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Scott Manaker was walking from the practice one morning in the
outpatient building at the Hospital of the University of
Pennsylvania when he heard someone call his name. Looking up, he
saw a very thin man with dark brown hair whom he did not recognize.
But as the man began to speak, Dr. Manaker recalled him-as a
patient in the ICU some months ago. At the time, the man had only
one lung, was severely afflicted with respiratory failure, and had
been so gravely ill that many felt certain he would not survive.
Yet here he was, standing in front of him, thanking him for his
care. Recalling the encounter, Dr. Manaker says simply, "It was
As an attending physician in the pulmonary and critical care
division at the University of Pennsylvania Hospital in
Philadelphia, Dr. Manaker works two months of inpatient two-week
rotations, during which he is on call 24 hours a day. He says the
ICU duty is both intense and satisfying. "It has been likened to
being on a submarine, because you go down for two weeks with no
air," he says. "My work there is among my proudest accomplishments
though, because of the meaningful relationships you form with the
patients and their families. And I love pulmonary medicine because
it gives me the opportunity to really help patients."
But in the ICU, where the days are longer and the nights are
darker, there are times when Dr. Manaker is unable to help and such
times weigh on him heavily. He recalls one man in his thirties whom
he had treated in the ICU for refractory leukemia. "I remember his
wife, his oncologist and I standing there together and crying after
making the decision to let him go," he says. "Our three families
each had kids all the same age..."
Medicine and Donuts
Dr. Manaker is a thinker and internal medicine suits him well,
engaging his mind in a way that's a necessity for someone who
already had several different job options in mind by his fifth
birthday. While attending high school in the Bronx, he volunteered
in a psychiatry lab and developed an interest in studying the
brain. He veered toward psychology and went on to earn an
undergraduate degree in neuroscience, but turned to internal
medicine while in medical school.
During graduate school, Dr. Manaker worked a 24-hr Saturday
shift in the ER once a month to maintain his clinical skills. He
soaked up the experience and soon was a favorite with the staff. "I
would bring the nurses a box of donuts and I tried to see every
patient I possibly could," he recalls. "It was such a tremendous
clinical experience for me because it showed me how much I enjoyed
taking care of patients." Looking back, he says he knows he made
the right choice.
"What I like about internal medicine is the flexibility and the
variety that I've been able to enjoy that has gone hand-in-hand
with continuing patient care," he says. "Medical students who are
trying to figure out which direction to pursue should know that
internal medicine offers professional and personal satisfaction at
once. The skills gained as an internist give you the flexibility to
do a lot and provide a variety of job opportunities. When you
couple that with patient care it's an enormous source of
The Quaker is the official mascot of the University of
Pennsylvania, where from his first day as an undergrad until now,
Dr. Manaker has spent a total of 31 years. His involvement with the
university and the hospital runs deep, as evidenced by a dizzying
list of faculty, administrative, and teaching appointments.
However, his current day-to-day job can be boiled down to two main
things: administrative duties as a Vice Chair for the Department of
Medicine, and treating patients; he says pursuing internal medicine
allows him to do both.
His thirst for knowledge has defined him as a teacher, something
he considers to be his most significant contribution outside of
patient care. "The milestone in my career that means the most to me
was being awarded the Leonard Berwick Memorial Teaching Award at
Penn," he says, "because I think that ultimately my work teaching
will have the greatest impact." He's been a teacher of students as
a lab instructor, seminar leader, and lecturer, in topics ranging
from brains and behavior to medical pharmacology to bioethics in
He teaches faculty as well, on topics that would make many an
eye glaze over-including "critical care documentation" and
"evaluation and management coding." But Dr. Manaker has reveled and
excelled in these subjects-so much so that he receives regular
invitations to teach them in hospitals across the country. It came
about by chance in the mid nineties when the U.S. government
conducted an investigation of hospital medical charts at Penn. By
the time it was over, Dr. Manaker became an expert in chart
documentation, coding and billing. He started out teaching Penn
staff, but soon gained a reputation and it wasn't long before the
job stuck. "It's a unique niche. There aren't many physicians who
would want to take on deathly dull subjects and teach them," he
jokes, "but I find great value in having the opportunity to educate
When he's not thinking about medical coding or intensive
pulmonary care, Dr. Manaker winds down with some more thinking
during his jogs around center city, Philadelphia. His running style
reflects his working habits-there are times when he enjoys a
running partner for companionship, and other times when he prefers
to be alone, so he can think. He doesn't wear an iPod and benefits
from laser surgery he got some years ago after a lifetime spent
wearing glasses. The surgery helps with the running, but he really
did it for his most important teaching job to date: teaching his
sons Jacob and Eli how to swim.
Check out previous
articles as physicians share what motivated them to become
physicians as well as why they chose their particular type of
April 2010 Issue of IMpact
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