[MUSIC PLAYING]
Which end do you want tie in first?
Go where that tree is, we'll go across that.
Real medicine is all around you.
How long have you been seeing Oscar as a doctor?
Long time.
You have a heart bypass or you got a heart attack?
I had a heart attack.
You have a stent?
They put a stent in you?
It's all that fried catfish.
That's it.
You know, I'm a big eater, you know?
I know you are.
[LAUGH]
Patients are complex individuals.
How often do you see him in the office?
He's been under such great control,
I just see him like every four to six months.
He's good about taking his medicine.
Oh, yeah.
Right now my official title is Resident Physician
in Neurosurgery at the Barrow Neurological
Institute in Phoenix, Arizona.
How many of these hooks do we put on this line?
These sorts of interactions, they're
extensions of the exam room.
Baiting them up there.
Yeah, we're baiting them up.
I didn't gain that understanding
until my third year of medical school when I rotated here.
It was during my family medicine rotation
that I met Oscar Lovelace and The Catfish
King of Newberry County.
[HORSE WHINNIES]
Come on.
I started a solo practice here on August 1st of 1988.
Prosperity is a little rural community in South Carolina.
It's where my grandfather and my great grandfather and my father
were reared.
There's a little rock church.
They gathered the rock in that church to help build it.
How are you doing?
I like your ride.
It's a place you might run into someone that you
know at the grocery store or across the street
into the hospital.
Everyone around here knows who Oscar is.
How's it going, man?
I got somebody to introduce you to.
This is Mark Pacult.
Hey, sir.
How are you?
Student working with me.
Nice to meet you.
The way that someone would understand our practice,
we're like the old school family doctor.
We take care of people in the office,
the hospital, the nursing home, and do home visits.
Anne, I am so glad to see you.
And I want this young doctor to understand
the value of family medicine.
We are more than the sum of our parts.
I not only take care of that patient,
but I take care of that patient's mother,
that patient's father, that patient's child.
When you treat a sweetheart like this,
everybody cares about mama.
That fellow over there, you met Buddy, and this is Angela,
and this is Anne's daughter.
And I had the privilege of delivering her children.
MARK PACULT: Wow.
How old are they now?
30 and 26.
Oh, my gosh.
Yes.
Continuity.
I think it's the most underappreciated aspect
of medicine, the continuity of care over the lifespan.
This is Mr. Wallace Hunter and Ms. Fanny Hunter
and they've been my patients for over 20 years.
For the most part rotating, it's a very controlled environment.
Dr. Pacult, he's finished medical school,
but he's still in his training.
You're kind of attached to a team of physicians, residents,
other trainees, other medical students.
Do you feel like you're getting any stronger, Wallace?
I'm getting a little bit better with my appetite.
Here Oscar is saying, you're going
to be my eyes and ears out there.
It's me and you.
So I'm really relying on you.
What's the workup you do?
Well, he's had a colonoscopy and an EGD.
And it was completely new to me as a medical student.
I remember my first day.
It was a wake up call.
I was on call, and he said, you know
you're going to go round at the hospital,
and I'll meet you there.
And you're going to kind of show me all the patients
and show me your plan, and then we'll go from there.
And I meet him for breakfast.
And I'm like, OK, first patient, A. This is their hemoglobin.
This is their hematocrit.
Here's their white count and it went up
two points and this decreased by one point.
And he just like stood back, and he was like,
what is going on with this patient?
And I had no answer.
I think one of the interesting things
is when a student comes back to present the patient to me,
I've been caring for this patient for 30 years.
I know so much about this patient, about their family,
about their economic situations, about the worst time
in their life, about the best time in their life.
As a medical student, going into the computer, and it's
like boom, boom, boom, boom.
Like labs, overnight events, new imaging.
And it's like you have your algorithm.
It's just, I had no idea what was actually
going on with the patient.
So that was my first day.
And then it just kind of got more chaotic.
[CAR ENGINE STARTS]
There is never a typical routine day.
There's always something very unique that happens.
You're going to round on patients in the morning,
see any new admissions that have come in through the ED.
In the meantime, you're going to come back to clinic.
And we've got a whole afternoon of scheduled patient visits.
You're at the nursing home rounding on patients
that Oscar is in charge of.
By the way, you know this patient called in and said
she has a fever, we may go check on her.
And interspersed in there, we may
have a delivery or two that comes in at the hospital.
And we'll get in the truck and go deliver a baby.
[SIREN]
Mark, we got to go.
It's late. It's ruptured.
We got to go.
There's a cop.
I know.
Lee, seriously, I got, I got a lady in labor.
I'm the sheriff.
I understand Dr. Lovelace and how
he gets about. I'm not going to necessarily say
it's unsafe speeds, but he does that quite often.
He's bringing life into the world.
You realize medicine isn't confined
to the hospital or the clinic.
It takes place kind of everywhere in between.
And this place gives you an appreciation for that.
I'm coming along.
All right.
So taking Mark catfishing with The Catfish King
is not only a great experience, but it's
a doctor and a patient sharing an experience that brings them
closer together.
Put that teriyaki sauce in there,
you get eye potatoes and onions, and cook it in a pot.
Man, that's some good stuff.
I have to say that that's something I'm really concerned
about with the changes in medicine,
there has been the breakdown in some of those relationships.
It's what's happening all across America.
Integration and scale makes economic sense
in every single industry.
But it's not just what lowers costs
or what creates data and quality.
It's value as well.
And we have to think about the psychological value to doctors.
We have to think about the value to patients.
Where I see it meet the road is, we see patients all the time
in the emergency room with brain tumors,
with aneurysms, with complex neurological disorders.
They don't have a primary care physician.
If I see someone in the emergency room,
I don't know what's going on.
And in an ideal world, you know, I'd call up Oscar and say,
hey, what's going on with this patient?
And they can tell me in a second.
Those relationships, those kind of networks, are dissipating.
I think we got one.
We got one?
Yeah.
Hot dog.
I got her.
Ain't not doubt about that.
All right now.
They don't call him The King for nothing.
Can you make stew out of that?
Oh, yeah.
I've thought a lot about, is this just learning the lesson
that we've been told our whole lives of there's wisdom
out in the country?
We got a catfish.
Uh, uh.
Oh, wow.
Who did you get it with, Mark?
We got it with The King.
With The King.
But I use the stuff that I learned during this rotation
every single day as a neurosurgeon.
We think, as doctors, what's holding us back is technology.
If we only had this drug, if we only had this treatment,
we'd be able to cure this disease.
But so much of what's holding us back is far simpler.
It's bridging the gap to the patient.
And I'll never forget that.
[MUSIC PLAYING]