Merry Christmas, Happy Holidays

David Hermanns 12/24/2002

As 2002 comes to an end, here's a brief recounting of the Hermanns/Ellermann family's activities.  We hope that all of you have had a wonderful year as well, and we wish you the best in the coming year ahead.  As you know, this year has taken us on a path perhaps not expected in the beginning.  I encourage each of you to live each day and year with the same realization that not only can things change unexpectedly, but also that YOU can be the one who changes, purposefully.

The year started with Claudia's sister Astrid and family (Winfried, Lars and Holger) all visiting from Germany. They were present for Christmas 2001, over the holidays and into January.  That seems so long ago now.  The major event was Lars consideration of perhaps doing a year in Boston (he would have been a junior in high school).  He interviewed at several Boston schools, but ultimately later decided to forego the "year abroad" after all.  At that point we didn't have any idea at all that we might be living somewhere else in 12 months.  I don't have any digital photos from that point -- bought my digital camera later!!!!

Our annual cross country ski vacation with the Stoddard's went off without a hitch in Jackson, New Hampshire.  We celebrated Cecile's 4th birthday there on  January 17th. 2002 will mark the end of a multiple year tradition where we and the Stoddard's (and sometimes Larry and Sally (Henry/Dungan)) made the trip together.  However, though 2003 will fall out, the true test of a good idea, not just one that gets carried on "because its tradition", is whether or not we can revive it next year or the year after!!!  I think right now I miss looking forward to the ski trip about as much as anything from Boston.

Spring (and change) in the Air

Somewhere in the depths of  winter, a mutual decision by Claudia and I led to my resignation at Beth Israel Deaconess.  As I look back on it now, I am amazed (and sometimes unhappy) that I had the courage to make such a leap.  Though many of my colleagues and friends know that I was not always the most complimentary about the management and leadership there, most folks who know me well, know that I tend to be critical of pretty much everything in my life, myself included.  Now, with the increasing objectivity that the distance of space and time brings, I must say that BIDMC was not all that bad.  In honor of my wonderful colleagues and patients there, here are a few photos of them.




In reality the decision to leave BIDMC and Boston hinged much more on some other important things in our lives.  I grew up in remote western Kansas, on a mixed farm/ranch.  I never really consciously "left" --- I went to college at Kansas State expecting that I'd go to Kansas University School of Medicine once I was done with my undergrad studies.  Somehow ended up in Houston at Baylor, then on to Boston for my residency.  Then a fellowship and first position.  But, never did I say "I'm never going back".  In fact, thinking about my 2 daughters growing up unacquainted and ignorant of the kind of rural/farm childhood that I had enjoyed, that bothered me.  Christina, the oldest, was in kindergarten last year.  And the reality of how fast they are growing up started to sink in.  They are at a wonderful "portable" age now.  Old enough to remember where they are and the experiences they are having, young enough to not be leaving too many friends behind.  And they still like being with Mom and Dad .... sometimes!



Now, that last photo exposes (Ha!) a certain problem with leaving Boston and going back to Kansas, even for a while.  What do you do with your house?  Especially a house that has been my pet project for 10 years.  We initially wanted to rent it out, but the economy tanking took the legs out of the rental market.  And the real estate market was (is??) going strong.  So what was initially thought to be a "temporary" hiatus with option to return, got a little more permanent when we sold our house.  I still have my moments of regret, but we were rewarded quite nicely for our labors at 30 Green Street. 

Summer 2002

As has been our custom for several years, we spent several weeks on the north shore, on Cape Ann in a rental property in Annisquam.  There we were blessed with visits from a number of wonderful friends.  Hans Juergen Hutter, a dear friend of Claudia's, whom I know from my days in Germany visited.  Friends Thom and Phyllis Carter, Madeline and Kasal spent much of the time with us.  A whole list of other folks came for visits.  Next year we will have the house there for several weeks again, and for the friends in the northeast, we are EXPECTING you to join us!!

2002 Annisquam Pics

The Move

Of course, from the relaxation and seemingly unchanging routine of vacation, our lives went into the hectic final weeks in Charlestown.  Packing up our belongings, finishing the final details of the home sale, and finally saying goodbye to all our friends.  Right down to the last days we remained somehow uncertain that the sale would go through, but it did and our home of 10 years was gone.  That same morning we helped the movers pack the truck, which I would drive to Kansas with the assistance of my brother Eric and his friend Adam.  Claudia flew with the kids two days later and we arrived in 4 days with the truck.

    Last days in Charlestown



We arrived in Kansas in the middle of August, middle of nowhere, middle of a rather nasty dry spell, etc. etc.  Luckily, it was not exactly a "new" arrival, but more of a homecoming, with many family members arriving to help unpack the truck and get us settled in.  Unfortunately, the old house had all the charms of an old farmhouse, and all the problems, too.  Now in December we are finally getting settled in to the place and are pleased -- though cold at times!!!

The Kids!!

Well, they are a major reason why this all was undertaken.  They have flourished.  New bicycles were on the promise list early on, and Christina's did not come with training wheels.  To our amazement  (and hers too), she zoomed off more or less with the first push and not looked back.  Cecile's bike did have training wheels, but over the ensuring weeks, they bent slowly upward till they were touching the upper frame of the bike!!!  So I took them off, and --- away she went too.  The broad open farmyard is covered in buffalo grass, a very tough variety that can survive the Kansas heat (in fact, the only way to kill buffalo grass is to water it).  It makes for an easy place to learn to ride, as it is short and yet a little soft too.

School started quickly for Christina.  She's done well there, in her class of 16.  The size make for lots of personal attention (though its actually one of the larger classes in her school!!).  They get music daily, as well as PE several times weekly.  Much less attention to standardized tests and learning how to take tests.  But they did take tests for one whole week in October too, so the testing and standards craze can be found here too.  The school is a true reflection of the community -- a small place that take pride in the few things it still can do right, of which education is one.

Chris and Cecile Pictures in Kansas

Animal House

Actually the only animal that is SUPPOSED to live in the house is our old friend and traveling companion Theo.  He started life about 10 miles from here on the farm of my uncle, made it to Houston years ago during medical school, on to Boston for training and our years there, and now he's back.  He'd like to go outside, but with no claws and no common "cat sense" left, he'd not last long.  So he stays inside, meowing at the door as if to say "let me out!".

Now, the dog (who we do let in occasionally), two outdoor cats who have taken up residence, the chickens on occasion, and many many mice all would like to get INTO the house.  So there is an interesting barnyard atmosphere at our back door, with everyone wanting to be on the OTHER side.

Apropos the dog.  Pretty good choice overall.  A mixed breed, mostly Labrador that looks totally like a yellow lab, but has enough border collie to make him a touch more mellow than your average lab.  We thought he had no bad habits, until he recently killed and ate our favorite rooster.  He's now in the rather gory process of learning an aversion to chicken (which I will not elaborate in greater detail, except to say that it is a time proven process on many a farm if you want a hound dog that NEVER bothers the chickens).

Some of the Farm Animals

Life in Rural Kansas

Here are a few photos we've snapped.  It hard to capture the beauty of this place with a camera.  The sunsets are fabulous, though often taken for granted by the locals.  Many of the old, abandoned houses and buildings are taking on that "old west" appearance.  Eerie at times, especially since this is home for me, and no one likes to see "home" looking like a ghost town.  It is beautiful though, in its unique way.  Many people anticipate all of Kansas to be flat, like Interstate 70 or the Wizard of Oz.  That's not really true here in the northern part at all.  Rolling hills with creek bottoms filled with trees.  Viewed across the tops of the hills, from a distance, it seems to go on forever, but if you drop down into the low spots, you can find yourself in a little nook where it may seem that mankind has never been.

Kansas Photos

Medicine in Kansas

Not really any pictures yet in this category, but our yearly report wouldn't complete without something about my work in Kansas.  The local hospital is blessed with outstanding doctors, nurses and management.  One of the things that this community can take pride in.  I really have always felt I should "give back" some of my talents to the place that produced me, and I also really don't think that a doctor can keep his skills current if he's not practicing and caring for patients.  The idea was that I would work part time, seeing patients two half days weekly and taking quite a bit of call to help the local docs in the way that is most useful.  They tend to have enough manpower to see everyone during the day, but every 3rd or 4th night on call, covering the hospital, the ER, several nursing homes and all the residents of Smith County (about 5,000) -- that gets real old.  The two other doctors are assisted by a nurse practitioner and physicians assistant who also take call, as well as some hired moonlighting residents on weekends. 

Now, what I have found, perhaps unsurprisingly, is that it takes a special kind of doctor/provider to take call out here.  You are the ER doc.  You can be called upon to see kids, babies, trauma, orthopedic stuff, and of course the gamut of internal medicine.  I feel like I'm back in residency every time I'm on call.  That can be good at times -- for those readers who are doctors -- do you remember the personal satisfaction that goes with dealing with a new problem yourself for the very first time?  But it can be damned stressful at others.  I have recognized all the more clearly how differentiated medicine, even "general internists" have become.  This is not a bad thing, only for a place like this, it does not serve the needs of the community.  Here, I must truly doff my hat to the Family Practitioners who attempt to "do it all", and at the same time always recognize their limits and seek assistance when they need it.

Specialists are different here too.  Because several larger medical centers all about equally distant at 70 to 100 miles away, there is a choice in referral patterns.  You can figure out what that means, practically speaking.  This may of course be read by a few of my Boston specialist colleagues -- I can assure you -- If I sent you this link, it certainly means you were NOT in the problem category!!   I cannot say if I truly think I could stay here.  Much too early to say.  At this point our plans still include a return to the Boston area or northeast in 2 years.


So, to close.  It has been a wonderful year.  Not without regrets, mistakes or  pain.  But certainly with the realization that you only live life once.  To let it go by while "sitting still" is a mistake, even if "taking action" may mean taking some wrong turns as well. 


Merry Christmas, Happy Holidays and a Wonderful New Year!!!


David Hermanns, Claudia Ellermann, Christina and Cecile

Link to Claudia's Christmas Letter (which we sent out)