Wisdom from 50 years a doctor [PODCAST]

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“This last doctor was also the happiest doctor I have ever met. He was not a youngster but had a wonderful following of patients and was loved by the entire hospital staff. And he had a very nice singing voice. Today this would be considered dangerous.”

Ronald Halweil is an otolaryngologist.

He shares his story and discusses his book, Fifty Years a Doctor: The Journey of Sickness and Health, Four Plagues and the Pandemic.

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Transcript

Kevin Pho: Hi, and welcome to the show. Rate and review at KevinMD.com/rate. Subscribe at KevinMD.com/podcast. Today on the show, we have Ronald Halweil. He is an otolaryngologist, and we’re going to talk about his book, Fifty Years a Doctor: The Journey of Sickness and Health, Four Plagues and the Pandemic. Ronald, welcome to the show.

Ronald Halweil: Thank you, Kevin.

Kevin Pho: So we’ll get into your book in a little bit, but first off, just briefly share your story and journey to where you are today.

Ronald Halweil: Right, quite a journey. It started when I was an infant, a newborn, maybe three or four days old. My mom invited her father to come see their baby, and when he came to see me, the first thing he said was, “He will be a doctor.” My mom heard that, and she loved it, because she wanted someone in the family to have a really great profession, and I was the only child at that time. So that was how it started.

And then, of course, as I got older, I saw other things. We lived near Ebbets Field, the home of the Brooklyn Dodgers, and I would occasionally get enough money together, like 50 cents, and be able to see a ball game. So I wanted to be a baseball player, but that didn’t last too long. And then I became very interested in science, and I wanted to be a scientist: biology, chemistry, physics. As that moved along, I would tell my mom, “Hey, I think I want to do this,” and she would say, “No, you’re going to be a doctor.” She was a strong woman, and of course I loved her dearly.

So time moved on, and I went to grade school, college, and then medical school, and sure enough, I was on my way to be a doctor. I originally wanted to be a general doctor, but this was the time when specialization started. I saw it was a toss-up between OB/GYN and ear, nose, and throat. OB/GYN because it would be more interesting, helping to bring life into the world, and maybe fewer bad things happening. And as an otolaryngologist, I was interested in the new technique of improving hearing in people who couldn’t hear, which involved microsurgery, and I really enjoyed using the microscope.

So I found out that I might have to stay up all night, for days on end, as an OB/GYN, because the way it was done in those days, once you saw the pregnant woman, you had to stay with her the whole time. There was no group; you were the one. How was I to know that in a few years there would always be a group of doctors, and I wouldn’t have to worry about that? But I became an otolaryngologist. I loved that field. I loved the microscopy and the teaching; at some point, I was teaching other doctors. I did a lot of surgery, facial surgery and ear surgery, ear, nose, and throat surgery, and I enjoyed that. I practiced; I had a private practice at a time when that was possible economically. Now it’s not really possible economically.

Kevin Pho: Would you say it’s impossible to have a private otolaryngology practice today?

Ronald Halweil: Pretty difficult. Maybe if you were the only one in a hundred miles, and there was no one else, you could do it. But it’s controlled, obviously, by the hospitals and the big organizations.

Kevin Pho: Now, as you reflect on your decades-long otolaryngology career, what would you say are some of the biggest advances that you’ve seen during your career?

Ronald Halweil: Oh, the big advances were the big ways to look at the parts of the body. We didn’t have any way of looking deeper into the body except with the knife, or scalpel. But now we have CT scans and MRIs, so you don’t even have to be a doctor to figure out what’s happening. That’s the big advance in medicine.

Kevin Pho: And for those medical students who may be listening to us on this podcast, what are some reasons they should consider otolaryngology as a career?

Ronald Halweil: It also involves plastic surgery of the face and a lot of other surgery, skin surgery and so on. So if you’d like to do surgery, that’s a field. And obviously, you can help lots of people with hearing problems, breathing problems, sense of smell, and throat problems. Yeah, tremendous.

Kevin Pho: All right, your book is titled Fifty Years a Doctor: The Journey of Sickness and Health, Four Plagues and the Pandemic. Now, tell me about the events that led up to you writing this book.

Ronald Halweil: Well, after I retired, I would often think back on the history, what I had been through. It was quite a period of time. And I would see the advances that had been made, and the errors, and I said, “Well, I’m going to write this down, and maybe this can help not one person at a time, but maybe hundreds or even thousands of people at a time.” Yes, I had seen the errors as well as the advances.

Kevin Pho: So tell us one of those stories that you feel would help hundreds at a time. Give us one example.

Ronald Halweil: Well, the example is very simple, and we see it all the time. We see people on the street who are too large. They’ve gained too much weight, they have trouble sleeping, and they have trouble breathing. And how did this happen? Did someone just plant a pill in them, or was this a slow problem, that we are getting bigger and bigger with time? And then these people were in danger of serious disease and death. And yet it could definitely be treated early if we recognized it, and that would help a lot in terms of medical costs and lifestyle. We had forgotten about lifestyle. We were more interested in medication and treatment rather than prevention, and these are all preventable problems that I saw.

Kevin Pho: And speaking from an otolaryngology perspective, tell us how some of these lifestyle issues affected patients as they came into your operating room.

Ronald Halweil: Well, often they wanted a quick treatment: “Can you operate on this?” and so on and so forth. And yes, there were times when I could operate on them and help them hear better, have a better sense of smell, and a better sense of taste, by removing nasal polyps, for example, and by talking to them about what they can do, without fancy stuff, to help themselves.

Kevin Pho: All right, what are some of the key messages that you want readers to come away with after reading your book?

Ronald Halweil: I want people to know that they are in charge of their health. Health care does not mean that they’re in charge of their health. It means that if they get sick, then they can get health care. But why can’t they get help? Because no one’s talking about it. Health is an old-fashioned thing. Hippocrates spoke about health. They didn’t know about these other things, but he spoke about it, that there were ways to stay healthy. Proper eating, diet, was the main thing: proper diet, exercise, which is also movement, and rest. Those things could solve a lot of problems, but apparently I’m the only person interested in that. And why is that? Why aren’t we talking about this more? Because we have a tremendous health care industry, and I fear that’s part of the problem.

Kevin Pho: So what are some ways that we could incorporate more health into our conversation? It could be inside or outside the exam room. What are some ways that we can do that?

Ronald Halweil: Well, we can do it, for example, by having a school class about health. Start early; you could teach people about that when they’re teachable. The other parts are a little harder, because we don’t talk to our patients as much as we used to. If you could talk to them for a long enough time, something might stick, and they might change. But now, with the economics of medicine, you can’t sit in your office with the patient for a long period of time just talking to them without doing something.

Kevin Pho: So you had an excerpt from your book on KevinMD, “Singing doctors in the operating room.” Tell us the story behind that excerpt.

Ronald Halweil: Yeah, it’s a great story. This comes from the chapter called “A Unique Residency.” I was lucky enough to get a residency in general surgery, which you needed to be an ear, nose, and throat doctor, at the Honolulu, Hawaii, hospital, the Queen’s Hospital. This was very exciting for me and my young wife at the time; I now have another wife. There were very few residents. My friends in medical school told me, “You’re going to Hawaii.” Well, what do they know? But the fact is, they knew a lot. There were many surgeons and very few residents, so I could be involved in every procedure that I wanted, from the head to the foot, anywhere. I would do the operation with the guidance, I would suture with guidance, and I saw the different ways that the doctors operated, and the results. I got to see the results.

One day I was working. I had helped the doctor do an appendectomy; I was the assistant. After he had sutured the wound, he started singing. He was a native Hawaiian with a wonderful voice, and he sang so beautifully that anyone within hearing distance would quickly come closer to hear more. I certainly heard it also, and I loved it. It was the opposite of burnout, of medical burnout. This helps the mind; the body relaxes. That was what I learned, and that was an important thing that I learned.

Of course, things changed after that. We were more controlled by the establishment. But at that point, I don’t think many of the doctors had burnout. They were singing; they were happy doctors. Great thing.

Kevin Pho: Such a stark contrast, then and now. Now, for a lot of young physicians or physicians in training who will be listening to you, what are some pieces of advice that you could pass down to them?

Ronald Halweil: Well, you have to really want to be a doctor at this point, and you won’t be independent. You’ll be working for a group, a number of people. And there is the satisfaction of helping, so you still have that satisfaction. And then there’s learning something: You’ll be learning about the human body, and something they may be able to use for themselves as well.

Kevin Pho: Any pieces of advice for those physicians who are practicing within a group? Because, as you mentioned earlier, there are fewer and fewer doctors practicing independently or in private practice. So within the framework of an employed position or a group, any piece of advice that you could share with those physicians?

Ronald Halweil: Yeah, well, they have to make sure that they get enough time out, what I call free time. Even I had a chance to have free time back in the days when I was at the New York Eye and Ear Infirmary: a full lunch hour. And if there wasn’t a lot of surgery going on, you were allowed to go out into the world and walk around. You didn’t have to be sitting all the time. Sitting, by the way, is not such a good idea if it lasts more than 10 or 15 minutes.

Kevin Pho: We’re talking to Ronald Halweil. He’s an otolaryngologist, and he’s the author of the book Fifty Years a Doctor: The Journey of Sickness and Health, Four Plagues and the Pandemic. Ronald, what are some of your take-home messages that you want to leave with the KevinMD audience?

Ronald Halweil: Well, I think the doctors have to stay strong. They have to be an example to the patients that they are taking care of themselves. They actually have time to exercise, have time to read a book, for example, and have time to have family and friends.

Recently, I’ve become interested in a dream that I have, and that’s a paraphrase of Martin Luther King Jr.: I have a dream that in the future, and hopefully not the far future, there will be a system of health where everyone will learn what health is. They don’t have to be taught what health is. The wisdom of Hippocrates, a long time ago, had everything that we now know about health, and mostly it had to do with diet. “Let food be your medicine” was what Hippocrates said. And most of the problems, if you’re not a heavy smoker, most of the problems involve diet at this point.

Kevin Pho: Ronald, thank you so much for sharing your time and insight, and thanks again for being here.

Ronald Halweil: My pleasure.

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