A Doctor for All Peoples
Those people I have known well and most admired were very different but shared a lifelong devotion to missions for which they sacrificed personal safety, traditional levers of power, and the rewards of conventional success.
Malcolm X was one of them. Another was the activist-pacifist A.J. Muste; Martin Luther King Jr. told me that it was Muste who first encouraged him to stake his life on nonviolence as the way to secure justice.
Also in that number was Dr. Paul Esserman, who died on February 13 at 77. He was on the staff and faculty at New York University Medical Center. As for the patients who came to his office on East 36th Street, Paul's idea of managed care as defined 2400 years ago by Hippocrates was to give every patient as much time and treatment as needed and more.
A week after he died, the large auditorium at the Ethical Culture Society was filled with patients and friends (the two were usually synonymous). Also present were physicians, some of whom had been his patients. He was known as the doctors' doctor.
One of the speakers was Tom Wolfe in a black suit who had been a patient for 37 years. Wolfe recalled a command to physicians from Hippocrates' precepts:
"Sometimes give your services for nothing. If there be an opportunity for serving one in financial straits, give full assistance to all such. For where there is love of man, there is also love of the art of medicine."
Paul Esserman's idea of a summer vacation in 1971 was to go to Ethiopia, where, at the time, the doctor-to-patient ratio was 1 to 250,000. There he set up a medical infrastructure for doctors and teachers of doctors as well as a medical exchange program with the NYU Medical Center. He also raised extensive funds to assure the education of a whole generation of Ethiopian doctors. He even helped arrange scholarships for Ethiopian medical students to NYU.
Over time, Paul was responsible for medical advances in China, helping to establish the first major medical college in Beijing.
Years ago, he asked me to arrange an evening of jazz for members of the Chinese delegation to the United Nations. Paul paid for the musicians, and I tried to tell the diplomats, as Max Roach often says, that jazz is a microcosm of true democracy individual expression within acutely responsive collective expression. The Chinese officials listened politely, but I don't think the message took hold. In any case, Paul would have gone anywhere to relieve suffering.
One summer, after reading of a missionary hospital in desperate need of help, he went to the jungles of Guatemala and found native people who had been written off by the government, which had cut off the funding for the hospital. It was cheaper to let the people die.
Another speaker at the memorial service was Sandy Juskowitz, who worked in Paul's office for more than 35 years. He became her mentor, physician, and friend. She told of what happened that summer in Guatemala.
Sandy, Paul, and his young son, Dean, were transporting youngsters who were very sick with dysentery to the Children's Hospital near Guatemala City. Suddenly, they were trapped in a horrendous traffic jam. Troops of the military government had set up a roadblock to ferret out opponents of the regime. (More than 200,000 Guatemalans were killed during those years by officers trained by our CIA. Many families are still trying to find the bodies of the missing.)
Determined to get those kids to the hospital, Esserman rushed off toward the roadblock. Sandy reminded him of his linguistic deficit: "The last time you asked for a ham and cheese sandwich, you nearly got us killed."
He pressed on and came striding back to the jeep, closely followed by two soldiers. Paul quickly told his son, "Wrap yourself in the blanket, look sick, start coughing, and don't stop."
Then, Sandy recalled, "Paul turned to the soldiers, pointed at Dean and loudly repeated, 'Tuberculosis! Tuberculosis!' Not only was a path cleared for us, but we had a military escort all the way."
Fiercely devoted to his patients, he would refuse an order from a cost-conscious hospital to discharge anyone before Esserman thought it was the right time. But otherwise, he was the most gentle man I have ever known.
Caring is a much cheapened term these days. The president is often referred to as "caring" for his people. But as for Paul, he once went to see a performance by my daughter, Jessica, who had become over my strenuous objections a trapeze artist in a circus. At one of her particularly perilous turns, Paul Esserman stood up in the middle of the audience and spread out his arms.
"I couldn't help it," he told me later. "I felt I had to catch her if she fell."
As Michael Daly reported in his account of the memorial service in the Daily News (February 28), Tom Wolfe told of when his wife, Sheila, "underwent a predawn emergency tracheotomy. There, as if he had come out of the air, was Paul."
Esserman knew that waking to a tracheotomy could be terrifying. "He was there to reassure her when she opened her eyes."
Years ago, I was in the hospital and had taken a turn that was not for the better. A nurse called my wife, Margot, who cuts through traffic like a cab driver. Minutes later, she saw Paul Esserman ahead of her on the way to my room. He had come from his home, which was much farther away than Margot's, but he was ahead of her, and she had to catch up with him in the corridor.
Paul was my doctor and friend for 26 years. At the memorial, Sandy quoted a Greek poet, George Seferis, who had been cited earlier in the memorial service by Dr. Edmund Pellegrino, this country's leading bioethicist and a friend of Paul's since medical school:
"The rich dwelling has fallen down, but its splendor lives in our memories." Added Sandy: "Paul's splendor lives in the legacy of trust he shared with me."
And with me.
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