I was raised in Detroit Michigan. My father, a tool and die man, reinforced my mechanical education when he dropped me off to work at Detroit City Airport beginning at 12 years of age. My uncle, Woodfin E. Coche', had established a large general aviation business, Skylark Flying Service. One-hundred hour inspections on aircraft stressed function and reliability of work. Participating in ground school, as a mechanic's assistant and marketing activities with Cessna, Mooney and Champion Aircraft franchises combined a knowlege of aeronautics and aviation technology with customer relations. Involved with all aspects of this multi-faceted business, the activity fed my ever increasing appetite for knowlege. At age seventeen, I co managed a business with a garage, gas station and a fleet of Hertz rental cars. This further reinforced the value of preventive maintenance and responsibiity learned while dealing with mechanical systems and the public.
Recruited to a Science and Arts curriculum for gifted children in the center of the city, I graduated from Cass Technical High School in 1965. Science was taught with the enthusiasm and fervor brought about by the early space race precipitated by the launching of Sputnik. The circumstance of teachers wanting to teach and the students wanting to learn, prevailed. A focus on the creative process with emphasis on theoretic development was emphasized. Additional reinforcement and review occurred at Wayne State University where I graduated with a degree in Chemistry.
While in college, I obtained a job at Hutzel Hospital, a Wayne State Medical School Teaching Hospital as a "Therapy Technician". This job consisted of maintaining all the IV's in a 480 bed acute care hospital, doing respiratory therapy,and pariticipating in the resuscitation team. It was there that I came to love acute care. Accepted into The University of Michigan Medical School in 1969, I graduated third in my class on the second part of the National Boards scoring in the 98th percentile. The first and the third parts scores were 95th and 99th percentile respectively
Chemistry was chosen as my major in a conscious effort to find a middle ground between physics and biology. The resultant synthesis of the three allowed me to better understand scientific knowledge applicable to the foundations of life. My decision has proven invaluable in developing a better approach to healing. Upon initial presentation, basic science and it's revelations applicable to medicine can be as foreign to practicing clinicians as ethnic medicine and often more difficult to convey. The historic pattern is for many years to pass before a new insight is recognized as truth. The present age of communication coupled with an increase in average education and understanding is reducing the time involved in dissemination. Much effort still remains neccessary to overcome political and economic inertia.
Eclectic in my approach to medicine, I've established several hospital programs now operating in different fields, Emergency Medicine, Drug and Alcohol Rehabilitation, Wound Recovery and Family Medicine. Thermodynamics in medicine is an overview that I have held as a guiding principle since 1975 and is involved in every clinical decision I've made since. In 1978, at Oil City Hospital, Oil City Pennsylvania I treated my first patient with congestive heart failure with beta blockers, the results of which were predictable using this theoretic framework.. The concept also applies and predicted our recent revelations about anti-inflammatories.
The second law of thermodynamics is one that applies to our human body as a thermodynamic system. The body, like an internal combustion engine, is subject to the development of "Entropy" or wear and tear. Excess kinetic energy not used for effective work becomes disorder, or wear and tear. This excess energy, a given part of the stress reaction, is especially destructive in the face of delayed repair. Repair, when defined in cellular terms, is equivalent to normal inflammation. The energy required for this activity is less available during the day and more available at night, a reflection of the circadian rythm. The adrenal gland is a transducer shifting energy from the body to the repair systems. The fight flight reaction provides energy to the soma for short term survival, sacrificing energy to the repair side. Following resolution of the conflict, energy should return to the repair, or microscopic anti-entropy, "negentropic" system. Persistant elevation of energy due to stress results in more energy converted to damage and less devoted to repair. Persistance of this state accelerates degeneration and aging.
The sleep we enjoy at night is a "pit stop" in our race to survive. A refined understanding of energy distribution and stewardship is essential to an understanding of the healing process. Stewardship of the energy within the body is the seminal, scientific concept leading to Total Health's Vision. My going to the alter at age twelve and returning to the fold at age 28 has also provided me a quiet "helper" with an increasing influence on my path.
The maturing of the American experience includes recognition that our country has finite resources. With the development of the international marketplace and the free trade agreements, we need to be economincally competetive with other countries. We cannot achieve this if our populace is not healthy and our medicine too expensive. The impact of healthcare costs on GM and Ford reflect this.
Move with us to a balanced approach that makes sense. Let's use those gifts that God has given us to maintain his temple and allow your body to flourish. We need also to be thankful for the technology that is available and the people gifted in it's use. Help us to be guided in the selection of those interventions that are least risky and most beneficial. Let us also be at peace and have faith when more aggressive interventions are needed, prioritized and applied when those with less risk have failed..++++-
