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Dr. Peter Selwyn: Mortal Combat


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Doctors don't like to talk about death very much -- it's usually taken as a sign of fallibility -- but Peter Selwyn can't seem to stop. "I was drawn to it without knowing why," says Selwyn, 45, who still looks like a graduate student in his faded checked shirt and Dr. Martins. "The role of accompanying a patient through a terminal illness is very meaningful to me." Three months ago, he became chairman of the Department of Family Medicine and Community Health at Montefiore Medical Center in the Bronx, the same hospital where he first made a name for himself back in the eighties as director of the Drug Abuse Treatment Program. At the time, aids was decimating intravenous drug users in the South Bronx, and Selwyn contributed to early aids research, publishing papers and lecturing widely. But while battling the epidemic on the research front, Selwyn still had to watch helplessly as every one of his patients died. He discovered that the most important treatment he could provide was the simple fact of his unyielding physical presence. "He is a fierce protector of the humanity of his patients," says Dr. Sherwin Nuland, clinical professor of surgery at Yale School of Medicine and author of How We Die. "I've been with him at bedsides, and people recognize that he cares desperately about them." Last year, while associate director of the aids Program at Yale, Selwyn published Surviving the Fall, an extraordinary memoir of his experiences in the Bronx -- and of coming to terms with his father's suicide. "We're taught, mistakenly, that ignoring our own emotional histories makes us more effective as care providers, but I think the opposite is true," says Selwyn, fingering a silver aids bracelet, a present from his teenage daughter. Selwyn has made palliative care a specialty, co-founding Leeway, a nursing home in Connecticut. But now he's back in the Bronx, back where his career in family medicine was first sidetracked by the aids crisis. Sitting among the still-unpacked boxes in his new office, he reaffirms the principle that got him into medicine in the first place: "If a patient needs to take twenty pills and refrigerate some, but he's homeless, the fact that the drug works is not enough. You have to treat the whole package."


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