That same year I started dating Collin Anne MacAskill, who had transferred from Allegheny College in Pennsylvania. Collin was the perfect combination of spunky and practical. She had a reasoned approach to life as a college student and paid attention to details and rules much more than I did. Her father had spent a career as a Marine officer and had deployed to three wars. Her brother was a Marine serving in Vietnam. She knew discipline and rules and protocol, but she also displayed a reserved sort of spontaneity that marked her as vivacious and willing to take risks. If that were not so, she would have never dated me. Disciplined as she was, she practiced her Christian faith in a manner that defied the more traditional religious norms of her Presbyterian upbringing. She involved herself in campus ministries that encouraged the growth of faith and compassion among students. It was attractive to me to see how she made faith such a central part of her life without making it overtly and harshly religious. Collin majored in recreational therapy and was a natural at helping people meet their needs for fun and companionship. That was her gift.
Our first date was during the tail end of my music studies. As a course assignment, I had to attend the Utah Symphony Orchestra and write a critical paper for theory class—free tickets compliments of the music department. I asked Collin if she would like to go, and she accepted. The seats were in the far back of the symphony hall, right behind a huge marble pillar. I asked if she wouldn’t mind sitting behind the pillar, since I had to observe the musicians and write a paper. She rolled her eyes but agreed. Miraculously we had a second date, and more followed. We got married in 1972, during the spring of my fourth year of college.
In my final undergraduate year, I explored a military career as an alternative to business and medicine. I had several college friends who participated in either Air Force or Navy ROTC. They all talked enthusiastically about their military careers and the opportunities they had. I sought out the campus Marine recruiter and asked about a career in aviation. He started me on a path of screening interviews and application forms. I met all the qualifications and planned to finish college with a business degree, go straight to officer training, and then on to flight school. I would potentially go to Vietnam to fly fighter jets off an aircraft carrier.
My father-in-law, who had spent combat tours in the South Pacific, Korea, and Vietnam, advised me to consider what I would be risking for a military career and suggested that I might think about alternatives—consider other choices. He gave me pause. He was a Marine colonel; I was a college student married to his daughter. I figured he might know a bit more about the Marines and the current situation in Vietnam than I did. I trusted his advice and opted for a civilian business career. In the short term, that career turned out to be a part-time job at the Salt Lake City International Airport where I pumped jet fuel and parked corporate aircraft—minimum wage, no benefits. Collin and I lived in a twenty-by-twenty-foot basement apartment, paid one hundred dollars a month for rent, drove a used orange Plymouth Duster, and lived from paycheck to paycheck. We wanted something different, something more.
The University of Utah offered a master’s degree program in human resource management that required only one year of coursework for those students who already had a business degree. It minimized the math and finance requirements of typical MBA programs and emphasized the people end of business. I enrolled in the fall and we budgeted our expenses to Collin’s income. I worked in a student internship at the university and continued the airport job on alternate weekends. I completed the program in the summer of 1976. A business degree was practical, it would serve to provide a well-paying job, yet it was not the career that I wanted to frame my life. And as with the completion of my undergraduate degree, I stuffed my dream of becoming a doctor into a subliminal closet while I pursued the more practical aspects of starting a career. Whenever I dressed the part of a businessman, I would walk into that closet and see the dusty edges of my dream, that stubborn vision of me as a doctor. And I held two dreams of myself: one defined a practical survival; the other defined who I really wanted to become.
—
Master’s degree in hand, I landed a marketing job at IBM and was offered a chance to relocate. Collin and I choose Anchorage, Alaska. In the fall of 1976 we traded in our Plymouth Duster for a new International Harvester Scout and drove the Alaska Highway to our new home. During our first year in Alaska we bought a house, a bush plane, and a camper. We spent weekends camping and fishing. In January 1978, our first son, Justin, was born. That summer we took him salmon fishing in a backpack baby carrier. We hiked and hunted, worked and dreamed.
As an integral part of IBM’s training and business culture, I learned to write an annual marketing plan that listed all the steps required to accomplish my business and personal objectives for the coming year. Every year, at the top of my plan, I would write, “Go to medical school.” Before my manager reviewed the plan, I scrapped it and wrote a different list with hard-core business objectives displacing my more personal goals. When I thought about what I was doing, I realized I was still unsettled about my future. The plans worked. I won numerous marketing awards during our family’s three years in Alaska. My success at IBM drove me, but I still found myself wanting something different. And I knew exactly what that something was—the dream that I kept hidden and alive.
We relocated to Chicago in the late spring of 1979 in preparation for a marketing promotion. Within months I realized that my IBM career lacked the sense of promise that it held when I worked in Alaska. Darren, our second son, was born in September and my focus began shifting toward family and fatherhood responsibilities. Internally, I still had lingering thoughts of becoming a doctor, but they seemed so unrealistic and out of touch. I was at least ten years past the prime of entering medical school, and money and career opportunities were not things to be abandoned for a dream.
At age thirty, married, and with two children, I decided on the practical course. I would pursue further education and an academic career as an alternative to medicine. The educational part was also an incognito means of bolstering my academic credentials for a run at medical school if academia didn’t work out. I didn’t tell Collin the hidden part of my plan because I felt it might reveal I was still unsettled about my future, even though I had agreed with her that an academic career would make sense in providing a challenging outlet for me and stability for our family.
My advisor at the University of Minnesota was Professor Chuck Manz, who researched and wrote about self-management. Professor Manz was young, energetic, and just enough of a maverick in pushing graduate students that he was a perfect match for me. He thought my proposal for research, a study of the physiology of stress and work performance, unique among the more typical business research proposals. With his guidance, the School of Business approved my rather non-traditional PhD proposal to integrate coursework in the School of Public Health within the College of Medicine. The college offered one particular course in the fall semester that I considered central to my plan, occupational medicine, taught by Professor Robert Veninga. It was designed for physicians and graduate students entering the field of public health.
After I presented my term paper, Professor Veninga called me into his office to discuss it. His first words were “Great paper.” He had follow-up questions and generally made comments as to the importance of the original insight that it offered. Then he said something that jolted me.
“You should consider studying public health or medicine.”
You should consider studying medicine. I needed those words. When I heard them, it seemed as if they enlarged their meaning as they traveled toward my brain. They reminded me of the Oneida healer’s blessing I received as a child. I experienced an instantaneous awareness of a possible reality that nested itself in the word “medicine.” My dreams about becoming a doctor became more than an undergraduate fantasy; they became transformed into image and movement and direction, and I felt connected to medicine once more. I tried to respond to Professor Veninga
with the outward appearance of an objective and critical graduate student. Casually and almost nonchalantly, I acknowledged that I had, on occasion, considered the study of medicine. In my heart I felt like William Harvey himself had just opened the great doors of the renaissance medical school at the University of Padua, Italy, and said, “Please come in, we’ve been expecting you.”
When I left Professor Veninga’s office, I headed straight to the College of Business to talk with Professor Manz. I told him I wanted to switch directions and study medicine. He smiled and said he wasn’t surprised and that I would be an excellent doctor. He offered to help by keeping me in the business program for another year as a teaching assistant. That single act of support gave me an endorsement to follow my dream. And like the comments of Professor Veninga, I needed that encouragement from Professor Manz. His support helped me understand that I would find my way to study medicine.
During the next two years, I studied the necessary science prerequisites for my application to medical school. I absorbed lectures in chemistry, physics, mathematics, and biochemistry, engaging the readings and the labs, often studying until after midnight. I would run my fingers over the pictures in the cell biology and biochemistry textbooks, mesmerized by the beauty of cellular structure and the intricacies of biochemical interactions.
On September 1, 1981, Collin gave birth to our daughter Jordan. She was born with a constriction in her aorta that required surgery. During Jordan’s first two years, we spent numerous days each month in the offices of pediatricians and cardiologists. Our lives were anything but planned or predictable. We lived in a no-man’s-land of uncertainty about Jordan’s health and our future. She had her surgery at age two and a half and recovered without complications.
In the midst of that uproar of family stress, I continued my preparations for medical school while teaching at the University of Minnesota and at Bethel College in Saint Paul. Collin wondered how we could provide for our children if I left academics. She worried about the future and had questions about finances. I didn’t have the answers. I thought perhaps I didn’t need answers—only the confidence to get through. I assured her medical school would work out, that it was a now-or-never proposition.
We argued, she complained. We argued, I complained. We both felt angry and confused and out of control. Sometimes we screamed. Sometimes we cried. I felt she didn’t understand my life’s ambition. She felt I didn’t understand or care about her needs. I told her I wanted more for the family. She said I wanted more for myself. Occasionally we gave each other the silent treatment. Sometimes we got on the same wavelength. We both felt a mixture of fear and hope as we muddled forward and backward, one stressful step at a time.
—
Before I sent out medical school applications, I visited the campus of the Mayo Medical School in Rochester, Minnesota. I met with the dean, Dr. Roy Rogers III, and we discussed my application. The only Roy Rogers I knew of was the one I had watched on television. I wondered if the dean was related but didn’t dare ask. Dr. Rogers assured me I was competitive enough to make the first cut and was rather impressed that I made the extra effort to visit the medical school prior to applying. About a month later Mayo responded with a letter inviting me for an interview. Part of me marveled in disbelief; another part of me expected it. I set it up for late January. The morning of my interview, a blizzard hit and turned the roads to ice. The drive to Rochester from my home in Apple Valley, Minnesota, normally took little more than two hours. I left my house at 6:00 a.m. to allow enough time to get to Mayo. When I left the house, the wind chill was minus twenty degrees. When I arrived in Rochester at 9:30 a.m., it was minus thirty, cold enough to make my nostrils stick together when I breathed.
While I was on the road, one of the admissions staff members phoned my home to advise me not to travel and to reschedule the interview. Too late. I was already in their medical library warming up. I had my interview at 10:30, as scheduled. Dr. Rogers greeted me and I told him a blizzard could not keep me away from medical school. He chuckled and offered me coffee. The entire interview lasted almost an hour. I got extra time because the applicant scheduled after me canceled due to the weather.
Afterward, it took almost twenty minutes to clear the ice from my car and get it warmed up. As I traveled back to Apple Valley, I turned the radio on extra loud and drove perhaps a little too fast. Confident and a bit elated, I laughed and sang. “Hot damn! I’m goin’ to Mayo.”
Two weeks after my admissions interview, I received a letter from the Mayo Medical School. I took the envelope downstairs to my makeshift study to read it in private. I noted how thin the letter was, how light it felt in my hands. I had heard from other premed students that thin letters didn’t contain the admission’s “welcome packet” and were therefore rejections. I hesitated, tensed my shoulders, held my breath, and carefully slit the envelope open. I pulled out the letter and unfolded it. The first four words read, “Congratulations, we are pleased…” I breathed, said yes repeatedly, and finally sat down. I read the letter several times and focused on the first four words. My stack of MCAT books sat on the floor. I picked one up, fanned the pages, and laughed out loud; then I stood and shouted, “I’m in!” I would begin medical school in the fall of 1984. I had just entered the class of 1988 of the Mayo Medical School. And that was an awesome, yet almost frightening reality. I would finally become the physician that I had so often dreamed about.
—
The day before classes began, I spent almost three hours exploring the halls of the Mayo Clinic and the adjacent Plummer Building, which held the medical library and the stacks of thousands of medical journals. At each lecture hall in the medical school, I sat in several different seats; first in the front row, then in the back, trying to find which ones gave me the best vantage point. In the student center, I checked to make sure my name was on a mail slot. It was. After a half hour I double-checked it. Still there. The anatomy building was surrounded by flower beds. I stepped over them and ran my hands over the walls, lingering as my fingers touched the weathered, tan bricks. I wanted to absorb anatomy through the walls like osmosis—let medical science flow through my skin and saturate my body, let knowledge become my oxygen.
As I continued to explore, I walked back to the Plummer Building and rode the elevator to the fifteenth floor, which housed the medical antiquities collection. I explained to the librarian that I was a new medical student and loved to read about William Harvey and the classical anatomists. Before I could ask, she volunteered to show me some original sketches from the earliest anatomy books in the collection. We entered a humidity-controlled inner room where the librarian placed an ancient book on a large oak table. It was an original by Andreas Vesalius, De humani corporis fabrica. The fragile, slightly graying pages held printer’s ink from the year 1543. The ink seemed to me only slightly faded; the smell of ancient paper drifted ever so slightly above the drawings. I gazed in silence as if in meditation. Almost imperceptibly, I nodded my head in affirmation. I was so overcome by the beauty and the historicity of the drawings, I struggled not to show emotion. The librarian said I could come back during the posted times; she even told me about an opportunity to study ancient books as part of an elective. As I left, I felt humbled by the study of medicine.
Anatomy was my favorite subject, as I guessed it would be. The course detailed every aspect of human structure, every bone, every organ, every cell, and their anatomical relationship to the whole body. It was one of the cornerstones of biomedical science. The anatomy professors, Drs. Cahill and Carmichael, did not assign lectures to graduate students but did all the didactic work themselves. They spent hours drawing magnified details of the human body with colored markers on whiteboards, often working through lunch. I tried to copy their drawings freehand in my notebooks. Dr. Cahill emphasized the ability to draw anatomical relationships from memory, arguing that a student who could sketch the details of anatomy was a student who understood the body, artistic skills aside.
&n
bsp; Our medical school library housed numerous life-size and scaled-down models of the human body. I studied them all in detail, sometimes disassembling and then reassembling the models just to get the feel of the shape and size of the organs. Occasionally, while I was studying, I would remember the Visible Man of my boyhood days, the afternoons spent learning all the parts, taking them apart and putting them back together.
The pathology course included an optional research component that lasted six months. I took the option at the encouragement of one of the professors, Dr. Bahn, who used to say if doctors mastered the pathological basis of disease, they would be better prepared to diagnose and treat disease. I wanted exactly that. Pathology included duties on the autopsy service and in surgical pathology, where I accumulated hundreds of hours analyzing whole organs and their corresponding histological specimens. I studied diseases by system, organ, and cell and learned to determine causes of death at each level. I worked on a particularly difficult case that involved the autopsy of a teenager who was killed in a home fire. The teen had escaped the fire and alerted neighbors to contact the fire department, only to rush back into the burning house to help her mother escape. Both died of smoke inhalation. That was my first encounter with violent death and it shook me. I had seen other deaths in pathology, but this one was particularly tragic because it was so unnecessary.
Crossings Page 4