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Physician, Teacher and Writer... Sergent Shares Healing Words
He was attracted to medicine by the kindness of his childhood doctor. "Then in high school I found I really liked chemistry and biology." Even though he was also interested in law and politics, "in the end, I just thought medicine had it all —science and interaction with people," he said. A Case to RememberFrom Healing Words:Charley Benz Charley had aplastic anemia and was dying, at age 18, because he had become immune to platelets. I was a third year resident and was called to the ER to see him one night. He had clearly suffered some sort of intracranial bleed. I wanted to admit him, although other than pain control for his headache there was nothing to offer. His parents (father was a surgeon, mother a nurse) decided to take him home, clearly to die. When I got home, around 2 or 3 in the morning, I couldn't sleep, so I got up and started reading the journals that had just arrived. The lead article in that month's (July 1970) Annals of Internal Medicine was on the use of platelets from immunologically identical siblings to support people with aplastic anemia. Tissue typing was brand new, with only two labs in the country fully certified, and we were just setting ours up at Vanderbilt. Anyway, Charley had three siblings and I knew the odds of a match were one out of four with each. I called the woman who was setting up our lab, around 5 am, and she said she would run the samples but would rely on the reference lab (U. of Wisconsin) before we would do anything. Around 5:30 I called the family and we all met in the blood bank, drew the bloods, and air-shipped them to Wis. That afternoon, the lab here called and said she thought there was a match, and the next morning Wisconsin called and said that Yarrott, Charley's 15 year old brother, was a match. We got them into the blood bank and very slowly and laboriously — this was before the continuous flow centrifuge — we got four units of platelets from Yarrott over about a four hour period. When we infused them into Charley it was the most amazing thing I've ever seen. The oozing from his gums stopped right before our eyes, and within several hours his headache was completely gone. We maintained Charley with Yarrott's platelets for the next five years, when Charley unexpectedly went into remission. He had a terrific several years until, at age 31 and 13 years after I had met him, he developed acute leukemia and died. I learned a lot from that, including the fact that the physician-patient relationship is a 2-way street. I also learned that you really can make a difference. After graduation from Vanderbilt University and then the School of Medicine three years later, Sergent did his internship and residency at Johns Hopkins Hospital in Baltimore and at the National Institutes of Health before returning to Nashville as chief resident in medicine. He has been a leader in his specialty, rheumatology, serving as national president of the American College of Rheumatology in 1992-1993. He was named a Master of the American College of Physicians in 2007. His people skills have especially come into play in his role as teacher and mentor of medical students at Vanderbilt. His talent for communicating has underlined all his activities but received a new focus when he became a member of the "fourth estate" as a contributor to the op-ed pages of the local paper. "When I was chief of medicine at Saint Thomas Hospital, one of my jobs was as chair of the ethics committee. This was in the late 80s, and the living will movement was just getting off the ground. They had a column in The Tennessean in those days called the "Nashville Eye" and invited people to send things in, and I sent in several on end-of-life issues and the importance of living wills, and they were published. Things just sort of grew from there." Twenty years worth of Sergent's Saturday columns have been compiled into a book, Healing Words, A Compilation of the Best Columns of John Sergent, M.D., which was published last month. The columns have ranged in topics covering everything from the practice of medicine, the right to die, the reemergence of certain infectious diseases and our current healthcare crisis … to cicadas, Charles Dickens, his daughters' weddings and the wonder of grandchildren. He's even written a column on Vicks VapoRub. They are thoughtful, touching and often very amusing observations of a healthcare practitioner, teacher, philosopher and optimist. Regarding the old theory that "laughter is the best medicine", Sergent says, "I'll stick with standard medicine. However, whether it prolongs life or not, there is no question that acutely or especially chronically ill people who maintain an upbeat, positive outlook have a better quality of life, even if they don't live longer. A good friend of mine, when diagnosed with myeloma several years ago, said he told his hematologist that all he asked for was 20 years of poor health. He has continued to be upbeat despite a series of serious setbacks, and his enjoyment of family and life in general has been wonderful to watch." Sergent writes with insight and perspective about things he knows. He is in a unique situation to observe people at their best and worst and to write about them with the same qualities that he teaches his students are important – thoughtfulness, humor, honesty and compassion. Tags:Healing Words A Compilation of the Best Columns of John Sergent M.D., John Sergent, Nashville Eye, Tennessean, Vanderbilt University School of MedicineBookmark:
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