‘Informed Patients Get the Best Care’
Think of him as a Dr. Spock for adults. Dr. Isadore Rosenfeld--through books, articles and TV appearances--has been telling us how to get the most from health care for years. He’s an internist at New York Hospital Presbyterian Medical Center and professor of medicine at Cornell University medical center in New York City who treats heads of state and celebrities. The Montreal native has written several bestsellers, including “Live Now, Age Later: Proven Ways to Slow Down the Clock” (Warner Books, 1999).
On Nov. 12, Rosenfeld, 73, will be named the U.N. Citizen of the World for 1999. Previous recipients include Walter Cronkite and Nelson Mandela. He recently chatted about his love of writing, getting older and the changing world of medical care.
Question: What has compelled you to reach out to the public while you’re a full-time cardiologist?
Answer: I’m the Ronald Reagan of medicine--I’m the great communicator. Ever since I was a kid, I loved to write. When I was still a medical student . . . I wrote political speeches for Cabinet members [in Canada] and one for the prime minister of Canada.
As for what motivated me as a physician. . . . I tell the story I was examining somebody and pointed out I was putting my finger in the space above the [collarbone]. I said, “Aren’t you interested in why I’m pushing in that little spot?” He said, “Yes, but I would never ask what a doctor is doing.”
I said, “Well, in that spot, there are tiny glands and when there are cancer cells in the chest or the stomach, they . . . are trapped by these glands and the glands get bigger. I put my hand in that spot and immediately I can make a very complicated diagnosis.” That was the first time I realized that people know so very little about their bodies, about the diseases that strike them, about how the diseases should be treated, about how doctors go about doing it.
Over the years, I not only realized how little they know, but also that the best-informed patient gets the best medical care. That is becoming more important now that we have so much managed care . . . where your own doctor may not recommend the optimal therapy, but only the most cost-effective therapy approved by the HMO.
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Q: Many seniors suffer from depression, correctable with therapy or medication. Do you find doctors so focused on the physical that they overlook the psychological?
A: The problem is one of time. In the pre-technology, pre-managed care, pre-insurance era, your doctor really knew you as a human being, not as a gallbladder or as an appendix, but as a person. Knowing somebody as a person enabled them to evaluate mood changes, behavioral changes, psychological problems, which today’s doctors rarely appreciate.
Doctors . . . have enough trouble trying to sort out the significance of the physical complaints, without addressing themselves to mood, behavior and other changes. When they do, they’re apt to sit down and write a prescription for Prozac and that’s it.
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Q: You write about stress reduction, relaxation and finding contentment. How do you achieve these?
A: I just came back from a vacation. I couldn’t wait to get back to my practice and my word processor. My contentment is my work. Superimposed on that is the bonus of grandchildren, who give me enormous pleasure. Basically, contentment means enjoying what you do.
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Q: You also advise common-sense measures, such as giving up smoking, following a low-fat diet and exercising. Do you do all three?
A: I gave up smoking on April 12, 1960. I was demonstrating a piece of equipment [and] every time I inhaled [cigarette smoke], I got an irregular heart rhythm. I looked at that and decided it was enough.
I avoid excessive fat but can’t say I’m on a low-fat diet. The reason is, I have high cholesterol and take one of the new statin drugs. That has normalized my cholesterol and permitted me to eat the diet I enjoy. I do the treadmill every morning, followed by 20 minutes of stretching.
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Q: You seem open to alternative medicine.
A. I have always had an open mind . . . and what clinched it was I went to China with a team of doctors in 1979. We were invited to witness open-heart surgery at the University of Shanghai. They wheeled this lady in on a gurney, and she was wide awake and smiling and laughing, and the only anesthesia was acupuncture. When I saw this, I said “Jeez, how does this work?” I didn’t know how it worked, and I’m still not sure I know how it works, but I realized that you . . . can’t always understand.
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Q: What’s next?
A: My next book will be what you have to know to be your own doctor.
I’ve also written a memoir for my children. Starting from my parents’ courtship and arrival as immigrants in Canada, my desire to be a doctor, the obstacles I had, my experiences during my training, what molded my direction in my medical career and experiences with some of my more notable patients, Aristotle Onassis and Danny Kaye.
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Rosenfeld is a keynote speaker Saturday at 2 p.m. at The Times Festival of Health at USC.
