dig this gig

Find Your Dream Job—Or Invent It
By Laura Dodd

CITADEL PRESS

Copyright © 2011 Laura Dodd
All right reserved.
ISBN: 978-0-8065-3245-5

Contents

Prologue...............................................................................................xiiiChapter 1: Healthcare Gigs—Beyond the MD Option..................................................1Chapter 2: Entertainment Gigs—Show Business, 360 Degrees.........................................32Chapter 3: Do-Good Gigs—It's Cool to Do Good.....................................................63Chapter 4: Green Gigs—One Earth, Billions of Footprints..........................................93Chapter 5: News Gigs—All the News That's Fit to ... Print, Televise and Blog.....................122Chapter 6: Government Gigs—In and Around 1600 Pennsylvania Avenue................................149Chapter 7: Derailed Gigs—On Second Thought ......................................................181Chapter 8: Outdoor Office Gigs—Nature's Cubicle..................................................213Acknowledgments........................................................................................247Sources................................................................................................249

Chapter One

Healthcare Gigs Beyond the MD Option

Introduction

Virgil, the classical Roman poet, summed it up succinctly: "The greatest wealth is health."

Our generation "gets it." Health consciousness is nonnegotiable. If you don't have your health, you don't stand much chance of working, much less pursuing a career you love.

But it's not just about fitness—healthcare is a hotbed of job growth, ironically, thanks in large part to our parents. The industry will generate 3.2 million new wage and salary jobs between 2008 and 2018, more than any other industry, mostly in response to the accelerated growth in the aging population, according to the U.S. Bureau of Labor Statistics.

Many of those jobs will be related to caretaking for the elderly—the number of home health aides is estimated to increase by 50 percent and physical therapist assistants by 33 percent, suggests BLS. Familiar titles such as registered nurses ,dental hygienists, and medical assistants are expected to flourish in coming years, too. The surge is across the board: ten of the twenty fastest-growing jobs are healthcare related, according to BLS.

With the movement to prioritize health comes new jobs that are gaining traction, like naturopathic medicine and genetic counseling. Profiled here are four gigs plucked from the plethora of options out there—two with a new twist on traditional jobs and two that explore less traveled (for now) routes.

Chrissie Norton is a nurse for dual-disorder patients in Durham, North Carolina. Her patients suffer from mental illness and substance abuse, and they are often the population most people would prefer to ignore—which is exactly what drew Chrissie to the position. "I wanted to talk with people," she says simply, a modus operandi that some feel contradicts conventional medicine's acute focus on "fixing" the illness, not so much the person.

The job is not without its challenges. "How can I help someone be 'healthy' if they are using drugs every day or if they are living in a different place every time I see them?" she continuously asks herself, having dealt with multiple patients who drift from place to place. Part of the answer, perhaps, is to just keep showing up.

You can't cover healthcare without addressing the business side. Someone, somewhere, whether in a private company or a government-sponsored program, is watching the bottom line. And at the core of the healthcare-as-a-business conundrum is the insurance industry, often painted as coldhearted arbiters intent on making a profit at the expense of the patient.

Brent Smith works as an insurance salesman in New York City. His sales pitch is part of a new school of thought that employers and employees are beginning to warm to—a hybrid model of personal responsibility and employer participation.

Take smoking and obesity, for instance. Studies suggest a healthy employee is a more productive employee. Companies are listening and getting inventive with ways to motivate workers into taking better care of themselves. Employers are offering incentives to their workers to quit smoking and lose weight—anything from cash to gift certificates to reducing an employee's premium, or contributing to a health savings account (Brent will explain a little more about this trend).

The concept is not based on charity—smokers cost an additional $1,850 a year to insure, and obese workers cost private employers $45 billion a year in medical costs and lost productivity, according to the National Business Group on Health.

Speaking of new-age careers in healthcare, here's one that has roots dating back thousands of years: naturopathic medicine. "It's a traditional form of family medicine that emphasizes the prevention of disease and the use of natural, non-toxic therapies," says Dr. Nick Bitz, a twentysomething naturopathic doctor based in Vail, Colorado. In his practice, Nick advocates the use of herbal medicine, nutrition and nutritional supplements, detoxification and hydrotherapy, among other methods, to bring about "optimal health and well-being."

Judging from medical school enrollment numbers, the field is growing in popularity. In 2000,1,908 NDs graduated from U.S.-accredited naturopathic medical schools. Five years later, the figure jumped to 3,265 graduates. Almost a decade later, there are no signs of interest plateauing.

A healthcare profession with much less of a historic foundation, but with all the guns pointed at the value of preventative care, is genetic counseling. Generally defined, genetic counselors help patients through the before, during, and after process of getting a genetic test to forecast health issues. Chrissy Seelaus, a counselor specializing in cancer testing, will elaborate.

The field is exploding. Less than a decade ago, the number of genetic tests available to consumers was in the hundreds; today, more than a thousand tests are available to patients, according to the National Society of Genetic Counselors. And to help walk patients through this unchartered territory are genetic counselors specializing in a range of up-and-coming areas, including prenatal, pediatrics, neurology, and cardiology.

Sidney Wolfe, MD, founder and director of Public Citizen's Health Research Group, a consumer nonprofit advocacy group, and this chapter's mentor, aims to treat healthcare from a large-scale perspective and address systemic problems. "My view is that by improving the public health on a large-multiplying basis, I can have more impact than I would practicing medicine," he says.

On the job he is a tireless, relentless patient advocate. Outside the office, however, he may be slightly less vehement, but no less passionate about whatever he takes on—even for fun. You can't reach him by cell phone (because he doesn't have one), and he tunes out of email when not at work. But give him a hiking trail to trek or put him in front of a grand piano, and he is content.

Chrissie Norton Nurse for Dual Disorder Patients Durham, North Carolina Age: 27

It's the middle of the workweek in Durham, North Carolina, and Chrissie Norton is preparing to attend a funeral. She hasn't been to one since her mother passed away eight years ago, and she's nervous it'll stir up emotions she has struggled to manage.

Technically, Chrissie really shouldn't be going to this memorial service. The deceased woman was her patient. Healthcare industry standards generally frown upon "getting attached," and warn attending could be crossing a boundary.

But what they'd been through in the past year, as nurse and patient, defied boundaries. There's no denying they were an odd team. Sheila, the patient, was a bipolar, alcoholic, heroin-addicted mother of two young children, whom she abandoned years ago. Chrissie, the caregiver, was a free-spirited nursing student, who grew up going to cotillions and was the daughter of adoring, affluent parents.

When they first met, Sheila had recently moved from a tent in the woods into city-subsidized housing. Acclimating to each other was difficult. "She was a very tough patient—bad attitude, stubborn, resisted most treatment," says Chrissie, recalling the time Sheila refused to allow her bed to be moved against the wall to prevent her from injuring herself by falling out in a drunken stupor, as she did frequently.

Breakthroughs were few and far between—the day Sheila agreed to have bed guardrails installed counted as a small victory. Getting her to the dentist to address her rotting teeth was another.

But Sheila was in the depths of her addiction, a place where no one could reach her. Efforts and pleas to stop fell on deaf ears. At fifty years old, she died from multiple organ failure, years of alcohol and drug abuse finally taking their toll.

Chrissie is a nurse for chronic substance abusers and the severely mentally ill. Think incorrigible alcoholics, homeless drifters, and repeat domestic abuse offenders. Think the headaches on society for whom people have a hard time rousing empathy. Think Sheila.

"I know they can be considered a drain on society. I see that when I step away. But they're people and they deserve respect and care," Chrissie says.

Empathy. It's one of Chrissie's great gifts, and occasionally, her Achilles' heel. At twenty and a junior in college, she had her own bout with demons. Mourning her mom's death from cancer brought her to her knees, and she sank into a deep depression. The once gregarious soccer player skipped classes to sit in her room in her pajamas, shades drawn, and drink. Daytime soaps played on repeat, fast-food trash piled up in the corner. Friends were dismissed when they staged an intervention. Chrissie sank deeper.

A year passed like this and slowly Chrissie clawed her way out, aided by a grief-counseling group she started on campus. It was only by talking to people who had experienced a crushing loss, as she had, that made the difference. "We all spoke the same language," she says. "I learned that I wasn't alone, that I wasn't crazy, and that things would not stay like this forever." Only those who have been through it understand: one never completely heals; one merely learns to cope.

Connecting with people is Chrissie's forte, but making a living out of it didn't occur to her. After graduation, she moved to Asheville, North Carolina, and tried the corporate thing, working as a receptionist at a swank hotel. "We had to wear an ascot and follow a stupid script: 'I'd be delighted to upgrade you.' 'I'd be delighted to show you to your room.'"

I'd be delighted to get the hell out of here, she thought to herself. But where to? She counseled herself, "Well, I like biology and science comes pretty easy to me and I like helping people." How about nursing?

After some thought, she packed up her stuff, drove four hours east, and unpacked in Chapel Hill, North Carolina, where she was accepted to graduate school, and could begin her nursing career chapter. One semester into a two-year program and she wanted to kick herself. The assignment on the first day of clinic: give a 350-pound, schizophrenic male a suppository.

"I started dry-heaving." This is what nurses do? She panicked. The mental disorder she could handle; the gory side she could not. Two more years? "I didn't even know if at the end of all this I wanted to be a nurse."

To make matters worse, everyone else seemed, well, delighted to be there. Chipper nursing students lined up for the day's demonstrations: inserting a catheter, changing a wound dressing, taking blood pressure. "I was not your typical nursing student. I was the student who wanted to talk to the person in the hall in restraints for throwing her feces across the room and smearing it into her wounds. The patient who everyone walked by, without a second thought."

Patients like Sheila.

As a last-ditch effort before quitting outright, Chrissie met with a mentorlike professor who explained that there was another side of nursing. "I didn't have to go and be miserable in a hospital," she recalls of the "phew" moment. Nurses, she learned, could do community mental health by incorporating their training in a social work–type position—a combination of counseling and medicine, like checking blood pressure, giving injections, assessing mental status, and providing motivational support.

Her first nursing job was in community mental health on a team that worked with patients suffering from dual disorders. Now her shift begins at an office building where there's no trace of a catheter or colonoscopy bag. Motivational posters tacked to the wall and images of famous people who have battled mental illness—Beethoven, Abe Lincoln, Charles Dickens—serve as "you're not alone" reminders. Chrissie, who earns $22 an hour, and her team—a group of thirteen mental health care providers specializing in psychiatric support and substance abuse counseling—meet each morning at 8:00 a.m. to discuss crisis calls received the night before and update other pending cases.

Afternoons are spent in the field, sometimes literally. Chrissie helped one of her patients move his tent from one part of the woods to another because the area had flooded. "Eighty percent of our work is done in the community. You learn a lot from going into someone's space," she says, whether it is an apartment, a street corner, or a jail cell. "This can be pretty stressful depending on the circumstances. A lot of our clients live in unsafe neighborhoods. Others live among the elements—heat, rain, snow, insects—which can make providing services difficult and somewhat uncomfortable."

There's something to be said about showing up. In person. On the patient's terms. When treating a patient in an office building or a hospital, "it's easy to get upset if he's not taking his medications or has started using drugs again. But when you go to them and see their day-to-day environment, you realize he's living with twelve people in a boarding house and his brother steals his medicine."

The circumstances don't excuse the behavior, but they can help explain it. The more Chrissie knows about the patient, disorders and otherwise, the better nurse she can be. "I cannot have expectations for them. It's their recovery, not mine." When a patient has a setback, the starting point is reset. "We'll pick up where you are right now," she tells patients, because today's progress means nothing tomorrow. "With these patients, so much changes every day. A patient you see today may be stable, but tomorrow he is in the hospital."

Few people can keep up the intensity for long. It's an emotionally draining job, and turnover is high. Even Chrissie may not be immune to the long-term strain. "I don't want to do this forever. It burns you out. There are no immediate rewards from your work."

The rewards may not be immediate, but they are every bit as gratifying. "I've had the opportunity to work with survivors," she says proudly. "My clients are some of the strongest people in the world. They have endured hardship, trauma, prejudice, and pain and keep struggling despite adversity. I have more respect for these individuals than words can express. They are my teachers."

Brent Smith Health Insurance Salesman Brooklyn, New York Age: 25

Rush hour in mid-town Manhattan is not a pleasant scene; in the subway, it's downright grimy. Commuters are cranky, tired, and ready to get home. Nevertheless it's the unsavory setting where Brent Smith chose to stage his heart-healthy intervention, and a metaphorical "ground zero" to begin building his career in healthcare.

"I'll give you one dollar—no strings attached—to take the stairs," he shouts to weary commuters pouring off the subway and mechanically exiting via escalators. "Free money!"

For effect, he waves a bulging wad of dollar bills to entice them to take the aerobic route. The bribe is partially successful: a few takers trickle out of the escalator queue, snatch the bill, and begin the climb.

This is just one quirky scene from an amateur thirty-minute movie called SickCare that Brent produced about people and the unhealthy state of healthcare. The-stairs-versus-escalator vignette is purposely lighthearted, but Brent's underlying message is deadly serious: people should take responsibility and ownership for their health. "Eighty percent of medical costs in the United States today are from preventable illnesses," he says, and he should know: he spends his days poring over the dollars as a salesman for one of the largest U.S. health insurance companies.

Brent is an advocate for a new way of doing business in healthcare insurance. The current system is broken, he argues, and in order to fix it, both the business model and Americans' attitudes need an extreme makeover.

His philosophy is this: "Bad behavior is contagious. If most of your friends are overweight, there's a good chance you are, too. The good news is that healthy habits, such as weight loss and smoking cessation, have also been proven to be contagious. We have to stop the ball rolling any farther before we start pushing it the other way. The goal right now should not be for people to lose weight, but to just stop gaining it."

(Continues...)


Excerpted from dig this gigby Laura Dodd Copyright © 2011 by Laura Dodd. Excerpted by permission of CITADEL PRESS. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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