Episode 2: The 3 AM Advocate

June 10, 2018

So many stories to tell and so little time….

I grew up on a dirt road in the middle of nowhere - the south shore of Staten Island, basically the country in the middle of the city. I had an older and younger brother, my father was a machinist, my mother was a stay at home mom.

From an early age everyone told me I was smart enough to do whatever I wanted in life. I never knew how to take that as I did not think I was anything special. My brothers weren’t stupid, but in the end I was the only one who went to college. They pointed that out to me pretty often, calling me “different”, in both good and bad ways. Back in high school, my guidance counselor asked me what colleges I had in mind. He gave me that “puzzled dog look” when I said I probably wasn’t going to go to college and had no real plans. Then, one day, senior year, I go to homeroom and there’s a note from the counselor, Father Gannon, to meet him during my calculus class. Now, I had NEVER missed class. Realize that I made up my mind in 4th grade that I would never be absent or late ever again. I wasn’t happy but I went. I show up for my appointment and he wasn’t even there. Even his secretary was confused and told me an admissions rep from Notre Dame was there, maybe he wanted me to see them. Fr. Gannon had a policy that if you handed him a college application before the start of homeroom he would fill out the school portion of the application and put it in the mail by that afternoon. I figured I’d make some work for him. Every time he pulled me out to see an admissions rep I filled out an application. Eventually, he approached me and said I didn’t have to apply to every school he had me come down to see. I looked him right in the eye and told him I only thought he had my best interest at heart and that if it was important enough for him to interrupt my academic schedule then I should honor his intent. He said now that I had applied to several schools he would leave me alone. I guess I had shown him, or had I?

It turned out that the only schools I had been accepted to were “those” schools – Notre Dame, Columbia, and Lehigh. I asked my counselor which of my choices had the highest acceptance rate from our high school into medical school and he didn’t even let me finish the question, “Notre Dame.” There was no guidance from family, this was uncharted territory. I visited Lehigh and didn’t like the campus or the surrounding area. Columbia just seemed depressing and I wanted to go further away from home. So, site unseen, I figured, Notre Dame it is, how bad can New Orleans be? Remember, I didn’t send for the application or mail it in. When I had to mail the acceptance back I looked at the return address and saw South Bend, Indiana. South Bend? Indiana!?!?!? When did they move from New Orleans and who asked me if that was okay. Oh well, I figured it was the right place and I never looked back.

I graduated high school in 1976. Several decades later, while making rounds one day, I thought about calling my old guidance counselor. I realized I had never actually thanked him. I called my alma mater and they said he was now principal at another high school. Okay, not uncommon for the parochial schools on Staten Island for personnel to be moved around. His secretary took my call, said he was busy. I figured at least I had tried. He called back about five minutes later. I asked him if he even remembered me some 30 years later and he said of course. He asked what prompted the call, I said “something told me you needed a call today, I never thanked you and figured today was the day. I wouldn’t be who I am and achieved what I did, personally or professionally if you had given up on me.” We talked about my family, life, his going from one school to the next, etc. He died 6 months later.

You never know when someone needs help but it’s important to trust your feelings when you have them. Just noticing that something is “different” is a good start. It takes very little to snap someone back. You could just say something obtuse, not offensive obtuse, non sequitur funny kind of obtuse, to get them out of their funk. For myself, when I feel my head spinning, for whatever reason be it personal or professional, having a place I can think of where I can remember being calm is l alI need. Just take a second to think about it. I don't know what it is, simple distraction, some chemical change, but I gotta tell you, it works.

What’s with the origin of the 3 am story I keep bringing up in lecture? I could fill page upon page of things that happen in the middle of the night (I shared a few with Humza and he did print them up, but they were WAY too long). Just last night I was at the wedding of a colleague’s daughter. Another friend whom I used to practice with was there and he starts off a story of something that happened to him recently with, “it was 3 o’clock in the morning….” Just accept it, it’s going to happen. Why do I keep repeating it? When it does happen, and it will, stay calm, think of me, and just say to yourself, “I got this.” To be forewarned is to be forearmed as the expression goes. Think of it as an initiation to a secret club. Years later you will run into one another at a wedding or something and laugh over all of your own 3 o’clock in the morning stories.

What brought me to NYMC? I was in the field of surgery for 20 years. Rushing to the hospital to attend a surgical meeting prior to a busy day in the OR, I slipped on the ice in my driveway and shattered my left distal radius and ulna. While the fracture healed uneventfully I sustained neurologic damage to my distal ulna nerve resulting in motor and sensory deficits in my left hand which worsened over the next few years. After multiple neurologic and surgical consultations it was recommended that I stop operating. I did just that the very next day, no hesitation, no plan for my future in mind.

My wife, a formally trained musician and music educator, said that I had a knack for teaching. She calls it a unique way of explaining things to someone in a way they can understand. For lack of a better descriptor I call it teaching to the person. She told me I should just start calling colleges and tell them I’m free, see if they needed biology teachers, maybe get a teaching degree and teach high school (could you honestly see me teaching high school?). Settting out to prove my wife wrong, which let’s just say never ends well, I called up NYMC, my alma mater, and was eventually put in contact with this Dr. Pravetz guy. I explained my situation, told him I was free and was looking for something to do and got the standard reply about budget cuts and hiring freezes. At this point, it was May 2004, I told him that I worked 24 hours a day, 7 days a week for 20 years and was going to take a little time off. He said great and that I should call when I got back. I went to Florida for a few weeks and checked back with Dr. Pravetz when I got home. He said they did need help in the lab here and there, not every day, not both sessions in a given day, but I could fill in as needed. Now this is a 40 + minute drive from my home. After a few labs, I asked if I could volunteer to stay for the whole day. It didn’t make much sense to me to make such a big round trip for only one lab regardless of whether or not they paid me to do the second lab. Eventually, 1 lab session turned into both labs, and then to giving a lecture, and eventually to where I am today. The important thing here is to realize that failure, for lack of a better word, is just an introduction to a new path of success. Don’t wait for opportunities to come your way and never rest on your laurels. Had I done that, I wouldn’t be here now.

I’ve been here for 15 years. That’s longer than any 1 place I’ve worked before. I don’t feel like I’ve really ever left the field. I still “practice” but nothing I charge for. I still diagnose family and friends, consult with them to help make medical decisions or to understand their care outcomes and options, send them to the appropriate specialists as needed, etc. Teaching has reminded me of the importance of all the stuff I learned that I never got a chance to use in a surgical practice. I’d like to think I’m a still a help to the community and society, in a different way than when I was in practice, but important nonetheless.

What did I listen to on the way here?
Well, I got tired of talk radio – pseudointellectuals and self-important talking heads. Remember, on a 40+ minute drive in to school there is a lot of time to fill. On the way in today I listened to Bleachers, Alabama Shakes, the Drifters, AJR/Rivers Coumo, Bob Seger, to name a few. I like skipping around, finding that part of one song I like and moving on to the next. It drives my family crazy. I like finding mashups. It’s interesting to see what other people hear and their interpretation of that song. If I hear a song in a movie, someone’s redo of a classic rock song or something, I will go to great lengths to find it. I will listen to just about anything, but, there is one group I will NEVER listen to (a group that my brothers listened to morning, noon, and night when we were growing up and is like aversion therapy, can’t stomach the sound at all).

If you could have any superpower, which one would you choose?
I think I would like to have the ability to make people live up to their potential.
Realistically speaking, how would you define something as a super power? It would have to be something that was unique and would make a difference. If everyone could fly, it’s not a superpower. A primate looking at us might think having opposable thumbs is a superpower. Us looking at fish, breathing underwater would be a superpower for us. As for a more lighthearted answer, dinnertime in my house gets really interesting because I like to ask my kids all sorts of silly questions or pose all sorts of thoroughly untenable philosophical thought exercises. I’m really big on family and I think it helps keep us together. Superpowers, my go to answer has been the ability to shoot spaghetti out of my nose. Just think, if someone bugs you, you can suddenly send linguini their way. How cool would that be? Think of ending an intense argument by flinging tubes of mostaccioli someone’s way. That usually then spurs the discussion of what type? Cooked or uncooked? Al dente or over cooked? Pros and cons of each. Can you switch back and forth or are you limited to one or the other? Would it hurt you? With great power comes great responsibility….There’s another answer to this question, my new preferred superpower, but if you want to know that, you should ask Humza for that one.

Pick something or someone from NYMC go give out a shout out to!
I think I want to give a shoutout to Dr. Sato. She’s not well right now and it would help for people to just give her a thought.

If someone wanted to talk to you, they should lead with…:
To me it’s never about the what, but the how – sincere, honest, jovial. I think tone and body language set the mood better than content, even for an unpleasant topic. Never any profanity, I’m very big against it and I don’t respond well to it. I’ve never been the type to yell or throw things. My number 1 focus is always being calm, jovial. I frequently hear that people are afraid of me or that I always look angry. I am always thinking, about topics serious and silly (more often more of it silly than you might think), but, as I have said, we all have a certain look about us when engaged deeply in thought. Outwardly, none of us are aware of it but we all do it. Pick someone who has a really serious look on their face and just say hello in a real friendly way, ask them how they’re doing, and watch how their expression changes. I think you’ll find that I’m not that difficult to talk to, it’s all in the approach, but, be careful, it can be hard to shut me up. And, as I tell my own children, remember, I am on YOUR side, always.