The genuine pearls of medical wisdom

By Erika Schwartz, MD

When I was in medical school and then in training in Brooklyn at Kings County Hospital, I saw the most gruesome and unusual medical and surgical problems you could ever imagine. Gunshot wounds were routine; horrible diseases, both acute and chronic, filled the halls of the more than 1,000-bed hospital; and the ER was a place where more people were seen in a day than live in any of our beloved Westchester or Fairfield neighborhoods.

The Brooklyn ER was like a war zone. Rooms filled with terribly sick asthmatics of all ages. The C1-critical care area, where cardiac arrests, trauma victims, the elderly and the very sick were cared for, was where we lived. I had no idea there was anything unusual about the way things were at Kings County.

To help us learn more, we had weekly grand rounds in which the smartest and the best among us – all young, hot-dog, newly minted doctors – presented the most unusual cases while our elders, professors highly experienced and intimidating, would grace us with medical pearls of wisdom that never ceased to amaze or impress us about the treatment and diagnosis of the very sick. Life in that hospital was life in its own reality unrelated to the rest of the world.

By the time I made it to Westchester, the ER at Westchester Medical Center seemed so far removed from the MASH-like atmosphere in Brooklyn, I thought I was put out to pasture.

Granted, there was some trauma, but the gunshot wounds were few and far between, and the too-common, horrific child abuse cases greatly diminished. But to my surprise, so were car and hunting accidents as well as undesirable encounters with deer, boats and trains. Of course, there were plenty of the much maligned but overabundant sexually transmitted diseases.

But then, that was a long time ago. What I learned at Kings County and applied at Westchester was acute care – how to identify sick people, how to diagnose them quickly and how to treat them, get them out of the hospital and back to their lives and families as fast as possible.

When I went into private practice in Irvington, I wanted to connect with the patients and be part of their lives. I wanted to apply all the pearls of Kings County and Westchester to people who did not need acute care.

In time I realized the best thing to do was to help people stay away from the hospital.

That’s when I entered the world of prevention and started acquiring real pearls of wisdom that changed the way I live my life and became rules to help my patients live theirs.

This issue is about gems and that’s exactly what we need in our health. It’s a time of dramatic change in health care, a time when people don’t know where to turn or how to figure out their own health needs, so I thought I would share the most important things I learned, use and am happy to tell you are helping not just me but also my patients and thousands of people I come across in my daily travels.

Please read these and share them with the ones you love, but above all, use them for yourselves.

1. You are in charge of the outcome of your life. When you are 40 or 50 and you look at what your life looks like, it is all the result of choices you have made. So when you make a choice, don’t blame anyone else or follow anyone else for that matter, just make your choice and make sure you can live with it. Example: If you go to the doctor and have a test done, what will you do with the result? Ask the doctor, if you aren’t sure you agree or are clear about it, just don’t automatically do it. The goal is not to find something wrong at all costs. The goal is to live a peaceful, balanced life.

2. Take the lead in the doctor-patient relationship. This is where you have total control and if you don’t choose to be in charge, you may get hurt. The doctor is there to serve you. His or her advice may or may not apply to you. “Doctor knows best” is wrong and totally false. Doctor doesn’t live in your body, so you have to learn to listen to your body and use the doctor’s advice as it applies you. If you like your doctor, you are more likely to do well than if you are afraid or dislike your doctor. If you don’t share everything with your doctor – what medication you are taking, what naturopath you are seeing, supplements, hormones, other information you may think irrelevant or are afraid to divulge – you are shortchanging yourself, not the doctor. If the doctor doesn’t listen or belittles your choices or behaves unkindly, leave the doctor. Otherwise, you will get hurt.

3. Don’t make decisions based on fear. Our entire health care system is based on intimidation and fear-mongering. If you want to live your life feeling good about yourself and your choices, eliminate fear. The only fear that is justifiable is the fear of death. But then, we are all going to die, so the sooner you accept that fact and stop obsessing about it, the sooner you will actually live.

4. Make decisions alone. Do not live by committee. When I see a patient come in with three family members or friends, I worry the decisions he or she makes are tainted by others’ opinions. I don’t mean don’t get opinions, share information, research or talk to trusted counsel. I mean decide alone. Don’t allow your decision to be made by others. They won’t be living with the consequences.

5. Common sense is free and not taught in medical school. The “pearls” I learned in my intensive training years and applied in my disease-focused practice did not take into consideration the invaluable lessons of common sense. For that reason, they did not work.

For more information, email Dr. Erika at

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