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President’s Letter
Saving Lives
By Stephen J. Ezzo, MD
T“You saved his life.” and join my clinic so I could retire. We set up a follow-
hese words came from the mother of one of my up appointment, and I went to see the next patient with
patients. Her tone was excited and appreciative, newfound energy. Still, I felt his mom’s statement had been a
and she even laid a hand on my forearm. I bit too inflated.
held her gaze for a moment, trying not to look
embarrassed. “Well, we had a lot of people who helped us At the end of the day, as I was completing his chart, her
with this journey.” I do not recall if I shrugged as I spoke, words came back to me. Having time to reflect, I began to
but most likely I did. realize that, although dramatic, she was in a way correct.
We know through studies that patients with ADD who go
I always have been uncomfortable with praise, doing my undiagnosed have a higher incidence of school failure and
best to deflect and minimize it. I imagine some of this stems dropout, lower self-esteem (my patients with untreated ADD
from my years of Catholic education — a phenomenon that report feeling “stupid” because they do not do well in school)
is not short on instilling guilt and “rewarding” any perceived and higher rates of substance abuse. By making the correct
braggadocio with a few swift ruler raps on the knuckles. diagnosis and finding the right treatment plan, we were able to
allow my patient to meet his potential and open up worlds to
But some of this also is in part due to decades of him never considered. He had discovered the gift of education
practicing medicine, and being reminded time and again of — something I constantly stress to my patients is the key to a
not only its difficulty but its capriciousness. You can treat happy, successful and fulfilling life.
an illness in textbook, evidence-based fashion and, yet, the
patient will confound you by actually getting worse. So I I relate this story to remind each of us that in our everyday
have strived for maintaining an even keel, reminding myself dealing with patients, what we say and do for them can have
of what my friend and mentor Duncan Morton, Jr., MD, profound and lasting consequences, even if we initially view
always said, “Hero in one room, goat in the next.” Yet, we it as something minor or routine. Our patients seek our help
all know how hard this is to do, as we want our patients on a variety of matters, many of them not necessarily what we
to get well, and quickly, and our frustration mounts when consider “traditional medicine.” They ask, nonetheless, as our
they do not follow the game plan. Thankfully, it is precisely years of training make us appear learned and trustworthy.
this attachment we have to them and this attribute of our
profession that allows us to be better physicians. Remember: Even the most casual of advice may be taken
to heart. This is something, like most things in medicine, that
Back to my patient. What had I done that altered his life so took me years to learn and understand. I find it elicits a wide
significantly? Nothing so powerful and immediate in the way range of emotions in me: appreciation, humbleness, fear and
we commonly think of saving lives (as portrayed on TV) — even conceit (yes, doctors can be conceited on occasion).
curing a severe infectious disease, discovering a tumor early
enough in the course to achieve total eradication, or finding We chose medicine in part because a streak of altruism
the resources available to help keep an addiction at bay. runs deep in all of us. We influence patients in everything
we say and do for them. Our idea of what is significant may
No, what I did was something I do quite frequently in my not match theirs. Proceed with caution, but be filled with
practice: diagnose him with ADD. I listened to the concerns optimism. You never know whose life you’ll save.
he, his parents and his teachers had noted over the years.
We performed the appropriate psychological testing, worked “We cannot live only for ourselves. A thousand fibers connect
with his school and teachers to create a learning environment us with our fellow men.”
more conducive to success, laid out strategies for homework
and began a trial of medication (as I said, I had a lot of help — Herman Melville
in the journey). Now, six months later, he had gone from a
student close to failing with a dread of attending school to an Question: Who was Mary Mallon?
A/B honor roll student eager for each day of classes. It was a See page 10 for the answer.
wonderful outcome and one I have been fortunate enough to
share in several times over the years.
Obviously, I was pleased and shared their excitement.
When he told me he wanted to enter the medical field, I
jokingly urged him to hurry up and become a pediatrician
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