I was raised in Detroit Michigan. When I was 12 years of age, my father, a tool and die man, reinforced my mechanical education when he dropped me off for my first day of work at Detroit City Airport, where my uncle, Woodfin E. Coche', had established a large, general aviation business, Skylark Flying Service. "One-hundred hour" inspections on aircraft stressed function and reliability of work. Participating in ground school, as a mechanic's assistant, and marketing activities with Cessna, Mooney and Champion Aircraft franchises, instilled in me knowledge of aeronautics and aviation technology combined with customer relations. Involved with all aspects of this multi-faceted business, the activity fed my ever increasing appetite for learning. At age seventeen, I co-managed a business with a garage, gas station and a fleet of Hertz rental cars. This further reinforced the value of preventive maintenance and responsibility attained while dealing with mechanical systems and the public.

Recruited to a Science and Arts curriculum for gifted children in the center of the city, I graduated from Cass Technical High School in 1965. There, science was taught with the enthusiasm and fervor brought about by the early space race, precipitated by the launching of Sputnik. The circumstance of teachers wanting to teach enhanced by students wanting to learn prevailed. A focus on the creative process with emphasis on theoretic development was emphasized. Additional reinforcement and review occurred at Wayne State University, where I graduated with a degree in Chemistry.

While in college, I obtained a job at Hutzel Hospital, a Wayne State Medical School teaching hospital, as a "Therapy Technician." This job consisted of maintaining all the IV's in a 480 bed acute care hospital, doing respiratory therapy, and participating in the resuscitation team. It was there that I came to love acute care. Accepted into The University of Michigan Medical School in 1969, I graduated third in my class on the second part of the National Boards, scoring in the 98th percentile. My first and third parts scores were 95th and 99th percentile, respectively.

Chemistry was chosen as my major in a conscious effort to find a middle ground between physics and biology. The resultant synthesis of the three allowed me to better understand scientific knowledge applicable to the foundations of life. My decision has proven invaluable in developing a better approach to healing. Upon initial presentation, basic science and its revelations pertinent to medicine can be as foreign to practicing clinicians as ethnic medicine, and often more difficult to convey. The historic pattern is for many years to pass before a new insight is recognized as truth. The present age of communication, coupled with an increase in average education and understanding, is reducing the time involved in dissemination. Much effort still remains necessary to overcome political and economic inertia.

Eclectic in my approach to medicine, I've established several hospital programs now operating in different fields: Emergency Medicine, Drug and Alcohol Rehabilitation, Wound Recovery and Family Medicine. Thermodynamics in medicine, an overview to which I subscribe as a guiding principle, has been integral to every clinical decision I have made since 1975. In 1978, at Oil City Hospital, Oil City, Pennsylvania, I treated my patient for congestive heart failure with beta blockers, the results of which were predictable using this theoretic framework. The concept also applied to and predicted our recent revelations regarding anti-inflammatory medicaments.

The first law of thermodynamics is one that applies to our human body as a thermodynamic system. The body, like an internal combustion engine, is subject to the development of "entropy," or wear and tear. Excess kinetic energy not expended for effective work becomes disorder, or wear and tear. This excess energy, a given part of the stress reaction, is especially destructive in the face of delayed repair. Repair, when defined in cellular terms, is equivalent to normal inflammation. The energy required for this activity is less available during the day and more available at night, a reflection of the circadian rhythm. The adrenal gland is a transducer, shifting energy from the body to the repair systems. The "fight or flight" reaction provides energy to the soma for short term survival, sacrificing energy to the repair side. Following resolution of the conflict, energy should return to the repair, or microscopic, anti-entropy, "negentropic," system. Persistent elevation of energy due to stress results in more energy converted to damage, and less devoted to repair. Persistence of this state accelerates degeneration and aging.

The sleep we enjoy at night is a "pit stop" in our race to survive. A refined understanding of energy distribution and stewardship is essential to an understanding of the healing process. Stewardship of the energy within the body is the seminal, scientific concept leading to Total Health's Vision. My going to the altar at age twelve, and returning to the fold at age 28, also provided me a quiet "helper" with an increasing influence on my path.

The maturing of the American experience includes recognition that our country has finite resources. With the development of the international marketplace and the free trade agreements, we need to be economically competitive with other countries. We cannot achieve this if our populace is not healthy, and our medicine too expensive. The impact of healthcare costs on GM and Ford reflect this.

Move with us to a balanced approach that makes sense. Let's use those gifts that God has given us to maintain His temple and allow our bodies to flourish. We also need to be thankful for the technology that is available and the people gifted in its use. Help us to be guided in the selection of those interventions that are least risky yet most beneficial. Let us, also, be at peace and have faith when more aggressive interventions are needed, prioritized, and applied if those with less risk have failed.