Episode Transcript
[00:00:00] When I was a kid, I remember I saw the movie the Godfather. And maybe I can elaborate on it, but I remember Michael Corleone telling his father when he said, I didn't want this for you. I wanted you to be a governor or a doctor or something like that. And he said, maybe, Grandpa, we're going to get there, Pa. We're going to get there.
[00:00:20] So that led me to believe that I wasn't going to wait another generation to get there.
[00:00:26] So when I got out of the.
[00:00:29] Of the movie and I stepped out, I thought to myself, well, you know, there's not going to be another generation.
[00:00:37] Welcome to skin deep. I'm Dr. Anna Chacon, and today we have a very special guest joining us. Get ready for some expert insights you won't want to miss.
[00:00:48] I am Dr. Arsenio Chacon. I practiced medicine in mostly Miami during the last 30 years and currently retire. I grew up as a kid in Cuba until the age of 13 when I moved to the United States. My life in Cuba was very interesting because I lived in the countryside. The stories that I can tell you from Cuba are the typical stories of a child in the country of animals.
[00:01:16] We had no cars. We had horses. So we move with the horses. And in my house, we had basically the basic necessities of life.
[00:01:27] And they were there, available to us like coffee from the coffee trees, cane from the sugar canes that we had in the backyard, milk from the cows that we had.
[00:01:41] And we consumed most of the products created by.
[00:01:47] By my parents.
[00:01:49] So it was a very agrarian type of life.
[00:01:54] And subsequently, when we moved to Miami, it was totally different. But we were looking for liberty. We were not looking for other things in life.
[00:02:05] But in Miami, we really enjoy the freedom of the United States, the opportunities that this country gives you, which was a little bit different from where I came from. The biggest difference was the language. Obviously, I had no knowledge of English when I came.
[00:02:24] I was good at math, so that helped me a lot in school.
[00:02:29] And learning the language was pretty hard, I must admit. I'm not good at languages. I'm very good at math and numbers and in language. It was very challenging, to say the least.
[00:02:45] But once you set up a goal to overcome that, you usually achieve whatever goals you have in life. We used to watch tv. Baseball was very important for me as a kid. I watched a lot of baseballs, and I remember all the World Series during that time.
[00:03:04] Subsequently, I don't watch baseball anymore. But back then it was baseball, football. But the Miami Dolphins were champions in 1972. So I had to. I enjoyed that season with Don Shula and whatever, and I learned a lot of English with Don Shula, who was a great coach and spoke English in a very nice way compared to the. The coach that we have now that only speaks English and really doesn't look like he speaks English. So back then with Don Shula and programs like Gomer Pyle and things like that, I learned to communicate, basically. And then at school, I went to public schools here in Miami. My family came from Cuba to the United States via Mexico. There were no direct flights back then from Cuba, so we migrated to Mexico. And after we stayed there for about three months, we were accepted as political refugees. It was basically, we applied for a visa as a political refugee. My father spent some time in jail in Cuba due to political abuse, and for that reason, the United States gave us the status of refugees. He had land and he had a hotel, and it was confiscated. And obviously, when the government takes your possessions, most people don't like it. And he was not the exception.
[00:04:41] So he was really upset about that. And then he started conspiring against the revolution and Castro, and they put him in jail. He spent a few years in jail.
[00:04:51] And I grew up with my mother, basically.
[00:04:55] He was not too talkative. He basically was planning, donating money, arms, and things like that against the revolution, basically. He was a very hardworking mother and very smart, and sorry for me, but growing up with my mother, she was very intense, hard worker, and we helped her a lot with the chores, and she was very concerned about my education and not only that, how I was going to survive the system, basically. And she didn't want me to be part of the system.
[00:05:48] So we decided to come to the United States for that reason. The hard work that she did influenced me into what I grew up and what I became influenced them in hard work. My daughter is very hard worker, and I motivated her to be a decent person, basically, a.
[00:06:13] A very hard worker. You know, honesty to me is very important and to make sure that everything that we do, we do it in a very honest way. You can have other adjectives in your life, but the most important thing is to be honest. And I think as a doctor, I always was honest with the patients, telling them what they had and what were the expectations of the disease.
[00:06:49] And if we actually made a mistake dealing with treating the patient, now they have a rule that you're supposed to tell them. But even before they had that rule, I used to tell them, and I think the parents appreciated that. It depends on the field in some fields, for example, pediatrics, the majority of pediatricians in the United States come from minority background, in my opinion. But dermatology is very difficult. It's a very difficult field.
[00:07:22] I had no connections to how a doctor gets into a training program in dermatology because most of the cases and people that I saw were involved in becoming pediatricians. And sometimes I encourage them to do some rotations with me and the kids of my friends, doctor friends, send them to the hospital so they could learn a little bit of critical care pediatrics with me. But I had no idea how to approach the situation with dermatology. It's a totally different field. It's not a hospital based field. It's more mostly a clinic. And I had no way of helping her out.
[00:08:09] That was, I think, the main reason we wanted her to choose something where I could help her.
[00:08:16] And besides, she could inherit or take over my practice. Totally different pediatrics. I did critical care pediatrics, which is very intense. It's called intensive care pediatrics. For that reason you're dealing with life and death.
[00:08:31] I can give you two or three examples of problems that I dealt with frequently, which in Miami is near drowning sepsis, where the child is sick and infected with something.
[00:08:45] So the blood pressure is all over the area, but usually low. You gotta give medications that we call pressors to raise the blood pressure.
[00:08:55] And those medications, you usually give it intravenously. You cannot give a presser through a cream. And basically dermatologists, mostly creams, but they do biopsies and stuff. But it's mostly applying different type of creams, different type of ointments.
[00:09:11] And in critical care pediatrics, we don't put a cream, we put IV fluids, IV antibiotics. IV is intravenous, by the way, antibiotics. So it's totally different. It's medicine, but it's totally different.
[00:09:25] I feel very proud. I feel very proud when she takes challenging cases. And sometimes she tells me about some of the cases and how she's dealing with different skin tumors so that she removed the tumor or she drained an abscess.
[00:09:44] And as parents, we feel, and I personally feel very proud that she can do this. She did a year of surgery, so she's very good at doing surgical things.
[00:09:56] As a dermatologist, I think it helps her to do the urosurgery. And I actually encourage her to do surgery instead of internal medicine, where you just see patients. You don't do things with your hands. So with surgery you do a lot of things with your hands. And she is very good at That a piece of advice in the next stage is to be good as a doctor, be honest with the patients, but also enjoy life in a different way.
[00:10:27] Do things that are not related to medicine. I had a saying when I was a critical care doctor that the patient is the one with the disease, which means that you take care of the patient, but you don't bring the patient home. And that includes not bringing the patient home or they.
[00:10:46] Economical situations of dealing with the patients. Sometimes the patients don't pay for whatever reason, or they give you a check that has no.
[00:10:56] The check bounces, things like that.
[00:10:59] Well, the things that you don't do at home is that you don't come and tell. When I used to work, I never show up and told my wife that the patient gave me a false check or the check bounce or whatever. I completely eliminated that from my conversations at home. And I tried to basically having dinner with my wife and my kids, not mentioning all these issues related to patients that were dying or difficult situations with the parents or difficult situations at the hospital.
[00:11:38] I tried to. I kept the hospital situation away from the house situation and vice versa. Basically the house situation away from the hospital.
[00:11:48] And I think he helped me. I used to go to the hospital in the morning if I had issues in the house, never spoke about it. And if I had issues in the hospital and came for dinner, never spoke about the issues in the hospital.
[00:12:02] That is basically my best advice, not only to Ana, but to every doctor in the world that wants to enjoy life a little and have a basically sane life. Very much I enjoy getting up in the morning and going to the hospital, seeing the patients, chatting with the nurses, Even walking around the hospital was a pleasure. I mean, I think I was born to be a doctor and it's hard to suddenly stop doing what you're doing. But in my career compared to hers, you have a limit. You have a time limit, like neurosurgery, critical care. You got to do procedures. You cannot be too old for that. You got to be young, vigorous and have good eyesight. Good.
[00:12:52] And time catches up to you. So it gets to the point where you lose a little bit of those abilities. Now if you do, for example, dermatology, you can practice till the age of 80 if you're healthy. So it prolongs your practice in time, depending on the career.
[00:13:13] But if you are a orthopedic surgeon, you're not going to go to an orthopedic surgeon who's 75 years old. Most likely you would like to see a 50 year old orthopedic surgeon. So as a patient, the patients, you.
[00:13:28] If you have a skin problem, you will not mind getting an 80 year old to check your skin as long as she or he can see.
[00:13:35] But if you go to an 80 year old critical care pediatric doctor, you're going to have questions, is he going to be able to save my kid? Things like that.
[00:13:44] So the time, the age makes a difference in the career, I think.
[00:13:50] And there was a time where I felt that I was ready to retire and basically sold the practice to younger generation of doctors that can probably have the energy to continue doing what I was doing. I think maybe the late teens, I decided to think about what to do with my life. And I felt that medicine was something that I could do. I don't recall having a defining moment where I decided to become a doctor. I think becoming a doctor is a process, and in my case it was a gradual process where I decided to study and prepare myself for, for the career. I think as a, as. As a Cuban in Miami, as an immigrant, one of the things that not only my mother, but other Cuban mothers inculcated in us was that we could do whatever we wanted to do. Not to think that we were gonna be discriminated against or that just because we came to this country at 13 years old, I wasn't gonna be able to do what I wanted to do.
[00:15:05] And when I was a kid, I remember I saw the movie the Godfather, and maybe I can elaborate on it, but I remember Michael Corleone telling his father, well, he said, I didn't want this for you. I wanted you to be a governor or a doctor or something like that. And he said, maybe, grandpa, we're gonna get there, Pa, we're gonna get there.
[00:15:27] So that led me to believe that I wasn't gonna wait another generation to get there.
[00:15:33] So when I got out of the movie and I stepped out, I thought to myself, well, you know, there's not gonna be an older generation. I'm not gonna be just, you know, a plumber or something like that, which there's nothing wrong about being a plumber. But I did not want to be a plumber. I want to be a doctor. And I want to skip that generation. That was, in a way, a classical way in the United States. You come here, you do some manual labor, and then your kid becomes a doctor. And maybe the other kid, your grandchild, becomes a governor or a senator or something like that.
[00:16:13] And I felt that in my situation, I was gonna at least shorten that with one generation. The Competition, you get to meet a lot of people, a lot of people. That the challenge in medical school is basically that you are competing against very smart kids and they force you to be better than what you think you are.
[00:16:38] But I think in medicine, like anything else, if you put the hours and you put the effort, you can overcome a lot of things. And you don't need to be a genius to become a doctor or anything else in this world. All you need to do is put the work, put the time, put the effort, and you're going to achieve that. Of course, you can achieve that also in business and in law or in accounting, in any profession that you would like, or acting. As long as you put the effort, put the time, time and effort, you can achieve a lot. The way I started the career was initially doing what we called residency in pediatrics. And I did three years at Cook county in Chicago. It's a big hospital, one of the biggest hospitals in the United States. So I did the three years and I remember that at the end I wanted to do critical care pediatrics or emergency room pediatrics.
[00:17:36] Both of them are hospital based. In other words, you work in the hospital.
[00:17:42] There was an Indian doctor, Dr. Janakiraman, who called him Dr. J.
[00:17:49] And he was the head of critical care pediatrics there. So I was good at procedures. I was always good at doing stuff.
[00:17:56] And when you rotate, everybody rotates through different areas of the hospital. I rotated through the critical care unit and he liked what I did. So he called me and offered me the fellowship. The fellowship back then was two years, and I accepted the offer and did the two years of critical care pediatrics. And after I finished the two years, there were not that many doctors without training in the United States in 1989.
[00:18:26] So I had a lot of offers to work in different places, including Illinois, Southern United States. I had a lot of opportunities, but I decided to move to South Florida because my parents live here. So I started working in Broward County Plantation General Joe Dimayo Hospital, before it was called yo de Mayo, and in Boca West Boca Medical Center. I don't even know. I think they changed the name.
[00:18:55] And then we acquired Baptist Hospital here in Miami. Our group and I decided to stay mostly in the Baptist area, which is Miami Dade.
[00:19:07] And my other partners will cover the north side of Miami Dade and Broward and part of Palm Beach County.
[00:19:16] And we had Andrew, which was a big hurricane that in 1992, I think. I believe it was in 1992. And the traffic was unbearable after Andrew and moving from one county to Another was very hard. So we decided to separate and I kept the south part of our practice and they kept the other part.
[00:19:43] So I worked mostly at Baptist for 30 years.
[00:19:48] And it was intense in the sense that we had a lot of patients and the career was new. Back then a good pediatrician used to handle the critical patients.
[00:20:03] So after I moved, to date, most of the pediatricians will call me to handle the critical care cases. Instead of coming from the clinic and seeing a critical care patient and then going back to the clinic, it was not appropriate to do that.
[00:20:22] That's the way medicine evolved into this other fields.
[00:20:28] We had different areas in the hospital. We have a critical care unit and then what we call a step down when they get a little bit better and then the regular floor. So I used to handle the three departments and I was the head of a critical care unit, the head of the floor.
[00:20:44] And that's the way I did it for many, many years. The kids were in school.
[00:20:52] My wife was very good at also dealing with the family and managing the transporting the kids, although I used to go and pick them up every once in a while.
[00:21:02] And that was mostly the way my life evolved during those years. They were good kids, studying hard and I basically had no main issues. The economy was good too. As a critical care doctors, you don't do as good as a dermatologist, but I did well. It was private practice and that meant that you build every patient and whether they pay or not.
[00:21:31] Because the way the system works is that these are emergencies.
[00:21:37] So all the insurance companies have to pay if it is an emergency. But if we saw a self pay, we did it for free. We also did a lot of cases at Honorum, from Haiti, the Dominican Republic.
[00:21:53] And I also did close to 10 days to two weeks a year of social service in the Dominican Republic, near the Haiti border, where I used to go and see patients for free for about 10 days. And it was very helpful to do that too. For my soul, the most proudest moment in the career was taking care of a very sick patient that everybody was saying that he was going to die and eventually we saved him.
[00:22:26] So I think that that was one of the proudest moments. But I had multiple cases like that. But I remember one that was very particular.
[00:22:35] The work that I did impacted Anna in the sense that she was around, she saw what we did.
[00:22:41] When I used to go to the Dominican Republic, I took my son, not Anna, there because he wanted to become an engineer. So they were building a bridge at the same time that I was seeing Patients in the clinic.
[00:22:53] But she heard about it. She used to listen to those conversations when we came back.
[00:22:59] And I believe I took my wife in two or three of those occasions, so she will tell them about it.
[00:23:07] So I think that that type of work impacted Ana in traveling.
[00:23:15] We also took her to many places in Latin America. We took her to Costa Rica so she could see the jungles in Costa Rica. So she enjoyed her childhood with us during our travels through the world. It was a busy time. I was doing the training, and I had to juggle the situation of going to the hospital and taking care of things with the family.
[00:23:44] And back then, we had no paternity leave like we have now.
[00:23:49] That I think they give you three, four weeks of paternity leave, they gave you maternity leave, and that was it. I felt that I had to go to the hospital. So I had to juggle the situation, go to the hospital, come back and see Anna. And I believe she was. The following day after the delivery, I went to the hospital, and they said, oh, she can stay another day. I said, no, I'm taking her home.
[00:24:12] So I took them home.
[00:24:14] They should work hard as doctors. The hope that I can give them is work hard, but don't forget about the family, basically, and keep on trucking. I want to share a memory that I was in a horse, and that basically we both felt the horse fell on top of me, and then the head of the horse was pinned, and my mother wanted to push the horse, and the workers were saying, no, we will break his neck. And my mother said, just push.
[00:24:50] And they pushed, and I came out okay. Was the horse okay? The horse was okay, too. The way I look at it in medicine is that you don't have to kill anybody. You can basically try to save everybody and you don't give up. This is what I basically told my co workers and the other doctors, never to give up.
[00:25:16] And believe it or not, as a doctor, sometimes the nurses want you to give up. And we said no. And there are very few cases.
[00:25:26] Most of the cases, the nurses were right. The patient was going to die. But I can tell you that two or three of those. Those cases, the patients survive.
[00:25:35] So you got to get a doctor that doesn't give up. And it's hard because sometimes the hospital wants you to give up, the nurses want you to give up. Consultants don't even want to see the patients because everybody thinks the patient is going to die.
[00:25:49] And if you get that feeling that the patient has a chance, you save them. And sometimes they survive. Critical Care is expensive.
[00:25:58] And if they feel that the best way is to make them hospice, which is economically feasible for the system, you know, the insurance companies love it. Medicare loves it too.
[00:26:13] Everybody says, you know, just give up. They send you a hospice doctor, they put you on morphine, and the things change. From being aggressive with the patient to just be on morphine drip until you die. There is room for that. Don't get me wrong. There is room where you have no other option. For example, a bad cancer, you have metastasis all over the place and there's no hope. But sometimes there is hope. And it depends on how the doctor feels about it. And it depends on how you perceive the situation. Sometimes you get that feeling that you can do something and you do it irrespective of what everybody else thinks.
[00:26:57] And that's the most important characteristic that a doctor should have, in my opinion, besides being honest, is that if he has that gut feeling that he can do something, he should do it no matter what the hospital, no matter what the other consultants are telling you, no matter what the parents are telling you or the family's telling you.
[00:27:21] Because there are so many variables into what you do. For example, let's say in adult critical care, the family may want actually the patient to die because they may inherit something, believe it or not.
[00:27:36] The insurance company may want the patient to die so they don't pay more. The hospital may want the patient to die because, and it's hard to say it, but maybe the truth, because they want another bed, they want that bed. You know, they think we're just wasting our time and it's futile.
[00:27:52] But if you don't feel like that patient, the time is there for that patient to die, don't do it irrespective of what everybody else tells you.
[00:28:02] So you gotta have the guts to say no when everybody wants you to say yes, and vice versa. You gotta have the fortitude to say yes when everybody wants you to say no. And I think that that is very important as a doctor. You cannot just be rubber stamping everything that they tell you. And medicine is getting to the point where most doctors can make a good living just doing what they are expected to do without rocking the boat, without making major decisions. And you can just go around doing the basic stuff. And I think most unfortunately, most doctors and in every profession, I believe that that is the way they approach the situation. I was never like that. I always felt that I had to make the decision based on what I believe and not made the decision based on what others believe. That that was the case. And in a way it helped me. I think that most people in the hospital trusted me and they respected me because I was not pushed around by anybody without being aggressive or without being disrespectful. But you have to set limits and set boundaries with the family, the nurses, and make sure that they understand that you are not going to be doing stuff just because they want you to do it. They picked me up with.
[00:29:36] I don't know if you noticed, but whenever you have a passport, it says where you were born. Not only if the passport could say you're an American citizen, but if it says that you were born in Cuba or Afghanistan, something like that. So my passport said that I was born in Cuba. And back then, and I think it was 1976 or something like that, or 77, there were Cubans that were involved in guerrilla or supporting the Marxists in Guatemala. And I had a beard and I was young and they felt that I was. They had a feeling that I was involved in something like that. So they put me. They detained me, Interpol detained me.
[00:30:23] But I used to live in the Opus dei, which is a Catholic organization. And they immediately found out that I was detained. And it took them three days to get me out. But they eventually got me out of the detention center and they had me with another Cuban that they picked up that was in a similar situation, and the daughter of a US Ambassador that they caught her with a truck full of marijuana. So the three of us were together there.
[00:30:54] Obviously, I didn't eat for the three days. I didn't want to go to the bathroom. It was pretty, pretty nasty.
[00:31:00] So all the food that the priest will send me, I used to give it to the girl with the marijuana issues.
[00:31:10] They picked us up and I left her there. And we felt bad about her, but I think that eventually that she was going to get deported back to the United States.
[00:31:20] But that was an experience. I'd never been in jail in my lifetime, but that was.
[00:31:27] That experience taught me that sometimes you don't have to do something wrong to go to jail. Because I did nothing wrong. It just happened that I was. So I think the Cuban background has affected me throughout my life because they either think that if you go to other countries that I'm a communist, or if you're in this country, that you're a radical right winger.
[00:31:50] And that may not be the case.
[00:31:53] So what I do nowadays is that if I go out and I'm in Spain and they ask me where I am from, I try not to tell them that I'm Cuban, I'd rather say I'm Puerto Rican, and we look Puerto Ricans, say I'm Puerto Rican and we leave it alone. The taxi driver doesn't ask too much about Puerto Rico. But if you say you're Cuban, then they start talking and they start mentioning stuff, and it's more convenient to say Dominican or Puerto Rican. Sometimes I say Dominican or Puerto Rican, but try not to say that I'm Cuban and keep it to a minimum. Basically the same thing. In the hospital, I never really spoke about the fact that I was Cuban unless they ask.
[00:32:34] So you don't need to explain to the family where you're from or whatever. All they care is that you save the kid.
[00:32:42] So I think it helps not to get too involved with going back to medicine with.
[00:32:50] With a patient in a social way. Basically, what you do is you keep it to a minimum. And my saying the patient is the one with the disease is real. Because sometimes when a patient has many, many issues in the family, and you have to talk to the family, you have to talk to everybody involved, it gets to the point that sometimes they even blame you for their problem.
[00:33:18] So it's better to keep it in a very professional way.
[00:33:22] Be nice, be friendly, but keep things, you know, separate your life from the life of the patient and the family.
[00:33:33] And it's hard, but you can achieve that. My mother, just to give you an example, my mother had a heart attack, and my partner was out of town, so I was working while my mother was in the hospital with a heart attack. And she died from the heart attack.
[00:33:50] So I had to go to the emergency room and 20 minutes after she passed away to see a patient. And I was able to see the patient without even telling the ER physician that my mother had just passed away.
[00:34:02] So the career is like that. Sometimes you gotta keep on trucking, but you keep your situation or family situation separated from your work. And one thing that I learned from my mother is that she would have loved for me to go to the emergency room and see the patient. That's the way she raised me. So I just did what I had to do. The Opus DEI was a Catholic organization that was founded by Jose Maria Escriva Balaguer, who was a Spanish priest who is now a saint.
[00:34:36] But when I study there, he was not a saint. We used to call it Father Jose Maria de Vanaguer. And the father had a few rules that to create the Opus dei, for example, that a priest had to be a professional first, such as a Doctor, engineer, lawyer, and that you achieve sanctity based on your work.
[00:35:03] So you don't have to spend the whole day praying, you could work. And that was sanctity. Basically, you could become a saint by just doing the everyday chores of life.
[00:35:15] And so we learned that.
[00:35:19] And also the priests, some of them were doctors. I remember Father Chang, Chinese guy who was graduated number one in the university as a doctor.
[00:35:32] He was there for questioning. So if we're studying anatomy or physiology or something like that, if we had a question at 2 in the morning, we could ask Father Chang, because he was always walking the hallways at 2, 3 in the morning. He never slept. So we could ask him about it. He would gladly go over the topics with you. So that was very helpful.
[00:35:55] I think that was something that you would not have if you live in your home.
[00:36:00] And if you had a question about physics, you could always ask a priest that was an engineer and he could help you out with that.
[00:36:09] So that helped me a lot to go through my career. And I remember that in one of the classes that we had, that was pretty hard, biochemistry, we had a priest that gave us tutoring in biochemistry.
[00:36:30] Before the exam, we listened to Father Herbe with the chemistry issues. And then we used to go to the university. And basically it was a little bit unfair because we had the best of the best teaching us all this stuff. So we did pretty well.
[00:36:48] And one of the rules that they had was they had to keep your room super clean. And if you shave, you don't leave any hair in the sink.
[00:37:00] So all those things, really, it was almost like the army, but in Catholic dorms.
[00:37:07] And it was. I think it helped me with the way I behave later on as a doctor, because one of the things in critical care that you need to be good at is be methodical. And the nurses suspecting what you were telling them in a very, I would say, methodological way. In other words, you don't come up with crazy ideas every day, because the nurses will go crazy.
[00:37:38] So if you tell them, you know, a patient comes and the blood pressure is low, they will know what type of persons I wanted even before I asked for them.
[00:37:45] So they just hung up the bottle. The same thing about antibiotics. You don't use too many. You use the ones you like and use them appropriately, put in central lines. They will know about the age, the ones I like the best.
[00:38:02] So I think the opus, they taught me how to deal with things in that way that you have to be very methodical and not come up with new plans. Just like that. So if I had a new idea about what to do with certain cases, I will discuss this a priori with the nurses. So they will be ready in the next case that we were going to be doing something a little bit different.
[00:38:31] In any career, I suppose that is very important. I think if you do accounting and your secretary knows what you do all the time, and who do you call, or your helper knows what your plan is, then things roll over nicely and you can do this in a very smooth way. That's the way I think medicine is, that as long as you do it methodically, you can achieve your goal, which in medicine is to save the patient.
[00:39:00] So save the patient, basically. In critical care and dermatology, I don't think you deal with life and death unless it's a tumor that you missed or something like that.
[00:39:12] I can tell you a story that kind of correlates with what I did compared to what you did. I remember that there was this individual in the hospital. He was an administrator, and he had something in his toe that was not healing.
[00:39:28] And we were in the cafeteria, he took off his shoes and he showed us the toe, and it was dark and brown and looked ugly.
[00:39:37] And a surgeon that was sitting next to me said, I think that looks ugly. I think you need to get a biopsy. He said, but I'm going to this dermatologist who's giving me a cream for the last three months, and it's not getting any better.
[00:39:51] So he actually got out of there, ran. They did a biopsy with another dermatologist, and it turned out to be a melanoma. Unfortunately, he passed away from the melanoma.
[00:40:02] So that is the only situation where I can tell you that we saw a derm situation in a hospital situation because it was one of the unfortunate administrators. And he was a young guy that did not survive.
[00:40:19] Based on the fact that I think that the melanoma was missed.
[00:40:24] My father was in prison first, and then my mother. And the reason my mother got imprisoned was that we had coffee in the farm.
[00:40:33] And the farm was divided in what they call colonies.
[00:40:40] And we kept one colony because it was less than the amount of land that you could keep. Because they passed the law that if the land was large, they took it away. So they left us with a little piece of land, and my mother cultivated the coffee there. But in a communist society, you have to sell it to the government.
[00:41:03] So she wasn't pleased with that because she wanted to sell it in the black market, which you make more money.
[00:41:09] So she Sold some of it in the black market. And they picked her up. They found out, and they put her in jail because of that, for selling her own coffee in the black market.
[00:41:20] So we had to solve the issue.
[00:41:24] And eventually she was released. And once she was released, a few, I think a year or so later, my father was released, and then we moved to Mexico. He had what I call a waiver visa. My parents had a waiver visa, but since he was in jail, he could not leave. So once he was released, we all left. We landed in Mexico, and we had no money. But he had a friend, I think that they went to school together. He became a dentist, and he was working in Mexico City.
[00:41:58] So we located in the same area where this friend of him was.
[00:42:03] And Cubans kept on coming, and they had relatives in the United States. So my father used to go and pick them up at the airport and take them to the border and.
[00:42:15] And then the family will pick them up in Texas.
[00:42:19] So my father was like the first Cuban coyote back then, in the 1960s, 70s, and he was basically helping them get into the United States. Of course, when the Cubans landed in the United States, they were given a refugee status back then.
[00:42:40] So it wasn't like it was illegal because they had a law in the United States where Cubans could just come in and migrate to the United States. We opted not to cross the border because my father was actually making good money with that. So we stayed in Mexico until finally they closed the flights from Cuba to Mexico. So the business was, you know, business doesn't last forever. Nothing lasts forever. So once my father did not have all this Cubans coming in, we decided to come to Miami. But actually, economically, he was doing very well in Mexico City. Well, I left as a kid, but I have many, many relatives that were doctors. As a matter of fact, in the little town called Giza, where I grew up, the first doctor was my cousin Nico.
[00:43:38] And he was a family practitioner. He stayed in Cuba, but he graduated a year before Castro took over. And my uncle sent him to medical school in Havana.
[00:43:54] And the reason he sent him there, my uncle was very wealthy, and he sent him there to become a doctor so he could help the poor people of the city.
[00:44:05] So he graduated, and he basically was the only doctor in town. He did the deliveries of the babies. He did the surgeries, the appendectomy. He did everything until he died. So he was basically a general internal medicine surgery doctor.
[00:44:25] But then a lot of people from my family became doctors, and you met a bunch of them here. In the United States.
[00:44:35] And some of them came to the United States. Some of them stayed there.
[00:44:40] The ones that stayed there, some of them like the system.
[00:44:45] Others stay there basically because they were not allowed to leave.
[00:44:51] Some of them at this particular moment. I have a first cousin who just moved to Guyana. From Cuba to Guyana.
[00:44:58] But some of these doctors do what they call international service, where they go to other countries and they provide services, but they don't get paid directly.
[00:45:10] The Cuban government gets the money and then they give them something like 10% of what they earn and the government keeps the 90% that by definition should be considered slavery. Modern day slavery.
[00:45:28] They confiscate their passport and they give it to them when they go back to Cuba. And some of them, they have a family, so they have to go alone. And then when they come back, they meet the family. Some of them miss their kids. They spent two, three years. I had a cousin who went to Zimbabwe and he had a family and he stayed in Zimbabwe for three years. Tony, my cousin who lives in Tampa.
[00:45:50] So they have gone all over the world. It's a business for the government, in my opinion. And they make money out of that. Of course, a lot of people make money out of doctors.
[00:46:02] You don't have to go to Cuba. In the United States, a lot of people make money out of doctors. We have a company here called Leon, which they're very wealthy and they basically. I don't believe in my opinion, that they pay the doctors what they deserve.
[00:46:17] And some, if you want to see well dressed people with the best cars in the parking lot is the hospital administrator, not the doctor. So they don't go to school, but they make the money. Go figure, right?
[00:46:32] So hey, it's the way it works. Most doctors don't know about business.
[00:46:38] That's another thing. I had no idea how money was made and never care.
[00:46:44] And eventually I did because I saw how they were abusing the system and abusing me.
[00:46:50] So I decided to learn about business.
[00:46:53] And even though I'm a double boarder, I'm boarded in pediatrics and pediatrics, critical care.
[00:46:59] And I never studied formal business.
[00:47:01] I believe that I'm very good at business because I have auto educated myself in business and I ran a practice.
[00:47:11] I had a bunch of doctors working for me, nurse practitioners. So I decided to learn about business and how to run a successful practice. And the reason I did that is because I saw these guys who went to college for three or four years or less than that, became hospital administrators. And then they were telling people like me who went to school for 12 years and then did two or three years of training or maybe five years in my particular situation. And then they were telling us what to do and how to do it. So I figured, you know, this is not fair.
[00:47:50] That's not the way I went to school for, that's not the way I studied medicine for, but it is the reality. So in Cuba, they abuse, in my opinion, they abuse the doctors by sending them to different countries and then paying them very little. But in the United States, they also give you a contract.
[00:48:11] A lot of these young guys just graduated, think that that is money. And they sign the papers three, five years, and then some administrator who just was savvy is keeping half of what they make right, or maybe more.
[00:48:29] So in every profession, especially medicine, I think everybody should know a little bit about business because capitalism is the best system in the world. But it has that flaw that people can abuse the system. And sometimes not the most smart guy, but the most savvy guy makes the money and the smart guy just works like an animal.
[00:48:57] So I think I told you that you're smart enough to realize that and you don't let too many people abuse you because that's the way life is.
[00:49:08] Sometimes people take advantage of hard worker, you know, nerdy type of guy or woman that is just basically dedicated to the patient. You're dedicated to the patient, you're seeing the patient, you work, worry about saving the patient's life, and in the meantime, they're making money out of you. There are different generations. And one of the things that older people like me think that we had it right and that we were correct and the new generation does not get it. And I think that's the opposite. I think the new generation will figure out a way and every new generation has something to contribute.
[00:49:45] So you always have to be positive in life, be positive, because new puppies are coming and they will be able to deal with it.
[00:49:55] So don't worry about your kids, don't worry about your grandkids. Just teach them how to be nice people, honest people, and they will figure out a way to survive. Ana is amazing. She is very hard worker. And I'm surrounded by people that are very intense and hard worker. And sometimes I tell them that my daughter is the hardest working individual. And sometimes I think that they don't believe it. But I do live with her.
[00:50:24] She is such an intense individual. She's always working, she's always figuring out what to do with life. She doesn't watch tv, she's all work.
[00:50:36] And we are very proud of what she has accomplished, and she has a lot of things to do in the future. So I'm very optimistic about Anna and my son, that both of them are going to do well, and sometimes we save to leave them something. But I believe that Anna and my son don't need any of that stuff that we have provided and that they will make it no matter what. And if there's one last dollar hanging around in Miami, I think it will be in the hands of Anna before it disappears, because not because she stole it, but because she worked for.
