My First 25 Years in Practice


25 years ago today, I started my career in private practice. My notes were written in paper charts, I carried a pager but not a cell phone, and I had a head full of hair. Appointments were written in a book, controlled prescriptions were written on duplicate pads, and antibiotics were handed out like candy. HMO medicine was new and so was the group I joined. It was an exciting time.

My practice had a very wide scope back then. I had an active hospital practice and managed the inpatient care of both children and adults at Hoag hospital. I managed septic patients in the ICU, patients with diabetes out of control and with heart failure, often without consulting specialists. I took care of children hospitalized with bronchiolitis, dehydration and asthma attacks. I felt there was nothing that I could not do. One particular patient utilized all of my skills, a young pregnant woman with viral meningitis and pre-term labor. I performed the spinal tap myself, gave medications to stop labor, and managed her inpatient care without consulting anyone. Those heady days are long gone!

Hospital patients are much sicker nowadays. Many of the conditions that previously resulted in hospital admissions are now managed as outpatients. Skin infections, kidney infections and even new onset atrial fibrillation, conditions once thought to be serious, now do not even merit a visit to the emergency room. Those patients sick enough to be hospitalized are now beyond my knowledge and expertise.

For 12 of my early years in practice I provided maternity care and delivered babies. I was perpetually on call, only unavailable when I was out of town. It was demanding and challenging but I loved it. Welcoming new life into the world was one of my great joys, and it is what I miss most about those days. I delivered my last baby in 2007.

My office practice has changed as well. The era of “one problem per visit” is long past. Every visit to my office is now an opportunity to address multiple health concerns. Patients who come in for respiratory illnesses may find themselves leaving with orders for cancer screenings and routine blood work. Other routine visits evolve into impromptu counseling sessions. The result is fewer patient visits per day, but more care per visit. Where once I saw as many as 35 patients a day, my Physician Assistant and I seldom see that many patients between us.

The business of medicine had changed for me as well. In 1994 I was part of a multi-specialty group of over 30 doctors. Neurologists, cardiologists, obstetricians, internists, surgeons and family doctors, we were all in the same building with shared management. The business styles of the doctors proved to be as diverse as our specialties, and there was frequent conflict. The three physicians with whom I shared a suite joined together with me to leave and found our own Family Practice, Beach Family Doctors, I’m 1995. I managed that practice for 7 years.

By 2002 the practice had grown to 5 doctors and I had grown weary of managing it. In February of that year I went on my own, moving into a small suite across the hall from my former partners. Ours was an amicable parting, and we remain friends to this day.

Two years later, when driving back to my office one afternoon I passed a small house on Beach Boulevard. The “For Sale” sign caught my eye and two days later I was standing in the doorway of the home, imagining where I could put up and tear down walls to convert it into a medical office. Escrow closed in February 2004 and I moved into the office November 1st. It has been my medical home ever since.

Much has changed in the last 25 years but the most important thing hasn’t. I wake up every day knowing I will have the opportunity to make a difference in the lives of the patients who come to see me. This knowledge still brings me joy, and it is that joy that will sustain me in the years to come.


A special thanks to the many patients who have entrusted me with their health over the years. It has been a blessing, a privilege and an honor.  


A Few Words About Boobies

Two Boobies, it seems they often come in pairs.

Two Boobies, it seems they often come in pairs.

Boobs matter. Just not in the way some people think.

If there was any doubt that the world has gone completely guano crazy, that doubt was just removed by the 10th circuit court of appeals in Colorado. The court just issued its ruling in the case of “Free the Nipple vs. The City of Fort Collins.”  (I am not making this up)

Free the Nipple is a movement that, in the name of “gender equality” protests laws that discriminate against women by making it illegal for women (and not men) to bare their breasts in public. They claim that the breast is merely a gland and not a sex organ. They argue that there is no difference between the male and female breast (This is likely news to the millions of men who hid Playboy magazines under their beds in junior high).

Many notable celebrities have lined up in support of Free the Nipple, including Miley Cyrus, Chelsea Handler, Rhianna and Chrissy Tiegen, all of whom have made social media posts supporting the movement. (I would suspect that there are countless men who would also claim support for the movement as well, but their social media posts would likely get them in trouble.)

As silly as this may seem, the boob case made it all the way to the Court of Appeals, one step away from the Supreme Court. In a 27 page opinion the court stated, among other things, that “statutes that differentiate between men and women very likely reflect outmoded notions about their relative capabilities”, that statues banning toplessness may in fact reflect “archaic and overbroad generalizations about gender”, and a “stereotype engrained in our society that female breasts are primarily objects of sexual desire”.

The court rejected the City’s argument that there is a difference between male and female breasts. (I guess I should start shopping for a “bro”) It knowingly rejected the findings of other courts, including the 7th Circuit court of appeals, that upheld similar bans on female toplessness, saying, “None of these decisions binds us, though; nor does their sheer volume sway our analysis.”

In reading the court’s decision several thoughts came to mind.

-          Where do these people find the time and money to protest such things?

-          Is showing one’s boobs in public a basic human need?

-          Have we reached the point where we are going to reject even the most obvious differences between men and women?

Common sense may be dead in the 10th Circuit, but it lives on in the real world. I dare any man on his next trip to the beach with his wife to try ogling attractive bikini clad women and defend the practice by saying, “Don’t worry dear, it’s not sexual.” I also doubt that the court’s arguments will cause any fathers of 13 year-old girls to allow their daughters to go topless to the next school dance.

It seems some may think it is time to change the words on the Statue of Liberty to “Give me your tired, your poor, Your covered nipples yearning to breathe free.”

I for one choose to agree with the book of Genesis which reminds us, in reference to God that “male and female He created them.” We are different, men and women, in many wonderful, complementary ways. It seems silly to have to remind the Circuit Court that saying two things are different is not the same as saying one thing is better than the other.

The more we ignore this, the more we lose.


Thanks for reading my rant!

The World's Richest Failure


I am better off than Jeff Bezos.

What a remarkable thought. Jeff is the richest man in the world but I have things he will never be able to acquire.

I have a successful family life.

Sorry Jeff, but there are no second bites at this apple. Successful marriages are based on enduring love, respect and commitment. You may marry your current mistress, may even consider yourself happy, but your children forever be the product of a broken home.

I have integrity.

I have faults galore, but stealing the wife of a good friend is not one of them. There are lines good men never cross. It goes without saying that cheating on your wife with the wife of a friend is one of them.

I keep my promises.

I am sure when Jeff and Mackenzie said their wedding vows in 1993 they promised to love one another until “Death did they part.” Oops. He forgot to add, “Unless my friend has a hot wife.”

When Lisa and I said our vows nearly 37 years ago we meant them. We work everyday to keep the promises we made and we will get them as long as we live

Friendship means something to me.

I may not be the best friend in the world, but I betrayal is not an option for me. I would die before I would do what Bezos did.

I am content

Money cannot buy contentment. I have a wife who loves me, kids with whom I am close, an adorable grandchild, and two dogs. Who could ask for more? (other than more adorable grandchildren). I am smart enough to know that there is no woman who could make me happier than Lisa, that I have more money than I need or deserve, more stuff than I can ever use. I am not looking for a better life. The life I have is good.

I never cease to be amazed at the monumental failures of supposedly successful people. I have learned that true success can be achieved by anyone regardless of the size of one’s bank account. It is the things money can’t buy that are the true measure of a man’s wealth. As Jesus said nearly 2000 years ago, “What does it profit a man to gain the whole world and forfeit his soul?”

The Heart of a Mom

Our first date. I was swept off of my feet and am still head over heels

Our first date. I was swept off of my feet and am still head over heels

“She’s the type of woman I would want to be the mother of my children someday,” I thought, surprised that the thought even came. It was our first date, we had only known each other for 8 days, and prior to that evening had only had a few brief conversations. But as I sat next to her that evening, talking when we were supposed to be dancing, (it was a church sponsored Sadie Hawkins square dance) I was overwhelmed with the kindness and tenderness I saw in her.

I was certain she would be different from my mother. My mother was incapable of affection. Her alcoholism and mental illness rendered true maternal love impossible. Beatings outnumbered embraces, curses were common and kind words rare. As I talked to Lisa that night of our first date I realized there was something in her that I had never seen before, something powerful.  I couldn’t explain  what it was I saw at the time, but I was certain she would be for her future children everything my mother had not been for me.

37 years later I can say with confidence that my initial impression was incredibly accurate. Lisa is an amazing mom. From the moment our son took his first breath to today, she has been a model of sacrificial love.  Watching her love our children these last 29 years  I can now describe the heart that I perceived so long ago, the heart of a mom, a heart that-

-Sees our kids. She sees their desires, their fears, their hopes and their dreams. She sees them for who they are and for who they want to be. She sees the good in them, even when I can’t.

-Hears our kids. She listens to their stories with genuine interest. She is fascinated by every detail of their lives and every feeling and emotion matters to her.

-Encourages. She rejoices in every success, and comforts every failure or struggle.

-Feels for and with our kids. She shares every pain, every hurt and every tear. When their hearts break, her heart breaks as well. Even as they reached adulthood, she  shared their pains and disappointments.

-Always put our children first and set her own interests aside. She always let the kids pick the TV channel and the radio station. She planned meals with their tastes in mind, and if there was any doubt as to whether there was enough food on the table she would take smaller portions to make sure they had all they wanted.

-Prays for our children, for their health, their faith and their happiness. Sometimes with joy, sometimes through tears, always with passion, she has gone before God on their behalf.

-Took the time to play with our kids. If she had a dollar for every game of Candyland, Uno, Sorry and Trouble she played with our children, we’d be retired by now.

-Laughed with our children. She delighted in their quirks and jokes, and responded with a joyous laugh that was filled with love, a laugh that is to me the most beautiful sound in the world.

Everyday, in every way, Lisa was and is a mom, a priceless gift to me and our children.


Lisa and I met February 5, 1982. 37 years ago this Tuesday. Our first date was February 13th. I am forever grateful not only that I was able to see her for who she was, but that she saw me for who I am, and loved me anyway!

Our Hate Parade


What would I have to do to make you hate me?

If you are a regular reader of this blog, it would probably take a lot. You have read stories about my family, about my struggles, fears, and my desire to be a better man. You know that I care about people, try to take care of them, and want to do what I can to help them. If you believe these things, you may be predisposed to like me, to think good of me. Hating me would require a marked change in your perception and understanding.

What would it take for you to hate a stranger?

For many Americans the answer seems to be, “Not very much at all.” Consider recent events,

A group of high school boys went on a school trip to Washington DC. They were standing near the Lincoln Memorial waiting to be picked up by their adult chaperones. Before they knew it, they were hated. They were called vulgar names, mocked and insulted. Because they were wearing red “Make America Great Again” hats.

While they were being mocked by members of “The Black Israelites”, a Native American activist approached them, pounding a drum. He walked right up to one of the boys, chanting and beating the drum mere inches from the boy’s face. He stood there, an awkward grin on his face, clearly uncomfortable. Some of his friends, similarly behatted, chose to respond to the taunts and affront by chanting school slogans. Brief clips of the interaction were released online, clips which painted the boys in an unfavorable light.

Almost instantly the boy and his friends were hated by countless strangers. On social media and in traditional media the boys were called racist thugs, losers, scum bags and worse. Their parents were threatened, their school defamed.  The question comes to mind, even if they were wrong, is what the boys did worthy of hate?

This type of hate has been a part of our culture for years now. Most will not even recognize the name “Memories Pizza”, but its owners will never forget the firestorm that led to the closure of their restaurant. In 2015 the state of Indiana passed a law providing a religious exception from certain civil rights regulations. In response to the law’s passage a news reporter sought out the Christian owner of Memories Pizza, asking him if as a Christian he would cater a gay wedding (because so many wedding receptions have pizza). The owner, who had never been asked to provide pizza for a gay wedding, answered the hypothetical question in the negative, saying he would not.

His hypothetical response had real world consequences. When the report came out he was deluged with hate. The Yelp page for his business was inundated with negative reviews from angry people who had never been to his restaurant. Complete strangers made it their mission to destroy his livelihood. One woman Tweeted, “Who’s going to Walkerton with me to burn down Memories Pizza.” A man who started a GoFundMe to support the owners received death threats.

Memories Pizza is now out of business, destroyed by hate.

My own family has been impacted by hate. One relative severed ties with a brother because he had not voted for Hillary Clinton. The fact that he had not voted for Donald Trump either was irrelevant. If you did not share the relative’s political viewpoint, you deserved to be hated.

I struggle with this aspect of current culture. I am an opinionated man with strongly held convictions. Not a day goes by that I do not interact with someone who disagrees with me or who considers my opinions and beliefs to be foolish. I disagree with these people and think many of them hold positions that are worthy of contempt, yet I don’t hate any of them. I wouldn’t try to deny them their livelihood nor would I wish them harm. Some of them are patients I love and care for. Generally speaking, I find it hard to hate people.

Shouldn’t hate be hard for all of us?


Thanks for reading and sharing, and for not hating. You can subscribe to the blog by clicking on the subscribe link, thus getting posts in your email. Questions and non-hateful comments are welcomed.