Enjoyed reading some of your blog posts both older and the newer army related ones today. Lots of smiles and chuckles, Thanks.
Laughter? In response to this blog? That’s TERRIBLE. This was supposed to be serious stuff. Like taxes. This is information. Data. Recommend re-read.
I’m curious to know why you signed up?
I signed up for the Army for one major reason and one minor reason.
The major reason was the craven want of money. I wish it was something more patriotic, but the primary motivation was an offer of a loan repayment grant and monthly stipend during my years in residency. The Army required nothing in return during my training years. Faced with sneaking my 6-member family into a 2-bd apartment that allows only 4 people, I took the money. Instead of the apartment, I was able to put my family in a cute 3-bd home on a quiet corner two blocks away from my training hospital.
The second reason was patriotic. Despite my vehement opposition to the war in Iraq, and moderate opposition to the war in Afghanastan, I was fully aware that primary care was severely lacking in the U.S. Army at a time when young Americans were throwing themselves into war. Irrespective of how I felt about those conflicts, I remain an American. News of my countrymen dying or suffering partially due to lack of good medical care was something I couldn’t tolerate.
I have always been taken with depictions of how our nation pulled together and sacrificed during the second world war. Back then, those war efforts were truly a national affair. Virtually everyone gave to the effort in some fashion. And, I think a huge reason for the wealth and power we have enjoyed for the past 60 years are a direct result of those sacrifices made by our Greatest Generation.
“Earn this,” CPT John Miller, dying from a mortal wound during the Battle of Ramelle, implored Private Ryan in the Spielberg movie. The message, as I took it, was our generation (and the Boomers before us) must understand that great sacrifices were made to allow us to live on the top of the world as we have as Americans. It remains our mandate to earn that sacrifice; it was made before we even deserved it.
So I signed.
I saw posts about officer training and an earlier one about trying to figure out the military scheme as a civilian. What got you in?
I think you’re referring to how I got into the Army as a civilian. If so, the answer is website: http://www.usajobs.com. Everything runs through this site. I applied to this site in the winter of my senior year of residency, and forgot about it. Literally. When I was called by the clinic here in Germany for an interview in MARCH the following year, I had no idea why.
If you want to get a job overseas, however, this is one of THE best routes. You can’t work for the State Dept as a doctor until you’ve been in practice out of residency for 5 years. You can’t get a job with any of the aid organizations unless you know someone AND don’t need money. So, this is a good option because the pay is steady, only slightly beneath the national average, and comes with perks that don’t usually accompany private-sector jobs.
There’s lots of archane goofiness that come with Army medicine. There’s lots of unusual quirks that are a result of non-medical “commanders” decreeing all kinds of demands from on-high.
But, in reality, every managed care organization functions like this these days. I wouldn’t put Army medicine behind or beneath any of the major HMO’s (in principle, I haven’t worked with any of them). I think Army Med is about on-par with most of American medicine…approximately 18th best in the world.
Also wondering why Olympia was your first choice? You’ve said elsewhere that Ventura is probably the best FM program in the US. I’ve heard of a number of graduates going to Tacoma Family Medicine and lots of interest in Alaska, too. Can you comment on them?
I am very proud of my FP training program, and maintain the belief that it is one of the best programs on Earth, and THE best on all outlying planets. I firmly believe that Providence is one greatest healthcare organizations anywhere.
But in all honesty, I have to say that Olympia is not the best. Just MY best.
Ventura is better. Better than anywhere else I know of (and I practically got a PhD in FP residency research during med school). The hands-on experience they allow there, assuming times haven’t changed, is second to none. The faculty are top-notch; some are dual-certified, etc. Facilities suck, too, which is great. I can think of no better means of preparing an FP to deal with a crappy, under-funded, under-supplied environment where the only thing you have to give to patients is your training.
I was told I had a shot there. What they told me likely sounded MUCH like what they tell EVERY short-white coat wearing minion worshipping at the altar of VCMC during their exit interview. But I still like believing I coulda made it in there. I never ranked them, however, because my large family would have needed to live in a box on the beach to afford the cost of living in Ventura. And, truth be told, since I could have reasonably placed that box at the point at Fairgrounds (read: KILLER surf spot), residency would have been AWESOME for me. Just not for my kids waking up with sand fleas in their eyes and facing yet another breakfast of seaweed and/or Wonderbread bologna plus peanut butter sandwiches at the local Rescue Mission.
One nuance Ventura is the dual FP/MPH program at Dartmouth which is as good as it gets if policy and health system design is your calling. Love it or hate it, the Obama Health Care plan wisely referred to the health resources utility research out of Dartmouth. Although barely ranked, I am of the opinion that Dartmouth is actually one of the best – if not THE best – MPH program in the country because the research and work they do is prescient, unassailable, repeatable, tested and longstanding.
Tacoma is a great program, but they have nothing on Olympia. Their city smells weird, their facilities aren’t any better than ours, and we do rotations at the Peds ER up there anyway. So I recommend ranking them 1/2 with the top choice going to the town you like best.
Alaska is probably a lot like Ventura. Sans wicked right point-break and unfortunate box.
20 year ago tomorrow, the Berlin Wall was breached. The first East Berliner to make it across – legally – was a woman named Angelika Wachs (news to me…old hat to everyone over here).
My favorite band of all time – U2 – performed a live show in Berlin this past Thursday to start the festivities, which will continue through this week. We live 3 hours from Berlin, and may as well still be in Olympia, unfortunately. The celebration isn’t history…but it will get close and I’d love to be there.
The U2 show was free. All you had to do was get a ticket via the internet. And you had to do it within a 3 hour time-span because that’s how long the 10,000 available tickets were available. Being a free concert, you might find the need for tickets a bit ironic.
Even more ironic: if you didn’t have a ticket, you couldn’t see the show. Why? Because MTV (the show’s producers) had erected – you guessed it – a WALL to obscure the performance.
I suppose the title of this entry could just as easily refer to a patient who reached a century of life, but I’m actually musing on the centenarian building where I’m working this month.
I’m sentimental. I love history – loved it more than biology in undergrad. So a building like this place carries whispers of the past into my psyche every day I arrive. I bask in a steady breeze of stories – known and unknown – each day when I walk through the back door. New Yorkers often explain the love of their city by describing the enormous number of engaging cultural things available to do…even if they never do them. This building offers the same thing, but in the currency of stories.
You could spend months here just learning about all the things this building has seen. You can ponder the tree stump near the front door where a guy blew himself up with dynamite while his wife was inside for an appointment. Or think about the years when the building served as the town’s hospital, complete with an ER, lab, mortuary and second floor (since removed). Also drifting through the single hall and 4 exam rooms are the ghosts of the doctors who pioneered the practice, and the dogged support staff that kept this place running through years of desolation, poverty, isolation and depression. This building survived storms, heat, wind, rain and over a hundred hunting seasons.
Consider the relative youth of even the oldest parts of our culture: We’re tykes on the world stage. The oldest American culture – Native American – has been essentially glossed and veneered over by our exuberant European ancestors so that our main cultural heritage in America references the late 1700’s. I suppose if you’re really trying to push the date back, you could reference 1492 and Columbus, but really, the American Experiment started in 1776. This makes us babies among world cultures. Embryos, practically.
So a building like this is one of the few material references to times and people long dead or moved away. We are a transient culture, and our history is still too new to be truly memorable. We need a good couple thousand more years to really figure out who we are, what we’re about. Until then, some of us hold on to places like this: a lonely building filled to the weakening rafters with wisdom, loss and joy.
(At left: the earstwhile “pharmacy”, also a kitchen and occasional birthing room – now where pharm samples are kept)