I'm a 70yo doctor from Iowa who hasn't taken a salary for 16 years in one of the poorest countries in the world. I have treated undocumented farm workers in California, was a rural doctor in Mozambique and even became a UN election monitor. I am a...

what is a practical solution to reduce malnutrition in timor? more food more money less mouths to feed better government/distribution?

One of the key elements is improved water quality and hygiene however all that you mention are important. But underlying almost everything is dealing with women's position in society. The men eat first, take all the meat, and the women and children get the scraps.

so great. is there a simple solution to improve water quality? and is there progress empowering women?

is there any thing that fat rich americans can do to help in a meaningful way?

Water should be not only free of pathogens but also easily accessible...to the extent that you can create that situation, health will improve dramatically. Resources are key to this, as well as for many other programs

Women are beginning to realize that they too have rights. This is a huge step forward. Awareness counts for a lot. We currently have a women's health program founded by Sidalia, an amazing Timorese woman that is starting to expand this awareness throughout Dili and into the countryside

The Americans (and those around the world) can donate resources or volunteer. Both are beautiful things to do. Check us out here for more information: bairofoundation.org.

what is the state of diagnostic imaging at bairo pite clinic? what specifically could be done to kick it up a notch? do they need equipment? personnel? training program?

the american college of radiology has an international outreach program. they may be able to provide a connection.

Please send a digital X-ray machine (and a radiographer) immediately. Make sure you include a maintenance contract. We have some imaging services available through a local clinic, but our images are not always of the quality one would typically expect at a large medical center in the developed world. There is only one CT scanner in the entire country, and the technology is from the 90s. All of those things would be helpful in expanding our diagnostic imaging

Dr. Dan how do I survive pathophysiology? Test next Thursday.

Review the entire the entire mechanism of the Na pump. Be able to describe what is seen on a peripheral blood smear. Those two things will carry you a long way

Huge amount of respect for what you're doing Dr. Dan.
Any plans to turn this into some sort of movement so it will be a continuous, progressive and collective effort instead?

That is the general idea. We already have links with training community midwives and Cuban trained Timorese doctors around the country.

This country could become an example for others to learn from. My son says however that even more important than doing something for the massive poverty that we face is drawing attention to the rape of the environment that will ruin us all (especially here in TL).

With the high birth rate coupled with the challenge of maternal malnutrition, what are your midwifery staff doing to encourage healthy pregnancies and healthy babies? How does education play into the prenatal care?

We screen every prenatal woman for HIV, malaria, anemia, Syphilis, and Hep B. We try to vaccinate for rubella prior to the pregnancy. Everyone gets iron and folic acid and we educate on diet and other issues during prenatal visits. In general, we haven't had children born with signs of malnutrition. This becomes an issue at the time of weaning, when they switch from breast milk to a strictly starch diet.

How well do women do with breast feeding? I know it can be an issue in countries with high rates of malnutrition as it can affect mom's output. What are womens' attitudes toward breast feeding?

Breast feeding is almost universal, however many people don't realize exactly how important it is for the child and for reasons which may not be relevant, they might stop breast feeding. We encourage it at every chance we get

Hi Dr. Dan! I've recently been accepted into medical school and am actually traveling to Timor Leste in July. Out of curiousity, how did you end up in Dili? Also, any words of advice to a traveling (future) medical professional, and in particular, one traveling to Timor?

Having been a convicted felon for refusing to participate in the Vietnam war, I found myself gravitating towards places that are struggling for self-determination. Nowhere in the world has suffered to the extent of the Timorese people. Where else to come?

When you come to Timor, first stop should be Bairo Pite Clinic. I can give you lots of connections on places to visit in East Timor that would be inspirational and valuable for you.

How do you get food, lodging, clothing and afford travel and anything else while essentially volunteering and not collecting a salary for so many years?

I had some savings and for the last 8 years, I've been living off social security. Plus, if all you do is work and then come home and eat vegetables and rice, you don't have many expenses.

If you could fix 1 thing about western medicine what would it be?

Universal access would be a beautiful way to start being more effective

Are you still a criminal in the US ?

I still wear the badge of being a convicted felon in the US. To some, this is anathema. To others, it is heroic. President General Ford offered us amnesty to all of us convicted under selective service non-compliance. Many of us refused to accept any amnesty and instead stated that the government should be the one asking for amnesty.

I'm also blacklisted in Indonesia by the way. If I were to go, I'd be imprisoned on arrival and sent to Cipinang.

Have you ever had regrets of spend your hole lives in helping each other?

Sometimes I feel like my life is passing me by and I haven't had the whole experience. But on the other hand, who can claim to have spent their entire professional time exercising compassion for those in need.

What is the current social and political attitude towards family planning, and what are the family planning services that are made available by your clinic and by government health programs?

Although we are a majority Catholic country, that doesn't pose a significant contra-indication to spacing. We at the clinic push for a 3 year interval between children and many women can access this, however it needs to be more widely available. This will be crucial for a country like Timor to manage their growth (>5 babies/mom currently) at a more manageable level.

Thank you for your reply and for the work that you are doing. When you say that there is a clinical push for a 3 year interval between children, is that being supported by the availability of contraceptives?

Yes. Except it isn't widely available enough. To get to some rural villages is a huge undertaking so many women still have no way to control their reproductivity. At the clinic, all women receive some counselling on family planning.

Do you guys play any basketball over there?

Might be a stretch of the word saying basketball, but we go out on the court and have a lot of fun. It is a good chance for me to look for some assists and play defense, which I'm not really used to. Last Sunday, I blocked two shots from a girl who was nearly 5'2" playing for her first time. She lets it fly from the hip. Caught her from about three feet out. Didn't feel great, but I did it twice anyway.

How much TB is there in Timor Leste? How are you able to diagnose it?

No clinic in SE Asia sees as many cases of tuberculosis as Bairo Pite. We eat, sleep, drink, and breathe mycobacterium tuberculosis. As I said that, I had to clear my throat a little bit. We check sputums for AFBs and have a PCR machine as well.

I can imagine there are decent days and really emotionally challenging ones. My question is, what serves as your motivation? What encourages you to overlook those really bad days and continue moving forward with compassion?

I can tell you that working in a place like this you can't dwell too much on any event. Something new comes up every ten minutes that will require your complete focus and attention. When something bad happens, I just keep telling myself...compassion, compassion, compassion. The old Bhuddish mantra. I try to keep my head clear so that I can be objective about whatever is next to walk through the door. There are certainly many tough moments at BPC, but there are many more uplifting ones.

Hi Dan, I'm a junior doctor from Australia and very inspired by your work. Following International Women's day earlier this week (I saw the post from the clinic's Facebook page, great of the clinic to raise awareness). I wondered if you could comment on the state of women's equality in TL, particularly with regards to education and healthcare. And also to what degree the clinic is involved with advocacy for women's rights in TL? Thanks! Alice

Awareness of women's rights is increasing quite rapidly, but we have started at an extremely low level. Our clinic plays a crucial role in advocating for women throughout the country. We feel that empowering women is the key for Timor advancing and avoiding becoming a failed state.

How do the locals feel about western medicine? Is There much resistance?

People appreciate anyone and everything trying to help their condition. However, they usually cover their bases by also seeking a cure through traditional medicine.

What about the role the white saviour complex plays in this environment?

White, tall, American, older, speaking their language. It makes the placebo effect much more powerful.

So if all of the rich Americans gave you $1 million dollars tomorrow, what do you think it should be spent on?

The worlds greatest needs are addressing the gross inequity in income distribution throughout the world and also protecting our environment and switching from the use of non-renewable resources. We have become super consumers and that is going to bury us in our own garbage.

As the country continues to develop its economy and healthcare system, how are the healthcare needs of the population changing? Are you seeing a shift in your resources from one area to another?

We are seeing an increase in things like diabetes and hypertension, even obesity occasionally, but basically 50% of the population has very little access to any of the health care system. We are working on expanding health care access as well as massive efforts in the areas of tuberculosis and HIV

How is HIV handled in East Timor? I know that it can be tricky to test for it in low resource areas because it can be difficult to then provide the expensive antiretroviral therapy needed. Are the efforts to decrease transmission mostly focused on prevention?

Worldwide, there is great support and funding available for both HIV prevention and treatment. Having said that, we don't have very extensive testing. Secondly, by the time someone has an opportunistic infection, we don't have the resources to adequately diagnose or treat it. The problem in Timor isn't huge, but the cases we do have could be treated better.

Can you fix the constant PVCs ive beeing dealing with for 10+ years?

Cut back on the caffeine and keep your exercising going strong.

Probably right, but thanks. Very admirable what you are doing sir. Ever need help let me know.

Thanks for your support!

Thank you much for your time:

Dr. Dan, you respectfully change a lot of lives every day.

My question is, have any of your patients changed your life, and how? :)

Every day. I am trying to become an expert in compassion. I have also become a compulsive practitioner of caring and reducing the suffering of everyone within my reach. I see examples of this in my patients and their family members every day. I simply try and emulate them.

I am an American and know of a young man from a village in Armenia who is in need of medical assistance.

I have been searching for an agency that might help him, but most orgs I have found only help kids or specific illnesses (i.e. Diabetes)

Do you know of alternate places/agencies/etc that I may contact to try to get him help?

It depends on the problem, but MSF (Medicine Sans Frontiers) has a presence throughout most of the world. There are also some hospitals in Israel who are reaching out to people on every continent. We've had one child who got open-heart surgery there and was treated very well.

What does a typical day entail for you?

I wake up and lift every morning at 6 AM. Then we round on our 50 inpatients starting at 8 AM starting in the maternity ward, then heading through the 2 wards dedicated to tuberculosis, and end by seeing our malnutrition unit. I follow this by seeing ~200 outpatients. Then I go home, eat some rice and local vegetables, put on a good movie and fade into the sunset.

Hi Dan, congratulations on the unbelievable work that you have done, truly inspiring. What I would like to know, is who do you think would win in a 7 game series between the 2016 GS Warriors and the 95/96 Bulls?

Without a doubt, Warriors. Even the vaunted Bulls defense can't match what GS comes at you with. I would challenge ANYONE one on one to slow down Curry

You do really inspiring work Dr. Dan. I'm actually studying to go into the medical profession myself. With that being said, any predictions for March Madness or the Finals? Think Golden State can be beat? Or do you not really get a chance to keep up with it being as busy as you are? (Also, sorry if this was already asked but I got excited) I'll go read the other questions now, might comment again with more.

March Madness is filled with many unknowns. Teams have been pretty inconsistent. Anyone could make the final 4. Of course, being from Iowa, I strongly favor Iowa, Iowa State, and my real favorite UNI. In the NBA, given there are no catastrophic injuries, I don't see anyone matching up with Golden State.

I love the work you do but I'm still sore over that close win over my Salukis last week.

I have to hand it to UNI. They're playing above their ability over and over again. Somehow their coach gets them to do the right things.

How do you stop Steph curry?

I still think you're better off making him work like crazy to get the ball, and once he gets it...double team him and get the ball back. Hopefully you'll end up with someone like Bogut at the three point line. They're pretty smart though, but I don't see how else it could work.

Hello! I'm a Brazilian woman, and I've always wanted to volunteer abroad. I'm well educated, but I don't have a college degree. Should I look into volunteer opportunities in Timor Leste, or would that do more harm than good, aka, take away opportunities for the locals?

There is a huge need for teaching Portuguese. It is the national language but most are not fluent. There is also need for teaching computer skills, reading, and communication. If you have these skills, I'm sure you would be quite helpful here.

Are there any bizarre cases you've seen that stand out in your mind?

One time I was called to maternity because of a baby being born with 2 heads. This was in Mozambique. I went to see what the deal was, and it turns out they were actually Siamese twins, with bodies conjoined and 2 heads sticking out. They were way premature, lower than 20 weeks gestation, so unfortunately they had no chance at survival. It was a very memorable case.

What is your opinion on DDT for Mosquito control?

We use permethrin almost exclusively. DDT is not environmentally friendly. Thins eggs, destroys species.

I heard you like basketball so I wanted to ask you about your favorite team, and how you feel about the Warriors?

Love em. I'm a Celtics fan though.

Do you like seafood?

I'm philosophically a vegetarian but fish also fits my fancy.

What would be the most helpful action by those of us overseas to begin to help alleviate poverty in East Timor?

Be informed. Then, take action, which can be anything from resources to volunteerism to raising awareness. Even political action at times is very helpful

It's hard to find accurate timely information about current issues in East Timor, any suggestions?

If only Donald Trump would mention East Timor, but so far no luck. But try ETAN

How hard is travel from the US to the countries you work in?

It's expensive and it's clear across the world. Being blacklisted at one of the main access airports doesn't help (Denpasar, Bali). It's quite a long flight, but it is quite accessible. It's definitely worth the effort, though, to visit, because it's a beautiful tropical environment that hasn't yet been spoiled. In fact, the SCUBA diving here is like nowhere else.

My other question was were you involved with the Ebola crisis in West Africa in any way, or was that not the region you were in?

I was not in West Africa during this time. I did spend some time in Southern Africa in my earlier years but never quite made it up past the equator.

The East Timorese government has outlined efforts to invest in healthcare infrastructure in its strategic plans - have you seen any effects of these investments?

Facilities have been upgraded and there has been a significant investment in training healthcare providers with the help of Cuba. These workers are now disbursed throughout the country. However, traditional practices are hard to break. What seems to be missing is a solid network within the communities that puts into effect any policies or deals with deficiencies. Therefore, life for the 75% of the population who lives in rural villages is much like it was 1,000 years ago.

That's interesting - do you think more satellite clinics would be helpful rather than large hubs of healthcare resources? What would be your path to a solution?

Empowering local people to deal with their own problems which they have the capacity to address is the key to changing the dynamic at the village level. Top down approaches rarely make a significant difference.

to that effect - are village or territory-specific community health workers being trained by the hospital/government/BPC?

We have been training village women to elect a local woman to come to the clinic and train for 3 months and perform at least 100 deliveries. This has been one of our most successful programs and we have professionally trained midwifes now helping women in pregnancy all over the country.

Hello? It's me

I was wondering if after all these years you'd like to come to Timor-Leste and meet us at the clinic

What do you think about the movie Predator?

Haven't seen it. Sorry. But in general I'm on the side of the prey.

Any way to clone Larry Bird with a good back and return him to the Celtics?

We can always dream. The game has changed though and I'm not sure our old heroes would make the cut today. We should also clone the 96 bulls and pit them against GS today to answer PhilD90's question

Hi Dr. Dan, thanks so much for doing this AMA and for all your work! I am currently a medical student at Iowa planning to go into general surgery. I have been involved with global health work throughout school and plan to continue working in global surgery throughout my career. I have a couple questions: -What are some ways you have seen NGOs/foundations work well with and not so well with communities? What sets successful projects apart? -Have you seen changes or advancements in surgery in low resource settings throughout your years of work?

I think successful organizations are those that commit to a long term presence within a community and those that remain flexible. Bairo Pite Clinic has attempted to evolve with the needs of the Timorese people and has been here for 17 years now, remaining functional through some years of horrendous violence and misfortune. Some NGOs have a narrower focus and do it very well, so I would say there are many ways to succeed. Commitment is key. The same is true for surgery and we have recently seen a greater commitment to surgery in Timor from Australia and Timorese surgeons trained in PNG. We still have a long way to go, but this is hopefully a good start. Go Hawks!

Is the government doing anything to support/hinder you from what you've been doing this whole time? By the way, thank you for fighting for humanity.

We work closely with the Ministry of Health in dealing with the scourge of malnutrition and tuberculosis in this country. Believe me, there is enough to go around and every little bit helps. Our midwives also work closely with the national hospital to ensure safe delivery of the 100+ babies delivered here each month and ensure all mothers receive ante-natal care.

How is mental illness treated in Timor? Are there problems with addictions?

Very few facilities in Timor address mental health. We see these problems at the clinic on a daily basis with many patients being treated for depression and anxiety successfully for many years. We have some medications and counseling, but in general, mental health is treated at the village level in a very primitive way. Much stigma and inadequate care for these sick people. Much to be done unfortunately.

Do the people tend to self medicate their depression and anxiety?

Yeah, we have home brew that is quite popular. It can vary every time -- different strengths and different tastes. We think about PTSD, and when we have access to medication we use that, but mostly it's being supportive and being accessible to people who are not feeling as well as they would like

Fortunately, most people are too poor to afford drugs at this point. But as our economy grows, we worry that they will become more accessible.

Are English speaking therapists any help or is the language barrier a problem

Actually, if you could learn 50 words of the local language, you'd be quite effective. Facial expressions are also very effective in showing a caring attitude. We also have excellent interpreters to help us. So the language barrier is there but is not so much of a problem

Hey Doc, my brother is over there working with you now, and he's really excited about his time there!

My question is, what has been your biggest challenge while working abroad? Supplies? Facilities? Finding competent help?

Being able to influence the well-being of a large portion of the population would be an admirable goal but is an extreme challenge.

what is your favourite episode of south park, the simpsons and seinfeld?

I know Seinfeld, I've heard of that. The Simpsons I've seen but not much. And I don't even know what South Park is.

Who you got winning the NBA championship this year?

The Steph Currys. Can't see anyone else coming close.

What's going on between East Timor, Australia, and the US right now? It has been in the news quite a bit recently.

We've got a tiny half of an island trying to fight for survival and well-being with everyone else trying to take a piece of the pie, which is basically off-shore oil. US now has a permanent Marine Corp base in Darwin, Australia. In East Timor, we have the Seabees, which are basically Navy engineers. They've helped our clinic on several occasions. Many Australians have also continued with overwhelming generosity. So we're trying to find our way among all of these special interests is a very challenging task.

Hey Dr. Dan, do you ever play basketball with patients you have had?

Only a few. The staff at the clinic are pretty good though. Chuchi, a Philipino nurse on the TB team has a great shot from the elbow. And Lucia, one of our experts in malnutrition, has been working on her reverse lay up.

Really look up to you sir and what you do! As a biomedical science student and an aspiring doctor,what words of advice would you give me? Thank you, Lee

Listen to people such as Paul Farmer, but also read publications such as Where There is No Doctor by David Werner. These will keep you motivated to promote great health care access throughout the world

How do you think Timor would cope if zika virus were to arrive?

We here at the clinic are trying to deal with the day to day of taking care of these sick people in Timor. It's quite possible that Zika is already here, but we have not been able to do any testing for it. Obstetrics and maternity care is a huge part of what we do here at the clinic, and we will continue to do this work and take on new challenges as they come.

When were you working with the undocumented farm workers in California? Do you speak Spanish too?

I can speak Spanish, but espanol de la calle. I also speak a couple Philipino dialects, some Arabic, I had to learn a few bantu dialects when I was in Africa and some Portuguese, and here in East Timor I speak some of 15 or so dialects.

I worked in California from 1971-1978. I marched a picket line with Dorothy Day, founder of the Catholic Worker. We had some good times out there. I went to jail in California. It was a crazy and romantic time. And Cesar Chavez...if you're in a street confrontation let's just say you want to be on his side. He was an organizer. Great guy.

How many 3 pointers can you hit in a row?

I think I have a pretty decent shot for an old man. One of our trainers, Terry Newman, was interviewed for an article by Sports Illustrated a couple of months ago. They asked him if I was ever any good, and he said he sure wouldn't leave me open. I'll take that. But I rarely shoot 3-pointers. I'm more of a layup and shoot-from-the-elbow kind of guy.

Lebron or Michael Jordan?

MJ. Mentally a little more disciplined. Tougher. Doesn't frustrate as easily. Although Lebron is better than he used to be, he is bigger and stronger than MJ, he isn't as tough. Also, I think MJ had more flexibility in his game.

I'm currently in my third year of med school... Is there a way for me to do an elective with you for a month next year?

We welcome medical students. We have two here right now. Check out our website: bairofoundation.org and that should have all the details. Any help you can provide is much appreciated and I think you'll get quite an educational experience out of it as well. How many cases of TB have you seen at home?

Do you think shooters like Curry are going to be the next evolution in the game?

I don't see how they can't be. There is a great ESPN article comparing how Curry is breaking the record books this year with how Babe Ruth reset the home run records. I agree entirely. Kids shooting hoops around the world started taking a lot more shots from downtown this year.

Two questions, can the hawks make a deep run in the tournment this year? And do you any good stories about Leon Koster?

The Hawks would be quite unlikely to make a run. They seem to have lost their confidence over the past month. They haven't been able to count on any consistent offense and the other teams keep getting better and better. They may win a game or two, but I can't see them going deep. As for Leon Koster, he is a guy that has a character that automatically befriends almost anyone he comes into contact with. He has done so many good things in his life. He has helped our clinic, he has helped me in so many ways, that I am bubbling over with praise for him. He did have an incident one time when he was younger and had to do chores on the farm where a cow wouldn't go where it was supposed to go. He threw a 2x4 at it, it hit him in the head, and he killed it. Man did he have to pay for it. His father was a big guy. There was also a good party out at his house one time when his parents were out of town. I've got a lot of good stories about him.

Iowa vs IL just tipped off, how far do you see the Hawks making it in the NCAA tourney?

Rough loss. The Hawks really lost their edge down the stretch. I think they could make it deep, but it depends on their seed and who they match up against. They are a very match up dependent team. Should be a fun tournament for Iowans this year though yet again.

Bird or Magic?

Jordan or Lebron?

Bird. I'm a Celtics fan so that one is easy. And MJ for the mental toughness. I've seen Lebron give up on the court before. Never saw that in Jordan.

How do you eat? Pay rent? Are you living poor like the rest? I.e do you have power and air conditioner or a mud hut with a mosquito net?

And keep up the good work!!

I pay thanks to American taxpayers and social security. Plus, rice and vegetables are cheap and my house is quite modest although not a mud hut. I have electricity, a terrible internet connection, and 4 ceiling fans. You adjust to the heat.

I know this has nothing to do with your profession, but do you follow the NBA currently? If so, do you have a favorite NBA team? Thanks!

The Celtics are in the process of taking over the league again. Keep track.

Don't you hate Kanye West?

Doesn't everyone. He's not Justin Bieber, but he probably deserves a lot of wrath. If he gives some money to the clinic, I'll play his songs every day.

How did you get involved with the UN?

I was an election observer in the first multi-party elections in Mozambique, but I actually represented the world council of churches, not the UN.

I seem to recall hearing about a clinic in Uganda that started offering to insert IUDs to women who delivered there, and the women were usually glad to take it up. No extra trip, no pain from insertion (cervix already open), husband need not know. Have you considered this?

Great idea. We just need the IUDs. Do you have a stockpile? There is also a higher risk that the IUD will fall out if placed immediately post-partum.

I always miss the good AMAs. What would it take to volunteer in your area?

Send an application. bairofoundation.org. All the info you could need.

Important question : what do you suggest to people about what you did to be Financially independent? So they can work free /serve humanity without getting paid.

First of all, you have to pretty much abhor shopping. Second, if you can finish your education without getting into debt, you haven't sold your soul. You're still free. Third, being in debt is actually a huge advantage in this world. Everything gets better with simple inflation. You haven't done a thing.

Given your obsession for basketball, who is the greatest in your opinion? Wilt? Larry? Magic? Michael? Kobe? LeBron? Curry?

Bill Russell. And Jack Twyman for his humanitarian work and his all out hustling style of play.

Ever worked on the South Dakota reservations? They could use help and you'd only need to go next door to Iowa.

I haven't worked there, though I've been there. I think that would be a good alternative. The problem is, how can you work towards self-determination for the American Indians. That's a tricky one.

Thanks for all you do. Do you have a favorite NBA team and if so..who and why?

I'm a Celtics fan, but I certainly enjoy the up tempo style that Golden State provides. And just when you think you've seen it all, they take it to the next level. But ever since the time of Bob Cousy and Bill Russell, I support the Shamrocks.

How do you feel about Steph Curry? Where do you stand on the whole argument that he wouldn't be as good in eras where hand checking was allowed?

Also, what's the most rewarding part of the work you do?

Very few people get close enough to even hand check the guy. He's just too fast.

The most rewarding part of the work I do is that it is all in a political context that provides legitimate self-determination for an entire country.

Are the Cavs gonna get their shit together or what?

I don't think they have the parts to go all the way. They can't do it this year.

drdanmurphy, I do 't know you and I've not heard of you until today and I am truly intrigued. My question is, why do you do it? What's your motivation? (Okay, that's 2 questions)

Guilt.
I was brought up way too strictly and am having trouble with self justification. I'm also a workaholic and I can't stand failure. So this is the perfect thing for me to do.

Are there any big international charities that you recommend?

A friend of mine in Poland is an orthopedic trauma surgeon. He and his friends are putting together a first response team with the idea of going to a disaster area and get to work immediately. If you are really interested, send me an e-mail and I can put you in touch.

Thoughts on the Jayhawks chances of winning it all this year?

10%. They're pretty good, but a lot of teams are pretty good. To put together a string is going to be tough for anybody.

What is your opinion on the healthcare scene before and after the Affordable Care Act?

Improving access to healthcare can never be seen as a bad thing, but there are still problems with the US health system which desperately need fixing. I find it hard to see how politicians can argue for anything but a single payer system with access for all. I think Bernie is on to something.

Hey doc, would you consider studying medicine worth it? all those years studying, i'm kinda unsure if to follow that path, but at the same time i'd love to.

They have kind of taken the fun out of it in most places, but there are still a few good things to do. What I am doing now is very very special and it will be difficult to find something as meaningful in your life.

Hey, fellow Iowan here! Were you born in Iowa, and if so what town?

I was born in ALTON in Sioux county