An excerpt from Jimmy’s Story: Forging a New Path for American Healthcare.
Looking back, I had submitted my fictional tale, “Standing Vigil 2020,” to the New England Journal of Medicine (NEJM), a premier peer-reviewed professional journal. The NEJM had sponsored a fiction-writing contest, and I had received a terse letter of rejection of my submission. Little did I know at the time of the writing that my grandson would ultimately change the course of health care, despite the powerful forces aligned against doctors and the patients they serve.
The emotions I felt having received the rejection for my writing spanned the spectrum, from disappointment for not winning the writing contest to realizing that the story was incomplete. Perhaps the editors rejected the main character’s aggressive action against her boss. Maybe the crime of breaking and entering by the main character was not forgivable in the minds of the editors. Admittedly, I had created a problem without offering a solution, leaving the reader with a sense of unfinished business. What follows is my take on why Jimmy’s story is important for changing health care for the better.
- Health care is not working for the people who need it.
- I understand the problem because I have lived it in practice.
- Rethinking the roles of doctors, patients, and those who pay for care is essential.
- Alignment of incentives with rewards for health outcomes encourages best medical practices.
- The end result is better health and better experience at lower cost.
Jimmy’s story serves as the framework for a better model of American health care. His story also serves my purpose of narrating details of a unique journey before they become a clouded memory.
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Part 1: preparing to sail
Chapter 1: Camden, Maine
“Cast off the lines, Jimmy, and step aboard!” I called out to my grandson as we motored away from the dock in Camden, Maine. Once we were outside the marina and into the Penobscot River, Jimmy helped unfurl the mainsail while I set our course for Penobscot Bay and the islands. In good weather, it is a sailor’s paradise. Once we were at full sail, feeling the wind and the sun, we joyfully experienced harnessing a force of nature for another adventure together.
Chartering a 36-foot sailboat had become an annual summer event for my grandson and me. A few days at sea allowed us to reconnect after Jimmy finished the school year and before his parents carted him off to their summer home.
“Hey Doc, when can I take the wheel?” Jimmy was eager to feel the boat respond to his grip and to maximize the power of the wind in the sail. Over the course of several trips together, Jimmy had grown proficient at handling a sailboat, first as a crew member and then ultimately as a skilled sailor, even before he could legally drive a car.
“Hold this course by the compass and we’ll head toward Vinalhaven,” I called. Jimmy smiled as he took the wheel, and I went below deck to prepare our lunch. A ham and cheese sandwich never tasted as good as it did while sailing at a good 10 knots across forgiving water.
After a full day of sailing, we entered a protected passage between islands known as Eggemoggin Reach. The moderate winds remained consistent as we navigated our way toward Deer Isle and the mooring we had reserved for the night.
The view of the land from the deck remained unspoiled, like it did a hundred years ago. Our course took us past rocky shores and stout farm buildings set back from the water. The beauty of the Maine coast never failed to intoxicate me with dreams of having a place of my own on the water someday.
As the sun started to set, I motored toward our designated mooring. Jimmy held the boat hook to retrieve the pendant and to secure it to the bow cleat. Once we were settled and the diesel motor was turned off, the quiet became surreal. We were blanketed by a light summer breeze on deck as we enjoyed our celebratory drinks. I set up the grill on the stern and cooked our steaks and vegetables. Staying upwind of the fire was no problem in such calm conditions. Jimmy ate quietly, savoring the food and the satisfying feeling that comes from a day of strong winds that have finally let go.
Paul Pender practiced clinical ophthalmology for 38 years, specializing in the medical and surgical treatment of eye diseases. He completed his residency at the world-renowned Wills Eye Hospital. His honors include a lecture series in his name by the New England Ophthalmological Society and the Secretariat Award from the American Academy of Ophthalmology for his work on webinars for clinicians.
Pender is passionate about patient-centered care. He believes that the patient-physician relationship should serve as the fundamental building block for health care reform. He is an advisor to Vxtra Health, a company committed to collaborating with physicians to earn trust and to reduce health care costs. By limiting the drain on health benefits budgets by intermediaries (health insurance companies, pharmacy benefits managers, and hospital systems), Vxtra Health establishes a path toward a new model of care, based on price transparency and fiduciary responsibility, starting with self-insured middle market employers.
He writes on timely medical issues on his website, his KevinMD author’s page, and other popular social media. He is the author of Rebuilding Trust in Health Care: A Doctor’s Prescription for a Post-Pandemic America (2020), the ebook Standing Up and Speaking Out for Patients and Doctors: First Steps Toward Focused Health Care Solutions (2023), and the novel Jimmy’s Story: Forging a New Path for American Healthcare.
