{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/ng4gm83h7r/manifest","type":"Manifest","label":{"en":["Dr. Jerry Stubbe"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Date"]},"value":{"en":["1991-05-05 (created)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["Society of Teachers of Family Medicine","family medicine","family physician","Dr. Jerry Stubbe","Voices of Family Medicine"]}},{"label":{"en":["Subject"]},"value":{"en":["Dr. Jerry Stubbe (personal name)"]}},{"label":{"en":["Language"]},"value":{"en":["english (primary)"]}},{"label":{"en":["Rights Statement"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine.  Disclaimer:  The views presented in this broadcast are the speaker’s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. \u003c/p\u003e"]}}],"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150925/file/278324","type":"Canvas","label":{"en":["Media File 1 of 2 - Stubbe_Jerry_1991.05.05_-_Side_1.mp3"]},"duration":1884.79588,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150925/file/278324/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150925/file/278324/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/278/324/original/Stubbe_Jerry_1991.05.05_-_Side_1.mp3?1750863304","type":"Audio","format":"audio/mpeg","duration":1884.79588,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150925/file/278324","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150925/file/278324/transcript/81403","type":"AnnotationPage","label":{"en":["Dr. Jerry Stubbe interview transcript [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150925/file/278324/transcript/81403/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Jerry Stubbe\n\nMay 5, 1991[You may want to check this against\n\nPhiladelphiathe tape--he mumbled a lot]\n\nQ. - John Frey, M.D.\n\nA. - Jerry Stubbe\n\n___________________________\n\nQ.  So as you reflect on the 25th reunion, it must make you think, what happened to you after you finished high school and went on to medical school, and I'm curious, Jerry, what was in your mind as you looked around and thought of the kind of medicine that you wanted to practice?  What was it that drew you to being a family doctor?\n\nA.  I'd say at that time there was no departments and no role models in medical school to speak of.  So you really had to, at least for my--what influenced me was reading about--this is what I want to be.  You know, whenever I read something like 'The Life of a Family Doctor' or '(??) Family Doctor,' I conceptualized the family doctor.  And it actually was exactly what I had in mind about doing the rest of my life.  So it actually was something that was, that came out of a vision or a creation of my imagination of the way medicine should--I looked at medicine as a way to, just have, see your patients with every kind of illness, and--\n\nQ.  Did that come from some personal experience that you had in your own life in some way or the other?\n\nA.  Yeah, probably.  I was always kind of like that.  I liked variety, I do not like things that bog me down and it cannot be remedied.  Just that I was always very practical.  I liked to do a lot of things that were practical.  (??) my (??), lot of trying to get things fixed and helping get things fixed.  It's sort of in a simple way, you know, not very elaborate, just--I was always kind of, I always liked to have the fewest interruptions, the fewest barriers between what I was doing and the effect of what I was doing.  (??)  I've always been like that.\n\nQ.  Was there any point along the, so you made the connection between that type of work and being a family doctor.\n\nA.  Yeah.\n\nQ.  Was there any point along the line that, as you think back, that you wavered or you were uncertain, or you might have been considering something else?\n\nA.  Sure.  There were times when, like everyone else, you know.  I had no (??), so whenever I had patients, say, in third-year medical school, and I stayed with that patient and found out about the life history of that patient, and yeah, I just got to know a patient so well and they were just in that university hospital for a while, but I made in that short time I made very strong relationships with my patients.  And I felt, you know, I don't want to lose, you know, unless you have that relationship, then you lose it.  So it serves, that started me thinking, I do not want to be in a place that I just have, you see a patient and then never see them again.  That was one of the first things I decided.  I wanted to have, choose a specialty where I could see patients and see them all the time and see them in their habitats, sort of, you know, and see the whole family.  So I got to know the whole family.  They--as a medical student, they brought me to, you know, 'these are my kids,' 'this is my grandfather,' that type of thing.  And I just liked to see the whole family.  So I had, in a certain moment I had to choose between pediatrics, you know, internal medicine, there was no role model for general internal medicine.  We had lost that already in my--it was, you had to, that was just a stepping stone to another specialty.  So there was really no general internist in my mind.  They were all specialists for adults, so--and then the old people, you know, the old people were like, they were like the ones nobody wanted to take care of.  So there was sort of a void there, and I didn't want to, for the rest of my life not take care of children if I chose one or adults if I chose the other.  And at that time Ob/Gyn you know I liked, I liked surgery, I liked everything.  I still do.  And I do a lot of outpatient surgery, and--even the prenatal care.  The patients, although they might be delivering with somebody else because of the malpractice problems of (??), I see them probably more often than their ob/gyn, because they come for a cold, or they come for everything that happens, when they get sick during pregnancy they come see me.  And so yeah, I even--I didn't want to lose that either, I, you know, you lose a patient so (??).\n\nQ.  What year did you graduate from medical school?\n\nA.  1974.\n\nQ.  So how--given all of what you were feeling at that time, how did you make--I mean what happened as you--\n\nA.  It was a gamble.\n\nQ.  Was there a family practice program in Puerto Rico?\n\nA.  There was one program, we were at the, sort of, we were going to be the first class.  It wasn't even accredited, you know, it was really a gamble.  We, I chose an unaccredited program to go into, and based on the notion of, we're going to get accredited.  But that's, it was really a gamble, choosing family practice.  It wasn't established, you know, but I believed it, I believed in the vision I had of what a physician was, you know.  There is no other physician.  The rest are just locking doors, you know, I didn't want to lock those doors.  That's, and I still believe that.  We shouldn't lock doors.  We should leave them open all the time.  We shouldn't categorically say, we should be OB, or we shouldn't be this, or we should--\n\nQ.  Practice limited to, we don't want to have anything (??).\n\nA.  Don't put those limits there.  Leave it open, leave it open, that's the way we are, you know, it's, you don't select the patient (??).  That patient's going to come in with whatever, at whatever age and whatever condition and whatever sex, there's no preselection to that patient.  They come in, we'll find a way to (??), or, and it's for (??) people whatever.\n\nQ.  So you entered into an unaccredited program, you had this vision of what you wanted yourself to be as a doctor.  Who or what happened along those first few years that somehow made it possible for you to keep going, I mean, I guess what I'm saying is that people who make those kind of, what look like leaps of faith, that somewhere there has to come some confirmation or some support or some person or some experience.  Do you remember any of--\n\nA.  Well, my residency director, Noel Marin(???), was the--he was the only graduate of the general practice residency in Puerto Rico.  The only one.  I mean there's really--everybody was special.  So he was, but he wasn't--and when I chose it, he wasn't that model.  He became the model in the residency program.  And he maintained, you know, my faith in--he was the key person to keep me going.  So I would say without him I don't know what would happen.  But he was the key person there.\n\nQ.  And what was it about him that made it possible for you to keep going, I mean--\n\nA.  Number one, probably his humanism, his person--you know, his warmth, personality, with his patients.  He was always hugging the patient and always, you know, so patient with every patient.  Taking his time, just put everything in perspective.  He always, we wanted to know everything as soon as we saw a patient, you know, before rotating through anything.  So he was the type who'd say, 'Oh, wait, take your time, we'll work through this.'  And so he was very patient with us, the same, he was the same way he treated his patients.  So he became a real role model during the residency program.  And--\n\nQ.  What were some other--who were some other teachers or influences on you?\n\nA.  We did have some subspecialists that were family physician types, you know, that had the caring and the comprehensive-type care.  Number one, Dr. (??), that I still relate to a lot.  He was a very, very caring person, you know, also very patient.  Putting the patient before anything, the patient's health before anything else.\n\nQ.  Did you feel you were part of a movement at that point?\n\nA.  Sure.  I mean I--\n\nQ.  How, how did that become clear to you?\n\nA.  It became very clear whenever I rotated.  It served, you have to go through every rotation, had to go through this education, educating the other people and everybody becoming neg--everybody that was already established was very negative. But then many of the people, like the medical students, and you were (??), and they were rotating, they grabbed onto what--to us, more than they did to the other specialists.  So they, I guess family physicians have a natural duty to educate, to teach, to--and medical students like that, you know.  We have the patience to sit down with them and teach them in a way that was not threatening, you know, it was a growth experience for them too.  So they usually hung around with us, and--\n\nQ.  But it certainly was true in Puerto Rico, too, that that kind of care was not being embraced by the medical school.  And so, you know, did you feel different than other people when you were a resident, but did you sense that--I'm not sure what I'm--you know, there was this idea that family medicine was a reform movement in some way or the other.  I mean did that ever--\n\nA.  Oh, yeah, they called us communists, they called us, oh, yeah, socialists--\n\nQ.  Why?\n\nA.  Well, in Puerto Rico the, you know, the political situation, you know how it is, so it's, it was easy at that time to (??) up, to cast a negative feeling, very negative connotation to anything by calling them communist.  Sort of like the McCarthy--\n\nQ.  Right, the Red-baiting is what they--\n\nA.  Okay, so the same thing happened.  You know, they, 'cause we were very socially conscious, you know, it was very family-oriented, social, what's the best for--and that was very different from, you know, our case presentations were very different from, and whenever we had rounds, you know, we started with, this is the patient, you know, he's been drinking, his wife did this, his situation is such, and he got--lost his job, and we went through all that before we even stated why the patient was there.  You know--\n\nQ.  Chief complaint came later.\n\nA.  Yeah, the chief complaint came later, so they--and that was sort of put in our hands from the start in the program.  So every resident after that, and up to now, that's the way we start things off, you know.  Who is this person?  And that is, now of course, they know that when a family practice resident will present it's going to be like this.  They accept it.  But at that time it was kind of, you know, and we went out of our way to find ways to get what the patient needed, even if it wasn't accessible.  Whereas another resident might say, 'well, we don't have this.'\n\nQ.  So you were an advocate.  Advocacy--\n\nA.  Advocacy role.  That was sort of a communist role.\n\nQ.  Right.  You always think, 'what should we have done according to their rules, which in some ways I think, I keep feeling that if you care about somebody, it's this--it's a kind of educational corollary of the idea that you can't get too close to your patients, 'cause somehow it might cause problems and academically or educationally they said, 'You can't care too much because, you know, something bad will happen.'  You know, they'd always put it in those kinds of terms.  So when people started, you know, when you heard those kinds of terms being thrown around, what was your reaction to them?\n\nA.  Well, first, you know, initially it was, the first feeling was why does medicine have to be the doctor versus the patient?  Because that's what we were told.  That's what we saw on the rounds, and we saw in the hospital.  It was, oh, another patient, another one of these, and another one--another drunk that comes in, you know, with (??).  And it was all, you know.  Number 51 or number, the other guy, and--it was very dispective(???) and so I thought, you know, I said I can't practice medicine that way.  There's no way.  I would not stay in medicine and be a physician if I had to do that.  I'd rather quit and choose another, another profession.  And so, you know, in a sense it became a family medicine versus medicine issue.  You'll know we didn't want to, the main reason you have advocacy role, we brought, established medicine against us.  It's just--\n\nQ.  I think, I mean my perception of that is that, that we were, we were reminding medicine of its own shortcomings, you know, and people don't like to be, don't like to have their deficiencies pointed out.  You know, and thoughtful people in other disciplines knew that something was wrong, you know, that patients were being lost in that system and that something had changed, and they felt badly about it, but instead of saying, 'You're right, we should all change,' there was this kind of reaction, saying, 'You're wrong, we have to hold on to how we are,' and so it was a kind of we-they system that got formed.  Because you're right, I mean all the values that got espoused weren't ones that anybody could argue with.  But somehow they created this hostility and anger in people that was really quite extraordinary.  So then you stayed on and became a teacher.  Why?\n\nA.  Well, just the experience of having to develop the image of, as a resident you sort of, the what do you call that--\n\nQ.  Ambassador.\n\nA.  Ambassador of family medicine, (??) it got to the point where you create, you have, you're forced into a leadership role.  I was not a, you know, I wasn't thinking of that at all.  Although in medical school I was a reformist type, you know, I was always, I was in medical school, a student representative to the medical school admissions committee for 2 years, just because I felt that the medical school was not accepting the right students.  And I was, you know, in those meetings I was very outspoken about, we should take, you know, guys who even though their elementary school might be up in the mountains, you know, you can't judge that guy.  That was my role at the time, trying to get that type of person into the medical school.  So I had my commitment, but I hadn't envisioned that this, that it would have gone this far, you know, of staying, becoming the chairman of the department and becoming a residency director.  That happened while I was in the residency program.  It's just, I saw, you know, we've got to do something, the residency program made me, family medicine made me develop my leadership.\n\nQ.  I think it's a kind of natural extension if you're talking about how you felt, that you had to be an advocate for a patient in front of the system, it's not all that much of a jump to become an advocate for a particular way of thinking in front of, you know, this tradition of medicine.\n\nA.  I thought I could really change, you know, I really thought we could, you know, we could make tremendous changes in medicine fast.  (??) work and (??), it's just, it's like (??) you're almost there, and still--\n\nQ.  Sisyphus (??).\n\nA.  And you keep pushing, and when you think you've finally reached the point where everything is going to (??) become real, then it sort of tumbles back again.  And it's very, sort back and forth, it's like the crisis is not in (??) in health care.  Even in Puerto Rico, (??) for revolutionary type of change.  You know, it's been patches, still patches.\n\nQ.  Some people say that maybe family medicine coming along was a way of patching up and putting off what needed to happen 20 years ago, and in fact we have not helped the system overall, we've kept it from changing.  What do you think about that?\n\nA.  That's definitely, it's something that has to be, that we have all thought about, you know, at least periodically we go back and think those 3-year plans and see what have we done, and you really analyze what you've done and you, at least in the medical school definitely you have, we have worked with the establishment in saving the school from catastrophe by, you know, now we can say well, we've got family medicine.  But they're not saying, 'family medicine is not (??) here.'  But when somebody comes, you know, to inspect the school, whatever, to legislature, 'well, we've got family medicine.'  Well, you know, family medicine can be taken out like that, because it hasn't changed, it hasn't really changed the medical school.  So in a sense we were their ticket to stop the rest of the, you know, the whole process of change, we were, like once you get a department, they could show that they were doing something that's community-related, but that was just such a small piece of the whole, whole medical school process, the whole medical school establishment process.  But just enough so that there was not a big revolution.\n\nQ.  Like a controlled nuclear reaction.\n\nA.  It was like a controlled--I felt that at times, yes, many times, that--but at the same time we, you know, it takes, maybe that's why I'm leaving medical school.  I hadn't thought about it, but maybe that's why I'm leaving, because that feeling I had when I started, that I could risk everything and go into this, you know, and even though it was unaccredited, that feeling when I go the medical school is not there.  I know I can go in there and shout my head off and nothing--some little thing might happen, but not much, because the system supports that so much.  It's got so much support from everywhere, you know, from--it's so well-established.  Even though it's corrupt, it's like the Mafia, you know?  But it's so well-established.\n\nQ.  Has its own codes.\n\nA.  And you feel that you can't change it, you know, that something big has to happen.  Really big.  And even if you quit it, you know, or you do whatever you do, it's sort of--it's a lot stronger than you ever thought it was.  And all the support it has, it's everywhere, that you didn't even know, you know, after 12 years I know now how's everybody's got their support system all spread around, the Legislature, politics, the whole thing is just--it would take I think like any, like the wars happen, you know, an economic type of catastrophe to really, really--it won't be family medicine doing the changing, it will be economics.  So I feel we're, we didn't end up the agents of change we thought we were going to be.  And that's sort of, personally I liked the developing creativeness, and the medical school has just taken away my creativity and my enthusiasm for change.\n\nQ.  And as you said, the poss--somehow the idea of taking risks, you know, being able to, you know, step into something that you don't know exactly how it's going to end is exciting, and somehow that excitement has to remain there in your life or it's not going to be happy.\n\nA.  And when you feel, your gut feeling [??] okay, when you lose that gut feeling that you can change something, when you take a risk at least you got to have it, your guts have to tell you you can--when I went into family medicine I knew, you know, the program was going to get accredited, we were going to make it.  But at the medical school, I don't feel we can make it happen.  You know, it's kind of that feeling that--\n\nQ.  So what do you think is going on with the people that, I mean, what are your hopes and what are your fears about people who are choosing to go into family medicine now?  I mean your residents, your students--\n\nA.  Well, I think we should--the way I look at it, we should continue developing the soldiers and the generals for when that time comes.  So it's, you know, we have to be ready for attack.  But we're not going to provoke that, which is what I thought we could have, you know, from the inside of medical school.  It's got to come from the outside, and how can I help that happen from the outside?  Well I, get into leadership positions in the community, get the, you know, the people on the outside are, the ones on the inside are eventually going to have to respond to the ones on the outside.  And that's where I'm going now.  I'm getting, there's a Puerto Rico Community Foundation, which is one that receives (??) grants and Robert Wood Johnson grants, Ford Foundation grants.  Now I've been on the board for that foundation, I'm chairing the program committee of that foundation, going to review how the money's going to be spent in Puerto Rico, that type of situation.  Developing an HMO for the family physician is the person who's in charge of the patient.  That nobody can tell me not to do.  And it's going to mean family physicians, there's going to be pressure, in the medical school, the medical (??) family practice to get into this type of system.  And I'm doing that in a lot less time, you know, the 12 years I spent in the medical school and in 3 years I got an HMO with federal qualifications and everything all set up (??) 1300 physicians, you know, got 20,000 (??) already we're responsible for, and so you do, you feel you've--and the way I started was, you remember what made me go into family medicine was, I liked to do and see the results, you know--\n\nQ.  Put your hands on it.\n\nA.  Hands on it, you know, and I go visit all the physicians directly and have contact with physicians, you know.  At the medical school I had this barrier, I couldn't get to the medical (??), no, he's got to go through this, and you feel so frustrated, you want to teach so much and you can't, you get frustrated.  You're just sort of put up in that little corner there and you might get a week with them the first year and--one week, the whole year gone for one week.  It's not, it's not me.  I tried everything, we developed the residency program.  Fellowship program accredited, geriatrics, sports medicine program that our physicians are the Olympic team physicians in Puerto Rico, they're in charge of the sports medicine clinic at the Olympic Village.  It's a beautiful (???), faculty development besides those two, we've got a one-year fellowship that's flexible so you can do it in, say, Ob/Gyn or family therapy, we keep, we've got three fourth-year positions, in addition to--so we think family medicine, again your basic three, where if you want to be a teacher you need an extra fourth year, and if you want to be, you know, special ed or geriatrics, you need those two more years.  So we've done everything to prepare the teachers and prepare a super program.  We teach geriatrics--\n\n[tape side ends]\n\n(???) geriatrics, the board of geriatrics in the medical school, and still the medical school points so many of (??), has, you know, was trained to head the geriatric committee to, and then (??) this report saying that this is what the medical school has in geriatrics and omits everything we've done.  Imagine how we felt.\n\nQ.  I can imagine.\n\nA.  I went to the dean, I said, that's got to be corrected, it's going to be circulated to the curriculum committee, and before I leave I want, if that person cannot be (??) doing that (??) on purpose, because we knew, it was obvious, that person cannot check.  So we're fighting for that committee chair, we've done everything in geriatrics in that school, and then they name an internal medicine person.  But's a typical thing that gets you mad, you know, I say ah, there are so many years, you can't even consider, when we thought--and we can't, within our, within family medicine, within our department, we can't blame anybody else.  We've published, you know, we're publishing the (??) Puerto Rican Association of (??) works that are, (??) for Puerto Rico, and the research production it's really, it's at a level that's really tremendous.  Nobody's doing the quality of ambulatory community type research (??).  And still the medical school, it's--so within our department, I know that within the medical school change is so frustrating.  I, it would take, to me to keep on (??) it would be like one more year of pushing the stone back up.  I want it on the outside, I'm going to do, I'm going to establish the way medicine will be practiced in Puerto Rico.  That's my goal.  And I'm going to do it through the government system, I'm going to the private sector system, and if that doesn't get the attention of the medical school--!  So I really, my goals are still there, but now it's on a bigger scale, we're going outside, going to be working a lot more with the industry and the Legislature.\n\nQ.  On the way up here you said that you really thought that history is important.  Why?\n\nA.  Well, after practicing medicine for, I can't remember, 15, 20 years now?  17, okay.  I still find the best advice for treating patients comes from talking with my other colleagues, and I--you know, I try and look up in books and things the way we treat patients and it's not anywhere.  Well, this is the best way to take care of X--there is no best way in any book, because nobody, because us, we family physicians in (??) we should have done, which is, you know, taking care of this type of patient, and this works very well, and you check to see if this is really, because of the way I take care of them, simple thing, you know, and (??) publish so that the other family physicians can use that.  And I think that 95 percent of the things family physicians (??), which are great, are not in any book.  And I don't think that applies to family physicians only.  I think that applies to surgery, to anything.  Why do surgery in some (??) was mentioned today, such a variability.  It's because everybody has their own little book, and nobody studies, or nobody wants to show that little book and show people that it works the way they do it.  And then somebody else can say, oh, this is the way I do it, and then we share things, you know?  So I believe that most of the medical knowledge is still in doctors' heads everywhere, all the time, and most of the knowledge of anything is in people's heads.  Very few people write.  So I think talking about the history of, is probably going to end up helping a lot more people, you know, their--\n\nQ.  I think one of the things it will do is, you know, at least capture for all of us and anybody else who comes along, you know, what are the, what are the passions, what are the--what's your heart's desire?  I mean it's a word that an old teacher of mine used to use when following your heart's desire, part of it is to say that it's to be clear with people about what's, what was the heart's desire, what is the heart's desire of the people who started this--we didn't start it, we started--we just kind of reorganized it and renamed it, but the passion and all those things have been there all along, it's just that we've given it a voice now, which is different.  But if you look back, okay, you look back almost 20 years, say, when you started medical school, what keeps you doing it?\n\nA.  What keeps me--\n\nQ.  Doing family medicine.\n\nA.  Family medicine?  It's your own value system, you know.  What you value is a relationship (??) so you feed that value with those, you know, continue those relationships, establishing them.  So that's what drives you.  I think you've got to be a family doctor, and it's the best alternative to--because nothing can limit your practice but yourself.  Nothing.  Nothing can come across the relationship between you and your patient.  There isn't.  Even though you might not know what this patient has, and you might need to consult or--you're still the one that, the basic person you're related to, the patient relates to is you, not the one you're referring to.  It's like a marriage, but being married to a whole bunch of people.  Yeah.  But it's, at the same, it's a relationship much like marriage, you know, you have to have a lot of trust, a lot of trust.  You've got to first trust in yourself, I think without that--and I can say without any doubt that my teachers, you know, made me--before I knew what I could do--the teachers that made me what I am trusted me before I trusted myself.  And feeling that trust in me, they believing in me before I even believed in myself and what I could do, kept me going.  Having somebody--'you can do it, yeah, you have this talent, you got that.'  And you're there so insecure, you're starting here, how can I take care of patients, and people just believe in you?  You know, that's your good--that's what kept me--and so I, it's the same thing I did with my (??), I took that experience that I had with my teachers and I tried to do that with my students, with my residents, with my faculty.  Right now it's really with my core faculty that it gets to the point where it's--but that core faculty I trust them, and I tell them, you're--I believe in you, you can do it, you're doing much better than I can, and they're nervous, sure, they're in that position and they--but just telling them you trust them, and then when they go ahead and do this, be sure to give that positive reinforcement.  And that's the role of the chairman.  And I heard Rachel said it today, it's a role, but I think it goes way back to having good teachers, and way back, it goes back even to my father.  If you want to go really way deep down inside, it goes to your parenting, and having parents that believe in you, you know, versus parents that put you down, and it helps you believe in yourself.  Keeping those role model parents, you know, it's, that special, to have that special way of imparting a real sense, not an artificial sense, a real sense, they do really believe in you, it's not artificial, they do, you can feel they do.  And they may--they actually commit, you know, take firm actions to prove that they do by telling you, 'no, you're going to do it, you're (??), and you're going to do it.  You're going to chair this, or--'\n\nQ.  In a sense you're--if you had any fear about stepping into this unaccredited program that was built on some vision that you had of what a doctor should be, that it wasn't--you weren't doing it by yourself, you had your life experience until that point of your family, and then your parents saying, 'You can do that.'\n\nA.  Right.\n\nQ.  That's very powerful.\n\nA.  Yeah, it's powerful, it's I think the most powerful thing we can give ourselves, students, it's the same, that's why I said like a (??), it's the same thing, it's the trust that you can do it, believing that you can do it and believing that person before that person ever believes in himself.  Before it's molded.  And that, people like that are, in family medicine there are lots of people like that.\n\nQ.  Yeah, I think there are.\n\nA.  And this is so different, when you go to round somewhere else and it's just chastising people.  It's--we have a whole different culture, the way we nurture versus, the other specialties here are military type, you know, you got to prove this and you've got to prove your worth, you're worth nothing and--we're so different, that's why it's so hard to stay in that environment that's, when your value system is different.  It boils down to that, your values.  You can't, you can live with somebody that's completely different than you are, if your value systems are the same.  (??)\n\nQ.  And no matter how much you're like somebody else, in some ways, if the value systems are different it doesn't work.\n\nA.  It doesn't work.  So I, I guess family medicine has (??) system.  We share the value system.  The Society of Teachers of Family Medicine for me represents that value system, and we should never abandon that value system.  Because, my experiences with the Academy were different, you know, their value systems--they're more protectionist of the doctor (??), what I saw happening happens a lot there, a lot of, even though it's more balanced than any other specialty society, but it still is not the Society of Teachers.  That's why even though I leave the Department, I will always come to these meetings, because it's friends I have here have the same value system, we share the same things.  And it doesn't matter that some will be teaching full time, you know, to produce the same value system, to produce people with that same value system.  And I will be doing something else, but it's still the same (??). That's why when I heard the speeches today, some had nothing to do with teaching.  Some had to do with health services, and I say great.  The Society of Teachers should have this broadness, it shouldn't be this narrow thing.  And we should just be prophets of a value system, prophets teach, and that's why we're teachers.  It's not, the teachers of family medicine, family medicine has the value system, but you can teach it, it doesn't have to be the classical teaching in the medical school.  It can be anywhere, anywhere you teach family medicine.  And I will never stop being a teacher, because you teach your patients--\n\n[interview ends]","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150925/file/278324#t=0.0,1884.79588"}]}]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150925/file/278323","type":"Canvas","label":{"en":["Media File 2 of 2 - Stubbe_Jerry_1991.05.05_-_Side_2.mp3"]},"duration":935.41719,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150925/file/278323/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150925/file/278323/content/2/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/278/323/original/Stubbe_Jerry_1991.05.05_-_Side_2.mp3?1750863303","type":"Audio","format":"audio/mpeg","duration":935.41719,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3629/collection_resources/150925/file/278323","metadata":[]}]}],"annotations":[]}]}