It has
been four years since my retirement, after 26 years with Northwest Permanente
Medical Group (NWP). As one of the people who helped birth this publication
and the Clinical Contributions Editor for the inaugural issue, I was
asked to comment for this fifth anniversary issue.
My appreciation
of history--personal, professional, and general--has become stronger
in direct relation to my age. As I've grown older I've had an increased
desire to look for the connections to the past. I'm sure it has to do
with the realization there are more years behind me than in front. That
fact pushes self-examination and the need to look for meaning. Increasing
age adds its own perspective to the mix.
A
Doctor Reading About Doctors
I'm rereading one of my favorite books, Doctors, the Biography
of Medicine1 by Sherwin Nuland, a surgeon and
medical historian. Having a long line of professional ancestors, I feel
a deep sense of connection with this type of history. Each time I read
this book, I am stirred, inspired, and awed by the biographies of the
individuals responsible for some for some of the landmark contributions
in our continuing evolution as medical practitioners. These were people
who, through their observations, reasoning, and devised methodologies,
found new truths, which changed medical history because they had the
courage to share their ideas, often radical and revolutionary, and not
always welcomed.
The inspiration
from reading Nuland's book comes from his describing the ability of
a practitioner who can change and intermingle perspectives. It has to
do with seeing one patient at a time and having to deal with the "here
and now" for that specific person on the one hand, but also having
the ability to put the patient into a broader context as well. It's
as though we work in a forest: at times we need to concentrate on the
leaves and at other times it is important to consider the limbs, the
tree itself, or the forest in its entirety. It is this resonance from
the one to the many to the one that gives perspective; that brings connection.
Physician
As Editor
Deciding to be a physician editor came from a passionate belief
in Permanente's rich fund of knowledge and collective wisdom and the
feeling that the more we can share our clinical experiences and perspective
with each other, the better. It is right and good to promote institutional
and individual communication.
Dr Robert
McFarlane preceded me as Director of Continuing Medical Education for
NWP and had started the planning for a written forum for the physicians
of NWP. When I became Director in 1986, the planning continued and we
started the newsletter Permanente Practice. This led to the establishment,
several years later, of a regional journal, The NWP Journal of Clinical
Practice, which, in turn, ultimately served as the basis for the
proposal to create a national journal, The Permanente Journal.
Reflecting
on Medicine After Retiring From Practice
I feel fortunate for the professional life I've had, being a doctor,
a director of education, an editor, and being with Permanente. I have
no regrets. I would do it again in a heartbeat. Looking back at the
history of medicine, with its long, rich cast of characters and events,
and looking at what we are doing now, I marvel at the still unfolding
story. This medical group is part of that still unfolding story and
The Permanente Journal embodies the effort to communicate ideas
and ideals. Professionally, we share a long tradition that embraces
all of the human traits, both splendid and low. To me, though, the nobility
of our professional heritage comes from the caring about others and
a determined search for truth. It is in the learning about each other
and how we connect to the world that matters.
Reference
- "Doctors:
the Biography of Medicine," Sherwin B Nuland, New York:Vintage
Books, 1989.
Phillip M Brenes, MD, is a retired pediatrician
and CME Director for NWP. He was also the inaugural "Clinical Contributions"
Editor for The Permanente Journal.
