Richard M Houck MD - Assume the Position: Memoirs of an Obstetrician Gynecologist

Recently retired after four years of college, eight years of medical training and twenty years of active clinical practice, and given the unsolicited challenge of change your life or change your wife with no clear path ahead, the future was uncertain other than I chose to change my life and not my wife. The crush of paper work, malpractice worries, unruly partners, a wife unhappy with but protective of me, managed care everywhere, increasing government interference in the practice of medicine, 80 employees, a Womens Health Research organization, and an acquired occupational sleep disorder, I decided to offer myself up for volunteer work in medicine and go back to my medical roots- just caring for women - no hassles and no remuneration. Medicine as it should be: The sick, the injured and the insane, as Benjamin Franklin stated it in 1751 when laying the cornerstone at the Nations first hospital, Pennsylvania Hospital, where I received my training. Some might have called me the insane in this scenario for leaving it all behind at the age of 50, but so be it. It was time for me to move on and seek other challenges.

Telluride, Colorado, located in the beautiful San Juan mountain range in the Southwestern corner of Colorado, is the county seat of San Miguel County, the most rural and least densely populated corner of the State.

We had recently moved here after retiring from actively stewarding several thousand newborns into the Phoenix, Arizona desert. There are no traffic lights in the County. The town is located at 8500 feet above sea level and entered through the Valley Floor, home to majestic elk herds, grazing deer, foraging coyotes scouring the mounds of prairie dogs peering out of their homes on some of the most valued land in the State, occasional bears, and all surrounded by 14ers, as the 14000 foot peaks ringing the area are called.

(The view from See Forever ski run to the LaSalle Mountain range in Utah and over the Telluride Airport.)

Located in a box canyon, there is only one way in to the mines at the base of the mountain, then turn around and back out the other way. The fall Aspen trees were spectacular in their color and vibrancy.

Ski slopes such as the Plunge drop right into downtown Telluride. Sure, one can drive a jeep up and over a narrow boulder strewn mountain pass once navigated only by mules, to Ouray, a 15-mile drive that takes three hours and risks life and limb. One really needs considerable off road driving skill and nerves of steel to undertake this venture that I would undertake when in the right frame of mind. Every year there were deaths and near deaths on this wondrous jeep trail through colorful high alpine summer wildflower fields of pink Penstemons, mauve Columbines, variegated Indian Paint Brush, purple Lupines, and Blue bells. There were old abandoned gold, silver and tellurium mines high above tree line, accessible only by the hardiest of miners with their pick axes. The road was only passable for a few of the summer months due to heavy snow depths. Hardy souls used to live up there in what is a small ghost town now, called Tomboy, during the active mining days.

So how did I find my way to Africa to care for women from here? There were no road signs anywhere. Every path I had taken to this point in my life, including the hiking trail up from downtown Telluride, past the cool refreshing mist of Bridal Veil falls, along one of the most difficult jeep trails in the country, Black Bear pass, then up the side of glorious Ajax mountain at the end of the Valley to stand on its 14000 foot peak and look down one mile onto the Valley floor that housed Telluride, was more or less well defined for me. I had made my choices deliberately and pursued them endlessly for three decades. After taking in the gorgeous scenery, the still of the green Valley far below, the coolness of what air there was at that altitude, and Ingraham falls plunging onto the carpeted Valley Floor, it was obvious to me that the path down then forward was a path not so clear. I was not sure where I was going, or what life had in store. I felt like my two miniature Schnauzers, Rosie and Lucy, who had accompanied us on this hike, darting right and left from the trail, exhausted and aimlessly pursuing the scent of Marmots yet never finding what they were looking for, outsmarted by the shrill warning sound of the sentry whistle pig, as they are called. The poor girls smiled at me with delight when they caught up with us and sought praise for their efforts.

Everything I had accomplished at this point in life had been a goal for me that I pursued day in and day out. I was most fortunate that I had accomplished what I had in life. But things were about to change now. It was just that I didnt know anymore what the future would bring. I was going to create a new life for myself, start over again, and see where it led me. There was a certain amount of fear and apprehension about this path into the unknown.

Making the decision to volunteer medical services is one thing, something I had often considered but never had the time to explore and accomplish. But how was I to begin? The Internet is a wonderful tool for researching this kind of thing. Dozens of organizations are out there that are happy to have people like me volunteer. I researched them all and considered them all, including Doctors without Borders. Being in the crosshairs of someones rifle in a war zone didnt particularly appeal to me. I reasoned that if I was shot I wouldnt be much good to anyone. There are loads of faith-based organizations. As a Jew, one popped out at me from my computer screen called American Jewish World Service, AJWS. I called and began the application process. There was no discussion of where I would go nor was there any request on my part where to send me if accepted. I just put myself in their hands to see how it played out.