Life in the Shire

 

When, after a 16 year journey through college, medical school and post graduate training, I returned to the town of my birth and public school education through high school, Washington, D.C., I told myself the choice of this place made sense, as there was a recession on, and this town is recession proof, and my father still lived there and if we had kids, as my wife insisted we were going to have, it would be nice to have a grandfather around and besides, we had visited Washington during a gorgeous Spring weekend and the azaleas were in bloom, so it made sense.

It may have also been true that I had some unresolved issues from high school, which I had left with a vague sense of defeat, and so there I was, there we were.

And Washington did offer some fun, excitement and interesting people and we found a little village to live in hard by the Potomac and my two sons took full advantage of the river and the woods surrounding us and the public schools were good.

But, more and more often a story, likely apocryphal, I had heard about Tony Fauci when I was still at The New York Hospital burbled up from somewhere deep in my brain. The story was told by Lou Drusin, an odd duck who hung out in the hospital cafeteria, eating with medical students or interns, or anyone really. Lou still wore his medical school nametag on the lapel of his white lab coat, even though he was 10 years out of med school. It was never exactly clear to me what Lou was doing at the hospital; it was rumored he worked for the Department of Public Health, which had almost no status at the medical school and wasn't even housed in the hospital itself, but across the street in a derelict town house. 

But Lou was the best source of hospital gossip ever and he was good company at dinner, and he forgave you if your beeper went off and you had to bolt in the middle of one of his stories. 

The story Lou told about Tony Fauci, he told me when I was a fourth year medical student in 1973 and there were about three of us fourth years at the table listening.

As Lou told it, the day Tony finished his year as Chief Medical Resident, they called him into the resplendent offices of the Department of Medicine, into the main conference room, with it's gleaming, long oak conference table, and the framed photos of all the men (and was only men, in those days) who had been Chief Medical Resident lining the walls, along with portraits of the luminaries of The New York Hospital, men like Dr. Papanicolou, who developed the Pap smear, and the high and mighty men of the New York Hospital gathered round and presented him with his framed certificate for doing the Chief Residency and with a document appointing him to the faculty of the Cornell University Medical College and then, with the letter granting him "admitting privileges" to the hospital, so he could go find an office on Park Avenue and exercise those privileges to admit his patients to the hospital and to receive consultation referrals from the rest of the hospital staff. It was like being granted partnership in a big law firm, or credentials at the New York Stock Exchange, or a job at Goldman Sacks.

Fauci said thanks but no thanks. It was an honor and a privilege, of course, but no thanks.

"If he had set off a bomb, it couldn't have rocked that room more," Lou said.

One of Tony's friends chased him down after he left the room.

"Tony, how could you turn it down?" his friend asked, incredulous to the point of disorientation.

"Some day," Fauci replied, "I will be either very rich or very famous...But, if I stay at the New York Hospital, I will be neither."

And so Dr. Fauci embarked off to new adventures at the National Institutes of Health, in Bethesda, Maryland, just three miles down the road from my office in Chevy Chase.

As the years rolled by, sitting in my office, I contemplated whether I had made the choice, the safe, expected choice Tony Fauci had walked away from.  Coming back home, hanging up my shingle, reconnecting with old friend from high school and the old neighborhoods had been a regressive move, in some ways. It wasn't moving forward, exploring new frontiers.

There were certainly rewards in the practice I eventually built and there was something which felt predestined in the act of return, but there was also something stultifying about going backwards.

We often, in America, question the restlessness of our society, where people move away from their families and childhood friends, and we say this contributes to a lack of community to a sense of alienation, but I think that's untrue.

The people we knew when were were 12 or 16 are not the same people we still know when they are 52 or 66. They may have the same names and they may even live in the same neighborhoods, but they have been transformed by time and experience.

At some point, I reached the same conclusion Dr. Fauci had reached, that there was no way to really make progress in life unless I left that cocoon of my birth and found something new.

New Hampshire has been new and different.  The ocean is 3 miles away, biking distance.  Two hours north are the lakes and the mountains.  I cross country ski when it snows, right out my front door.

And I've found people I genuinely like, some I adore. I haven't known them for 50 years, as I knew some of my friends back in Washington, but in some ways, they allow me to know them better than my old friends ever did.

Watching my own kids, who lived in New York City and then packed up for LA and places I'd never have thought of, I have to think: good. Try something new.

You may never be rich or famous, but at least you'll explore new worlds. And trying to stay in the old world is a fool's errand: The old world never stays the old world. It keeps changing along with you.