A Conversation with Dr. Steven Lee Berk

“When you are really committed to the care of the patient, then you will always figure out a way of getting them the care and overcome all challenges that come in your way.”

Bio

Steven Lee Berk, MD, is the Dean of the School of Medicine and Executive Vice President for Clinical Affairs at Texas Tech University Health Sciences Center at Lubbock. Dr. Berk graduated from Boston University School of Medicine and completed his Internal Medicine residency and Infectious Disease fellowship at Boston City Hospital. He is the author or co-author of over 150 peer-reviewed publications and four textbooks. Dr. Berk has served on the NIH Special Advisory Panel on the evaluation of vaccines against infections in the elderly, on the editorial board of the Journal of the American Geriatric Society, and as a reviewer for most Internal Medicine and Infectious Disease journals. He has served on the Board of Directors Nominating Committee for the Association of American Medical Colleges (AAMC) and chaired the AAMC community-based deans subcommittee for eight years.

What were the major events that shaped your success?

“I was fortunate as a high school student and also in college to have a summer job taking care of children with muscular dystrophy, cerebral palsy, spina bifida, lots of different neurologic diseases. All of my summers were spent giving these kids a great time and trying to make it like a real summer camp with modified football, baseball and swimming. But at the same time, I saw the disabilities that they had to overcome.” Those experiences guided Dr. Berk towards academic medicine.

From there, Dr. Berk wrote a grant, developed a theory, and began doing research at Boston University in muscular dystrophy with Dr. William Ulrich. Over time, his focus shifted from adolescents. “I was more interested in taking care of adults, realizing that my fantasy about curing muscular dystrophy was not going to work.”

Dr. Berk’s ambition and compassion for others would guide his life and his decision making. As a medical student at Boston University, he had opportunities to become a faculty member at Boston University or Harvard. But he laid those aside, took a leap of faith, and went to a new medical school in East Tennessee that did not have any infectious disease physicians.

What role has mentorship played in your life?

“I don’t think I had the same great mentorship opportunities that others have had and maybe that’s why I try to be a good mentor for as many students and residents as I can.”

“A lot of Tennessee was without mentorship. But at Boston City Hospital, the great mentors for me were the individuals who not only knew all the facts and wrote all the papers, but you could tell right away if they had the bedside skills that we all want to develop.”

“I think for physicians, the most important role models are those who are skilled at the bedside. And even more than that was someone who could be skilled taking care of patients at the bedside and still have residents and students around the bedside and not lose anything with respect to the relationship that you develop with the patient.”

How did you develop your skill for bedside care?

In the early days of her time in East Tennessee, Dr. Berk notes that there were relatively few attendings. “My first year, I was a ward attending eight months out of the year. There’s nothing you can do better than to have the constant experience of what you want to do best in. It’s not much difference than the violin player who has to practice 10,000 hours or the hockey player who has to figure out how to be on the ice for 10,000 hours.”

“I know from my son who’s an assistant professor at Brown now, that sometimes you’re only attending on the wards for two months out of the year or one month out of the year. That’s probably not enough early on in your career. The other thing about bedside medicine is really understanding the physical exam. A lot of medical students and residents don’t want to say anything when they don’t appreciate a physical exam issue. That’s a big mistake.”

“I have this theory that the students that are best at physical exam are the ones that say, ‘I didn’t feel that spleen like you did. Can you please help me do that?’ I think that’s really important. The other thing that students need to realize is a bedside manner. They say that the patient decides whether they like the physician or not very quickly. And you’ve got to be one of those that gets the confidence of a patient very quickly. Not just to develop the relationship, but to get the whole story.”

Who was one of your most successful residents or students?

“Dr. Abraham Verghese was my student in East Tennessee and he became interested in infectious disease like me and went to Boston City Hospital as a fellow. But Abe wanted to do more than just be a physician. He wanted to be able to share his experiences with everyone as a writer. So he spent a year in Iowa and learned to write and then wrote My Own Country, which was about AIDs in East Tennessee, and has become internationally known.”

“He wrote the best-selling book in 2009, Cutting for Stone. But also, the principles of his book are similar: respect for the patient and the importance of the bedside. He has written eloquently about how even the best residents are spending way more time at the computer than they are at the bedside.”

“Again, I think most of the very successful students and residents I’ve had come with some of those same basic principles of putting the patient first, time spent with the patient at the bedside, and sharing your skills and experience with students and residents coming up.”

What is one thing you wish you knew when you entered medical school?

“I would say to keep your eye holistically on the profession and recognizing that if you do your best each day and try to get rid of the worry about success, recognizing the sacrifices that you’re making as a student and a resident will eventually be worthwhile as you get a chance to use your skills to take care of patients.”

Dr. Berk is bothered by how many students spend far too much time on unnecessary worry. “For example, I know that my students last year taking anatomy, in a survey half of them had a very high level of anxiety about the course and about passing anatomy. Bot a single one failed anatomy, but all of that worry and all of that anxiety put in perspective, makes absolutely no sense.”

“I tried to convince students that almost all of them are going to graduate. Their success is almost guaranteed as a physician. Not only that, but their happiness is guaranteed as a physician because if you can’t find the field in medicine that you’re happy going into, then you wouldn’t have been happy doing anything because the opportunities are really vast!”

Pearls of Wisdom

1. Develop qualities of staying calm and clear headed, no matter how stressful the situation.
2. Gratitude is one of the key qualities of a good mentor and student, and this will keep us on the right path.
3. Be committed to patient care. The more committed to patient care you are, it will make overcoming challenges more manageable.
4. Continue to build enthusiasm in medicine: Remember why we started, and keep that passion alive throughout your years. At the end of the day, keep a holistic eye on our profession.