Reprinted from Helios Rheumatology: March 2021, by Dr. Chuck Radis
The lobster boat tied off at the wharf. It was Ben Shipman, my rheumatoid arthritis patient, and he offered me a ride to Chebeague Island where my medical clinic was scheduled. Maneuvering the boat into the channel, he sipped coffee out of a thermos and offered me a cup. The steaming coffee fogged up the windshield and Ben removed a work glove to wipe the glass. The knuckles on his right hand were swollen, but improved from several months ago. He slid off the other glove and balanced his hands on the wheel. “I’m a good 50% better, maybe more, on the weekly methotrexate the rheumatologist prescribed. And the shots you gave me for my knees worked — they’re fine.”
I learned more in the 15-minute trip to Chebeague Island about Ben’s rheumatoid arthritis than in a half-dozen office visits. By wrapping the wheel in foam tubing, he now had a larger, more forgiving surface to navigate his boat. Crates and barrels were lighter and smaller. His marine radio’s controls were changed out to larger, oversized knobs. Still, the 28-year old’s RA was not anywhere near remission. He was lobstering, but I could see it was still a struggle. It was more than a half-day trip back and forth to Portland for a rheumatologist visit, but he needed something more than I could provide.
I think that was the day I decided to leave my primary care internal medicine practice on the Casco Bay Islands in Maine, and —at age 37 — apply to a rheumatology fellowship. Or perhaps it was after seeing my giant cell arteritis patient hobble into our island market with a recent thoracic spine compression fracture, 5 months into high-dose prednisone. Or the marble-sized tophi on my alcoholic gout patient paying his bill at the Gull where I often ate breakfast on my way to the 6:15 morning ferry.
Living in the same community with my patients was a privilege that physicians years ago took for granted. They interacted with the same patients in the general store, post office or church that they may have seen an hour previously for an office visit. They responded to emergencies. Perhaps, like me, they ran by the local cemetery where their patients reposed, and wondered, “could I have done more?” On Peaks Island, my failures were always nearby.
When I returned to Maine after completing my fellowship at the University of Pittsburgh in 1993, my wife Sandi and our two children, Kate and Molly, moved back into our old house on Peaks Island. The children walked to our elementary school until they graduated from grade 5 and caught the 7:15 morning ferry to Portland for middle school. I no longer ran the Peaks Island Health Center as a primary care physician. Instead, I commuted to Portland on the ferry (or later, in my own boat) where I jointed a community of rheumatologists skilled in recognizing and treating immune-mediated disorders, even if the results were uneven. Then came a revolution in pharmaceuticals and our patients’ lives dramatically improved.
Last summer, I saw my patient, lobsterman Ben Shipman, now well past middle age, pulling traps. Those of us whose practices bridge the divide before and after biologics remember when our ministrations were often insufficient to stem the tide of early disability or premature death. Now? Pass the melted butter and grab a boiled lobster, freshly hauled by a man who has had RA for 30 years.
Love this one Chuck.
Enjoyed the story. Such true observations about having a close relationship with patients/ clients. As a speech/language pathologist the pandemic year of providing teletherapy has taken me into my clients homes week after week. It has definitely reminded me of the absolute importance of meaningful, functional goals in therapy and in medicine. Dr Radis, thanks for sharing your stories! – Therese McCoy
Thanks Therese. For as much as we chafe against the electronic medical record and employers, there is much to celebrate in helping patients—whether it’s on-line or in person. Chuck Radis
must make your heart sing to see patients doing so well!
Great essay, Chuck. Thanks for writing and sharing.
Thanks Anne. I hope your brood is well. We’ve had several vaccination clinics here on Peaks recently. Great to see so many people in person after a year of restrictions.
Great story Chuck, you are a gifted caring physician that have made me proud
Thanks John. Your own story of persistence to have a long career in medicine is awe-inspiring. Stay well. Chuck
I love reading your stories and knowing how blessed we are to know you and call you a friend and fellow islander
Thanks Stephanie. With the vaccination clinics on Peaks, I continue to be amazed at the spirit of volunteerism we have on Peaks. Thanks for all you do. Chuck
Another great write and read Chuck. Thanks for sharing it.
A NOTE: Please change my email address to
I no longer use
Thanks Chuck. Happy Spring!
Best Regards to you and Sandy, Barbara R. Perry
Hi Barbara…… The new e-mail address you sent didn’t go through. Can you resend it at cradis@maine.rr.com? Chuck
Thanks for sharing your story, Chuck!
-Ivan
Thanks Ivan. How did you decide to go into allergy/immunology? Chuck
I always love your stories, Chuck. Not are they about humanistic experiences with your patients, but they are written in a similar style that non-medical professionals and patients can appreciate. What a great partnership with Healio and that Cleveland Rheumatology community. My only reservation on this story is I feel like you were restricted on the length. I wanted more! Maybe that’s a good thing. 😀 Love, Jackson
Great decision. I know I and your patients are grateful that you chose this speciality.
Joanne
Your story provides a beacon of hope and a ray of light for those with rheumatoid and systemic diseases. I appreciate the historical perspective you provide as well as the personal glimpses of the life transitions you have made as a doctor in medicine.
Hi Judith. When I joined Rheumatology Associates in 1993, there was a rheumatologist who was getting ready to retire. He’d spent his entire career treating RA patients with high-dose prednisone and intramuscular injections of gold. In those days, Maine Medical Center had an entire wing devoted to RA patients who needed to be admitted with complications of their disease (life-threatening vasculitis, lung inflammation, and complications of treatment). He said, that in the 20% of patients in which gold worked long-term, it was very, very satisfying and he felt like a biochemist inching up and down extraordinarily toxic treatments. Eventually, when the biologics were released like Enbrel and Humira, we expected success, and so did the patients.
So interesting. I loved the description of your trip with Ben and your thought process when changing your direction for your medical career. Hope I get to meet Ben someday.
Yes, please pass the butter – I’ve been missing Maine meals of lobster!!!
Hi Kate….. you know, Rob and I may have passed Ben’s boat (not his real name) when we were out a few years ago when we were down towards Chebeague Island.
When I was first trying to accept having RA in my early 20s, I couldn’t understand why anyone would want to specialize in rheumatology. I projected my anger, and actual hatred, on poor Dr. Shearman. When my RA caused me to be an emergency admission to the hospital I wouldn’t even look at him when he came in for a bedside consultation.
Luckily I have matured somewhat but I still feel the hopelessness of those early years and don’t fully understand the attraction to the specialty, though I sure appreciate it!
In those early years before there were predictably effective medications, it was very difficult for both patients and doctors, but particularly the patients who lived with their diseases every day. Are you planning on getting out to sing later this summer when the audience and you will be immunized?
What a wonderful story. You may question whether you could have done more, but from where I sit, I think appreciating all the lives you have improved and prolonged should be front and center. Thank you, Dr. Radis, for your commitment.