My Kind of Medicine: Real Lives of Practicing Internists: Aysha H. Khoury, MD, MPH, FACP
"I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel." --Maya Angelou
This quote by Maya Angelou is a source of inspiration for Dr. Aysha Khoury, an internist who cares deeply about connecting with patients. "My interaction with patients is what is most rewarding to me," says Dr. Khoury, "and the best reward is someone trusting you enough to let you know what's going on in their lives, so that you can treat them effectively."
In her role as a Clinical Decision Unit (CDU) internist at The Southeastern Permanente Medical Group (TSPMG) in Atlanta, Dr. Khoury loves the amount of time she spends with patients in the CDU setting. "We see patients who are too ill to be home, but may need 24 hours or less of evaluation and care." TSPMG's CDU is the first outpatient 24-hour observation unit (unconnected to a hospital) established in the state of Georgia. Typical illnesses treated in the CDU might include congestive heart failure exacerbation, chest pain, pneumonia, renal failure, COPD exacerbation and cellulitis.
Dr. Khoury believes it is essential to build a rapport with patients. "Patients need to know that you care and that it's not just a job." Before she begins clinical discussions, Dr. Khoury says she always looks for a way to connect with a patient. Sometimes it's a discussion about food, sports, or the patient's cultural heritage. "Getting to know the patient better is helpful," says Dr. Khoury, "because I might discover the patient is suffering from depression and not stomach pain."
The process of discovery is what stimulated Dr. Khoury's interest in medicine as a child. Fascinated by what she was learning in her 5th grade health class, Dr. Khoury says she loved the idea that a physician is a medical detective, studying evidence and figuring out what is wrong.
Curiosity and courage
Solving mysteries and helping others is a trait she shares with her only sibling, her younger brother who is a police officer with the Atlanta Police Department. Dr. Khoury laughs, "Yes, different careers, but we both like investigating problems." Their curiosity and desire to serve others is likely the result of their father's influence.
Born in Toronto, Canada, to a mother from Trinidad and a father from Sierra Leone, Dr. Khoury says it was her father who raised her and her brother and moved them from Toronto to Atlanta when she was 8 years old. With obvious pride, Dr. Khoury says that her father's willingness to move to a foreign country—alone, with two young children in tow-was an act of courage that well defines him and left an indelible mark on her. "My father," she says "is a person of extraordinary faith and incredible humility. He taught me I could be whatever I wanted, as long as I worked hard."
And Dr. Khoury has indeed worked hard. After graduating high school from the prestigious Woodward Academy in Atlanta, she went onto Georgia State University where she earned her bachelor's degree in biology, and then onto Morehouse School of Medicine where she received her medical degree. Dr. Khoury says she enjoyed all of her medical clerkships and considered specializing in pediatrics; but, when she began her medical residency in pediatrics, she says, "I was miserable."
"I thought it was because I was an intern," says Dr. Khoury. "Interns are supposed to be miserable, right? But then I got to Internal Medicine, and it was extraordinary. Internal Medicine is just so vast and intellectually stimulating," Plus, she candidly admits, "I'm too soft-hearted. Working with sick children was too hard for me."
After completing her residency, Dr. Khoury practiced clinical medicine for a year, and then returned to Morehouse to earn a master's degree in public health. "A part of me felt that clinical outpatient practice was not going to be enough," she says, "I went from trying to figure out what is wrong with patients, to asking, 'how can we keep whole groups of people well?'"
"It's not hard to diagnose a diabetic," says Dr. Khoury, "the hard part is answering the questions, 'does this patient have a safe place to exercise, access to healthy food, and enough money to buy medication?'" Yet, despite her passion for the field of public health, Dr. Khoury quickly returned to clinical medicine. "Frankly speaking," she admits, "it is an extraordinary experience to help one individual at a time. It's a really personal experience."
The tale of the advocate . . .
Dr. Khoury credits ACP Master, Jacqueline Fincher, MD, for recruiting her into the fold of ACP. After hearing Dr. Fincher speak on the topics of Medicare, Medicaid, and advocacy at a medical economics course that was part of her residency program, Dr. Khoury says she got hooked on advocacy. "I thought, here is a way I can fight for my patients, not only as their personal physician, but also in the political spectrum. That was very important to me."
"Dr. Fincher really embodied for me what it is to be an internist and what professionalism looks like outside the clinic," she says. Dr. Khoury became active in the ACP Georgia Chapter, served as the Chair of its Council of Early Career Physicians, and was named the 2011 recipient of the Chapter's Outstanding Resident in Volunteerism and Advocacy Award. In addition to her service to ACP, Dr. Khoury has provided medical education to teenagers and adults, helped the Georgia Department of Public Health create guidelines to improve emergency response efforts, and she supports CARE, the international humanitarian organization dedicated to fighting poverty.
As a clinical practitioner with a public health background, Dr. Khoury is particularly impressed with the mission of groups like CARE and Doctors without Borders. "What does it take for someone to be healthy?" she asks, "Things like safe food, water, shelter, and having access to education. If we can give people those building blocks, we can improve health both nationally and internationally."
. . . and the armpit
An avid reader and fan of National Public Radio, Dr. Khoury has a passion for subjects beyond medicine-especially culture, politics, and history. She also enjoys hiking, practicing yoga, and is very involved in her church; and not surprisingly, the church's volunteer activities-efforts to help the victims of tornados and providing assistance to the homeless.
Dr. Khoury's spirituality and love for science do not simply co-exist—for her, they are one and the same. She vividly recalls an experience she had as a medical student when she was cutting into the axilla (armpit) during a dissection exercise and was so awe-struck by the miracle of human anatomy, she announced, "for me, this is God."
Seeing God in the human armpit might seem a bit unusual, but hearing Dr. Khoury's enthusiasm for the science of medicine makes it easy to imagine. "The human body is complex and fascinating," she says, "As you study how things work-how we walk and breathe, our beating hearts—it is truly a remarkable and spiritual experience."
The power of the human body and the image of God within—like Dr. Khoury, it is a vision that leaves a lasting and memorable impression.