Portal de Periódicos da CAPES

My Two Careers

2001; Lippincott Williams & Wilkins; Volume: 10; Issue: 3 Linguagem: Inglês

10.1097/00019048-200103000-00004

1536-9943

Claire Panosian,

ONCE A MONTH, I open e-mail with an extra rush on anticipation. It’s usually the day after my column, “The Doctor Files,” runs in the Health Section of the Los Angeles Times. Because the column shares true stories as well as the emotional side of doctoring, it invariably touches someone. Sometimes I receive as many as 20 responses—positive and negative. I might go through a dozen drafts to produce my final 800-word version, but I consider the time well spent. Revealing medicine’s humanity and inner workings to readers has become, in a way, my personal crusade. I’m an infectious diseases and tropical medicine specialist. Since 1987, I’ve also been a broadcast journalist, a lay lecturer, a magazine writer, and a columnist. I didn’t set out to combine medicine and communications. In fact, 17 years ago, as a rookie ID attending, the possibility of someday linking two careers never crossed my mind. How it happened and where it’s led are the subjects of this article. But my objective is to encourage selfdiscovery and outreach by other infectious diseases doctors. Drawing on the medical and life knowledge you already possess, don’t underestimate the good you can do through a radio interview, op-ed letter, school lecture, whatever—not to mention the personal satisfaction of serving the public in a new, creative way. Here’s another way to think about it. In our profession, science and human truth are our daily bread. Today, more than ever, patients hunger for the same fare. Lacking trustworthy guides, many turn to the Internet. Even worse, some fall prey to ill-informed gurus and antiscience crusaders. In this information era, there are many competing voices. That’s why the time has come for front-line doctors to speak up and (sometimes) fight back. I’ll admit, when John Bartlett first suggested I write my story for IDCP, I hesitated. I’m a private person by nature—certainly not a “leading figure” in medicine or journalism. But after thinking it over, I saw things differently. Sometimes a little soul baring can bear surprising fruit. And that’s my true goal. So thanks, John, for the opportunity to share my hybrid career, still deeply rooted in patient care despite the occasional burnout day (we all know these days). After all, for anyone with a bent for journalism, what better inspiration is there than clinical medicine? Everywhere you turn, it’s chock full of amazing stories, high drama, and human emotion. Anyway, that’s my prologue. Now it’s time for the back story. For starters, although it may sound sacrilegious, I never saw medicine as my life’s calling—not really. Liberal arts was always my strong suit. Then, in high school, I discovered biology. Left-brain learning aside, it entranced me. Around the same time, I also started working as a hospital volunteer. In pinafore and cap, I pushed wheelchairs, served meals, washed faces, and measured outputs. The assignment didn’t matter. Basically, I liked the patients, being part of a team, and observing the sheer drama of human illness. Looking back, an after-school job as a waitress or a newspaper copy girl—anything that injected new people and energy into my sheltered universe—would have captivated me. After all, I was only 16 years old, a minnow in a very small pond. But at 16, at least I knew this: I wanted into a bigger pond. That’s how, with just a whiff of biology and medicine, a taste for adventure, and a dog-eared copy of Sinclair Lewis’s “Arrowsmith,” I impulsively chose doctoring as my life’s path and escape route. “Arrowsmith” deserves special mention. It kindled my interest in tropical medicine. Of course, unlike Martin, I never battled plague on a (fictitious) Caribbean island. However, by age 21, I did witness death almost daily in the real town of Limbe, Haiti. While working there as a medical volunteer, I also dispensed meager hoards of pills for every sort of tropical scourge, played with pot-bellied orphans recovering from kwashiorkor, and privately stifled panic over life’s frailty, my own included. Haiti was a banquet of human experience and my first true taste of mortality—a perfect feast for any aspiring writer. Except that I didn’t yet know I was writer. After all, wasn’t I heading off to medical school? My life was planned, or so I thought. The next 12 years of training in Chicago, London, and Boston are chapters too familiar to colleagues to rehash here. Instead, I’ll fast forward. By 1984, I was an assistant professor at UCLA Medical School and the solo ID specialist at a small county hospital in Los Angeles. Fresh from fellowship, bench research in leishmaniasis, and an overseas stint in Asia, I found myself in charge of an infection-control program, antibiotic formulary, and burgeoning AIDS and TB clinic, not to mention (along with housestaff and visiting attendings) a full load of adult and pediatric consults. Many unforgettable people and stories lined up at our county hospital doors—immigrants, laborers, exotic disease sufferers, their illnesses interwoven with everyday life and trials. From an illegal alien who developed full-blown tetanus while locked up in the county jail (he was unceremoniously delivered to our psychiatric ER by local police; they thought he was crazy) to an exquisite Kashmiri teenager whose advanced scrofula was kept secret during sight-unseen marriage negotiations. After one botched operation, I was asked—no, begged—to “cure” her disfiguring lumps and sinus tracts in time for the scheduled nuptials. Launching life as a young attending with a full plate of duties, I was finally grown up. But 3 years later, I was also spent. Although the work was stressful at times, my job was not the real problem. After years of marching to medicine’s drum, I yearned for something more; I just didn’t know what. All I did know was this: I couldn’t find “it” unless I bailed. So, despite shocked reactions and kindly warnings from mentors and peers (one even said I was committing “professional suicide”), I left my structured world. It was a death of sorts. For the next year or so, I drifted. I joined a medical fact-finding mission to the Philippines. I visited the Australian outback. I taught medical students in Pakistan. Meanwhile, back at home, I staffed a free clinic, dabbled in children’s book writing, and considered new avenues of work, ranging from disaster relief to international medical intelligence. Thankfully, my romantic notions of medical spy work cooled around the same time a small ad appeared in the New England Journal of Medicine. Bottom line: Lifetime Medical Television needed a full-time doctor– editor. Back then, LMT was the West Coast partner of a national cable network that aired medical shows all day Sunday. I answered the ad, drove my aging Saab to the interview, and prayed my search was over. No such luck; someone else was picked. But, at least, Lifetime’s VP said he’d call back if they ever needed a freelancer. Three months later, the phone rang. Could I start work as a technical adviser on a 1-hour special called “The War Against Hypertension”? You bet. It wasn’t NOVA, but no matter. I now joined a team of veteran news and documentary producers whose living rooms held awards like a doctor’s office sports diplomas. To them, medical television was a decent-paying gig. To me, at $25 an hour, it was a priceless introduction to the multifaceted process of production. Even more amazing, I was a needed contributor. The collaboration was a joy. By the late 1980s, with more TV work under my belt, I became senior medical editor/writer/reporter and finally co-anchor for LMT’s weekly flagship program of medical news, profiles, and special reports. Another paid apprenticeship—this time bestowing a full set of on-camera skills (reading teleprompter, conducting in-studio and satellite interviews, performing stand-ups in the field). That job lasted until 1993, when Lifetime’s parent company reclaimed Sunday for nonmedical programming. Then I moved on to freelance video reporting and moderating. My favorite projects included several series on AIDS, managed health care, a public health documentary filmed in the former USSR, and an award-winning profile of Dr. Roger Bone (an eminent critical care physician and medical school dean) as he bravely faced death in his 50s from metastatic kidney cancer. Most recently, in 1999 and 2000, I coproduced an international documentary on hepatitis B now airing in multiple languages throughout Asia. Writing came later in my creative rebirth. Although I had basic TV script skills, I needed more. So I took seminars and evening classes in print journalism—news-writing, features, creative nonfiction. For me, the classes were like candy to a baby. I couldn’t get enough. Today, writing is my first love. However, getting published in mainstream newspapers and magazines was another hurdle. (If anything, my academic publications were a liability; to capture the hearts and minds of lay readers, you basically “unlearn” technical writing.) My first real break came with a trio of Los Angeles Times book reviews; I slaved over them, but it was a labor of love. Then I moved on to editorials, health articles, a continuing series of tropical medicine cases for Discover magazine, book review/ commentaries for Scientific American, and “The Doctor Files,” my story-driven column for the Los Angeles Times. The column, now in its second year, has turned out to be my most personal, eclectic work thus far. In it, I find myself mining incidents that hark back to medical school right up to last week’s consults, with themes ranging from breaking bad news to missing a diagnosis to respecting patient confidentiality in hospital elevators. With help from my editor, I try to keep the column readable and patient oriented, steering clear of doctor jargon and stereotypical thinking. Sometimes easier said than done. Fourteen years ago, I also returned to UCLA with a 60% medical school position in infectious diseases and tropical medicine divided between patient care and teaching. This year, I’ve accepted another appointment in the Program on Global Health and Education on UCLA’s main campus. There, I’ll be teaching a course on world health to undergrads as well as developing outcomes `research on domestic and international medical communications. In sum—if my life is any example—I believe there are many ways for infectious diseases doctors to utilize communications, both locally and globally. And there are so many untapped opportunities! You could start by offering yourself as a resource to a local radio or television news program. School-based campaigns are another dream of mine: I often think how simply introducing sixth graders to real-life microbiology and infectious diseases might help shrink future ranks of the medically misinformed. And where infectious diseases doctors lead as guests in the classroom, other specialists could follow. If you want to tool up, fine; there are many avenues to learning the crafts of print and broadcast journalism, even acting classes and Toastmasters to aid effective public speaking. But the foremost key is discovering your own message and passion, whether it be antibiotic use and abuse, food and water safety, or vaccination. Most importantly, never underestimate the power of a human story, simply and honestly told. And in infectious diseases, do we have stories.