Maureen Kuhn, November 6, 2019

Title

interviewee

Maureen Kuhn

interviewer

Jessica Goon

Date

2019-11-06

Subject

Nursing

General Practitioner

Medicine

Community

Small Town

Travel

Ireland

Paris

Discrimination

Medical Technology

Cherry Valley

Helping People

Description

Maureen Kuhn is a general practitioner in Cherry Valley, New York. Kuhn was born in Mount Vernon, New York on April 16th, 1956. She became interested in medicine at an early age by taking care of her siblings. She wanted to do something with her life that allowed her to take care of people and help them with their health.

Kuhn has been working in the area for 37 years and is fond of working in a small community. Even though there have been changes to the medical field during her career, she still tries to emphasize the importance of listening to her patients and building real relationships with them. She also enjoys helping her patients adjust to diversity in the community. As a member of the LGBTQ+ community she was met with a lot of questions and concerns from conservative patients and she helped them adjust to something new. Kuhn is keenly aware of the changes that are happening to the medical field because of technological advances and new research. The improvements with surgery and record keeping come with their own new challenges and complicated relationships with drug and insurance companies.

Outside the office she enjoys a lot of activities that the area has to offer. Kuhn and her wife are both very active people and enjoy skiing and playing golf. They often spend time with friends dining at local restaurants and listening to music. They also enjoy traveling and have future aspirations to travel Europe and explore the United States more. They have already visited Ireland and Paris together, and have taken a Mediterranean cruise.

Transcription

MK = Maureen Kuhn
JG = Jessica Goon

[START OF TRACK 1, 0:00]

JG:
This is Jessica Goon interviewing [MK: Maureen Kuhn] for the Cooperstown Graduate Program at her home in Cooperstown New York. It is 9:00 am on November 6, 2019. So, could you please tell me when and where you were born?

MK:
I was born in 1956 on April 16 in Mount Vernon, New York.

JG:
Can you tell me a little bit about your family?

MK:
Sure, I am the oldest of five children in an Irish Catholic family. I have two brothers and two sisters. And both my parents are still alive at 90 and 91 living in New Jersey in a place where they say there are too many old people [laughs]. But we're in five different states and all out and about doing our own thing. So, I've got eight nieces and nephews so they keep my pocketbook well used [laugh]. Yeah, it's good.

JG:
How did you become interested in being a general practitioner?

MK:
When I was in high school I always liked kind-of taking care of folks, and being the oldest child in a family I was sort of the babysitter and the caretaker and helping my folks. But when I went to college I though maybe I wanted to become a physician. But I also liked teaching and at the time in the late 70s medical school was really competitive for women. I didn't really have the grades and there was this new, fairly new, nurse practitioner role that was kind-of a nice combination of nursing, education, and teaching, kind-of like a mini doctor. It involved a lot of basic stuff. It was mostly focused on wellness, which was sort-of an interest of mine, and chronic diseases. So, I went to Pace University and did a generic masters program so I got my nurse practitioner and my nursing all together in a really intense program. It was a little bit of everything that I liked. It was taking care of people. It was teaching. It was educating. It was social work, a little bit of everything. I think it's changed a little bit as healthcare has changed in that it's much more disease focused because people are sicker. And then I came here to do an internship in 1980 after I graduated from nurse practitioner school and I went away for a couple years and then I came back. Then I came here on the five-year plan and it's been 37 years, so I'm going to retire from here and see what the next step brings. It's been a great career. We had a memorial service for a 34-year-old that was killed tragically in California on Sunday in Cherry Valley where my clinic is. It was a gathering of lots of generations who I've take care of for 37 years. A lot of 34-year-olds who were grieving and their parents. Somebody said to me, “Well you've kind-of taken care of all of us for a long time and know a bunch of us in ways that other people don't.” It's a real honor and a gift to work in one community for a long period of time where you've taken care of five, four, and three generations. It gives you a different perspective on family practice. It's kind-of been everything I wanted it to be, and more. It's been good for me and good for them.

JG:
Without providing any identifying information, can you talk a little bit more specifically about what it's like to work in a community like this?

MK:
Sure, I think as a small health center and a clinician, you become sort-of the focus of healthcare in a small town. Not that everybody comes to the health center, because people have choices at the hospital and go to other places. But you're dealing with people at their most vulnerable times, good and bad, and so you have a level of intimacy that you don't maybe have when you have a corporate job or you're working in a big hospital where you're just seeing people acutely. But I've been there so long that you develop relationships. You go to the soccer games and I've been known to dress up as a cow or a cheerleader or something to root the kids on. You're out and about and you attend funerals, you attend weddings of your patients. It's a little unique because it's a small town and I think you have an influence. Now that I'm kind-of on the cusp of retiring in about two to three years I've been getting a lot of feedback like “Oh, you can't retire” or “What are we going to do without you” or “You listen so well” or “You've always taken care of me, I don't think I can go to anybody else.” It's a long time to be taking care of people consistently. I think that's the way you have an impact. You try not to judge people and you try to be there for them when you need. Yesterday I went to a funeral of an 89-year-old patient that I hadn't seen in a couple of years because she had gone to live with her daughter because she had just gotten too ill to take care of herself. They appreciated that, that I went and took a little time out. Because I had the ability, it was my administrative time so I could. I was talking to another patient there and they said, “Oh, it must be hard to come to all of these funerals” and I said, “well, I can't make all of them.” You either have to make a decision to go to none so you don't offend people or you just go to the ones that you can. I think it's important. At this gathering of this young person I was talking to a patient whose father had died and I had gone over, when he died, gone over to the home where he was living and helped the family prepare his body for burial. Wrapped him in some high end, we were joking about the high end sheets that he had. His sons made the coffin right at the house. So it's the kind of things like that that are pretty unique. You know, you have that kind of impact because you reminisce about those good times and bad times: the birth, the death, the divorce, you know, those sort of things. It's pretty remarkable.

JG:
What do you find fulfilling about your job?

MK:
I think it's sort of being able to help people stay healthy, and when they're not healthy help them stay healthier. I think when you've worked with somebody for years and they just haven't made any changes and then all of a sudden the light bulb goes on and they make some changes it's sort of like not giving up on patients and patients appreciating that. There's always patients that get fed up with you and they go someplace else, or they don't like something that you said and when that happens I feel bad because it's like “What did I do wrong?” But then there are the patients where you really see that you've had an impact. Even at this gathering of kids for this memorial service I said, “You guys all grew up together. You saw each other day in and day out. And I only saw you for little bits and pieces of healthcare concerns or physicals.” One of the guys said to me, “But you've touched our lives in many many different ways, and literally you've touched our lives.” You know, you have some sort of impact and that's hopefully what makes a difference. I give to them, but I also get stuff back. I have a farmer who says, “You gotta keep me alive until this day” and then he brings me 40 pounds of hamburger or has king crab legs flown in for a dinner that he invites me to. It's just that you're appreciated. It's getting harder and harder because the work's harder and sometimes it's not as rewarding because you're tired. But I think that's true of a lot of careers. Healthcare is tough. People are sick, and they're sicker. You don't want to miss something. Just having an impact on people's health and helping them cope with dying, helping them cope with chronic illnesses. I had one patient who recently had a stroke maybe four months ago and was in with some urinary tract stuff that's kind-of related to the stroke, infected the bladder somehow, and she's just miserable because she keeps peeing. I just did what I normally do and put her on antibiotics and she put something over Facebook like “Yeah! Life is really good because of my healthcare provider who listens.” I try to listen. It doesn't always happen because you're trying to get through, you're already an hour behind and you're like, “Oh my god, I'm already an hour behind, I gotta speed this up.” But I think people are okay waiting if they know you're going to listen to them and spend time with whatever their worries are. And they know it's sort-of a safe place that they can talk. That part is good. That's what I like about my job. I like the listening and the talking and the helping. I don't care about the sore throats or the UTIs or the STDs or something, it's more about trying to help people manage their illnesses and cope with diversity[adversity?].

JG:
Have you seen any changes in the things that people talk about when they come to visit you over your time practicing?

MK:
That's kind-of a good question because I think economically people are more strapped, like farms. When I first came here there were probably 300-500 dairy farms. If there's 20 now that's a lot. So, you see farmers struggle financially. You look at kids; they're so involved in sports and travel programs. There's just sort-of a busy-ness about people more so than there used to be 30 years ago, even 20 years ago. Families are just go go going. Healthcare is expensive so people are making choices about what they really need. I think that's harder because 20 years ago I could just make all these recommendations, order all these tests, and people would do them. Now, they are looking at their pocketbook and “No, I don't need to have that colonoscopy. I don't really want to have it but I can't afford it because it's going to be 3,000 dollars and my deductible is ten,” or the copays are higher and so they don't want to see the specialists every four months, they just want to see me. So I manage things that are maybe a little out of my bailiwick a little bit. I just think people are busy and strapped and that's different. I think life is more challenging overall. Technology helps that in some ways because people have instant gratification which isn't always good but it's different. People are also, because of technology, they're more informed. So, they come in with their piles of internet information and want you to read it before you make a decision about how you're going to treat them, or they already know what they want, or they already think they know what they have because they've been on the internet. And of course they say “I know I shouldn't go on the internet, but…” So that part is challenging. I think the other thing that's challenging about healthcare is that now you have all these insurance companies that tell you what to do, or tell you what drug they will pay for and what drugs they won't pay for. They will try to tell you what tests you can order so it makes it more difficult to take care of patients because you've got somebody else, Big Brother if you will, managing costs. Which are important, I mean, we are one of the highest countries in the world in terms of healthcare costs, but it's not always ideal. To tell you, “Well you can't use that antidepressant.” The patient has been on it for years and all of a sudden they can't take that one? Or they're on a blood pressure medicine that they want to change. So it's gotten harder. Technology is harder. Medical records are electronic and for folks that are older like I am who weren't really grown up on computers it makes it a little harder. Recently we had an upgrade and they moved everything around and its sort-of like they moved everything around in the kitchen and I don't know what drawer its in because I can't find it but its there. And so your muscle memory is a little worse for wear because “Where is that problem list” or “Where did the medications go” or “How do I order that.” Those are some of the challenges that I've seen in the last five to six years where electronic medical records have come on. It takes away from the interaction with the patient because you're looking at the computer, and you're trying to look at the patient, and you're trying to put the orders in so that you're not there until ten o'clock at night so you can finish your notes. But you want to get the information where before we just talked to the patient, go back, dictate a note or we had something different. I think the electronic medical record is helpful in some ways, but it's a deterrent in other ways. It's like everything else, there's good and bad. I think that's a big complaint of a lot of clinicians, unless you're 25 or 30 and you've grown up with it and it's just intuitive. It's not intuitive for me. It's crazy.

JG:
Can you tell me a little bit about what its like to be a woman in the medical field?

MK:
It's interesting because nursing, traditionally, until recently, maybe the last ten years, has always been primarily women. Now, there are certainly a lot more male nurses. I think physician's assistants tended to be more males, but that's sort-of balanced now. When I moved to Cherry Valley 37 years ago I think it took the locals a little bit, at least that's what I heard, to get used to me as a woman because there had been a male provider before me. After a couple of years of getting to know me I was respected and people built trust and it didn't really become an issue for me. I went to a woman's college so I already was grounded in self confidence in terms of being a woman. I think there is still some, it's not discrimination really, not so much anymore. But in the beginning, when I first got here I think I was looked at like “Oh, there's that woman” or “I'm not gonna have that woman doing that to me.” Once they get to know you and you have a comfort level with them and the words out it's okay. I think initially it was an issue but I didn't perceive it as an issue. It was only after talking with some of the folks. There was a guy in town who had a barber shop right up the street, literally like three doors down from the health center and he had a coffee club. It wasn't as busy so I might sneak out of the clinic and just go up and have a cup of coffee for five minutes and just hang out with the guys because that's where the guys hung out. So some of it is just about building relationships and knowing how to do that and getting people to know you. That breaks down those barriers. Making sure that I go out. When I first got here making sure that I go to the farm bureau meetings or going to the 4-H meetings so you had a presence so people got to know you. I think that's another way to break down barriers. Making sure I was at school events and having a presence in the community.

JG:
How long would you say that it took you to build that relationship in the community?

MK:
I don't know, probably a couple of years maybe. Not that long just maybe a couple years. When I first came to this clinic where I am now I was there two days a week, but it was after three or four months that I was there full time. I was single, I had a lot of time on my hands so I made a lot of social appearances and just knew I had to build a practice that way and try to get people to know who I was. I had another partner that came on board and we were both sort-of in the same boat, both women. It's just about nurturing people in the community, having a presence. I was pretty comfortable after a couple of years, certainly my practice built. I remember, I don't know how many years I had been there, probably it was seven or eight, ten years maybe, when it sort-of had been figured out that I was gay. I had this senior older guy who's very conservative who had been one of my patients, he called me up one day and he said, “You know they're saying things about you in the hills and I'm worried about that,” and I'm like, “Well what are you worried about” and he wouldn't say, He says, “I'm really worried about how this is gonna affect your practice, what they're saying.” And I said to him, “Well you don't have to worry my practice is full,” and I said “Does this have to do with my lifestyle?” and he said “y-y-yes. But I still wanna be your patient,” and I'm like, “Ok, well, that's fine. But my practice is fine. It's a very busy practice and I'm not worried, it doesn't seem to be going anywhere, but thanks for your concern.” That was an issue at one point. I'd gotten a couple of funny messages on the answering machine and a funny note when I first got there. It was mostly high school kids or something like that. Really, the community embraced me regardless. And when Carrie and I got married everybody was really wonderful and people I didn't think would approve were sending us cards and presents and stuff like that. That was seven and a half years ago. You kind-of worry about it a little bit when you first get to town, but after a while it just was not an issue.

[START OF TRACK 2, 0:00]

JG:
What kinds of changes have you seen in terms of gender discrimination or any other kind of discrimination in the field?

MK:
I'm kind-of isolated really because I'm just in this tiny little town where I've been taking care of people. I don't have a lot of exposure at the hospital. Healthcare has always been a welcoming place for people. Gender issues, gay and lesbian, we kind-of always joke about it as a field, it kind-of attracts folks like that, “like that.” I haven't really run into any of that. With some of the folks with transitioning, transgender, there's been some lack of knowledge that people have had to try to learn about and capture. I think in terms of the workplace I haven't heard or felt any of that. I haven't known anybody else who ran into those issues unless there was another issue that was above or superseded their gender issues. We certainly live in a very white area, for the most part. A lot of my patients are unhappy with the foreign born residents and interns. That seems to be an issue for a lot of them. They can't understand them. There's been some discrimination, I think, towards some of the physicians that are not white or American born. At this gathering the other day there's a big family that originally the parents were born in Jordan and there's about ten kids I think. They're really sweet and nice. Two of the brothers were at this service and they said “so-and-so was really good to us. We were a little different” because they were a Muslim family in this very redneck, Christian area. To have a Muslim family was different. They never felt really discriminated, but felt a little different and said this person that had passed was really welcoming and wonderful. I remember getting a note on one of the family members that said “this Muslim male…” and I thought, “Well, why do they have to say that,” but I remember in training we would say “this white male 25-year-old” or “African male” or something like that just sort-of describing that because sometimes there are health concerns associated with a race or you want to be aware of a religion. I haven't just seen some of that. When I first got here there were very few women physicians, and I think now it's about 50 percent of the interns and residents are, maybe a little more, women. Most of the administrators were males, except for the vice president of nursing, but most of the leadership has been traditionally male. It's a little different now, but still more swayed towards male. I think that does create a bias a little bit, because men think differently than women about some things. I don't know if other people have had those issues. I know there's been some role discrimination where some of the physicians think they should have more privilege than the nurse practitioners or the PAs in terms of different things. That's changing too I think as people need us more, when there's been a harder time getting physicians. So yeah, I think the world is full of discrimination. African Americans still are probably more discriminated against. We have a small population here, but it's still pretty small so they stand out. For some people that's an issue and for others it isn't, but I haven't felt any of that really.

JG:
Can you tell me just a little bit about your life in the area?

MK:
It's funny because when some of my friends thought I was moving to the boondocks and when they first came to visit they were like, “Wow, it's really nice here.” It is, it's beautiful here and there's a lot to do. When I thought about coming here, I grew up outside New York City and I grew up in suburbia and my first job was in the Boston suburbs, so coming here was like “Okay, there's two colleges, there's a couple of hospitals.” I wasn't a big shopper, so I came here knowing there was a good medical center, there was academia. Then, since I've been here, there's opera, and there's theatre, there's a big lake, there's a great sports center. I like to do outdoor things, so there's lots of skiing and the lake itself. Golf is a big interest of ours and skiing, so there's plenty of stuff to do within an hour and a half to three hours. We have a nice network of friends and colleagues that we do things with and sometimes there's just not enough time to sit down and read the New York Times because you're so busy. The quality of life here is good. It's not terribly busy. It's busy because of work, but there's always something going on. This coming weekend there's a film festival [The Glimmerglass Film Festival]. Last weekend there was a bunch of stuff to do. So, we're busy and we have a lot of friends now that are retired so they go away in the winter. So, we have our golf buddies, and we have our ski buddies, and we have some friends that we try to get together with and go out with. Gathering places like going out to Mel's on a Friday night and having a drink and a dinner and listening to a band. The hotel is nice because it has a great venue and you can just sit on the porch and have a cocktail or sit by the fire bar. It's a small community so people know people. Its just fun. It's just comfortable. It's safe. You don't really worry about locking your doors for the most part, although we do. Neighbors are mostly neighborly. So, it's comfortable. You have to think sometimes whether you want to go to the movies or if you want to go shopping. You have the Adirondacks. They're three hours away, and the Catskills. They're an hour and a half away. We live in a really beautiful part of the country. It's comfortable. It's nice living here. We think abut retiring and we think about, Would we stay here? Would we go away? Mostly we think about staying here and going someplace else in the winter for a couple of months or traveling. There's so much in the country to see and so many places we want to go. We have a church that we like to worship in. We have friends and eateries. The hospital is here. It's a nice comfortable place to live. It's not busy. We go to New York for the weekend or someplace, like we went to LA [Los angeles] on a trip and it was like “Oh my god, the traffic.” It's 40 minutes to go six miles. It takes us 20 minutes to go 15 miles [laugh]. It's all relative. I know when I first came here, because I was a downstater, a guy that I was working with when I first came home, came back after being home for a weekend, he was a little nervous I was not going to stay very long. Because I was a “city girl.” And I was like “Oh my god, the noise and the traffic down state,” and it's like, “Oh good, you're going to stay.” And it's true, we have one traffic light. It's nice. It's quiet. I had a niece, I don't know how old she was when she came here, she was probably eight or nine, she lived in New York City, and the fire whistle went twice the weekend they were here and the birds were chirping and it was all this stuff. She was like “Oh my god, it's so noisy here, I'm never coming back,” and I'm like “It's noises.” It's perspective right? You live in New York City and it's constantly noisy. But she didn't notice it. She comes to the country and it's like fire whistle and birds. It's reassuring [laugh].

JG:
What was it like to transition to living up here from downstate?

MK:
I came here and I didn't really know anybody except the people that I had done my internship with, so it was trying to find where everything was. Trying to figure out where you had to go to get things, like I had to go to Albany, that was an hour and 20 minutes. That was before New Hartford started having more of the stores. That's only 50 minutes. But I think it was just trying to find my way in a community that I didn't really know that was a little rural. Things were spread out. When I first got here there was grocery stores and shoe shops and dress shops here, but then that sort of all disappeared as internet shopping got more available. They just couldn't afford to stay. I think once I made some friends and colleagues and got used to it, it wouldn't have been really any different than if I'd been someplace else. Except it was a little more rural and you had to travel further to get things, but then when you factor in the traffic downstate it probably took you just as long to get to Oneonta as it did to go five miles in Rockland [County]. It was just transitioning to cooler nights and some things that were different, quieter nights. It was a little more quiet. When I first moved here I lived outside of town in Hartwick, so I was really in the country. It was a little scary as a single person. I had a neighbor next door, and an older woman and her son lived up the street. Trying to find your way, watching out for the deer. That was a big worry. That was something I didn't have to worry about where I grew up, or even where I worked in Boston. So animal life was different. What else? Winters. It was a little colder and a little snowier. When I first got here snow tires were kind-of mandatory back then, not so much now, but I wasn't driving an all-wheel drive car either. It just became a way of life. Lazy afternoons on the weekends, getting together with folks, and riding bikes, paddling a canoe or going to the gym and playing squash five nights a week or something just to get out. Trying to figure out the pattern.

JG:
Can you tell me a little about one of your travel experiences?

MK:
We've been really blessed to be able to travel. When we turned 40 we went to Ireland because we had talked about wanting to travel on one of our first dates. Neither one of us had travelled a whole lot, at least any place of substance, far away or foreign. So, we went to Ireland for two weeks and that was a lot of fun, just exploring. Both of us have some Irish heritage, so it was nice to have a real pint of Guinness in the home country and just see a different culture and a different landscape. We did that for our 40th and for our 60th Carrie wanted to go to Paris. I didn't really have any desire or need to go to Paris, but she's a foodie and I said, “Okay, we'll go to Paris.” We decided we would spend a week in Paris and a week in Provence because we had heard wonderful things about the countryside of France. So, we did that for two weeks and that was just amazing. I liked Paris more than I thought I would like it. It might have had something to do with the wine and the food. The food in Paris was a lot better than the food in Ireland. I mean the food in Ireland wasn't bad, but it was basic, you know, lamb, mutton, shepherd's pie and nothing fancy. Paris had some really nice meals and Provence was just some beautiful countryside. Even though it was the fall it was a little off shoulder season, but we met lots of nice people. We were a little intimidated. We didn't really speak any French, maybe some basic stuff. We learned a few phrases we thought would be helpful to be polite. We just enjoyed driving around the countryside, the wine, and the cheese, the bread in southern France. Neither one of us are big museum people. We did the obligatory museums: The Louvre and a few other places and gardens. It was nice to just meet other cultures. We like to travel and we hope to do more of that. We skied in Cervinia which is right in the base of the Matterhorn. We were in Italy but we did ski over to Zermatt one day and that was amazing. We skied like 15 miles down a trail into downtown Zermatt and then took a tram back up so we could get home to our little hotel, which was nice. That was beautiful. We had some wonderful ski days while we were there. We've done a bunch of stuff. I know you just asked for one. We've done a couple of cruises. We did a Mediterranean cruise where we got to see a lot of [places]. We went to Rome and Florence just for a day. It's sort-of a little teaser when you go on a cruise, unlike going to Paris for a week. Marseille and just a lot of different little coastal towns that we had been to that were really nice. I can't remember the town that [Napoleon] Bonaparte is buried in but that was a really beautiful island off the coast of France. It was nice to go to Ireland and just hang out in the pubs and listen to the music and see the old Irish folks dancing and drinking and eating fish and chips out of a newspaper [laugh]. Paris was a whole different ballgame. Everybody had scarfs and berets and had their wine in cafÃ©s. It's interesting. When we went to Italy to ski, we would go in for a break and we'd have hot cocoa and then we'd be right out after we warmed up and get to skiing. Well, we'd come into the lodge and there'd be tables of white linen set with bottles and carafes of wine and bread. When the Italians came in for lunch they'd have this big meal and just hang out and take an hour or two for their lunch and we'd be out in 20 minutes to go back out and ski because we wanted to get the most for our money. They were really big mountains. The trails were nice and long. It was good. So, those are my basic travel stories.

JG:
What are some of your travel goals for the future?

MK:
A lot of our friends have retired to Florida, for the most part, or the Carolinas. We don't want to buy another house. We think we want to travel more and see more of this country. We talk about buying a small camper and travelling around. I don't know that we'll do that, but we talk about it. We'd like to go see more of the national parks, go away in the winter. We definitely want to go, one of our big trips after we retire, we'd love to go to Australia and New Zealand for a couple of months. I want to go to the Galapagos before it disappears. The barrier reef, we want to go there. And we want to just spend some time in Europe. We haven't been to Germany ever. I'd like to see more of Spain. I'd like to see more of the UK, Wales, and England. There's a lot to see. Those are our big trips on the bucket list. I'd like to play Pebble Beach out in California sometimes. It's outrageously expensive, but that's on the bucket list. We've seen a lot of different states. In the winter when we ski, we've skied in Canada, the West Coast, but I think we'd like to go back to some of those places that we went to in the winter and see what they're like in a different season. Those are the big ones. I mean we like it here, but there's so much to see. We've kind-of done New England, we've pretty much done that. We love Maine. We love the Cape. We have friends all over the place, so we don't need to buy another house we can just go stay a week with friends here or there and the next place [laugh] as long as they stay alive long enough. Those are some of our big bucket list travels. There's so much to see in this country. We got out senior park pass when we were out in California. About three weeks ago we went to Joshua Tree. We stopped at a little place after we did that and the lady said, “Well, I hate to tell you this but you really should be up there right now because sunset is beautiful and when night comes in the park you can see all the stars in the sky and you should just camp for a couple of nights so you can get the full feel,” and I'm like, “Camping? I don't think so. Maybe a trailer.” It's something to look forward to assuming our healths and our parents stay healthy. We have four parents and they're in various stages of health so it's one of the things we're going to have to balance with our travel plans. It's all good. It's all good.

JG:
Just to kind-of bring it back around to healthcare, I know you talked a little bit about insurance and electronic records being a change that you've seen. Are there any other changes you've [seen through your career]?

MK:
Certainly technology. Now they do robotic surgery. When I was first training that was not heard of. You did an appendectomy you had a big scar like this. Now you do an appendectomy and you have three little dots. Or even major aneurism repair. Sometimes they're done robotically with very few…Gall bladders, it used to be this huge scar from the right side of your body down to the left. There was probably like an eight to 12-inch scar. Now you have three little holes. I think surgically I've seen a lot more. Certainly cardiac stuff, they're doing very minimally. Now they're repairing valves by going through your arm with a catheter. That costs more money. The technology has gotten more expensive. And medications. There's been more antibiotics and some more germs. Antibiotics and hypertension medications. When I think I first started there was maybe a dozen antibiotics that we used and now there's a whole lot more. Some of that has to do with resistance of organisms. X-rays and technology, surgery, all really changed a lot. When I got out of nursing school in 1980, chlamydia was the big STD that you worried about. Then there was herpes. Then there was AIDS. AIDS was an issue in the mid 80s and people died from that. Now people don't die from AIDS. It's kind-of a chronic illness kind-of like COPD or lung disease or diabetes. It's just another chronic illness that we manage. We've seen a lot of advances with medications, with surgical techniques. People are living longer. When I first came here my patients died in their 70s and their 80s. I just had a patient who was 102 that died. I have a lot more 80 and 90 year olds than I did when I first came here. I think people are living longer because of technology and because of medicines. So, that's a big change when you think about it. I hadn't thought about it that way.

JG:
Where do you see the future of healthcare ending up in the next 20, 30, 40 years?

MK:
Oh, I don't know; I'm going to be gone [laugh]. We were actually taking about this the other day with one of my physician colleagues who was out. He kept saying, “We're old” so the technology is like telemedicine. We don't have the same level of specialists that we used to have; we can't keep people. So now, we have a dermatologist in New York City that sees patients on the television and somebody in the office has taken a biopsy for them. We have somebody in the University of Rochester that's consulting with surgical people on the floors. The technology is so that you can listen to heart and lung sounds and do that. I think we're going to see more and more of that. I'm not crazy about it but it's just the reality. It's like George Orwell, 1984, here we are. 2020, 2040, technology is just making things a whole lot different in terms of access and availability. Babies are still going to have to be born the way they're born but the technology of monitoring them is changed too. Telemedicine and “docs in a box” on Facebook or FaceTime is kind-of where things are going. People don't want to work 50, 60, 70 hours a week. They want to work four days a week or eight or ten hours a day. It's different. It's a little less personable which the old fart in me doesn't like [that], but that's the reality. This is all about history, right, so it's like I can remember my grandmother saying, “Oh, those kids with the long hair” and now it's the kids with the tattoos or the rings in their nose. There's always societal changes. Folks like us as we get older are like “Oh, the kids today” [laugh]. Everybody's plugged in. There was something on the news or an ad this morning about DWI deaths are down but distracted driving is up. My niece had a classmate from college that was killed in New York City at two or three in the morning and everybody was like, “Well, were they drunk or were they just looking at their cell phone and walked off the curb and got hit by a taxi?” There's always something new that comes along to distract people. I don't know, I kind-of got off on a tangent. Healthcare is going in a different direction that's driven by technology and research. I mean, it always has been driven by how to better stuff. Or how can we save people putting polio viruses in somebody's brain to treat a glioblastoma at Duke and doing research to try to cure. Breast cancer doesn't usually kill people anymore because we have all sorts of gene technology and chemotherapy that's related to the gene. Lung disease now we have treatments for people that are specifically targeted at the particular kind of cancer. So, I think that's where we're going as long as we can continue to finance the research and people want to try to continue to try to save and cure disease. That's the beauty of science. It keeps getting challenged by whatever the new disease is. I think when I first started in healthcare, babies died from leukemia. Now they don't die from leukemia anymore. Nobody dies from leukemia, unless you're old, generally speaking. I mean people die from it but it used to be a death sentence, now it's not. Hodgkins, all these other diseases that used to take your life, they don't so much. Look at AIDS. AIDS, you had so many deaths in the 80s of gay men. Now they don't worry about that. We have things that they can take before so that they don't have to worry. So, they're maybe not as careful. I think science and healthcare are always changing. I can see a lot of changes in my 40 years. Even here, when I started here we had one hospital and everything was focused. There were three health centers and now there's 27 health centers and three or four hospitals. It's just become a big system. Systems are getting bigger and small isn't good, which is sad but that's the new normal.

JG:
Okay, so, just to wrap it up, is there anything else that you want to add to anything that you've said?

MK:
No, I mean I think I've been really blessed and lucky to live in a town that I really love…

[START OF TRACK 3, 0:00]

MK:
…and that respects me and loves me. I've made a life with my wife and with friends. I have a job that for the most part I've loved and liked. I think it's getting harder as I get older. When I'm away on vacation I'm like, “Yeah, this could be all the time,” and then you come back and you have these momentous events that sort-of remind you why you got into this business in the first place. It gives you some sense of accomplishment and some sense that you made a difference. I've always just wanted to make a difference in the world. I think like a lot of young people when I first came here I sort-of wanted to save the world. Maybe I thought about going to the Peace Corps and doing all that kind of stuff and at some point I just thought “If I can just make a little difference in Cherry Valley, I'll be happy with that.” I think I know that I have, so that's comforting. I'm not sure of the right word but it's empowering. I hope I can go out on a good note. I talked with a colleague once that said he retired when he did because he was getting to the point where he just didn't want to go out with really doing something bad because he was tired or older or not as sharp. I think it's always that fine line between making a difference and not killing somebody because you're tired or not up on something. You have to know when it's right. I think it's been a good life and it's been a good journey. I'm really blessed to have been here and made a difference and see what the next 20 or 30 years brings. [laugh]

JG:
Well, thank you for your time.

MK:
Oh it's my pleasure. I hope it's been insightful and helpful and historical. My father was in public relations. when you're talking to people. It's been fun. Thank you for the opportunity.

Coverage

Upstate New York

Cooperstown, NY

1956-2019

Creator

Jessica Goon

Publisher

Cooperstown Graduate Program, State University of New York College at Oneonta

Rights

Cooperstown Graduate Association, Cooperstown, NY

Format

audio/mpeg

20.9mB

28.8mB

2.2mB

image/jpeg

72 in

Language

en-US

Type

sound

image

Identifier

19-09

Item

Maureen Kuhn, November 6, 2019