My Kind of Medicine: Real Lives of Practicing Internists: John Eisold, MC USN, FACP
The Office of the Attending Physician to Congress is a well-oiled machine. Each day, underneath the tall dome of the U.S. Capitol, a team of physicians, nurses, technicians, ambulance crews, and assistants take on the job of keeping America’s governing body in good health. On an average day, their office is like that of any other physician group—meeting with patients, scheduling consultations, recommending further treatment. But on other days, it can be quite different. It can be taking nasal swabs following an anthrax attack or providing initial treatment for an intracerebral bleed of a U.S. Senator. It is a lot of responsibility, but John Eisold, MC USN, FACP, takes it in stride. "I suppose to outsiders looking in it might seem stressful,” he says, “but what we do here is just an extension of what all physicians do."
It was aboard a nuclear submarine named the USS Francis Scott Key in 1971 that a 25-year-old Eisold, then a Nuclear Submarine Officer in the Navy, rewrote his life’s plans. A fellow crewman had fallen ill with meningitis, and despite the efforts of the physician on board, the man’s condition could not be reversed. Eventually the man passed away. The commanding officer then made the decision to surface to deliver the body. Even though it was a sad and unfortunate event, Dr. Eisold saw something else: what it meant to have someone’s life in your hands. "I was impressed by his composure," he says of the physician. "I saw the power of what a pair of healing hands could do. I decided then and there to resign my commission; I thought that’s what I should be doing."
John Eisold, MC USN, FACP
His next step was to enroll in Dartmouth Medical School in Hanover, New Hampshire; he had already earned an undergraduate degree in physics at Dartmouth College. After graduating, he served his internship and residency at the National Naval Medical Center (NNMC) in Bethesda, Maryland. It was during this time that he says he made a clear-cut decision to pursue internal medicine. "I wasn’t one of those people who wanted to do every specialty after they finished a rotation," he explains. "I knew I wanted to be an adult doctor from the beginning, and I could tell that internal medicine would give me the challenge I was looking for, as well as the kind of relationship depth I wanted with my patients." He liked the accountability of it as well. "I like being in charge, that’s part of the fun," he says. "I actually want patients to call me after hours. I want them to know I’m accountable. When a patient calls me in the middle of the night, I find it to be a high compliment."
Dr. Eisold has been in his current position for 14 years. His office provides medical care for the U.S. Congress and U.S. Supreme Court Justices, their staffs, as well as any visiting tourists in need of medical attention. "The stakes are high," he admits. "There’s no softball." A fast hardball was delivered in 2001, when anthrax attacks were reported in the office of Senator Tom Daschle. Although the Office had a detailed contingency plan ready to go in case of such an event, the reality of it was striking. "My first reaction was 'This is exactly the scenario we’ve trained for and I can’t believe it’s here,'" he says. Dr. Eisold and his staff took nasal swabs from nearly 6,000 staff, employees, and visitors—anyone who had potentially been exposed to the bacteria. There were daily press conferences. People unraveled. Dr. Eisold says those tense three weeks were the longest of his life. "What we were really doing was managing fear," he says. "That was the most startling thing to see, the sheer panic. Looking back on it, I am glad that we were able to convey a confidence to reassure them. There is something comforting about putting someone in a line, even if they had to wait for three hours. At least they knew we were doing something about it." His staff was awarded several honors for their management of the attack; Dr. Eisold was personally awarded the Distinguished Service Medal.
The Front Desk Approach
His take on patient care is a valuable lesson in humility. "Front desks should be conduits, not barriers, to care," he says. "'The doctor’s busy’ falls short. Everyone is busy. Patients are often late for reasons not of their own doing. They may be confused and show up on the wrong day … they may be angry, but always take the high road and trust them."
He has a unique affinity for older patients, something he honed as an intern working at NNMC, where many of his patients became like good friends to him. Once again, his ability to extract and celebrate the good in an otherwise difficult situation made geriatrics a natural choice for a subspecialty. To some physicians, an elderly patient with multiple chronic conditions is just that; to Dr. Eisold, the patient represents much more. "I’ve always loved older people," he says. "Some think these patients may be more complicated, but they’ve always been my favorite," he says. "They have wonderful stories." He says medical students and physicians just starting out should not view death as a failure but rather as a natural event, and recommends attending as many patient funerals as you can. "Never underestimate what your presence means to a grieving family and friends," he says.
Prior to his current assignment, Dr. Eisold worked as Special Assistant to the Navy Surgeon General and later as the Chairman of the Department of Internal Medicine at NNMC, where he earned his current rank of Rear Admiral. He says both positions were satisfying and even "fun," but he longed to return to what he had discovered on that solemn day in 1971—the satisfaction and joy of hands-on patient care. "I could go on and on about internal medicine, why I think it’s wonderful and why I love it and love being a physician," he says, "but for me it comes down to the doctor-patient relationship. People need a relationship—and not just for a year—for five, ten, fifteen, twenty years. That’s what internists are about. The cornerstone of the practice of medicine is the doctor-patient relationship. It transcends all, including information technology, pharmacology, and the newest diagnostic studies. Its value will never be diminished."
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