No Plan B

Rachel Goodman

I FIRST MET RACHEL many years ago. She was applying to medical schools and wanted some help with her applications. I had worked with many applicants to med schools of all kinds. Most do not get into their preferred school. But I knew that Rachel would not be one of those. It was her determination and worthiness. It is now 2024 and she has started her own practice. She is my doctor, so we have reversed roles. She is helping me.

When did you become interested in being a doctor?

I was five. We were in Chicago on a family trip and we were in a university bookstore. I begged my mom to buy me this college textbook on human anatomy and physiology, which I still have. And I was so excited! I was just fascinated with the body. I looked through the pictures and memorized the 13 different systems in the body. I just had this innate obsession. If I had a pet goldfish, instead of being upset when it died, I would take it out and dissect it.

You came with that chip.

I never had a plan B.

Did you choose classes in high school based on being a doctor?

My stepfather would say to me, In order to go to med school, if that’s really what you want to do, you have to study hard. So it did drive me. I remember in second grade, Dr. Abby Barwell brought in frogs to our class to dissect, and I was way into it and I brought home all the organs in my lunchbox. My mom tried to take them, but I hid them around the house, in the couch, everywhere.

Also, I had a distant cousin who was a heart surgeon, and when I was in high school, he took me into surgery. I saw my first open heart surgery. It was the very first clinical thing I had done. And I just remember being in the OR,

watching him and thinking, how cool would it be to be the one that is fully in charge of all this, making the decisions.

Why did you choose women’s medicine?

At first, I wanted adrenaline. At one point in high school, I said, I’m gonna be the head of an ER. And then I realized I really wanted be a surgeon no matter what. So I went into medical school assuming that I was going to do some sort of surgery and I had actually never heard of OB-GYN. But there was this girl who came to med school to be an OB-GYN. I was curious.

The first two years were academic work, and then we started third year in clinicals and my first rotation was in OB-GYN. It was like six weeks. And my first two weeks were gynecology, which is a surgical sub-specialty. And my second two weeks consisted of uro-gynecology, which is also surgical. And so I was just so excited to be in surgery and learn about OB-GYN. And then there was a resident who came up to me and my best friend, and said, You two. You’re going into OB-GYN. And I remember kind of rolling my eyes and being like, Yeah, nope. I’m gonna be a surgeon.

But then as time went on, I loved talking to teenagers about sexual health, talking all the women’s issues, the politically charged issues. It really became clear that OB-GYN was combining those things I was passionate about. And I learned that I do much better when there is a focus, like a part of the body that I could become an expert in and really focus on.

What are the hours like?

Insane! I was the last class before they put work hour restrictions on. The year after me, they started capping it at an 80-hour workweek.

So how long was your longest shift?

One time I worked for 21 days straight without a day off. There were six residents in each class, so we had to cover every weekend. That meant either we did Friday night and Sunday day, or a 24-hour Saturday.

And long, long hours. And a very clear hierarchy. But this part I loved, actually, I mean like the institution of medicine, the old school, my medical school was a very old-school, white-coat culture.

Recently I’ve left the hospital for private practice and there’s a whole underlying story of my making the switch. I was born in Cerrillos, was raised by hippie parents, mostly alternative care. I remember when I told my dad, I wanna go to med school and he was like, you’re going to do what?

He wouldn’t go to doctors. So there was this whole other side that I was always raised with. I remember in medical school being in a lecture, and the doctor was bashing alternative care and Native American rituals and medicines. I was appalled and complained to the school.

I also remember our pharmacology professor lecturing on supplements for arthritis like glucosamine and chondroitin sulfate. The next day, we were in another lecture and the doctor was bashing supplements. I raised my hand and I was like, there’s a discrepancy in what you’re teaching us. We were taught by this other professor that these do work for arthritis and you’re telling us that they don’t. Can you please clarify?

And the first professor, who happened to be in the lecture, slammed his fist on the desk, stood up, and said, They do work. Absolutely! And I just said, thank you.

Really, every doctor brings their own personal experiences to the field and to their practice and their beliefs. This has really become like a very strong interest of mine, realizing that we don’t know all the answers.

What’s your sense of these black and white CDC guidelines?

Prior to the pandemic, the CDC had very little impact in my daily practice. I would go to the CDC’s website, they have a great chart that talks about medical conditions as it relates to prescribing birth control and vaccine schedules, etc. That was pretty much it. Now, since the pandemic, there is so

much research and information coming in all the time. It’s important for people to keep reading, try to stay on top of it, and consult their doctors. I think it’s super important that people take control of their health.

You have Crohn’s Disease.

I found out during my finals week. I was really sick and throwing up. I lost 12 pounds in two weeks and I looked at the doctor and I said, what am I supposed to do? What do I eat? And they said, oh, you can eat whatever you want.

So now I have Crohn’s disease. I came home to New Mexico, a place that thinks outside the box. I met a nutritionist who I worked with very, very closely. I completely changed my entire diet. Within two months I was off of medications. I’ve managed it for almost 20 years, all off meds.

I tell my patients Western medicine is wonderful at some things, and we’re still figuring out a lot of other things. I think that a true holistic approach to health is necessary. It’s wonderful to go through medicine, get tests done, rule out all the serious things. But taking and using some things from Western medicine, and also things from other modalities that have been around for years is vital. That’s what I’ve done.

You have a new private practice. How hard was it for you to move from the safety of an institution?

In an institution, there’s the pressure to see patients in 15-minute visits and try to solve all their issues. I was chronically late, running behind, feeling really uncomfortable because I left a room and I didn’t address half of what I wanted to. For years I tried to figure it out. But, at the same time, I was very well supported. There’s a lot of protection in an institution. Legal, financial, etc.

But when I looked at my kids and raising a family, It was really difficult for me to straddle the two. I wanted to be there more for them. I can’t tell you how many nights I’m getting them ready for bed and have to run out the door. So I worked with a business coach over the past year and it was like therapy, giving me the courage to walk away and to do my own thing.

I’m still affiliated with the hospital. And I think the hospital’s really important and has wonderful people, wonderful doctors. It’s important for the community of Santa Fe to have the hospital succeed. And for the doctors and nurses to be happy and be treated well.


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Photo Mark Berndt