A Physician’s Call for Help – Rewarded by the Best Payment of All

My wife and I were sitting down to an uncharacteristically late dinner for us Friday at a local eatery when my cell phone rang. Caller ID identified it as Dr David Rosenberg, a family physician practicing concierge medicine about one hour north of my home in Jupiter, Florida.  We had not spoken in months and after some pleasantries and catching up he said, “Steve I just saw a story on the TV News that there is a back to school community fair in Pearl City in your community tomorrow morning and the doctor they had counted on to perform the required school exams for new students had cancelled due to a personal crisis.

Dr. Rosenberg wanted to know if I would join him for a few hours at the Wayne Barton Learning and Community Center and perform the physicals. He told me he had phoned fifty physicians and no one had yet agreed to come. He was prepared to do them himself.  I gave my wife that “duty calls” look and she nodded back approvingly and I told him it would be my pleasure. I agreed to meet him at 10 a.m. at the center.

Wayne Barton is a former City of Boca Raton police officer who is now a community leader and activist. He created a nonprofit agency and, with generous philanthropic support, has built an educational and community center for students from poor homes. He provides year-round learning and tutoring for students and has an annual “Back to School Jam” where new students receive the required school physical plus receive backpacks filled with school supplies that their working parents have great difficulty affording.

Mr. Barton greeted me at the entrance as I walked in and thanked me for coming on short notice. The regular physician who cancelled due to a family crisis has been volunteering for years and is my personal friend, mentor and is my patient. Trying to fill in for him is a tall order and made the experience even more special for me. Dr. Rosenberg, who organized this last minute physician participation, was there as well and with him were two other concierge physicians and a wonderfully warm physician’s assistant.

For the next several hours, with the help of a large dedicated volunteer staff, we saw numerous lovely children with their families. A mother and her high school age daughter and son, who had escaped the ravages of the earthquake in Haiti, were among the first.

A young woman and her two children who had escaped Communism and Castro’s Cuba nine months ago came through my station.  I saw a young man with lead poisoning requiring treatment and follow-up and another lad who wanted permission to play football despite the jaundice in his eyes tipping me off to his history of sickle cell anemia that he had conveniently left off his form.  I was able to stay for three of the four hours and I received the best payment of all – beautiful smiles, blessings from several and a thank you from all.

The degree of appreciation coupled with the level of need leads me to believe it’s time to discuss with Mr. Barton a regular free clinic at the center.

Once last thought, I couldn’t help but notice that the physicians who responded to the call for help were all practicing in a concierge medicine model.

Whooping Cough – Adults To Young Children

Whooping Cough is caused by bacteria called Bordatella Pertussis which produces a severe upper respiratory tract infection in unvaccinated children with a severe cough and “whooping “sound. The cough is so severe that they stop eating, breathing and surviving. There have been over 100 deaths of infants in Texas and California this year due to whooping cough. The disease can be prevented by immunizing children with a series of shots beginning at 2 months.

Most of those reading this article had the DPT shots as children and expect to be immune to whooping cough forever.  Recent studies have shown that our immunity wears out as we reach middle age. Adults can catch a form of whooping cough with a severe bronchitis which produces a prolonged cough without the classic “whooping” sound children exhibit. In most cases the adults and their doctor have no idea they have whooping cough.

If not treated with antibiotics the bronchitis lasts for months and they can spread the infection for months after the symptoms resolve.  The adults have no idea they are still infectious.  If they come in contact with children who have not completed their vaccination series, or who just didn’t mount an immune response, those children can get the life threatening whooping cough disease.   The disease is passed from well meaning adults to susceptible children. It passes from parents and grandparents to infants as well as from teachers and caregivers to infants.   There is no simple out- patient laboratory test to distinguish simple adult viral upper respiratory tract infection with bronchitis from the whooping cough variant.

The best way to prevent giving this disease to young children and, infants in particular, is to receive a booster vaccination of Tdap. The Center for Disease Control is suggesting that every 7 to ten years all adults receive a tetanus and diphtheria booster.  One of those vaccinations should be the Tdap version.  Originally Tdap was limited to 45 – 60 year olds, but last week the CDC said it is safe for all adults and seniors.  Protect your children and grandchildren against the whooping cough epidemic. Ask your physician about getting Tdap.