By Shannon Winakur, M.D.

Kate Gace Walton, editor of Work Stew, just posted a link on Facebook to an article about the high rate of physician dissatisfaction. It is disheartening to read this article, as well as the results of a 2012 survey conducted by a large malpractice insurance company that claimed that 9 out of 10 doctors surveyed would not recommend the profession.

Is it really THAT bad? In some ways, yes, it is that bad. There are more and more demands on doctors these days, especially the least well paid of my colleagues, those in primary care. See more patients, fill out more paperwork, answer more phone calls, learn a cumbersome computer system…all for the same or less income. Many physicians feel that the public looks down on them these days, that they have been vilified in the whole Obamacare debate. We certainly don’t command the respect that we once did. Reimbursements from Medicare used to be the “floor” in comparison to what other insurers paid for physician visits and procedures, and are now the “ceiling.” Every year, these reimbursements are cut, or there is a threat to cut them by Congress. And many physicians face a higher income tax bill due to changes made to pay for the Affordable Care Act.

Now, don’t get me wrong. Doctors still make a good living, for the most part. But we sacrifice a lot to get where we are now. The years of training are long, arduous, and essentially are rewarded with pay that is less than minimum wage if you factor in the number of hours worked. And now we are being at least partially blamed for driving up the cost of medical care. What doesn’t get discussed as much is the fact that we have to practice defensive medicine, in the face of a significant threat of being sued for malpractice. Because most lawmakers are lawyers, the tort reform needed to do away with defensive medicine will likely never happen…but no one sees the lawyers as the ones causing the high cost of health care.

In spite of all of this, I still like what I do, and I would still recommend medicine to my daughters as a profession. I am a cardiologist, and I am fortunate enough to be able to work part time: three days a week, with one weekend of call a month. I feel privileged to be of service to my patients, and I am honored that they share so much with me. I have been inspired by the work of Rachel Naomi Remen, author of Kitchen Table Wisdom, and My Grandfather’s Blessings. Rachel is also a physician, and talks about how each patient has a story. In reading her work, I have come to appreciate how lucky I am to hear these stories each day. I am fortunate in that I still have enough time to listen.

I find the workings of the physical heart fascinating – the muscle, the valves, the blood vessels, the electrical system. I am energized by educating patients and the public, especially women, about their cardiac risk factors and how they can prevent heart disease from developing. But even more compelling to me is the emotional heart, and how much emotions and stressors can affect the physical heart. To help with this aspect of heart health, I need to listen to each patient’s story. It is so gratifying to help a patient make the connection between the mind and the body, between the emotions that she carries and the physical symptoms that she experiences. In my view, the symptoms are “real,” even when patients don’t have anything wrong with their hearts. I do my best to go the extra step not to dismiss patients’ symptoms and fears when their testing turns out to be normal. Something made them come to the doctor, and that something still needs to be validated and addressed. I feel that that is my role as a “healer,” and I am grateful for this aspect of my job.

I am fortunate that my hospital has taken the issue of heart disease in women very seriously, and has developed a Women’s Heart Center. The program now consists of screening appointments with a cardiovascular nurse who educates each woman about heart disease risk factors. A profile is generated to help each woman know her own risk factors and what she can do to decrease the chance of having a heart attack. It is gratifying to know that we are giving women the tools they need to prevent heart disease – the number one killer of women.

While I thoroughly enjoy my job as medical director of our women’s heart center, my ultimate dream is to include the emotional heart in the process, and to give women the tools they need to take care of their whole heart – physical, emotional, and spiritual. I dream of having a more integrative center, providing women with ways to care for themselves through yoga, meditation, spiritual practices, and other methods to ease the stressors that affect their hearts and their psyches. This will likely take years to develop…so until then, I will continue to find the blessings in my job, in spite of all the “negatives” that exist. I will continue to find the rewards, one heart and one story at a time.

By Heath Hardage Lee

One gorgeous spring afternoon, my husband walked in the door of our Richmond, Virginia home and announced that he had just gotten a spectacular job offer. An offer he could not in good conscience turn down.

In IOWA!

This must be a really bad April Fools’ joke, I thought bitterly. But apparently he was deadly serious.

“What the HELL?” I snapped, my East Coast snobbism kicking into high gear. The Midwest? The FLY OVER ZONE? Do they even have electricity there???

As it turned out, the job offer ultimately WAS too good to turn down. This was 2008 and Virginia, like many other states, had quickly descended into a deep economic recession. The kind of job my husband wanted in the financial industry was at that point almost impossible to find in the South.

As I fumed and fretted over this decision, the famous quote by American writer Horace Greeley jumped to mind: “Go West, young man, go West.” Or go Midwest in this case…

I had a successful fundraising consulting business in Richmond, my immediate family all lived there (my sister just two doors down from me), and my children were happy in their respective schools. Richmond was and still is my “happy place.” I love the culture, the food, and the history. But now it was time to put on my big girl pants and take one for the team.

So we moved in August of that same year, with me crying into my Starbucks cup all the way to Iowa, freaking out and generally thinking my life was over. It did not help that my father had just died unexpectedly. And I was about to turn the dreaded 4-0. In my mind, 2008 was turning out to be my Annus Horribilis. My Horrible Year.

A few months later, the tears had dried, I had the kids settled in their new schools, and we had moved out of a dreary corporate apartment into a lovely home. I decided I was done mourning my old life and former job. It was time to get over it. I had moved successfully before, to Charlotte, N.C. where I had jumped from teaching into the museum work that I loved. It had been a big turning point for my career, I suddenly remembered.

This move, I decided I would do the very thing I had been avoiding doing for about 15 years: writing a biography of a Southern historical figure that my museum career and educational background had completely prepared me for. In my hometown, I was always way too busy to do it. I knew too many people, was on too many volunteer boards, and I had too many family obligations.

Now I was something I had never been: anonymous. And I could do whatever the hell I wanted! Woo hoo!

So I did. I buckled down and made lemonade out of lemons, bloomed where I was planted, and came to love my new hometown of Des Moines. Which by the way has not only electricity, but also a surfeit of creative culture, great schools, and highly educated people.

Here, I have met some of the best friends I will ever have anywhere, joined the Art Museum as a docent, and attended the Iowa Summer Writers’ Workshop. I have also skied in Colorado, been to Mount Rushmore, and shopped the heck out of Michigan Avenue in Chicago. More than once.

Oh, and I did finally buckle down and write my book: Winnie Davis: Daughter of the Lost Cause, which was just published a few weeks ago by Potomac Books, a division of the University of Nebraska Press.

I think, ultimately, it took moving to the Midwest to gain the perspective I needed to write this biography. I needed expanses of time, as well as some distance from a subject I knew perhaps too well.

As I write in my book’s Acknowledgments, “Writing about Winnie has been a therapeutic way to stay connected with my southern past.” That past is an inextricable part of me, but getting away from the South and my home allowed me to flourish as a writer, an historian, and an independent woman. I think Winnie, who also left the South to pursue her writing career would be proud of me for making the move. She became the best version of herself in New York City. I can only hope the same transformation has occurred for me here in Des Moines.

Heath Hardage Lee has worked in the fields of museum education and historic preservation. She has also written for numerous magazines, newspapers and blogs. Winnie Davis: Daughter of the Lost Cause, her biography of the daughter of Confederate President Jefferson Davis, is her first book.