Episode 75: Dr. Philip Nizza D.O. Infectious Disease & Loss - The Natalie Assalone Nizza Memorial Award

In today’s episode, we interview Dr. Philip Nizza, D.O., a board-certified infectious disease physician. Dr. Nizza went to medical school at NYITCOM, followed by a three-year internal medicine residency at North Shore University Hospital and ultimately a two-year infectious disease fellowship at Memorial Sloan Kettering in New York, arguably the most prestigious cancer center in the world. Dr. Nizza discusses with us his responsibilities as an ID physician as well as how his D.O. degree shaped his experience and perspective on medicine and patient care.

Dr. Nizza goes on to share with us how he met his wife, Dr. Natalie Assalone, during medical school at NYITCOM and how they built their life together through residency and raising children in a “two-physician household.” He ultimately relates Natalie’s battle with a rare type of cancer and her tragic death. He touches on the unique experience of love and loss made more difficult through the lens of a skilled physician.

This episode touches on heavy topics and difficult experiences that many of us do not expect to encounter in our lives. However, Dr. Nizza’s story is an inspiring one and teaches us the many valuable lessons he has learned despite the hardships he has faced.

Dr. Nizza and his family have created the Natalie Assalone Nizza Memorial Award in her honor, which gives $5,000 annually to a graduating student who demonstrates dedication as a parent while simultaneously balancing their passion for medicine.

Last year, the award was given to Dr. Larysa Aheyeva, who grew up in Belarus and moved to America to better her daughter's life. She is training to become an OB/GYN.

This year, the award went to Dr. Yisroel Grabie, a father of three who matched at Staten Island Hospital for internal medicine.

Dr. Nizza has asked that anyone moved by Natalie’s story consider a donation, no matter how large or small, to the scholarship fund. Donations can be made through the NYIT.edu website by clicking in the right upper quadrant on the “give” icon, choosing "other," and typing in "Nizza Memorial." You can also use the following link https://alumni.nyit.edu/giving/nyitcom and then select Natalie Assalone Scholarship from the dropdown menu.

We hope you are moved by this episode.

Transcript

My name is Dr. Ian Storch.

I'm a board certified gastroenterologist and osteopathic physician, and you are listening

to DO or do not.

If you're interested in joining our team or have suggestions or comments, please contact

us at DoOrDoNotPodcast.com.

Share our link with your friends and like us on Apple Podcasts, Facebook, Twitter, and

Instagram.

We hope you enjoy this episode.

My name is Hadi Tharik, and I'm an OMS-1 at the Alabama College of Osteopathic Medicine.

On today's episode, we interview Philip Nizza Dio, a board certified infectious disease

doctor.

Dr. Nizza went to medical school at NYAT COM, followed by a three-year internal medicine

residency at North Shore University Hospital, and ultimately a two-year infectious disease

fellowship at Memorial Sloan Kettering in New York, arguably the most prestigious cancer

center in the world.

Dr. Nizza discusses with us his responsibilities as an ID physician, as well as how his DO

degree shaped his experience and perspective on medicine and patient care.

Dr. Nizza goes on to share with us how he met his wife, Dr. Natalie Asselone, during

medical school at NYAT COM, and how they built their life together through residency and

raising children in a two-physician household.

He ultimately relates Natalie's battle with a rare cancer and her tragic death.

He touches on the unique experience of love and loss made more difficult through the lens

of a skilled physician.

This episode touches on heavy topics and difficult experiences that many of us do not expect

to encounter in our lives.

However, Dr. Nizza's story is an inspiring one, and teaches us the many valuable lessons

he has learned despite the hardships he has faced.

Dr. Nizza and his family have created the Natalie Asselone Nizza Memorial Award in her

honor, which gives $5,000 annually to a graduating student who demonstrates dedication as a parent

while simultaneously balancing their passion for medicine.

Last year, the award was given to Dr. Larissa Ahayeva, who grew up in Belarus and moved

to America to better her daughter's life.

She is training to become an OB-GYN.

This year, the award went to Dr. Yisrael Grabi, a father of three who matched to Staten Island

Hospital for Internal Medicine.

Dr. Nizza has asked that anyone moved by Natalie's story consider a donation, no matter how large

or small, to the scholarship fund.

Donations can be made through the nyat.edu website by clicking on the right upper quadrant

on the Give icon, choosing Other, and typing in Nizza Memorial.

We hope you're moved by this episode.

Today, I am interviewing Dr. Philip Nizza, who is an infectious disease doctor from New

York.

Welcome to the show.

Hello, and thank you for having me.

So can we start with you telling us about what your normal day looks like?

Sure.

So I'm infectious disease is basically a hospital-based specialty.

So I get up usually on a regular day.

We round at three hospitals, we rounded at one university hospital, two community hospitals.

So an average day is get up, make rounds at that hospital, and that's where you spend

most of your day wherever you're stationed.

That usually involves on rounding on about 15 to 20 follow-ups and probably three to

seven new consults every day.

There is one half day a week where I do office hours from one to five, and outpatient ID

is not very brisk.

Maybe from seven to 12 patients in the office, mostly follow-ups for people who go home with

IVs via PICC lines or home infusion, some travel shots, some outpatient consults.

That's a half a day a week.

And then weekends are really where it's hard, which really what's tiring me out after 20

years is you round at all three hospitals, you're on call from essentially four o'clock

Friday afternoon through Sunday morning at 8 a.m., handling pages from three consults.

So you could do as many as 15 to 18, I've done over 20 consults in a day, written, rounded

on as many as 35 to 40 people a day each day of the weekend.

And our practice is at least merciful, we give ourselves a day off during the week.

So like today's Tuesday, which is my day off, to be able to do this and be home and gets

me to get all my errands done, bank, and things, especially if you're on one call this weekend.

So I have to get everything done today that I won't be doing Saturday and Sunday because

I'll be working.

So that's the average day.

But I do about 900 consults a year, inpatient consults in the hospital.

And I don't know how many thousands of follow ups, quite a bit.

So it's a busy source.

As quite busy.

Yes.

So how did you become interested in medicine and decide you wanted to be a doctor?

So that's a good question.

I'm from a family of very blue collar people.

My father was a carpenter.

My mother worked as a receptionist.

There are no other doctors in the family.

Prior to me, I have a sister who's an accountant, brother who's a pharmacist, probably the closest

thing to the health field.

And when I graduated high school, I liked science.

But at some point, I kind of realized I didn't want to be a lab guy, wasn't comfortable doing

research.

It wasn't my forte.

And I wanted to combine science and being social.

And so it wasn't one of these lifelong burning desires.

It said, well, medicine seems like the right thing to do.

And that's how I wound up there.

And that's the reason I applied to medical school.

And ironically enough, I was very lucky the way it all worked out.

So I started off as a very private, old boys Catholic high school finished very well, thought

I was a big shot, wasn't, went to college, got my butt kicked for a couple of years,

handled the whole college experience, probably pretty poorly in terms of thinking I was going

to fly through it and crashed and burned for a couple of years, got myself back on track

and was lucky to get into medical school and here I am.

So I've been through every level of training from the big name school to the no name school,

back to the big name place.

So I think I've had a lot of different experiences.

So I'm just blessed and happy to be a doctor, to be honest with you, can't see doing anything

else.

I think that journey is something that a lot of pre-med students can relate to.

College and medical school can be very humbling, very humbling, especially college medical

school, not so much.

I enjoyed it because you were doing something you love, the work isn't so bad when you're

suddenly sitting through an organic chemistry class, not having understanding why it applies

to your life at all.

Bit of a different experience and a lot of weeding out because I went to a big program

at NYU for undergrad, which was, you know, started off with a 300 person organic one

auditorium and then by the final there were like, you know, 25 sole survivors who were

strung out barely making the grades.

So it's a different experience, not one that I'd recommend to be honest with you.

When you did go to undergrad and other than the weeding classes, were there any experiences

that led you into medicine or osteopathic school specifically?

So osteopathic school was a revelation to me, I'll be frank and honest, I had no idea

what it was.

I was applying and now NYU, like I said, big school, not the most personal.

I met with this advisor and we were talking about medical school and she was looking at

my grades, probably thinking, what the hell is this guy thinking of doing applying to

medical school?

And she said, have you ever heard of osteopathic medical school?

I said, no, I have not.

She said, well, there's an excellent school in Westbury, you should go check it out.

And I said, all right.

So that night, I guess it was pre-internet, I actually kind of tried to research what

I can about it.

This is now circa 1993.

So no, couldn't really do anything on the web.

So I looked a little bit into it and I said, yeah, let me go on the interview.

I didn't want to leave the country.

I was pretty sure about that.

I wanted to stay in the United States.

I didn't want to be in FMG for whatever reason, I thought from that.

And I wasn't, I don't think I was probably mature enough already to leave home.

So I went on the interview and I thought I was going to get panned.

And all I remember is the one saving grace of my undergraduate education.

So I was interviewing with the man and he looked at my transcript and the guy said,

oh, you got a couple of C's and I think it was physics or the physics or organic chemistry.

And the person interviewing with him looked at him and said, oh, he went to NYU, their

pre-med program is terrible.

It's ridiculously hard.

And I was like, oh, maybe somebody gets it.

Maybe the, like that was like that moment I kind of knew.

And then once I got the acceptance, I was more than overjoyed to accept.

I applied to a couple other New York schools.

I got wait-listed at one.

I'm from Long Island.

I wanted to stay on Long Island.

So that's where I wound up.

So yeah.

I didn't know anything about osteopathic medicine until almost two months before, like a month

before I interviewed there.

And then obviously when I was there, so, but I had no idea prior to that.

How was your experience at the school you ended up going to?

The school was great.

I loved it.

The rotations were excellent.

We got to do a lot of city hospitals in Brooklyn and Manhattan for the rotations.

The professors were excellent and became a pretty tight knit group over the years.

I think once you're in medical school, and I think I can stress this enough.

Once you're in, you're in, and then it's up to you to put the time in.

You could be a good doctor coming out of a quote unquote, osteopathic, or it was not

a real medical school.

You know, you get that crap every now and again, which is nonsense.

But if you put the time in and put the effort into being a doctor, it will pay off if you

do the work.

And once I was there, I loved it.

I made some lifelong friends, I still know, and I loved the whole experience.

The rotations were excellent.

Professors were very good.

I really wouldn't change it for anything, actually.

Really enjoyed it.

It's changed a lot.

When I first stepped back on the campus, now 20 plus years after I graduated, I almost

didn't recognize it.

But it's beautiful.

And, you know, I really, like I said, I wouldn't change anything.

It was a good experience for me, probably the best educational experience of my, of

my time.

Wow.

Nice.

So when you were there, did you seek out any specific opportunities like research or clubs?

No, I wasn't really a research guy.

I'm trying to think if I did need clubs, if I can remember, you know, I don't think I

was heavily involved.

I gotta be honest with you.

I think I spent a lot of time studying.

I was living at home to save money.

So I was commuting every day from, from home by car.

Spent a lot of time in the basement, either in my house or in the library.

I don't think I did many extracurriculars.

I'm trying to think if I was in any clubs, but honestly, it's a while I played a lot

of foosball.

They had a nice foosball table up there.

And they also played, worked on my ping pong game, which was also in the, in the student

lounge there.

So I got really good at ping pong, which has come in handy now that I play with my boys.

But, you know, I, I gotta say, I was probably a bit of a nerd.

I probably spent most of my time head first in a book more than anything else.

Well, that is the most important thing at the end of the day, I just wanted to get there.

And once you, once you know you're in and you can taste it, it feels great.

So it wasn't hard to absorb the info.

Definitely.

So my next question is how did you meet your spouse and how did you navigate medical school

and residency together?

So weird.

My spouse was two years behind me when we met.

So I was, she was on the on-campus portion of the education.

I was on the off-campus part of the education.

I went to the library to copy what they call the green book at the time, which is probably

foreign to you guys now, which was a green book listing all the residency programs to

apply to when I was looking to go to a residency program.

So I went, I got the green book at the library.

There was only one copy machine at NICOM, don't ask me why.

And they had to get away for the copy card from the lady.

And they said, the lady said, there's someone down there's already got the card, but you're

next.

I said, well, wait, fine.

I took the green book down.

She was at the copy machine, copying information for a test, study materials for a test.

And we just struck up a conversation.

And as they would say, the rest is history.

But if we had not been in that space, not a huge believer in karma, but if we had not

been in that space, one or two minutes apart in any direction, our paths would have never

crossed.

So that is, I still to this day find that fact astounding.

As far as going to school together, I think the best thing about dating another doctor

or dating someone, even your same medical school is built in compassion, built in understanding.

Like there was never a debate.

It was, I got to study tonight.

Okay.

Or I got a big test tomorrow.

Okay.

Or I had a long day of my rotation.

I just want to crash.

Okay.

When people are doing the same thing and you have shared pain, so to speak, you understand

that person's drive, motivation, hours, mental stress completely.

So it leads to a very seamless, wonderful relationship where we never explained to anything

to each other.

If it was, yeah, can I do it or I can, or can I be there or I can't, there was never

any misunderstanding from residency through when I was a fellow through when we were both

attendings together through even raising a family.

When you have children, it was, can you make this event?

No, I got to work late.

You got this one or you got this or I can't be there.

It's just, it's nice that it's so natural.

And I think you'd have to be the ultimate hypocrite in the world being a doctor and

not understanding if your spouse is a doctor who's, who's working a similar grind.

So I think it was one of the best parts of a relationship besides shared culture and

shared background, shared profession is actually probably the most important of those things.

That is such a good point.

I think with medicine, unless you have experienced it yourself, you just can't explain it to

anybody else.

People don't get it.

Family members, friends, even like, what do you mean you're not coming?

I can't.

What?

I got to work late.

All right.

You know, I didn't get out the eight o'clock.

I'm not going to be home.

No one gets that.

So unless you're doing it, there's no chance of anyone really having this inner gestalt

of why don't I understand?

Why can't he just leave?

And you just can't leave.

And I think only people in our fraternity get that.

People or physicians get that.

No one else does.

So it's definitely is a relationship saver in terms of just everything was just a nod

and completely understood.

So we never fought about time because we knew our time was precious to each other.

So when we had it together, it was great.

But if it didn't happen, or if it was one of us was just passed out on the couch and

sheer exhaustion, the other one just said, all right, I get it.

So it was great.

Now a bit of a transition back into how did you decide on the specialty that you are practicing

right now?

This one's pretty easy.

I stink at procedures.

You know, the old days, they used to have a procedure log when you were a resident.

You actually did procedures, but everything was virtual.

You had to do 10 IVs, 10 lumbar punctures, yet they had a little purple book and you

ran around like an idiot during the three years in the residency to have someone signed

off.

So someone was dying.

18 interns showed up looking to get their codebook logged up for sticking in a central

line or doing a lumbar puncture.

So as things went on, I'm like, I didn't like the, I'm not a proceduralist, so I wasn't

particularly wonderful with my hands.

I also didn't like the idea that each subspecialty kind of pigeonholed you into a set of things.

If you're doing GI and you've got to learn to scope.

If you're doing, if you're doing a poem in critical care, it's about ID.

What's the most important thing is the problem solving really drew me the, the analytics

of it all.

You have to have a good and still have to have a good base of internal medicine to do

infectious disease because it covers every subspecialty.

So the swath of pathology is broad and it makes you appreciate things from all different

disciplines in terms of what you have to know.

So I liked the problem solving.

I liked that.

And then when I rotated in one of my first rotations, my mentor was an ID doctor and

my medicine rotation is a PGY three.

I'm PGY three.

What am I saying?

I'm MS three and I just loved her.

She was brilliant and what she did and she spent time in a hospital and I found hospital

so much more interesting than outpatients.

Being pigeonholed in an office, waiting for someone who may or may not show up, who may

come in with five pages of internet questions that I want to ask you.

It was too wild card for me.

I liked the hospital setting.

These were the critically ill people.

These are the people I was helping.

I found that much more amenable or more enjoyable for me.

So very few hospital based specialties, there's ID being a hospitalist, which wasn't a thing

yet when I was, when I first started, there were no hospitalists.

That was, that was a very new term started maybe around 98 or 99, but there were no hospitalists.

So either you were an internist and you ran back and forth from the hospital to the office

so I could check it without a head, which I didn't want to do, or you did a hospital

based thing, but all the other fields, the exception would be critical care, had a large

significant outpatient component and that just didn't interest me.

So probably a combination of very good mentors, my, both my, when I was a PGY, let me keep

saying PGY, MS three and four, I had two very strong mentors that were both infectious disease

doctors and I learned so much from them.

They just kind of inspired me to go into it.

What was your application process like to residency?

How did you choose your program?

Okay.

So yeah, so different now in New York, everything has changed, right?

So when we, where I am, NICOM was really one of the only two New York medical schools on

Long Island.

There was NICOM and then there was Stony Brook.

So to stay on Long Island, the big programs out here, which are, which was, which is now

called NYU, which used to be something called the Winthrop and then there's, there was Stony

Brook, there was North Shore before it was North Well, before the giant empire became

what it was.

It was a very good university hospital and there was LIJ.

I knew I wanted to stay on Long Island.

My family was here.

I'd been dating some of the time was in Long Island, so I didn't really want to move.

And the way for us, it worked that coming out of an osteopathic medical school, if you

wanted North Shore, which would Manhattan, which was a very good program, you really

had to dazzle on your sub-eye.

So I did a sub-eye there and the telemetry unit and, and you had to bust it.

You have to be better than everybody.

And we worked hard.

All the NICOM guys that went through there that landed, stayed there for residency.

They made their sub-eye like their life.

And so I was lucky enough to make a good impression.

So when I implied, I knew I was getting in that climate has changed in that now, since

all these other systems have feeder medical schools into these systems.

I understand from what I hear, it's harder for osteopathic medical students coming out

of New York anyway, to get into these programs, which are being fed by their own medical schools.

So North Well has its own medical school now.

So it puts its own medical students in its residencies, same with NYU.

So I think it's changed.

I kind of got in at a very good time where they were taking seven to eight DOs a year.

Matter of fact, classmates of mine made very huge strides.

Dr. Katetsos, who I graduated with in medical school, followed me to residency as the first

DO ever taken into North Shore's cardiology program, he was the first cardiology fellow

from an osteopathic medical school.

My friend who I graduated became the first ever taken into Winthrop, or it was now NYU,

and Mineola's first OB-GYN resident taken out of a DO school.

So we had some pretty groundbreaking guys doing stuff that no one else was doing because

they worked their tail off and they worked hard to make an impression.

I don't know what it's like now, but again, I pretty much knew I wanted this in Long Island.

Where I wanted to be was North Sherman-Hassett, that's where I wound up, and it was a great

residency.

Yeah, everything is changing.

I mean, there's no Stingis private practice anymore.

There's a whole bunch of things that have changed that people like yourself will never

know almost in terms of what is a private practice, or what is the idea of a hospital

and a hospitalist, or palliative care doctors.

There's a lot of things that have popped up now that weren't present when I was in training,

which for better or for worse, I think made us better doctors.

But you have to go with the times you live in.

So I sweated it out, believe me, when I applied, I wasn't sure I was going to get in.

And it was my first choice and I was lucky enough to match, so I guess I made a good

impression.

Yeah, I must have.

I know you kind of answered this, but if you were to choose between a large or a small

institution, private or public, for training, how did you decide between those two?

I think training is about pathology.

You go with what you went to see, where you're going to learn the most.

So as much as I work in a community hospital now, and there are lovely places to work as

an attending, I think as a resident or an intern, you have to get a place where you

can get the most pathology so you'll never forget what you see.

So North Shore was a university hospital, 500 beds, you saw everything.

A fellowship after that was at Sloan Kettering.

The premise I thought there being that if you're going to be an infectious disease doctor

in a large institution where no one has an immune system at all, you better learn what

you're doing.

The program director there is Dr. Sepkowitz, who's actually, he's nationally occasionally,

he's been on Late Night with Jon Stewart, he just did an article for CNN, he's a very

charming guy, but he was a great mentor.

So as soon as I met him, I knew I wanted to train with him for my fellowship.

So I think the big places are where you train, and I think what you experience that you can't

necessarily always get at a small institution.

So look, I'm not saying, I have a residency program where the hospital I'm mainly at now,

which is a 240-bed community hospital, but I think the rigors and the pathology is not

quite what I saw when I was a resident in a 500-bed hospital, too many things you need

to see, especially internal medicine-wise, where you need to round yourself and see everything.

That's a really good point.

I had never even thought about the aspect of the pathology.

Yeah, it's the pathology, right?

You're only as good as the pathology.

As much as you study for everything you've ever seen, you'll never forget the case you

see, not the one you read about.

So your first case of, name it, you'll never forget it.

My first case of pneumocystis pneumonia in an HIV patient around the time before antiretrovirals

were really potent, you'll never forget seeing that.

I saw a large breast abscess, and my first day in the city in a diabetic that was uncontrolled,

I could almost see her face.

I had an ALL girl at Sloan Kettering who was a BOMAR transplant who had a very rare mycobacterium

infection, mycobacterium hemophilum.

I remember the case.

I remember the girl.

Her name was Candice Payne.

I remember her dad.

He was an islander family.

Cases I wasn't going to see anywhere else.

We had a person in fellowship who was loaded with toxoplasmosis, so much of it so you can

actually see it in a peripheral blood smear because they were BOMAR transplant who died.

So pathology, you can read all you want, but once you see a case, you go, it's locked in

there forever as opposed to turning through Harrisons or whatever you have to read.

So I think pathology is huge to what you train.

If you're going to go to a place that only sees diabetic foot infections and community

acquired pneumonia, it's great, but that's not as valuable as seeing something broader.

So what was your residency like, and did you have any different experiences as a DO?

Yeah.

So residency was great, hard, and the days, I almost think days of giants because I almost

like I'm old now, but you worked ICU rotations, for example, I started July 1 as an intern

in the ICU.

They said, oh, just put this guy.

He seems pretty good.

Put him on the ICU.

So I remember being up for, I don't know, maybe 25 hours in a row, the longest time

in a row was 30, I think I was up 31 hours in a row once, and just doing 15 admissions

in an ICU here.

Here's how you do an A-line.

See one, do one, teach one.

I'll never forget my second day in the ICU, I had a six foot nine resident, was still

a very good friend of mine this day, he went to ID, and he said, go put an A-line on this

person in hypertensive crisis, and I put the line in and I missed, and I pulled the line

out and the blood was like a geyser shooting up to the ceiling.

I said, Paul, just get up there and put pressure on it.

So I was like standing on like a stool with all my body weight trying to stop this bleeding

arterial puncture.

So it was great.

And the DO part was interesting.

Here's where I really remember it.

We used to rotate, this is before I became a fellow at Sloan Kettering, so Nortra used

to send residents.

Sloan Kettering doesn't have its own house staff.

It only has fellowships for oncology and other stuff, but no residents, they're all transplanted

from NYU and other places.

We were in this big pathology conference, and it was a lot of snooty NYU residents who

thought they were the best residents in the whole damn world.

And so I was in a room, and I'll never forget this, I don't know why I remember this, but

in a room and this lady was doing a pathology slide, and she put up a slide of these cells

with these big giant vacuoles on them and said, does anyone know what this is?

And I jerked up my hand, I don't even know why I remembered it.

I still remember this day.

I said, it's Chedi Akagashi syndrome, it's empty vacuole disease.

Whole room went silent.

She went, wow, you know, I said, yeah, I know that.

So I always felt we had to do it better, carry ourselves stronger, carry ourselves higher.

We never wanted to hear, oh, he's, you know, because there was discrimination when we were

in, when I was a medical student, the NYU kids who used to go to North Shore used to

get special rotations with what is attending.

You would never include any students that weren't in a room, certainly would not include

any of the DO students, and she looked down on you.

I mean, she literally looked down on you.

So I always felt I had to walk around with a bit of a chip on my shoulder and carry myself

that way.

So you were asked, what is a DO, you know, are you a real doctor?

I feel even in my first couple of years in the attending ship, as a specialist, I would

get, well, are you a real doctor?

I said, well, the paper behind me on the wall with board certifications kind of says I am,

but if you don't believe me, we can stop this conversation now that I had lost patience

for it at that point.

I said, you know, I'm boarded by the same boards as everyone else.

I did the interim ABIM, I did the ID boards.

So if you don't, you're not comfortable with the letters that's my name, you can leave.

But in the beginning, yeah, you were, you, you worked it harder.

I didn't want to hear any excuses that, well, he's from a DO school.

He's not that good.

That was not going to fly.

And I felt my colleagues who are of my year, years that followed, really pushed that envelope.

I mean, we were the first year at NICOM to make the degree Doctor of Osteopathic Medicine.

Okay.

We weren't doctors of osteopathy, not that I have anything against that, but we practiced

medicine.

We were medical doctors as well.

Yes, we learned osteopathic medicine.

That's great.

But we were doctors and the word medicine should have been the title of our diploma.

So we made sure that that was done.

And we actually voted to get that changed.

And I think it's been that way ever since the class of 1987.

So it's important for us.

But yeah, you have to have a chip on your shoulder to be a good DO.

I think you just do.

And I don't think it's a bad thing, but you got to tell them I'm as good as you.

I'm smart.

I'm better.

I'm not even good as you.

I'm better than you.

And I'm going to show you how.

So yeah, that's really died down now, but I'm a 20 year attending now.

So at this point, I don't think anyone's going to ask me anything, at least they don't, at

least they don't dare.

But even the DOs I see in my training program, in my residency program, I always give them

a little high five.

I said, you know, DO, Nikon, where are you from?

And I usually give them a fist bump and try to show them that there's light at the end

of the tunnel.

Oh, there it is.

You go to school and be a successful attending and be good at your craft.

Because I think they need to see that.

I think that's important.

And I think that's the only trepidation when you walk into a DO school was that, am I going

to be good enough?

Does anyone question my degree?

Can I make a living?

Am I going to be like, you know, shunned?

And you're not.

You're just going to work hard and carry yourself, that's all.

So takeaway advice is just be better than everyone else.

Be better.

Carry a chip on your shoulder.

If they question you, then show them up.

If they want to ask you something on rounds, present it better.

If they want to make it, do it harder.

If they want to make you think you're insignificant, then show them you're not.

Get the patient reviews, get the reviews on rounds.

I just felt it was important for your dignity, I think.

I mean, you're not working any less hard than anyone else.

You're reading Harrisons, you're going through atlases, you're staying up at anatomy labs

late, you're doing all this stuff.

And there are bad doctors with MDs after their name too.

Plenty of them.

I met them.

So I think, I just think DO guys have to have a chip on the DO.

DO physicians have to have a chip on their shoulder, especially in areas where people

don't know what it is.

I know California may be a little different or certain parts of the country, middle of

the country probably, a little more accepting, a little more everything else.

But in Long Island, sometimes very affluent areas, Long Island and a lot of spoiled people,

your training will be asked.

And the only good thing I can tell you is at the end of the day, no one ever asks really

any more about medical school.

The last question they're ever going to ask is, which DO ID training?

And all you got to do is say a Sloan Kettering and everyone goes, ooh, ah, you know, they're

all happy.

But again, I think I would have done well no matter where I went.

You've got to want it.

So what was your experience like looking for a job?

Yeah, so that was another weird thing.

I was in North Shore and I thought I was going to join this big ID group.

My friend had just joined, the guy who told me to put the pressure on the central, on

the arterial line.

He finished his ID fellowship two years before me.

He joined this very big group that rounds, a private group, used to be a private practice

that rounds at North Shore.

I want to be a private practice guy.

I don't want to be a faculty guy.

Let me see if they have an opening.

So I sent the director of the group my resume and what I really wanted.

They had known me because I'd worked there and he called me back and said, no, we don't

have any openings.

We're not looking to hire.

Okay.

I found an ad in the New England Journal of Medicine for an ID practice in Eastern Long

Island.

Now, if you know anything about Long Island, it's Eastern Long Island, Suffolk County is

around the 35 mile mark to the end of the island of Suffolk County.

It's a big county.

It goes all the way to Montauk.

And I said, I don't know.

I don't know if I want to be that far out, but I said, let me go in the interview anyway.

So I went on the interview.

I met my still current partners and they interviewed me and they said, you know, you'd be number

three in the group.

They gave you a nice starting salary plus a bonus after you passed your boards.

Everything was split equally.

It was what sold me on it.

The call was one in five, I went to three at the time, holidays were split, weekends

were split.

Like I wasn't a Ponzi scheme.

I wasn't walking in to do more call.

And for whatever reason, for religious and cultural reasons, it turned out that my two

senior partners happened to be Jewish.

They're like, you never have to work Christmas any day the rest of your life.

And I said, great.

And I covered their holidays.

They covered mine.

Everyone was happy.

And I worked like a dog, I worked really hard.

I was on call Q3 covering at the time four hospitals and killing it.

But the funny part of the story is as soon as I signed that contract and dropped it in

the mailbox to join this group, the other group I applied to called me and said, oh,

we have an opening if you're still interested.

And I said, yeah, you know what, fate is fate.

I'm going to ride it out here and try this situation and make a name for myself a little

further east and best decision I made probably in the scheme of things.

So I knew I was going to get a job coming out of Sloan Kettering.

I knew there were some ID practices.

I just didn't know essentially where I was going to wind up.

I just knew I was so much more a clinical bedside guy.

So I wanted a private practice, again, thing that doesn't exist anymore, but private practice

where you spend most of your time seeing patients.

I didn't want to be a faculty appointment where I had to spend a research block or get

a grant or run journal club.

I enjoyed bedside patient care.

That's what I wanted to do.

That's what this job provided.

So there's a no brainer at that point.

So I know my strength, my strength is face to face and bedside patient care, not labs

and writing for grants and it just never appealed to me.

So it happened to be lucky enough to find the niche that worked for me.

Now we're going to change gears again, now transition to a bit more into your personal

life.

Sure.

So if you wouldn't mind, I know we touched on this before, but if you could elaborate

on your experience with starting and raising a family with a spouse who was also a physician.

So again, as fate would have it, when we made this interview and I took this job, she was

finishing her internal medicine residency program in a place in Brooklyn.

We had lived in Queens.

So I drove into Manhattan every day to Sloan Kettering and she took what is now known as

the Jackie Robinson Parkway to Methodist Hospital in Brooklyn every day.

So that was our commute.

We said goodbye in the morning.

She went south, I went over the bridge and I finished my fellowship and she finished

her residency.

Now she had thought about doing a fellowship, maybe a permanent critical care, which was

an interest art, but ultimately decided we were married.

We got married in 1999.

It was now 2002 when we were finishing.

At some point it was maybe time to have a family and figure out what was going to happen.

So her sisters and all her sisters and my parents lived in Suffolk County at the time.

So we took this job.

I was like, I don't want to work this far out.

I don't want to be this far out.

I don't want to be closer to Manhattan.

It turned out to be the best thing because when we were working, she managed to get a

part-time job to start.

So she was working four days a week, no weekends, oh no, one weekend a month, I think, correct

me.

And then we had our first child at 2003.

And then two and a half years later, baby number two in 2005.

So she wanted to get back to work.

She certainly earned her stripes to work and she enjoyed working.

So we had, my mother would watch the baby on Fridays all day, which was five minutes

from her office.

Her sister would watch the baby the other couple of days.

I was off on Tuesdays as my schedule day off.

So I became daddy daycare on Tuesdays and learned how to become a dad really fast, which

was much more scary than residency has ever been.

And she had to get on Thursdays.

So we carved out a child rearing schedule that worked and it was exhausting.

Little children are exhausting.

And so I can remember just like getting up and I was trying to, we used to split feeding

duties in the middle of the night because we were both working.

So I remember picking up my kid at two o'clock in the morning one day, like burping him with

my tie.

I couldn't reach him.

Like I threw my tie on.

One day I was so tired, he was up and he was not a good sleeper.

And I broke my toe because I kicked it on a, I had a very old, big Italian bassinet

that was in the room next to us that the kid was sleeping.

So I stubbed my toe so bad I broke my toe and I had to round that weekend.

So I actually wound up making rounds on a long weekend on a surgical shoe with a broken

toe because I broke it feeding my kid.

So it had challenges, right?

We closed on our house and signed our life away.

And while we were doing this after eight hours in a banker's office signing away my life,

I meant made rounds in the hospital afterwards.

So it was really hard, but again, really rewarding because we both got it.

Like it was never like, oh, well, you take care of the kid and I'm just, I'm the doctor

here.

You just, you know, we were on a completely, I mean, God, I would not be the first to admit

she did more work than I did.

She's the mother.

So she was, you know, she was in charge, but ultimately we shared almost all the responsibilities

we had to because it wasn't going to work any other way.

And God bless our families who surrounded us with so much love and support.

So our kid never saw a daycare center.

So never came home with 25 year infections.

Our kids never had, it wasn't even all at play dates.

They were always in the care of family.

So I could just, I took a deep breath.

You know, you drop your child off someplace, you don't know who's taking care of them.

Anything can happen.

When you drop them off at family, it's, oh, all right.

I didn't have to worry.

It was, it was, it was quite lovely, actually quite a, quite a blessing.

So yeah, it takes a village and believe me, I had help, but having someone who gets it

or understood what happened, it pays off at the end when they're older, but the beginning

boys at heart, lots of sleep deprivation, lots of crankiness.

And unfortunately a lot of the, what's the word I'm looking for?

Temper or things you want to say to a patient after in a hospital, you have to hold in all

day because you can't want to be fired immediately.

So you may be a little snippy to each other after a long day of work, you know, her being

an office full of people, primary care and, and me doing hospital medicine, you got a

little snippy at the end of the day.

And again, that level of understanding probably saved a million arguments because we just

got it.

So yeah, it was a hard job, the hardest job in the world, apparently the residency, walking

the park fellowship, not a problem.

These two kids who harsh thing you can ever hope to do.

So I'm the two and then, yeah, it's tough stuff.

But again, you get best and hardest job in the world.

Now can you share with us your wife's story and how you managed during that time?

Yeah.

So, you know, we've met and I told her in residency, we got married in 1999 and everything

was really hunky dory.

Let's say we had our children, we traveled, we learned that was our passion probably.

So we took a lot of trips, took the kids everywhere, Costa Rica, Alaska, Wyoming, wherever we can

go.

That was our vice as a family to get away.

So it was around the end of 2018, it was around New Year's time, around that end of the year,

Christmas, New Year's, she had been complaining of a cough.

I think kids were a little sick too.

And how this all worked out is it was a cough and I said, dang, you got a cough, I was only

not sick one.

Kids were coughing, she was coughing, I said, probably just a bug.

Cough lingered and it lingered.

So we, I said, you got to go, I know a friend who's a pulmonologist, I said, go see him,

get an x-ray, find out what's going on, see if you have pneumonia, maybe just need antibiotics

and you have a post viral pneumonia, you know, spoken like an ID guy, like I had the idea

of anything else.

And I remember I was sitting in the St. Charles emergency room, she was in the doctor's office

two miles away.

She shot up her phone, she showed me a picture of the x-ray, it was a large pleural fusion.

I said, that's weird.

I said, do I have an, you know, so they set her up immediately for drainage.

So we were in the intervention radiology suite in the hospital a couple hours later and I'm

watching the drainage and more blood than anything else.

It's like a bloody tap and it's maybe acid, it's hard for an empyema, it's strange, like

nothing had crossed my mind that this could possibly be anything worse than an infection.

They drained it, they sent the central hormone antibiotics.

I said, okay, we'll see how the antibiotics go, see if you feel better.

And she, being a more astute doctor than me, turned to me and said, I don't think this

is an infection.

I said, all right, well, we'll have to see.

So about maybe 72 hours later, we got a call, there's some unusual cells on the cytology

but we don't know what they are, no one could figure out what it was.

So as it turns out, it took a very long time, it was done at Stony Brook, their pathologist

could figure it out.

They sent it to Sloan Kettering for a second opinion and it turned out to be this very,

they think it looks mesothelioid or sarcomatous, mesothelioma, why would you get mesothelioma?

She never smoked, she didn't work in a shipyard, her father didn't work in, you know, wasn't

in asbestos in the house, as far as I know.

And as it turns out, we went for a VATS and then we went for a VATS procedure, they stuck

a camera in and her whole pleura was studded with something.

So they took more samples and I know the doctor who runs a giant oncology conglomerate out

here called New York Blood and Cancer and I said, I just got Dr. Vasarko who I've known

we have residents together, I said, you got to do something.

So he got her set up for chemo and I know he treated it as if it was almost a mesothelioma.

He got her around to chemotherapy and got an appointment with the best thoracic surgeon

in the city, this Dr. Flores in Mount Sinai and said, go see him.

So this I won't forget because certain things will stick with you.

We went to the city, said, oh yeah, it's plural based, you finish this round of chemo, we'll

set you up for resection, you should be able to get most of it out.

I thought it was encouraging, it was Valentine's Day, that's why I remember this story.

So we went and had, for Valentine's Day they launched dirty water dogs, two dirty water

hot dogs in the corner of Mount Sinai and two sodas, laughing like this was the most

romantic Valentine's Day gift ever.

And as it turns out, she ended up just developing worsening pain and worsening respiratory distress

and he said, bring her in right away, we'll get her in there.

So we brought her in right away and he said, I'm going to take her to a possible pneumonectomy

and take out the right lung and we'll see, though she had had a scan that maybe showed

some already activity under the diaphragm on the adrenals or in the abdominal cavity.

So then I do what you got to do.

And then he came to me in the surgical waiting room and said, yeah, it's all attached to

the great vessels, there's nothing I could do.

You could try some radiation and there's a mesothelioma specialist at Sloan Kettering,

you should go see.

I said fine, she knew, I told her the diagnosis as soon as she was awake on the bench, she

just shook her head.

And we went to Sloan Kettering and there was possibly a trial, but we couldn't get in for

another two weeks, they couldn't get the drug for three weeks, but try radiation.

Radiation did nothing, essentially.

She was getting oxygen at home, wearing a nasal BIPEP and becoming progressively short

of breath.

But compounded by the fact she was in pain, she was taking pain meds, so it was worried

about her respiratory rate.

It all came to a head one night, she had to bring to the hospital, she couldn't breathe

and wound up in a ventilator and they did a CAT scan, it was just wildly advanced.

So this is where I tell doctors and anyone in the field, you have to practice what you

preach.

We have talked, we had talked about patients, the best thing about marrying a doctor is

you can bounce patients off each other, we talk all the time.

Patients teach you very true things, how you want to live and how you don't want to die.

And she goes, you're not going to do this to me, no feeding tube, no tracheostomy, none

of that.

I said, you're right, I wouldn't do that to you, it would have been cruel and unusual

punishment.

So that's it, we woke her up, she wrote out her goodbyes and she passed away.

So again, 80 days from diagnosis to passing.

And that doesn't leave you a lot of time for closure or almost anything.

So I just can say that she probably made me the best person I could be.

And I had more than 20 years than many people have their whole life.

So I'm grateful for that.

It's the cruelty of being on the other side.

And I will say as a doctor, the true cruelty is feeling helpless, like I wanted to do something.

And as it was happening, as it was evolving, we both knew there was nothing to do.

And that maybe is the worst feeling in a profession where you take charge in two things.

Not being able to do that was the hardest thing in the world.

So yeah, it was just difficult.

I never thought it would be that way.

You had to be calm and you had to do what your loved one wanted and not necessarily

what they want.

And you have to respect people's dignity.

And I don't think people understand that enough now that you can keep someone, I always tell

patients this, often my phrase go to phrases, you can keep someone alive, but are they living?

And I kept her alive.

But she wouldn't be living her best life.

So at 45 years old, she passed away and left the legacy.

And I said, I'm over the anger, most of it, sadness never really goes away.

But yeah, but NICOM started, so the best thing I got at a medical school was a wife.

So that's hard to beat.

Did you feel like being a physician, I know you touched on this, and her also being a

physician, you were just hyper aware of what was going on.

I wish I was stupider.

We both wish we were stupider.

She was astute.

And she was a realistic woman to begin with, her patients loved her because she just didn't

pull any punches.

She called it as she saw it.

And she turned to me, she goes, I'm going to die.

You know that, right?

I did not want to admit it, did not want to come to grips with it.

We're both smart people, both do board certified doctors, looking at x-rays, looking at the

pathology, and when the guy says, oh, there's only like 17 cases that's recorded in the

literature ever.

And it's a combination of two very terrible tumors, it's a mix of a sarcoma, which everyone

knows what the outcome for that disease is, and mesothelioma, you know, the writing was

on the wall.

So I wish that was a lot dumber, because it's hard to be hopeful when you know, when you

ultimately know the truth.

So that was the hard part.

I think in the lack of time to really have the closure you wanted.

But conversely, after 20 years of marriage, we had nothing left unsaid.

So at least I don't have regrets in that regard.

But being too smart is not always a good thing.

And being powerless, I think is the worst feeling a doctor can ever have, whether it's

professionally with a patient, or even closer to home with a family member.

You want to do everything and you just you can't.

So it humbles you.

And I think I told you this when I worked with a pandemic, in the subsequent years as

an ID doctor where I was seeing 50, 60 people a day, and young people younger than my wife

even dying of COVID when there was no treatment, nothing to offer anybody, it gave me some

perspective in that I'm not the only unlucky man in the world.

This is happening minute by minute in hospitals around the world, people losing loved ones

who shouldn't be going from a pandemic that is wiping out people.

And not that it gave me solace in terms of my life, but it gave me perspective and an

ability to move on.

I think the pandemic saved my life by being able to work and give something back to help

anybody else rather than sit at home and feel sorry for myself.

The best thing I did was work.

It just felt good.

So the whole process between the pandemic and what I went through personally is the

most humbling thing in terms of just teaching you your place in the universe in terms of

how big the world is and how scary it can be sometimes, how there's so much we have

to learn as a nation and as a people have science to conquer things to come.

So yeah, it was going through that death and then followed by the pandemic was an unbelievable

combination of things.

But like I said, I may be the only crazy person who said that pandemic may have saved me because

I just put my shoes back on and said, I got to go to work.

If I could do nothing else, I could help people.

If I sit home, I'm just going to be home and miserable.

I had set the example for my children to show them that life is going to knock you down.

It's not how hard you get knocked down, it's how you get up.

So you got to get up.

So I think I can't probably say it better than that.

Yeah.

I know you also mentioned the COVID pandemic, but do you feel like you have a new perspective

on just ID medicine as a whole, like as a physician now?

Yeah.

I mean, I think you realize the world is going to end much more likely from a microorganism

than an atomic bomb, right?

With outbreaks of various viruses, now that we're reading about things and the more we

encroach on deforest areas that shouldn't be deforest and we bring people into contact

and nature of things that were not meant to be pushed together, we are going, death will

be from a microbe, not a bomb and not a nuclear power plant and not the ozone layer.

It gives you perspective how something so small can do so much damage and how it gives

you really a lot of perspective of how, again, where our place as humans in the world is

that's older than us, these microbes will be here long after we're gone.

It gives you a little bit of some pretty harrowing perspective because watching it evolve and

being helpless, especially during wave one, warfarin treatments that weren't going to

work and just figuring out who was going to live and who was going to die is one of the

scariest things I've ever seen.

So it definitely, like I said, humbles you to where your place is in the world and also

makes you understand how important a world based on science and fact is when it all got

discarded and people were questioning science and people don't understand, be making up

their own facts, their own studies, their own information, how dangerous that is to

us to exist as a species or race, whatever your nationality is.

I used to tell people, you know, when they politicized all this, that COVID doesn't care

if you're black, white, Asian, Muslim, Christian, Jew, it killed everyone equally, I promise

you that.

I told them I see it all the time.

It was amazing how hard it was to get that point through to some people though.

I found that fascinating too, like we were more united as a country after a horrible

terrorist attack in the World Trade Centers than we were over a microbe that was killing

so many more people.

I still just, they don't understand that.

I don't, it wasn't personal, but everyone was taking it personal.

I just let smart people do their job, stay out of their way.

I don't go to my mechanic and tell them how to fix my car.

You should probably go to the NIH with your high school degree and tell them how to fix

a pandemic.

You should stay in your lane, like we have people who are smart in fields, we should

use their knowledge, not belittle them.

I find that whole thing very distasteful.

So yeah, this has been from 2019 to now, wow, it's been an interesting, rough run for me,

but like I said, I think I've come out understanding a little more humble about my place in the

world and how valuable each day really is.

So going off of that, given the extensive time commitment that medicine requires, many

students enter the field with a delayed gratification mentality, whether that's about starting a

family or paying off our loans and getting a living salary.

We forget sometimes, or we don't consider how precious our time is and that in fact

may be limited.

So given your journey, do you have any thoughts based on this?

I think the journey is to work hard and play hard.

I think pour yourself into being a good doctor and when you leave your job for the day, whatever

it is, intensivist, hospitalist, primary care doctor, when you come home, when you put your

head on that pillow at night to finally close your eyes, know you didn't cut any corners.

You weren't lazy.

You did provide the best care you could for your patient and know your time that you have

free will be less than any other probably person you know.

Use that time valuably to enjoy, enjoy the fruits of your labors.

Look, we're not going to starve, whereas physicians, we will be well compensated, we will make

a good living, have a nice life, that is fine and it's earned.

But I think that balance between when you go to work, I think the easiest way of saying

it is people either work to live or live to work.

So which one is it?

Work to live or live to work.

So which one is it?

I don't live to work, but it is my part of defines who I am and I think you can't escape

that.

You spend so much time and part of being a doctor is part of your core, who you are,

what you do, how you exist, and you shouldn't deny that.

And when you're not working, enjoy life, go travel, go see the world.

I was in Greece last summer in between pandemics waves and I was sitting in an arena in some

islands of amphitheater that was built, I don't know how many years ago, you know, five,

seven thousand years ago.

And I was sitting there and there was a thing, the natives used to sit there and I was sitting

on a seat that someone else sat on seven thousand years ago.

And then how really we are but a grain of sand passing through the world in that one

instance.

And again, it's perspective.

So if you don't let the little things consume you, medicine should teach you that at the

end of the day, big things consume you, love your family, take care of your children.

But getting caught up in very little minutia, it's so it's in the grand scheme.

It's like that pebble.

It's like there's it's so small.

So I think get that perspective early in life and not worry about everything else.

Be good to your patients, be good to your family and enjoy your free time.

Everything else will settle itself out.

They will.

You'll make money.

You'll pay your debts.

You'll pay your mortgage.

You'll get your kids through school.

But whether the Johnny A. Green beans for the first time on Tuesday or did in the end

of the day doesn't really matter the time you may think it does, but it really doesn't.

So I think that's important, I think, in keeping a sense of balance about where you are in

the world.

So I think that's important.

I think that's the only thing I could stress because it could be gone.

Everything could be taken away from you in a second.

So try to live so corny to say that life of no regrets, everyone's gonna have some regret,

there's something in their life.

But understand your you could be turned upside down, your whole world could be turned upside

out like mine and I didn't see it coming.

I'd planned a future where we put an apartment in Manhattan and we were traveling and our

kids were in college and it's all gone.

So you got to learn to adjust.

I think that's the hardest part of this generation, not even so much yours, but the ones behind

you.

We weeded out the coping mechanism, everyone's not allowed to fail, everyone's not allowed

to struggle.

Oh, it's true.

You're allowed to fail, you're supposed to fail, you're supposed to struggle.

It's okay to have a hard time, but you can't crawl up in a ball every time a little thing

doesn't go your way.

You're gonna pull yourself up by your bootstraps and stand tall.

No one's around to feel sorry for you, you still got to handle yourself and take care

of your business, take care of those around you.

So I think that's my take home point from the pandemic, some travel and the tragic life

of it.

Right.

That's very valuable advice and I think it's better to take it on early rather than later.

Exactly.

Just don't cope.

You got to cope.

You're going to fail.

It's going to be hard.

It was an easy job.

Every woman do it.

It's not an easy job.

It's hard.

It's going to suck.

You're going to question it.

You're going to hate patients.

You're going to fall down.

You're going to feel miserable.

You're going to make a bad day.

You're going to miss a diagnosis.

All those things are going to happen to you.

And not take apart.

Realize that it's just a small part of what you're going to do in impacting people's lives

then don't bother getting up.

You got to get up.

Got to keep answering the bell.

So I guess that's the easiest way to say it.

Yes.

Can you tell us more about the medical school and high school scholarship funds you've created

in your wife's honor?

Sure.

So when she passed away, my younger of my two sons, my middle schooler at the time decided

to honor her memory, but he wanted to raise money.

So he made two very impassioned speeches in the middle of the school musicals and sat

outside with his friends and they set up a collection box and they raised almost I think

$8,000.

So we made a, I think a $5,000 donation to the American Cancer Society in her name and

they actually came in a nice photo op with a big picture of the check and all the money

he raised and then we started $1,000 a year scholarship to a student graduating high school

that has an interest in medicine.

And we've handed out the first one last year and the second one's about to be awarded tomorrow

as a matter of fact.

And we get to screen the applicants, they send us fibers to people we think we liked

and then we kind of weigh in who we would like.

Medical school, I started personally reaching out to friends and family and one of my wife's

classmates, his name is Dr. Leader at NICOM, she's wonderful, shared about Natalie's passing

so you should start a scholarship and meet with the dean and come and meet with them.

I said, all right, final.

I went in and since inception I've raised, well I raised my family and friends and the

people I've raised about $28,000, $29,000 and we decided to have an endowed scholarship

and we give out $5,000 every year.

And we gave out the first award last year to a young widow, ironically enough, woman

from I believe Ukraine who was going into OBGYN and had a child and I wanted to give

it to mothers or even parents specifically, preferably mothers, but it could be this year's

award is going to a man, people raising children while trying to be doctors to help them out

in any way it can because I know it's the hardest thing to juggle of being a doctor

and being a parent.

So we've raised, like I said around, we have the largest endowed scholarship, private scholarship

at NICOM, so proud to say that and we continue to raise money every year and that second

award will be going out, went out, actually they invited me to graduation which I haven't

been through in 23 years which was cool, I actually sat through graduation, loved it

and brought me back a little bit and I'm having lunch with the scholarship recipient next

Tuesday in the afternoon and I'm going to have a lunch with the dean and I got to meet

him and take some pictures and everything else.

So it feels good to give back and it feels good to see something with her name on it

and I think again, as I told you, part of who you are as being a doctor, part of who

she was is a doctor.

So to have that name carried out, hopefully add in for night at least as long as I'm walking

the planet is I think the biggest honor I can give her.

So it's really helped me give back and I think, you know, maybe that's where I end up one

day, who knows, maybe I wind up back in academics and teaching or once I'm done killing myself

as a clinician, maybe I wind up doing some teaching back in NICOM or something like that.

I'd love to, I don't think they need me right now but that might be where this all ends

up for me.

But yeah, it's been a great experience.

I think she touched a lot of people's lives.

I mean, I know she did based on the turnout at her services and everything else and people,

we still share patients who she had as a primary care doctor who have seen me as an infectious

disease doctor and they come and crying all the time and telling me how much they miss

her and everything else.

So she impacted a lot of people.

So I think it's important to give something back to somebody, especially a parent or someone

striving to be a doctor to make the world a better place and it's kind of, let me come

full circle and bring everything kind of close a loop for me.

It's really beautiful.

So it's really nice.

So we're going to end with our final question.

What is the best piece of advice you got throughout your education that you would like to pass

on to other students?

I mean, I think of all the professors I had, at least in medical school, there was a doctor

who since passed away and then Dr. Mancini, he was the professor of pharmacology at NICOM.

As a matter of fact, his course was the hardest.

He pushed and pushed and pushed and to succeed in this course, you actually have to do very

well.

I actually won his pharmacology award when I graduated, but he was an inspiration because

he didn't take it easy on you.

He made it hard and to do well, you had to put the work in.

There was no skimming.

And I ran into him years later and he was a patient in the hospital, ironically enough,

I was attending.

This had been maybe 15 years after I was in medical school, maybe longer.

And he wheeled by me in the hallway and I stopped, and even though he was there, and

he went, hello, Phil, and took me completely by surprise.

And I think the message is you've got to, nothing is given to you.

You have to earn it.

Continue to be curious.

What drives a good doctor is a curiosity.

Oh, what about this?

I don't know anything about that.

Maybe I should read up about this or maybe I should read up about that.

I think that curiosity, that fire, which probably draws all of us into this, don't let it go

out.

Stay motivated.

Stay curious.

Stay.

And it's hard to do from all the pressures of family and friends and children and real

life stuff that we live in.

Even to this day, 20 years in attending, 25 years at a medical school, I'll still get

a case and it'll charge me up and I'll try to pass that to the residents and say, what

about this?

Well, you see, it's cool.

And it's got to keep that going.

Whatever it is, whatever your discipline is, whatever it makes you go, find something.

Because I think to keep that fire going will only make you a better doctor.

And take the time.

The only other piece of wisdom I can give you, because I'm from a hybrid computer slash

note generation, don't look at the computer screen so much.

The notes are not as important as taking care of the patient.

Be that patient's advocate.

Don't put your back to them while you're typing.

Or don't be so worried about whether the note hits 17 Roman numerals because it has to to

get billed properly.

Then you understand the crux of the case.

I think when I used to write my notes on the charts, you wrote and thought at the same

time so you were a good clinician.

Now everyone's copying and pasting notes and copying pasting items.

And everyone has stopped thinking because they're so just worried about getting the

notes done and following the algorithm.

The algorithm isn't always right.

Patients don't read the algorithm.

So take care of the patient individually.

Make eye contact.

Take that time to get to know them a little bit.

You'll be a much better doctor for.

So I guess that's my probably part of the wisdom.

That's a great note to end on.

Thank you so much, Dr. Neza, for sharing your story with us.

You're very welcome.

Thank you so much for having me.

It's very nice to talk about it and it's been a while.

So I wish you well.

I wish you well on your journey.

And if anyone if anyone calls or has contact questions about infectious disease or any

questions, they can feel free to contact me with my email or they could shoot me a message

or more than happy to lend a hand.

This concludes our episode of Do or Do Not.

Send all inquiries, comments, suggestions and even let us know if there's someone you

want us to interview to do or do not podcast at gmail.com.

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We have plenty of more interviews lined up and we're excited to share them with you.

This is Tianyu Shea.

Thank you guys so much for listening to Do or Do Not.