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Archive for the ‘Physician Lineage’ Category

terrybeth

For those of you who have followed my journey since being diagnosed with a bone marrow cancer called multiple myeloma in September of 2013, I wanted to bring you up to date. Myeloma, as of now, is still considered incurable but treatable. So, I have been on continuous chemotherapy since my diagnosis.

The most recent chemotherapy had been working well, but a recent PET scan has shown some new myeloma activity in a few of my bones. This is not unexpected for many of us dealing with multiple myeloma since relapse is common after initial treatment. I have recently begun a new chemotherapy drug with the hope that this will keep the myeloma under control for as long as possible.

This new  drug that I am now receiving, is called Daratumumab or more commonly referred to as Darzalex. It is in a new class of drugs called monoclonal antibodies, and was just approved for use this past year. It binds itself to a marker on the surface of the cancerous myeloma cell directly affecting the cell as well as enabling the body’s own  immune cells to kill the myeloma cells. As with most of the chemo drugs for myeloma, they usually only work for a period of time before losing effectiveness and then on to a new and different treatment.

In general, I feel well and am learning to live with the neuropathy of my feet as disabling as it has become. I try to push myself, by exercising as much as I am able to do, which I think is helping to make me feel better. I would recommend exercise, to the best of one’s ability, to anyone suffering a chronic disease as part of an overall treatment program.

There are, in development,  new treatments for cancer in general and for multiple myeloma in particular. One of the new and exciting directions in cancer treatment involves the use of our own immune systems to fight the disease such as the drug I am currently using. Also, the rapidly expanding field of genetics also will play a big role in diagnosing and treating cancer.

Of course those of us with cancer hope to survive long enough to benefit from the new treatments on the horizon. Hopefully, in the near future as we develop a better understanding of cancer, it will, in many cases, become a mostly preventable and curable disease.

Thank you again for your prayers and well wishes.

PS:  I would like to start a local support group for myeloma patients. If you, or someone you know would be interested in this, please contact me at valleydoctor@sbcglobal.net

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TerryHollebeckMD

Since a previous article concerning my relapse with multiple myeloma cancer and the effects of chemotherapy, and after much thought and soul searching, I have decided to retire from the practice of medicine.

Having just turned 70 years old and having practiced medicine for the past 43 years (28 of those years in my current practice of urgent care medicine in Scotts Valley), I think it’s time to move on.

At this time I do feel very well, all things considered. I look forward to having some more time to spend with my wife Beth and my daughter Emma, as well as to pursue other interests, such as restoring my good old ’71 Volkswagen bus.  Beth is a musician and music educator and I’m sure I’ll spend more time as her “roadie”.

Being a doctor is something that I had wanted to do since childhood, and it was an honor to follow in the footsteps of my father and grandfather. I have never regretted my decision to enter the medical field. I can’t imagine having pursued a more personally  rewarding and satisfying career.

The difficult part of this decision is that up to this very day, I have thoroughly enjoyed practicing medicine and never really thought about retiring. However,  besides the health issue, there is also the struggle with the time consuming and impersonal electronic medical record, the seemingly daily burdensome rules and regulations coming from a variety of sources, and the constant concern of  malpractice, all of which I will not miss.

But, what an honor and privilege it has been to practice medicine. I have found tremendous satisfaction in treating patients,  being able to alleviate suffering, curing illnesses of all sorts and even saving lives. I have enjoyed the one on one interaction I’ve had with patients and having the opportunity of getting to know them and appreciate them for who and what they are.

I’ve been in Scotts Valley long enough to have taken care of children who are now coming to the clinic with their own children. I’ve been saddened when people whom I have come to know have passed away but,  on the other hand, I’ve enjoyed watching families grow and witness their changing dynamics. In    the past 28 years at Scotts Valley, I figure I’ve had over 100,000 patient visits and therefore have been able to treat a significant number of people from Scotts Valley, the San Lorenzo Valley, and surrounding areas. I’ve always enjoyed walking into a local store or event and seeing the familiar face of a patient and be able to talk with them  and to see and know them outside of the medical setting.

I will miss my wonderful supporting clinic staff with whom I have spent much of my recent life and who had become like a family to me. I am also honored to have been associated with as fine a group of physicians as there could ever be, 30 of them when I first began my work with the Santa Cruz Medical clinic in 1987, and now numbering some 210 physicians with our Palo Alto Medical Foundation affiliation.

Most importantly, I want to thank each and every one of you patients who trusted me and allowed me to care for you over the years. It’s my interactions with you that I will miss the most.

However, I am not going away completely. I will continue this medical column as I have many more topics to share with you and much more to say. As I have previously mentioned, I plan to publish a book  incorporating the most interesting articles. I’m excited about continuing this work.

Since I won’t be seeing you in the clinic, I look forward to seeing you out in the community.

My very best wishes to you all and remember, life is a gift, gives thanks for each and every day.

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TerryHollenbeckMD

As many of you know, two years ago I was diagnosed with multiple myeloma, a cancer of the plasma cells in the bone marrow. It was put into remission after 2 1/2 months of chemotherapy. It took awhile to get back to my old self again but for the past year, other than the neuropathy of my feet, I feel great. I returned to work half time last October and was happy to be “back in the saddle” again, doing the work that I love to do.

The stem cell transplant I was to have had after my first round of chemotherapy two years ago was postponed because it was thought that it could make the neuropathy worse. So I’ve been on a low dose maintenance drug and my oncologist has been following monthly blood tests to monitor the myeloma activity. After about six months the numbers were slowly creeping up but no one was too alarmed. Then it was decided to do a PET scan (a CAT scan using a radioactive dye) which I had done in late August. Surprisingly and unfortunately, it showed a lot of myeloma activity affecting many parts of my bones. In other words my myeloma has relapsed. However, unlike the first time I was diagnosed, I really feel very well and as everyone tells me, “You look great!” I’ll take that as a good sign.

Because the steroids from my first round of chemo have caused a deterioration of my hip joint, I was to have had a hip replacement last month, but that has now been postponed so that I could begin chemo right away. I have just finished my third week of chemo, still feel very well, still have my hair and my most recent blood test shows very favorable improvement already. That is music to my ears.

I’ve begun an extended leave of absence from work to deal with the new round of chemo and to keep me from exposure to sick patients. I’ll miss seeing many of you but I find myself once again as the patient and now I’ve got to take care of myself.

I will continue writing my articles and, in fact, I will have more time to do so. I’ve been encouraged by many to put my articles in a book format which I hope to do this coming year.

Thanks to all of you who have had me in your thoughts and prayers.

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hollenbeck

Wow, what a year.

Early this year, I was told that I was in remission from the multiple myeloma cancer which had been diagnosed late last year. Two and a half months of chemotherapy did the trick. I didn’t have the stem cell transplant in February as was originally planned.

I spent the next 8 months dealing with the neuropathy in my feet, the persistent but much-improved back pain which was my initial symptom, a new heart problem from the inflammation that developed around my heart, and now hip pain as a late side effect from the chemotherapy.

Most of you have heard all of this before and I’ll spare you the details. Needless to say, I’m hoping 2015 will be a bit better.

What I realized the most through this experience was how different it is to be the patient and not the doctor. I was the one who had to take the medications, the therapy, the surgery, and the imaging studies. This time it was other doctors taking care of me. I’ve gained a lot of insight and understanding about how patients deal with and feel about their medical problems.

From the first moment I heard that dreaded word “cancer,” to eventually hearing the word “remission,” I knew that I was in very capable hands and had a fighting chance to overcome this disease.

I have a strong faith and knew that if God wanted me to survive, that I would. I have to admit that I know some people who also had great faith and yet didn’t survive, a mystery that I believe we will understand someday.

I’m back to work and am so happy to see the faces and to receive the heartfelt greetings of those patients I’ve come to know over the past 28 years. I love working with my wonderful staff and fellow providers. I hope to continue practicing medicine for as long as I am able to do so.

I just looked at the summary of all my medical expenses for this past year. Boy, am I glad I’ve got medical insurance.

We’ve come a long way in treating and overcoming diseases, but it ain’t cheap, and, unfortunately, it’s not going to get any less expensive.

We all, (that is to say, doctors, patients, administrators, drug and medical device manufacturers, and legislators) need to come together to devise a more affordable health care system.

This will only happen when these groups put aside any selfish interests and work toward a common goal. Obamacare is an attempt to improve the cost and delivery of health care but falls far short of what’s needed.

All that aside, I’m excited for the near future of medicine. I see the rapid development of new drugs, cancer treatments, surgeries, and cures for all sorts of diseases.

I think and hope these will be available to us in the very near future. We’re seeing the results already today. My being alive is a testament to this.

I think we have a very bright future in medical care, but it has to be made affordable and widely available.

Here’s wishing all of you from the bottom of my heart, a happy and very healthy new year.

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Terry

I am in remission of my multiple myeloma cancer. The three months of chemotherapy last fall and winter did a great job in knocking out most of those cancerous plasma cells which were taking over my body. The stem-cell transplant I was originally to have following chemotherapy has been canceled. I will have my blood tested regularly to monitor my remission. My thanks to Dr. Michael Wu and his wonderful caring staff at the Palo Alto Medical Foundation oncology department who did a superb job treating my disease.

I discovered that one doesn’t necessarily have to leave Santa Cruz for state-of-the-art cancer care that I found right here through my group at PAMF. I sure wasn’t used to being — nor particularly enjoyed — being on the patient side of the doctor/patient relationship. It was a humbling experience and has taught me more about patients and patience along my journey.

Unfortunately, I am suffering from a fairly severe neuropathy of my feet from the chemo drugs, and this is currently adversely affecting my ability to walk normally. I do, however, feel it’s a small price to pay for my successful cancer treatment. I’m told the neuropathy should improve with time. I’ll try to be patient, (not one of my virtues however).

Another little complication I had in the past month, most likely unrelated to my cancer or treatment, is a condition of my heart called constrictive pericarditis. This occurs when the sac of tissue surrounding the heart (the percardium) becomes inflamed and tightens in on the heart, causing the heart to pump less efficiently.

This threw me into mild heart failure with significant shortness of breath, swelling of lower extremities and general fatigue. Dr. Neil Sawheny, one of my cardiologist partners at PAMF, is treating me for this unexpected complication and I seem to be responding well and improving day by day.

In general , my overall well-being is improving significantly. I feel as though my life as I once knew it is being slowly restored. Once my neuropathy shows signs of improvement, I hope to return to work at least half-time.

I’ll give myself a break to work a bit less since I’ve now been practicing medicine for the past 40 years, 27 years in urgent care Scotts Valley. I love my staff, my patients, many of whom I’ve come to know quite well. Most of all, I love the satisfaction I receive in helping make people feel better and in maintaining their good health.

My thanks to all of you who have mailed get-well cards or sent email messages for my recovery. I am a strong believer in the power of prayer and I know your prayers for me have been heard.

My personal lesson from my cancer experience is this: If you have any health symptoms that seem unusual to you or are lasting longer than you think they should, see your doctor for a work up. If everything checks out OK and your symptoms soon improve, then be thankful.

If something serious like cancer is found, the sooner it’s treated the better the outcome. This a proven fact. Also, for those many of you who are healthy, give thanks every morning that you can begin a new day.

My best wishes to you for long healthy lives.

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hollenbeckAs many of you know, I was diagnosed this past October with a cancer called multiple myeloma. This is a cancer of the plasma cells which are found in the blood and produce antibodies for our immune system. These malignant cells multiply rapidly and can cause damage throughout the body, especially affecting bones and kidneys and ultimately lead to death within two years if left untreated.

 

Myeloma’s effect on bone causes extreme osteoporosis (thinning of bones), which brought about my first symptom of back pain. This was due to several of the vertebral bones of my spine collapsing, which is referred to as compression fractures. Blood tests were done to find out why an otherwise healthy guy like myself would have these fractures. The specific test for myeloma was positive. This was shocking news to me as I immediately saw my life passing in front of my eyes. I was reassured, however, by being told by my oncologist that there is great new treatment for myeloma that can bring about long remissions.

The next step was a bone marrow biopsy to determine the severity of the disease. This procedure involved numbing the skin over the back of my pelvic bone and inserting a needle into the bone marrow to obtain a specimen for more detailed evaluation.

I then began a two month course of chemotherapy at our oncology infusion center here in Santa Cruz. I received three drugs. One was given as a shot (not by IV) and the other two were in pill form. One of the pills costs $700 per pill! Not an uncommon price for the new generation cancer drugs. My particular course of chemotherapy did not cause me to lose my hair, make me sick to my stomach, or any other of the common chemotherapy side effects. I was feeling pretty smug about how I was sailing through the therapy when finally a side effect caught up with me. I developed numbness of my feet and my hands, a condition called peripheral neuropathy. It is causing me some difficulty walking and maintaining my balance. I am told this condition should improve with time, but there is no guarantee that it will go away completely.

Regarding the ongoing back pain from my compression fractures, the day after Christmas, I had a procedure called kyphoplasty, done by a spine surgeon at University of California, San Francisco. This procedure involved my receiving a general anesthesia followed by the surgeon inserting a large needle into each of 4 compressed vertebral bones. Through the needle a small balloon is blown up to help open up the collapsed bone. The balloon is then removed and a rapid drying cement like substance is injected into the boney space. This helps to restore some integrity to the compressed bone and keeps it from collapsing further. It also usually improves the associated back pain, which fortunately proved to be true for me.

So I am now with much less back pain, but with numb feet, weak legs and some unsteadiness. I am tentatively scheduled for a stem cell transplant which will take place at UCSF in mid-February. At that time I will be hospitalized for an estimated three weeks, then allowed to return home, and will be on house confinement for another four weeks. After that it should take a few months to return to normal activities.

So, it is at this time that I will take a short leave of absence from writing my column, to allow me to focus in on the upcoming stem cell transplant and recovery. I will resume my writing after all is said and done and describe this experience.

Thanks for the prayers, cards, emails and general well wishes I have received from so many of you. It makes this all somewhat easier for me, as well as for my wonderfully supportive wife Beth and my dear daughter Emma.

I’ll be back!

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multiple, myeloma, cancer

I would like to begin this week’s article with a deeply sincere appreciation for the outpouring of emails, cards, well wishes and words of encouragement from my readers, patients, friends, family and even strangers. This support will go a long way in getting me through my recent diagnosis of multiple myeloma. I’ve survived my first two weeks of chemotherapy and feel fine, except for the persistent back pain.

Although described as being somewhat uncommon, I’m aware of a number of people who have had multiple myeloma and many more who are acquainted with or related to someone with the disease. The good news is that most of them are doing well. I like to hear that.

So what is multiple myeloma?  It is a cancer that causes an over production of plasma cells — a type of white blood cell found in the bone marrow. Plasma cells function to produce antibodies which are necessary for our immune system to fight infections. In multiple myeloma, the growth of the cancerous cells causes them to produce an over-accumulation of a certain protein called immunoglobulin that travels throughout the body and can cause damage to various organs.

The other problem, as in my case, is that the plasma cells can enter normal healthy bone causing osteoporosis as well as causing local areas of bone weakness leading to bone fractures, such as I have in my spine. I also have the typical anemia because the plasma cells crowd out the red blood cells in the marrow.

The cause of multiple myeloma remains a mystery, however there are some associated risk factors such as:

– Being over age 65.

– Being a male.

– Being African-American.

– Having a family member with multiple myeloma.

Early stages of multiple myeloma may cause no symptoms. However, as the disease progresses, plasma cells accumulate in the bones and other tissues causing these symptoms:

– Unexplainable persistent pain in any location of the body especially the back.

– Extreme weakness and fatigue.

– Unintended weight loss.

– Recurring infections.

After seeing your doctor for any of these symptoms, you will have some blood tests done and if there is some indication that you may have multiple myeloma you will be referred to a doctor specializing in blood and cancer diseases. Further testing can prove or disprove whether or not one has multiple myeloma.

Therapeutic options include the one I just began, which is undergoing up to four months of chemotherapy followed by a stem cell transplant which I will explain in more detail as I get further along with my treatment.

What I have learned from my experience is that it is important to recognize early symptoms and see your doctor about your concerns. As with any cancer, the sooner it is detected and treated the better the chance of survival. If you or a loved one have any of the above-mentioned risk factors and unexplainable symptoms, see your doctor.

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For every article I write, I start research on my subject of choice and find I’m always learning something new, or I find the research to be very interesting. This week I’ve been forced to study up on subject that I didn’t know much about, but only because it was something I was just diagnosed with: multiple myeloma. This is a cancer of the plasma cells which are growing in my bone marrow.

Plasma cells function to produce antibodies to fight infections. My disease is producing an overabundance of plasma cells which left untreated can enter and weaken bones, cause anemia, and most seriously can destroy the kidneys. As I received the news, I found myself on the other side of the doctor patient conversation and felt the pang of hearing I have something that is life-threatening if not treated.

My journey with this disease began several months ago when, after recovering from the hip injury secondary to my bicycle accident, I developed pain in my lower back which was at first attributed to the result of the bike accident. When the pain continued worsening, I saw one of our back specialists who ordered an X-ray followed by an MRI of my spine. These studies showed that I had three compression fractures of my vertebral bones, which was quite unusual and was unlikely to have been caused by the bicycle accident.

I then underwent another X-ray study of my bones called a Dexa Scan which showed that I have osteoporosis, which is a thinning of the bones. Soon to follow was a battery of blood tests to find the cause of osteoporosis, one of which showed an abnormality which could be caused by multiple myeloma. Next step was to get a bone marrow sample where, after numbing the skin, a large needle is inserted into the bone marrow in the back of my hip bone and a sample is obtained. This specimen was then sent to a special laboratory in Southern California.

I had a PET scan, which is a modified CAT scan, to look at all my bones to determine the extent of my myeloma. In the end, it was determined that my PET scan showed spots on my bones and the bone marrow study showed fairly advanced myeloma disease.

The final decision is that I will begin chemotherapy this month, lasting at least four months. Then I hope to get a stem cell transplant at the University of California San Francisco where I will have to stay for another four months.

I’m told that my disease is treatable and can add years to my life if I do what is being planned for me. I am currently on an indefinite leave of absence from my work, which I will thoroughly miss.

So here I am, the doctor now the patient. Have to admit, I like the doctor role better. But this is what life has dealt me and I envision myself on a path toward healing. The journey will be rough and dangerous at times, but I will do what I can to restore my health. They say doctors don’t make good patients, I hope to prove that wrong.

I do plan to continue writing my articles as long as I am able to do so. In fact, I look forward to sharing my journey with you as events unfold.

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Dr. Terry Hollenbeck, Scotts Valley, San Lorenzo Valley

This month marks my 40th year of practicing medicine. I think back to my childhood living in Milwaukee, Wisc. with a father who was a family doctor in a solo practice on call 24-hours-a-day, 7-days-a-week. Our home phone rang day and night and Dad frequently left his comfortable home and much-needed sleep to go make a house call, admit someone to the hospital, or deliver a baby

I remember going with Dad on house calls, hospital rounds, and helping him treat patients in his office, which was conveniently located on the first floor of the duplex where we lived. I was absolutely fascinated by my early immersion into the practice of medicine.

I also heard stories about my Grandpa Hollenbeck who was also a family doctor  in the early 1900s and how he made house calls in a horse and buggy and often accepted chickens and garden produce as payments for his services. Grandpa’s brother, Henry Stanley Hollenbeck was a medical missionary in Angola Africa. He was named after the famous English journalist Henry Stanley who searched the African jungles for Dr. Livingston “I presume.” I heard fascinating tales of him practicing medicine in the remote jungles. With these influences I knew from an early age that I wanted to be a doctor.

After graduating from the Medical College of Wisconsin in 1971, I headed to sunny San Jose, Calif., to do an internship at Santa Clara Valley Medical Center. I found a calling in Emergency Medicine and stayed there as an emergency physician for almost 10 years. I then had an opportunity through the Christian Medical Society to go to Honduras in Central America, where I spent two years practicing medicine in the jungles along the Caribbean Coast working with the native Miskito Indians. Being the only Caucasian English speaking person within a 50-mile radius, living without electricity or running water and being among those wonderful people was one of the highlights of my life.

From Central America I returned home to California and began a career in the new field of urgent care medicine. I found this form of practice much to my liking and ended up working for the Santa Cruz Medical Clinic when it opened up its first satellite clinic in Scotts Valley. We opened our doors there on March 1, 1987 and I’ve been there ever since. I am privileged to work with a team of outstanding physicians at our Palo Alto Medical Foundation as well as a fantastic support staff made up of medical assistants, patient service representatives, nurses, physician assistants, nurse practitioners, and medical technicians.

What I love most about my current practice are the wonderful patients with whom I have had the privilege to treat. Having been here in Scotts Valley for the past 26 years, I have become quite familiar with many patients in our locale. I’m now taking care of people in their 20’s and 30’s who I first took care of when they were babies or toddlers. I feel that I have grown up, and older, with many of my patients over the years. I’ve shared in their joys and their sorrows.

It is a tremendous honor and pleasure to continue working with such wonderful patients. To be able to improve health, alleviate suffering and to sometimes save lives, is the ultimate of satisfaction for me. So thank you to all my patients for the privilege of working with you which makes me want to continue practicing medicine for as long as I am able to do so.

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Happy Father’s Day to my late grandfather, Norman Hollenbeck, M.D., and my father, Stanley Hollenbeck, M.D. You both were the inspiration that led me to my chosen career of medicine. How proud I felt when I graduated from the Medical College of Wisconsin, the same medical school that both of you attended.

Grandpa, although I never met you, I grew up hearing stories about you. The wife you left behind, my wonderful grandma, Lillian Hollenbeck, told me all about you. It’s amazing to think of the days of doctors making house calls, and you did it in a horse and buggy. What was it like practicing medicine without CAT scans, antibiotics, comprehensive blood tests, intensive care units, paramedics and all the things we take for granted today? You made life-and-death decisions without the use of medical specialists, computers or X-rays and blood tests.

When people had no ability to pay you for your services, you accepted chickens and vegetables. Some of your patients couldn’t even afford that. You delivered babies and continued treating them as they grew older. You were the only doctor most of your patients ever knew.

My favorite story about you was when you delivered a baby at someone’s home, which was the custom then. Apparently, after the baby was born, the mother hemorrhaged and lost a lot of blood. She was in danger of dying and there was no time to get to the hospital (there weren’t emergency rooms then anyhow). So you called one of your medical colleagues, and right there in the patient’s bed, you two doctors hooked up an IV line from your arm, directly into her bloodstream.

You gave your very own blood to save her life. She lived, but you became very anemic and had to recuperate for two months. That’s a story almost too hard to believe, except that grandma gave me a copy of the article from the local newspaper, which I still proudly possess.

You died way too young, but you left an incredible legacy for my father and me to follow.

Dad, I grew up and remember hearing so often from people how you were one of the greatest high school football players to come out of the city of Milwaukee. Octogenarians today in Milwaukee still remember your football fame. How sad that during your last high school football game you sustained a severe knee injury that prevented you from pursuing the professional career that everyone expected of you.

So you chose the medical career of your father. Shortly after you set up your family practice and joined the Wisconsin National Guard, the United States entered World War II and you were called up to active service.

You were part of the 32nd Red Arrow Division of the U.S. Army. After a quick basic training, you and your comrades were sent to Buna, New Guinea, in the South Pacific. There you were the commander of the 14th Portable Surgical Hospital, which was the forerunner of the MASH units which became so well-known in the Korean War.

You kept a diary, which I now possess, that describes your daily life on the front lines. You and your crew operated in a hot steamy lantern-lit canvas tent, trying to patch together the wounds of the brave young soldiers who were engaged with an enemy literally within several hundred yards of your hospital tent.

You were a true hero and I have in its original frame the Silver Star you won for gallantry in action.

You came back from the war (thank God) and you continued your successful general practice.

I was so proud of being with you, because everywhere we went you were constantly recognized by your patients and greeted with a hearty “Hi Doc, how ya doin?”

I loved going on house calls with you and making Sunday morning hospital rounds.

I remember that almost anytime you took me somewhere, whether it was to a Milwaukee Braves baseball game or a Green Bay Packers football game, you would be paged to go to the hospital. You received phone calls from patients 24/7, and you took only two weeks of vacation a year. But I knew from early on that after watching and helping you treat patients in your office (downstairs from our home) that I wanted to be just like you.

So, Grandpa and Dad, Happy Father’s Day — and thanks for the inspiration for the wonderful career I have chosen.

Terry Hollenbeck, M.D., is an urgent-care physician at Santa Cruz Medical Foundation in Scotts Valley. A doctor with 34 years’ experience, he invites health-related questions at valleydoctor@sbcglobal.net. Information in this column is not intended to replace professional advice. For any medical concern, consult a qualified practitioner.

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