Monday, July 18, 2011

The Brothers Mayo and their Institution

In July, I got to go to Rochester to attend a course in Internal Medicine. It was summer and beautiful. I had never been to Rochester. Rochester, Minnesota is best known for the world-famous Mayo Clinic. All these years, I had read its name in jounals, studies and the popular press. I finally got to see the place for myself.

What impressed me most of all is the vision of the Mayo brothers. Here they are (maybe it's just me, but don't they look like they're made of chocolate?)
The plaque near the statue is shown below:

I have a brother too. I love that neither of them ever wanted to claim credit for themselves, but always spoke humbly of themselves as a team.

The vision of these two surgeons and their father led to an institution that put Rochester on the map and created many notable medical breakthroughs.
Here is the entrance to one of the older buildings called the Plover building. It is named after one of the first physician-scientists that the brothers hired to part of the 'Mayo Clinic'. He went on to win a Nobel prize. The rest of the building is shown below. My lack of skills in photography limit me from doing justice to the beauty of the building.

Here is an elevator in the building. Wow!
The main clinic building is in the next two pictures shown below:
The Brothers Mayo believed in education and also build a medical school:

The moral of this story: vision can accomplish great things.

Sunday, July 10, 2011

Camp Angel Summer 2011

It's summer!

Once again, Angel On My Shoulder ( put on its summer camp for kids experiencing cancer through a loved one. Who comes to these camps? Boys and girls, ages 8 through 12. This year, we had 45 camper and 11 counselors. What's so special about these kids? Well, just for samplers, one has a brother with an inoperable brain tumor, 3 of them a mom with lung and brain cancer, 4 more have moms with cancer, several have brothers and sisters with leukemia and a pair had their mom die from cancer just within the last week. Kids deal with these tragedies in different ways. Often the illness casts a deep and dark shadow over their childhood. Here at camp, they can be kids again. The camp was held, as it is most every year, at Camp Luther ( This is in northern wisconsin just north of Rhinelander and Three Lakes. 

I arrived late this year. Clinic was VERY busy and I only got in to camp at about 9:30 pm at night. Camp was rather uneventful from a medical standpoint (the way I like it). I treated some cases of heat exhaustion, abdominal pain and one little girl with whom the dialog went something like this:

"Hi! I'm Dr. Vijay. What's wrong?"

"My tummy hurts and (sniff), I'm homesick!"

On Friday evening when the campers arrive, we have icebreakers (to get everyone to know everyone else). They then report to their camps -- rustic camp sites constructed and named 'The Tower', 'Fort', 'The Ark' and 'Treehouse'. The Camp Luther's website (link above) has pictures of these camp sites.

Once settled in, the campers came back down to the main center for dinner. After dinner, there was a special visit from the Northern Harley Club. These bikers give their time to visit the camp and let the kids oogle and pose on their shiny Harley Davidson motorcycles. Campers went on a scavenger hunt after that, and then headed back to camp for the night.

The next morning before breakfast, campers were out on the court playing 4 Squares and shooting hoops. I learnt to play four squares last year. There is a square divided into four with a player in each sector. The goal of the game is to bounce your ball into another square. There are by-laws like 'chicken feet' and 'black magic' to modify the rules of the game.

4-Squares - black magic and chicken feet

I learnt a new game this year: Ninja. Players stand in a circle and after bowing to each other,
Ninja -- yyyyyaaaah!
strike a Ninja pose. Then each person is sequent has a turn. The player tries to touch another player on the hand or wrist. If they succeed, that player is out. Of course, that player can move their hands out of the way. It is great fun to play and to watch. Here are some pictures.

After breakfast, we headed out to Eagle River for a ride on a Pirate Ship ( This year, before getting on board, Captain Steve's daughter, gave us all a class on hoola hoop dancing. The kids loved it.
Captain Steve's daughter teaches the Hoola
Can you do the hoola hoop?
We saw the ship come in
Pirates returning from a trip
and climbed aboard for a fun ride on the channel. Our ship was piloted by Captain Steve and his first mate, Steve-O.
Captain Steve and Steve-O steering the ship. Aarrhhh!

While on board, we ate popcorn, drew on white t-shirts which we got to take home,
Drawing on the T-shirts

and saw cool things like this eagle's nest (check out the eagle sitting above it),
Eagle Nest -- can you see the eagle sitting on the branch above?
a giant red chair on the shore near someone's house,
The Giant Red Chair
and a duck and her duckings in a row.
A duck and her ducklings. Ahoy, mateys!

There was swashbuckling sword duels with bubble swords (see picture)
(Bubble) sword play with the Captain

and listened to Pirate songs (like "My name is Roger the Pirate and my favorite letter is R(arrrrrhhh!").

We came back to camp to a barbecue cook out, then spent time in the water, tubing, swimming and doing crafts.
Tubing behind a jet ski. Hold on tight!

Some kids went fishing and I hear, we caught 20-odd bluegill and other fish. Some were as big as my arm (okay, not really). As I do every year, I got my painted rock. This year, I chose a penguin. No, I did not paint it myself. (see picture).

After cleaning up. in the evening, we had dinner and DJ Dan brought out his music system. We had fun dancing
Dance Revolution
, doing the Tonga and seeing how low we could go under the bar (of course, some of the little kids could just walk underneath with no bending needed (see the picture).

How low can you go?
Sunday morning, after more games of Ninja
A final game of Ninjas -- the Masters at work

and 4 squares, campers boarded the bus to go back home.
Time to go back
It was fun. Campers could forget the seriousness, tragedy and pain of home for a while and just be kids. Volunteers (counselors, cooks, fisherman, helpers, doctor, face painters, jet ski-ers) all came and helped out.

We'll be back in Winter for another camp.

See you at camp in winter 2012!

Friday, July 01, 2011

Julia (not her real name)

I first met Julia when she brought in her newborn son, Caleb for a well child visit. She seemed thrilled with her new baby and doted over him as moms do. During the course of getting a history, I discovered that Julia worked as an exotic dancer. She was not entirely sure who the father of the baby was but thought it was her 'agent'. She told me that she planned to have nothing to do with him.

Over the next few well child visits, Julia seemed to be coming unglued. She complained that the neighbours were teaching Caleb to say vulgar words and that she had caught him saying them (he was about 2 months old at the time). Her speech was rapid and she rambled on not giving enough pause for me to interject a word in sideways.

Julia established care with me since she did not have a doctor. Reviewing her medications, I noted she was on medications for bipolar disorder, ADHD and anti-psychotics. I asked her about her psychiatrist and she told me she saw him regularly.

After several strange phone calls to the nurse line, a social worker was sent to Julia's house. Someone had expressed concern for Caleb's wellbeing, although at every visit, Caleb was gaining weight, meeting development milestones and always looked clean and well cared for.

Caleb was taken away from Julia by the court.

Julia's mental health seemed to worsen. She told me that her psychiatrist and counselor had 'fired' her for noncompliance with treatment and missing scheduled appointments. This was confirmed by a letter to me by the psychiatrist that said very little other than that they would no longer see Julia.

One day, Julia came in claiming that someone had come into her house, cut her hair and stole her ADHD meds. She wanted an early refill on them. I politely told her I would not refill the meds until she either brought in a police report documenting what had happened or showed me proof that she had established with another psychiatrist. She lost her temper and stormed out of the office, after telling me that she no longer wished me to be her or Caleb's doctor anymore.

After being rejected by other physicians with whom she tried to establish care, Julia called my office again and asked for an appointment with me. She mentioned that she was told that until she had taken her medications and was more stable, no-one else would take her on as a patient.

Julia still does not have a psychiatrist. She has not regained custody of Caleb. She continues to have good days and bad days and alternates between being flirtaeous and threatening.

Has the healthcare system failed Julia?