Marco Werman: Even if immigrants don't get the chance to vote in New York City, they can get sick and count on getting quality care. Especially if they live in Elmhurst, in the bureau of Queens. Elmhurst, New York, 11373, is according the National Geographic, the most ethnically diverse zip code in the U.S. Elmhurst Hospital provides care for nearly 2 million patients a year. The international range of patients there makes the hospital a medical melting pot. That's how Rivka Galchen describes Elmhurst Hospital in her story in this week's New Yorker magazine. It's titled, Every Disease on Earth. Rivka, set the scene for use please. What's the impression you get when you walk into Elmhurst Hospital?
Rivka Galchen: Well, I mean even before you get to the hospital you're sort of going by the Chinese bakery, and the Spanish bakery, and the Korean video store, and then when you come into the hospital, you know, in some sense it's a comfortably normal hospital. They do, of course, have the information desk labeled in probably 50, 60 languages, so it has the feel of an airport. And it also has the feel of airport a little bit in that it's chaotic.
Werman: Right, so how many diseases are they skilled at identifying?
Galchen: I mean I guess I couldn't even really say. It probably comes off the most dramatically with infectious diseases because there's so many infectious diseases that we really only associate with other parts of the world. Whereas a disease like Malaria, which we fortunately just hardly see at all in the U.S., it's almost a kind of a hum-drum disease. Everyone's already learned about it.
Werman: I mean if there's a reason for Elmhurst Hospital's ability to spot these diseases, it sounds like one doctor that you profile, Dr. Joseph Lieber, how did he get to this position, caring for all these nationalities, and knowing all these diseases?
Galchen: The amazing thing about Dr. Lieber is there are of course also wonderful infectious disease specialists at Elmhurst, and wonderful surgeons who are sort of familiar with kind of, fairly unusual presentations from around the world, but Dr. Lieber's sort of familiar with everything and every specialty. His own training was a little different than maybe your mainstream physician in New York. He trained in Guadalajara, Guadalajara Mexico, so that's a very big urban center. So, already from the beginning, besides his intellectual interest in all sorts of obscure diseases as well as things you're going to have to take care of all of the time, he just was exposed to things that most doctors aren't going to be. For example, I remember him telling me about how he saw a lot of cases of leprosy, which I think for most of us is only a disease in the Bible, you know?
Galchen: We don't think of anyone having it.
Werman: You follow Dr. Lieber around when you reported this story. Give us an example of the kind of global diagnostic savvy he has.
Galchen: It's always fun to follow Dr. Lieber around. In part, I mean even when you just have sort of a regular renal transplant patient coming in. They might be from Greece, and the next one will be from the Dominican Republic, and the next one will be from India, and some of them will be sourcing their drugs because they're cheaper from other countries, and he's going to be familiar with how that going to change things and.
It's like I remember there was a woman, and she herself was from the Philippines, was a newlywed, and had just passed through Hong Kong, but had also had a number of cosmetic surgeries that are popular in Brazil, that can lead to sort of shortness of breath. Injections, you know, sort of, all sorts of plastic surgeries that are more often done in those countries. And he was sort of able to, sort of, pull together all the different kind of noisy clues.
Werman: Yeah, another one you point out is the presence of these little sparkles across the body that might throw some doctors really for a loop.
Galchen: Exactly, on an x-ray, you can get, sort of, a very mysterious and kind of beautiful x-ray you can get. Just a chest x-ray, and it just, it seems like someone just sprinkled glitter all across the patient's chest. And you would think, you know, my God, has this person been like working in a strange jewelry factory inhaling God knows what small metals? I mean, I don't know what kind of diagnostic guesses you'd be led to unless you knew that, oh, you know, patients who, especially Korean patients or a few other people who go for Korean acupuncture, they purposefully break off the tips of the needles and leave them under the skin. And so that probably has absolutely nothing to do with fever, or sputum, or whatever it is, and so he knows not to be distracted by the glittering chest x-ray.
Werman: Right. And it's interesting that you note that despite the heavy workload and noncompetitive pay with private hospitals, a lot of doctors return to Elmhurst Hospital after a residency. Did you find out why?
Galchen: Almost always people say Dr. Lieber was a huge role model for me, and they say I miss the patients. I sort of, I went to another hospital, it was, it was, you know, slightly more organized, there was less of a workload, and maybe the paycheck was a little better, but people really miss the patient population, and I think also, you know, people crave that intensity. That may be why they went into the field in the first place.
Werman: You can read Rivka Galchen's story, Every Disease on Earth, about Elmhurst Hospital in Elmhurst, New York, in this week's New Yorker magazine. Rivka, thanks for speaking with us.
Galchen: Thank you for your time Marco, thanks.