Why Medicine? Why the Military?

Neither my grandfather nor my father-in-law ever served in the military. They were too young for the First World War and too old for the second. In fact, as my grandmother told me, most of relatives on that side left Russia to avoid service in the Tsar's Army. Twenty-five years as a Jewish conscript was not considered compatible with a long and fruitful life.

I don't know about my maternal grandfather, he died before I was born; severing the little contact that exsisted with that side of the family. Where he was born or where he was from, I just don't know. I have no idea either if he served in the Great War. My grandmother Esther died in the early 90s along with Grandpete and Grandmother Anne. In those years I never thought to ask family history kinds of questions. Prior to my father's service in WWII, I am not sure of anyone in the family having served.

Not caring for his name, my father changed his first name to Mark upon high school graduation (an accelerated program) and promptly enlisted, lying about his age. I am sure that he did not please his parents. He worked as a photographer on various installations in the US during WWII. Never shipping overseas, instead documenting training and continually changing rank along the way; not being known for really agreeing with authority. I have yet to ask him if Judaism had much impact on his service, but I doubt it.

Neither is medicine a tradition in my family, the closest is Esther who did nurse’s training at Chicago's Cook County General Hospital in Chicago in the 1920s. Which, when you think about it, could easily qualify as combat training as well. I know that she met her husband (that grandfather) in Chicago, later moving to Los Angeles where he was a cameraman in one of the major film studio lots. My mother was born there, she and my grandmother only later moving to Minnesota at some point during the Depression.

So I was not coming off any traditions when I finished my undergraduate studies. The problem with a degree in psychology is that you can not get a job; something that I badly needed in order to feed myself. Looking at the options and seeing what those around me were doing for applications the choices seemed to be 1) graduate school, 2) nursing school, or 3) medical school in no particular order. My grades were not actually good enough for graduate schoolas I had taken a lot of honors science courses my first year at college before I hung the sciences as having too many hours of lab courses for me to work (and thus have the money to eat). Nursing school told me that I would have a full year of pre-nursing courses to take because my science courses were not good enough. ! I said, honors sciences were not good enough? No, they said, we need you to take Sciences 1, 2 & 3. I pointed out that I was a College of Liberal Art's student and we could not take those for credit. Only student in Nursing or Elementary Education were awarded credit for those courses; they were not considered academically challenging enough for the rest of us.

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Note, this is not a way to win friends or influence people. I was told that I did not have the appropriate attitude or personality to become a nurse and there was really no point in me completing the application.

Ok, that left medical school. Took the MedCATS, found out I was not as stupid as I thought. And, given a choice of 3 years to become a nurse, or three years going year a-round to become an MD, well the choice to me was obvious. Started school in the fall of 1972 and finished in spring of 1975.

Somewhere along the way, I actually found out that I had a few distant relatives off my father's side of the family that were in the medical field. In fact, it seemed like all of the boys were doctors or clinical psychologists - go figure, I can't (Manny, Stephen and Stanley).

From graduation it was a short jump to surviving internship. I was officially signed up in Physical Medicine & Rehabilitation. That meant I was farmed out for the first six months to a Family Practice program, then did three months at the U of MN and another three at St. Paul Ramsey Hospital. I went insane at U of MN as I had my patients plus all the medical support for the patients belonging to the other resident whose grasp of the science was excellent but had some issues with English. As a result he did not handle the basics of diabetes, hypertension, or wound care well. The three months at Ramsey I had a ward of 30 patients for which I was the only physician. Did I mention that nurses did not start IVs or draw blood at this hospital? If I had not gone to medical school in Minnesota which meant that I knew a large number of the other interns or residents at the hospital, I would have gone 3 months without getting any sleep. I traded the excellent ability of the Rehab social workers in placing hospital patients for help when my patients got ill after hours.

The problem with Rehab is that nothing happens very fast. And I got impatient, transfering into Family Practice. I am not sure that FP was delighted to gain me, but the PM&R faculty were likely glad to see me go. It was my last year in FP that I joined the Army Reserves, actually on a lark. I wanted the Air Guard, but they had no openings. So it was the Army or nothing.

So this was the 5501st US Army General Hospital, Ft Snelling, Minnesota.

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The less said about the unit the better. In reality, there is not much the hospital was capable of doing. Not with only 14 physicians out of the 60+ that were needed to really have a hospital. The best you could say is that the other CPT, the one PA who drove down from North Dakota and the MAJ Pathologist and I ran Physical Exams for our weekend drills while the COLs sat around and signed off papers. I was not impressed.

Instead of the normal Officer Basic, I drew two weeks at Ft Sam Houston, part of which I was on duty running the urgent care clinic off of the Emergency Room. Me, medics, and a bunch of interns who had no clue how to deal with a 1LT Medical Corps officer. A rank of doc that only exists in the Reserves.

Is it any wonder that my total outlook on the military is a rather strange one?

But I survived that, and a couple of ADTs over the next two years, meeting both insects and slime at Ft. Leonardwood and the real challenge of the Cuban Refugee crisis in summer 1980.

Imagine if you can, working out in the middle of nowhere Wisconsin. There is just you, and a small slice of your reserve hospital to take care of the MP BTN from Ft Riley. The MPs are there because there are 10,000 male refugees behind the wire. It is August with heat, dust and pollen. The Public Health Service had provided a team to take care of the refugees. Their PAs and NPs were excellent. Since the PHS doc on rotation at the time was neither primary care nor sober, we did not bother with him. Not after he could not figure out why we wanted to treat all positive GC cultures. He just could not figure out why we had + cultures after the first couple of months, since this was a male only camp. Hello? Castro had booted out everyone he could that was considered undesirable. Criminality, insanity, severe medical problems and homosexuality all feel into that category.

I literally worked insane hours that August. There were just two of us with primary care training. The pathologist did what he could, but there were limits to what he was willing to tackle. A chopper flight with someone intubated was not on his list, neither were the fools who kept knifing each other till all they had left as eating utensils were plastic spoons. And then there were all the Cubans with steriod dependant asthma in haying time in Wisconsin.

After that, I felt I could handle just about anything. And certainly the military. George and I had been married a couple of years by this time and he was finishing up a major case in Legal Services. From there it looked to be back to Landlord-Tennant cases and family disputes. During the past year, the concept of HMOs was starting to take off in Minnesota. From being the only physician in an underserved area, there were now two subsidized clinics. My patients were on Medicare, Medicaid, or uninsured. In good conscious I had to refer patients, as it was economically best for them. I was still doing over 100 deliveries a year, partly because I was one of the few female FPs who did all of her own deliveries and partly because I did a lot of support for the alternative community.

George mentioned that if I could hack the military, he would really like to live in Europe for a few years.

Talking to the Army, Navy and Air Force was a real experience. The Navy was quite socialble, and was willing to send me to Iceland, Spain or Italy. George, as it turns out, really wanted to go to Germany. The Air Force mentioned that they wished everyone to do a tour in the US first. What did I think about Minot? I am not stupid, I live in Minnesota and know exactly how to drive to North Dakota, or the alternative, Plattsburg Air Base. I was not looking for that kind of alternative culture. The Army? Which of our 11 hospitals in Europe do you want? Nine are in Germany; there is also one in Belgium and the last in Vicenza, Italy.


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