Realism, Standards and Performances

About the Book

        These essays draw upon the historical record, observations of others, data from credible sources, and personal experience. Both generalizations and specifics are displayed to make reading and thinking more productive.

        Many specifics come from a lifetime of work in health care services, consulting roles, civic affairs, organized medicine, education at the university level, and observations as a studious visitor to over fifty other nations.

        There are many difference between much behavior today and the standards when the country was younger. There are many current disagreements over national policies and procedures.

        The principled judgments and actions of thoughtful, informed individuals contain  much more potential for constructive responses to important challenges than the reactions of those who act in haste, with fragments of information, without serious consideration of the consequences of actions, or under the influence of strong emotions.

        Differences of beliefs and opinions are part of the experiences of living. The dispassionate examination of such differences is more likely to advance understandings and progress than unwillingness to consider views of others.

        My fundamental purpose is to stimulate thoughtful individuals to reexamine their assumptions, information, reasoning, and value systems as a prelude to their conclusions about important contemporary issues.

        The well being of our country is the well being of every family for together we are the nation. There is no place for comfortable illusions, dodges of reality, or escapes from the consequences of our actions.

        Our families and our nation need the best efforts of all of us.

About the Author

After undergraduate work at Columbia College of Columbia University and a short tour of duty in the Army of the United States as a medical corpsman, I entered the Cornell University Medical College in January of 1944.  Our class graduated in 1947. After interning at the Cornell-New York Hospital Medical Center, I invested four years on the Cornell Medical Service of Bellevue Hospital. This experience included two years as Chief Resident and one year as a National Heart Institute Research Fellow. Then I moved to a faculty appointment with the duty of Assistant Director of the Comprehensive Care and Teaching Program at Cornell.

        During part of the Korean War I served as Assistant Chief and then Chief of the Medical Services at the 2500th US Air Force Hospital. Next, I served as a Consultant to the John Gaston Hospital and the University of Tennessee Medical School in Memphis to offer advice about their outpatient care and teaching programs.

        From there I joined the Faculty of Medicine at the Upstate Medical Center in Syracuse New York. I was responsible for all the ambulatory care programs of the Medical Center and for the outpatient care and teaching programs of the Department of Medicine. In addition, I was active in community and medical society affairs. The former included the role of Co-Director of the medical portion of Civil Defense for Onondaga County.

        In 1956 five of us left Syracuse to assume the responsibility for the development of the new Health Sciences Center of the University of Kentucky in Lexington. This included new colleges of dentistry, medicine, and nursing along with a new university hospital. These responsibilities took me throughout the Commonwealth, to one third of the university dental centers in the United States, to many of the academic medical centers in the country, and into interactions with many governmental agencies.

        In 1964 I joined the group  planning a new University Health Sciences Center on Hospital Hill in Kansas City, Missouri. My roles included those of Executive Director of the Kansas City General Hospital and Medical Center and Associate Dean of the University of Missouri School of Medicine with responsibility for the University’s medical education programs in Kansas City. In 1969 I became the Acting Dean of the new University of Missouri-Kansas City School of Medicine. With the activation of the school I became the Dean. In 1978 I returned to my primary role as an internist, professor of medicine, and senior docent. In 1990 I retired from clinical practice and in 1993 from university roles.

        During the fifty years between 1943 as a medical corpsman and 1993 as an Emeritus Professor and Emeritus Dean of Medicine, I was fortunate to have many remarkable experiences. These include interactions as a consultant, informal staff member, volunteer physician, and responsible agent for branches of government at all levels from county to nation. I have been a consultant on medical education matters to major universities. For several years I served as the Executive Medical Consultant to the Norfolk, Virginia Medical Center Authority. For more time than I like to remember I was in Washington, DC as often as once a week serving on committees  or carrying out other responsibilities.

        Since I am convinced that we all must play responsible roles in our professions, businesses, or occupations, I always have been active in medical affairs. This includes roles at the county, state, and national levels. I have volunteered to help develop and guide one of the outstanding Office of Economic Opportunity Neighborhood Health Centers. I volunteered to be the medical consultant for one of the eleven federally funded Channeling Projects which provided services to 1600 frail elderly in their homes. Here, as in the rest of my practice life, I have made home visits with many of these in the inner city. My patients have ranged from General Officers in the military, to politicians, to community leaders, to many residents in the inner city. These are specific examples of the generalization that active clinicians have the privilege of seeing into the homes and lives of the full range of citizens.

        The University gave me the responsibility to develop our geriatric programs in Kansas City. This occurred when the specialty was just beginning to develop in this country. These responsibilities took me again into national activities including a role in helping to found the American Federation for Aging Research. With others I studied geriatric and health service programs in Canada and the People’s Republic of China. As the Principal Investigator, I was responsible for the design and conduct of the Missouri Geriatric Education Center. This provided the opportunity to work closely with health professionals and extension specialists in representative rural communities in Missouri.

         My wife, who is a distinguished leader of volunteers in health services, and I have made formal study and exchange visits to Australia, New Zealand, the Netherlands, and Germany. We have visited many other countries to observe and learn.

        Universities have contributed much to my understandings through the challenges of stimulating colleagues, service on a variety of major bodies, and appointments to faculties other than medicine.

        During a busy lifetime, clinical duty has helped keep me focused on the job of clinical medicine which is to offer the best possible care to the stressed humans who are ill or whose family members are ill. This demands mutual respect with cheerful cooperation between members of all the health professions. Research, teaching, administration, and financing are necessary but they all are only tools to serve the needs of ill humans.