A Life of Service with Dr. David Borge, M.D.

[00:00] Michelle: This week, I had the great pleasure of speaking with my friend and colleague, Dr. David Borge.

[00:07] David is an OB/GYN who has retired from the traditional 9-to-5 work schedule and now enjoys using his expertise in Saipan, and more recently, Panama, his country of birth.

[00:21] As the son of missionaries, David spent his early years with his five siblings in Panama, France, Egypt, and Madagascar.

[00:30] His father, a physician, often brought young David to the hospital where he could round on patients and observe surgeries.

[00:38] These experiences profoundly enriched his life, fueled his passion for service, and motivated him to become a physician.

[00:47] David's Next Adventure Travel blog chronicles his work with the Floating Doctors organization.

[00:53] You'll read the stories of his time in Saipan, treating women with cancer, birth defects, and high risk pregnancies, compounded by a lack of medical support, which will make you appreciate life here in the United States.

[01:07] Although he hasn't yet written about his recent trip to Panama to establish a medical clinic with midwives, I am eagerly anticipating his stories.

[01:17] After delivering thousands of babies in eight countries, David has discovered that kindness, compassion and competence resonate across cultures and are unified by our common humanity.

[01:31] Prepare yourself for an emotional conversation filled with wonder, laughter, and tears with an exceptional human. In the five-minute snippet: Well, they are a travel necessity.

[02:01] Well, good morning, David. Welcome to the podcast.

[02:04] David: Thank you. I am humbly honored to be on your podcast. I've never done anything like this before and 

[02:12] Yeah, it's wonderful, one and two, like I said, I'm humbly honored. Thank you very much.

[02:18] Michelle: Well, thank you for coming on. And I know that you probably have some nerves and that's entirely normal. And this is just going to be a conversation between two friends and two colleagues, because that's what we are.

[02:33] We've known each other for a good number of years. We've worked together and we have a mutual respect of one another.

[02:43] And so this is just a conversation.

[02:47] David: Oh, cool.

[02:49] Michelle: So let's just start with an introduction. Who is David Borge?

[02:56] David: David Borge is a retired OB GYN trying to find his new way in this world as a retired doctor, which is a hard thing to give up, but I'm getting there and trying to be me after years and years of, okay, we need you for this.

[03:18] Do this for us, do that for us. These patients need you. And it was always patient, patient and family first. And now It's David first and, okay, what are you going to do with the rest of your life?

[03:33] So this is one of those.

[03:36] This is one of those events that helped me find my way. So thank you.

[03:42] Michelle: I've had the same struggles in retirement, and it's simultaneously wonderful and terrifying. I can totally relate.

[03:53] David: Oh, good. Yeah.

[03:56] And I retired without a plan. I just said, okay, I'm stopping.

[04:03] I was in Saipan, which is in the middle of the Pacific Ocean, just south of Japan and by Guam.

[04:13] And I had it. My first maternal death. And it was something that couldn't have been avoided. And I did save the baby. And the nurses were very nice and said, you're the only doctor here that would have saved that baby.

[04:26] And so I did a C-section on a lady that was being coded. And after that, I got very depressed, and work became work instead of my passion. And at that point, I said, okay, I'm out of here.

[04:39] And I quit and came back to the States and tried, okay, no, no, no, I'm not going to get ready to be retired. And I applied for a few locums jobs and jobs around, and I didn't get anything.

[04:54] And what was it? And they said part of the reason was, oh, you haven't delivered a baby for two years, so we don't want you. And excuse me, I've delivered 10,000 of the damn things.

[05:04] You think I'd not forget that. But eventually I just took it as my mom and dad, who are in heaven, directing things for me. And I ended up, now I'm doing,

[05:17] I decided after consultation with myself, no more deliveries, no more hospital work. And I work in a little clinic for the underserved one day a week. And it's good clinic and good folks, and they like me.

[05:31] And I'm taking care of basically the same folks that I was taking care of down in Visalia and Tulare County.

[05:41] So that's David right now.

[05:44] Michelle: Well, there are so many parallels to, you know, both of our stories.

[05:50] And I can relate. And I know a lot of retired people, especially people in the medical profession, can relate to all of a sudden giving up that, man, I don't even know what to call it.

[06:05] Like an, it's not really an image, but it kind of is. You know, you're a professional. You're a working professional. You're delivering babies, you're doing surgeries, you know, all these things.

[06:17] And then you have this moment of tragedy that you had losing a mom, and then you have this huge life decision to make.

[06:28] And then your competency is being questioned, you know, because you haven't delivered a baby in two years. So that experience doesn't just go away.

[06:39] And I remember shortly after I retired as well, I had a moment where I thought, you know what? Maybe I need to go back to work, but not to the hospital.

[06:50] I'm going to go back and teach. Because I had done that before at a nursing school as adjunct faculty and, you know, went through the whole application process. And then, you know, my heart was just shattered because I was told I didn't have enough clinical experience as a nurse for 36 years.

[07:10] So those things hurt. They hurt our ego, and sometimes it can be hard to recover from. But I like where you took it. I like where you went with it.

[07:23] So tell me about Saipan.

[07:25] David: Oh, and I'm also doing medical mission work, and I just got back from Panama, which we can cover a little bit later. But I was doing no deliveries, just working out in communities, far away communities.

[07:39] But Saipan was an interesting place.

[07:44] After I retired from Tulare County, I needed something to do, and so my daughter and I went to New Zealand, and I thought, oh, do you guys need doctors here?

[07:55] And they says, oh, yes, yes, yes. And I applied through a locums company, and it just took them forever. But in the meantime, the locum said, hey, do you want to go to Saipan?

[08:05] I said, where in the hell is Saipan? And it's this little island of 70,000 people, and it's beautiful, but it's a administrative wreck and economic wreck because of the tourism and Covid and all that.

[08:20] But it was a wide variety of patients from all Asian, Japanese, Chinese, Thai, Cambodian, Afghani, and then the islanders. And the nurses were good, and the patients were good. I won't comment on my fellow physicians, but, yeah, the nurses, a lot of Filipino nurses come over and they would work to get their US license, and then they'd get this.

[08:49] They get to the States and do travel, nursing, and making a bunch of money. So it was,

[08:56] It was a nice variety of patients and nurses that I worked with.

[09:02] We won't talk about staff.

[09:06] It was one of those places where, you know, I'm done with work today. I'm going to go lay on the beach and go snorkeling and go diving, and it was just beautiful.

[09:17] But then you open your eyes and you see all these abandoned hotels and abandoned factories and people living in FEMA tents from a typhoon four years ago, and they just hadn't figured out what to do

[09:32] with them. And so it was. It was. Yeah, it was nice. I'm glad I went there. I'm not going back.

[09:40] I went back for a little while. I had a friend that was there and I did. They have a terrible cervical cancer problem.

[09:50] Hey, I'm sorry. Excuse me for interrupting.

[09:53] Michelle: Oh, no, no. We have a delay, so it's just making it a little bit crazy. But, you know, I have to say that I watched, because you started a travel blog, it's David's Next Adventure travel blog.

[10:08] And I'll put the link in the show notes for everybody to access that. But this is from your travel blog. So you say in one day, I delivered ladies from Russia, Bangladesh, China and Saipan.

[10:21] And I've seen patients from Palau, Japan, Singapore, and good old USA. So many cultures, religions and ethnicities to wade through. I am finding, though, that kindness, compassion and competence speak the same language and live by the one common denominator of being human.

[10:41] So I just loved that. And I loved all of your pictures from the beach that you would post. It definitely looked like a beautiful place.

[10:52] David: Yeah, it was and is. And it was a wonderful end to my career and a career that I just have to say I'm so blessed in having and what I've done.

[11:05] And it was just wonderful and it was wonderful. Like, I always relate this story. I would, the Bangladeshi women, Afghani women, really didn't like men taking care of them.

[11:18] And every once in a while we would have to take care of them. And when I do a C-section with them, they had the spinal. And so before I would cut, I would say Bismillahi, which is Allah be with me, because they were very Muslim.

[11:31] Very, very Muslim. And then so that the patient could hear it. And then when the baby. When I delivered the baby and the baby cried, I would say Alhamdulillah, which is basically God is great.

[11:44] And the patients loved it.

[11:48] And no one else, no one else would even think of doing that or capable of doing that. So it was. And I liked it, and the nurses liked it, and the staff liked it, and the patients loved it.

[12:01] So it was one of those things that I took my whole career and came down to that moment and everything that I had learned in my life.

[12:14] And like I said, blessed. Absolutely blessed.

[12:19] Michelle: Well, I feel like the people there were blessed to have you there. And that's.

[12:23] David: Thank you.

[12:24] Michelle: That's part of your humanity. And you talk about your compassion and relatedness to the people there. So you, you know, learned some of their language, their customs and, and I'm sure they appreciated that.

[12:43] David: You know, I think they did. And I was rewarded because they would come back and see me and they wouldn't switch doctors to switch over to a woman. They would come back and see me and.

[12:55] Which I was like, well, thank you very much.

[12:59] Thank you.

[13:00] I'm happy to take care of you. And working with them by their rules and by their customs and not. Well, excuse me, I'm the doctor here and I'm from America and I know everything.

[13:12] No, it's like, okay, you have customs and rules and things that you're comfortable with. I will work with those and we will do it as safely as possible and communicate as much as possible.

[13:26] Michelle: Yeah, I think that just improves everything.

[13:29] Well, let's talk about some of their maternity practices there, because we know what we do in the States as far as when a mom and baby deliver.

[13:39] And I know that things are done differently in other countries, but what differences did you see in maternity practices in Saipan versus the United States?

[13:51] David: It was pretty much since Saipan is a commonwealth, it was pretty much the same.

[14:00] Yeah, it was pretty much the same. You come in here in labor, you deliver, you get them to make sure that they had their prenatal visits and all that other.

[14:12] But we basically did everything the same as we did in the States.

[14:17] You take some place like Panama, which I just got back from, is where there it's traditional midwives. You know, 90% of the, of the people, the indigenous tribe that I took care of were delivered by, by traditional midwives in their home or in, on the street or in the bushes or wherever.

[14:40] But other than that, Saipan was pretty much the same. And it was American, quote, unquote, American medicine there. Usually most of the doctors were American and the practices were the same.

[14:56] Michelle: So did they have like the same technology, like ultrasound and stuff like that?

[15:03] David: They did.

[15:05] They had a good ultrasound. I could get level two ultrasounds. They had basically the same technology. The only problem was that if there was a maternal fetal was absent.

[15:19] We'd have to transfer patients to the States, transfer babies to the States. Even though it was right next to Guam, which had the capacity and it was right next to Hawaii, they said, I'm sorry, we don't take those people there.

[15:36] They have Medicaid and whatever. And so they would have to take a 24 hour trip to the States and be taken care of in San Diego. San Diego was a place where we transferred most kids and kids would go, newborn kids would be going in an incubator with a respiratory therapist and with a nurse and if need be, with a doctor.

[16:00] So that was crazy. That support was non existent. And I, we had to take care of the complicated ones and do it, you know, phone consults and that was about it.

[16:14] So. And then if someone was from Thailand or Japan, I would have to transfer them back there, which would mean talking to a doctor through a translator usually, and sending them back there.

[16:29] And many times they would not have liked that. Especially the ladies from Thailand. They didn't have any visas and they were just brought over as labor and okay, you can come over here.

[16:43] We don't care if you don't have a visa or a green card, just come on over. And then for them to get home was difficult. So there was that complication of taking care of the patients.

[16:54] It just wasn't, and you had to work at it. You had to work at it. And some of the folks that I worked with just said, okay, sorry, go back to Thailand.

[17:05] And they wouldn't do the due diligence to get them back and to get them the proper medical care.

[17:14] Michelle: Wow. Seemed like so many barriers to care there. What about breastfeeding? You and I are both fans of breastfeeding and we know that our breastfeeding rates, well, here in Tulare county are pretty bad, but nationally, not great.

[17:30] How about the breastfeeding practices in Saipan?

[17:35] David: That was pretty much a given that you're going to breastfeed because one, it was A,

[17:43] It was just understood and that's what you did traditionally. And two, the getting bottles and getting milk and stuff like that was a chore for the patient. So they really kind of didn't have any choice unless they had a lot of money and a lot of connections to get breast milk and stuff like that.

[18:01] They just. Everybody breastfed. And as I recall, I might be wrong in this. We did have a breastfeeding nurse.

[18:09] So. Yeah. So breastfeeding was up there.

[18:14] Michelle: Wow. So much different than here, right? Yeah, it's almost the opposite. Yeah.

[18:20] David: And the other very interesting,

[18:22] The other great thing about it was there was such a community that the whole family would take care of the mother and the baby. I chit-chatted with them sometimes about nursing homes and like, what in the hell's a nursing home?

[18:38] And why do you have nursing homes? The elder, was just taken care of by the family. You know, when someone was dying in the hospital.

[18:49] A islander was dying in the hospital because out front there was a huge crowd of people that were there. And when I had to go out and tell the patients, the patient's family about the death, there was a whole waiting room full of people at 1:00 in the morning.

[19:08] That was the refreshing thing about their. You knew that the whole this, the baby that I saved there was. The whole family was going to come together and take care of this baby.

[19:20] Didn't have a mama, but we're going to be there.

[19:23] Michelle: Yeah. Again, so different from here. Right.

[19:26] And so much better. Yeah. A lot of extended family.

[19:31] Well, I want to go back for a second because we're talking about family right now. So you come from a big Norwegian family with five siblings.

[19:42] What was your life like growing up?

[19:45] David: My life like growing up when it was.

[19:49] Michelle: So when you were a kid?

[19:51] David: When I was a kid. Well, here's the story of my life growing up. I was born in Panama because my father was a physician and he was working down there doing some studies and he wanted to study surgery as well as tropical medicine.

[20:07] So I'm born there, I come back to the States, and then we take the Queen Mary over to France, where you spent a year. They were learning French. And we traveled around Europe and then we took a freighter down to Madagascar and we went through the Suez Canal and stopped in Egypt and then went to Madagascar.

[20:26] And I grew up in Madagascar for the first 12 years of my life. And so by the time I was. I counted once, and by the time I was 8 years old, I had been through like 10, 11 different countries.

[20:41] And so my life and Madagascar was looking back at it. It was just an incredible time. And then, you know, I, by the time I came back to the States, the first time I had seen two movies in my life.

[20:58] No electronics. And your childhood was go out and play in the ocean or go out and collect butterflies or just you were on your own. And I went to a boarding school and with the other missionary kids, it was a mission school.

[21:19] And so I played a lot with the other mission kids. We didn't hang out with the Malagasy kids too much, but mostly mission. And so my childhood was. And, you know, with six kids, the.

[21:34] You had to help with this and help with that. And then I, But I, you know, explored Madagascar and a lot of people, it's like, where in the hell's Madagascar?

[21:43] But I.

[21:45] That's where I grew up. That's where I grew up. And so that childhood was wonderful. Then we went back and I was there until I was 12, 13 years old and then came back to the States.

[21:57] And so on one hand, it was a lot of moving and a lot of changing friendships and making new friendships and doing new things and coming back to the States as a middle schooler and adjusting from Madagascar to the States was.

[22:19] I'm not sure how I did it, but I managed. And I guess it made me malleable and adaptable.

[22:29] Michelle: I'm sure all those experiences just added to the richness of your life.

[22:34] David: Oh, I look back and I am absolutely blessed. I am absolutely what my life was about, what my career was about. It was incredible.

[22:44] Michelle: Well, there's one person that we both know and love, and that is Jennifer Caposella. So Jennifer.

[22:52] David: Hi, Jennifer.

[22:52] Michelle: Yeah. Yeah, Jennifer couldn't be here today. She wanted to get in on this. Yeah, she did want me to ask you something. And so you talked a little bit about it, but she was fascinated by all your stories of Madagascar.

[23:12] And I guess I should let everyone know that Jennifer is my sister. Longtime labor and delivery nurse. Worked, gosh, a couple decades with David and then went on to ICU and then went on to flight nursing and all of that.

[23:29] But she, you know, she said, you gotta ask him about Madagascar. So you talked a little bit about it, but just give me like a day in the life. Like, what was just a typical day for you?

[23:40] What did you do?

[23:42] David: If it was school, it was school. And school was interesting because there was big one one room classes where you had, you know, three different levels in the rooms and you had one teacher teaching all three levels.

[23:58] And so. But that was good. And kids left there and got into college. A typical day was get up and eat your breakfast of rice. And it was rice all the time.

[24:13] And then go out and play and go out and find your thing. And I had, I'm not sure why I got to do it, but dad would take me up to the hospital and it was Malagasy Hospital, and so you could do anything.

[24:25] And I would watch him do surgeries and go on rounds with him.

[24:32] That was a blessing as well. And that's, I think, where. That's. I know where I got my, my urge to go into medicine just from, you know, he would just take me around and, you know, six, seven years old and, or even.

[24:46] And then when I got older, he would take me and let me watch surgeries. And then we had. It was. Since it was an island, the ocean was nearby, so we were always swimming in the ocean

[25:02] And hanging out with other missionary kids.

[25:06] Michelle: So it sounds idyllic.

[25:09] David: It was phenomenal. It was phenomenal. It's like I said a million times, it was such a blessing. And it was. And then having Madagascar and then coming to the States and having the States as well.

[25:24] Oh, and then I got to tell you about going back. I took my kids, my family, and we went back to Madagascar. We gathered up a bunch of, I got from Kaweah

[25:36] I got a bunch of throwaways that would have been tossed. Gloves and towels and sutures and other things that they would have just tossed. And so we took all these medical supplies with us and T shirts with us and clothes with us to give away and went there.

[25:56] And I worked in the hospitals that dad had. One hospital that he had helped build and another one that he had planned and build and worked with some nurses that he had actually trained.

[26:09] So it was amazing. It was amazing. And I went to one hospital, the second hospital that he had worked at, and of which he received the medal of honor from the Malagasy government for all his work.

[26:24] But I went to this one hospital, and in the morning, they would always have chapel. And so it was kind of dark, and I just heard this murmuring as I went into the chapel and came out, and there was a light, and there was 100 people waiting to see me.

[26:39] And they had put out the message on the radio that the son of the doctor who used to raise people from the dead is here seeing patients. So I saw patients all day long and operated and delivered.

[26:57] And just to get you an idea that one of the patients that I delivered, they brought her to the hospital in a cart drawn by POWs. And from the edge of the hospital to the hospital itself, they brought her in in a wheelchair.

[27:16] I mean, a wheelchair. And I in a.

[27:20] What do you call them? In a gurney.

[27:24] No, not gurney. A wheelbarrow. A wheelbarrow was like, oh, my God.

[27:29] And I immediately had to take her in for surgery because she had to have a C-section. And I said, well, we need to get blood. And they said, well, that's going to be,

[27:42] Meaning it's going to be a couple hours because we have to go to her village, bring those people back here. And so it was quite an experience. And they ran out of beds, and they said, oh, we have a patient that's in a malaria coma.

[27:57] She's out on the veranda. Can you deliver her? She's got a 28, was like a 28 week baby that was a fetal demise. And I said, well, do you have this?

[28:10] Nope. Do you have that? Nope. And so I'm delivering this baby on the, on the veranda of this lady that was in a coma. It was. So it was quite an adventure.

[28:21] It was quite an adventure. And I was able to show my kids where I went to school. And this is the beaches that we swam on. And we swam on them and took them around.

[28:31] And so it was quite a second adventure to Madagascar.

[28:38] Michelle: It just sounds like such a phenomenal experience. And to be able to bring your children and come full circle to where your father practiced in that community, obviously very highly regarded and respected and, and treasured.

[28:54] And then for his son to be there and to be having that same experience of just the love of the people and man, what a phenomenal experience. And that was one of my questions of, you know, did you go into medicine because of your father's influence?

[29:14] And you talked about that. But how did you choose obstetrics?

[29:19] David: You know, there's serendipitous events that happen to us. And I was, I went into medical school and I'm going to be a surgeon like my dad. I would just want to be a general surgeon.

[29:29] And I, in one of my rotations in my third year, I worked with this surgeon who was the, God bless them, but he was the stereotypical surgeon and ego and hard work and just, he just drove me crazy.

[29:45] But then the next rotation I took with an OB GYN and who his patients loved and he was a hard worker and he did surgery. And it struck me that, look, you take care of basically healthy folks and you don't take care of chronically ill patients.

[30:01] You take care of healthy folks. I did residency in Texas and in Houston and he had done residency there and he hooked me up and I did a rotation down there and just there was it.

[30:13] I'm going to be an OB/GYN.

[30:15] Yeah. Take care of, help. Basically healthy people, put them through the worst pain in their life and they still love you and are happy for your, for your care.

[30:27] Michelle: I think it was perfect. It was divine intervention because certainly that's where you excel. I will say.

[30:39] David: Thank you. Yeah, it's divine intervention. I'm a big believer in angels. And my dad had died shortly before I got into medical school and so I take it as his guidance and his moving me there and moving me here and opening these doors and shutting other doors.

[30:58] So. Yeah, I believe in that stuff and I believe in, you know, angels. And my mom and dad and sister are in heaven looking after me. Oh, and we had an interesting thing.

[31:10] And when I was a year and a half, when I was two, two and a half years old, my brother. When we were in Madagascar, my baby brother, who was 18 months got bit by a black widow spider and died.

[31:25] And dad took care of him. He was the only, it was, you know, missionary kids. You can't transfer them, you can't do anything. And so he took care of them and.

[31:34] But he never talked about it. Never talked about it. And mom just talked about it as in the last years of her life. But when I was there, I ran into a nurse who took care of Bobby with dad when he passed.

[31:51] And so he told me a bunch of stuff and it was. Yeah, it was. Thank you, thank you, thank you. So.

[31:59] Yeah, in the side.

[32:02] Michelle: Well, that's

[32:06] a heart wrenching story, David, and one I did not know. So I'm learning something new, too.

[32:13] And, you know, I don't know if that was. Is that a generational thing about, you know, not wanting to talk about that? Because my mom is 85 and she lost her brother.

[32:27] He was a senior in high school and it was just a few.

[32:31] weeks before graduation and he died in a car accident.

[32:37] And she said how they handled that was her parents, like, the next day, they took all of the pictures down from the walls. They took everything out of his room and they just never talked about him again.

[32:52] And, you know, to be a sibling, to be a child of somebody that's, you know, approaching such a tragedy that way, man, I just, you know, I can't fathom it, but I don't know.

[33:05] And I've heard that from other people, too, that that's kind of how they handled things, you know, back then, quote, unquote. Do you think that was part of it or do you think there was something else going on?

[33:17] David: Oh, I think that was very much part of it. He was a Midwestern Norwegian, Lutheran. And they just didn't talk. They just didn't talk and took whatever he did. She said, okay.

[33:32] And it wasn't until, like I said, the last years of her life where she talked about it and now to ask her stuff and she would tell me and she told me stuff that I never knew.

[33:43] And so on the upside of that, it's made me communicate with my kids. I have a difficult patient.

[33:52] I have a good patient. I have this experience. I always talk to them. I always talk to them and let them know what's going on.

[34:01] And that was a lesson that I got from my parents to talk to your kids, talk to your kids. Don't be like them. And that was just, you know, I remember when we went to the funeral and mom said, okay, funeral's over.

[34:19] Let's get on with life. Dad just sort of moved on.

[34:23] And I don't know, I don't know what. And I don't know how he dealt with it. I could, goodness sakes, if I had to take care of one of my kids and they died, I wish, I don't know what I would do.

[34:35] And so, yeah, so, yeah, it is absolutely a generational thing. Okay, he's gone. Move on.

[34:44] Michelle: Well, you mentioned your late sister Carol, and I want to talk about her for a moment because she came into my life through you at a very pivotal point in my life when I was diagnosed with breast cancer in 2009.

[35:02] And you were very compassionate, very concerned, and you knew that I was worried and terrified about what was coming for me because your sister had gone through that experience with breast cancer as well.

[35:20] And so you hooked me up with her, and I got to speak with her. And that was such a blessing, David. And I know I've told you that before, but I'll tell you again that it just was such a blessing to talk to Carol.

[35:37] And at the time that I spoke with her, she was already 25 years out.

[35:43] And when you're faced with something like that, you think, you know, I'm not going to see you next month or next year. And to speak with somebody that went through that at such a young age and got through it so gracefully.

[35:58] She had, you know, little kids, I guess. I think she was also just a few months postpartum, and she had a husband and a family, and she brought me such peace.

[36:10] And she just was such a light in my life. And I thank you again for connecting us.

[36:19] David: Wow, I forgot all about that, but goodness sakes.

[36:24] Yeah, it was. And I'm glad, so glad that you and her connected because, Yeah, I don't know. It's something I do.

[36:36] Carol, can you talk to Michelle? And she. So, yeah, I'd love to.

[36:41] And so, yeah, I mean, you're talking to someone that's states away, but she, she helped you. Thank you. And thank you for reminding me of that. I guess I did a few good things in this world.

[36:57] Michelle: Just a few, David. Just a few.

[37:01] Yeah, it was, it was a beautiful moment and a beautiful gesture on both of your parts. And I firmly believe that really helped me in my journey.

[37:10] Because when things got tough. Yeah. I kept thinking back to Carol and, And what she said. So. Thank you so much.

[37:20] Okay, so let's go to nurses.

[37:25] I'm a nurse, you're a physician. We have a relationship professionally. And I'm going to preface this with when I met you way back in the day, and I mean no harm through this whatsoever.

[37:44] But here is my initial reaction, David. When I met you, I thought, this guy is a real asshole.

[37:53] And I know you've had other people that have told you that. And when I go back and I try to analyze why I thought that and why that was my first impression.

[38:03] First of all, you're a very large presence, both physically and so you're very tall.

[38:12] You move quickly, you speak loudly, you have that deep voice.

[38:19] And so my initial reaction was just like, you know, this guy's kind of brisk and, you know, he moves fast and he talks loud and. And he just must be a jerk.

[38:31] And, man, I couldn't be further from the truth then when I got to go to your deliveries and see your interactions with the labor nurses, with the families, with the patient, and I saw such tenderness and such compassion and humor.

[38:50] Such humor. And it just changed me within, you know, a couple of weeks. I was just a huge fan.

[38:59] David: Thank you.

[39:01] Michelle: Yeah. So talk about your relationship with nurses and how, how special that is.

[39:07] David: You know, I thought about that and I go back to take care of patients. It takes a village, and it takes a village with the foundation of communication, compassion, respect for each other's job and each other's role in taking care of the patients.

[39:31] When a nurse calls me at 2 o'clock in the morning and say, you got to come in here for delivery. It's not like, why, and what's this?

[39:40] And what's this? I'll. Nope, I'll be right there. And that's.

[39:46] And it's a mutual thing, too, where they need to respect me. I know that I get away with a lot of crap because I'm a tall, white male doctor.

[39:58] And it was. It took me a while to unleash from that. But it's also.

[40:06] Nurses are so important in the care of the patient. They have. They fill a role that we don't fill, and they fill a role and like I fill a role that they don't fill.

[40:18] And we just work together. And that's what I mean, that's a thing, too, that I don't know that you have in many other professions where you have two different.

[40:31] roles that have to work closely. I can't do nursing stuff. Nurses can't do my stuff. But we have to, it's a 1+1=5.

[40:46] And the patient. The nurses do certain things and I do certain things, but we do them together. And it takes, you know, I had done it where I didn't respect a nurse for some reason or another and go back and, no, that was a mistake.

[41:04] And I, you know, I spent a lot of time, you know, in the heat of battle, I will yell and curse and we got to get this baby out.

[41:12] But I always went back afterwards and apologized and tried to make up for it and tried to explain for it. And while your action shouldn't have been.

[41:25] Shouldn't have made you need to go back and. Well, when we needed to get this baby out, we needed to get this baby out. And if I yelled at you, it's not yelling at you, it's yelling because I'm frustrated and I'm nervous and I'm, you know, under a lot of stress to get this kid out.

[41:43] But I would always,

[41:45] I would always go back and say, you know, I'm sorry. I didn't mean anything personally. You're wonderful. And so.

[41:52] And I didn't see that a whole lot. Where there was the respect for the nurses and various aspects of my life. They were just someone that was there to start an IV or to give me the instruments that I need instead of.

[42:07] I guess it comes down to. Just like with patients you treat, you're not treating a disease, you're treating a person, and you're not working with a registered nurse. You're working with a human being.

[42:24] They have feelings and they have skills, and that needs to be respected. And I've tried to do that. I've tried to do that. And, yeah, throughout my life. And like I said, when I would screw up and lose it over a tough delivery, then.

[42:43] But I would always go back and say, I'm sorry. I didn't mean anything personal by it, but. And it was just the heat of the situation. I don't know if that always fixed things, but it.

[42:54] Yeah, that's what I think about nurses. They're wonderful and love them, and they always respect their opinion and their judgments and go from there. And if there was something that she said, it was A, but it was really B.

[43:12] Then we talked about it, and this is why it's B and it's not A. And so tried to teach and you had mentioned that going back to wanting to be a teacher.

[43:23] And that's part of what I'm doing with, with the clinic that I'm working at. I have a wealth of experience and knowledge and I'm want to pass that on as much as I possibly can.

[43:36] And I try to do that wherever I am is, you know, pass on some knowledge. I'm not so stressed and overworked that I can't do it. So, yeah, passing on everything that I've learned and done and try always to do that with the nurses that I'm working with too.

[43:55] This is why we're doing this and this is why we're doing that. Do you have any questions?

[43:59] Michelle: Yeah. That relationship is so important and so unique, like you said. And I love that you said one plus one equals five. And it takes a village because so true.

[44:13] And the reality is in a high stress situation, because we would have these in the NICU as well. You know, when you have a baby that you're resuscitating, it's. It's very tense and, and things get said and feelings get hurt.

[44:30] And you know, we had neonatologists that would say things, you know, during a code

[44:37] And we understood and they always came back like you and said, hey, I'm sorry how that came across. That wasn't my intention and I apologize. And I think that's so important.

[44:52] And again, going back to my initial impression of you, it was totally unfounded. I don't know why I had it because I never felt disrespected by you anything. It's just like your presence.

[45:07] You just had such this big presence and you moved fast, man. You moved very fast.

[45:15] So you proved me totally wrong and I love it. And thank you for talking about that relationship because it's so important.

[45:23] So, yeah, I do want to talk about Panama because you just got back from a trip to Panama.

[45:29] So tell me about that. What'd you do there, why'd you go there and what's your plan for the future?

[45:35] David: I went there, my main objective was to go down and work at this place called Floating Doctors, which any of the people listening should look up. It's a group that has a compound off the coast and doctors.

[45:56] When I was there this time, there were doctors from Netherlands, from Germany, from Spain, Argentina, Russia. And we work together and we go out to these communities, the Ngabi communities, which are indigenous folks that we got these communities where there's no electricity.

[46:16] And once I went and it took me, I had to ride a horse for five hours. And this last time I had to take a boat for an hour, hour and a half.

[46:27] And then you go to this place and then you carry all the equipment up and it's not a mile to the community.

[46:33] They would go and visit these communities and like every month to three months, and we'd bring the medicine, we'd give them medicine, we'd do the treatment. I was working with a Pap smear program that they're just starting, and I'd have to set up my Pap smear table.

[46:50] I'd have to set up the whole thing and then do the Pap smears myself. And so that floating doctors and anybody interested in doing.

[47:01] It's a good organization. And it's, you know, the international community that you work with and the people that you work with, the patients that you work with, who are. It was very.

[47:13] It was very satisfying and a good thing. I'm going to work with them.

[47:20] They just started a traditional midwife training program that it was funded by Rotary Club.

[47:29] And they just started doing pap smears, which had never been done in the life of these folks. And so I'm working with them on that.

[47:40] I don't know if I want to go back and do all that heavy labor stuff, because I sort of decided that.

[47:47] And then on the compound, you had to sleep under mosquito net with the fan and cold showers.

[47:54] So, yeah, I think I'm done with that aspect of it and would like to start. The other thing that I did was I wanted to. I went to this community called Boquete and I wanted to see whether it.

[48:05] Since I was born there. My passport, my Panamanian passport is in the works. And so I wanted to. Is this going to be a place that I want to move to and retire to?

[48:17] I'm still pondering it and I may go back for another month or two and look at it more closely from that aspect of it.

[48:25] And then I'm working with Floating Doctors and being their informal consultant on this pap smear in this called Monchichi, a mother and child program.

[48:36] And because like I said, nine out of ten of the ladies that I saw would be delivered by a midwife. Oh, yeah, my grandmother's my traditional midwife. She's going to deliver me.

[48:50] And one of the other ladies, she was 42 years old, she was pregnant and she had had 11 kids. And I said, who's going to deliver you? She said, well, my husband and I have delivered all of the kids at home, between the two of us.

[49:05] So there's a one, there's a need that's being fulfilled, but there's other bigger needs from the standpoint of women's health that I'm working on and what I'm going to do with it, I'm not sure where it's going to lead, but I'm just step by step.

[49:23] Michelle: I love it. I love it. And must have been so cool to kind of go back home in a sense to Panama where you were born and be involved in those communities.

[49:35] And what a different model, the midwife model.

[49:39] I would imagine they have a shortage of physicians there.

[49:44] Is that true?

[49:46] David: Well, there's a couple things. One, if any of these ladies pregnant and they get in trouble, they have to take a four or five hour boat ride to the local hospital and the local hospital would treat them like crap.

[49:59] You don't speak Spanish even. You don't have insurance. And so there was that issue. And I had a Panamanian Spanish teacher when I was there and she told me about her deliveries and it was terrible.

[50:15] It was terrible. And these folks, don't. They get no respect.

[50:20] And so there was one guy in Guatemala who set up a labor and delivery and he had traditional folks come in there and midwives come in there and do the deliveries.

[50:32] But they had access to all the medical things and it was just overwhelmed with folks. And so these people really don't have any, don't have any choice in how they're going to deliver and what they're going to deliver.

[50:45] And so that's, it's real important that one. We respect these traditional midwives because they've been doing it for years. And an interesting thing I found out when I was reading about it is that they have all these traditional plants that they use, they've been using for generations and pain control and whatever, whatever, whatever.

[51:04] So one, okay, we respect you and you're doing a job that's needed and we're giving them tools that, that they can communicate more readily with a physician. Okay, I have this patient.

[51:17] What do I need to do with them?

[51:19] I would see them, I would see these folks in the clinics and they would come in just who had a portable ultrasound and they would come in, just see whether it was a boy or a girl.

[51:29] And that would be their only visit for the whole pregnancy.

[51:34] So Floating Doctors, folks, you want to do something good in Panama? It's right next to, it's right across the bay from a place called Boca del Toro, which is a touristy, fun community.

[51:49] And it's all beautiful and there's stuff to do there and good folks that you're working with and good folks and you're doing something very, very, very good.

[51:59] Michelle: Yeah, I think those medical missions are so important. And my brother, my late brother Joe, he was an OR nurse, and he went on several missions to Nicaragua and Guatemala.

[52:14] And, you know, he said exactly what you said. It's like they would do surgeries and they would, the village knew they were coming and people would be lined up, you know, just a huge line of people, hundreds of people that had never been seen for anything, never had seen a doctor, never had.

[52:37] Had any medical procedures done, any tests done.

[52:42] And then I interviewed a nurse on this program, too, Paras Barnett. She goes to Kenya several times a year with a, with an organization and the same thing. She's an OR nurse, and they do surgeries on these people that have never seen a doctor.

[53:00] And I just can imagine what a godsend you guys are to those communities. And thank you for, for letting us know about the organization that you go with. And I'll definitely put that in the show notes for anybody that wants to look into that.

[53:18] David: The other part of this is that, you know, it's very, it's very appreciated by the patients, but it's something too, that is. It gives back to you. And I just, I'm not doing this for any other reason than to help you, but I get such a satisfaction out of it.

[53:37] And, and it's a satisfaction in that, it's a satisfaction of the soul. It's not a satisfaction of the ego. Oh, I'm over here helping these people and I paid for my way over and many be dappity, but I know it's a satisfaction of my soul.

[53:57] And one, two. It makes you appreciate what, when we had talked a little bit about this, it makes you appreciate what we have here in the States, but it also makes you treat the person, not the patient.

[54:14] And there you're treating a person, and it's not a disease that I'm treating, and it's not. It's a person. And you bring that back with you. 

[54:29] And you are more sensitive, compassionate.

[54:35] I've gotten out of this as well, and I've grown from it, and I'm appreciative of it and thankful. Thank you for letting me come in and take care of you.

[54:48] It's an honor and I truly appreciate it. So there's many. And then bottom line is you're doing something good for folks that don't have anything. And I think everybody should make that part of their,

[55:03] All medical professionals should make that part of their life is to go someplace and do some medical mission work.

[55:11] Plus, you get to go to another country and it's a vacation. One and two, it's a working vacation.

[55:20] And so you get to experience. You can stay another week and hang out in Panama if you want to, or hang out in Guatemala and just go watch the monkeys or go explore a little bit.

[55:32] So there's so many pluses you can make. You can see that as a tax write off.

[55:37] Michelle: Well, it is a total act of altruism. Right? It's like when I talk to Paras about this, you know, she said there's such this misconception that you're going to go on this medical mission and everything's going to be paid for.

[55:52] And it's like, no, you. You have to pay your way. And, you know, the appreciation that you see in these people is just amazing,  the small things that they are so grateful for.

[56:09] And she said, you get back so much more than you give. And she, like you, highly recommended it to, you know, any medical professional. And I found that to be true when I retired.

[56:25] There's a free clinic here in Tulare county that I volunteer at. And it was a total change for me because I went from the pediatric and neonatal population to adult population.

[56:38] And these adults had chronic illnesses like diabetes and liver disease and hyperlipidemia and cardiac disease. And it was a population that knew really nothing about.

[56:52] So that was a learning curve for me. But just the, the amazing feedback that you get from them and how grateful they are and it just fills your soul in a way that is.

[57:07] It just can't be compared to anything else. Yeah, I highly recommend it.

[57:12] David: Yeah, absolutely. Absolutely. And if, and even, you know, when I was, when mom was in the nursing home, it was, you know, I'd see these patients just. They didn't have any family and they were just sitting in wheelchairs and they just park them in a wheelchair and the thing.

[57:29] And then, okay, it's time to eat. Let's go eat. And then they park them there again. And so I talked to my college that was right next to it, and I said, you need to send students over here just to sit and talk to these patients.

[57:42] They don't need anything more than someone to sit and talk to them and hold their hand. And they were so grateful for that. And it's something that, it's the same thing, helping, helping the underserved.

[57:55] And I think I got that from my dad and I got that from Peace Corps, taking care of these people in Peace Corps that had nothing, absolutely nothing. And so that's what I've done.

[58:07] My career is help the work for the underserved because there's, you know, patients with insurance, there's four doctors lined up behind you to take care of them. And. But these, but the folks that we take care of, there's no one there.

[58:21] No one there. And I, and as you said, I get so much, we get so much back from it. Non monetary just satisfaction and being a good person. Being a good person, yeah.

[58:37] Michelle: That's what it's all about. Being a good person, being a good human and really just diving into your humanity and it's a great thing. That's what I see you doing. And I'm so glad that we got to have this conversation today.

[58:54] Totally long past due, but I'm glad that we got to talk about everything.

[59:01] So thank you, David, for being my guest.

[59:04] David: Thank you for having me. As I said, I'm humbly honored to be on such a wonderful program. This is, it's just me. This is me.

[59:14] Michelle: Yeah, well, I have a couple more questions for you. So I've been asking my guests if there is someone that they recommend guest on this podcast. So I will ask you that same thing.

[59:28] Is there anyone you can recommend as a guest?

[59:31] David: Jennifer.

[59:33] Michelle: She was number three.

[59:35] David: Oh, cool. Good. Yeah. Yeah, right?

[59:40] Michelle: Yeah. And you don't have to tell me now. I know it's on the spot, so you can think about it and tell me later.

[59:46] David: How about Andy Phan?

[59:48] Michelle: Oh, wow. He'd be very good. Yeah.

[59:51] David: Oh my goodness.

[59:51] Michelle: He's a local pediatrician.

[59:53] David: Local pediatrician. But his history out of Vietnam. Oh my goodness. If you've never heard that, it's just incredible. He would be very good.

[01:00:03] Michelle: Okay, I will get in touch with him and tell him he comes very highly recommended by Borge.

[01:00:10] David: Oh my goodness. His story is incredible. It's incredibly inspirational and he's a fine human being and a fine physician, so I would highly recommend him.

[01:00:25] Michelle: I agree with all of the above.

[01:00:28] David: Yeah, I can't think of anybody right now, but I'll keep thinking.

[01:00:33] Michelle: Okay, well, for those folks that are listening that want to get a hold of you, where can they find you?

[01:00:39] David: What do you usually give. How about email?

[01:00:43] Michelle: If you want to share like your Instagram, your email is totally fine. Yeah, whatever.

[01:00:49] David: Email. BORGE1954@gmail.com

[01:00:55] Michelle: Okay. And I'll put that in the show notes again for anybody that wants to contact you.

[01:01:00] David: No, the email would be fine and I'd welcome any questions.

[01:01:06] Michelle: Perfect, perfect. I will add that. Okay, well, we got to the end, which means we're at the last five minutes and we're ready for the five minute snippet. And as we talked about before, the five minute snippet is just five minutes of fun for everybody to get to know.

[01:01:25] David Borge, off duty. So are you ready for the five minute snippet?

[01:01:32] David: Shoot. I don't know what to expect, but shoot.

[01:01:36] Michelle: It makes everybody so nervous.

[01:02:18] Convince me to live in Minnesota.

[01:02:22] David: Next question.

[01:02:25] Minnesota is a beautiful, beautiful state.

[01:02:30] It's a little bit on the red side if you get out of the big cities, but it's beautiful. We had a lake cabin up there. And the different seasons are incredible.

[01:02:42] You learn to deal with hardships in, you know, how shovel snow and how to get out of snow banks. It teaches you about survival, but it also teaches you an appreciation for the seasons.

[01:03:00] And I remember driving down to the lake with mom in the fall and she would just, oh my goodness, look at the trees, how beautiful they are. Oh, and then the thunderstorms.

[01:03:12] Thunderstorms are wonderful. Lightning and rain and it was just beautiful. So it's a beautiful thing. And folks, Midwestern folks are, they're good people. They're good people. And yeah, they're different.

[01:03:27] They're different, but they're good folks. It's worth nothing else. It's worth the visit.

[01:03:33] Michelle: That's fantastic. It sounds like you learned a lot of life lessons living there.

[01:03:40] Michelle: Okay, favorite local Saipan cuisine. Did you have one?

[01:03:46] David: There wasn't.

[01:03:47] The Saipan had restaurants from all over Asia and there was Japanese restaurants run by Japanese folks. Those were my favorites, the local Saipan cuisine. I don't recall that as anything that was really like, oh, my goodness, this is wonderful.

[01:04:08] Because it was mostly fish too, because folks, because that's where they got there, they didn't have to have anything shipped in. So there's a lot of fish.

[01:04:19] But I love the Japanese. Himawari was a favorite restaurant of mine, and that was Japanese, folks, from top to bottom.

[01:04:27] Michelle: Yeah, the fish probably isn't any fresher than over there, so that's cool. Okay, if. If you were stranded on a desert island, what book would you want with you for your reading pleasure?

[01:04:42] David: I would like to have the Four Agreements by Don Miguel Ruiz.

[01:04:50] And I would like to have the.

[01:04:53] The book of Tao, the Buddhist book.

[01:05:01] What other ones?

[01:05:03] That's where I would start with something that talks about life, whether you're on a desert island or whether you're in a busy city and how to deal with it and how to keep going.

[01:05:15] Michelle: I'm going to have to look into those. Those sound very good. They sound right up my alley. So I will look into those.

[01:05:21] David: If you haven't looked at Four Agreements, Don Miguel Ruiz, there's four agreements and then there's five agreements that he wrote. There's Mastery of Self, there's Mastery of Love, which are all wonderful books.

[01:05:33] And I look, I like books that tell me something that is a universal truth. And this is something that I can look into.

[01:05:43] Christianity, and some of the basic truths are there. And then Buddhism. Those are universal truths that cross all lines.

[01:05:53] Okay, next one.

[01:05:55] Michelle: Okay, this is a. Finish the sentence. When I am hiking, I am blank.

[01:06:04] David: When I am hiking, I am forest bathing. I am turning off my brain. And if I start thinking of some stupid thing that's bothering me, I stop, I look at the trees and I look at the animals and just absorb that and turn off my brain.

[01:06:24] It's. Yeah, it's in Japanese. It's called forest bathing. And Norwegians, Scandinavians, the same thing. Get out and just have a existential bath in nature. And when I'm walking sometimes and I'm hearing other folks and they're chit chatting about work or chit chatting, it's like, shut up.

[01:06:45] Just take the trees and look at the beautiful trees and the leaves and look at the birds and look at the ocean and just let go of everything. Let go of everything and just walk and appreciate nature.

[01:07:03] Michelle: Yeah, that's beautiful. And I've heard that the ions are actually different in the forest and they affect you differently. And, man, what a beautiful experience.

[01:07:14] David: They affect you differently. If you got your boundaries up and I'm thinking about work, and then the ions just bounce off you. But if you let them absorb you and relax.

[01:07:27] Heggi. It's called a Norwegian, and that's the same thing. Get out in the forest and just absorb. Absorb that nature.

[01:07:35] Michelle: Okay, this is fill in the blank. I always take_______ with me when I travel.

[01:07:47] David: Clothes. I always take clothes, toiletries, and I try to keep it as simple as possible and always have. What I always take with me, too, is a travel journal. So that I'm writing about some of the stuff that I've done, because I've noticed that in the past that I.

[01:08:04] I didn't use a journal and forgot about certain things. And so travel journal is something. A travel journal and a nice pen.

[01:08:15] Michelle: I love journaling. One of my favorite things. Okay, last question. When I think of my children, I feel_________.

[01:08:25] David: I feel blessed, happy, content, and I feel.

[01:08:31] What would you say I feel?

[01:08:33] How in the hell did they turn out so well? It's like, my goodness, what did I do? And they just. Because they all turned out wonderfully, and they're great, and we have a great relationship and.

[01:08:47] Oh, an interesting thing in the relationship.

[01:08:52] They came and visited my daughter and my son came and visited in Saipan when I was getting ready to leave, and we went on a rather difficult hike. And halfway through the hike, I noticed that Demetrius is behind me, catching me if I fall.

[01:09:07] Sonny's in front of me, giving me a hand if I need hand up. And it's in the past. It was me in back or me in front and running the show.

[01:09:17] And it's like, huh, we got a new relationship going on here. And I kind of like it.

[01:09:23] Michelle: Isn't it just so wonderful? And, man, like you,

[01:09:29] I look at my daughter and I go, how did you come from me? Because you have, like, all the best qualities that I see that. That I don't have or that I.

[01:09:41] That I aspire to have. And so it's just. Yeah, you see it through a different lens, and then you see the relationship changing, and they're doing things for you 

[01:09:54] As their parent that you used to do for them, you know, as your children. It's just. It's really magical, and it's a wonderful place to be in our lives right now.

[01:10:06] David: And it's. And the other thing is letting them do it.

[01:10:11] Okay, you want me to. You want to help me with this or you I'm having a problem. And I will ask them, I said, and this is going on with me, what do you think?

[01:10:19] And talking and talking to them. Sometimes I would look and say, I left, I didn't know them, and I ran into them in the grocery store. Would I like them?

[01:10:29] And the answer is yes. And. And I will, you know, ask for advice on certain stuff where before I was not, I was the advice giver. And now it's, hey, what do you think about this?

[01:10:41] And what do you think about that? And yeah, we're blessed. Blessed. Absolutely blessed.

[01:10:48] Michelle: I agree. And I've been blessed, again, doubly blessed, first by knowing you and then through this conversation, just getting to know you on such a deeper level. So thank you so much for that.

[01:11:01] David: Thank you. Do you get feedback on these things?

[01:11:04] Michelle: Oh, absolutely, yes.

[01:11:06] David: Oh, I'd love to hear some of what people thought.

[01:11:09] Michelle: I will share. I will share with you. Well, thank you so much for taking the time. And have a great rest of your day. David.

[01:11:16] David: And let's stay in touch.

[01:11:19] Michelle: Absolutely.