“Seeing America slowly, was in a way, like eating slow food — I wasn’t covering much ground in a single day, but I was digesting a lot more.” — Rinker Buck, The Oregon Trail: A New American Journey
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
My wife Pam and I have developed a habit of listening to audiobooks while traveling the American continent in our RV (TimBuckTwoBlog.com). A particular favorite for both of us was “The Oregon Trail: A New American Journey” by Rinker Buck. The book details Rinker and his brother, Nick, following the historic Oregon Trail in a covered wagon drawn by three mules in modern America. A recurrent theme in the text was the value of “seeing America slowly” from the buckboard seat of a covered wagon as everyday Americans whipped by on ribbons of asphalt at highway speed.
Granted, Pam and I resemble the Americans lamented by Mr. Buck in our gas-guzzling Class A motorhome, traveling fast from landmark to landmark. In fact, Rinker Buck spends a considerable portion of his book lambasting the RV lifestyle with a bit more venom than I thought was necessary. Perhaps the fact that our RV is our only home and we do not own a car might soften Mr. Buck’s outlook on RV nomads. Notwithstanding Rinker’s dig on RVs, we thoroughly enjoyed the story and historical account of one of the planet’s most significant migrations of people. We were particularly enthralled with the wisdom of seeing America slowly.
We have been enjoying the RV nomad lifestyle for over a year. We started not towing a car as most full-time and weekend warrior RV aficionados tend to do. We opted, instead, for electric bikes (https://lectricebikes.com) as our primary means of transportation in and around the venues we visit. Understand that I am definitely not being critical of those who choose to have a second vehicle. The pickup truck is necessary for fifth-wheelers (trucks towing a camper), and the convenience of having a car in addition to the RV cannot be overestimated. A spare vehicle has a limitless range, works in all weather conditions, is undoubtedly fast and adds an element of safety if the RV breaks down. Furthermore, there are some situations where a car is an absolute necessity. Pam and I have no qualms about renting a car or calling a ride-share in those situations. I am not a technophobe.
Despite the real advantages of a car, Pam and I still prefer electric bikes. Admittedly, I take a certain level of perverse pride in bucking conventions and taking the path less traveled. There is a feeling of accomplishment in successfully going to the grocer 5 miles away and completing our shopping with a bike that I have never felt in an automobile. It was also suggested by some friends and family that we would not last long without a car. Yes, I irrationally enjoy proving those naysayers wrong. Where bikes (and just plain walking to destinations) have really excelled in value is the absolute necessity when traveling to take in the environment slowly. Unlike traveling 55+ miles per hour in the RV or a car, I feel part of the scenes I travel through on a bike and therefore tend to experience and enjoy these places and moments more. Bikes can also be a “life hack” when visiting some of the nation’s most popular and busiest parks and monuments. Motor vehicle visitors often must wait in long lines and sometimes obtain special timed permits to visit some parks. Conversely, cyclists usually can pedal past the lines and need not worry about a timed entry. This advantage, coupled with a National Park Service Access Pass (free to active duty, veterans and their families), gives you the one-two punch of unfettered access to some of the most spectacular vistas this country offers.
There are occasions when we have lamented the limits of our cycling existence. Still, far more often than not, we are profoundly grateful for the advantages of seeing America slowly. At 8-10 miles per hour, the roadside flowers can be truly appreciated, the wildlife can be spotted, and the small-town inhabitants can be conversed with. Bikes also force us off the sterile highways and onto the paths far less traveled, usually only appreciated by the locals. Recently, while enjoying lunch on a roadside hill overlooking Arches National Park as the “cagers” in their cars sped by racing to the next scenic overlook, I felt genuinely sorry for a fellow who briefly stopped by our parked bikes, shoved a camera out his window for a few snapshots, and then abruptly left. He missed the spring flowers growing cheerfully beside his car, the fresh air at altitude, the feel of the high desert sun and the sand and gravel on his bum. While we were both participants in the beautiful scene and that moment, I feel I came away with a much richer experience.
At this point, many of my readers are wondering how this rambling about seeing America slowly could have anything meaningful to do with medicine. No worries, I will explain myself. Technology has sped up every aspect of our lives. Humans from a few hundred years ago could not contemplate the productivity and speed with which modern society accomplishes tasks. For example, I recently visited the Mesa Verde Cliff Dwellings, which archeologists estimate took 20 years to build. A modern contractor with construction equipment could accomplish the same project in a month. Medicine certainly has not been immune to this trend of enhanced productivity. As I have lamented many times in this column, the pace of change in medical practice during my 30+ year career has been astonishing. We hardly need even speak with our patients anymore as our machines scan, probe and evaluate their bodies to determine their illnesses. At the same time, our profession is under constant pressure to leverage technology for ever greater efficiency toward increasing patient numbers seen daily. For many clinics, patient throughput has become a more critical measure of success than the quality of care.
My travels in retirement have just reinforced what I spent much of my career teaching, but never articulated very well. We must strive to see our patients slowly. We must resist the temptation to accept the machine’s answer (I am looking at you, medical AI) at face value without taking the time to talk with our patients, to experience and soothe their emotions and to reach out to touch them with human concern. No machine or AI will ever be able to make this personal connection, and it is a healing power the medical community should guard jealously. Just like your inability to appreciate the subtle beauty of a roadside wildflower at 75 miles per hour, you will never really understand a patient solely from their imaging and blood work studies. The best healthcare providers know this intuitively and take the time to see their patients slowly. I believe clinicians who do not understand the value of human interaction in medicine and are unwilling to invest this time are not practicing good medicine. Instead, they are mere technicians enslaving themselves to machines. A physician, worthy of the title, leverages modern technology to inform but never replaces their judgment and human ability to connect personally with a patient. A physician always sees their patients slowly.