Landrus and Noel Pfeffinger: How to achieve success and live well while embracing important family and community values

Welcome to the third year of my Blog, It Really IS All About You!  What a joy for me to continue to feature so many of you and your fascinating and often inspiring lives.  This month we catch up with the extremely busy, partially retired, Pfeffingers.  If you or your family grew up in our community, you have probably had the pleasure of working with either Dr. Landrus Pfeffinger or his wife, Noel.  Doctor, teacher, nurse, parents and so much more, they offer a very candid view of the importance of strong family and community values.  They also share with us their thoughts on the evolution of their own professions with relevance to the times we live in.  You will want to hear what this remarkable couple has to share with us.

I think many folks who read our Blog may actually have met you, since you are very vested both as dedicated parents and hard working professionals with deep career paths in our local community.  In fact I first came to meet you at your youngest son, Nolan’s, birthday bowling party when you were kind enough to invite my son, Nick!  One of the things that’s always impressed me about you both is your dedication to and love of your children---all of whom are remarkably different from each other.  What was it like to raise three such different children in Lamorinda?  How did you manage, while working full-time as both a surgeon (Lan) and a teacher/tutor (Noel), to be able to carve out so much time for them and give them each what they need(ed)?

Lan and Noel Pfeffinger visiting Tuscany on a bike tour.

Lan: I enjoyed (ENJOY) being a parent albeit at times it can certainly be a challenge! Bringing a life into the world is a responsibility not to be taken lightly. Living in the Lamorinda area--Noel and I still live in the first and only home we’ve ever owned--now going on 30 years--has its positives, i.e., great schools, nearby culture, etc., but also has negatives in terms of "excesses" and at times a sense of entitlement mentality, which can be overwhelming. We always tell our kids that they live UNLIKE the majority of the people in the world and that they should appreciate that and make the best out of their lives--not only for themselves but also for others. As to being a physician/surgeon, early in my career I simply decided NOT to be engulfed by my profession other than taking care of my patients. That approach allowed me, for the most part, to be at home for dinner, and BE there for sporting events, plays, birthday parties, vacations, etc.

Noel: Basically, I was a stay at home mom until our youngest was well into grammar school and I started substituting, through which I found a full-time position teaching Spanish at  Acalanes High School. It was a challenge carving out as much time for the three children as I had prior to teaching when there were always the "after hours" obligations. Having been an RN, where I could leave my work responsibilities after the shift, I found teaching necessitated a lot more duties competing with family time. I found a couple of good alternatives, though, when I decided to find something more compatible to having a family and working. First, I did medical interpreting, which allowed me to still work in the medical realm and to speak Spanish, thus blending my two former careers. Then I settled into tutoring, which allowed me to schedule my own hours and arrange my hours around family time. I held some volunteer positions in my children’s schools but never "turned myself over" completely to the volunteering scene. 

Sometimes it seemed that parents were catering to children full time in that capacity, leading the children to believe that our role was to be "workers" for their behalf. I never saw nor experienced that growing up, and I think that allowed me to avoid promoting the "entitlement" mentality that unfortunately exists now. I do remember hours and hours of being on tennis courts with each of our three children and I think just playing with children over the years establishes a relationship of being there for them, all the while subliminally reflecting on character, honesty and competition. I loved the simple days of "just being with them" as they grew up and could have done away with the "rat race" of lessons, programming time, hearing all the advice in the Lamorinda area about "what you have to do" to have successful kids.

Tell us about where you both grew up and the core values instilled in you during your childhood.  What kind of childhood did you each have and where did you attend college? And how did you meet?

Lan enjoying the Trevi Fountain, Rome.

Lan:  I am originally from Gridley, Illinois, a small farming town of about 850 people. My father was born and raised on a farm to second generation immigrants. He had only an eighth grade education. He served in the Army during WWII, returned and became a carpenter by trade. My mother lived in town and was one of eight children. She had to leave school her second year of high school to help support her family during the Depression. While neither had formal "higher" education they both believed in the American dream for my sister and me and valued a good education as the pathway to that dream. We were taught the value of hard work and self-reliance. There certainly wasn't any sense of entitlement bestowed upon us and in that regard I am very thankful. It makes you appreciate much more that who you are and what you have are a result of your OWN efforts.

I attended North Central College in Illinois for undergraduate school and the University of Illinois for graduate school in microbiology for one year, before entering medical school at the Chicago Medical School.

Noel and I met at Children’s Hospital in Oakland while I was a resident at UCSF. She was/is a nurse. I was "smitten."
 
Noel: I grew up in Modesto in the central valley--a GREAT place in which to grow up. (Sadly, it's not such a wonderful spot now.) My dad manufactured poultry feed and my uncle was a rancher who grew walnuts and lima beans. It was a very agricultural area and, as a result, "living off the land" made people "down to earth" and hard workers. In those days, in that area, I don't recall knowing folks who were aggressive, pushy, wanting to get ahead. I think everyone knew he/she was doing a valued job and most people respected each other for their respective contributions. I don't recall my parents ever telling me I needed to go to college. It was just an unspoken "given." The last two years of high school I went to a Catholic boarding school in Marin County and  from there went onto Santa Clara University---the college where many of my high school classmates entered. I think it was the only college to which I applied. Lan and I met at Children’s Hospital in Oakland--I worked with adolescents, which was on the same floor as orthopedics.

Noel on holiday with the inscrutable sphinx.

How early on in your lives did you know what profession you were each passionate about?  How did that come about?
 
Lan:  I always did well in science and my older sister had become a nurse. By the time I reached college I had decided to go into medicine and thus majored in biology and chemistry. Aside from my sister, there were no immediate or extended family members in the health professions.

Noel: I have always loved languages and prior to going to Santa Clara I spent two summers in Brazil. Then in college, I went to Spain for my junior year abroad. I almost ended up in Spain and thought a Spanish degree wouldn't be particularly valuable in Spain, so, I decided to study nursing and enjoyed pursuing that career path as well. (If truth be told, I could easily have been a career student.)

We’d really like to know more about each of your professional paths.  Lan, let’s start with you, since as one of Nick’s doctors, I probably know the most about you professionally!  Tell us about your very illustrious career.
 
Lan: After medical school, I came to San Francisco to the University of California to do my internship and residency. After the 5 years at UCSF I did a year of post-graduate fellowships, one in adult foot and ankle surgery and the other on stroke rehabilitation and reconstructive surgery. I then joined a large orthopedic medical group and left the group after 18 years to "go it alone" for 8 years. After retiring from private practice in 2007, I began to work part-time at UCSF where I am an assistant professor teaching orthopedic residents. Additionally, I do independent contractor work at the county hospital in Martinez.

Lan, you decided to “retire” not too long ago.  I think there are great lessons to be learned in how you are accomplishing that, since you didn’t simply “walk away” from your profession one day and completely hang up the scrubs!  What are you doing now, and how did you determine that this was a good path for you?  And how did you decide when it was best to make the transition to part-time?
 
Lan: While I was ready to "walk away," I will give credit to Noel for suggesting that I might want to do something other than playing tennis, riding my bike, working out at the health club, and planning vacation trips. My part-time work has allowed me to "stay in the game" yet come and go as I want without the burden of running an office. Overall it has been a good transition from private practice.

Noel, you have helped and guided many students over the years.  Tell us about your tireless work as a teacher and tutor, and how this became your calling.
 
Noel: The common denominator for my "two careers" has been working with adolescents and teenagers. I enjoy being with them one-on-one, and helping them either health-wise or with their Spanish studies. One-on-one is definitely my style, as all my attention is focused on one person, listening to him/her and trying to adapt a plan to that person's needs. At that age, I particularly enjoy being with them when they are extracted from their peer groups and can be genuine and candid. Sometimes I think they need an adult who will see them as an individual, who allows them to relax and "be who they are." Plus, I really like seeing their improvement. There is a different dynamic going on with a student-tutor relationship than with one’s own parent-child relationship. 

Lan and Noel, Giza, Egypt.

You have also “retired,” Noel, but again, maybe not 100%!  What keeps you busy now professionally? 

Noel: In addition to still tutoring, I have a little job that I enjoy very much. It is reading and scoring essays for people trying to attain their GED. Spanish speakers can write their essays in Spanish, so those are the ones I score. I used to also score the English essays and it is very eye opening to observe the level of mastery of the English language and writing skills currently in the USA. Frightening, really. Living in this area we get a very skewed impression of the educational level of the younger generation. The general population's abilities are a matter of concern.

Let’s explore the philosophical side of your chosen professions, and how you see these two very important professions --- health care and education --- evolving these days.  With budget cuts, HMO’s, insurance companies playing a huge role in patient care, a possible nationally mandated health program for all ages --- so much to consider --- what are your thoughts, Lan, on the state of your profession?   In your opinion, what is the government getting “right” about health care and where are they missing the boat, so to speak? How about insurance companies and their involvement in the process?  What is your hope for the future of health care in our country?
 
Lan: I have a VERY guarded opinion regarding the current attempts at health care reform by the federal government. Americans have come to enjoy the BEST health care the world has to offer--this will NOT be the case in the current attempt at reform. There WILL be delay and denial of health care if current reforms are brought to full force. Many physicians will leave the profession, overwhelmed by an ever increasing bureaucracy interposed between them and their patients. I, like most physicians, believe there is a need for health care reform BUT NOT in its present form.

There have been numerous alternatives recommended regarding the current attempt to reform health care, which in my opinion is a thinly disguised predicate for single payer, government controlled health care, i.e., socialized medicine. As I have noted above, Americans have enjoyed the best medical care the world has to offer through private medical insurance plans, either individual or group. For the elderly we have Medicare, for children we have the CHIPS program, and for the disabled/poor we have Medicaid (it's call MediCal in California). Those who can afford it are self-insured.

A few options that could be considered include:
  

• Allowing small group employers to join with other "small employers" to form a larger pool, thus allowing them to afford "large group" insurance rates.
• Insurance companies should be allowed to compete across state lines, thus allowing greater competition with resulting lower rates not only for group but also for individual health plans.
• Tort reform is a necessary reform within overall health care reform. It IS a driver of higher health care costs.
• Mandated health care coverage by the government will drive up health care costs. (The Congressional Budget Office recently has indicated the current "Affordable Health Care Act" will now cost TWICE what was originally stated, i.e., it is now $1.8 trillion!) If Medicare is any measure of the cost of government-run health care, I feel very confident in saying that even "TWICE" will be an underestimate of eventual costs! (On a personal note, rather than see my health care premiums go down, as "promised" when AHCA was passed, my health care premiums have risen by 50% for the same coverage!) I know that I am NOT alone in that regard.
• Individuals should be allowed to purchase their OWN health care insurance, which is more tailored to their health care needs, AND be able to deduct such costs from their taxes just as companies do that offer group insurance coverage. In that manner they do not have to worry about losing their health care if they lose their job.
• Health savings accounts can be used and expanded.

Noel, as an educator, are you concerned about how funds are allocated in our public school system?  What are your concerns, and also hopes,  for the future of education?

Noel: I think schools should be modeled after the private sector--not be dominated by unions, tenured teachers and administrators. As a tutor, I see the differences between the various teachers in the district and there is a vast difference. I feel sorry for the students saddled with the teachers giving them an inferior education in comparison with some of the very good teachers. When we go to a restaurant, we don't settle for the restaurant deciding that some people will get gourmet meals and some will get packaged "TV dinners." The customers wouldn't stand for an arbitrary meal selection, where some get the good meals and others have to settle for the bad meals. Schools shouldn't be able to do that either. I think perhaps the superior teachers could end up accommodating more students by using technology, like on-line classes, because there are many more students than good teachers to teach all of them; there needs to be a way of providing everyone with the same advantages of good instruction.

One of the great things about your lives now, for lack of a better phrase,  is this “second act” of your professional path--the  ability to really spend time on your passions:  staying fit, bicycling, and travel--and still work part-time.  Oh, yes, and continuing to be amazing and supportive parents!   In fact, you usually come visit us now on your bike--and not just any bike, I might add! How did you become so passionate about bicycling?  What should those of us who are interested in it as a hobby be looking for in equipment, time commitment, getting in shape and best places in the Bay Area to cycle?

The Pfeffinger family cycling, Big Island, Hawaii.

Lan: With my current part-time work, with adequate notice I am able to take more time off for extended periods. We have done considerable traveling in Europe, Central and South America as well as Africa (Egypt). Our first bike trip was in France and we were "hooked." We have subsequently taken four bike tours from the Big Island of Hawaii to the countries of Italy, Austria and the Czech Republic. We have found it to be a great way to travel, far more "up close and personal," while at the same time staying in shape. Locally we go to the wine country for extended weekends with friends, family or by ourselves. Last year we did our own itinerary along the California coast from Monterey to La Jolla. We also take extended trips/ weekends to visit our kids who fortunately all live in California- at least for the present.

Noel: I had heard about a Tuscany bike trip a tennis acquaintance of mine went on and it became a goal of mine to do one also. It sounded like so much fun to me. It only took me about 4 or 5 years to get Lan  to come around. Now we are both loving the activity. Especially since we both have knee issues, so this is the ideal sport for people like us. Plus, we love to eat and bike riding allows us to "consume without guilt." 

Tell us about how you like to travel, some of your best experiences, and what’s still on the radar for future travel.

Lan: Aside from biking we also like to take cruises. Currently, we are planning a cruise tour to Alaska and Vancouver, Canada. In 2013 we are planning a bike tour in Argentina with additional time in Brazil, Chile, and Uruguay.

Noel: I actually like to stay in one spot for an extended amount of time and just live the day-to-day life rather than hit all the tourist sites. I haven't got a certain spot in mind, but, that's my style goal for traveling.

I think that one of the most interesting trips you made was a combination working trip as a volunteer doctor combined with a mini vacation to South America.  Lan, please share with us where you traveled, the volunteer care you provided, and what you learned about medicine in emerging countries on that trip.
 
Lan: In 2009, Noel and I went to Peru and Argentina. We spent two weeks vacationing and I spent two weeks in Lima teaching orthopedic residents at two of their "county hospitals." While I enjoyed the experience and found the people delightful and the medical staff caring, without sounding too negative, the level of health care and access to health care in their socialized medical system is far below the level the American people enjoy.
 
So, what’s next for the Pfeffingers?  And any final thoughts you’d like to share?
 
Lan: Stay active, be happy, take care of your health (it is YOURS by the way), love your children and help them to be the best they can be without helping them by doing everything for them!  Oh, and by the way, after 30 years of marriage, with all its ups and downs, I still thank God I met Noel, my wife.
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Noel: This is totally "random" but I would like to share one last "activity" in which I have been engaged for the last 3 years. Several weeks prior to the one year anniversary of my mother's passing away, I got a phone call from the American Red Cross requesting that I donate blood. When my mom was ill and receiving transfusions, I said to myself, "Thank goodness there are people who donate blood." It clicked. That was the way I would remember her every year. So, in place of putting flowers on her grave, I donate blood on the anniversary of her passing away and on her birthday. It makes me feel like her memory is productive for others. (I know that is random, but it's brought me comfort in doing that.)

What a great idea, Noel!  Thank you both for a very thoughtful Blog this month, and for sharing your inspirations and core values. 

So, dear Readers, in times such as these, I think the message of the Pfeffingers resonates well with many of you.  If you would like to chat with Lan or Noel personally, and perhaps continue the conversation, please contact me and I will put you in touch with the Pfeffingers.

Happy Spring!  (or, er, maybe Happy Late Winter?)!

Adios from Machu Picchu.

The opinions voiced in this material are for general information only and are not intended to provide specific advice or recommendations for any individual.

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