issue Summer 2023

‘10 Essentials’: Lessons From Beyond the Classroom

Photo by Michael R. Schmidt

David Feinberg, MD ’89, MBA, told the audience at RFU’s 109th Commencement that earning his academic credentials included “getting the hang of that kind of study/exam, study/exam cycle.” He immediately added a caveat: “So what happens next?”

“To be a really good clinician, you need your people (in) your corner to comfort you, to cheer for you, to listen to you and to hold you after a long day.”

The answer was learning the lessons only practice can teach. He shared his personal 10 essentials and the stories behind them:

  1. “Treat the rat bites, but more importantly, kill the rats: Go upstream to provide preventative care.” This real-world education stemmed from a residency on Chicago’s South Side, where he was told to focus on eliminating the causes of his patients’ trauma — in this case, rat bites — rather than just treating its effects.
  2. “Be the tiger: Health care is people caring for people.” A silent, seemingly unreachable 6-year-old liked a tiger-like striped shirt Dr. Feinberg wore to therapy sessions and enabled them to form a trusted connection.
  3. “Don’t be afraid of the nuns: Do what’s right for your patient.” Though intimidated by “strict protocol” at a hospital that kept neonatal intensive care unit (NICU) babies out of pediatric rooms, Dr. Feinberg approached the nuns in administration and obtained permission for a mom with postpartum depression to bond in a pediatrics room with her NICU baby.
  4. “Despite all odds — like being the world’s smallest baby — love can heal.” Given “the privilege of caring for what was at the time the world’s smallest baby,” Dr. Feinberg watched the mother stand by an incubator for two months — and shared in her joy when she could finally hold her baby.
  5. “A spoonful of sugar — or a bearded dragon — sometimes helps the medicine go down.” A 17-year-old worn down by transplants and treatments was convinced to undergo a bone marrow biopsy when his nephrologist agreed to buy him the bearded dragon he’d always wanted.
  6. “Thank you, Batman, for showing me that learning can happen anywhere.” Dr. Feinberg recalled a scene from a movie he’d seen on a night off — “I think it was Batman” — and used sodium amytal to help an injured psychogenic amnesia patient reveal information that reunited him with family.
  7. “A single diagnosis can change a family’s trajectory: Make health care easier to understand and navigate.” Giving a diagnosis of schizophrenia to the father of one of his very first patients, Dr. Feinberg realized that the terminology he was using — “neurotransmitters” and “nucleus accumbens” — was lost on the anguished parent.
  8. “Knowing that Perry didn’t stop at the second bell taught me sometimes it’s better to be lucky than smart.” Dr. Feinberg’s young daughter told him about a classmate who didn’t stop running after the second recess bell and hit his head on a pole. A few days later, he treated a patient by the same name and with a fresh cut on his forehead, and correctly diagnosed him with attention deficit hyperactivity disorder.
  9. “Watching Jake officiate at his sister’s wedding was the greatest gift: Our patients can have as much of an impact on us as we do on them.” A young man officiated at his sister’s wedding more than a quarter-century after Dr. Feinberg first treated him for extreme autism.
  10. “Health care is a hard profession. Find your people, find your Andrea.” “To be a really good clinician, you need your people (in) your corner to comfort you, to cheer for you, to listen to you and to hold you after a long day,” said Dr. Feinberg — who specifically mentioned his wife, Andrea Feinberg, MD ’90, whom he met while at CMS. “Andrea is my everything. I encourage you to find your people.”