Dr. James L. Achord has treated thousands of patients during his years
as a gastroenterologist-hepatologist. But the Mississippi physician immediately
recalls three extra-special cases.
One is a very determined older woman, another is a 10-year-old boy and
the third is a young woman who weighed only 82 pounds. All had serious problems
with their digestive systems.
"The woman had most of her small intestine removed so that her life was
barely compatible with any form of existence," Achord says. "But she was very,
very cooperative and extremely positive. She did everything we asked of her.
Her husband even gave her daily injections of saline under the skin. I last
saw her about four or five years after the surgeries and she was doing very
well."
The boy had a bowel disease that prevented him from growing. Controlled
usage of prednisone (a steroid) and careful monitoring by another physician
eventually controlled the disease. The patient grew to be about six feet tall.
The 82-pound young woman also happened to be very short. Extensive testing
pointed to a digestive disorder known as celiac disease. Achord put her on
a wheat-free diet, and the change helped the woman tremendously. She's now
135 pounds and working every day.
Dr. Noel Hershfield chose gastroenterology in self-defense. "I had some
health problems as a young adult that led to ulcer surgery. But the surgery
didn't go so well. That's when I decided on this field.
"The patients that I remember are the ones that may have been misdiagnosed
and I've had some trouble finding their problems. They're the ones that I've
spent a great deal of time with."
Dr. Carol E. Semrad chose gastroenterology because very little was known
about stomach disease when she was a medical student. "It was an open frontier
that needed unraveling. I thought significant basic science and clinical research
work needed to be done to better understand the field and wanted to contribute
to that understanding in some way."
And Semrad has contributed. A three-year research fellowship with Dr. Eugene
Chang led to significance advances in the study of diarrheal diseases. She
studied how sodium absorption is inhibited in the small intestine -- using
chicken intestine as a model.
One of Semrad's patients has inflammatory bowel disease, which required
multiple surgeries. "I'm working to help optimize nutrient absorption in her
remaining small intestine," say Semrad, whose work will have long-term effects
on her patient's quality of life.
Dr. Donald George is chief of the gastroenterology division at Nemours
Children's Clinic in Jacksonville, Florida. He remembers two infant girls,
one who overcame a devastating problem at birth and one who died. The first
girl was born prematurely without most of her bowels.
She lived, George recalls, surviving her first six years thanks to intravenous
feeding. Then a successful small bowel transplant gave her a new life. She's
now eight years old and can eat a normal diet.
The second infant went blind at three months due to a vitamin deficiency.
She soon developed cystic fibrosis and died while awaiting a liver transplant.
Gastroenterology is a very challenging field, George says. "The practice
is particularly scientific -- very highly scientific. But it comes with the
opportunity to heal through very personal interaction."