The Making of A Doctor: An Interview with Dr. Lise Alexander

TC:  It wasn't about the vitamins.

LA:  [laughter] Maybe it was the harassment I was giving them. But I think that that experience taught me that you don't have to do a lot to make a difference. You don't have to be a doctor to make a difference. Sometimes you just need to be there. And I am blessed and honored to be a doctor, and lucky. And I love the field. I love working with my population. But so often the thing that I offer my patients isn't the latest technology in medicine, isn't the latest, cutting-edge medication or the latest study or test or procedure that western science has to offer. It's helping them find a home. It's helping them get counseling that they need, giving them Tylenol because their knees hurt every morning. All of those things, and helping them develop trust with me, listening to them and trying to figure out what's important to them right now. And building that relationship and building that trust and slowly addressing their issues and making sure that everything that can possibly be supported is being supported. And then I can get to the medicine part of it.

And I can't offer most of my patients the cutting-edge of anything in medicine right now. We don't have it in our clinic and they don't have money to buy it. I'm doing, in some ways, third-world medicine right now in downtown Seattle. I have patients that need x-rays and can't get x-rays because they don't have money to pay for the x-ray. I have patients that need to see a specialist and can't see a specialist because they don't have money to pay for it, and they're not eligible for DSHS and specialists can't take them right now. They can't take uninsured patients right now. And so I have to practice medicine like I'm in a third-world country. How can I help this person get better? How can I help this person with their arthritis when what they really need to do is see a rheumatologist. But they can't because they don't have the resources. How can I help them with my education and my knowledge base until they can get to a space where they can see somebody? There's the standard of care, the gold standard in medicine; you're given a certain problem and you go look it up in the book and the book says, this is what you do: A, B, C, D, E. I can't always do that. So I have to think outside the box. How can I help this patient get better, because I can't use the standard of care for them. And to me, that's the fun part. That's the beauty of medicine, is making it work within the confines of what my patients have, and can do. Third-year residency? It's a blast.

TC:  Was that first-year hard in some ways?

LA:  It was hard. It was exhausting. The learning curve is straight up, which is exhilarating and exhausting at the same time. Your internship here you learn by doing. There was very little time for reading and studying. You learn because you're managing patients. You learn because you're doing the procedures. You learn because you're the one doing it. And so, it was hard in that way. There wasn't a lot of time to take the comfort of reading and researching. I was at the hospital a lot. And I was at the clinic a lot. And I was seeing a lot of patients a lot. The second year, I didn't have that much call time as I did my first year. My first year I was on call every fourth night for eight months out of the year. This year I'm on-call three to five times a month. So there's a huge drop. I'm doing way more reading. I'm still managing patients and doing procedures. But now I have the blessing of time to start bringing back in the reading and the literature review to put everything together.