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In the Foothills of Medicine: A Young Doctor's Journey from the Inner City of Chicago to the Mountains of Nepal

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In his book "In the Foothills of Medicine," Dr. Robert McKersie takes the reader through his days training as a resident in Chicago. His descriptions of meaningful patient encounters illustrate the rigors of medical training, and its toll on the human psyche. Dr. McKersie's openness with his personal emotions during these encounters is in stark contrast to the clinical discussions of anatomy, disease progression, and health statistics. The dichotomy of these two styles gives the reader a unique insight into the mind of a physician, who must be systematic, rational, and detached in their medical diagnosing, all the while struggling with their own humanity and frailty. It is clear that Dr. McKersie learned not only how to heal patients more effectively during this time, but also learned how to heal his own wounds, and how to reconcile the conflicting emotions. These lessons were learned not just in the ICU, but in the waiting room and in the community at large.
These vignettes are bookended by descriptions of the author's travels in Nepal to support and train native medical providers. While those of us who live in the U.S. think of how underdeveloped many third-world nations are, the practice of medicine is not all that dissimilar. In fact, these Nepalese have greater access to healthcare services than many Americans do, as the socialized nature of Nepal's national health care system is open to all its citizens In contrast, Dr. McKersie's experiences detail how fractured the U.S. health care system truly is. For those who are earn too much to qualify for public assistance (in the form of Medicaid), not old enough for Medicare, or are too poor to afford private insurance, the system is tragically difficult to navigate. With so-called safety net facilities, like the one in Chicago Dr. McKersie trained in, these patients can seek care without concern for cost. Unfortunately, the preventive care and continuity of care necessary for disease management is not available to many. While the Nepalese struggle with supply, proximity, and availability of medical care, many Americans are surrounded by abundant supply that cannot be tapped without the requisite finances.
This book would be a good read not only for those contemplating entering the medical field and those already practicing medicine, but for anyone who has ever had to interact with the health care system. The author's insights give the reader an appreciation of the struggles of practicing medicine in the current environment, where red tape and financial concerns often take precedent over appropriate medical care. It is refreshing to see a physician continue to struggle with these conflicts, and strive to engender a desire in future physicians to continue the struggle as well.

From the Prologue to its final Dedication, Dr. Robert McKersie's book, In the Foothills of Medicine is not just a story of one man's legacy to heal his fellow man on opposite sides of the globe. It is an epic of courage, passion, enlightenment, inspiration and above all, a tale of human love.

Throughout each inspiring page, the reader can see an unspoken virtue in Dr. McKersie that he could never attribute to himself. Persons of his caliber are blind to their own goodness. He is a physician in love with the beauty of human existence.

In the beginning pages of In the Foothills of Medicine, Dr. McKersie writes of the nine hour automobile ride into India's magnificent Ganesh Mountains to a camp, from whence a hike of several days would walk him to the first medical clinic of Tipling. Mostly, he dismisses the discomforts endured himself, but consistently writes of the trials and courage of those carrying heavy clinical supplies and equipment over steeply inclined, seldom-trekked mountain footpaths. These precipitous ascents and descents in some places were so hazardous, that a misplaced footstep or loss of balance could result in a death-tumble of hundreds of feet.

So why does he travel regularly to these remote medical outposts and leave his practice in the United States? McKersie is a thorough idealist. In these remote mountains of Nepal he can practice medicine as it should be practiced. He can establish a relationship with patients, because they need help and because they are human and beautiful. Here, he does not worry about salary. Rather, he worries about curing infection, controlling tuberculosis, stabilizing diabetes or a failing heart, or epilepsy.

In Nepal he does not hassle over medical insurance. The mountains provide no such aid. Instead, he labors to mend a broken arm or leg, or to deliver a baby. Nor does he obsess about begging specialists to see poor or underprivileged patients free of charge. Instead, he and a handful of doctors and nurses are the "general" specialists. They provide what help they can, then counsel village family members on continuing care.

A half world away during part of each year, Dr. McKersie is a regular family physician doing his utmost to provide the same kind of personal health care to patients on the South Side of Chicago as in distant Nepal village medical clinics. But should that statement not be reversed? McKersie would say, "No!" He often feels frustrated here in the United States attempting to arrange needed health care for seriously ill patients lacking insurance. In addition, there is the ongoing struggle for affordable medicines for those without big bucks. In the end, people who cannot pay for health care in this country are tantamount to a Nepalese villager.

In the Foothills of Medicine is a fascinating story - an adventure that leaps from its pages as you follow one doctor's efforts to heal the sick and promote social change in two vastly different cultures: Nepal and the United States. His vision of the latter is simple: the US needs a vital health care system now, for every citizen regardless of income.

Dr. McKersie's tell-it-like-it-is memoir will grab your interest from its first page. This book is an outstanding read for everyone, but has a special message to those involved in health care. It is a critical document for every politician. It is my hope that readers of In the Foothills of Medicine will urge their congress women and men to live up to their social responsibility and not rest until vital health care is available to every United States citizen. Hats off to Doctor McKersie for his remarkable story.

McKersie shares the ups and downs of being an older student in medical training and his descriptions of interacting with patients are heartwarming and charming. As a volunteer doctor in Nepal he illustrates that there are indeed two very different worlds of medicine and yet there are common problems. A good read that places you in both locations with the doctor.

In the Foothills of Medicine is a 'must-read' for all who are starting out in the field of medicine, and all those who care about human health in our global future. Dr. McKersie takes us on a journey, with humility and passion, that will pave the way for a better, healthier, happier world.

In the foothills of Medicine gives a true look at the medical system and the trials and tribulations of one passionate inner city doctor. The book is quite insightful, thoughtful and intense...I found the chapters on Nepal fascinating and a fast read. Dr. Mc Kersie is a young doctor and author to watch out for.

Cheryl Dent