A Road to a Sub-Specialty in a Specialty
by Jeffrey DeSarbo, D.O., Class of 2001
My entire road into medicine was certainly not one of the most traveled. Having graduated from Hofstra University in 1985 with a degree in banking and finance, my first job was working in foreign debt restructuring, one block from the World Trade Center. Within a year I started my own advertising and marketing research company, and while on a business trip in Baltimore, I had a bad cigar (actually having never smoked, I thought I was supposed to inhale). Later, I became sick at night and had a dream that I was a doctor.
When I returned from that trip, at the age of 28 with 2 children, a house and a very supportive wife, I discussed with my wife my desire to return to college for my premed requirements and to go to medical school to become a pediatrician.
It took sacrifice on both our parts, but I felt it was something I needed to do in my life.
So when I began NYCOM in 1997, I thought I knew I was going to be a pediatrician. I had two children of my own and thought I could make a good doctor for kids. By my second year in med school, I had become fascinated with infectious disease and thought I found my new “calling”. The thought of working for the CDC in a bio-level 4 lab and possibly traveling to jungles in a spacesuit hunting for a virus sounded so cool.
During my clinical rotations in the third year I was open to experiencing the different fields in medicine and began clarifying my specific interests. OB/GYN, not for me. Radiology, not for me. Internal medicine, possibly. Surgery, not for me. Pediatrics, something I was considering, lost my interest when I found myself dealing more with worried adults and less than I thought with the children, not for me.
Then, during a psychiatry rotation at St. Barnabus in the Bronx, I experienced something that I had never experienced on any other rotation; each day that I went to work, it never seemed like work.
It reminded me of something that was said by our Dean on orientation day at NYCOM:
“ If you enjoy what you do for a living, you’ll never have to work a day in your life.”
I also remember that in fourth grade I purchased and read a book called A Layman’s Guide to Psychology. I knew I had to pursue psychiatry.
It wasn’t a hard to decision for me to make although the idea of specializing in psychiatry never really occurred until my clinical rotation. However, my best friend, Marc Schwartz, who I attended premed classes with at Hofstra and grew close to at NYCOM, also found his psychiatry rotation to be the one he enjoyed most, but debated about diverting from his initial interests in surgery and GI. In the end, he too selected to pursue psychiatry and to this day is pleased with his decision.
The initial thoughts of going into psychiatry certainly made both of us initially feel that we would be “giving up” all our acquired medical knowledge and procedures that had been stuffed into our heads over the past two years.
We both realized, however, that we had to choose what ultimately gave us the most personal satisfaction. Once the decision was made, I (we) never looked backed or second-guessed our decision and have subsequently found that the field of psychiatry is becoming more and more biologically based. However, for both of us, we decided to sub-specialize, Dr. Schwartz in child psychiatry and me in eating disorders. Having known very little about eating disorders prior to medical school, I learned a great deal from my residency director at North Shore University Hospital, Dr. Victor Fornari, and especially from the patients I had during my training there.
I was attracted to the field of eating disorders for several reasons. First, in psychiatry, very few clinicians want to work with eating disorder patients. The condition is one of the most misunderstood illnesses and can be very frustrating. complicated and time-consuming for a physician. Secondly, eating disorders such as anorexia and bulimia nervosa, have the highest mortality of any psychiatric diagnosis including major depression, bipolar disorder and schizophrenia. For this reason, again, many psychiatrists avoid working with these patients who have a very complex presentation, while I felt this was another challenge to be improved upon.
Thirdly, eating disorders come with an array of medical complications affecting multiple organ systems unlike any other psychiatric condition. Thus, I have remained current with my knowledge in physical medicine for patient care and when coordinating treatment with other physicians. In fact, the medical presentation of an eating disorder patient has so many Trojan horses that I often lecture to other physicians about the specifics and unique interpretations of laboratory work and physical exams on eating disorder patients. Additionally, I have enjoyed the fact that my specialty and sub-specialty is advancing with the use of neuroimaging technology, and I have expanded my contributions to the field by developing a website newscast on eating disorder research and am currently finishing a book entitled, Demystifying the Biology of Eating Disorders. With a lack of intensive services for complicated patients and conditions, I have also started a center called ED-180 Eating Disorder Treatment Programs which offers Intensive Outpatient Programs (IOP) and day programs as well. And, as a rare psychiatrist truly specializing in eating disorder treatment, I have even been called to consult and treat patients in other countries. All this began at NYCOM.
Selecting a field of medicine and building a career and practice need not be limited by stereotypical roadmaps. What is most important is that one pursues a path that is fulfilling and then success will follow. As an osteopathic psychiatrist, the challenge of discovering a way to successfully treat patients requires the backbone philosophy of osteopathic treatment of seeing the patient as a whole, mind, body and soul, and the deliverance of care in the most compassionate form. For myself, the roads I have chosen as an osteopath have been very fulfilling.