Showing posts with label medicine. Show all posts
Showing posts with label medicine. Show all posts

Friday, June 15, 2018

Three Things


My father told me three things he would later come to regret. 

Deer Diary

            Usually it was my habit of ignoring his instructions that made him angry. Actually paying attention to his counsel, then applying it in ways that he did not expect or approve of, that’s what really put a burr under his saddle. The saddest part is, upsetting him was never my intention. It just seemed to happen regardless of my behavior. 

            Dad seldom gave advice. He preferred directives, usually preceded by the phrase, “You’re doing that wrong”, or “Here, let me show you something”, which was really just his other way of saying, “You’re doing that wrong.”

            The most useful and lasting advice Dad had to offer came from his candid observations.

            He couldn't go into a McDonalds, for example, without marveling at the organizational efficiency of the place. He always commented on the unidirectional flow of raw materials from the back of the building to the front, with value added along the way. What didn’t go out the front doors and into waiting cars, he noted, was neatly channeled into trashcans, and finally cycled in an efficient stream to the dumpster out back. Every action, every stop along the way was planned and executed for maximizing profit. He all but glowed over the prospect of cause, effect, and the managerial control that made it all work. 

            This marriage of knowledge, organization, and administrative power were epitomized by the university medical center where he worked, personified by the doctors whose budgets he managed, whose retirements he planned, whose paychecks he signed at the close of every month. 

            Dad practically worshipped order and control. His professional world functioned according to plan, with strict adherence to the dictates of established processes and concrete calendar deadlines. Things worked because people worked to keep things working. It wasn’t supposed to be fun. 

            Creative endeavors were a sideline, to be indulged only after the real work was finished. Even then, creativity should be productive. Practical. Exploration for its own sake was an unsupportable proposition, indistinguishable from play – which is why his occasional epiphanies to the contrary stood out in such stark contrast to his overall worldview, and carried so much more weight.

            Of the many opinions, directives, examples, orders, platitudes and heartfelt paternal memoranda Dad offered over the years, only a few somehow found their way through my adolescent armor, took root in my mind, and burrowed in to stay. They may have been issued from his castle of practical conservatism, but once filtered through the rebellious prism of my rationally contrarian personality, these three recommendations did more to convince me to pursue my own devices and fulfill my personal, creative agendas:

1. “An academic degree is like a bus ticket. If you don’t want to go where the ticket takes you, there’s no reason to waste your time getting it.”

2. “Most people are too busy making a living to ever make any money.”

3. “It doesn’t matter what you do for a living, as long as you can pay the bills.”


“An academic degree is like a bus ticket.”

  
            Academic medicine is a process marked by an endless series of milestones: diplomas, degrees, certifications, fellowships, continuing education and re-certification programs. After medical school comes the residency match, the pyramid system, and specialty board certification, followed by competition for positions in fellowship programs, election to national and international specialty colleges and professional societies, and hierarchal status within these same organizations. The academic career track provides even more markers of success (or lack thereof), in research and publication, assistant and associate professorships, committee assignments, and department administration. 

            As a surgical intern, all of these opportunities were laid out before me. If I worked hard enough, kept my nose clean, kept my mouth shut, did everything I was told without complaint, anticipated pitfalls, kept up with my reading, and behaved responsibly, one day I could make it all the way to Chief Resident. I might be offered a fellowship, then asked to stay on as an attending physician, and work my way up the academic ladder. If I proved to be good enough at medicine and politics, I might even enter the realm of administrative decision making.

            Yes, the road to being a surgeon was rough. I’d worked hard to buy the ticket, and found my seat on the bus. Once I got far enough along the path to see where that road was leading, though, I decided I didn't want to go there after all. 

            Why? In a word, it wasn’t fun.

         (“Work isn't supposed to be fun! That’s why they call it work!”)

           I needed a ticket to an enjoyable life. I didn’t need a ticket to academic surgery. So why not go for a solo practice? Just hang out my shingle and …

            Non-academic practices have pecking orders that rival the educational model, with rewards correspondingly based on competitive performance and supervisory review of board certification, licensure, association membership, continuing education and hospital affiliation. In addition, a solo medical practice offered all the hazards and pitfalls of self-employment plus the added burden of malpractice liability - without any preparatory business training, and peoples’ lives hanging in the balance. 

            I didn’t want a ticket to go there, either.

            So, what do you do when you buy a ticket, let it take you where you thought you wanted to go, then find out upon arrival you don't really want to be there? I’d earned my ticket to medical school, and gave doctoring my best shot. More important, I took an oath as a physician, and I meant it: Primo Non Nocere (First, Do No Harm). If my heart wasn’t in it, the most responsible way for me to do no harm was to exit, stage right. But if you do that, what is waiting for you in the wings? Are you allowed to get a ticket to someplace else? And if so, where did I want to go? 

            I didn't know. If only my dad had offered some guiding insights for the uncertain traveller…


“Most people are too busy making a living to ever make any money.”


            Dad’s general philosophy allowed that people who worked (to keep things working) did so grudgingly, and only because it was the only way they could put food on the table. Most people, in his view, were lazy, and, given the opportunity to stop working and sponge off of society, would do so at a moment’s notice, and happily keep at it for the rest of their lives. This was fact.

            But he could also see that doing right by society, holding down a regular job and providing your family rarely allowed anyone to get ahead. To become wealthy, you had to have an angle. You had to be clever, and work extra hard to come up with an original idea, then develop and promote that idea until it finally paid off.  

           He wasn’t talking about pipe dreams. He was talking about ideas that had real potential in the marketplace. Unfortunately, he noted, few people had the time, the energy or the intellectual and financial resources to take a concept from the idea stage to the store shelves at Wal-Mart.

            If people are too busy making a living to accumulate wealth, it follows that someone intent on moneymaking should not worry so much about the day-to-day cares of bill paying. Rather they should lower immediate expectations, minimize their cost of living in the short term, and spend whatever resources they have carefully, selfishly creating the environment and the means to produce something original. If they succeed, they’re winners. If not, then they have to go back to the grind of daily labor – and pay off all the debt they’d racked up by following their dreams.

            Legendary recording artist Sam Cook announced in his late teens that he was never going to get a job. His family was appalled. They knew that if you didn't work, you didn't eat.

            For his part, Cook observed that people in his family who worked for an hourly wage got paid on Friday, and were broke again the following Monday. They existed to barely make ends meet, in an endless cycle of labor and debt. Sam Cook wanted more than that. He broke away from the family mold, followed his talent, and went on to become one of the most successful, most influential performers of his time.

            I think Dad would have approved of Sam Cook. He certainly approved of Elvis Presley, a man with whom he identified at a basic level. Elvis was a truck driver from the country, who took a chance on his talent, and made it to the top of the list. Elvis made something of himself. He succeeded, against all odds.

            Both Sam Cook and Elvis Presley succeeded in unlikely careers because of their understanding that they each had a remarkable talent, and to capitalize on that talent, they would have to step boldly away from traditional societal and professional roles. Dad admired that, because they succeeded. 

            He also, once, admired an artist – for his work, to be sure, but mostly for his business acumen.

            Clark Bailey was an art professor at the Oklahoma College of Liberal Arts, where my father served as the school’s business administrator. An accomplished metal sculptor, Bailey wrought wonderfully sinuous human figures and abstract forms from such simple, available materials as coat hangers and car bumpers. By the time we came to know him, the artist had achieved a certain level of national recognition, and was making the best of it. 

           My father, whose signature appeared on the professor’s monthly paychecks (and likely his income tax forms as well), was well acquainted with the artist’s finances, and his sources of income both on campus and off:

            “That Clark Bailey has the world by the tail, let me tell you! He’s the only artist I know who found a way to beat the system, and boy he beats it like a drum.”

            Clark Bailey found a way to make a living that also left him plenty of free time to make money. His talent for doing so was separate from his artistic ability. Making art was a requirement of his chosen profession; making money was a function of his ability to use his art-making time to make business connections as well, and to put those connections to good use.

            “I was over at his house last weekend for a cookout, and he took me out to his garage to show me his collection of sculptures. Most people have no idea how many he has done, and he likes to keep it that way. That’s his secret. Now, toward the end of the year, he’ll decide how much money he wants to make, in addition to his salary. Then, he says ‘I’ll sell that one, that one, and that one.’ Those are the ones he’ll release to the galleries for sale. The rest he keeps in mothballs until next year. This guy literally sets his own pay scale! Now that’s freedom, I’ll tell you. The man is more than a good artist. He’s a brilliant businessman.”

            Create a consistent product line. Build demand. Manage the market. Got it. I don't know why that story wedged its way into the mind of a pre-teen whose only career interest was to someday get to medical school, but when it did, it sunk deep, permanent roots.

            The other enduring lesson I learned from Mr. Bailey was the urgency to create now, today, while you still can. Clark Bailey’s promising career was cut short in a hunting accident, just about the time I was entering high school. His passing reinforced the unspoken imperative given by my mother’s premature death: Your life comes with an expiration date, and it’s sooner than you think. Don’t put off happiness for some point in the future. You may not last that long.


“It doesn’t matter what you do for a living…”


          There was something else my father told me, about a man he once met in the mountains of eastern Arkansas, back in the 1950’s.  It was meant to be an object lesson in laziness:

      “He was as poor as a church mouse, this fellow, lived way up in the middle of the woods. A real Hillbilly. This man had nothing more than a shack to live in, and an outhouse, and an old dog for company. He kept a little garden out back, I guess, but mostly he ate whatever he was able to shoot.

      “What money he made came to him in the summer and fall, when he would act as a guide for people who wanted to fish in the mountain lakes, or hunt up in the hills.  He had no idea how poor he was. I once heard him brag to us city folks how foolish he thought we were:

‘I work two, three months out of the year, taking city-slickers up to the hills to catch fish or shoot some deer. I figger I’m walkin’ up that a-way anyhow, so what’s it to me if they want to foller along? They give me a hunnert dollars for it. A hunnert dollars! Come wintertime I can make three thousand, easy as that. The rest of the year I stay in my cabin, hunt and fish when I want to, come and go as I please. I don’t know many city folk as rich as that.’”

I don’t know many, either.

         Dad’s reason for telling me this story was cautionary: Don't sell yourself short. 

          Instead I took it as a grand parable: Decide what makes you happy, and pay no attention to how others judge your success.

          In my first half-century on the planet, I’ve been a student, a performer, a union laborer, a doctor, and an artist. According to many who have shared their opinions with me over the years, my father chief among them, the thing I was supposed to be best at was medicine. 

          Sorry, Pop. I’m much happier drawing pictures for a living. 

          I had been drawing pictures for twenty years when my father dropped by the studio for an unexpected visit. He rarely visited our shop, and his discomfort was apparent, as it always was when he saw me in the context of my art. That day, though, he seemed to have come to a place of resignation, if not acceptance. Whatever it was that led to his reluctant change of heart, I would never know. Maybe it just took that long to realize that art for me was more than a distracting sideline, or to acknowledge that with the passage of so much time away from the hospital, I would never be able to catch up with the medical advances required to go back into practice.

          As he looked around the studio, its walls filled with my drawings and my wife’s paintings, he seemed to relax for a moment.

          He sighed audibly, and said, “Son, I don't know what you do. I don't know why you do it. But you seem happy. You always seem to find a way to keep yourself fed… and you‘ve never once asked me for money.”

          That’s as close to praise as I ever could have expected from my father the accountant, and far more than I’d ever hoped for. 

          I hope at some point that he realized that whatever success I’d achieved came mostly from listening to his advice.

Wednesday, October 2, 2013

Taking the Leap


It took three decades, but it actually happened. 

I arrived at the studio this morning to find an e-mail from a disillusioned medical student, who said she planned to leave school today – to be an artist. 

“(Art) has always been my first passion and what I do best,” she said.
Did I have any advice to offer?

Maybe. So if there are other creative types out there on the medical assembly line who feel your time has come to jump ship, 

Listen up:

Unless you have already experienced the lifestyle of an artist, you are liable to be in for a shock.

You will instantly lose credibility. 

Doctors are revered. 
Artists are suspect. 

Your employment options may be few, since you have spent so much time focused on one goal, and because you are simultaneously under-experienced and academically overqualified for the job market, few employers will be willing to hire you. You will have little or no access to capital from banks or other lending institutions. Without some other means of support, you will be living hand to mouth for quite a while.

You may see friends and family distance themselves from you.

I personally was labeled an insane, drug addicted Communist homosexual devil worshiper by my immediate family members, as they struggled to find some reason to account for the obvious and sudden loss of my mental faculties. And these were the people who loved me. (Fortunately, I was not married at the time, thus avoiding a longer list of emotional complications, and even more name-calling from an extended pedigree of in-laws.)

Your medical contacts will honor your decision to drop away, meaning that at best they will stay focused on their studies, and with few exceptions, allow you to fade quietly from their lives. Some will take your move as a personal affront, and a disgrace to the calling. A few will chide you for your weakness, and judge you a failure. Others will secretly admire your courage in making such a difficult choice.  

Your non-medical friends will be concerned about you, and variably supportive of your decisions. Be ready to lose a few of these relationships – and to build a bunch of new ones.

The one person you will be able to rely on… is you.

I was fortunate enough to fall into the company of a group of old-school graphic designers, who gave me the tools I needed to make a living, and build a small commercial art business while I figured out what direction I planned to take over the long term. To my delight, the composite pictures finally took hold, and I have been eating steadily for the last 25 years. Mind you, that is not to say that I have any guarantee of continuing for another 25. The challenges of keeping a small niche business running are staggering, and force us to come up with new marketing strategies every day.

Passion is key. For much of my career, belief in myself, and the sheer fun of doing what I am doing has kept me going. My education has certainly been an asset, especially my liberal arts undergraduate training, so don't be afraid to draw on all of your knowledge and experience to build your new life, and make it successful and fulfilling. 

Enjoy your newfound freedom for as long as you can. Take time to do everything you always wanted to do. Explore all of your interests, and discover new ones. Read fun books. Hike, walk, ride. You never know where inspiration will come from to build the next phase of your life.

As for jumpstarting your art business, my rules are simple:

1. Do good work.
2. Tell everyone. 

This means friends, family, strangers, web sites, social media, news outlets, art shows, galleries, charities, and every kind of networking group you can identify. 

Generate a business plan, and follow it. Market yourself and your ideas relentlessly, until somebody listens, and somebody pays you for the products of your creativity. Remember – a paycheck is nothing less than permission to do what you love, again, tomorrow.

Create something new every day (a drawing, painting, story outline, musical sketch, business plan or birthday cake). At the end of the year, you will have made 365 new things that didn't exist before – and you and the world will be the better for it. Along the way, you may find something that takes hold of you, and sends you off in the direction your heart yearns for you to go. 

Remember that direction may even be back to medicine.

Being happy may be the hardest thing anyone ever tried to do. 

I wish you the very best in your journey.

Saturday, April 13, 2013

Past Medical History


Once upon a time I wrote a book. Actually, I have been writing for years, usually during the slow art selling season around January and February, before art show activity picks up again in the springtime. Short stories, mostly, very much like the ones that get posted here. 
Owl


This year, though, I was talking to a friendly professional acquaintance who is a writer, a real one, a famous one, who also publishes a line of his own books. I asked him if his company would consider publishing my next coffee table book, a collection of medical drawings that I've been threatening to print for a really long time. (Just as soon as I finish the drawings, which have grown from twenty, to thirty, to now nearly sixty, and still only ten or fifteen to go.)

He politely said no - picture books are not the kind of thing they do - but he did express some interest in another project I had in mind, maybe in another year or two from now, when I could pull together enough short stories to make it work. I figured I would need around thirty of the short stories I'd been working on, sporadically,  to tell my story - the tale of a young doctor who up and quit the business one day, and somewhere along the way decided to become an artist. Seemed like a story worth telling, and I thought I had a good start, somewhere in a file folder on my computer.

So I looked for a file called "Medical Book", where I soon discovered there were nearly100 documents gathering virtual dust, some long, some short, the majority of them already finished, each waiting quietly and patiently for a final edit.

In no time I was able to pull together 45 of these short essays, arranged them in loose chronological order, and discovered that together they constituted the arc of a story. I had a book.

Past Medical History was  born. 






Nothing to do but try and get it published. 



My friend the writer is swamped with other projects. He and others in the industry (in fact, everyone I knew who was even remotely associated with the publishing biz) told me there was but one alternative: Pitch my book to an agent, who would then pitch my book to a real, mainstream publisher.

Such began a process of self-education that has now lasted a couple of months, an adventure that has been at least as complex and fraught with pitfalls as anything I ever encountered in medical school, involving the multiple and oft-counterexclusive paths of mainstream publishing, vanity publishing, self- and assisted self-publishing, e-publishing, POD and POD (yes, there are two, sometimes used interchangeably), and giving up entirely. Not to mention e-mails, Query Letters, Synopses, Biographies, Overviews and Hooks, each an essential part of the cryptic language that transcends common business communication in meaning, intensity and importance.

What's more, there is a formulaic family of documentary formats that must be scrupulously followed in applying to publishing representatives of all stripes, no matter what their submission guidelines may imply to the contrary, with the added challenge of subtle, agent-specific, custom modification requirements representing a maze of tripwires in a minefield of minutia that all but guarantees failure for the novice writer. 

And all this just to convince someone to agree to accept a manuscript for review.

It has been, and remains, a challenge. But we persevere, and by now a formal Book Proposal for Past Medical History has been crafted, meticulously formatted, and recently posted on Scribd, should any sympathetic book agents or editors find their way here to catch the link (and perhaps tell me which portions of the proposal must be double-spaced, as opposed to those pages that will cause the entire project to be scrapped if they are mistakenly made so). In the meantime, all are invited to follow along with me on Facebook to watch as this adventure continues to unfold.

Please bring coffee.

Saturday, August 4, 2012

Rhinoplasty

 












"How long does it take to draw 
                            one of your pictures?"


"A month or so, though some take a little longer."   (Okay, some of them take a lot longer.)

Consider Rhinoplasty. This odd little item was randomly selected last week from my large and growing "I'll get back to these ideas one day - really, I will" pile of unfinished drawings, just so a visiting TV crew could get some footage of ‘the Artist at Work.’

“Here’s one I’ve been working on,” I said to the camera, pretending that I’d actually laid eyes on this drawing since… okay, I couldn't remember. I did recall that once upon a time the concept seemed like a fairly good idea (a rhinoceros made of plastic pieces still makes me giggle), that it was part of my Medical series, and that I had lost interest in the project at least twice - once after becoming hopelessly stuck on the developing design, and again after coming back and solving whatever creative problem had me roadblocked, and, satisfied with having gotten past that, finding little desire to keep going.

But how long ago had that been? I started looking for clues. 

One of my reference images for this piece was a Rhinoceros drawn by Albrecht Dürer, the famous German artist from the 16th century, known universally for his etching, Praying Hands. He signed his work with his initials, D tucked beneath a capital A that looks something like an oriental gateway.


Dürer completed his Rhinoceros in 1515. (I have no idea how long the work hung around his studio before he got around to finishing it.)

Apparently I decided to sign my rhinoceros drawing in a similar fashion, S inside a D, and did so lightly, in pencil, sometime after I was pleased with the overall design, which was at least a year after I first committed the idea to paper. Over time, my ‘DS’ had worn away, evaporated to a few ghostly gray lines. The date penciled above it was almost entirely gone, but with strong glasses I could just make out the number 2006.

So, I started this drawing in 2005, 495 years after Dürer. Seven years of waiting, and it still took another full week to finish.  For a little while I thought about putting it away for another three years,  just long enough to separate the two Rhinoceri by an even 500. I figured that would be a fitting homage to the Master. But then I thought about the slim chance that I would actually remember this idealized plan, and retrieve my Rhino-in-progress at any time in 2015.


After all, I still have the beginnings of a Grand Piano drawing that I started in 1999, scheduled to be completed a year later (in Two Grand).