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He has shared some really interesting insights that explain what influenced him to be a doctor, as well as some great anecdotes and advice.
doc2doc interviews... diabetesMD
What made you want to be a doctor?
I had two singular experiences growing up that prompted me to become a doctor. I grew up in a house with lots of love, but little money in a neighborhood that was not oriented towards education. When I was seven, I developed rheumatic fever with carditis and was put to bed for most of a year. While bedridden I could not participate in the normal activities around me and I became an avid reader. I was also impressed with my doctor who I found out later was once the President of the Indiana Academy of Pediatrics. I also was sent to a special school for handicapped kids. By the time a returned to my regular school I was an avid student. This prepared me academically to potentially go to college. However, that was not considered financially feasible at the time.
At the end of my junior year in high school, I had a terrible accident. As a parent I shudder at the thought of what that phone call must have been like. I had severe facial injuries and a renal contusion. A surgeon come in to patch me up and followed me during that hospitalization as they contemplated doing a nephrectomy. I was heavily sedated with narcotics because of the pain as my body tried to rid itself of the renal clots. Luckily I passed the clots and was discharged intact. However, from that day forward my only ambition was to become a physician like that man who cared for a badly injured teenager. I should add that my becoming a physician given our financial circumstances was made possible by the extraordinary support of public schools in Indiana at the state and local level.
Why did you choose your specialty?
This was pure happenstance. I was an academically successful first-year medical student and the head of Endocrinology at the time, Dr. Bill Deiss, had NIH monies to support student summer fellowships in research laboratories. I worked two summers in the Departments of Physiology and Pharmacology. The then Chair of Pharmacology, Dr. James Ashmore, was an expert in glucose metabolism and had trained at Harvard in the laboratory of Dr. Bard Hastings. Another former fellow was Dr. George F. Cahill, Jr. who has just been named the Director of the Joslin Research Laboratories at Harvard. Dr. Ashmore arranged for me to have a post-doctoral fellowship with Dr. Cahill and Dr. Cahill arranged for me to have a clinical diabetes fellowship at the Joslin Clinic and subsequently at the NIH. Following this I returned at Indiana University School of Medicine where I developed a diabetes research and clinical program.
What’s the most interesting thing about your specialty/job?
I have been blessed with the privilege of working with the best and brightest minds in diabetes research and clinical care since I went to Harvard in 1967. This has been a profoundly rewarding time to be in diabetes research and clinical care. During the decades of my career we have discovered the causes of diabetes microvascular disease and have learned how to treat them and eventually how to prevent them.
What has been your best moment in medicine?
What has been particularly rewarding has been my participation in a number of clinical trials, especially the Diabetes Control and Complications Trial (DCCT) that showed that we could prevent or delay microvascular complications in type 1 diabetes by intensive management and my subsequent role as Chair of the National diabetes Education Program (NDEP) to promulgate and implement the DCCT.
And your worst?
It’s a tie between two events that both occurred during my clinical fellowship at Joslin. When I arrived at Joslin we were doing hypophysectomies in persons with proliferative retinopathy to prevent blindness. One of my first patients was a 22-year-old woman. Following the operation she developed diabetes insipitus, as many did following the procedure; this required my around the clock management. This only lasted for a few days, but I really got to know her. She had traded her fertility for her sight. Shortly thereafter, we discovered laser photocoagulation’s benefit was more successful and never did another hypophysectomy. The second was a 28-year-old South Boston youth with an Irish brogue that you could cut with a knife. He has sandy red hair and piercing blue eyes and a heart attack after a dozen years of type 1 diabetes. He died that night. My memory of them has been a guiding force. I have spent my entire career trying to discover new treatments and to move research into clinical practice as rapidly as possible.
Would advice would you give prospective doctors?
I have a daughter who upon graduating from university informed her mother and I that she wanted to become a doctor. She had taken no science in college, this means that she will be in her early thirties when she begins to practice, assuming that she will be offered a medical school slot. I told her what I would tell any your person who wants to become a doctor. It is a very rewarding profession. The difficulties are overrated. It’s not the super-bright who make the best doctors; it’s the super-dedicated. Go for it!
What’s been your favourite doc2doc discussion of all time?
There are again two: the discussion on the nurse practitioners and the US ACA and the physician shortage in the US.
- Doctor Shortage Likely to Worsen With Health Law
- The cost-effectiveness of substituting physicians with diabetes nurse specialists
What do you do when you are not being a doctor?
I write an occasional personal blog http://presentatthecreation.wordpress.com/
I study languages
I play with my family: wife, three kids, two in-laws and six grandkids.