Monday, September 19, 2011

The Journey We Take Alone? -- Part 15

By Alexander "Sandy" Prisant

In the latter half of the last century, America had the power, but we also had the pain. Our first military defeat -- in Viet Nam. High profile assassinations. Watergate. Funny elections.

But we could always say ‘Thank God for modern medicine.’ In this one field, it seemed we could mostly agree we saw the advancement of civilization. Real progress. For mankind. The advances in research and the doctors who made them, right back to Jonas Salk. And by reflection, the doctors who treated us. This one group of people, regardless of your politics, made us proud and confident.

I’ve been impossibly fortunate to have a half-dozen close relationships with physicians who cared. And delivered.

When I was breaking free from New York in my late 20s, I had offers on the West Coast. My nephrologist at Albert Einstein College of Medicine sat me down for an unusual conversation. “We think it’s okay for you to go, so long as you’re under the care of one of these nephrologists.” He handed me a typed page with details of three doctors -- one at UCLA, one in Seattle and one at Stanford.

With an offer in hand to work for Ernest Gallo near San Francisco, I had the good fortune to draw the man at Stanford. Dr. Norman Coplon was a Professor of Medicine and a major player in the Kidney Foundation. But he was also an easy-going man from Syracuse with a ready smile and a wide repertoire of one-liners. Walking down the halls of Stanford Hospital with him, you’d see nurses take one look in his direction and collapse in hysterics. There is nothing aloof about Norm.

He quickly proved his medical skill, bringing my blood pressure under control in a way the top dogs in New York had failed to do. We had a wonderful ritual. One Saturday morning a month, I’d drive to Palo Alto from the San Joaquin Valley to have a check-up, draw blood and play tennis. Norm was ruthless; he’d often draw blood from my tennis arm.

It led to a burgeoning relationship between our families. Finally, the Coplons became our West Coast family.

As we began to travel and live overseas, Norm stayed by our side. When we first bought a home abroad in a very trendy neighborhood, Susan suddenly was hit with a terrible eye inflammation. We felt fortunate to be near the famed Moorfields Eye Hospital. We rushed Susan there, only to be told: “you must live in a depressed area with lots of construction dust. You must move.”

We went home to book a flight back to America for real care and called Norm for a referral. It was 4 o’clock in the morning in California. “Put Susan on the phone,” he said. Despite the pain, she calmly described every tree around our house.

“Go down to the pharmacy and get this stuff—you won’t need a prescription or a flight to the US.”

And by the next day, Susan’s eyes were nearly over the allergic reaction. Cured by a kidney doctor.

For several years, we lived a small village in Southern Italy. I kept a picture on the shelf above my bed, right over my head. It was Norm as a young doctor with chunky cheeks, thick, black-rimmed glasses and his smile. He was a Peter Sellers look-alike, taking his mother’s blood pressure.

I was pretty far away from any serious help in those years. Having Norm looking down on me each night helped get me through.

We continued to get care from six or eight time zones away well into the 90s. But we would still fly back to the US for the big stuff, like that triple by-pass in 1995, which set off a string of events. It was a lesson in how deeply integrated everything is in our bodies.

By then, it was already known that the contrast dye used in my angiogram was potentially harmful to the kidney. And because I was a prized patient, I was always given early access to new hypertension meds. A mixed blessing. I was effectively a guinea pig for several drugs. They all were beneficial until 1996 when Norm introduced me to an early Ace Inhibitor. This drug, combined with the contrast dye a few months before, sent my battered original kidneys into terminal decline.

But Norm was still there. “You’re going to get a transplant,” he declared. “We’ll take a kidney from your brother.”

When it comes down to the inevitable, even after years, the idea of asking anyone for a body organ is daunting. “Don’t worry,” Norm said.

A few weeks later, my wife, brother Marc and I were having a regular dinner at the Coplon’s. Just as we sat down, Norm announced: “Marc, your brother is having a transplant later this year and you are donating a kidney.” Marc was speechless. The table was speechless. Then somebody started passing the soup and that was that.

The Coplons kept my kidneys going for 20 years, sat by me in ICU for my first heart surgery, cured all manner of ailments from across the globe and interceded to directly arrange a kidney transplant.

Norm Coplon practiced at a time when doctors were deeply engaged in people’s lives—to every one’s benefit. The end of that era came when the insurance industry thugs imposed a new universal computer billing system. Norm could no longer be what he was—board certified and practicing for decades in both nephrology and internal medicine. Now he was told that he had to choose. He could only have one billing code in their system. The professor must throw away half his life’s work.

Norman Coplon, proud and accomplished, thought it over. He quietly closed his practice, took early retirement and went home to build a vegetable patch on a hillside.

To the detriment of us all.

Writer Alexander Prisant, who lives in Florida with his wife, Susan, has been writing about the serious health challenge he faces with his lifelong kidney ailment which now threatens his life.

1 comment:

Anonymous said...

Mr. Prisant,
You have captured a great deal of Dr. Coplon, perhaps the essence; however, there is even more amazing goodness to this remarkable man than you know. Did you know that when he set up the first dialysis units in Califonia that he made them all into a non-profit corporation? Did you know that all of the profit from those coporations went to research to prevent kidney disease and to help all those patients so afflicted? He started dialysis in California before it was covered by Medicare. Very few could afford it. He never turned anyone away and treated them all. After the 1974 catastrophic health care act created a mechanism to over the cost of dialysis, he could have become a wealthy man. Instead he gave it all away in an effort to treat those currently afflicted, and to prevent future kidney failure. Norm was a great role model for us all. He inspired us to go out and change the world as he was doing. Many of us left the Bay area to go to parts of the world where that inspiration and new technology would help us reduce by a decibel or two the agony of kidney failure. Others stayed at Stanford and inched back the frontiers of science. We all give credit for anything that we may have done to Norm. There is a saying in Eastern philosophy that says "He who has been my teacher for a day is my father for life." Norm had hundreds of intellectual children. Even after Norm is dead and all of his former students and fellows have died, he will go on helping through the research grants that he has developed and his legacy of inspiration that we have tried to pass on.
Best Regards,
One of the intellectual children