Today we’d like to introduce you to Martha M Grout.
I started out in the field of Emergency Medicine – largely because (a) we see just about everything in the ER – there is no specialization, we were privileged to see everything that walked in the door, (b) I learned a tremendous amount of medicine “on the fly” and (c) the hours were compatible with being able to have children and a family life.
When I started in this field, Emergency Medicine was actually just becoming a specialty. In fact I took and passed in 1980 the first seating of the Emergency Medicine Board Examination 9 years after I finished my residency, and 6 years after I started my first ER job, our hospital was between two housing projects with a pretty active Friday night rod and gun club, so we had plenty of experience with traumatic injuries.
My first job was at an inner city hospital in Rochester, NY. We saw at least 40-50 patients in an 8 hour shift, some of whom were level 1 trauma victims. It was pretty busy. I remember writing up all the charts at the end of my shift, because there was only time to jot brief notes during the shift. At that time smoking was permitted in public places, and I smoked 3 packs of cigarettes a day. The link to lung cancer had not been firmly established. It was my first experience with addiction. I did eventually quit smoking, but to this day have been sympathetic with the struggles that addiction puts us through – the need to cut through smokescreens, as it were, and face the reality of something which is generally considered to be a character weakness. It is a humbling experience.
Eventually I ended up in Florida, working at a hospital situated between two retirement villages. We had frequent experience with ruptured aortic aneurysms – just as bad trauma as the rod and gun clubs, but trauma from the inside rather than the outside.
Those ruptured or leaking aortic aneurysm patients were an exciting minority of the ER clientele. But after 20 years in Emergency Medicine, it was becoming clear to me that most of the patients who came to the ER for care were no longer truly emergencies. They had chronic illness that got to be overwhelming on Friday nights, or they had back pain that nobody could relieve, or they had a sore throat and their doctor was away for the week-end.
I began referring back pain patients to a neuromuscular massage therapist – because he had helped relieve my daughter’s back pain, and because the usual referral docs were pretty nasty to the back pain patients, accusing them of drug-seeking (a few of them were, but most were in genuine pain and wanted relief). The doctors who were no longer getting my referrals became upset, and went to the hospital administration to complain.
One day I was called into an office by the ER Director and the Hospital Administrator, and was told that I was not to refer outside the bounds of traditional Western medicine.
I went home, discussed the situation with my family, and took in my letter of resignation the next day. I simply could not practice medicine under those conditions. That action was not quite as brave as it sounds, because I owed the ER group 3 months’ notice if I wanted to quit. That gave me enough time to sell the house, decide where I wanted to go, and find another job. By that time I was supporting a family of six people.
I arrived in Arizona where I had arranged to work in a holistic Family Practice office. The day before I was to start work, the job evaporated. Fortunately we had savings on which to live, while I figured out the next move.
At the time, I was devastated. However during that first year I was able to complete a huge number of hours of training in holistic and integrative and homeopathic medicine, which would not have happened if I had been working in that Family Practice office. So in the end, it was all good. I got my homeopathic license as well as my Board of Medicine license, became trained in chelation therapy, acupuncture, orthomolecular medicine, neuromuscular massage therapy, allergy and environmental medicine and a host of other “alternative” techniques which are not taught in conventional allopathic medicine.
I did have to go back to full time Emergency Medicine work for a number of years, until I was able to establish my own office and still pay the bills. Finally starting in 2002 I went to full time office based practice of Integrative and Homeopathic Medicine.
I have never truly regretted the move, although I have had the occasional discussion with the Almighty about the difficulty of travelling off the beaten track. I think the most difficult concept to accept has been the astonishing antipathy of those who practice conventional Western medicine toward those of us who practice less conventional forms of the healing arts. There are times when I have questioned the wisdom of stepping off that well-trodden conventional medicine highway. But truly I have never doubted that the path I am on is the one that was laid out for me before I came in to this world.
In the end, I have come to the conclusion that I have control only over my own behavior, not over anyone else’s. I cannot control the medical licensing boards, or the patients who come to me for care. I can only do my best for those whom I choose to treat, and for those organizations with whom I choose to associate. I love what I do – maybe the financial bits not so much, but that is a part of running a successful practice as well. The patients are all extraordinary, most of them are extraordinarily kind and good people, and all of them have lessons to teach as long as I am willing to listen and learn.
I cannot imagine retiring.
Smooth road? Not exactly.
The first obstacle: when I arrived in Arizona, I was told that my Arizona Medical License was insufficient to allow me to practice medicine in the State of Arizona. I had also to get “credentialed” – exactly the same process as the license application, with exactly the same documents (only I could not use those documents already sent to the licensing boards, I had to get all new original documents) – and it took another six months.
So after the first Arizona job evaporated the day before I was supposed to start working, I still was not able to earn money to feed the family because of the credentialing issue. In the long run, I think this turned out to be a good thing because it gave me the time to do all that additional training that I truly needed to have, if I was to practice the kind of medicine that I wanted to practice.
After I became credentialed, I was able to work in different Emergency Departments around the state – not full time in any one, but part time in several – to put bread on the table while figuring out the private office thing. I would often work in one ER, sleep for a few hours, and then drive several hours to the next ER job in another town. I became quite clear that I could do all that I needed to do – but that I truly needed another two hours in each day in order to be able to accomplish the necessary tasks.
So I had one of those heart-to-heart discussions with the Almighty about the impossibility of the task I had agreed to do. The solution: for two years I slept only four hours a night. I would personally have chosen to sleep more and lengthen the day, but that’s not how it worked out. And I was fine for those two years, until life finally settled down enough that I could forego some of the more distant ER jobs, and go back to sleeping my habitual six hours a night. I still marvel at the solution that was given to me for what I thought was an impossible dilemma.
During my Emergency Medicine years I was sued for malpractice more than once. Those were difficult times. We do our best, we do not always get the results that people want, and they need to blame it on someone. The stress of the lawsuit, and dealing with the legal system, is hard on the psyche – we always wonder if we were in fact at fault, could we have done something different, would someone more competent or more intelligent have acted differently or gotten a different result…
And then there are the licensing boards. Now when a patient has a complaint, it seems that rather than going to a lawyer they go to the licensing boards. And those complaints are equally difficult and hard on the psyche. We still have to face our accusers – only this time the accusers are whose whom we had considered to be our colleagues, perhaps even our friends. We still wonder if we could have acted differently, used a different course of treatment, and made a better diagnosis, seen trouble coming sooner. We still wonder if our accusers were right and we were wrong in our actions.
In the end, our task as practitioners of the healing arts is to enable healing, not to cause harm. And when we are accused of causing harm, we always wonder if there was some justification for the accusation.
The Arizona Center for Advanced Medicine is the Southwest’s most diversified office of integrative medicine. We use the principles of standard Western conventional medicine, and blend them with the paradigm of Integrative and Functional Medicine, using tools from Oriental medicine and acupuncture, Orthomolecular medicine, Neuromuscular integrative medicine, Nutritional medicine, Detoxification and chelation therapy, Bioenergetic medicine, Hypnosis and guided imagery – each modality used on some patients but not every modality on all. We have a multitude of tools in the toolbox of Integrative Medicine, and use those which seem most appropriate to the task at hand. We serve as conduits for that healing energy which originates in the Universe and which is available to all who seek it.
We love what we do, and continue to follow the path which is illuminated for us by that Universal Light.
I would like to see legislation passed all over the country – and particularly in the State of Arizona – so that I and my colleagues who practice Integrative Medicine may practice this form of medical care without fear of our licensing boards.
There is no question that oversight by a body of our peers is needed, lest any of us become so puffed up with hubris that we think we can do no wrong.
However, when those who are familiar only with the conventional “standard of care” are charged with judging those who practice “outside the box”, the result is almost inevitably a clash of philosophies, and those whose heads stick up above the crowd are generally the ones who are chopped off – not because they are wrong, but because they are different.
Those who have studied many forms of the healing arts, and who are familiar with the concepts of integrative, holistic, homeopathic and bioenergetic medicine, are well aware that there is no black and white, but rather an infinite number of shades of grey. In every Yin there is a little bit of Yang – computers work with ones and zeros, but not the human body. There is no end to the circumference of a circle or the numeric value of pi. There are difficulties inherent in working with the human psyche. There is no such thing as a living isolated gall bladder. The human organism is a whole, made up of many parts each of which interacts with every other part in a never-ending symphony.
This form of Integrative Medicine can be the basis for medical care anywhere in the world. There can be true healing, if only we allow it to happen.
I have a dream…