Discovering the World Through People

by Al Sturgeon
(published every Monday in Desperate Houseflies)

DAVE FAIN: PEDIATRICIAN

Dave Fain began practicing medicine in 1976 and has been in private practice as a pediatrician since 1987. Dr. Fain is a legendary knowledge hound. In addition to an M.D., he also holds a Ph.D in Marine Physiology. Most amazing to many, he is also a self-taught Bible scholar who for decades now has impressed those sitting in his Bible classes with a knowledge level that surpasses seminary professors. Recently, Dr. Fain sat down with Desperate Houseflies to share a few things he has learned over a lifetime devoted to the pursuit of knowledge.

DH: Legend has it that you think sleep is a waste of time, get on average three hours of it a night, and spend your free time learning. How much of that is true?
DF: Sleep is a waste of time. If you live to sixty and get eight hours a night, you slept twenty years. What a waste of one-third of your life. However, as I get older I find time is a far stronger opponent than sleep. Since Laura [interview note: Dr. Fain’s daughter] became ill, I hit the sheets at midnight now and get up at six. So I'm averaging six instead of four. However, the learning part is true. This whole house shuts down by 9:30 (buncha weenies!) and I have until midnight to play and read.

DH: When was the first time it crossed your mind to become a doctor? How did that transpire?
DF: This story is absolutely true. Kathy [interview note: Dr. Fain’s wife] and her friend Gail (who should have fleas infest her arm pits) were working the night shift as medical technologists while I was working on my dissertation with saving the world from itself in mind. I had taken everything Southern [Miss] had to offer in my graduate courses ( I was even making up classes at that point) and was writing my final drafts of my dissertation. Kathy flounced into my office and said, "Gail (whose idea it was and hence the above statement) and I are going to take the MCAT (medical entrance exam) next time. With no forethought I said, "Get me an application. I just want to see how I do." No more forethought than that.

We took the test and did okay. About that time it became apparent to me that the world didn't want saving and I was going to have trouble finding a job. I had applied for a teaching post in South Carolina offered at a junior college, but no other prospects. We decided to apply to one medical school only, but I told Kathy we would apply early decision when they take 10% of the class. I figured that the high burners would be our competition. They took us one and two. Okay, now we were accepted. I had no money left after my dissertation (Would you believe they want MONEY to publish those things?) so I said "Let's apply for a full scholarship to the Air Force" They took us that year one and two in the program. After that I began to realize that God didn't want me to slog around in swamps, but wanted me to be in medicine. So we went.

DH: Why did you choose pediatrics as your specialty field?
DF: From my perspective, I wanted to be a radiologist. When I was taking Internal Medicine at School, I was given a diabetic woman to take care of. She was a drunk who would not take her insulin and drank herself into Ketoacidotic coma. On her sixth admission to me over twelve weeks, she died. As I was going to the morgue, I found myself thinking, "Good. Now she won't bother me any more." I suddenly realized that I did not need to be in internal medicine if I was that cynical already. However when we graduated, Keesler AFB had only four residencies: Internal medicine (I was way to cynical for that), OBGYN (I hated sticky screaming bleeding women), Surgery (I was married and wanted to stay that way), and Pediatrics. God's little joke again. It was the specialty that allowed me to interact with someone who did not cause the affliction they had.

DH: What are the most heart-wrenching things you encounter in your work?
DF: I get very attached to my kids. I don't handle death well. I have lost one child in twenty years to disease that I could not positively affect. I just went to a stat c-section two Fridays ago for a little girl that died from a abruption of the placenta. The OB had her out inside of five minutes. I attempted CPR for over half an hour before the OB came up and pulled me off. I'm still reeling over that. The hard part was facing that mom the next day. The other part that is so hard is when parents don't appreciate what they have been loaned by God and mistreat their kids. Poverty does not offend me. Abuse and neglect do.

DH: What's the best part of your job?
DF: When I'm at the mall shopping and I feel two tiny arms grab my leg and I see two little eyes that want to give me a sticky kiss. That's the best part (It's also why I don't do geriatrics). On the fourth of July 1980, I was given a four-month-old girl who was 20% dehydrated and was nearly in shock from diarrhea. I had to do a cut down on her leg to find a vein to start an IV just to save her life. She brings her two-year-old son to me now. Still has a scar on her leg. I think God knew I wasn't cut out for a swamp.

DH: If there were one thing you could magically teach all parents at the same time, what would it be?
DF: Listen to your kids. I wish I had listened better to mine. I think my greatest failing was on coming home I was too tired to hear my own children. I remember that when Chris was three, I was oh so serious about pediatrics. Chris came to me one night and said, "Daddy, let's play toys." That was his way of telling me to get down and dirty in the floor with him. Not missing a beat, I said, "Not now Christopher, I'm busy" and turned away. That hit me like a lead pipe. I closed my books and we played toys. I told my chairman the next day that a hundred years from now how good a doctor I was wouldn't mean anything. How good a daddy I was would mean EVERYTHING. I still had problems with them, of course, but I have been at every play, recital, program they have ever been in. And we played toys.

Oh and paying your bills would be nice too.

DH: What are some of the most common misconceptions about life as a doctor?
DF: The biggest one is that we are all fabulously rich and burn piles of money just to be warm. We are over-worked, stressed out, and live from paycheck to paycheck like everyone else. The attitude about the monthly statement is that the doctor had lots of money and he can wait. Unfortunately, the electric company, gas company, and phone company DO want their money every month. I have more month than money like everyone else.

Another is that we are arrogant and aloof. I hope I'm out of this business before that happens. When I was at the VA Hospital taking Psychiatry, I was a real know-it-all (I know you'd never believe it). I had a patient who was an air conditioning repairman (loaded and unloaded window units without help -- big guy) who was a Vietnam Vet and hooked on painkillers. I worked with him for six weeks tapering his meds. One night about 8 PM he came up to me and said that his head was killing him and he just needed some of his drugs. Well, in my most formal arrogant voice I said, "You know that WE have worked so hard on OUR addiction that WE do not want to have a set back now do WE?" He turned and walked away. Suddenly he grabbed a cane from an old man walking down the hall way and turned around waving it over his head screaming, "I'll kill you, you son of a ..." Well, you know what he said. I jumped into a steel-doored closet and while he pounded the cane to splinters and bent the door, I found a phone and called security who came up and rescued me, but too late for my shorts. I learned compassion that night in one lesson.

DH: What does the future look like for physicians? What advice would you give a young doctor just starting his career, or someone considering your occupation as a career path?
DF: Medicine does not seem to be the mission field that it was for me. I see young doctors more concerned with money and time off rather than little runny noses and bright eyes. The ART of medicine has suffered. I see student nurses who refer to their patients as room two or the gall bladder. I remind them that this is a person not a thing. To answer your question, remember that this is a person not a lab animal. I was trained to talk to the patient, even little kids. My chief resident taught me that if you'll just shut up and listen, the patient and his mom will tell you what is wrong. Good advice, I think.

DH: (I know this is a tired question, but...) If you literally had it all to do over again, what things would you do differently?
DF: I would not waste time with the swamp. I'd have gone straight to Med School. I would also become friends and a backer of Bill Gates.

DH: How has being a pediatrician changed you personally?
DF: I try not to take myself too seriously now. From the above stories (and others) you should be able to see that I'm a lot more introspective and respectful of air conditioner repairmen. I have always had a wacky sense of humor and I still like to enter a room and not be seen, but I have a deep appreciation for lives that cannot speak for themselves and am willing to speak for them if needed. I am still a Trekkie though.

(Note: Comments, questions, ideas, and suggestions are welcomed.)