Introduction

Hi, I’m Pamela.

I’m a family physician born into a family of physicians. Mom is a psychiatrist. Dad is an addiction specialist and pathologist at the hospital morgue. I spent my childhood playing in hospital hallways and stairwells. I loved the morgue. Dad made it fun. He talked to the dead people in the coolers, so I did too. From the morgue, we made our rounds to the city jail, drug addiction clinic, and the psychiatric hospital. Introduced as a doctor-in-training, I was set loose on inmates, heroin addicts, and schizophrenics while most girls my age were playing with Barbies.

My dream was to be an amazing doctor—like my mom and dad, only better. My parents warned me not to pursue medicine. They said government regulation and bureaucracy were killing the old-fashioned family doctor. But there was no way to stop me. I had already made up my mind.

Family doctors are the kind of doctors who do everything. I planned to deliver babies and help people die, plus treat criminals and people on drugs and people nobody else could help. Maybe I’d be a medical superhero and save an entire city. I’d go on midnight house calls by flying from town to town in my white cape, pockets overflowing with get-well stickers and cherry-flavored tongue depressors. Like most kids, I believed that being a superhero was a practical career choice. So I ignored my parents’ warnings and went to medical school and then graduated from residency in family and community medicine.

My first job was at a big clinic in Oregon. I didn’t feel heroic. I felt like a factory worker pushing pills into patients as they flew past me on a conveyor belt. I tried other jobs, but they were all the same—assembly-line medicine. Doctoring was dumbed down to a numbers game with cookbook protocols and computerized flowsheets. Patients were often excluded from care if they had no insurance or if they took too long to express themselves. Or if they were shy or different or addicted to heroin or in jail. Or if they were not easy, simple, healthy middle-aged people with good insurance and minor health problems.

Eventually I left all those jobs to pursue my dream.

This book shows how, with persistence, I came to live my dream. I hope my story inspires you to live your dream even when people tell you it’s not possible. Revolutionary ideas start as dreams. If nobody understands your dream, it’s okay. You are the visionary.

A Dream Clinic Is Born

After ten years on the treadmill, I was tired of being rude to people and neglecting myself—all in the name of health care. I hated interrupting patients to say, “Sorry, we’re out of time,” when I wanted to ask, “How can I help you?” So I dropped out of medicine and imagined returning to my college waitressing job just so I could be nice to people again. At least when I was a waitress, people appreciated me. And they left tips.

When I gave up doctoring, life seemed meaningless. I fell into a depression and didn’t get out of bed for six weeks.

Then—in a dream—came an epiphany: patients could create their own clinics! In my dream, I saw grandmothers and grandchildren, teachers and teenagers, farmers and firefighters—entire communities—coming together to build ideal clinics and hospitals.

Energized, I jumped out of bed. Feeling invincible, I phoned the newspaper and told the editor that I’d be opening an ideal clinic created entirely by our community. Then I called a series of town hall meetings and invited citizens to design the clinic of their dreams. I collected 100 pages of testimony, adopted ninety percent of the feedback, and opened our clinic one month later! In 2005, the people of Eugene, Oregon, had created the first community-designed ideal clinic in America.

Now reporters fly here from all over the country to study our clinic. Hundreds of ideal clinics have opened nationwide. Communities have even used our model to design ideal hospitals. I now know that just by living my dream, I can inspire others to live their dreams too.

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