Sunday, September 10, 2006

Small Town Roller Coaster

Here's a picture of one of Worland's many thrilling attractions, the "Screaming Dragon" Roller Coaster at Six Flags Over Worland . . .

Just kidding. You may be surprised, but there's nothing quite so spectacular as a roller coaster in these parts. There is, however, a kiddie park with a twisty slide.

But major theme parks aside, we have ridden a roller coaster of another sort in our first six weeks here, both enjoying and struggling with the realities of small town living. This weekend provided a stark contrast in our feelings for Worland.

Friday was supposed to be my day off. Since I had to drop Joy off at school anyway, I thought I'd stop by the hospital to finish a few things up. Four frustrating hours later, I stumbled home for a late lunch, my head reeling from a number of difficult, stressful, and wholly unexpected encounters: drug-seeking patients, complicated referrals, very abnormal lab results, scheduling issues, difficult families, delinquent charts, etc. It was the curse of the small town doctor visiting me for the first time: the inescapability from patients and problems.

Luckily, I had something to look forward to that night: Elizabeth's and my first Worland date.

But, boy, was that a bomb (or a fire), as driving down the main drag, we saw the venerable, ancient Worland Community Center engulfed in smoke and flames. We spectated there with the other half of Worland for a bit, then headed to a very lousy (but free) meal at a local Mexican restaurant. With the meal stomached and the Community Center burning to the ground, we then looked for something fun to do.

But nothing came to mind. We could have gone bowling, or . . . what else? We couldn't think of anything else, so we drove in the country around town for a hour, burning gas and talking, which was fun. But looking out from the edges of town across the barren desert stretching endlessly in every direction provoked a feeling of intense isolation for the first time since we've been here. We came home feeling bored, lonely, and stuck. We comiserated for the rest of the night, as both of us vented some negative feelings about the town that we've been politely withholding from each other.

But Saturday morning, something great happened. We met two new friends who have kids with similar ages to ours at a local park. The kids played wonderfully together while Elizabeth and I played tennis with the other couple . . . and we had a wonderful time. The weather was perfect the courts were fantastic (a very cool astro-turf court with light layer of sand over it that plays like clay), and we were very evenly matched with a fun and friendly couple. Then, we got to go home, and I enjoyed a Saturday full of great football games.

Overall, I love living here. And other than a few hours on Friday night, I haven't felt deprived of any big city conveniences. There are downsides to living anywhere, but a few good friends, some nice amenities (minus a community center), nearby mountains, and a strong church make this a most desirable place.

Now if we could just get a decent restaurant . . .

Saturday, September 02, 2006

A Developing Philosophy

As the new doctor in Worland, I was asked to write an article for the local newspaper explaining what a "D.O." means. It was interesting for me to express in writing my developing philosophy of medical practice--to "fling my banner to the wind," as A.T. Still once did.

I have benefitted greatly from both osteopathic and allopathic training, and I find my resultant personal philosophy to be an interesting mixture of both, coupled with a heaping dose of my own feelings about medical ethics and end-of-life care. Throw into that cauldron some natural medicine philosophy from Dr. Andrew Weil, and you have the healthy soup (chicken noodle?) that I want to offer my patients.

While I deeply appreciate all of the wonderful mentors and teachers I have had that have contributed to this philosophy, I must admit an ecstatic feeling of liberation that I can now more fully express, without the sometimes restraining oversight of preceptors, my own philosophy about the practice of medicine. Not that I do anything too radical. In fact, I do my best to adhere to national consensus, evidence-based guidelines. But I believe there are far too many needless prescriptions handed out and surgeries being done; I believe that people need to take responsibility for their health by practicing healthy habits and preventative care; and I believe everyone needs to understand their own mortality and the limits of modern medicine, and to accept the end gracefully when it comes.

Here is a reprint of my article:

Hello, Worland! Thank you to everyone here for helping my family feel so welcome.

I am Dr. Mark Foster, DO, and I have just joined WMC Clinic’s family practice with Drs. Jamey Jessen, MD, and Kjell Benson, MD. Some of you may wonder why I have the title “D.O.” after my name rather than “M.D.” I hope to explain the important similarities and differences in the space below.

D.O. stands for Doctor of Osteopathy. Osteopathy is a distinct branch of American medicine, founded in 1874 by Dr. Andrew Taylor Still. Dr. Still was a classically trained frontier doctor who became increasingly frustrated with the inadequacies of 19th Century mainstream medicine (known as allopathic medicine), some of whose toxic remedies included arsenic, bloodletting, and mercury bathing. When three of his own children were taken by spinal meningitis while he looked helplessly on, Dr. Still first became despondent, then resolute towards finding a better way to practice medicine.

A devoted anatomist, he was inspired by the miraculous structure of the human body and its capacity for self-healing. He noted how the healing systems of the body worked better when the musculoskeletal system was in proper working order. Through experimentation, he devised a system of “manipulations” to restore the proper functioning of first the musculoskeletal system, and secondarily of the entire human body. He felt that a physician’s responsibility was not just to treat disease, but more importantly to find health. He named his new philosophy of healthcare “Osteopathy.”

Initially, Dr. Still’s intent was to separate from mainstream allopathic medicine. However, through the early twentieth century, Dr. Still’s successors at the helm of Osteopathic Medicine accepted and then practiced the breakthroughs of modern medical science: antibiotics, insulin, surgery, pharmacology, etc.

Today, osteopathic physicians practice with the full scope of modern medical advancements. There are D.O.s that practice in all major medical specialties in all fifty states: cardiologists, neurosurgeons, pediatric endocrinologists, and family medicine specialists. D.O.s prescribe medicines, order CT scans, perform surgeries, deliver babies, give immunizations, and practice medicine in much the same way that their M.D. counterparts do, with a few important distinctions: D.O.s are trained in performing musculoskeletal manipulations; and D.O.s adhere to a unique philosophy of healthcare.

As a D.O., I practice in accordance with the American Osteopathic Association’s refined Tenets of Osteopathic Medicine (2002):
1 A person is a product of dynamic interaction between body, mind, and spirit.
2 An inherent property of this dynamic interaction is the capacity of the individual for the maintenance of health and recovery from disease.
3 Many forces, both intrinsic and extrinsic to the person, can challenge this inherent capacity and contribute to the onset of illness.
4 The musculoskeletal system significantly influences the individual’s ability to restore this inherent capacity and therefore to resist disease processes.

In short, I believe that if you take care of your body, your body will take care of you, and so I emphasize healthy habits and preventive medicine. When things go wrong in spite of this, I believe that medications are sometimes the right answer, but that often they are not. The purpose of my training is to know the difference. Finally, I am able to perform a range of manipulations if your musculoskeletal system needs some special attention.

Above all, I am devoted to you as a patient, and to discovering with you how to optimize your health and happiness. I am honored to work with Drs. Jessen and Benson, and to help complement their continued delivery of compassionate, patient-oriented healthcare to Washakie County. Feel free to come and visit!