An Unlikely Doctor


by Lawrence Elliott (Reader’s Digest, May 1997)

(In the face of a chronic and crippling illness, the young man resolved to follow in the path of his physician and mentor)

drbrianweinsteint-6006910The telephone jangles in Dr. Brian Weinstein’s ear at 3 a.m. Minutes later the 28-year-old surgical resident is trudging through a blinding snowstorm to New York City’s Mount Sinai Medical Center, where he’s just put in a 36-hour shift.

An 11-year-old boy needs an appendectomy–fast. But before operating, Dr. Weinstein takes a moment to talk with the pale little youngster. The doctor knows what it is to be a child in the hospital, suddenly alone and at the mercy of strangers.

“Are you scared?” The boy nods.

“Everybody is, even grownups. But you’re going to sleep through the whole thing, and when you wake up, your bellyache should be gone.”

He is rewarded with a wan smile. When the anesthetic takes effect, the doctor works deftly, cutting away the inflamed appendix. He no longer marvels, as he did when he began his surgical residency two years before, that he is now the doctor, not the patient. He is too busy reveling in moments such as this one, when he closes the incision, knowing he is restoring this sick boy to health.

Remorseless Disease. When Brian Keith Weinstein was an infant, he seemed to struggle for life with every breath. Diapers hung limp around matchstick legs; he was afflicted by one respiratory infection after another. By the fall of 1967, when Brian was six months old, he still weighed only 12 pounds.

“Cystic fibrosis,” a specialist at New York Hospital said after his examination revealed an inordinately high sodium and chloride content in Brian’s sweat. “We’ll do what we can,” the doctor told Sheryl and Michael Weinstein, “but don’t expect to have your child more than five or six years.”

Sheryl began to cry. Michael put his arm around her, his own eyes filling with tears. But they gained strength from each other. By the time they were back in their Brooklyn apartment, they were fired up by the same unspoken resolve: We don’t have to accept this!

Sheryl and Michael, a New York City police officer who saw despair every day but never lost his own gift for hope, began reading everything they could find about cystic fibrosis. There wasn’t much, and almost nothing encouraging. A baffling congenital disease, CF had been identified only a few decades before, and the medical profession still had much to learn about it. CF victims, all children and young adults, suffer from a complex cell disorder that keeps them from properly digesting food and, graver still, produces an abnormally thick mucus that hampers breathing and breeds recurrent lung and bronchial infections.

Graduation Promise. Sometimes, except for a chronic cough, a child with CF can appear healthy for years. But the literature warned that this was only temporary; CF was remorseless. One day the child would spit blood, a signal that his ravaged lungs were giving out, and then his lungs would collapse and his heart would stop, or he would die of pneumonia. Back then, 50 percent of the estimated 10,000 CF sufferers in the United States succumbed before their 15th birthday.

Undeterred, the Weinsteins set out to find someone willing to look beyond these terrifying statistics and help them fight for their child’s life. When Brian was still less than a year old, they found that person: Dr. Jack Gorvoy, who’d been involved in early CF studies and was now director of the Cystic Fibrosis Center at Long Island Jewish Medical Center.

During the Weinsteins’ first visit, Dr. Gorvoy eased some of their fears. “You ask me how long I think Brian can live. I don’t know. But I do think that five years from now the median survival rate for children with CF will have doubled, and that it is likely to double again in the following five years. Brian will always need special attention. But if he gets it–from you, from me–then I also think you’ll go to his high-school graduation.” So began the battle for Brian’s life, long before he could even comprehend the stakes.

Marching Orders. Twice a month Sheryl or Michael, often both, drove their son to Long Island. There Dr. Gorvoy monitored the child’s condition, adjusted his medication and instructed the parents in therapy techniques: the thumping of chest and back to dislodge the thick, tenacious mucus that clogged lungs and airways. Pneumonia was a constant threat.

The good news: latest therapies and antibiotics specifically targeting the afflictions of CF could counter these assaults. Supplemental enzymes, essential for the digestion of nutrients in food, would replace those that Brian’s body did not produce.

Within weeks the Weinsteins saw their listless, sickly little boy growing into a strong and vigorous youngster who was soon pulling himself up and trying to climb out of his crib. When Brian was a robust and venturesome three-year-old, his brother David was born, and the Weinsteins moved to a suburb 40 miles from Brooklyn. But not even this upheaval tempted him into playing the sickly child. Nor would Sheryl and Michael have permitted it. They had their marching orders from Dr. Gorvoy: “Treat him like a normal growing boy. Keep him active.”

Rite of Remembrance. On rare days when he was not well, Brian had the best loving care parents could give. The rest of the time he was expected to pull his weight–at school, doing chores, in his attitude. Since both parents worked, he was charged with getting dinner started; he turned into a first-class cook. He played baseball and soccer with his friends, although sometimes Brian literally lost his breath and had to take himself out of the game.

For Brian and his parents, every turning point in his life became a special event, and none was as eagerly anticipated as his bar mitzvah. Two prolonged bouts of illness when he was 11 dimmed Sheryl and Michael’s hopes: would their son live to celebrate the ceremony in which a Jewish boy assumes the duties and responsibilities of manhood?

But on the Saturday closest to his 13th birthday, Brian’s family and a circle of friends gathered at the synagogue in New City, N.Y. Brian chose Dr. Gorvoy to be among the 18 family members who each lit a ritual candle during the ceremony.

Brian did not fail to acknowledge the place Dr. Gorvoy held in his life: “Without him, I don’t think we’d be here celebrating this occasion,” Brian told the congregation. “And I have to thank my mother and father, first of all, for making sure that I grew up. Then I have to thank them again, for making sure I grew up like a normal boy.”

In fact, the real problem for everyone was holding Brian back. “What do you mean you want to be on the track team?” his mother said when he was in high school. “Where will you get the breath for running races?” Michael repeated virtually the same question when Brian decided he wanted to play the saxophone.

Each time, however, Dr. Gorvoy said, “Let him try. If he can’t, he’ll soon find out. And years from now he’ll have the satisfaction of knowing he made the effort.” Brian knew he had a staunch friend.

As it happened, his lungs weren’t elastic enough, either for track or playing a wind instrument. Brian accepted these disappointments and simply explored other dreams.

Fierce Loyalty. It always bothered him that he was thin–all ribs and joints, an embarrassment when he went swimming with his pals. He knew this was a consequence of his disease. But knowing it didn’t make him willing to accept it. One winter day, with Dr. Gorvoy’s encouragement, he started a moderate weight-lifting program, faithfully hoisting barbells morning and night. Eventually the 135-pound weakling added 30 pounds in muscle mass. It was Brian’s first real accomplishment, and it gave him confidence that he could do what he set out to do.

Along the way, Brian found a rocklike steadiness in Dr. Gorvoy. Detached as he might appear, the doctor was fiercely loyal and devoted. If Brian fell ill, Dr. Gorvoy would be waiting in the emergency room at 2 a.m. when the Weinsteins arrived with their son. And he would telephone every day to be sure his convalescence was proceeding on schedule.

When Brian started puzzling over questions that went beyond the answers in his biology textbook, he put them to Dr. Gorvoy. The doctor was impressed. After one conversation he said, “This is very perceptive of you, Brian.” The boy glowed. Soon there was no question: he was going to become a doctor–the kind who really cared about his patients, just like Dr. Gorvoy.

Deep Distress. In June 1985 Brian’s parents proudly attended his high-school graduation–just as Dr. Gorvoy had forecast. Meanwhile, the Weinsteins had come to a typically unflinching decision: Brian was going away to college in Albany, N.Y., more than 100 miles from home. There would be no one to remind him to take his medicine and do his physical therapy, no one to call Dr. Gorvoy when Brian began to cough or wheeze. But this was what they had all been working for: Brian’s independence.

He worked hard at college. It was the only way he knew. But he looked after himself. He checked in with Dr. Gorvoy regularly and made time at least twice a day for his therapy. He made the dean’s list each of his first two years.

One evening at the end of his junior year, he felt a sudden breathlessness, then a piercing pain in his chest. He knew at once that he was suffering a pneumothorax–blister-like swellings on his weakened lungs were leaking air into the pleural cavity. Sometimes such leaks seal themselves. But other times the lung collapses; air fills the chest and the heart is pushed to one side. Then it must be dealt with–swiftly. Brian knew the consequences if it were not: respiratory failure, then death.

In deepening distress he was rushed to Albany Medical Center, where a surgeon inserted a tube to release the air and allow the lung to heal. Within the week Brian was taking his final exams in a hospital room. Again, he made the dean’s list.

Ten days later Brian had stabilized enough to be brought down to Long Island Jewish. There he underwent an operation to minimize the chance of a recurrent pneumothorax.

Life’s Work. Although well aware that he’d reached the further limits of life expectancy for someone with CF, Brian was prepared to devote the rest of his days to one of medicine’s most rigorous specialties: surgery. Concerned that the added strain would undermine his health, his parents asked, “Do you really have to be a surgeon?” Each time, Brian’s answer was yes.

Even Dr. Gorvoy wondered whether his longtime patient might be testing fate. But Brian was unshakable. “I love surgery,” he said ardently. “I want to make it my life’s work–the way you did with cystic fibrosis. To try and to fail, that’s okay. But not to try–” he shook his head–“that’s not living.”

Over the years as Dr. Gorvoy lost patients to CF, he’d given up trying to maintain an emotional distance. But for some patients, he felt an attachment that couldn’t have been stronger if they were his own children. Brian was one of these.

“You’re going to make a fine surgeon,” Dr. Gorvoy said.

It took 41 minutes for the dean to call out the names of the 209 graduates of the State University of New York Health Science Center medical school in Brooklyn, N.Y. At last “Dr. Brian Keith Weinstein” was called.

Brian accepted his diploma from the dean, then he turned and walked to where Dr. Gorvoy waited with the graduation sash. Brian put out his hand for the traditional handshake, but instead his lifelong doctor and friend pulled him into an embrace.

Brian, whose application had been accepted by New York’s Mount Sinai Medical Center, started his five-year residency in July 1993. It’s everything he’d been warned against: grueling hours, a frenetic pace, traumas six or eight times a day–and he has never been happier.

Not long ago, Dr. Gorvoy had his second medical-school graduate, a young woman inspired by Brian’s example. She wanted to specialize in gynecology and obstetrics, but it was a difficult field, physically taxing, emotionally stressful. Should she? Could she?

“You have to,” Brian told her without hesitating. “If you can’t, you’ll soon find out. But years from now you’ll have the satisfaction of knowing you made the effort.”

He didn’t say, but could have, that this satisfaction has already fulfilled his life–no matter how long it lasts.