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It's a Thursday afternoon around 2 p.m. and Trig Brown's voice
is still hoarse from the night before when he and his wife attended
a Paul McCartney concert. "We know all of the songs so of course we
had to sing every one," he says. The fifty-eight-year-old Dr. Brown
is an enthusiast of many things, above all, his work. You won't
catch him playing the hero. "It's not the dramatic outcomes or
stories that give me satisfaction as much as the everyday things,
like talking to my patients," he says. "That's what gives me life
Mind and Body
Growing up in southwestern Missouri, Dr. Brown would watch his
father treat patients as the town's general surgeon. Since the town
was small, his father often practiced as an internist as well. He
held his father in awe. "There were times when he would let me
observe and I remember being completely intimidated by that, but
watching him take care of all of these patients made it an easy
decision to become a physician and also an internist," he
After graduating medical school at Washington University, he
headed east to complete his internship, residency, and Fellowship
at Duke, where he developed a taste for academic medicine and
psychology. He stayed on at Duke working as a junior faculty
member. He and several of his colleagues created a combined
psychiatric/medical clinic, a time which was both difficult and
exciting. The mind/body ideology had yet to catch on with the
profession and patients alike, which made many things an uphill
climb. Yet as Dr. Brown explains, it was also this fact that made
it worthwhile. "I felt like we were doing something innovative," he
He has carried this head-first approach with him since he left
the world of academic medicine in 1991 and calls upon it frequently
today as a general internist at Durham Internal Medicine, where he
has been since 1999. A recent visit with a patient illustrates how
he uses the skill. A regular at the practice, the patient would
present with a combination of symptoms, including muscle-skeletal
problems and depression and anxiety. During her last visit, she
complained of palpitations and shortness of breath. As she talked
and Dr. Brown listened, she grew panicky as she revealed what Dr.
Brown recognized as the underlying root of her anxiety: a
problematic and stressful relationship with a sibling. When he made
a suggestion for how to better cope with the situation, she
replied, "No one ever told me I could do that."
It's this approach that defines Dr. Brown. "I make a conscious
effort to listen," he says, "because as an internist, you deal with
people on levels that are so profoundly deep that you need to be
listening. You talk to people about aspects of their lives that
they can't talk to about with anyone else."
A letter and a race number hang framed in Dr. Brown's office. He
looks at it every day and thinks of the patient who sent it-a man
well known in the Durham running community. He came to Dr. Brown's
practice with a complicated clinical syndrome with fever, abnormal
liver function, weight loss and sweats. The patient had seen an
infectious disease specialist and even a general surgeon, but no
one could determine the man's condition. Finally, a rheumatologist
diagnosed him with adult stills disease, a rare condition. Dr.
Brown had never seen it before. "by that point, I'd been in
practice for 20 years, and I'd never seen it!" he explains, "and
this is one of the best things about being an internist-every day
you are going to be challenged by something you've never heard of."
Dr. Brown and his colleagues treated the man successfully; three
months afterward the letter came. It read "Thanks to you I'm back
in the races." As a runner himself, Dr. Brown appreciates how much
it means to the patient. "Being there for my patients means
everything to me," he says.
At Durham Internal Medicine, Dr. Brown works with a group of 14
other physicians and specialists. He loves the work and the life it
gives him. He sees about 17 to 22 patients a day and says the
practice is set up in such a way that he can practice the kind of
medicine he wants to. "I determine my schedule, I can treat my
patients the way I want to," he says, "and I have time to do the
things I want." Among those things, spending time with his wife of
30 years, Victoria, and running. He says music is a way for him to
nurture his soul, and while he used to be a marathoner, he gave it
up after he noticed that he was training too hard for the Boston
marathon. It had become more of a pressure than a joy, the latter
being something Dr. Brown refuses to go without. He's also found an
unlikely home in Durham, NC, far away from his native Missouri. As
a young man in college and in medical school, he assumed he would
one day return, but as he explains, fate proved otherwise. "Good
things just kept happening to me here," he says, "and becoming an
internist was one of them. Looking back, I know that this is what I
was meant to do."
Check out previous
articles as physicians share what motivated them to become
physicians as well as why they chose their particular type of
August 2010 Issue of IMpact
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