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Best Doctor Hall of Fame 2002

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Dr. Michael Argenziano
HEART SURGEON

Claim to Fame:
Dr. Michael Argenziano is as devoted as a man can be to hisda Vinci -- in his case, a robot used to perform intricate cardiac surgery.Not only is he the first doctor in America to use this technology inclosed-chest bypass surgery, but the Jersey-born 35-year-old, who is thedirector of robotic cardiac surgery at Columbia-Presbyterian Medical Center,is currently the principal investigator in two more FDA trials of advancedrobotic procedures on the heart.
Robodoc: The way da Vinci works is simple: The machine has three sleek armsthat enter the chest cavity via small punctures made in the rib cage. Onceinside, one arm holds a 3-D camera while the other two use standardinstruments like forceps and a scalpel to work on the heart, leaving onlythree tiny scars. "I basically sit at a large video-game console through thewhole thing," says Argenziano, who's also an assistant professor of surgeryat Columbia University.
Full-Hearted Thanks: Last July, Susan McSwiney became da Vinci's firstclosed-chest patient in America when the robot repaired a hole in her heart."I was very nervous at first," recalls the 34-year-old. "They introduced meto da Vinci beforehand and assured me that if anything went wrong, they wereready to finish the operation the conventional way." It went off without ahitch: "I have two small kids, and I was picking them up just a few weeksafter the surgery. Dr. Argenziano is truly amazing."
Open Heart, Open Mind: While acknowledging that he's still in "the Model TFord phase of all this," Argenziano sees this method becoming commonplaceover the next decade. Which, according to division chief Dr. Craig R. Smith,is entirely possible with Argenziano at the helm: "He has an ability toidentify new developments long before other people." Some doctors, however,are skeptical about the technology. "You see more of an emotional problemthat occurs -- doctors can't allow a machine to do what you were trained todo," says Argenziano. But younger doctors like himself are less worried: "Igrew up in the Nintendo generation, so I was used to a virtual reality at avery young age." --DAVID AMSDEN

Dr. Lawrence Newman
NEUROLOGIST

Heal Thyself:
"My headaches started when I was about 12 years old," says Dr.Lawrence Newman. "Every time I took a step, I thought my head was going toexplode." Newman is the director of the Headache Institute at St.Luke's-Roosevelt Hospital Center and attending neurologist there -- and he'salso a migraine sufferer. "The diagnosis my parents were given was that ithad to be stress. It wasn't until I was in medical school that I diagnosedmyself."The Pain Event: "Cluster headaches are called suicide headaches, becauseuntreated, people will kill themselves," says Newman. "The pain is soexcruciatingly severe that sufferers will pace, scream, and bang their headagainst the wall. I ask patients to rate their pain on a scale from 1 to 10.A tension headache is a 2 or 3. Migraines are between 7 and 10. Clusters are40." Cluster headaches can occur up to eight times a day, and the cause isstill uncertain. "It has to do with an area of the brain that is thepacemaker for the brain," says Newman, "the part that makes you wake up andgo to sleep. Some patients have been misdiagnosed for years. We put them onthe right medication, and in one day their headaches are gone for thatcycle."
Head Case: "He's done outstanding research on unusual headache disorders,"says Dr. Richard Lipton, professor of neurology at the Albert EinsteinCollege of Medicine and president of the American Headache Society. "He'sdescribed some very rare but treatment-responsive ones that most cliniciansdon't recognize." For Ingrid Rossellini, a professor of Italian literatureat NYU, her headaches worsened in her late forties. "With the change ofhormones," says the twin sister of actress Isabella Rossellini, "it's theworst time for women." She came to Newman last month after six trips to theER. He began intravenous treatment with DHE, a drug that also weans patientsoff medication they are overusing -- in Rossellini's case, the drug Fioricet, acombination of Tylenol, butalbital, and caffeine. "Like a plant you give alittle water to," she says, "I just bloomed back to life."
Phone Home: "People with pain need to speak to you," says Newman. "I spoilthem in a way. My patients know that if they call me, I will not leave theoffice until I've returned their phone call. I'm the old-time doc usingnewfangled techniques. "--LAUREN DeCARLO

Dr. Robin Herbert
OCCUPATIONAL MEDICINE

Work Hazards:
In any given year, Dr. Robin Herbert, co-director of MountSinai's Center for Occupational and Environmental Medicine, treats thousandsof New Yorkers -- from financial analysts and journalists to garment workersand cleaning women -- for work-related problems like asbestos exposure andcarpal-tunnel syndrome. But in the months since September 11, her clinic hasseen a new group of patients: hundreds of rescue and recovery workerssuffering from health problems stemming from exposure to caustic dust atground zero. "We're seeing irritant bronchitis, severe sinus problems, andasthma. Many of the patients I see, when you look in their nasal passages,the skin is bright, bright red, almost as if the top layer was burned off,"she says. "And we're still seeing this now, eight months later."
Road Trip: In the early seventies, still in college, Herbert got a job on avan offering medical exams to cannery workers throughout California. It wasan exciting but sobering experience for a girl from Westchester. The workingconditions she saw at the canneries were deplorable: One man had lost an armwhen it was caught in a cutting machine. "That accident could have beeneasily prevented," says Herbert. "Seeing that got me interested in workersafety and health."
Treat the Cause: Herbert frequently acts as an advocate for her patients,helping them navigate the workers'-compensation system and intervening withtheir employers. When a garment worker came to her complaining of pain inher right shoulder, Herbert quickly identified the cause: The woman spenteight hours a day in a sequin factory turning a crank with her right hand.She investigated further and found that there were 60 other women at thefactory doing exactly the same thing. Herbert worked with thegarment-workers union and the factory owner to have the hand cranks replacedwith foot pedals and to provide adjustable seats for the women, preventingdozens of potentially disabling injuries.
Ground Zero: Some workers' advocates have charged that the EPA withheldcrucial information in September about the causticity of the dust from thecollapsed towers -- some of which had the pH of liquid drain cleaner -- thatrescue workers were exposed to. Herbert diplomatically says only that theinformation released at the time "does not explain the health problems we'veseen clinically."
Truth Squad: Herbert will serve as co-director for a large-scale medicalscreening program being established by the National Institute forOccupational Safety and Health to examine approximately 8,000 ground-zeroworkers, beginning in July. "I think the question of how widespread thesehealth problems may be has not yet been answered," says Herbert. "We need tosay, 'If something else happens -- God forbid -- how can we be better prepared thenext time around?' "-- EMILY GITTER

Dr. Florida Olivieri
GERIATRICIAN

Good Neighbor:
On a Friday morning at Linkage House, an East Harlemsenior-citizen-housing complex, the elderly residents are waiting in thecommunity room for Dr. Florida Olivieri. Each week, she comes to do theirblood work and deliver a health talk. Today's topic is calcium, andOlivieri, a chief geriatrician at Mount Sinai, speaks first in English andthen in Spanish. "It's important to reach out to the community and makehealth care accessible," says Olivieri, whose mother was a pediatrician inGuatemala, and who came to geriatrics by way of an earlier career in familymedicine. "It's hard for the elderly to get around.'' Olivieri spends asmuch time as possible out of the hospital, either in patients' homes or inMount Sinai's clinic at Linkage House.
Patience Rewarded: Since 65 percent of the geriatric population is female,"Flori was the ideal choice for doing community-related work because she isone of the few bilingual woman geriatricians in the city," says Dr.Frederick Sherman, medical director of senior health programs at MountSinai. Most doctors don't have the patience for elderly care. "Often youcan't make big improvements," Olivieri admits. "But you can make multiplelittle ones that really make a person feel better." There are benefits forthe doctor, too. "The elderly are more pleasant to work with," she says."They become very loyal."
Open Classroom: Olivieri calls herself a "clinical educator." She writes amedical column in Spanish for Siempre, on topics ranging from diabetes toanthrax. And she insists that Mount Sinai's third-year medical studentsspend time with seniors in the context of their lives, preferably in theirhomes. "She's the front-runner in making people realize that the bestmedical care isn't only in hospitals," says Dr. Reena Karani, now a fellow in geriatrics.-- AJA MANGUM

Dr. Nasser Altorki
CARDIOTHORACID SURGEON

Where There's Smoke:
There's a hole as big as a pineapple in the chest of Dr.Nasser Altorki's patient -- a 69-year-old ex-smoker who, during a routine chestX-ray, was found to have a tumor in her right lung. "The black stuff in thewrinkles of the lung?" Altorki says, slicing out potentially cancerous lymphnodes where the right upper lobe used to be. "That's carbon from cigarettes.And she looks better than most." Altorki is performing a sleeveresection -- the lung equivalent of a bypass -- in which he patches togetherbronchial tubes that have a cancerous section cut out.
Necessary Targets: Outside the OR, Altorki, the director of cardiothoracicsurgery at New York Presbyterian Hospital, works with the Ludwig Institute,an international research group, on a lung-cancer vaccine. Unlike vaccinesthat give patients a tiny dose of a disease, Altorki's is meant to stimulatethe immune system to fight antigens on tumors to keep them from growing. "Weneed to lower our sights a little," says Altorki, a Saudi, born in Beirut,who speaks fluent Italian and Arabic. "Our attempt to kill the tumor cansometimes kill the host."
Cancer Powwows: At New York Presbyterian, Altorki is now running two separateclinical trials of vaccines; so far, 35 patients are participating. Twice amonth, he meets with Ludwig's team at a summit of immunologists, biologists,surgeons, and oncologists: After reviewing the trials, he presents data onantigens he's discovered in other patients; the researchers then formulateways to target those antigens. "Not all lung surgeons are willing to workwith new therapies like he has," says Dr. Eric Hoffman, Ludwig's director ofclinical trials. "You need lung surgeons to recruit patients. And patientslove him."
Clearing the Air: "There are 45 million former smokers in America alone,"Altorki observes. They did their part; he'd like to prevent them fromgetting cancer anyway. "The problem is some nasty cell is wandering aroundthat can cause trouble years later. If I can target that son of a gun, maybeI can win!"-- ROBERT KOLKER


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