Physicians From Los Angeles

"My greatest satisfaction is being able to treat children all over the world for a disease that a few years ago, was considered hopeless."

"Some of the challenges I have faced have been in getting trained in pediatric surgery and in pediatric surgical oncology. When I applied to be a pediatric surgery fellow, I did not match the first time, second time or third time because there were no other Black pediatric surgeons. I am the first board-certified U.S. Black female pediatric surgeon. This was a huge hurdle to overcome. It was challenging at first, but I love my profession now."

"Even though I wasn’t sure of the effectiveness, I was sure that doing nothing wasn’t going to make anything better,"

"It takes 10-14 hours, sometimes 20 hours. The longest operation I’ve done is 22 hours. That individual had over 2,000 tumors"

"For those who wish to write, the craft of writing is a life-long journey."

"ONCE A MONTH, I open e-mail with an extra rush on anticipation. It’s usually the day after my column, “The Doctor Files,” runs in the Health Section of the Los Angeles Times. Because the column shares true stories as well as the emotional side of doctoring, it invariably touches someone. Sometimes I receive as many as 20 responses—positive and negative. I might go through a dozen drafts to produce my final 800-word version, but I consider the time well spent. Revealing medicine’s humanity and inner workings to readers has become, in a way, my personal crusade. I’m an infectious diseases and tropical medicine specialist. Since 1987, I’ve also been a broadcast journalist, a lay lecturer, a magazine writer, and a columnist. I didn’t set out to combine medicine and communications. In fact, 17 years ago, as a rookie ID attending, the possibility of someday linking two careers never crossed my mind. ... If you want to tool up, fine; there are many avenues to learning the crafts of print and broadcast journalism, even acting classes and Toastmasters to aid effective public speaking. But the foremost key is discovering your own message and passion, whether it be antibiotic use and abuse, food and water safety, or vaccination. Most importantly, never underestimate the power of a human story, simply and honestly told. And in infectious diseases, do we have stories."

"The truth is, medical doctors are more likely to commit suicide than any other professional group. But facing this fact remains largely taboo. Fear of stigma is one reason broken healers often hide or self-treat their pain (with substances legal and not). Fear of repercussion from hospitals and licensing boards is another. Why certain physicians kill themselves is harder to parse. Are they melancholy from the get-go — or does work push them over the edge? Although research suggests that many doctors are emotionally muted, experts also believe they start life with no greater risk of depression than anyone else. Yet once a day, on average, an American physician takes his or her life."

"Dengue incidence has increased thirty-fold over the last fifty years. Fifty percent of the world's population is theoretically at risk."

"The formula [that challenge the health risks of animal foods] works beautifully for people selling food. It works beautifully for people selling drugs to treat the diseases that bad food causes. And, it works beautifully for the media, which can give us a new story about diet every day. … But despite the appearance in our media of confusion, there is massive global consensus about the fundamentals of a health promoting diet and it's a diet that every time, no matter whether it's high in fat or low in fat, higher in carbs, lower in carbs, in every population, every kind of research, it's a plant food predominant diet, every time."

"[In likening Slow Medicine to Slow Food:] Slow Food was not really about fast or slow in time. Rather it was about privileging the basics-- the ingredients, which do take time: farmers' time and gardeners' time, and also their skill, experience, and knowledge. It was about accepting what is-- the seasons, weather, climate-- and flowing with it, not against it. It was about removing what is in the way of a plant being the healthiest, the most fertile, the happiest it could be, and doing so by little actions, by fussing and fiddling. That was how it was "slow.""

"We can allow for Slow Medicine beds in our hospitals so that doctors have enough time to find out what is really wrong with a patient, and patients have enough time to heal."

"Everything looked so good in the computer, and yet what Father had gotten was not Medicine but Health Care-- Medicine without a soul. What do I mean by "soul"? I mean what Father did not get. Presence. Attention. Judgment. Kindness. Above all, responsibility."

"I had the time to try things, to stop others [referring to medications]. And what impressed me was how efficient it was and how much money I saved by having that extra time. And I will give an example. Most of the patients I met for the first time were very sick for a long time, and most of them, on average were on between 15 and 26 medications. Most of them only needed three or four of these medicines but no other doctor had the time to go through and find out, try this or take them off."

"Sweet's goal came to be to ask of her patients, "Is anything interfering with viriditas [vigor]? What can I do to remove it?""

"Sweet's argument is that what the people who come to her hospital need above all is "sanctuary, a safe place." She realizes that even to her hopeless patients she has a gift to give, friendship."

"Sweet realizes that her job, as "gardener-physician", is to realize that her patient has a "natural ability to heal." Her own viriditas [vigor] will heal her, if it is not obstructed."

"Patients are not consumers, but sick, scared, vulnerable. Doctors and nurses are practicing a calling, a vocation, a craft and an art."

"[Regarding the saying "the secret of caring for the patient is caring for the patient"] The way we talk about patient care in our society is almost the opposite of what's actually happening. It's almost like the less we care in any way for the patient the more people talk about the patient, the "consumer" of health care. What was actually meant by that saying was that caring meant doing little things for them; it's the little things that establish the relationship between you and the patient, not some abstract "love for your neighbor." It's doing something actual and physical for this neighbor."

"Every time a new drug comes out, I read what the side effects are and how many people really get better, and I add in the side effects and the adverse reactions. When you do that, and subtract out the placebo effect, not many new medications make a difference."

"...when you're on your pilgrimage, you don't even need to know where you're going. You just have to know when you're off your path."

"What I discovered was that the two ways of looking at the body—the modern and the premodern, the Fast and the Slow, as a machine to be repaired and as a plant to be tended—are both effective when they are applied to the right patient at the right time. For illnesses that come on suddenly—an inflamed appendix, a rip-roaring infection, a car accident, a heart attack—it is best to think like a mechanic—boldly, reductively. What is broken? What should I do to fix it? Desperate illnesses require desperate remedies. But not-desperate illnesses do better with not-desperate remedies. Diseases that come on slowly—chronic infections, complex medical conditions, the aftermath of the appendectomy, the heart attack, the chemotherapy—are best approached like a gardener, asking myself as Hildegard would have done, not what is broken but what is working? What are my patient's strengths and how can I support them? What can I do to nurture viriditas, the natural power of healing?"

"The essence of Medicine is story-- finding the right story, understanding the true story, being unsatisfied with a story that does not make sense. Healthcare, on the other hand, deconstructs story into thousands of tiny pieces-- pages of boxes and check marks for which no one is responsible."

"We don't need to remake our health-care system or rebuild it from the ground up. We don't need to do very much. It's pretty simple, quite attainable. Just an added perspective and a change of pace."

"...I learned a Slow Medicine lesson: how individual medicine was. It wasn't true that one size fits all, that everyone or no one should have that treatment or this pill. Rather, the right answer had to do with style, with who you were, who the patient was."