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PROFILE IN COMPASSION: Medicine is a Calling – John Gurley MD

John Gurley MD has practiced interventional cardiology at UK for over 30 years. He well remembers deciding to be a doctor in his teens growing up in a small Ohio town where his father was a dentist. His mother worked briefly as a nurse, but eventually devoted herself to raising 6 sons. John loved science, technology and gadgets. He notes, “In that sense, I really haven’t changed- that’s still what I do. I develop new techniques and new tools in my academic and clinical life.” He could easily have taken the engineering path in college but chose pre-med instead. He gives credit for this decision to his parents.

He remembers asking, along with his 5 brothers, ‘When is Dad coming home? Why can’t we go out in the boat?”- as his father often worked well beyond 9 to 5 to care for his patients. Their mother explained that their father had something more important to do. If one patient needed him, he had to be there. She made clear to him that being able to help other people in their time of need was something special.

He says, “We all feel good when we do something to help someone- start the car, cut down a tree, anything. But to be able to help your fellow human being preserve their body and health and mind- that is something special.”

John found in medicine an opportunity to unite these two worlds- using gadgets and technology to do something really special for other people. Interventional cardiology provides an opportunity to use elaborate technology and develop new technology in service to doing something special for people with cardiovascular disease. He says, “I feel so fortunate to have landed in just the right spot, developing new technology for a purpose that is special. I ended up doing what I was supposed to do.”

John says, “Medicine was never a job. Medicine is a calling. If you go into medicine as a job, expecting a certain income and having a certain lifestyle, it will never be as fulfilling as it could be. If you go into medicine because you know it’s what you were meant to do, you have a purpose every day. You know you’re making a big difference.”

John admits to sometimes staying awake at night but not because of worrying. Rather, he uses the peace and quiet of those private moments to figure out how he will approach a difficult case, how he will deal with possible complications, essentially devising an algorithm of cardiac intervention unique to a given patient with a problem for which there is no established standard of care. He says, “I enjoy the problem solving. It’s like a puzzle.” He might spend days or weeks thinking about an innovative strategy for a patient with a unique problem.

He feels a close kinship with the primary care physicians that refer their difficult cardiovascular patients to his tertiary care lab. “We approach the patient from a different perspective but we share the goal of helping solve difficult problems for our shared patients. Every day I go to work is something new. Every day I look forward to going to work.”

UK internist Connie Jennings MD says, “John and I have been close partners in care for decades—he is the best! He tries to be more than the cardiologist to his patients. He listens to all their concerns and seems to never get tired, is always patient, friendly—and devoted to the whole patient. The heart is his focus in the physiology of care, but more importantly, it is the focus in his commitment to the patient”

Cardiologist Tom Whayne has worked with John for 18 years. He says, “I consider him to be the most talented and innovative interventionalist I know, with very special skills to accomplish the most difficult of case procedures.  He deals very well with patients and families and has true empathy for the anxiety and suffering he is trying to alleviate.  If I ever need an interventional cardiologist, I hope he is available.”

Kevin Pearce MD is UK chair of family and community medicine and has co-managed many patients with Gurley, who he describes as “one of the finest cardiologists (and finest physicians, in general) with whom I have ever worked. He is responsive to patient needs and to primary care physicians’ concerns about their patients.  He has special expertise in endovascular procedures; expertise which he regularly expands.  He is extremely busy, but my patients report good doctor-patient interactions with him.”

Chipper Griffith MD is an internist and vice-dean for medical education at the UK College of Medicine. He says, “When I think of John Gurley, I think of excellence. Whenever doctors at UK think about the “best” in terms of advanced and difficult cardiac procedures, John is the first name that comes to all of our minds. He is the one we would want for our friends and loved ones if they need such procedures. But also he is caring. One of the most impressive things he did was being one of the founders in the 1990s of our student-run Salvation Army Clinic, which has provided free medical care to Lexington’s indigent population for over 25 years, a testament to John’s vision.”

Kim Morton, RN is the manager of the UK interventional cardiology lab and has worked with John Gurley for over 20 years. She says the staff have developed a staggered schedule so some can plan on a definite quitting time at day’s end while others know they will be staying with Dr. Gurley until the last case is finished- often well after 5 PM. She says, “We have sick patients and they need to see him. He doesn’t take ‘no’ for an answer and will do whatever is necessary for his patients.”

Despite loving the challenge of his work and feeling he is making a difference in people’s lives, he admits to having periods of stress that could even be labeled as burnout- but never for more than a couple of days at a time. He thinks all physicians experience this at times. He says, “Our empathy and compassion well is not endless. Patient care can sometimes feel like a battle. I’ve had times I’ve sacrificed time with my family and friends and it isn’t healthy but I can’t help it. Patients need help. At the end of a long day, who needs the rest more- me or the patient who has been waiting all day and is hungry and scared? A lot of us choose to take care of our patients. You’re tired but your patient is in need.”

Academic healthcare and corporate bureaucracy can take a toll. Sometimes it’s hard to just do the right thing for one patient at a time. He also feels the burden of futility treating IV drug abuse patients with vegetative valvular lesions. Yet they also need our professionalism and service. He says,“We can’t say they won’t turn their life around.”

His self-care strategy for stress management includes being in nature, hiking among the trees and horseback riding in Eastern Kentucky forests. As someone who is “not much of an organized religion person”, he finds a kind of spirituality in this contact with nature, seeing how determined life is, just looking at a tree and knowing it was there before he was born and will be there after he is gone. He says, “This connection reminds me that whatever my purpose is in the overall context of life is not that important except in the difference it can make for other people in their time of need.”

He loves working hard in the yard in his plants and flowers, spending Sunday afternoon cooking the week’s meals with his wife and enjoying all the little things in life- good conversation, sharing a meal or a cup of coffee or tea. He says, “These things bring me joy. I still love what I do. I get up every day looking forward to my work and seeing my patients. What do we all need in life? Nice stuff? Nice car? Nice house? Or do we want to be relevant and make a difference in people’s lives? I think that’s ultimately what most people want.”

“The gift of medicine, if you accept it, is that you have an opportunity to do that all day every day. There’s no other walk of life that offers you that gift. If you take that gift- you are in.” His approach to medical colleagues who struggle with job and career dissatisfaction is based on this philosophy- that we physicians are part of something special that transcends our own problems. We have chosen medicine as a calling- to make a difference for others.

He imparts this message and this ethos to medical students on rounds, introducing them to patients as young doctors-in-training. He urges them to adopt the professional persona of physicianhood without having to wait for medical graduation, saying “It’s not the diploma or piece of paper that make you a doctor.” He reminds them that they have made the commitment to dedicate their lives to medicine- and that is what makes them a doctor.

He says, “Accumulating stuff and being entertained is pretty shallow. We are all passing through for a fairly short period of time. The privilege of medicine is the opportunity to make a difference in the lives of other people. Medicine is a calling.”

About the Author
Dr. Patterson Chairs the Lexington Medical Society’s Physician Wellness Commission, is past president of the Kentucky Academy of Family Physicians and is board certified in family medicine and integrative holistic medicine. He is on the family practice faculty UK College of Medicine and U of L School of Medicine and teaches nationally for Saybrook School of Integrative Medicine and Health Sciences (San Francisco) and the Center for Mind Body Medicine (Washington, DC). After 30 years in private family practice in Irvine KY, he now operates the Mind Body Studio in Lexington, where he offers integrative medicine consultations specializing in mindfulness-based approaches to stress-related chronic conditions and burnout prevention for helping professionals. He can be reached through his website at www.mindbodystudio.org

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