Melanie Cole, MS (Host): Welcome to Neighbors Helping Neighbors, the official podcast of Ward memorial Hospital, as we present candid chats with local medical experts and leaders, bringing health, healing, and hometown pride to every episode. Today, we're thrilled to introduce you to Dr. David Castro, a family medicine physician with Ward Memorial Hospital that brings his global experience and practical care close to home.

Dr. Castro, it's such a pleasure to have you join us today. Your medical path has taken you from Peru to advanced geriatric training in Spain and family medicine in Texas.

What first drew you to medicine, and how did those experiences shape you as a physician?

David Castro Alvirena, MD: Well, thank you for having me first. What I would say is when I was a child, I always wanted to help people. That's what draw me to medicine. And in addition to that, I always wanted to make my mother proud. And then with this combination, I always wanted to make my mother proud and seeing her as a role model, how she drew me through the life to do better is how I just decided to combine both of them and pursue medical education.

So, I started my education back in South America, in Peru. And then, I moved to through different continents, and I ended up here.

Melanie Cole, MS: Thank you so much for sharing that, Dr. Castro. After training and caring for patients in several countries, what made Monahans and Sandhills Family Clinic the right place for you? What drew you here?

David Castro Alvirena, MD: So, Monahan has a specific quality, and that is will give me to practice family medicine in a way that I like, which is establishing long-term relationships with my patients. It will allow me to see pediatric population, middle-aged population. It will allow me to see geriatric population.

And through this time, I can establish a long-term care with them. And this is something that I really enjoy since I was practicing back in South America and could make a comprehensive assessment of my patients. I always want to establish long-term relationship with them.

Melanie Cole, MS: Well, see, that's so lovely because that's really what everyone's looking for. Now, when we think of our older patients, preventive care and long-term health are central to your practice, and you have special training in geriatrics and complex chronic care. What should older adults and their families know? I mean, it can be quite dizzying about managing multiple medications, changing health needs as they grow older, chronic conditions. What would you like them to know?

David Castro Alvirena, MD: Well, first I would like them to know that the most important, the best treatment is know how many medication we have. There is something in geriatrics called polypharmacy, in which the patient has so many condition that they start having so many medication, and sometimes the side effect of these medications can jeopardize the health of the patient by itself. So, we want them to know that the patient should have only the medication they need in the dose they need. The less, the better. That's one thing.

The other thing is it's important that the patient and the family understand why this patient is taking this medication. Sometimes there are problems that occur due to misunderstanding of why the patient's been taking it.

And the other thing is the quality of life of this population. We have to aim to see what is the goal of this 75-year-old male, or what is the goal of this female that now is 90 years old, and what does she want in life.

Melanie Cole, MS: That's so important, Dr. Castro. And your interests also include musculoskeletal and functional health. How do mobility, strength, and everyday movement affect a person's health and independence? And how do you like to work with your patients on those things?

David Castro Alvirena, MD: So, mobility is another important topic in geriatrics. So, we know that if we move less, our joints become stiff, we lose flexibility, and that's when we start having issues with balance, and our patient can fall. And fall is another geriatric syndrome. So, what we want is our patient to start moving more based on her baseline.

And then, if we can improve the tonicity, the strength, they can have a better quality of life. We decrease the weakness. We stimulate our patient to move. And here in Ward Memorial, definitely, we have a physical therapy team that is awesome and encourage all our patients to do better. So, I will invite you, all our listeners, to come to see us, and especially the physical therapy team, and you will be so rewarded.

Melanie Cole, MS: Dr. Castro, what is your philosophy of care? You've been to so many countries and done so many different things. What would you like patients to know about how you approach wellness and care for the whole person?

David Castro Alvirena, MD: What I can say through the time and through this experience in different part of the world is that this allow me to give a comprehensive assessment to see a patient, a person, not only as a disease. I don't see a disease. I see a human being with different characteristics. And also, I see his or her environment and how is his or her social situation, his or her family situation, his or her cognitive situation in addition to a transitory pneumonia, for example.

And then, with this approach, I can help this patient to come back to the community in the best way possible. I can see and make the assessment of the functional status while I've been admitting a patient for this pneumonia, for example. And then, if the patient doesn't have family support or social support, try to bring some tools that it can help my patient to improve. So, in short, is giving a comprehensive care and not only a disease what we are trying to do at this time.

Melanie Cole, MS: Dr. Castro, one thing I've learned about you is that you are a third-degree black belt in judo. How has that discipline and continuous improvement influenced your approach to medicine? And what do you want your patients to remember after meeting you?

David Castro Alvirena, MD: Well, yes. I did and I do judo. And yes, I'm a third dan black belt. So, I've been doing judo my whole life. I've been doing more judo than practicing medicine, because I started when I was a kid.

What judo taught me all the time is just being constant, showing up. Every day, we learn something else. Be dedicated. Some problems appears because most people just quit. They decide not to continue. So with judo, we have to continue every day. And I would say the hardest is being a white belt because everybody will think that person has no skills. But it's through having the commitment to continue in the class, to showing up, which is going to shape the judoka. That's one thing.

The other thing is falls. The first thing we learn in judo is How to fall. and why is this, why falling, learning how to fall is important? And it is important because in life we are constantly having problems. Life is not perfect. And we learn how to stand up after each fall. So, they teach us how to fall on the right side, on the left side, how to fall forward, how to fall backwards. So, no matter what, the judoka is going to stand up. Same thing in life, same thing in medicine. We might have problems, we might have diseases, we might have conditions, but they teach us also how to stand up. Yeah, that's super important. And there are so many lessons, the philosophy of this Japanese martial art that it is now in my heart and I try to teach fellow students when I have the free time because I also teach some judo classes in Odessa, yes.

Melanie Cole, MS: Such dedication and discipline, and I can see where that really does help balance, but not only our physical balance, but kind of a life balance. Now, Dr. Castro, you've told us about judo. What do you do for fun besides that? What about your life and your family? Tell us just a little bit about that. What do your patients and your colleagues may not know about you?

David Castro Alvirena, MD: Well, I'm a husband and I'm a father. So, my beautiful wife is Georgie. We met in in Madrid, Spain when I was doing training, and she was pursuing higher education as well in human resources. And she is from East Europe. So from Romania, she moved to Madrid, Spain. I moved to Madrid, Spain. We got together and we have these these twins. They are twins, Matthew and Luke. So, what I do in my free time, I just prefer to enjoy my time with my family. I really love spending time with them.

Melanie Cole, MS: Well, that certainly shows. And I could hear the passion and the compassion in your voice. Dr. Castro, give us some final thoughts, what you would like patients to know about you at Ward Memorial Hospital.

David Castro Alvirena, MD: I want my patients and their families to know that we are here at Ward Memorial offering the best care that we can give to our patient with passion and comprehensive care. I want them to know that we want to build relationships with them so they know us, and they know that they can count on us.

And also, I want them to know that this is a teamwork. It's not only Dr. Castro. This is a team. We have wonderful nurses that are dedicated to our patients. We have care managers that they help us every day to give a lot of resources to our patient. We have physical therapists. We have respiratory therapists. We have a nutritionist. And all this group are here just for you guys. I want you to know that also the ER team is willing to help you. If something acute happen, you can come and visit us at any time. So with this, I want you to know that this team has one goal, one focus, and this focus is you because we are neighbors helping neighbors. So, I want you to know that.

Melanie Cole, MS: Thank you so much, Dr. Castro, for joining us today and sharing so many details about yourself. Thank you so much again. And for more information or to learn more about this and other healthcare topics, please visit our website at wardmemorial.com. I'm Melanie Cole. And that concludes today's episode of Neighbors Helping Neighbors, the official podcast of Ward Memorial Hospital. We'd like to invite our audience to download, subscribe, rate, and review this podcast on Apple Podcasts, Spotify, iHeart, and Pandora.