Doctors Spurned Riches to Comfort the Dying : Medicine: They were offered fame and fortune for their achievements but chose the spiritual rewards of working with advanced cancer patients.

Fame came early for Drs. James Cimino and Michael E. Brescia. But they ditched life in the limelight for the quieter rewards of treating patients dying of cancer.

They insist, repeatedly, that they’re not heroes. “We aren’t saintly,” said Cimino. “Whatever people do, they do with the motivation of self-gratification.”

They praise co-workers at Calvary Hospital in the Bronx and speak with awe of the nuns who founded the hospital.

“We took a road,” says Brescia. “To the left, it looked shiny and gold. But to the right, it looked happier to us.”

They came to the crossroads 25 years ago, when as internists at the Veterans Administration hospital in the Bronx, they developed a procedure now widely used in kidney dialysis.

Medical journals touted their achievement. Research opportunities rolled in. They were invited to speak at conventions. They were offered an entire Westchester County hospital, for a token $1, if they would turn it into a kidney center.

Instead, they chose the day-to-day rewards at Calvary, the nation’s only acute care hospital devoted exclusively to advanced cancer patients.

“We didn’t go home if someone was suffering,” said Brescia. “We learned to live with tiny victories: The patient was able to eat today, or go to church, or sit in a chair, or play with her children. We’re mature enough to accept that.”

Without that attitude, he conceded, a patient could “put tremendous anxiety in you by looking at you and expecting what cannot be done: those pleading eyes, looking at you, telling you that you’ve failed.”

In 1961, Cimino, director of renal services at the VA hospital, began spending a few hours a week as an adviser at Calvary. Then Brescia, one of his residents, joined him. Gradually, it became their life’s work.

“We felt this was a mission,” said Brescia, who, like Cimino, is a father of six. “We saw unbearable suffering of patients and families that we, as physicians, could relieve.”

“It was an adventure,” said Brescia. “But I wasn’t unhappy taking it. To me, it looked good and right.”

Cimino became medical director and Brescia his assistant. Under their leadership, Calvary won accreditation.

The two capitalized on their fame to lure other doctors to Calvary. In 1980, they dropped their titles to become assistants to the medical director and senior attending physicians; mostly, they were “just doctors,” and the patients think that’s just fine.

“I came from another hospital,” said Vivian Dowling. “This is heaven in comparison--and I’m not just saying that because the doctor is here.”

“I love Vivian; she’s brave and courageous,” said Brescia. “When you work with patients like this, the things you thought were important--you get home and somebody went through the garage door--don’t mean anything.”

Calvary, unlike a hospice, is a full-fledged hospital. It uses medical treatments to slow the spread of cancer, fight other ailments brought on by the disease, and alleviate pain. But the emphasis is on comfort, rather than cures.

Dowling, for instance, “came here in terrible pain: not from the cancer, but from a hole in her back,” said Brescia, 57. “I cured the hole. Now, she’s a whole person.”

Cimino and Brescia maintain that, even in an era of hospices and patient rights, the terminally ill often are shunted to the back wards of big hospitals and ignored by busy doctors.

“Some oncologists are not able to work here. They want to see the patients get well,” said Cimino, 60. “A place like this could be very defeating for persons with that attitude. That’s why so many of these kind of places are led by religious groups.

“One of the worst things in this stage of life is to feel that you’re not worthy of the attention of a professional,” Cimino added.

It’s not uncommon for doctors at Calvary to telephone a patient on a holiday. New patients are presented with a rose. There is a free beauty parlor and barber. “Even the security guards are told to be gentle. Everything is done with human dignity,” said Brescia.

“It’s equally important for the doctors to comfort the families,” he said. “The families have been through hell: They’re devastated. Sometimes we sit them down with a cup of coffee. We’re trying to undo all the spiritual and emotional neglect.”

Many patients, some of them lying on colorful gurneys, also attend Catholic, Protestant or Jewish services in the chapel or watch them on closed-circuit television in their rooms.

The staff relies heavily on “cancer care technicians,” who work under the supervision of registered nurses to change tracheotomy tubes and surgical dressings, groom patients and “give the most essential quality of care: kindness and love,” said Cimino.

“It’s the philosophy of non-abandonment. You keep your promises to the patients; you never let them feel isolated,” he said.

And along with the attention, said Brescia, “We always leave a tiny bit of hope in the patient.”