My training was interrupted by my military service. As the saying goes, don’t cry for me. I knew I would have to leave my training program in Internal Medicine after the first year because the Navy pretty much insisted that all of us “go to the fleet” before beginning our second year. A buddy of mine and I, after looking into where the jobs might be, elected to enter into the Submarine Navy and became Diving Medical Officers and eventually Qualified in Submarines. I ended up completing my military career (the last 3 years of my 5 year commitment) in a half time clinical-half time diving billet (military for a job) in Kaneohe, Hawaii. This happened to occur during Desert Storm so I proudly tell people who don’t know me very well that 40 years after my dad’s generation I successfully helped keep Pearl Harbor from falling to the Iraqis.
When I arrived in Kaneohe, I found out that half of my time was to be spent providing primary care, mostly to the wives and children of the Marines. I was given two exam rooms, an office, and a prescription pad. I quickly found I was suited for the job, able to see the relatively healthy patients in the 20 minutes allocated efficiently and provide care that was appreciated (based on the satisfaction surveys, at least). I also learned a lot about myself.
I knew I was only there for 3 years and would have to find residency to complete if I wanted to move from the Navy into the “real world.” I had completed a year of Internal Medicine, so strongly considered completing the final two years of this residency. The nurses I worked with urged me to consider Family Medicine (my ultimate specialty choice) because of my winning personality. On a busy day I would end up seeing about 24 patients. At the end of those days, my feet hurt. Moving from room to room in regulation Navy shoes was hard on the arches. In our clinic we had an x-ray machine that we could use every day but only had a radiologist once a week. This was before electrons could be sent all over the world so we had to read out own x-rays 4 out of 5 days. On the day the radiologist was there, he would “over-read” the films and if I missed something I would have to call the patient and explain that I needed the patient to return for another film, go to the Army Hospital for ongoing care, or find out if they had died from my miss. I became quite good at reading films and on those days my feet hurt would think to myself, “If I were a radiologist, I would get $75 a film for showing up once a week, sitting down in a chair in a dark room, and second guessing the primary care doc.”
I thought about those days this past week-end as I was speaking about a career in Family Medicine to 33 medical students at the Alabama Academy of Family Medicine. These were medical students who want to be someone’s doctor. They asked me very good questions and indulged me by listening to my Kaneohe stories. Though my feet sometimes still hurt at the end of a full day of patient care (I wear much more comfortable shoes now) I was able to recommend the specialty without reservation. Not only are they going to be much more in demand than their radiology colleagues (see this New York Times article for details) but their care will result in a measurable improvement in the health of Alabamians. My advice to them was to wear comfortable shoes.