Growing up in Baton Rouge in the 1960’s, I am genetically predisposed to be a fan of  LSU and Saints football. LSU is an easy team to declare one’s allegiance to as it has a proven winning track record, one Heisman Trophy winner, several national championships (both before and after the creation of the BCS) and a real tiger habitat to keep its tiger in. The Saints, are a different story. To be a fan of theirs, you have to be used to creative book-keeping. Some would say that since that opening kick-off in 1967 (run back for a touchdown) it has been downhill. In their 42 years of existence, they have had 14 head coaches, have never been to the Superbowl, have only been to one championship game (and lost), and have only been to the playoffs 7 times (including this season). They went 11 years before winning and losing an equal number of games and went another 10 years before posting a WINNING record. I travelled to the game last night and watched them lose knowing all along that they will find new and creative ways to disappoint me.

Also, as mentioned previously, I am training for a marathon. I have been running relatively long distances since I was 16. Not being very fast, I discovered I could outlast some people on street races and when I was 18 I decided to run the Mardi Gras Marathon. Being 18, I assumed training was optional. I ran it in about 4 hours which in hindsight was pretty good for someone who showed up to “gut it out”. I have now run about 5 or 6 marathons and know that for survival as a 49-year-old, training is an 18 week experience. I am now finished the last hard week but still have some miles to put in before the race on the 10th.

What does any of this have to do with health care reform? I chose to go into the military so that I could practice medicine without consideration of personal debt entering into my career choice. I chose the specialty of Family Medicine because it was the one that allowed me to deliver the care to my patients in a personal, cost-effective manner. Like selecting the Saints, my choice of specialty was not based on “winning” but on what was a good fit between me and my patients. When I chose the specialty, interest in the field was down. Specialty colleagues were convinced that Family Medicine was dead. I fell in with an outstanding group of Family Physicians (Ellen Sakornbut, Perry Dickenson, Frank deGruy) who felt otherwise. One of them (Perry Dickenson) had done some work for the young governor of Arkansas and felt like if he were elected President he might just be in a position to put the pyramid upright and place primary care at the base again.

Working on healthcare reform might seem like a sprint, but it has been much more of a distance run. We pick up a schedule and train, preparing for our time. We, like Saints fans, believe in what we are doing and even  the Cowboys are about to kick a field goal to put the game out of reach, we believe that they will miss (which happened). Bill Clinton blew it (as did Jimmy Carter, Richard Nixon, Lyndon Johnson, John Kennedy, and Harry Truman) but those of us who believe in the importance of primary care are ready once again. This time, we’re really close.