A Conversation with Mike Rabow, MD
The last quarter of the year is filled with lots of big holidays. Is there a holiday or special celebration that you enjoy celebrating the most?
My favorite holiday is Halloween! I love the chance to wear costumes and getting to pass out candy during trick or treating. I love to do multi-person costumes – One year, I went with a few friends as a giant 10-ft tall foam fork, knife, and spoon set and we were celebrating Halloween at the Castro. We couldn’t miss each other in the crowds because we were so tall. Another year, I dressed up with 2 other people and we were H20. We were the hydrogen and oxygen molecules and had slinkies connecting us together to represent the chemical bonds.
Are you a cat or dog person?
I am definitely a dog person, there’s no questions about that! I grew up allergic to cats so never connected with cats as a kid. When my kids were younger, we got a dog named Zambi, and my relationship with her is one of the most important in my life. We got her right before the pandemic and spent a lot of time together taking walks. Her name was inspired by a mini sabbatical where I spent 3 months traveling with my family in Africa and Europe. When we got Zambi and were trying to think of a name for her, my family and I thought about how fun we had on the Zambezi River between Zambia and Zimbabwe, hence the name “Zambi.”. I wanted to name her “Taco,” but I lost that vote.
What's your favorite activity to do with your dog? What other things do you like to do outside of work?
She loves going to the beach without a leash and playing with the water and other dogs.
I also really enjoy taking long walks and hike trails with her around the Bay Area. During Covid, Redwing, Zambi, and I would spend Saturdays walking and exploring the Bay Area. Another favorite activity that I like to do outside of work is macro photography. I particularly like photographing things close up because I believe that if you look at something close enough, you can usually find something beautiful about it.
You've had quite a career in UCSF starting with medical school, and then residency, and you’ve been faculty for over 25 years. Was there an ah-ha moment in your career when you realized that palliative medicine was your calling?
I was a 3rd year resident on call at Moffitt and got a call from the nurse to see a patient late at night. When I went in the room, I saw a man sitting on the side of his bed with his head in his hands and a bottle of Golytely (a laxative given to patients in preparation for colonoscopy) next to his bed. I didn’t know the entirety of his clinical situation at the time other than that he was being evaluated for a potential cancer. I remember walking in the room and had a strong intuition that what mattered most to me was his suffering and experience, even more than the diagnosis, illness, and treatment (though, those are important, too). That was the beginning of my interest in end-of-life care, which later became known as palliative care.
You work a lot on building the mentorship in the DPM. Did you have a mentor or role model who guided you in your career journey?
My main mentor was a general internal medicine doctor named Steve McPhee, a founding member of DGIM. He was an amazing mentor because he supported me in finding opportunities to be part of reviewing papers and joining research groups, but mostly he helped guide my passion to the particular work that I ended up doing. Steve McPhee and I were doing palliative care when HPM wasn’t a field yet, and he really took the time to listen to me and me create a vision for what I wanted to do and guiding me to make that happen.
What do you find most rewarding about your job?
I’m a hero junkie, which means I really enjoy witnessing people in a heroic moment in their lives. We know people would rather not be in an ER or hospital or clinic, and that they are only engaging with us in a healthcare setting because they were forced to by the implications of their illness. To see people respond to that incredible challenge is inspiring. I am inspired by seeing people face their fears, bring their strength and grace to this challenging and often tragic time in their lives.
I heard that you used to fold cranes to remember patients in your care who have passed. Could you tell us a bit more?
It started when I was a resident. Before computers and cell phones, we used to keep our patient’s information on a ring of queue cards. In the mornings when residents would report to the attendings on a patient who passed away overnight, everyone would rip off the patient’s queue card and throw it in the trash. It seemed horrible to me that a person’s name and memory would be treated with such cavalier attention. So, I started keeping the queue cards of the deceased patients and used them to fold paper cranes. It’s important to me to preserve the name and memory of patients in my care.
Folding paper cranes is a Japanese tradition to honor and remember those who had died in Hiroshima and Nagasaki, and it was an honor to see so many paper cranes in memorials during my trip to Japan years ago. I have a bag of my own cranes in the trunk of my car.
You have had such a prominent and successful career so far, founding the SMS and the Mt Zion palliative care consultation services, published in peer reviewed journals, lectured at national conferences, started a wide breadth of educational programs in UCSF, and won major awards in teaching, mentorship, and the Soros Project on Death in America award and the Cunniff-Dixon Physician award. Do you have any career advice to the rest of us in the DPM?
When you’re climbing your ladder of success, make sure the ladder is up against the right wall. There are lots of ways people can succeed according to other people’s criteria, but the real key is doing the things that are important and gratifying to you. Once you know what you want to do, you can use the system, advancement, promotions to accomplish your goals. It’s hard to do the work when it’s not your passion and desire. Each of us as an individual have to figure out our personal mission is so that we can make good decisions about opportunities that come up.
The other element is my belief and practice to be kind. My favorite quote these days is, “Have compassion; everyone is involved in a great battle.” I like this quote because it reminds me that everyone is going through something in their lives and, as a result, may come off across as “difficult” (at work or elsewhere). It is rarely personal.
Can you tell us a bit more about your passion for writing and poetry?
I’ve always liked writing since the 9th grade. Most of the writing I’ve done is journal writing to help process the experiences I’ve had. Writing is how I reflect on those elements of compassion, sorrow, tragedy, community, relationships, hopes, fears, etc.
Do you like to travel?
I do like international travel, but what I’ve been really into lately is jumping into a camper van and driving somewhere without any plans. I’m in the market to buy a camper van in the next few years and hit the road as frequently as possible! I have a retirement vision that I’ll drive with my wife Barb out of the driveway and our first decision for the trip is figuring out if we should turn left or right. My goal is to visit all the national parks in the US in my camper van. The coolest thing about a camper van trip is that I can bring my dog and bring her on all the adventures with me and Barb. She’s always lying there at the front, between the driver’s seat and the passenger seat, ready for petting anytime.