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Doctor wields Woody Allen flair

By Dawn Brazell
Public Relations

You could say MUSC has its own Woody Allen now that Dr. Frank Brescia is back.

With the same cynical, dry wit and penchant for a philosophic take on life, the men share uncanny similarities. Brescia, M.D., just comes packaged in a medical version in his roles as oncologist and teacher.

Dr. Frank Brescia with wife an two dogsDr. Frank Brescia enjoys a moment with wife Jane and their dogs, Charlie and Max, on their back porch.

Brescia returned to MUSC in April of this year after a short stint in private practice. He left MUSC in 2007 after his wife had breast cancer and he suffered a heart attack, thinking he might need a change of pace. What it allowed him to see is how much he values the camaraderie and intellectual stimulation of an academic medical institution. Thrilled to be back, he will begin seeing patients in the fall.

"What I found was that private practice becomes more about billable hours," he said, in typical Brescia-style. "You have to wake up in the morning in this kind of a practice and say, 'This is fun! I want to get up in the morning and work.'"

No one knows that better than this native New Yorker who sees critically ill patients all the time. Colleagues note that he brings his extensive training in supportive and palliative care in a humorous way that helps many patients get a new lease of life. Dean Schuyler, M.D., a psychiatrist who worked with Brescia, recalls Brescia knocking on a door and telling a patient 'if you're going to complain about something, I'm not coming in there.'"

Schuyler laughs. Doctors just don't say that. Unless they are like Brescia.

One of Brescia's true gifts is his ability to establish rapport, he said. "He's an absolute marvel with patients. He establishes a relationship with patients that doctors don't know how to do or they are too busy to do."

Named MUSC's Outstanding Clinician of the Year in 2003, Brescia has a strong effect on people, said Schuyler.
"People feel close to him and feel he cares about them and thinks about them. Frank is an incredibly gifted teacher and engages students on all levels. He says things and does things that other people won't do. People go out of their way to make contact with him."

Describing him as one of the most stimulating people that he knows, Schuyler said he's excited what he'll do now that he's back. Brescia is interested in palliative and supportive care and medical ethics, a field experiencing rapid change and growth. As a visionary, Brescia gets the bigger picture. Schuyler praises the way Brescia set up a comfort clinic for cancer patients in 2000. They worked as a team seeing 1,200 patients, with anyone who wanted to use Schuyler's services being able to without having to take the time and energy to make a separate appointment.

Brescia said patients apprecited the clinical trial program. The model gets to the heart of offering cancer patients more holistic treatment that acknowledges the complexity of a disease that affects everything from a person's sleep patterns and sexuality to answering the big end-of-life decisions.

"There are very good people scattered about this institution who have unique skills. I'd like to tap into them and figure out how we bring them together.

Programmatically, can we develop programs that make things easier for patients?" said Brescia. "You have to be very passionate about how you do this. There's nothing more important than these things because every one of us faces this at some time."

Tribal Member
Brescia doesn't try to sugar coat it. He wasn't the best student early on in life, and he jokes that his mother said he was the best contraception there was. Brescia's brother is 16 years younger than he. Growing up in a tight-knit extended Italian family in New York, Brescia said it was a fun childhood. His mother was a dressmaker, and his father worked in construction.

"I always say I grew up in somewhat of a tribe. You always felt very much part of a larger piece. You always felt loved. You couldn't go too far, you'd get in trouble. There was an uncle who would slam you."

Learning to play piano early, Brescia ended up in a rock and roll group. "We sang and wore pink jackets. It seemed like a good idea at the time. We were called Jerome and the Fascinations if you must know. I guess it was like bees trying to attract the opposite sex. You want to look different."

Dr. Frank Brescia at the pianoBrescia enjoys relaxing at the piano.

An important part of his tribe was his grandmother who helped raise him, instilling in him a love of cooking and roaming New York's Italian neighborhoods to shop for fresh meat and bread.

"She was a tremendous influence and a great cook. She was just a terrific woman. She'd take me down to Broadway in Manhattan. We'd go to the Paramount Theatre and watch a show, and then we'd go have lunch downtown somewhere in Times Square. She had the patience of Job."

It was a simple, but good life, where he learned to be comfortable with the natural ebb and flow of life. He recalls when his great grandmother died, and she was laid out in the parlor. "It seemed there was always someone laid out in the living room, so death wasn't a frightening thing. It was really part of what went on. It wasn't anything that was strange or frightening."

Seeing education as important, his father pushed him to do something that was noble such as medicine. When he was in middle school, he dissected a frog and enjoyed it and wondered what it would be like to do that with a human body.

"Then I thought, 'I don't know crap. I'm not getting into any of these good high schools."

He decided he had to get serious about his studies. High school marked one of the hardest periods of his life as he struggled to develop the skills, discipline and financial means to reach his newfound goal. Becoming obsessed with getting good grades, Brescia began to put himself on another track.

His determination paid off, with him earning degrees in biology and philosophy from Fordham University in 1963. His love of philosophy dovetailed nicely with his interest in oncology and fascination with Woody Allen.

"I'm dealing with medical oncology, so you're seeing all these existential questions. Is life meaningless? What does it all matter? What does life mean? You see so much death. Every day the human drama facing people who are dying throws this up at you. What's important? You realize that relationships and all the things that seem kind of a cliche become the issue. It changes your focus."

Brescia loves the serendipity of life – how the unlikeliest events ultimately have led him to good places.
Take his service in Vietnam, for example.

Brescia was caught in limbo after having completed his internal medicine internship at Cornell University Medical School and being drafted into the war in 1969. He ended up working at Calvary Hospital in New York for a few months until he was to serve. A hospital that specializes in advanced cancer and dying, Calvary was to have a profound effect on him.

Patients from Memorial Sloan-Kettering Cancer Center, where Brescia would end up doing his fellowship in medical oncology, were sent there to die. "I was amazed by the care they received at Calvary. I became intrigued by the issue of what hands-on care meant. I was really taken aback by that.

After service in Vietnam and finishing his fellowship at Memorial, he went into private practice. When Calvary built a modern facility and was looking for a medical director, he applied and held that position for 14 years, starting the Palliative Care Institute while getting his master's in philosophy and working with Georgetown University.

Brescia, who would go on to work at four academic centers before coming to MUSC in 1998, said of all the honors and awards he's received, his proudest accomplishment is raising his six children. Brescia has had his hands full parenting, given his four biological children, one step-son and a daughter he adopted with his second wife, Jane.
Jane recalls meeting Brescia at Calvary Hospital in New York. He was part of the first hospice movement in New Jersey, she recalls. She caught his eye when she was hired to do a management training session for employees. She brought in an expert on health and humor that had participants sporting red noses at the end. "Just because you're doing what you're doing, you don't have to be grim," she said.

That was music to Brescia's ears.

They became friends, and though Jane moved to Charleston, their paths were to cross again following a tragedy in Jane's life after she was struck by a car. As she was enduring the painful recovery process, she learned her mother, in Chicago, was dying of breast cancer. Brescia offered to check on her mother, and then began helping Jane.

He helped her get set up with a specialist in New York, where she had a specialty surgery and more physical therapy. "I look like an erector set if you looked at my X-ray," she said. Brescia became a surrogate father for her son, Matthew. They married in New York in 1993, blending their two families and later adopting their daughter.

Other than his penchant for wearing hideous pumpkin-colored shirts and having a single-minded focus that makes multi-tasking impossible for him, Jane loves his high energy and wisdom. "He's funny. He's cynical, but that is part of the humor. He's very warm and loving. He's very insightful. The kids get so much wisdom from him."

It's a wisdom gained in part from the incredible role models Brescia has had and his patients. He wants to pass that on and find ways to help MUSC students realize how careful they need to be in this new world of high-tech care to learn the language of the clinician as well as the language of the scientist and to know how to sensitively weigh looming questions of medical ethics posed by patients living longer.

Dr. Frank Brescia lectures to students at MUSC. Dr. Brescia lecturing to MUSc students

"I've been given by society an enormous gift to get into people's lives, and I know secrets about people that no one else even knows—like husbands and wives. So you have this unique and noble road."

But if doctors never look up from their computer screen, if they never make a meaningful connection with the patient, if they fail to realize the connection of religion, philosophy and medicine, then something essential is lost in the practice of medicine, he said.

"What you lose now is the sense of what a physician is. The picture of the physician staying up all night with a kid at the bedside, where is that? The big word is abandonment. Who's my doctor? Where is that continuity of care? Who knows me? We have to be careful how we do this training in this state of our world, and what it means. They have to appreciate that they are more than just scientists."

Brescia's Life Lessons
Toughest obstacle you've faced: Dealing with Jane's cancer in 2004, particularly since she had the disease I treat, and my mother's pancreatic cancer in 1999. I felt very frustrated and helpless. You think you have magical powers when you're a doctor sometimes, particularly with your own family. You think that you can ward off things that you can't.

Hobbies: I love music, playing the piano and reading.

Goals on his bucket list: Now that my kids are older, to try to enjoy those other relationships and figure out how to work and enjoy the things I love to do. I love New York. We still have a place there.

Favorite view: The view of Central Park from our place in New York. I love to watch the city, particularly at night, just when the lights are just going on.

Favorite book: I read a lot of philosophy and a lot of Woody Allen.

Proudest accomplishment: Raising six kids and all of them being really good kids.

His religious belief: I want to believe, but I'm not quite sure.

Advice to other doctors: We forget that we are part of this human family sometimes—that we're no better and no worse. The truth of the matter is that we're all like Job in some ways. We're all going to be a part of the bigger questions. And at the end of the day, you hope you're not going to be alone.




Friday, July 22, 2011

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