregnant for the eighth time, her first seven sons all in foster care due to her addiction. We are piloting an intervention for narcotics dependent people in jail, so I asked her if she wanted to change her life. I brought my ultrasound to the jail to examine her unborn baby. She made a decision to change the direction of her life and to step into recovery.

She has been clean and sober since, and for the first time this year she is experiencing the joy of being a mommy. I think you can understand my smile, seeing her walking behind her baby stroller. She has graciously agreed to be our keynote speaker for a healthcare summit this week, a grassroots meeting to bring our communities together to discuss health disparities that are causing human suffering, but are typically unattended in the usual clinic model- homelessness, poverty, unemployment, mental illness, broken families, despair, marginalization, addiction.

Family doctors are in the business of transforming lives. We see as our patients not only as those who come through the doors of our clinic, but also those who cannot. The marginalized, the uninsured, those whose thinking is chaotic and unsound.

You will find us in the most unlikely places, in our jails, in our streets, in refugee camps, in the backwater clinics and hospitals across this globe, and in the audience of governors and lawmakers. We are here not because we particularly think that our trade will be enhanced by further legislation, but because we are the voices of the voiceless.

We have carved out a place for them at our tables, and because they are our patients, we cannot lay down our charge. We speak to you because they cannot come. I hope that you hear us and help us to build a more equitable system of healthcare where every person has a seat at the table, and where family doctors play a central role. Having a personal doctor who knows you and cares for you is still of great value.

Barry Bacon, MD
Colville, WA