My Kind of Medicine: Real Lives of Practicing Internists: Brian Hertz, MD.
Family at its best is a haven—a place where we come from, a place we will always belong, and a place to which we can always return. For Dr. Brian Hertz, family means all of those things, but so much more. It meant practicing patient care before he even knew what it was, at the age of 14 when his little brother Kevin suffered from spinal bifida. It meant taking on his share of responsibility when his mother, an ER nurse, needed his help. It meant learning the delicate art of caring for the terminally ill. It meant learning the importance of family, what it means to lose someone you love, and how you need to be strong for others. It was a premature role for Dr. Hertz, but he accepted it gladly.
Dr. Hertz and his wife, Cathy, on the west coast of County Mayo in Ireland.
Spending those long days with his brother and his mother left him more than memories; it shaped his decision to pursue medicine and set the tone for his approach as a physician. “When Kevin was in the hospital I met a lot of the doctors and the students,” he recalls. “They spent time talking to me and would even play videogames with me. I always remembered that, it really resonated with me.” In the years following his brother’s passing, Dr. Hertz’s introduction to the medical field was further encouraged by the conversations he had with his mother about her work. He was intrigued by the stories she told him, and later during his fourth year of medical school she was the one who gave him the inspiration he needed to make his final decision. “I knew from my mom that ER work is really like shift work—you never really get to know the patients,” he says. “I chose internal medicine because you do get to know the patients and establish lasting relationships with them.”
Something Old, Something New
The major milestones of Dr. Hertz’s life—the big decisions, his choice of a career, his passions, his marriage—all hark back to something in his past, especially when it comes to his family. His decision to pursue a medical career was highly influenced by his mother and brother. His wife, like his mother, is also a nurse. At Hines VA Hospital he treats veterans—veterans like his father, godfather, and father-in-law. As an assistant professor, Dr. Hertz teaches medical students in the same program he attended himself at Loyola University; his bachelor’s degree was earned at Notre Dame, which is the same alma mater of his mentors.
He is well aware of the parallels and admits to finding comfort in them. “The fact that my advisors went to Notre Dame made me feel more comfortable,” he says. “My program director at Loyola was particularly welcoming and he taught me a lot. He was very intuitive in the lectures he gave and he was always very responsive to my questions.” But once he felt at home, he understood that it was time for him to grow. He says it was during his residency that he learned some of the most valuable lessons. “Residency really helped me improve my communication skills,” he says, “my mentors taught me the front-line aspect of the job—how to interview a patient and how to effectively communicate with many different kinds of people.” Residency also forced him to learn to work in a way which was unfamiliar to him. “Around that time I also improved my ability to work on a team. In the past, I would have tried to do all of the work myself and get it done as fast as I possibly could. But working with a team where I wasn’t the lead really taught me to step back. Through those experiences, I learned how to be a better leader.”
One of the more professionally rewarding experiences for Dr. Hertz has been his travels to San Lucas Toliman, Guatemala, with a program offered by Loyola University for students and physicians to treat patients in third-world countries. He went for the first time as a first-year medical student in 1999, then later in 2003 and 2005 as a physician liaison to students. Paradoxically, the thing Dr. Hertz loves most about his job can be at times the same thing which makes it difficult—caring.
“I had an idea of what it might be like, but when you immerse yourself in a culture you realize that they don’t have the resources we do,” he says. As a result, many conditions which are treatable if caught early-on go undiagnosed, such as breast cancer. “On one of my first trips there was an older woman who came to us with a large breast mass,” he remembers, “and we were pretty certain she had fairly advanced breast cancer. We advised her to try to reach a more urban center to get a biopsy, but in reality, I don’t know if she was able to do that. We were unable to follow up with her,” he says sadly.
Back in San Lucas in 2003, Dr. Hertz treated a young man in his twenties for a sexually transmitted disease. Because he lacked the appropriate resources to do a complete workup, the only thing Dr. Hertz could do was prescribe an antibiotic, refer him to the local urban hospital, and wish him the best. It reminded him of the encounter with the older woman with breast cancer, and it stayed in his mind for the next two years. In 2005, when he returned to Guatemala, he was determined to follow up with the young man. He made a house call, where the former patient told Dr. Hertz how much better he felt and how grateful he was to have been treated by him. “He was really very sick when we had seen him two years before,” says Dr. Hertz, “and then here he was, recovered and just so happy that we had come.”
It is quite obvious how deeply Dr. Hertz is invested in his job and with his patients. It is easy to see how his compassion for people translates into career satisfaction. “I love the field of internal medicine,” he says. “It can be challenging and difficult at times, but it is also a lot of fun. It is a remarkably rewarding career.”
The Tie that Binds
At the age of 31, Dr. Hertz has had his share of personal heartache. About a year ago, Dr. Hertz’s mother, the ER nurse who inspired him to become a doctor and who nursed his little brother through his illness, had to be hospitalized for an extensive and invasive surgery, the outcome of which would affect her daily living for the rest of her life. Once again Dr. Hertz found himself at the bedside of a family member. “One of the toughest things as a physician is caring for another health care professional, one of their family members or one of your own family members,” he says. He was older and wiser this time around, but the pain was all too familiar. “Seeing my mom on a breathing machine was difficult,” he says.
Sadness may not be a stranger to Dr. Hertz, but thankfully, neither is joy. Since last year, his mother has recovered from her surgery, and Dr. Hertz, along with his family, is focused on the road ahead. He and his wife, Cathy, are planning to have children someday, after she completes a clinical nurse specialist degree. Cathy is a close ally to Dr. Hertz—she worked alongside him in Guatemala, she has supported him through hardships, and she shares with him common goals and dreams. The two met in Loyola’s Medical Center, where Dr. Hertz was completing his medical school training and Cathy worked as a nurse in the cancer ward. Against a dangerous combination of warmth, dedication, determination, beautiful brown hair and a killer smile, Dr. Hertz was no match. Their first date was at a Mexican restaurant called Fernando’s. They talked and laughed over burritos, and found they had more in common that they thought. As it turns out, they grew up in neighboring towns.
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