After 30 years in medical practice the business of medicine has broken my heart. Medicine has been the calling of a lifetime for me – carrying on the legacy of generations of my family. It has been my deepest honor to listen to the fears and secrets of countless patients over the years. While people may have come to the Emergency Room for what appeared to be accidents, it was only during the course of treatment that the personal stories of conflict and sorrow with family members and work colleagues were revealed. Allopathic medicine is very good at treating the symptoms of acute illness, but not so good at avoiding chronic illness or maintaining health. Visits to the Emergency Room are not always accidents but are often the result of lifestyle and choices. I wrestled with how to help people make wiser choices in the midst of a crisis, since that is actually the time when people are most open to change. Years have passed. The problems in healthcare delivery that were present during my training have persisted and increased. Primary care providers are not available. Insurance companies tell me what medications, tests and treatments I can prescribe, despite standard medical practice. While my patients struggled to keep jobs, pay bills, feed their families, maintain homes and afford medications, our clinical staff would collaborate to arrange effective care across disciplines and across hospital systems. These arrangements would often be denied by health insurance companies, leaving patients in worse health and leaving the clinical staff disheartened. Any attempt to collaborate across systems results in a paralyzing amount of paperwork. Hospitals and insurance companies like to keep patients in one system. This makes bookkeeping easier even if results in the inefficient use of manpower and equipment. For years I continued to go through the motions of practicing medicine in an increasingly dysfunctional system. It was taking longer and longer to get less done until I finally had to accept that the business of medicine would not allow me to share my love of medicine with people. Fortunately, in the midst of my disillusionment, I came into contact with permaculture. Interactions with plants and plant knowledge have been my anchor for years, long before entering the medical field. Permaculture is a system of sustainable land management that uses the patterns and relationships found in nature to bring balance into a disordered landscape in order to produce a yield. This yield may be tangible and intangible. It may be a crop or the pleasure of the view from a window. Sustainable agriculture encourages cooperation and collaboration among different aspects of a home and community. Finally, here was a system that would allow me to address health from the ground up. Health starts from the soil that produces our food and supports our homes, and thus forms the basis of the lifestyles that affect our health. Here was a system focused on acknowledging our strengths, avoiding waste, making best use of our resources, on integrating differences, on diversity. It takes a broader perspective of health, incorporating human health with our environment. Here was a way to affect the stories that people would tell in the privacy of their doctor’s offices. I am again honored to offer my services for the health of the land and the people, plants and animals who live on it.
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