These stories were written by Jamie Saxon, Barbara Figge Fox, and Kathleen McGinn Spring.
Who among the living does not have a medical drama to relate? Most of us either have a story of our own to relate, or we have a close friend with a story — the time we were rused off to the hospital with chest pains; the dermatologist who spotted the skin cancer in the nick of time; the orthopedic surgeon who mended the torn ligament.
But the healthcare practitioners who make these stories possible are seldom heard from. They move on to new patients and new challenges. For this annual Health and Fitness edition, U.S. 1 tracked down eight patients and their caregivers from the central New Jersey area.
20 Years of Radiation
Forms Lasting Bond
Attorney John Gavula, 54, was born in Jersey City and grew up in Passaic County, the son of a welder and a Kresge’s saleswoman. He graduated from Rutgers in 1973 with a bachelors in political science, then graduated from Rutgers Law School in 1978. In 1986 he earned his masters in library services, also at Rutgers, with his eye on becoming a law librarian. He spent 10 years working in the arena of legal ethics and since 1999 has worked for the Federal district court in Trenton as a pro se attorney, doing preliminary evaluations on cases.
His wife, Beverly Tannenhouse, is a deputy attorney general with the state of New Jersey, working in regulation of the casino industry.
In the summer of 1986 a mass was found in the left part of Gavula’s cerebellum. It was surgically removed in August, 1986, at NYU Medical Center. It was hemangiopericytoma, a very rare and slow-growing type of cancer.
“The neurosurgeon had actually been one of the doctors called in when JFK got shot. He was actually in his 70s and had never seen this before,” says Tannenhouse. “John needed radiation but the question was how much radiation.”
Not all of the tumor had been removed because of vascular complications during the surgery, and it was recommended that we get two opinions. We went to the National Cancer Institute and John Baumann had been at the National Cancer Institute and when we mentioned we lived in Princeton they immediately recommended Baumann.” When they went to Mt. Sinai for the second opinion they discovered the doctor there had been a classmate of Baumann’s at Harvard. “I said to him, ‘so you’re saying it’s safe to get radiation locally in Princeton,’ and he said, ‘No, I’m saying it’s safe to get radiation from John Baumann.’”
“So I started my 20-year relationship with Dr. Baumann,” says Gavula. He started his first bout of radiation in September, 1986. he has since received radiation in 1996, 2000, 2003, 2004, and 2005, and is currently receiving radiation. Through Baumann’s contacts at Mass General, Gavula has made trips there to receive both stereotactic radiosurgery and proton beam radiation. “I am hard put to articulate my respect and affection for Dr. Baumann,” says Gavula. “He is an extraordinary doctor and an extraordinary human being. Objectively and emotionally I feel that he has been with us every step of the way. I couldn’t ask to be treated by a better radiation oncologist. I couldn’t ask to be treated by a better man. He is an absolutely unique blend of intelligence, ability, and compassion.”
Says Tannenhouse: “We have dealt with many, many doctors, and many, many institutions over the course of 20 years, and Dr. Baumann is an absolute stand-out. He treats you with a lot of dignity and quality. There is no condescension. We find that a lot of times doctors withhold information, they’re the decision makers, and we just do what they tell us. Dr. Baumann is never like that. He talks to us, he tells us what’s going on, he elicits our opinion. We feel that we are his equal, which is very unusual in the medical profession. We are all collectively making decisions. He also has an extraordinary way of delivering the news, he’s had to give us difficult news, and he always does it in a way that you are fully apprised of what’s going on, and he delivers it in a way that’s always hopeful. He has a way of saying what you need to know in a way so that you are never crushed.
“For example, John’s had a lot of metastasis in the last couple of years, so Dr. Baumann says, ‘John, I’ve got good news and bad news. The bad news is you’ve got more tumors in your body; the good news is that for 20 years I’ve been giving you the bad news and you’re still here.’”
Baumann has gone out of his way on innumerable occasions to help Gavula and Tannenhouse make decisions, even outside the realm of radiation oncology. In 1993 when Gavula had a recurrence of the brain tumor, his original neurosurgeon had retired and they had to find a new one.
“This was a big decision and scary,” says Tannenhouse. “So Dr. Baumann sat me down and said, ‘These are the questions that you ask the neurosurgeon.’ I feel like I’m brokering the deal, yet I’m a layperson. I never could have done it myself. He identified the issues, and he educated me. He said to go with an aggressive neurosurgeon. We had to choose between Pennsylvania and New York, and we did choose the more aggressive one, and he’s been our neurosurgeon for 13 years. Baumann is not only a fantastic practitioner but he’s wise. The way he explains things, it gives me a feeling of peace.”
“You have the triple combination,” says Gavula, “a wonderful doctor and a wise and good human being.”
The son of a stay-at-home mom and a mill work estimator who later built houses, radiation oncologist John Baumann grew up in southern Maryland near Washington, D.C. He earned a bachelors in economics from Princeton in 1973 and his M.D. from Harvard in 1977, followed by an internship in internal medicine at Walter Reade Medical Center, and a residency and fellowship in radiation oncology at Harvard.
‘When I was at Princeton I had absolutely no idea of what I was going to do. I wanted to keep my options open for medical, law, and business school until the last possible minute. So I majored in economics and took all the pre-med science courses. The medical school applications were due sooner than any of the others and the process of generating those applications was so grueling I decided that was enough, I wouldn’t do the other applications.
“In my family there are no doctors — there are sea captains, horse thieves, chicken farmers. One of my distant relatives on my mother’s side was James Oglethorpe, who founded the colony of Georgia. Another was Governor Joseph Wall, who was hung in the 18th century in London for the crime of having a soldier flogged to death for interrupting him at a party.
“I got into radiation oncology purely by accident. No one ever grows up wanting to be a radiation oncologist. There was this course everyone had to take in second year of medical school at Harvard: intro to the patient. Then you had to take a three-month course in medicine. Everyone was trying to strategize: would you be better off jumping right in and taking that course and appealing to the mercy of your instructors since you have so little medical knowledge, or would you be better off attempting to acquire the knowledge first so you’d look better when you did take the course.
“In the course of those deliberations, one of my friends was advised by his advisor, ‘Don’t take the medicine course, come over and take a one-month course in radiation oncology. In our specialty you will have the opportunity to examine more patients with more interesting medical situations.’ The adviser was Sam Hellman, one of the giants in radiation oncology. This advice naturally circulated among the friends. Seven of us took the course.
“What we saw during that course was that every radiation oncologist there had previously been trained in something else they didn’t like, and had retrained in radiation oncology. And it was one of the few specialties I encountered where they really enjoyed what they were doing. They were ex-surgeons, radiologists, internists, medical oncologists, all of whom had gone back and retrained. They were there by choice. That attitude was infectious. Once exposed to it, you could see radiation oncology was a wonderful mix of serious medicine and intense contact with individual patients over a prolonged period of time.
“John Gavula has been my patient for 20 years. Not everyone is so fortunate that they can have their cancer controlled. I would love to see all my patients for 20 years. Gavula’s case is extraordinarily challenging, his care is very challenging to the medical profession in general and very challenging to radiation oncology in particular. Yet that’s infinitely less important than taking care of John as a person.
“I consider myself to be absolutely blessed with my choice of a profession. I get to deal on a daily basis with people who are forced by their difficult circumstances to rise to meet a challenge, which is their cancer, that demands every ounce of their personal courage, and that transforms many people. They are different than they were before they got their cancer. They are much better people. The only other experience I can think of in which ordinary people rise to demonstrate extraordinary virtues are combat soldiers; they’re the people who used to be the stock clerk but somehow turn out to have more courage than five people. I get to work with people who are showing the very best that humans have to offer, and I don’t get shot at in the process.
“My specialty gives me the time to spend with patients, much more so than with many specialties. As with most things in life you master the technical aspects pretty quickly, that’s not what’s interesting; what’s interesting is the people to whom I get to apply those technical skills to help. For most people, radiation oncology is a brand new experience, so for me it’s always fresh. I get the best patients; I’m not dealing with people with neurotic illnesses and psychosocial illnesses. I have people with real illness, often in a life and death situation, and these people are reaching deep into themselves to find the courage that lurks somewhere deep in all of us but most of us never have to search for. I get to associate with those sorts of people.
That is far better than writing legal briefs or saving other people money. I could not have imagined that I would have the satisfaction I do with my particular little niche in the medical world. The patients are inspirational; I get to tag along with them.”
Radiation Oncology Consultants of New Jersey, 253 Witherspoon Street, University Medical Center, Princeton 08540; 609-497-4304; www.princetonradiology.com
A Stern Voice Helps
Jessica O’Gara, 27, grew up in the Oranges, then moved at age 13 to South Brunswick. Both her mother and stepfather worked for AT&T; her mother later retired from a business management position at Lucent. Her father works for the West Orange Board of Education. She earned an associate degree in education from Middlesex County Community College in 2002, graduated in 2004 with a bachelors in social work from Monmouth University, continuing on at Monmouth to earn her MSW in 2005.
She currently lives in Manville and works the graveyard shift in a psych emergency unit of a central New Jersey hospital. She is getting married this Friday, June 23, to Jamie Mankowski, a police officer.
‘When I was in sixth grade I stopped eating meat. Then I stopped eating breakfast. When I was 15, I wasn’t eating at all. I was an obnoxious 15-year-old. Pretty much from as far back as I can remember, I was always conscious of my weight. I lived on and off with my mom’s grandparents, since both my parents worked. My grandparents are Italian, and they would always say, ‘You’re getting fat.’
“My mom, who was overweight, was always on a diet. My brother was heavy-set but I was always really tiny and underweight. My father is Irish, so I’m more like him. When we moved to South Brunswick, I moved from a Catholic school, where there were only three kids in my class to a huge high school. I began to have behavior problems — and I never went to school. I convinced my mother to let me get my G.E.D. at 15 so I wouldn’t have to go to school. I wanted to go to college.
“Initially my mom took me to a regular doctor. I was 5-foot-3 and 109 pounds, not exactly underweight. But I had weighed 118. I was taking diet pills. My mom’s friend’s daughter had seen Dr. Willis, and I started in 1996. I had numerous in-patient visits (at the eating disorders unit of the University Medical Center at Princeton, which Willis founded).
“He’s very real. He’ll tell you like you’re acting like a brat but he’s also really caring. When he needs to be, he gets stern with you. He’ll let you rant and rave but he won’t budge. He’s so smart. He’s told me things I didn’t believe, and then I check into it and realize he’s right: One time I read my diagnostic code and said this isn’t my diagnosis. A couple months later I learned about the diagnosis in school and I had to go back and eat crow. He just thought it was amusing.
“Occasionally he would let me do things you weren’t supposed to do: at one point I was so determined to finish school, and he arranged it so I could meet with my therapist once a week as an outpatient instead of as an in-patient. To avoid being admitted you have to weigh at least 100 pounds. At one point I was 86 pounds and putting dumbbells under my shirt, bound with Ace bandages to make myself up to 100. I can’t believe they didn’t see them under my exam robe. I wound up telling my therapist; I pulled dumbbells out of my bag, I had to wait there to see Dr. Willis. He was shocked but he was very supportive. He didn’t get mad at me, he let me come back as an in-patient.
“He knows how to get you, he’ll show you a blood tox and say, ‘Your body’s eating you.’ He sees patients at 10 or 11 at night. I have called that man 80 times over a weekend, literally, and he takes every call. It’s knowing that he’s there; I know I can’t fool him. Nobody forces me to go to him, it’s not covered under insurance. He knows me so well; and that’s what I need, someone who’s not going to trick me, someone who knows my family.
“I have seen some bad psychiatrists in my profession, so if someone’s had a bad experience, I would want them to know that Dr. Willis is very calming. The waiting list to see him is ages. Everyone who has Dr. Willis at the hospital in-patient program, even just talking with him in groups or in the hallway, wants him as their doctor. I’ll probably make him give me his phone number when he retires.”
Psychiatrist Kenneth Willis grew up in northern Florida, southern California, and New England, moving frequently with his biological mother. He was adopted when he was 12. His adoptive father, a physicist, worked on the Manhattan Project with Oppenheimer, then was a physics professor at Dartmouth. Willis graduated with honors from Harvard as a biology major in1974. He earned his medical degree in 1978 at Dartmouth, then stayed for a four-year psychiatry residency. He moved to New Jersey in 1982 to take a job at the Carrier Foundation. Today he is in private practice and the attending psychiatrist in the eating disorders unit at Princeton Med Center, which he founded in 1996.
‘I’m mixed race, African-American and Irish. I grew up in many different cultures and in different parts of the country; I’ve always been interested in people and a student of people. Even from an early age I was interested in people. At the time I didn’t necessarily like moving so much, but at the same time, in every cloud there’s often a silver lining, and in this case the silver lining was being exposed to many kinds of people early in life. I had an innate curiosity about people. Even though people have so many differences they do have commonalities.
“I was always curious and studious. I loved learning from a very early age and was always a good student, I was very inquisitive about the world and about people. I think I wanted to engage in a profession that would utilize that curiosity. I decided in high school that because of my love of the biological and social sciences, medicine was a great profession that would utilize my interests. After Harvard; I took a year off doing research in nuclear medicine. While I was an undergrad at Dartmouth I took a course in psychosomatic medicine, and I realized the powerful connection between the mind and body. That was when I decided to become a psychiatrist.
“In medical school, I had different interests and abilities and a strong desire to do a number of things, but the reason I ultimately settled in psychiatry is because it was the one specialty where you’re actually allowed to spend time getting to know your patients. When it’s practiced properly you utilize your training as a general physician as well as being a student of psychology and behavior.
“Because I had a strong interest in psychosomatic medicine, it seemed eating disorders was a natural fit. In 1991 I was asked to take over a unit that had closed at Somerset Medical Center. I restarted that unit and it became a success. Then in 1996 I felt that there was a better opportunity here at Princeton. Today we treat hundreds of patients a year, mostly from the northeast, but also some from other parts of the country, even internationally; we’ve had patients from Japan, Italy, and other parts of Europe. The unit has grown from initially a 12-bed unit to an 18-bed unit, always 95 percent full with a one-month waiting list.
“Contrary to what a lot of people think, eating disorders are complex and multi-factorial in causation. It’s not just an obsession that people have with being thin. There are so many different underlying psychological conflicts — mood disorders, sometimes history of early childhood trauma, and family conflicts all play a role in eating disorders.
“When I initially saw Jessica she had features of both anorexia and bulimia, but was definitely anorexic. Today Jessica is a great example of someone who had a difficult course when she was in the throes of her illness, but has emerged triumphantly and is totally, virtually symptom-free and leading a functional life.”
“When you’re working in psychiatry, you deal with difficult areas that people don’t want to acknowledge. Psychological change is very difficult for everyone. In order to help people change in psychiatry, you have to confront the harmful behaviors from a place of compassion and concern, but you often meet with resistance. People are reluctant to give those behaviors up even though they’re causing harm to their families or themselves.
“As a psychiatrist you can’t be afraid to confront the patient’s distorted beliefs that are not working for fear the patient will be angry and not like you. You can’t let your like for the patient get in the way of the dislike for the illness.
“One of things that I’m really fighting and crusading for is that there are a lot of forces operating in medicine — administrative forces, fiscal realities, difficulties getting access to care because of managed care, the increased workload of physicians — that potentially work to depersonalize the work of medicine. My strong desire is to treat every human being as if I were the patient, provide the highest quality of care despite those kinds of realities.
“I experienced quite a bit of adversity when I was young. Having survived that, I think, has made me a stronger person, and having overcome obstacles myself gives me a strong belief that my patients can also do the same thing.”
Kenneth W. Willis MD, 168 Tamarack Circle, Montgomery Knoll, Skillman 08558; 609-497-1560; fax, 609-497-7670.
Against the Odds,
A Rewarding Save
Bioengineer and soccer coach Jeff Fedor, 40, is a native of Pittsburgh, where his father was a nuclear engineer at Westinghouse, and then the family moved to Princeton so he could help design the Tokamak reactor at Princeton Plasma Physics Laboratory. Fedor’s mother is a nurse at University Medical Center at Princeton. His parents own Duncraven, formerly Helen Boehm’s farm on Bear Tavern Road, and have turned it into a hunter-jumper horse farm, managed by one of three sons. Jeff and his wife, Kate, who works at Wachovia, have two teenaged daughters.
Fedor majored in mechanical engineering at Drexel, Class of 1984, and has a master’s degree in engineering management from New Jersey Institute of Technology. He worked at Therics, which did tissue engineering and implantable biostructures at University Square, until Therics downsized. He is now the operations manager at Applied Containment Engineering in Lawrenceville.
At 40, Jeff Fedor climbed mountains and coached and managed traveling soccer teams. In 2004 he found himself in the hospital unable to move his arms and legs. He had an arteriovenous malformation — a mismatch of veins around a spontaneous blood clot of the spine, resulting from a tangle of weakened vessels. When his blood clot burst it applies a hydraulic pressure to the spinal cord.
Two years later Fedor is as active as he ever was, and he credits the “save” to his neurosurgeon, Mark McLaughlin. “His situation was the bottom of the ninth, two outs, bases loaded,” says McLaughlin using a sports metaphor. “Now it is neat to see him out coaching soccer.”
At the time of Fedor’s medical emergency, he was trying to find a job and had to depend on his wife’s medical insurance.
“I felt very intense pain in my neck,” Fedor remembers. “My wife was at a meeting, so I called my mother, a nurse, at the medical center, and she took me to the hospital. A blood vessel had burst in my neck. The feeling in my legs would come and go.
“A short time after I arrived, when I was in the MRI, I could not move my arms and legs; I was acutely quadriplegic. At that moment Dr. McLaughlin was a couple of blocks away at the Valley Road school, where he is the head of PAWS, Princeton’s recreational wrestling league for school-aged children, and he was coaching a match.
“He ran the couple of blocks from the school to the hospital, assessed the situation, and said ‘We have to get you into the OR as soon as possible.’ The staff at the hospital were amazing. They got me into the OR in 30 minutes. A nurse stayed with me and made sure I got to where I needed to be.
“In a 90-minute operation, Dr. McLaughlin was able to remove the clot, stop the bleeding vessel, and reverse my quadriplegia. He was there when I woke up. He spent a lot of time with my family and me, explaining things and being reassuring, taking a difficult situation and making the best of it. Later, when I was in intensive care, he spent 30 or 40 minutes with me though his four children were waiting in the lobby.
“My family was were in shock because I had never had any health problems before. Initially they were told I would never walk again. It was scary, because if you research this condition, it makes you a little ill. It is like walking through a graveyard. Most cases result in serious long term damage or death.
“Dr. McLaughlin kept my family updated. When I woke up, I started getting more movement than he had predicted. I started to move my right side, and 12 hours later I started to be able to move my left side. In another day they had me out of the chair and I was taking slow steps. I am now back to work and have essentially no neurological deficit.”
Before the emergency he had had his initial interview with a British firm, Applied Containment Engineering, which designs and makes isolation containment systems, which keep pharmaceutical employees from getting exposed to active drugs during the manufacturing process. If hired, he would be in charge of the United States office.
The second interview took place when he was in St. Lawrence Rehabilitation Center. “They were very kind. They just wanted to know when I could start.”
A life threatening experience, he says, has the value of “forcing you to focus on relationships with people close to you, and to not worry about material things.”
Neurosurgeon Mark R. McLaughlin MD, the son of an attorney and a teacher, majored in philosophy at the College of William and Mary, Class of 1988, and went to the Medical College of Virginia, followed by a residency at the University of Pittsburgh and a fellowship at Emory in complex spine surgery. In practice for six years, he works at St. Mary’s in Langhorne and the University Medical Center of Princeton, and has privileges at St. Francis. He lives in Skillman with his wife, Julie, and their four children.
McLaughlin’s first encounter with fame was in 2000 when he was featured in Parade magazine in 2000 for staging a Russian-American spine surgeon’s conference in St. Petersburg. When he rescued Jeff Fedor two years ago, surgeon and patient were celebrated in newspaper articles and in the medical center’s annual report.
McLaughlin used that moment of glory to teach life lessons to the youngsters on his wrestling team, PAWS, which offers instruction and recreational competition for 70 children.
He emphasizes that they are scholar athletes, that one part of being a wrestler is to give your very best, to go your hardest. “I love the intensity of wrestling; you have to rely upon yourself to perform,” says the surgeon. “It helped me a lot in neurosurgery, where you have to be very sure of yourself in situations where you don’t have all the information, to make important decisions that affect people’s lives, to do your best and know that the outcome isn’t always what you hope for, but to walk away knowing you did your best, and come back again.”
“I tell the wrestlers that wrestling is like neurosurgery,” says McLaughlin. “I go to a locker room, put on a uniform, and go onto hallowed ground, where I have to perform and the odds are against me. It is physically and mentally grueling, but the rewards are great.”
— Barbara Fox
Princeton Brain and Spine Care, 713 Executive Drive, Princeton 08540; 609-921-9001; fax, 609-921-9055. Mark R. McLaughlin MD. www.princetonbrainandspine.com
Fighting Cancer, But
Realizing a Dream
Ann Liang Mark, 60, is associate director of multimedia communications at a large pharmaceutical company, where she has worked since 1987. Born in China, she grew up in Taiwan, the daughter of a two-star general under Chiang Kai-shek and a stay-at-home mom who worked for a period at a Taiwanese orphanage. She graduated from a girls’ college in Taiwan, and moved here in the early 1970s. She earned a bachelor’s degree from Rider University in 1993. An amateur photographer, she currently has two pieces in the Princeton Photographers Club annual members’ exhibition at Montgomery Center for the Arts in Skillman, on view through Sunday, July 2. She is single and has two grown children and a grandson.
‘In 2001, during a yoga class, I discovered a lump the size of a tennis ball in my stomach. My gynecologist at the time treated it very lightly; she just ordered a CAT scan and ultrasound, then I had it surgically removed at UPenn. It was September 17, six days after the World Trade Center disaster.
“My chemo was a total disaster. They put me in a clinical trial, which I later learned there was no reason for me to participate in unless my case was very certain and it wasn’t. My main problem was with the doctor’s office staff. Once, when my white blood cell count dropped so low, I was given a prescription to which I had a terrible reaction, which I read about on the box under possible side effects. I called the office and they dismissed me saying they never heard of this kind of reaction: ‘Oh, Ann,’ they said, ‘did you read the box and have the reaction or did you have the reaction first and then read the box?’
“After my first bout with ovarian cancer I wrote about my experience for a Chinese newspaper (written in the third person). This excerpt begins after my chemo was complete. ‘The sun was bright and the ground was covered with golden leaves. Through the viewfinder of her camera, she adjusted the focus onto her daughter and her newborn grandson. Her recently regrown hair was touched by the autumn breeze, her recovering body was warmed under the morning sun. She watched her daughter, once her baby, now with a radiant smile, kissing her own baby. With watery eyes and trembling hands, she clicked the shutter button.’
“At the end of 2004, a blood test indicated my CA125 number was getting higher, an indicator that cancer may be present. This time I went to oncologist Peter Yi, who was recommended to me by other friends, who were treated by Yi for cancer. I had my surgery at Sloan-Kettering and did my chemo with Yi. The difference between the first doctor and Yi was like night and day. He proactively watched my red and white blood cell count carefully, giving me shots to boost them when necessary.
“He is very approachable, very understanding. His office staff is wonderful and they always get back to me quickly when I call with questions. He does not make you believe you’re fine. Even as he said the recurrence rate for ovarian cancer especially is high he made me feel he understood my anxiety and fear. He does not give you fancy talk. ‘This is it and we’ll do our best to deal with it,’ he said. That’s how I wanted to be treated. I did not want fancy words and hope.
“Driving across the country had been a dream of mine since coming here in 1970. After that second round of chemo I was scheduled to be back at work July 7, 2005. My last chemo was on May 16, 2005. I asked Yi, “After being sick for so long, can I drive across the country?” He looked at me with a smile and said, “Why not? We all need a break.” He checked me before my trip, and gave me a phone number he said to call at any time. The day before I went I needed a prescription from my gynecologist. He said, ‘Ann, your cancer has spread to your lung. There is only so much chemo you can do.’ I called Yi and I told him what the gynecologist told me. Yi said, ‘Really!’ in that quiet voice of his and paused. ‘Tell you what, Ann. You can delay your trip or —’ and I said ‘No.’ I thought what good is it not for me to go. It was very disturbing.
“Dr. Yi often has a very a quiet smile and doesn’t say much, but with what he does say he makes you feel that you are in good hands. So I left June 5 with a friend, driving from New Jersey to California and back, arriving home almost a month later. Since then I have had three or four CAT scans, all showing that I am stable.”
Oncologist Peter Yi was born and raised in South Korea. His father owned his own import/export business. In 1972 his father came to the U.S. and the family followed two years later, when Yi was 18. He earned a B.S. in chemistry and biochemistry from the State University of New York at Stony Brook in 1980, then attended Cornell University Medical College in Manhattan. After an internship/ residency in internal medicine at Harvard’s Brigham and Women’s Hospital in Boston, he returned to Cornell for a fellowship in oncology, which he completed in 1990. He moved to Princeton the same year.
‘I was always good in science. In college, when I was trying to make a decision about medical school vs. graduate school for chemistry or physics, I thought it would be wonderful to combine the knowledge of science with helping humanity. I put off the decision as long as possible and then said to myself, ‘I have to make a decision tonight.’ I soul searched all night and decided to go to medical school. After that I never looked back.
“During my undergraduate years at Stony Brook, I worked in the lab of oncologist Stanley Zucker. Whenever there was extra time left, I asked him if I could tag along on his rounds next door at the hospital. I went with him a couple of hours once a week. What I saw, in addition to the different treatments they had at the time, was a lot of patients who did not have a lot of hope; I saw a lot of hopelessness in their expression. I thought maybe I could do something in this field to bring a smile and give hope. I continued to have wonderful mentors — at Sloan-Kettering, which is part of Cornell in New York, and at the Dana Farber Institute, part of Harvard. So my decision to become an oncologist really extends from my undergraduate experience.”
Princeton Medical Group 419 North Harrison Street, Suite 101, Princeton 08540; 609-924-9300; fax, 609-924-3477. Peter Yi, oncologist.
Life Without Dance?
A Doctor Says ‘No’
Dancer Alma Concepcion grew up in Puerto Rico, where her father was a lawyer and a politician. She was a soloist with Ballets de San Juan and performed in Spain with the famous dancer Antonio. She has been been teaching Spanish dance and ballet at Princeton Ballet School for more than 20 years. She also teaches children’s dance in a grass roots organization, Taller de Danza, that she founded for Hispanic children and their parents in Trenton, and she works in a literature outreach program (People and Stories — Gente Y Cuentos). Her husband, Arcadio Diaz, is a professor at Princeton University, and they have two grown children — their daughter is a New York-based dancer.
‘In 1989 I was having trouble with my feet. It was very painful. I went to a podiatrist who told me that I should not try to dance any more. My time with dance was over, he said, and he thought I should do something else with my life. This doctor did not explain. He just told me, ‘You have danced long enough.’
“But I could not accept that. I had been dancing since I was six years old. I was choreographing and writing about dance, I was dancing and teaching, and I depended on my feet. I could not see myself not using my feet.
“One colleague, Ze’eva Cohen, at Princeton University, said, ‘Alma, I can see you with some pain in your life, but I cannot see you not dancing. I don’t see how you can not dance.’
“Another colleague told me about Dr. Ricketti and assured me that he could help me.
“At my first visit. Dr. Ricketti asked me what I did. ‘I am a dancer,’ I said. ‘You think I am crazy, right?’
“‘No, I don’t,’ he said, ‘I am going to put you at 100 percent of what you do.’ I couldn’t believe my ears. I had just come from this other doctor who had said the exact opposite.
“Dr. Ricketti told me I had fallen arches, and made special orthotics for me. And that was it. He also prescribed special shoes and said that I should use just those shoes. And as time has gone by, it has gotten better. I can use any shoes. I don’t need to use the orthotics all the time any more.
“He was very positive about what he was going to do. He is a specialist in sports, and he had worked with dancers before. There was no doubt in his mind. The orthotics were $250 which at the time was pretty expensive, and medical insurance did not pay for podiatrists.
“For many years I have continued to dance — to take class, and teach, and perform. I did stop performing — it is better to stop at your peak rather than too late — but I dance when I am demonstrating for my students. I can’t teach sitting down. I have to engage myself.
“He also helped my friend, who had pain, he thought, from doing a lot of walking, and who thought it was something wrong with his feet. It was Dr. Ricketti who, watching him walk, told him that something was wrong with his spine. My friend went to the neurologist and learned he had a spur on his spine and needed an operation. Had he not had the operation, he would have become paralyzed.”
James C. Ricketti DPM does podiatric medicine and surgery and sports medicine; he has privileges at Robert Wood Johnson Hospital at Hamilton and the New Jersey Surgical Center in Mercerville. He grew up in Mercerville, the son of an accountant and a housewife who had four sons — the others are now the co-owner of a steel company, an allergy/pulmonary specialist, and a vice president of the Federal Reserve Bank.
After graduating from Rider University, Class of 1977, he earned his DPM degree from the Ohio College of Podiatric Medicine and did a residency at the James C. Giuffre Medical Center in Philadelphia. He and his wife Maria, who teaches in the Mercer County Vocational-Technical program, have two sons, one at Rider and the other at Steinert High.
An early injury influenced Ricketti’s career choice. “I stubbed my toe in high school, and it got infected. I went to my brother’s former college roommate, who was a podiatrist, and he impressed me,” he says.
Ricketti had his first experience designing orthotic shoe inserts for dancers soon after he graduated from podiatry school; he consulted to the Cleveland Ballet. To help Concepcion, he watched her perform. He saw that for flamenco, a type of Spanish dance, the balls of her feet pound the floor to make percussive rhythms. “I had her dance for me,” says Ricketti, “and then I knew what the problem was and how to control it.” He designed a special orthotic that is made of different material from the usual prescription inserts.
Also in Cleveland Ricketti had his first brush with major league sports players. After he helped loosen the hamstrings of Len Barker, a pitcher for the Cleveland Indians, Barker pitched a perfect game against the Toronto Blue Jays. As a result of that success Ricketti did some work for the Red Sox in 1985, developing a shoe appliance for Roger Clemens that led to Clemens’ 24-4 record and that helped the team get to the World Series.
“I still have quite an extensive sports practice, but now I treat high school athletes,” says Ricketti. “When I fix a high school or college athlete’s foot, and they go back and play and are all-state, it gives me gratification — they thank me. The pros are a bunch of babies, more aggravation than they are worth.”
James C. Ricketti DPM, 2273 Route 33, Golden Crest Corporate Center, Suite 204, Hamilton Square 08690; 609-587-1674; fax, 609-587-2206.
In a Long Battle,
A Doctor Listens
Teacher Kathy Ritz, 38, lives with her husband, David, an industrial engineer, and her son, Michael, 7, in the Hamilton house she grew up in. She runs the science lab for grades 3-8 at St. Paul’s School in Princeton, teaching three days a week. Her father, now retired, owned a liquor store, and her mom helped him in the store. Today her parents live just three blocks away from Ritz, one brother lives around the corner, and her in-laws also live in West Trenton. Her other brother lives in Burlington (Ritz says her mother wonders aloud, “Why would he want to live so far away?”).
‘In 2001 I found a lump in my right breast during a self-exam. I was 33 years old, and my son was about a year and a half. I had a lumpectomy at Fox Chase in Philadelphia. The cancer was Stage II. Following the surgery I had six months of chemo followed by six weeks of radiation at St. Francis in Trenton.
“I had regular check-ups for four years. In February, 2005, a Stage I recurrence was detected in a mammogram; I had been having a mammogram every six months on the right side, and every year on the left. Shortly before the diagnosis, the doctor who I had been seeing at Fox Chase decided to get married and go back to her family in Chicago. I called the Cancer Institute of New Jersey Hamilton (affiliated with RWJ University Hospital Hamilton) because it was so close and because I wanted a second opinion.
“When I met Dr. T [oncologist Deborah Toppmeyer] I just clicked with her. She’s very positive. I knew she was listening to me — that’s important when you’re not feeling well. Toppmeyer [who, as associate professor of Medicine at UMDNJ/Robert Wood Johnson Medical School in New Brunswick, spends the bulk of her time in New Brunswick, where the Cancer Institute of New Jersey headquarters are located] had been coming to Hamilton only sporadically filling in until an oncologist who had left had been replaced. When they told me she would only be here occasionally and she really wasn’t keeping her patients, I begged her to keep me as a patient.
“She’s not only interested in my medical health, she interested in my whole being. Dr. T. was the one who encouraged me to go back to work after my treatment. She is a very positive listener; she kind of reads between the lines. I feel like I could have her over to my house for tea.
“I had a mastectomy with the same surgeon I had had at Fox Chase, Ellen Sigurdson, followed by 12 weeks of chemo at Hamilton. The first time was harder, the second time I knew what to expect, and it was a different drug combination, not as harsh on the system as the first time. The infusion area looks out on a landscaped garden with sculpture and a rock waterfall called Grounds for Healing. All the chairs face windows so you’re looking outside at plantings, benches, and bird feeders. They give you lunch, they bring in musicians who play harp music or guitar, they bring in petting dogs, and there are social workers checking on you all the time.
“They all know you by name, even the receptionist. Trish Tatrai, who runs the breast consultation program and is Dr. T’s right-hand person, is so excellent. If I had a problem I could call her and she would call right back. If she couldn’t answer the question, she would find out and call me back.
“I asked Dr. T about the survival rate for a second occurrence. She doesn’t give you numbers. She said, ‘I have a large patient base who has survived a second occurrence.’
“I have a strong supportive family and a lot of good friends. I’m strong-willed; most people can’t even believe what I’ve been through. I go to church every week and my faith has been tested. You try to get through and rely on whatever you can.”
Breast cancer oncologist Denorah Toppmeyer, 47, was born in New York City and grew up in Manhasset Hills, Long Island. Her father was an electrical engineer, and her mother owned a marketing research company. She earned her bachelors in chemistry/psychology with a minor in math from Ohio Wesleyan University in 1981 and her M.D. from Albany Medical College in Albany, New York, in 1985. She completed her internship in internal medicine at the University of Pittsburgh School of Medicine and fellowships in medical oncology at the Dana-Farber Cancer Institute and Brigham and Women’s Hospital in Boston.
‘I fell in love with Dr. Kildare when I was 10. I always wanted to do ‘save the world’ type of work and be in some sort of health-related field. When I got into medicine, I was drawn to the uniqueness of the oncology patient, the holistic approach of how you manage patients — the comprehensive medical care, and the many psycho-social issues that you address in their treatment. The biology of breast cancer and the continued scientific discoveries is what really attracted me. I also enjoy the interpersonal relationships you form on many different levels in medicine.
“I am particularly interested in the treatment of young women with breast cancer, and the unique challenges they have. We have a program at Hamilton called the Life Center, which provides counseling, risk assessment, and risk-reduction strategies to young women at high risk for breast cancer. Younger women (with breast cancer) have a very different set of issues (than older patients) — the financial considerations, how they interact with their own colleagues, fertility. Kathy (Ritz) is among that group: she is young, and the struggles she’s had to deal with included having a young child at the time of her first diagnosis.”
Cancer Institute of New Jersey — Hamilton, 2575 Klockner Road, Hamilton 08690; 609-631-6960; fax, 609-631-6888. Michael Eleff MD, medical director. www.cinj.org
Family Atmosphere; No Long Waits
Executive assistant Diane Dell, 66, was born in Trenton and currently lives in Ewing. Her father built custom homes, and her mother was a realtor. She is a graduate of Villa Victoria Academy in Ewing, and is currently an executive assistant in human resources for a large pharmaceutical firm.
‘Dr. Fernando — I call her Dr. Cha, almost everyone who knows her does — has been my doctor for 20 years and has become a trustworthy friend. I do not hesitate to recommend her, and at least 15 of my friends go to her, including my two daughters and son-in-law.
“Her office is not like a doctor’s office — it feels like you’re visiting a person’s home. Dr. Cha is warm and welcoming and there is no white-coat anxiety. There are never a lot of people in her waiting room. They keep their appointments on schedule with minimal wait-time. I’ve gone during the work day, and they know people have demanding jobs; they see you right away. You can get an appointment in a minute, and you can even walk in without an appointment. Her husband, Bruno Cole, is a cardiac surgeon at RWJ University Hospital, and helps with the practice. You can get your X-rays taken and your blood work done there so there is no need to make multiple stops.
“Dr. Cha is wonderful, almost like an old-time doctor. When I have needed specialists she recommend someone right away. I feel that she’s always there for me. She’s someone you can call and run over to see, when you have your doubts about something.
“Because of my confidence in her abilities, I recommend her. Every time I turn around I feel like I’m saying, ‘Isn’t Dr. Cha your doctor?’”
Internist Chandani Fernando grew up in Sri Lanka, the daughter of a deputy governor in the central bank (the equivalent of our Federal Reserve) and a Swedish mother, who worked in the Swedish Embassy. She completed medical school in Sri Lanka, then did her residency in internal medicine and her fellowship in infectious diseases at RWJ University Hospital in New Brunswick, finishing in 1996. She worked as an assistant medical director at a major pharmaceutical firm from 1996 to 2001 before opening her own practice with her husband, Bruno Cole, a surgeon specializing in cardiac, thoracic, and vascular surgery at RWJ University Hospital.
‘My uncle is a physician, and my mom’s sister is a dentist. It was always something I liked to do. (In medical school) I became interested not only in the part where you interact with people but also the academic part, the fact that the medical field is always changing — it’s an ongoing process, and you never stop learning.
“At that time new knowledge about HIV was coming out and that field was changing, and that interested me. I also became fascinated with infectious disease. It is one of the specialties where, if you found a reason for an illness, such as something that would respond to antibiotics, you could help someone with quick results.”
Princeton Primary & Urgent Care Center LLC, 707 Alexander Road, Suite 201, Princeton 08540; 609-919-0009; fax, 609-919-0008. Chandani D. Fernando MD, medical director. wwwppucc.com
Alternative Approach To Chronic Back Pain
Story teller Susan Danoff has had chronic problems with muscle spasms for most of her life. “When I was a little girl, it was a stiff neck,” she says. “I couldn’t turn my head.” The attacks came on with no warning, and were triggered by the simplest thing — bending down to pick something off the floor, catching a falling pot.
Her first health practitioner was her mother, who gave her asprin and a compress. When she was a child, the spasms lasted for a few days. “When I got older, they hung on longer,” she says. “It could be totally debillitating.”
The worst attack came in the fall of 2004. “That bout lasted five months,” she says. Unable to tolerate drugs, she was in pain all of the time. The spasm sapped her of energy, and made her favorite physical activity — walking her two dogs — completely impossible. Driving was difficult and uncomfortable, but Danoff did continue with her work.
A native of Wilkes-Barre, Pennsylvania, Danoff earned a degree in East Asian studies from Princeton University in 1975 — with the third class to include women. She then spent a year teaching in Taiwan with Princeton in Asia. Quickly deciding that teaching was the career for her, Danoff earned a teaching certificate at the University of California at Berkeley and then a master’s degree in English at Rutgers.
But it was a chance encounter at the Princeton Public Library that set her career course. “I saw a story teller there in 1979,” she recalls. She knew right away that she wanted to combine story telling with teaching. “I was interested in it as a teaching art,” she says. She worked on her story telling skills and repertoire while teaching writing part time at Princeton University for nine years. All the while, she was looking for work as a story teller.
“When you’re developing a career no one has heard of, it’s hard to get work,” she says. But she persevered, first getting work from the New Jersey Council on the Arts, where she worked for five years in the early 1980s, and also performing on her own and making tapes. “In the process,” she says, “I learned that story telling is an incredible vehicle for teaching urban children.”
She began to pursue contracts with urban schools for year-long story telling programs, and in 1996 founded Storytelling Arts, a non-profit that now has enough work to keep 10 contract employees busy in schools around the state.
Danoff was able to keep Storytelling Arts going during her latest — and possibly last — bout with muscle spasms, but it wasn’t easy. “I was at my wits end,” she says. A chiropractor she had been seeing was out of town, so she went to another chiropractor. Her condition got no better. Then her trusted chiropractor returned. She thought she would get relief at last, but he was unable to help her. The spasm lifted, but quickly came back.
Next she turned to her primary care physician, suggesting that it was time for tests — perhaps a CAT scan or an MRI. But her doctor was quite sure that the problem was not skeletal, but was indeed muscular. He gave her the name of an alternative medicine practitioner, Lucero Mejia, a Lawrenceville resident who performs MAT — muscle activation techniques.
With nothing to lose, Danoff went to see Mejia, and is sure that she will never have serious problems with spasms again. Explaining just what MAT is, Danoff says “It’s totally different from chiropractic. That’s bones, this is muscles. It’s not massage. It’s very scientific. She locates where the muscle is weak and contacts that muscle.” Each muscle is tested to see just where the weakness is. Practitioners of MAT believe that spasms occur because the muscle is no longer communicating properly with the brain. They restore the connection through muscle manipulation.
“It’s totally pain free,” says Danoff. It is also meant to be permanent. “This is not therapy where she wants you to come back,” she says. “She wants you to be healed, and not come back.” The therapy generally occurs over about four sessions, but Danoff’s treatment took longer because she had had such severe spasms for so long. She was also given isometric exercises to do at home, and, as a next step, she says that she will probably go back to Mejia, who is also a personal trainer, for a course of strength-building exercises.
At the moment, Danoff is enjoying her new pain-free life, her work, and her family. Her husband, Neal Tolchin, is an English professor at Hunter, and her son, Jonah Tolchin, just graduated from the eighth grade at the Princeton Friends School. Her dogs, a golden retriever and a Cavalier King Charles spaniel, are getting a lot more walks now, and she is full of energy as she prepares to promote her first book, “The Golden Thread: Storytelling in Teaching and Learning.”
In her own life, the golden thread was the one that led her, after a lifetime of pain, to Lucero Mejia.
Lucero Mejia, MAT therapist, says that Susan Danoff is the most challenging person I have ever had,” says Lucero Mejia. “I put stress on individual muscles,” she says of the muscle activation technique (MAT) she practices, “but I couldn’t put much stress on her. She was too weak.” When Danoff first came to her, Mejia recalls thinking “I don’t know how she’s getting better.”
A case of mononucleosis Danoff suffered while in her 20s contributed to the weakness, in Mejia’s opinion. “With mono — and with Lyme disease — you become weak,” she says.
But Danoff, after a five-month seige with muscle spasms, did respond to the MAT therapy, and now, nearly two years after working with Mejia, is confident that she will no longer be bothered by the condition.
Mejia speaks about MAT just three days before she is due to fly to Denver for further training in the technique. To become certified she completed a 17-month internship in 2003, spending one week each month in Denver, learning the technique developed by Greg Roskoph, biomechanics trainer for the Denver Broncos, Denver Nuggets, and Utah Jazz pro sports teams.
MAT, as explained on www.resistancetrainingspecialist.com/mat, is “a unique and practical approach to evaluating and dealing with neuromuscular imbalances that contribute to dysfunction and ultimately to injury. The MAT system provides trainers with the necessary skills needed to treat neuromuscular inhibition and the resulting tension/protective mechanisms in the antagonists that will restrict range of motion.”
Like Danoff, Mejia has crafted her own career. A native of Colombia who immigrated at age 18, her first job in this country was fielding directory assistance calls for AT&T. Her reaction to her first job was: “I can’t take the abuse of these customers. I have to get an education.” She first attended Mercer County Community College, and then earned a finance degree summa cum laude from Rider University. By furthering her education, she was able to move up in the ranks of AT&T, specializing in marketing, and coming within a stone’s throw of upper management. But after some 15 years with the organization she began to question her life’s work.
“In 1995 I realized I had a house, a car, materialistic things, and I asked ‘Should I climb the ladder, or do something else?’ I asked ‘If I had all the money in the world, what would I do?’”
The answer went back to a life-long pre-occupation. “A little on the heavy side” as a youngster, Mejia had been interested in fitness and nutrition all of her life. At a career crossroad, she decided that “by 2000 I will be a fitness guru.” She began holding personal training sessions in her home gym, and doing fitness career research.
When AT&T offered her a buy-out in 1998, she quickly decided to “take the money and run.” She then earned a fitness and nutrition diploma from the International Correspondence School in Scranton, Pennsylvania. Next was an ohashiatsu certificate from the Ohashi Institute in New York City.
As her personal training and nutrition practice grew, Mejia was frustrated to find that her clients were getting hurt, and were having trouble healing and getting back to their sports. It was then that she heard about MAT, which preaches that biomechanical imbalances lead to injuries. She now incorporates MAT into her practice.
The mother of two sons, one about to become a Lawrence policeman and the other a senior at Harvard, Mejia, who is married to Jorge Mejia, a chemical and environmental engineer about to start a new job with Merck, says she is “super fit.”
And while Danoff’s case presented her biggest challenge, perhaps the best advertisement for her brand of alternative medicine is her father. Along with her mother, he had business and real estate interests in Colombia, and worked as an accountant after immigrating. “I changed his nutrition, and he is very healthy,” says Mejia of her dad, who is close to his 94th birthday.
Feel Rejuvenated LLC, 10 Tracey Drive, Lawrenceville 08468; 609-844-0775; fax, 609-896-9018. Lucero Mejia, owner. www.feelrejuvenated.com.