ES: Tell me about your interest in storytelling.

RG: I was a storyteller long before I ever knew I would be a doctor. My first love was in the performing arts. In the rural town that I grew up in there was a lady who had moved there from New York to teach Shakespeare to kids, so I grew up doing full length Shakespeare plays from the time I was twelve until I graduated high school. I was acting, doing stage management, getting interested in the etymology and culture behind these stories. It really got me tuned into how much stories shape our lives – the way that we think about ourselves, who we think we can be, whether those are limiting or expansive. Stories are the lens through which I understand most of human relationships. That was really my passion.

ES: What kind of work did you do in the performing arts?

RG: I lived in Turkey for a short time doing improv and I noticed we hit these moments in our stories where we have our own barriers about something – but if you’re able to push past it, art happens. Then I was in Belarus for a time working with a performing arts company, Belarus Free Theatre, which is an underground theater. All art in that country is state-sanctioned only, so they were doing something illegal and it was an exploration of what it means to tell stories that the government says you can’t tell. And then performing and being in plays in community theater, though never in a professional fancy way. After a few years a friend asked me, “Would you like a job that pays you?” and I said, “Yes, that would actually be really nice.”

ES: What happened next?

RG: I started doing consulting and I saw the same thing. The way an organization works is based on the story of its mission, its idea of what it's doing and who it serves. After a few years of contract-based state projects, I started my own company working with creative entrepreneurs before getting interested in healthcare. Then I spent the second half of my fifteen year career as a consultant working in healthcare with a strong interest in palliative care. And I found the same thing in medicine – the story of what is medicine? Who do we give it to and under what circumstances? What is it to give care to somebody? Is it a pill? Is it a relationship? Is it a new perspective on their own life? There's so many sides to this. I started to see medicine as a vehicle for helping people, a way to hold that door open for someone to retell that story for themselves. That’s how I ended up doing a post bacc and then doing med school and now being in residency in family medicine, with the hope of doing a fellowship in palliative care.

EG: Tell me about the Sierra Family Health Center. I love the word “Sierra.” Such a beautiful word. When I hear it I obviously imagine mountains. But tell me about that place and community.

RG: The Sierra Family Health Center is an FQHC. It was started by the physician who's still the CMO, Dr. Peter Van Houten. He came to the area because he'd been at UCSF and then in Stockton, and was looking for a different experience. He was up in the Nevada County, northern Yuba County area, and fell in love with it, and saw that there was literally no health care available, like at all. So he put a sign on a shed and started a clinic in a way that you basically can't do anymore. 

That practice has now been around for over 40 years. It expanded to include integrated care: warm handoffs in the office between medical and behavioral and mental health and dental and chiropractic and acupuncture. It's a very integrated clinic. But like for many rural FQHCs, it’s been a challenging few years. We're in the process of joining with another network of FQHCs in the area called Western Sierra. The aim is to be able to continue to provide care in these underserved areas through the FQHC model. So it's going through a big transition. That was one of the things that got me interested in this opportunity – the story of this clinic is changing right now. It’s a chance to invite Dr. Peter and help him process the work that he's done and what it means to move forward in this way that's so different from what he imagined. 

I became involved with the clinic – this October it will be ten years of being on the board. It's been incredible. I was there as we went through the application to become an FQHC, through C-suite level changes, and now through this transition of providing care as a different organization and navigating that process. It's given me respect for the challenges of primary care in our current medical system. That story is an interesting one too. There's so much consolidation of medicine into big structures – but medicine is in the community, in these capillary beds. These places that are rural outposts, for even that little bit of exchange. I've been really fortunate to get an intimate view of that over the last ten years.

ES: Tell me about the area.

RG: My dad used to like to say you know you're entering the area because it's where the oaks begin. You're entering the Sierra foothills. You're up in the kind of territory where it's going to snow a couple of times during the winter. There's a lot of exposure with wildfires now. Northern Yuba County has a handful of towns that are anywhere from one to 4,000 people and that are tight knit and incredibly diverse for how small they are. Some of the bigger cities in the area like Nevada City and Grass Valley are well known. That’s “going to town.”

ES: I actually went to Nevada city for a conference once.

RG: Was it the Mettle conference?

ES: Yes! I had never been there before and was so charmed by the town. I felt like I was on a movie set.

RG: Totally. Clint Eastwood is here somewhere! 

ES: It was at the Nevada Theater, which you proposed for the event, and which is an absolutely incredible theater.  

RG: Yeah, I'm excited. We’re talking about dates.

ES: Speaking of your event, maybe you can say a couple words about it. What do you imagine? What’s your vision?

RG: I see this as a performing arts event, primarily – not coming to hear doctors talk. I envision people coming in, there'll be wine and good local food. There will be local music. I see people in the community really leading the event. There's an amazing number of small organizations trying to make medicine work here. My plan is to engage with as many of them are interested and a lot of them so far have been interested. People are excited. I mean, there’s a – you got a taste for it when you were here?

ES: Yes, there’s an energy there. I think in Arizona they call it vortexes? But you can feel it in the air. There’s a mysticism or something. 

RG: Absolutely. My best friend is an equine massage therapist that studied geology back in her day. She calls it her theory of “cultural geology.” There's just places where the plates meet. And this is one of those places. The stories belong to the community. This is just the excuse to bring them to the surface.

ES: Anything else you want to share to get people excited about your vision?

RG: These stories are also medicine. The idea behind the event is that there's something healing that can happen that we maybe don't even realize we need. Also, somebody who is going to be a big part of the planning is a woman named Deb Plass, who is the current CEO of Sierra Family. She's a nurse. She used to be in operations for fifteen years at Sierra Nevada Memorial Hospital when it was that and has been practicing in the area for a long time. She's connected to the heart of this community and has been a big advocate already.

ES: Thanks so much for chatting with me. Great to meet you and be working with you.

RG: Thanks for the opportunity.