If you want to know my story, here it is:

With my followers increasing, I thought I'd let you know what I do, and why.

About me:

I’m an emergency doctor.

I’ve been working in New Zealand for the past 17 years after training in Emergency Medicine at Los Angeles County Hospital. Before that I did a surgical internship, after my medical school years at the University of Chicago, and an undergraduate Biology degree at Johns Hopkins University.

[Because some readers asked; this picture is of a resuscitation bay…it’s not my picture, just an online pic, and it’s not LA County. Though many trauma centres might have looked similar, years ago, after a massive trauma where a patient likely required bilateral thoracostomies (holes in the chest made to let air /blood escape in the case of major chest trauma… or a thoracotomy to expose the heart/lungs in penetrating trauma.]

In medical training I was elected to represent the public doctors of Southern California, and eventually the whole of the United States, when I got elected to the National Executive Board of CIR/SEIU, the union of public hospital doctors. In those days we “won’ the right to not have to work more than 80 hours a week as junior doctors. For me, having worked a some 120 hour weeks in training, it was a big win.

One thing was always improtant to me: providing health care to patients based on their need, and not on their ability to pay. I’d grown up on welfare, raised by my mother, who was an immigrant, and who was widowed when I was six years old. Me being independent and self-sufficient was always a goal of hers, and became a goal of mine from a very young age, when she got a bad head-and-neck cancer. I was around 10 years old, and some of my earliest memories were of spending a summer going with her to radiation therapy treatments. I’m sure those early experiences formed a big part of my character, and made me want to dedicate my time and efforts to caring for people in greatest need, rather than exploiting business loopholes or amassing assets and profits. The world has enough predators and wealth hoarders, and armies of politicians, lawyers & accountants to serve them.

I wanted my work to focus on helping the people in the bottom 90% of the economy. Regular folks just trying to survive.

I came to New Zealand with two toddlers and my wife who is a Obstetrician/Gynaecologist doctor. One kid is now an engineering student, the other a medical student. New Zealand, and specifically Northland, has been a wonderful place to work and raise kids. 17 years ago Whangarei became our home.

We came for 6 months initially, just an OE really, but loved it so much we stayed for the next 17 years and counting. Always in Whangarei, Northland, New Zealand. The patients here are wonderful to take care of, and the work (though not easy) is profoundly worthwhile.

In NZ I ran for, and was elected to, a District Health Board where I tried to make things better for patients. It was hard to make change, if I’m being honest. Governments, and “the system”, is not built to help the poor and the sick.

But if the point of a Government is not to make a society stronger and healthier, what the hell is the point of a Government? Merely to help the rich get richer?

Too many of our laws, and our politicians, and our tax codes and our regulations, have been written to help the very wealthy become extremely wealthy.

While we are taught to hate the poor who are said to be stealing our tax money, it is actually the very wealthy that have rigged the entire system to ensure that taxpayer’s money flows upwards. The assets of the extremely wealthy have been growing by obscene amounts (today’s income equality is approaching that of the 1910’s-1920s, having entirely erased 50 years of middle class growth), while wages and essential public services have stagnated literally for decades. If this continues, the future is bleak for our kids. Combine wealth hoarding and worker exploitation with widespread environmental destruction for profit, and you’ve got a mandate to act. We must do better.

Worldwide there’s squeezing of the middle class—while the mainstream media tells you its the poor, the disabled, and the marginalised, it’s actually the wealthy that have ensured they avoid taxes and accrue assets and wealth, along with tax benefits the working class can only dream of.

In my years in healthcare, I have always worked in underprivileged areas, and always with high-acuity (ie, very sick) patients. I went into emergency medicine to help people facing the worst day of their lives get through it.

My interests are in critical care, trauma, ultrasound (I’m a DDU sonologist with a specialty interest in emergency ultrasound), and pre-hospital and retrieval medicine (I worked part-time as a doctor on board the Westpac Rescue helicopter for a few years).

Because I believe that terminally ill patients shouldn’t be forced to suffer prolonged and needless suffering (when they may want to choose a gentler, peaceful, medically assisted death) I do some work when I have free time as a doctor with NZ Assisted Dying Service. I do very occasionally do volunteer work in international disaster relief with NZ Medical Assistance Team when the need arises.

For 10 years I’ve been medical director of a national rescue agency, helping to educate and supervise the work of selfless, courageous, hardworking volunteers. This work became a great outlet for me years ago, when I realised I could not make the kind of patient-care changes I wanted within the machinery of the DHB. Working to help volunteers in the community, with the ultimate goal of saving lives and keeping people safe, has been an antidote to the frustrations of working within a very large organisation where positive change is very slow to implement. And to put it all of this into some perspective, I write.

My writing started even before medical school, as a way of educating and informing people, and of organising my thoughts and reflections on what is an interesting and challenging job. I cared about it enough to get a Master’s degree in Science Writing from Johns Hopkins University, and to still be writing all these years later. For many years, I had a question-and-answer medical column in New Zealand newspapers, then online, where I responded to people’s medical questions. I love talking about medicine, and explaining things for patients, when I’m able to.

Emergency medicine is my passion and my love. I cannot think of anything better I would rather be doing.

—Dr Gary Payinda, on Substack

https://substack.com/@drgarypayinda