More Than Half Full
Tom Hermann, MD

This month I would like to share with you a defining moment in my medical student education. I was a first-year medical student on the oncology/hematology service with Dr. Robert Marschke at Sanford Hospital (formerly Sioux Valley Hospital). I distinctly remember the day when one of our dying cancer patients said to me, "my cups half full, Doc.” His smile warmed my heart - which had been saddened by the steep decline this patient was facing due to his progressive cancer.  Here was a patient lifting me up in spirit and making me suddenly see how much he appreciated life and the care he was receiving. His positive attitude and appreciation for life was reflected in his thoughts and actions – which continued through the few days he had remaining.  There we were, his medical team, trying to help him medically survive and there he was, teaching us all that it was “okay.”  We all learn so many insights into living – as children, as adults, and as parents, and yes, as physicians involved in caring for our patients.  

The 2017 Legislative Session will be remembered as one that brought forward some pretty significant changes to the practice of medicine – to include the independent practice of advanced practice nurse practitioners (APRNs) and the practice and regulation of lay midwifery. The politics of medicine is also abound on the national scene as our newly elected congress and newly elected president seek to revamp the Affordable Care Act (ACA). The passing of the ACA was to bring forward many changes to the future of care – for example, MACRA, as well as the emphasis on access to care through Medicaid expansion and affordable health insurance for our people.  The costs of so many aspects of care continue to escalate – pharmacy, outpatient and inpatient, insurance premiums and deductibles, malpractice coverage, practice compliance, and medical education.  The challenges that our practices, clinics, hospitals, and health systems face seem to lead us toward the unknown regarding how the House of Medicine should view its own future.  Is our cup of medicine half empty or half full?  

On the personal side of life, over this past year many of us have faced changes and even crises in our own lives.  We have had to watch our medical school teachers, mentors, colleagues and loved ones become ill, face significant health issues, and in some cases die.  May we be grateful for all who touch our lives and appreciate those times we have together more fully.  For 135 years, our state’s physicians have come together to support our medical association – its mission is well known to us all.  What we as physicians, as a profession, have held most dear during all these years is the patient-physician relationship, which is at the heart of what we do every day – in every procedure, in every communication, and in every example of education.  Across our systems of care and our individual practices, the collegiality, the provision and professionalism of the practice of medicine brings us together and fills our cups, and our lives, with the special spirit of serving our people as physicians.  

Across many diverse cultural faiths and diverse clinical practices, may we continue to come together as a professional organization to support our profession and have the courage to advocate for what is best for patients and our practices. May the spirit of the season be uplifting for all and may we find our medical and personal “cups” more than half full.  Thank you all for being part of our medical team and family.