Dr. Cary Paine is a Clinical Assistant Professor in the Division of Nephrology. He kindly spent a few minutes with us discussing his work, his favorite things and his pet peeves.
Are you from the Seattle area originally, or did you move here?
I grew up in Issaquah, Washington. Last year we moved from our home in Seattle back to Issaquah so I have officially moved back out to the boonies!
Where did you go for your medical training?
I did undergraduate in St Louis and medical school in Chicago. When I finished medical school my wife and I were deciding where we wanted to go for residency, and we knew we wanted to be near family. My family is still in the area so we decided to move here. I did residency and nephrology fellowship at UW, and I was fortunate enough to stay on as faculty.
What is your main area of focus in your work?
I am a full time clinician; taking care of patients with kidney disease is my main role.
I am also part of the Kidney-Liver service, which is made up of myself and Dr. Raimund Pichler. We take care of folks who have both liver and kidney disease, with a focus on those who are going toward a liver transplant.
Our overarching goal is to care for patients both in the hospital and out of the hospital and throughout the whole course of their disease; before transplant, during transplant, and after transplant, and to take care of their very complicated kidney problems and other things related to fluids and electrolytes with their liver disease.
Is the Kidney Liver Program a fairly new service?
Right, this is something that we created just over two years ago. We felt that these patients are more complicated, they need more time, and maybe they weren’t getting the most coordinated care that they could be getting. We felt there was a need, so we created the new service.
For these patients, the main concern is liver disease, but in addition they have developed kidney problems. The issues are complicated. Our patients are very sick because they have two organs that are not working well. In some circumstances, we can bridge the patient to the point where the liver could recover. In most circumstances, I view our goal as keeping their window open long enough to get a transplant.
During medical training, were you taught how to manage the emotional component of working with very ill patients?
I think it’s called the “informal curriculum”. On some level you are learning throughout your entire training how to work with patients who are sick and don’t do well, and how to emotionally deal with that.
I talk to the fellows about this somewhat. It is so important. I think you have to have a balance, because you can’t wall yourself off. But there is such a thing as being too emotionally invested. I don’t know where that line is. It’s probably different for different people.
I had a memorable interaction with a fellow when I was attending; we were taking care of a patient that was a very young person and the patient died. I was tearing up as we were talking about it, and the fellow asked me, “Are you crying?” They were surprised. This is something I talk with the fellows about now. I acknowledge that yes, I was crying, and I think it is okay. I actually think it is not okay if you’re not crying every now and then. I think the more we talk about this as providers, when we feel sad about a patient, I think it’s good to say, “That made me feel sad.”
How did you decide on a career in medicine?
I always had it in the back of my mind. I thought that it would play to my dual strengths of science and math, and I like interacting with people. It is a deliberate thing to complete all of the prerequisites, so you don’t just fall into it, but I didn’t really have a lightning bolt moment about deciding to go in to medicine.
What interested you about going in to nephrology?
I went into med school thinking I was going to do pediatrics. In residency I thought I was going to do critical care because I really liked my ICU experience. When I did a nephrology rotation at Harborview with Dr. Leah Haseley, it was just great. Most folks who come through the UW residency program who then decide to go into nephrology have had some sort of positive experience with Leah Haseley. She really makes them want to do nephrology, and I was the same.
I realized that nephrology gave me the opportunity to take care of the complicated, sick patients that I saw in the ICU, but to also think about the aspects about them that I found most interesting, their fluids and electrolytes. I also wanted to have longitudinal relationships with my patients. I wanted to know them over time, not just to see them in the ICU for a week and then be done. It’s a good fit for me. If you had asked me five years ago if I was going to be taking care of kidney-liver patients, well, that wasn’t really on my radar but it feels like a great fit now.
What career would you like to have in an alternate universe?
My wife is a lawyer and she tells me that based on how much I like to argue I should’ve been a lawyer. I don’t think she means “fight-argue”, but I do like to “debate-argue”. I can see myself really enjoying being a lawyer. I think it would be fun.
What jobs did you have when you were younger? Did they influence who you are now?
I‘ve had jobs since I was the legal age to work. The one that I get asked about the most is when I worked in a soybean genetics laboratory. After I graduated college and before I started med school I moved to central Illinois (which could be the soybean capital of the world!). I was looking for a research job and found a lab manager position. I worked 1/3 of the time in the greenhouse managing the plants, 1/3 doing actual lab work running gels, etc. and 1/3 working in the fields and harvesting the soybeans. It was a fun experience, but I’m happy I’m done with it. Up to that point I had done nothing in my life that prepared me for it. I mean, I was sitting on the back of a combine harvesting soybeans!
I remember after the end of one long day on the back of the tractor I went to the grocery store and I had soybean dust all over me. A real farmer was there, and he said to me, “You getting your beans in?” I thought, Yep, I am, at the University of Illinois Soybean Genetics Laboratory! (Laughs) Overall though, it was good to have lab experience. The lab work I did there gave me a taste for what it’s like to do basic science.
Are your parents in the medical profession?
My dad works for a foundation that makes charitable grants, so he is in philanthropy and as he would say, “giving away other people’s money”. My mom is now retired, but she was a special education teacher. One of my sisters became a teacher, and my other sister became a social worker. Everyone is dedicated to helping others.
What are your favorite activities & hobbies, or things you like to do with your kids?
Cycling is what I like most, but that has calmed down a bit now that I have a 1 year old and a 4 year old. I’m not out mountain biking or road biking as often these days. We live at the foot of Squak Mountain, kind of near the woods, so we can almost go hiking or trail running out the back door. My 4 year old is getting in to hiking too. He also likes Legos, and he’s a big reader; we’re reading Harry Potter together. I’ve never read it, so he can tell that I’m enjoying it too. We read it for a bit and then we stop and process what happened, and then the next day we talk about it so he doesn’t forget. My daughter is almost 2. She likes to do whatever her brother is doing. She is very good natured.
Do you like to go out to restaurants? Are you a “foodie”?
I would definitely not describe myself as a foodie. I enjoy good food, but I can also enjoy crappy food. I just enjoy eating. I like to cook though; I have fun cooking. I make a pretty good brisket, and I like to grill fish. We eat a lot of vegies.
Even though I'm not a foodie, I am a bit of a pretentious coffee person. I like to go to Milstead in Fremont, and I like this place on Capitol Hill called Tougo. I think you almost feel an obligation to develop a coffee addiction when you grow up here. If you go somewhere else they’re like, “Oh, you’re from Seattle…Do you like coffee?” I have a friend that works in the coffee industry so I get good coffee from him, and we go to different coffee places. He travels all around the world sourcing coffee.
Do you travel? Where do you like to go?
With the kids I find traveling is more stressful than it’s worth. I’m hoping that changes, because I am excited to travel with them when they get a little bit older.
We vacation around here. We’ve done some camping with the kids; and my folks have a place on Vashon Island so we go there sometimes for long weekends and just do nothing, which is nice. We go to see my wife’s family in Minnesota, but for some reason we always make the very “smart” decision to go in January when it’s freezing…
How do you balance work with leisure time?
I start my days early. I get to work early, and I try to get home in time to feed the kid’s dinner and to be with my family. My wife and I try to split things 50/50 since we are both working. I help with the kid’s bath and bedtime, I do some reading for work, I exercise after the kids go to bed, and then I read a book.
Are you reading any good books you'd like to share?
I read a lot. I started reading even more in the last year since I set a rule for myself that I cannot watch any news after 8:00 p.m. due to our current political climate.
I just finished reading Invisible Man by Ralph Ellison. It’s a novel about a black man who moves from the South to the North in the 1950’s. Now I’m reading Mason and Dixon by Thomas Pynchon. It is kind of a weird, avant-garde historical fiction book about the people who created the Mason Dixon Line. It’s a novel, but it is loosely based in history.
What kind of music do you like?
I listen to a lot of jazz. I played the saxophone growing up and I still have it, although I haven’t played it in years. I like older jazz, like John Coltrane.
What are you most grateful for in your life?
I am grateful for my health; every day at work is a very good reminder of that. I am very grateful for the family that I came from. I have very supportive parents and sisters who are local. They are one of the big reasons that we moved back to Seattle. We really wanted to have kids and wanted them to be near family. I am grateful for my family, my wife and my kids. That’s the big one.
What are a few qualities that you value in people?
I value a sense of humor. I value people who are compassionate and kind. I value people who have integrity. Those are the big ones.
Do you have any Pet Peeves?
I have so many! I don’t like bad drivers! I probably have a little bit of road rage. I don’t like Seattle drivers at all, I don’t like people who drive slowly in the fast lane, I don’t like people who don’t get in line for the exit and then sneak in at the very end. Road stuff drives me crazy…
Is there anything you can’t live without?
First, I can’t live without coffee or caffeine. Coffee is preferred. I definitely drink too much caffeine. I have already had 5 or 6 cups of coffee today. It doesn’t make me feel too buzzed or jittery. I have a superhuman ability to fall asleep anytime anywhere. I don’t have sleep issues. I can drink coffee at 8:00 p.m. at night and still fall asleep at 10:00 or 11:00 p.m. But when I don’t drink caffeine I get a headache.
The other thing I can’t live without, or be happy without, is a regular exercise routine. It is part of my coping mechanism.
Do you have a life philosophy or a personal motto that guides you?
I don’t have a well-articulated motto, but if I were to try to explain it to my 4-year-old I would say this:
Every person has value and every person is flawed, and for the most part we are all just doing our best. So treat every person as you would want to be treated, recognizing everyone else’s humanity. Treat those that you come in contact with, in every part of your life, like people who have value.
I think if we all did this more, things would be better. I don’t know if it was exactly articulated in this way by my parents, but I know that I got this philosophy from them.