{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/v97zk57k3b/manifest","type":"Manifest","label":{"en":["Dr. Robert Werra"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Date"]},"value":{"en":["1990-02-28 (created)"]}},{"label":{"en":["Type"]},"value":{"en":["Interview"]}},{"label":{"en":["Agent"]},"value":{"en":["Dr. John Frey (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["Society of Teachers of Family Medicine","family medicine","family physician","Dr. Robert Werra"]}},{"label":{"en":["Subject"]},"value":{"en":["Dr. Robert Werra (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/3180/collection_resources/150929/file/278329","type":"Canvas","label":{"en":["Media File 1 of 1 - Werra_Robert_1990.02.28_-_Side_1.mp3"]},"duration":2697.608,"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/3180/collection_resources/150929/file/278329/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150929/file/278329/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/278/329/original/Werra_Robert_1990.02.28_-_Side_1.mp3?1750863964","type":"Audio","format":"audio/mpeg","duration":2697.608,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150929/file/278329","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150929/file/278329/transcript/81405","type":"AnnotationPage","label":{"en":["Dr. Robert Werra interview transcript [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150929/file/278329/transcript/81405/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Side 1: A couple of areas you talked about a little but I wanted to expand on. One is this question, in a community that is small enough so that you effectively know most everybody that lives there or a great number of everybody that lives there, the question of… particularly someone in solo practice the question of privacy. The other physicians are always curious about how you keep your personal and professional lives different. Why answer them if you can’t do that, really, but I think what they’re getting at is, is privacy an issue and if it is, how do you deal with that? How has that affected your family, yourself?\n\nDr. Werra: I’ve never even thought much about it and maybe it’s because this community is a little larger than the 1,000 or 2,000 and one of the few doctors in town. But even when I first started practice and there were many fewer doctors than there are now, it just never seemed to be a big problem. Patients really had… once you left the office, that was a whole different situation for them and it’s as if they divorced it and we divorced it and it really wasn’t a problem.\n\nSo there’s not a real problem of the community impinging on your family or yourself and time away?\n\nDr. Werra:. No, no, people don’t come up in the supermarket, hey, what about this or what about that? They know that you’re not practicing at that time so they don’t bug you. There are some, occasionally that do but by and large, it’s not a problem. I think of a joke that if they do too much, well, take off all your clothes and we’ll check it out. That old joke from the party when they ask the doctors about their aches and pains. But it really hasn’t been a problem, that I’ve perceived.\n\nYour family hasn’t felt that that’s been… being the doctor’s family…\n\nDr. Werra:. Well, the kids complained about it some and they sort of resented it but it wasn’t a big deal. They kind of forget about it too. My father was a doctor so we were the doctor’s kids and you learn to build a little bit of a shell and I think it’s less of a problem now than it was a generation ago, as far as identifying you with the doctor. They don’t identify that so much because they sort of separate that better than we did a generation ago.\n\nHow big was Waukesha when you were growing up?\n\nDr. Werra:. About 20,000.\n\nSo it was bigger than…\n\nDr. Werra:. Bigger than this, yeah.\n\nI keep forgetting how big some of the towns were back there. The other thing I wanted to get to talk a little ore about was, as you were saying, looking back on the time that you have been here, there have been, I call it notal points. That’s probably… points of transition where you may have gotten to a certain level of comfort with your practice. This whole sense of having to change your, not necessarily your focus but to change something in order to be able to maintain your life and continue with this town. You talked a little bit about sail boating and a number of things, both inside and outside your practice. Can you reflect a little as you look back?\n\nDr. Werra:. Well, inside the practice, the first part, you work hard and long, worrying about survival and working to make a budget, whereby you can have money to educate your children, which, at least the ethic that I was raised in, our primary obligation in our life, is to give education to our kids and knowing that the cost of education were doubling every 5 years or something like that, you have to really work at that so that we can give them what you got from your parents and what they got from their parents. So yeah, I worked hard and Marlene worked hard and we scrimped and we scraped and we fortunately made an investment, how much intuitively, but our first big investment, we bought some land. Debated whether to get stocks and now we’re buying some land we hope will appreciate and we bought 40 acres and worked out really neat because that gradually appreciated over 20 years and that paid for our kids education. We made a thing where… Marlene, she’s the one that really did this, figured out this trust where this money was theirs and we didn’t have to pay taxes and that went for their education when we sold it after 15 years or so. At the same time we had it, we went out there and played on it. You go out and play with your stocks, it isn’t very much fun. And so we’d go out there and photograph the birds and check out the wildflowers and we improved the land and planted trees, imagined all sorts of things of how we would develop it, none of which we came… we ended up selling it, Marlene did. But it appreciated enough, quadrupled or quintupled or so, so that we had enough money to educate the kids and it served its purpose.\n\nThe first kind of phase of your career here would be getting this kind of foundation for your family, foundation for yourself, getting the practice up and running.\n\nDr. Werra:. Yes. And then we can start doing maybe more things that I feel I could do myself in practice. I could maybe squander a little bit, as far as getting into things that I thought were important for practice. Maybe not as much as I like to do but that I’ve been able to do now, not worrying as much because I don’t have to worry about having this big next egg for the kids education.\n\nAt the time when you started getting involved in prospective medicine, was that a time… that was a representation of a change for you about a different way of looking at your practice?\n\nDr. Werra:. And that also was… and that was about 15 years ago, so about the first 15, working and then I was able to do some other things after 15 that I didn’t have to worry if they didn’t make any money for me. I could just…\n\nWere there any times during the course of that first 15 years that you and Marlene had thought about leaving here?\n\nDr. Werra:. Yeah… there was a fellow that started practice the same time as I did. It wasn’t so much leaving as maybe going back and specializing in something I could… a family left and became an ophthalmologist, who I thought had the same sort of commitment and we began to think about doing that. I guess in residency, I almost left my residency to become an anesthesiologist because I had a friend who was an anesthesiologist and he had all sorts of time with his family, 2:00 he’d go home and was off on weekends. I thought, what am I beating my head against the wall working my head off and won’t even become a specialist, not going to make a penny more because of my residency. It sort of boiled down, what really do you want to do? And I don’t want to look at people’s eyeballs and put them to sleep and wake them up. That’s what life is. You want to kind of be important to people’s lives and do the things that they really need to have done on the people-to-people basis.\n\nThat phrase about being important in people’s lives is something I’ve heard is a very powerful part of what keeps us doing what we do. Can you tell me a little more about how… as you think about…\n\nDr. Werra:. I think one of the main elements of family practice is that… I don’t know how normal it is, but in one element, to be important in people’s lives over a period of time. I saw that in my father’s practice particularly. I think it’s less so now because we do less to be important to people, as time goes by. We don’t do the big operations and then I quit doing OB after 15 years, that was the most important thing to do for a family, as far as in their perception. But it gives you a satisfaction that financially, you can’t measure. They come back and they trust you to deal with this and deal with that and they look to you for advice and they do what you tell them, to some degree. I discovered that people come back and I ask them… talk about smoking. I quit 5 years ago. Oh, what made you quit? You did, doc, you told me. So they do it. You don’t realize and it takes a few years to find out you are important to people’s lives and then you discover they are important in your lives. As much as we say we’re sort of separate, we see people coming and going, dying and living and we’re just sort of immune to this and move right on. The longer you practice, the longer you realize that they are important to you too and you’re pained and grieved when they do or when they reject you. And you lay yourself open for that in family practice because it works two ways. You’re important in their life and they’re important in your life too.\n\nThat’s really good because I hadn’t heard it expressed quite like that. It’s this sense of how important it is to have your patients in your own life.\n\nDr. Werra:. Yes.\n\nIt’s part of… I’ve heard people say, in a sense, that you become a member of their family. In a different way, they become a member of your family. Not as intimately as you are of theirs but their stories, their experience, how they’re reacting to you all, really make you have them as members of your family. Your family probably hears about some of those stories.\n\nDr. Werra:. I heard about them from my father, it’s all secret, don’t say anything. But you do share it and it’s important. Even in our family and my wife, we have a fairly intimately related practice so it kind of works with her too. She knows the ins and outs of these people, she calls them to try to get them to pay their bills. It’s a two-person type of thing.\n\nThe other question I had about, and I have difficulty asking this really, in some ways, my perception is that physician in a smaller community becomes more of a social change agent. We just got back from the hospice meeting and your involvement with hospice, it’s not something, as you say, you’re not reimbursed for. It’s some sense of responsibility you have beyond your being a good doctor in the community. Some people are involved with political types of activities, school boards, is that a big part of what’s been true for you?\n\nDr. Werra:. Yes. In particular, I a community of this size, you have much greater opportunity to impact -- and part of it is because you’re a doctor, but part of it is because you have a knowledge and power base to do things and I think those are probably some of the main satisfaction why this has wedded me to this town. You think of things that make you come and make you want to leave, some of the things that I have difficulty leaving and I’ve fought leaving have been, 15 years ago, and not that you ever really do stuff yourself, there are always a lot of other people that have a lot to do with it.\n\nWithout you it probably wouldn’t have happened.\n\nDr. Werra:. But you have something important to do with it. And then I started the Home Health Agency when the Public Health Department closed it because they couldn’t make it go. And this was a really important service for this community, we didn’t have it. Started it and you go through a lot of fighting as time goes on and to keep it the way you perceive it ought to be, it’s been a struggle and many others have gone down the drain as things go on. What happens with home health agencies, it starts off as a community non-profit agency and that’s the way ours is and it still is but Medicare impacts, I’m trying to be sure that their money is being spent correctly -- so much bureaucratic financial thing that all of your money are going to satisfy Medicare. That’s, the tail is wagging the dog. Pretty soon you can go broke. We just struggle to survive and most of them have either become part of a larger agency or a big chain of for profit home health agencies or going with a big hospital. And we fought not to do that and it’s been a struggle but it’s been a very satisfying thing because we know we have a really good level of care that’s tailored to the community and our board of local community people. It really has been a very satisfying thing.\n\nPart of your legacy to this town is not just the good care you’ve given your patients but creating institutions that continue on.\n\nDr. Werra: Yes, and I think in family practice we’re more attuned to thinking of those things Why don’t other doctors do this? I think it’s because family doctors are geared more to people. We’re more people doctors, more people interest and that’s why we chose this field because we’re more interested in people than we are in disease, path of physiology of disease and the quantitative knowledge that’s required for that. That tends to make specialists become specialists. They miss this part but this is where we’re just natural attuned to, so we started that and we started the hospice 8 years ago and these kind of issues. Community health issues.\n\nWas it clear to you when you started coming to this town, when you started to choose Ukiah (?) and come here, that coming to this community would mean you all getting involved in a variety of other things?\n\nDr. Werra:. Not the slightest idea. We came here to practice medicine and raise a family and enjoy the trees, the lake with the sailing. We knew about wildflowers and our personal satisfactions and hobbies but sure… in fact, we really weren’t community oriented. I got briefly involved with the Junior Chamber of Commerce and the Rotary. I didn’t want to join any of those things and never have, really.\n\nWas your father involved in any of that? Did you watch that go on?\n\nDr. Werra:. You know, you end up mirroring your parents and you don’t realize it, but he did a similar sort of thing. Only he was ore active, like the school board and that was his major passion for many years. But he started some other sort of altruistic kind of things. We the people. It ended up like many of the things that I’ve done, it sort of faded away but it was a wonderfully challenging idea.\n\nI think that’s part of living. My sense is, that’s also… you said you started it 15 years ago and you got over that first 15 year period, building security for your family and kind of getting secure in your practice and then at that point, it’s interesting that you started to get involved with some other outreach. That probably happens for people.\n\nDr. Werra:. It takes awhile to see… then you begin to see needs. Maybe needs that other docs don’t see but after awhile, because of being family doctors I think, we see these needs and then they’re not being met so you say hey, we’ve got to meet them so you do stuff to try to meet them. Not that you enjoy doing the stuff but if you don’t do it, it’s not going to get done.\n\nOne question I had, again, I’m not sure how to exactly ask it. What’s been the hardest part about living and practicing in this community for you? Are there any specific things you can think about that are particularly difficult?\n\nDr. Werra:. The two things I didn’t perceive was that even in rural areas, people don’t meet my expectations of staying here and growing up because they’re moving. People come here and say, oh, I found this wonderful town, I lived in LA, I hated it. This is where I’m going to live together and this is going to be neat as years go by. And then 2 or 3 years later, they pick up and leave and go somewhere else and you just sort of invest in that family, get to know them and then they’re gone. I didn’t think that happened in rural practices, but it does. Then the other that I thought, as you alluded to in England, they’re your patients forever, but they’re not. You do one thing to cross them and they’re off to another doctor. Whether you’re here a year, 5 years, 10 years. It takes you awhile that you haven’t done anything really wrong, is that they perceived it and there’s no way you can correct it. But it still bothers you that this happens and that you don’t have again, that segment of people really loyal to you. The only ones that really stay loyal are the people you deliver and that’s why I’m really glad I do OB for the first 15 years. I think all family docs should do OB initially because those patients, you really live with and invest in years from now. I hate to say it but you can mess them up entirely, you can kick them while they’re down and tell them to get out and they keep coming back because they perceive that you did something superbly important in their life, even though it wasn’t, you just happened to be there.\n\nIt’s a bonding experience.\n\nDr. Werra: The one that delivers you, they think has done a great thing. Sort of like a surgeon. You operate on someone, they think you’re a great person. But an OB… but for other things, you can save their life 100 different ways and I’ve done that, particularly with more of the preventive things that you’ve done, even when you found a melanoma, you’ve taken it off of them and saved their life. You do something a few years later that they don’t like, they’re off to someone else.\n\nIn some ways it’s your willingness to really stay with people and be with people with whatever it is that comes up isn’t matched by their willingness to stay with you in the same situation.\n\nDr. Werra: And of course maybe you’re a little bit prejudiced and you think you’re so great. Maybe you don’t always do that great for people and so we haven’t met their expectations either.\n\nWhat do you think it is that’s kept you doing this for all these years?\n\nDr. Werra: Well, I guess the one thing that keeps me, I guess is this perception of wanting to be needed. When I think about, I ought to go off to Kaiser, you get these things in the mail, come here, such and such, this wonderful place, you get all this money, all this free time. Are you mad at the government because they’re shafting you one way or another? If I leave, what are these patients going to do? They kind of depend on me. Even though you know intellectually, they’ll even disappear in the world and health isn’t going to go to pot but there are people… he’s my doc and what are they going to do without me? And that sort of keeps… that’s why I don’t want to just leave them because they’re people who are going to have trouble finding something. Maybe you perceive that you are so much better than anybody else, that it can’t be duplicated by someone else and now, in the last 10 years, the other important thing that happened midway, and this was a lot of things that were accidental, again, I got a nurse practitioners, family, female, family nurse practitioners, 15 years given myself, 15 years ago, was the first one in town. It was happenstance that I could arrange this. She trained in my office for part of her training. The reason was, I wanted to attract another family doc to come and practice with me. But it turns out that you don’t need them and I thought this would really turn on the young doctors, oh go to this practice where there’s a nurse practitioner. As it turned out, once I had her I didn’t need another family doctor. She really filled a gap so that you can work better. She can cover some of my vacation time and my going off to medical meetings time, the economics. And that’s about the only thing economically she contributes. But what she did do for my practice is, it has kept my practice young. A really good mix. An internist I started in practice within, with 15 years, he was virtually all Medicare. Mine is… once you quit doing OB, OB keeps your practice young but once you quit OB, you lose that too. But when you have a younger female, it keeps your practice young because the younger women, that’s who they turn to… they really look for something like that. So you’re sort of right there with her so you get these young families and still get people when they have babies and end up taking care of them. And really kept a good mix of my practice. It really makes it more desirable than just having a certain age group. So that has been a very useful thing. Now the last few years, I’m thinking about retirement. Time I’m going to quit. What are you going to do about your patients at that time? And so I’m beginning to look for a family doctor to come, not that I need one and I don’t even know if I can give him what he needs, or she. Nowadays, it can be a she just as regularly as a he. But that I want to be able to pass what I feel is unique, etc., on to another generation of practice in this community, of rendering similar type of full range family care to the next generation of people.\n\nA sense of legacy. Everybody starts to…\n\nDr. Werra: That’s right.\n\nEric Erickson and the stages of a man’s life and so on, has to do with generativity and the sense of passing on. You pass it on through your children, you pass it on through your accomplishments but you also pass it on in a sense of having something continue after you…\n\nDr. Werra: I think this probably means more to a family doc because of the people aspect of it, than a specialist.\n\nAnybody can do a flex sig (?), for example but not everybody can do a flex sig on this person and put that procedure in the context of this person’s life who you’ve known for 25 years. It’s like someone said, anybody can deliver babies but they didn’t and I did and that’s made all the difference.\n\nDr. Werra:. That’s right.\n\nCan you show me some of the pictures that you have? \n\nDr. Werra: As far as reasons that I’ve stayed here and again, I started thinking about it, is this picture here. That is in a small town with four children, two of them have either returned or stayed in this community. Here’s my son, a carpenter and my first grandchild and this is my daughter, who decided not to be a family doctor. She has wonderful sewing abilities and she became a general surgeon and became what her mother would have been a generation earlier but it wasn’t suitable in her generation. And her mother actually vicariously, between you and me, has lived through her daughter. In fact, at one time she pretty near went to medical school because she got two acceptances and she looks really young and it had the wrong name. She was thinking of going to Irvine and becoming a doctor. But in a town like this, so now for the years to come, this is what keeps mere. I’ve got family within 5 minutes, got a grandchild and this will keep me here. They can offer me the moon but you can’t buy this. Part of it, in this sort of community, people will either come back or want to stay because it’s a nice place to live. If I was in the city, there’s no chance that 2 out of 4 of my kids would settle in that town and I could experience them and their grandchildren. After the adolescence, the things we went through with these kids, but if you recite the seamy side of your children and going through adolescence, you say… but when they get older, they get to be 20, 21 or so, suddenly the bonds begin to come back again and we become friends. My wife is much greater friends with one daughter than she ever was before. Then suddenly you start coming back together and enjoying each other and the company of each other. This can sustain us now for years to come and this is one nice thing about rural practice. The other thing is, I purposely made that so you can see the trees and the hills and the greenery. This is why I want to stay here.\n\nCan I take this along? I’ll copy it.\n\nDr. Werra: Sure. As far as other recreational things, the Sea scout (?). There’s my son and me and this is part of our fleet.\n\nEven with the drought you’re going to be able to sail.\n\nDr. Werra: Oh yes, that worked out okay.\n\nI envy you, I loved Sea Scouts.\n\nDr. Werra:. And then the wildflowers. I have lots of pictures of those. This has been a major attraction of this area for us and why we won’t leave, is because we have a native plant society and we keep going from one thing to another. I helped start the Ukiah Horticultural Society, which now, we’re interested in sort of growing native plants. And I can picture, I can potter with that in retirement and fill my life with that. But we figured it out, we can’t climb the mountains anymore. We go traveling all over the world looking at wildflowers. Now we can just potter around and raise them and that will give us satisfaction. And we’re very fortunate as far as the hobby part, and this is what… I spend time with these complete physicals and I sit and I ask them, what are their hobbies? They spend 15 minutes getting these hobbies and then implant in people what we accidentally discovered, is it’s good to develop a hobby when you’re younger that you both enjoy so that when you get older, we’re living on traveling once a year to see the wildflowers and now blowing pictures of them and entering them in the county fair and I’ll exhibit them at the wineries. But she likes the same thing, so she catalogs them and I’m sort of her photographer. We go together and she shouts to me, and this is a major part of our life. I think it’s important that couples start working on that when they’re younger, to find hobbies they both enjoy so that when the kids grow up, they can look at each other and say, we still have something that we can do together. And I think those are probably the major recreation and that sort of thing. The other part, analogous to the hospice… and here’s Thelma and I with our Hospice and list of patients and list of volunteers. And another role, I have a picture with Linda.\n\nThe other woman that was here this morning?\n\nDr. Werra: Yes. With the home health agency that we started. Then there’s the professional part of your life non-practice that has sustained me. We talked about switched from preceptering medical students to now doing medical research and trying to work things like that, with the Lyme Disease and this network business and I have a number of research projects that I can still work on doing, with or without the university but it would be better to work with them. And then the teaching, you get older and they don’t want you to teach anymore. \n\nYou mentioned that.\n\nDr. Werra:. I think you’re an exception. I think a lot of times they feel it’s more important for a student to relate comfortably in an age group culturally, with their mentor than the fund of knowledge that that mentor may have and they kind of consider outdated. But I’ve accepted that that’s going to happen and I won’t accept the rejection personally, and work out in other ways. That’s probably going to sustain me in the future. Community health activities. Then there are the peripheral ones. And one I spent a lot of time on was animal research, not that I wanted to but again, you end up filling a need. A group of people got here and were going to stop the county pound sending dogs that would be euthanized because the were unclaimed, to the university for research, to UC San Francisco. Gradually this has been eroding over the years, with animal rights, excuse me, anti-animal research activists, which they call animal rights. They were going to have it pull on the ballot and they had almost enough signatures to win the election for the petition to put it on the ballot. The board of supervisors wouldn’t grant it to them because the one good thing this board did was, they went to UCSF and said, tell us. So UCSF came up and told them the pros and cons and they said, we’re going to do it. Even though they were going to put it on the ballot and cost them $20,000, the county, to deal with this and even though those people said, forget it, we’ve got enough votes, you might as well save $20,000 and just ban the ordinance, put in an ordinance that they don’t go. Again, there were others. One of the board of supervisors had breast cancer, was going to Stanford for chemotherapy, or radiation and she knew what… and myself, and then a couple of other people. It was just four of us that said, we’re going to fight this. After 6 hellish months and sleepless nights and reacting, but we beat them. It was a remarkable event. Here’s a picture of the… there was a parade, the hometown parade. The animal anti-research people, they had money to burn. They had $25,000, I’ll give you a newspaper clipping on that. In the parade, they got a float, they rented it with all their money so we heard about it, so we said, we’ve got to do something. We went and said, all right, we got a rancher to say, you can use our truck. In kind, I went to this guy, a sign painter and said look, I’ll give you free care for a year if you do these signs for us. We met every two weeks about 6 of us. A guy from the Cancer Society, a guy from the Respiratory Society, a couple other concerned people, etc., and we mapped our strategy and we ended up beating them 2 to 1. We put radio spots on the air, went to newspapers, had a whole list of letters to the editor that I wrote, had other docs sign them. We met them in kind, a media blitz and turned it around. So we had our float…\n\nI like your float better, actually. Visually it’s a better float.\n\nDr. Werra:. Yeah, yeah. And so got local people that had actual things and these were all real people that had things and talked to them, hey, would you be on the float? When you talk to people, they’re very happy to do research when they find out that it really means a difference to them. So all of these people had, she had breast cancer, he had an aortic valve put in, he had leukemia, he had high blood pressure, lens implant, a lawyer, who’s now a judge with an artificial hip. At any rate… so the community helped needs, otherwise you lose. I went to the board for fluoridation of the water. All these senior citizens that didn’t have any teeth, saying it’s going to cause cancer and this, that and another thing and it was soundly defeated. Went to a 55 mile speed limit, to keep it, on highways. Went to the AAFP to have them fight for 55. Went to the State Medical Society, the County Medical Society, to fight for 55 because the statistics are clear that the speed limit… at one of the Prospective Medicine meetings I learned, the largest decrease in death from a percentage wise, from a single cause of death in the 20th century occurred in 1974 and that was the 55 MPH speed limit. At any rate, I was figuratively tied up, bound and gagged and thrown out into the cold. My own medical society.\n\nVoice crying in the wilderness.\n\nDr. Werra:. Yeah. What are you talking about? But at any rate, you lose things, the fluoridation lost. I wanted to have a residency program, extension of the residency program in this community. I spent a lot of effort on it because 3 months out of a third year residency, coming to a smaller town where they’re not just family practice, but they rotate with dermatologists, to really learn skin things, with an OB/GYN, got to tie tubes and Urologist… I had that all set out, had a house lined up and everything and I couldn’t pull it off. I called the head of residency at San Francisco General, he said, God, I don’t want those people to go up there, they might want to stay. At any rate, you have lots of failures too. That I tried to do through AHEC. For awhile I worked with AHEC. You have a lot of things like that, the research network at the university failed, some of my wanting to educate has failed, teach. But there are enough other things that have succeeded, like the Lyme thing. Yesterday I was interviewed for patient care. So you do have some things that…\n\nI think being able to focus on your victories as well as be saddened by your…\n\nDr. Werra:. You can so these things in a smaller town, I think easier than you can if you’re in… and part of it is being in solo practice and private practice. I have these things I can go do. I can go to these Prospective Medicine meetings, I get nothing of any real value to increase the efficiency or income of my practice. I can afford to do that because I’m solo. Otherwise I have to justify it to the partners or to Kaiser and you don’t get anywhere. So that part of it is…\n\nThe autonomy and independence is really strong.\n\nDr. Werra:. That’s right. And of course, work collegially with other doctors and you can get in bad habits. I’m sure there are some things that…\n\nAs you say, there’s enough doctors in this town that they serve as kind of checks and balances and you for t hem I’m sure.\n\nDr. Werra:. Oh sure. And ultimately, you’re not going to do stuff that is really hurting people because if you see that it is, you’re going to quit doing it.\n\n(RECORDING ENDS)","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3180/collection_resources/150929/file/278329#t=0.0,2697.608"}]}]}]}