It took seven and a half years of full-time effort to get my first yes. I went through an especially tough time about four years into it. A really, really bad time. A sort of, "Am I really going to keep doing this?" kind of bad time. And for a gal who never wanted to do anything but write, that was pretty darn bad.
Talking to a fellow writer recently, I tried to explain what got me through it. And the best way I could think of to describe it was that I broke up with the past. I broke up with the four years that had come before. I broke up with every person and situation that had dashed my high hopes. And, as you always have to do at some point following every breakup, I said, "Aw, screw you, anyway. I'll be just fine without you."
My sweetheart loves to fly fish. He never keeps the fish, just tenderly tips them back into the sea. So he’s plugged into various fishing networks, some devoted to survival of species that are imperiled by human impact. He’s the one who turned me onto Twyla Roscovich’s quite remarkable film, Salmon Confidential.
The film painstakingly lays out the way those who are supposed to protect Canada’s health and commonwealth have allowed fish farms—feed lots for fish—to contaminate wild salmon habitat with gruesome and terrible diseases, creating health risks for fish and other species, destroying a traditional source of food and culture for First Nations people, and affecting the livelihood of commercial fishers too. The massive decline in Fraser River salmon coincides with the licensing of fish farms directly along salmon migration routes; the species of salmon that have flourished and even expanded have no fish farms on their migratory paths.
After we watched the film together, my partner shook his head and asked, “How can they do that? How can they live with themselves?”
The grass in my front yard had grown so tall, I worried about Clyde. He lives around the corner, so I walked to his house on Friday night. He was in his yard, with a friend.
As usual, he grinned when he saw me. He said, "This is my friend, Betty."
Betty smiled. He said to her, "This is Jane. I told you about her."
I extended my hand over the picket fence. "Hi, Betty. It's nice to meet you."
Betty shook my hand. Betty doesn't speak. I'm unsure if she's shy, or lacks the ability. She smiles, though.
Clyde has a speech impediment. He can't pronounce some consonants, omits a few verbs, but he has no difficulty talking with me. I love our conversations.
This is the story of a medical career from my perspective as dermatologist, student, patient, teacher, father, husband, researcher and administrator. It is about the training I received on my path to becoming an expert in skin diseases. It is also about doctors, the medical profession, and the academic institutions in which many doctors work at some point in their careers.
Mostly, however, it is about the patients. Patients are at the mercy of doctors. All too often, outcomes or interactions are less than praiseworthy, for reasons as variable as the individuals themselves. This story explores behaviors, mostly by doctors, some by patients, some by me, which I ultimately viewed as less than praiseworthy. We can always do better.
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