An important lesson learned

At age 19 I was finished with Army basic training and went to Advanced Individual Training.  First, it was a few weeks of leadership school.  I learned principles like “Never let the sun go down on a man that hasn’t been paid.”  We learned basic marching skills for the person in charge as we were shortly to be tasked to march men to class, chow and medical appointments for shots.  We were going to be Sergeants in every-way except pay.  We would still be paid as privates.  It was the Army way.  They needed a principle like pay a man for the job he does and not for the rank he holds.  Never Happen! 

I learned an important lesson there.  We took a drill leadership test.   We individually marched a platoon of men through a maze.  When we each finished we were taken aside, critiqued and given our grade.  I did it perfectly, my proctor said so.  Then he said something that shocked me.  “I am giving you a D.”  Knowing I was shocked he continued,”You are getting a D because you did not care about those men, only about you.  What good is a great performance if you hurt someone.  Leadership is about them, not you.”  He could not have made that lesson stick any better.  I am aware of it everyday.  By the end of the summer I was a 91A10.  91 meant medical, A meant basic medic and 10 meant I did not speak a foreign language.  Before I got out 3 years later I would move up to 91C, a more experienced medic with 12 months training instead of just 10 weeks.  I loved it once I quit fainting.  One day, learning to treat badly burned patients, I fainted 4 times while trying to observe and learn how to do a cut-down to start an IV.  I was pretty much over it after that day.  I worked the hospital side of things and the emergency side of things.  I learned a lot and did a lot.  There are some rides in small planes not worth remembering.  I gained skills in suturing, starting IVs, splinting and casting fractures, taking x-rays, and general patient care and recording my visit in a medical record. 

 An Encouraging Word

The Docs I worked for were complimentary and encouraging.  You ought to go to med school they said.  They would not accept my bad grades as an excuse not to try.  Don’t go if you don’t want to, but don’t use an excuse to not do it they told me.  No one had displayed that kind of confidence in me before.  My Uncle had encouraged me to become a diesel fuel injector mechanic (indoor work, clean environment, new technology in 1968) which was as big a picture as he could imagine.  I listened, discussed it with my best friend and over my wife’s objections, got out of the Army when my hitch was up and headed back to college.  Not in Pennsylvania, but in Utah, where my army buddy was in school at Utah State.  I had never been there, but off I went with a child and a pregnant wife, no health insurance and no job.

 When the wind dies - start rowing

I solved each problem as it came up, except one, my wife’s fear and pain which lasted our whole two years.  It was easy compared to the next two, but the toughest we had ever had.  She got pregnant again while we were there, carried it for over 20 weeks bleeding the whole time.  She went into early labor, had to have a blood transfusion, and delivered the baby, who did not live.  No cold winter day was as cold and bleak as the next week or two.  It got better for me, but not for her.  She still does not like Utah.  When we eventually divorced, she still had that pain influencing her feelings many years later.

I wasn’t going to make it to med school for a number of reasons.  I was looking for an alternative when I remembered a Sargent I served with showing me a catalog for a new program at Duke University called a Physician Associate.  I had seen it once, didn’t know where Duke was, or if they were still doing that new stuff.  I investigated, found out the Univ. of Utah had a similar program but was rejected when I applied.  I was an alternate.

Next year I applied everywhere including  Duke, Wake Forrest, Oklahoma and  Western Michigan.  I got interviews and acceptances to every school.  I went to Duke.  Walking to school in 20 below zero weather, a month (Feb 75) with a high temp of 5 below, working nights in a meat packing plant, it all seemed worth it except the outcome of that third pregnancy.  We moved in August 76 after selling everything except our clothes, dishes and vacuum cleaner.  We sold our car and drove one given to me, a 10 year old Buick Electra without a key.  I used a padlock and hasp to lock the driver’s door and pulled off the coil wire every night.  When we moved to Durham, it was stolen one night.  The case of oil I had in the trunk was more valuable than the car.  I bought a Renault with 180,000 miles on it for a few hundred dollars.  The guy gave me another one that did not run so I could use it for parts.  I patched it together for nearly two years until it caught fire and burned one day.  My two kids thought all the firemen and firetrucks were great.  Most of the time I rode a bicycle but on rainy or very cold days I rode the bus.  We ate mostly stone-ground whole-wheat, non-instant baker’s milk we mixed in a 5-gallon bucket, with a stirring apparatus powered by a hand drill, and honey from the end of the season that was black as molasses and cost $5 for 5 gallons.  Those were the staples and we spent $50 per month on groceries for a family of 4.

 ”Little Luke, never be ashamed of who you are.”                Grandpa McCoy

School ground by.  I had the ability to take a tough situation and make it intolerable.  Thinking that Duke was above me, and that they must have made a mistake in accepting me did not help me endure well.  When it was over, I left for my preceptorship and graduated in Absentia.  That means I did not attend graduation ceremonies.  The university mailed me my diploma.  A nurse I was working with asked me what the embossed area was on the corner, when I looked it said Magna Cum Laude.  Geez, I had graduated with honors!  From Duke!  O.K. celebration over.  I put the diploma in a box where it has remained except when I retrieve it to make copies of it to prove to a potential employer that I really have one. 

I worked for a year in Baltimore in a very eclectic practice.  I was the person who saw patients at the Baltimore County Jail, Maryland training school, Towson state infirmary, Covered the Towson State football, lacrosse, and soccer teams, made house calls, visited nursing home patients - lots of them - was an assistant field medical examiner (it was a trial then, PAs do it for real now in Maryland) and had lots of one time duties.  I got paid $9 per hour and made about $32,000 per year.  That represents lots of hours.  Eventually I moved to Newport, NC and became the “doc” in a rural health clinic.  I stayed 17 years and the clinic grew from a few visits a week to over 200 visits/week and required me and a full-time doctor.  We were both work-a-holics and when I left he had to hire two PAs to replace me.