Art Imitates Life Imitates Art

celebration invite screen

On May 19, 2013 the Greater Louisville Medical Society held its annual Presidents’ Celebration at the Kentucky Country Day School Performing Arts Center in Louisville, Kentucky. On that day I was honored by inauguration as president of the medical society. Early in my address to those in attendance I was abruptly interrupted by a “heckler” in the audience. Here is a transcript of that encounter…

 

fraud title pose

 

Fraud

 

A play in one act by James Patrick Murphy, M.D.

gettng the gavel

Characters:

Doctor Murphy (DOCTOR) – A physician who has just been given the gavel and installed as the next president of his medical society.

Patient (PATIENT) – A female audience member.

Voices in unison (VOICES) – A group of people off stage who are never seen, but say the last line in unison.

*

The lights come up to reveal DOCTOR on the stage, addressing the audience. DOCTOR’s first line is somewhere in the middle of his acceptance speech.

doctor address  crowd 1

                                                  DOCTOR

I know there are actually some of my patients out here too. And I won’t ask anybody to raise their hand, because I understand the confidentiality but thank you…

(DOCTOR is interrupted by a voice from the darkened audience)

 

                                                  PATIENT

Thank YOU Doctor Murphy.

(Audience applauds)

silvie full in audience 2

 

                                                  DOCTOR

(Peering out into the audience, sheepishly)

Who was that?

 

                                                  PATIENT

(Raising hand)

Me.

 

                                                  DOCTOR

Do I…?

audience silvie 2

                                                  PATIENT

Yeah, you may not remember me, but I sure remember you. Thank you.

(DOCTOR is smiling, but is clearly rattled by this interruption)

 

                                                  DOCTOR

Thank you. Uh… Just a second. Can I talk to you?

(PATIENT gets up from audience and meets DOCTOR at the corner of the stage. After brief hushed conversation, DOCTOR invites PATIENT up onto the stage)

 

                                                  DOCTOR

(To audience)

This is kind of unusual, but she’s going to say something that really fits into what I’m going to say later on. This is kind of amazing.

first patient 3

                                                  PATIENT

(To audience, holding a microphone)

Well, I was Doctor Murphy’s first patient, ever. I was only eight years old. And he was on his… (Turns to address DOCTOR) You were on your first clinical rounds, your rotation in med school. And you came every morning and looked in on me and checked my pulse and my temperature and my lungs and got me ready for my open-heart surgery. (To audience) I had open-heart surgery. I was so little and so scared.

going to be okay 4

(To DOCTOR) And you just let me know that everything was going to be OK, that I was going to do great. And I did! And I swore I would never forget you. And I haven’t.

 

                                                  DOCTOR

Well, thank you so much. That’s great. (To audience) Isn’t that great? I remember that. Thank you.

(DOCTOR reaches to take the microphone from PATIENT, but at the last moment PATIENT pulls away and continues speaking into the microphone)

microphone 5

                                                  PATIENT

Thank you and I didn’t…I…I…You rotated away after that.

 

                                                  DOCTOR

Yeah, I know. I rotated in medical school.

that's OK navy 7

                                         

                                                  PATIENT

But that’s OK. You don’t have to explain anything, because I understood. I know how those things go. I trusted you and I was grateful for all that you did for me.

dont have to explain 6

                                                  DOCTOR

Thank you.

(DOCTOR attempts to applaud, but is cut off by PATIENT)

 

                                                  PATIENT

(Backing away a little more)

Oh and I remember I saw you at that clinic in the navy hospital in San Diego. Yeah, I was so nervous and you had some really bad news to give me, but you set me up with a specialist. But then after that I never saw you. You left the hospital after that.

 

                                                  DOCTOR

Well, I was in the navy. I had to go out on the ship.

 

                                                  PATIENT

(Backing away a little more)

Yeah, I understand. You don’t have to say anything. You don’t have to explain. I completely understand. I was grateful for all that you did for me. I trusted you.

(Backing away)

And then I remember you were my anesthesiologist before my surgery. I was waiting for my surgery. And you were a little bit under the gun, because the OR was ready and the surgeon was ready and standing by. And right before we were going to leave to go in I asked if I could pray with my pastor. And you stopped everything and let that happen.

pray 8

                                                  DOCTOR

Yeah, I remember that. And I hope you don’t think that you were inconveniencing me at that time.

 

                                                  PATIENT

(Backing even farther away)

Oh no no no. You don’t have to say anything. I understand. I trusted you. And I was grateful for all that you did for me.

And then I had to have all those pain medications because I had five back surgeries. And the insurance company had some doctor I’d never seen before look at my records and not at me. And you did write a letter after they said that the insurance shouldn’t have to pay for my medications. You wrote a letter but they still denied my medicine.

wrote me a letter 9

                                                  DOCTOR

I know. I was going to call, but, you know, the preauthorization takes so much time. And I’m so busy. And I have to see a lot of patients. I have to pay my bills.

 

                                                  PATIENT

(Backing still farther away)

Yeah, I understand. You don’t have to say anything. I trusted you. I was grateful for all that you did for me.

start all over 10

And then I got that letter. I got that letter that started off, “Dear Valued Customer.” And then went on to say that I was going to have to get another doctor because you were not in my plan. You’d been cut out of my plan. Or because you’d started working for this big health care corporation and they didn’t accept my insurance. So I had to go find someone else and start all over.

 

explaining 10.5

                                                  DOCTOR

Well you know there are so many regulations now. There’s so much. There’s laws. And there’s the EMR. I have to document so much stuff. I can’t do it on my own. I have an employer now. I’m part of a corporation. I have corporate policies. (PATIENT is now exiting the stage) You know, I want to be your doctor. I want to be the leader of the health care team.

not okay 11

 

                                                  PATIENT

(No longer on stage, now only a voice on the PA system)

I don’t think that’s OK. I really don’t like your explanation. I’m not sure I trust you anymore. I am not grateful to you. I’m not a person anymore.

 

                                                  VOICES

(Off stage)

I am a population.

population 12

 

                                                     END

 

sad at end

 

*

Postscript: Silvie Zamora played the role of PATIENT. Silvie is an incredibly talented actress and dear friend. She and her equally talented husband, Phil Ward (also a lifelong dear friend), were vital to this little one-act’s artistic value and true message.

 phil and silvie

When you watch the video, keep in mind this was never rehearsed on stage. Silvie is the queen of improvisation!

Initially, the audience was not aware that this was a ruse. From my vantage point on stage it was fun to sense each individual gradually becoming aware that they were taking part in a group theatrical event.

“FRAUD” was written to be a wake up call for all physicians.

And, by the way, the events depicted in the play actually happened.
…and this just scratches the surface.

thumbs up

*

*

*

 

Here’s the link to the “Fraud” video:

http://vimeo.com/67679697

 

 

*

 

 

 

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A love letter to a liberal arts education

The_columns_at_Westminster_College 

At Westminster College my intellect was challenged, my imagination was freed, and my passions were set ablaze. Here I made lifelong friendships that have sustained me. Here I thrived in the glow of mentors who sparked confidence and convictions.

–       This is my quote as it appeared in the Westminster College Alumni Awards Convocation program, April 26, 2014. It’s only a portion of what I submitted and does not tell the whole story.

 

walking on the grass at westminster

April 26, 2014 was a typical springtime Missouri morning – cool, crisp, sunny, and I was my typical running late self. Not to worry, a shortcut across the lawn and I should make it to the ceremony with at least thirty seconds to spare. Just behind me, I noticed a smartly attired lady who had chosen the same trajectory as me. Assuming we were going to the same place, I tried to be cute:

“Back when I went to this school they would fine you for cutting across the grass.”

She was cuter:

“Don’t worry. I know someone.”

That someone was her husband and Westminster College President, Dr. George B. Forsythe. Jane and I were going to be fine. She had her connections and I had a half-minute cushion. It was just like old times.

church inside

Twenty minutes later, standing at the business end of the center aisle in that iconic Christopher Wren church, came my singular three-minute opportunity to channel my inner Winston Churchill and somehow explain what this Lifetime Achievement Award means to me. As best I can remember, this is what this English major said…

*

at podium smiling

President Forsythe, distinguished guests, faculty, friends, students, and fellow award recipients, I am deeply honored by this recognition. If I am truly the person you described in that gracious introduction, then Westminster College deserves much credit.

I want to first thank my wife, Adele, and my son, Kellen, who are here to in share this experience. You didn’t know me while I was at Westminster, but this place helped make me the person you now know.

And I must thank my mom and dad for the foresight, vision, sacrifice and love it took to provide me this opportunity. My dad was a city fireman and my mom worked her way from our school lunchroom to registered nurse. I was their first-born and the first in our family to go to a four-year college. Sending me away was tough on them economically and emotionally. I can clearly remember Mom’s tearful goodbye as they drove away from the steps of Marquess Hall. Dad said Mom cried all the way to St. Louis. But they were very proud to send their son to Westminster College. And they would have loved being here today, but due to health issues couldn’t make the trip. This is their award too.

I also want to mention and thank the late Charles King McClure, a successful Louisville entrepreneur, who lived in my dad’s fire district. Mr. McClure was a Westminster alum and trustee. When he learned of my dad’s bright son, he convinced us to look at Westminster. But it really didn’t take much convincing. After one visit I knew this was the place for me.

There’s something about this small midwestern liberal arts college. I still can’t put my finger on it, but it might be akin to Kentucky’s unique nurturing of horses.

kentucky horses

The Bluegrass State has gently rolling hills for building strong muscles, nutritious grass for grazing, and abundant limestone in the soil to provide calcium for strong bones. There foals become colts, then competitors, then champions. Likewise, Westminster provides the essential ingredients to nurture thoroughbred students who become champions.

route z screenshot

Driving to Fulton this Thursday I longingly scanned the horizon for the exit onto route Z; my first opportunity to get off I-70 and into the countryside. Like the college, there’s something about the locale – an historic small town in central Missouri.

fulton the setting

This idyllic environment lends itself perfectly as the setting for a coming-of-age story.

Not to diminish the importance of academics, but driving on route Z through Calwood, the self-proclaimed “Crossroads of the World”…

welcome to calwood screen shot

…past farms, over creeks, to finally arrive in Fulton, my only thoughts were of my classmates, friends, professors, and fraternity brothers. Our four-year odyssey began trudging uphill through the Westminster columns as freshmen and ended downhill, as graduates, through those same columns on a misty day in May of ’81.

westminster columns sunny

These relationships were forged in a pivotal time – riding the last waves of adolescence; on the cusp of adulthood – and wove the calico fabric of who I would become.

At Westminster, “who I would become” seemed always to be in a state of flux. But contrary to popular belief, my decision to apply to medical school was not a last minute afterthought. I came to Westminster with that goal in mind. The problem was that I loved poetry more than chemistry. However, my faculty mentors – some of whom have honored me with their presence here today – advised me I could major in my first love and still take advantage of the breadth of educational opportunities encompassed by a liberal arts curriculum. I always felt a bit like their little experiment. But the experiment worked – and their Westminster English major got early acceptance to medical school.

I may not have been sure of my destination, but I never doubted the vital role Westminster played in my journey.

Our Town - filmstill

In Thornton Wilder’s Our Town, Emily asks, “Do any human beings ever realize life while they live it — every, every minute?”

Well, Emily, during my four years at Westminster I tried to realize it. And I have proof.

the med school ap

A few weeks ago, while going through some old boxes I came across a copy of my hand-typed medical school application from the summer of 1980. Reading the personal statement section took me back to that late night when, alone in my parents’ basement, my appreciation of my college experience took center stage:

I believe well roundedness is one of the most essential characteristics one can possess. This is one reason why I chose to attend a small liberal arts college. I am so thankful that I have been blessed with the opportunity to attend such an institution as Westminster College. There I have been able to assume leadership roles in honorary, scholastic, administrative, artistic, and social societies. I have experienced music, theatre, dance, creative writing, athletics, as well as the classroom. Also the year and one-half that I served as a dorm counselor and resident advisor allowed me to develop my understanding of human nature. At Westminster I was able to major in English and still pursue a pre-med curriculum. I chose English for two reasons: (a) I think the art of communicating with another human being with clarity, precision, and feeling is one of the most important skills one can possess; and (b) I simply love it. But just as important as anything else, I have made many dear friends at school who will remain with me in my heart as long as I shall live.

Yesterday, I had the pleasure of meeting with some current Westminster students.

Ya got trouble Westminster

My goal was to help them understand the value of a liberal arts education. In this day, where jobs are tight and competition is fierce, learning what and how might seem more practical than learning why. However, I stood before them as a testament to how practically perfect a Westminster education in search of why can be. There are many destinations in life, but only one journey. I left Westminster prepared for a journey.

last line screen shot

As I showed the copy of my med school application to the students, I noticed for the first time the last sentence and realized that it illustrates the most valued attribute born of a liberal arts education:

I am confident I could fulfill myself in medicine, but as sure as truth is always changing, should I discover later that it is not right for me, I know I would have the courage to move on in search of that which is.

 award from pres at podium

Today, alongside these other worthy honorees, I gratefully and humbly accept Westminster’s Alumni Lifetime Achievement Award. However, my journey is not over. Each day I feel it has just begun. And I do have the courage to move on in search of the next destination. I hope I have and will continue to prove worthy of this beautiful award. I will cherish it.

the dream of westminster

I leave you now with the full text of the quote I submitted; i.e.: the rest of the story:

At Westminster College my intellect was challenged, my imagination was freed, and my passions were set ablaze. Here I made lifelong friendships that have sustained me. Here I thrived in the glow of mentors who sparked confidence and convictions. My appreciation of those who shaped my collegiate odyssey is only exceeded by the profound gratitude I have for my mother and father. My parents’ love and sacrifice allowed me to realize my Westminster College dream, which has been one of the greatest blessings in my life. 

westminster sign