MedCast: The Podcast from MedChi, The Maryland State Medical Society

Ep. 15 - Dr. Rusinowitz

Episode Summary

The fifteenth episode of MedCast features Dr. Martin Rusinowitz, Medical Director for the Maryland Physician Health Program (MPHP). Listen in as Dr. Rockower speaks with Dr. Rusinowitz about his personal experiences to share resources and offer compassion to others going through the same thing.

Episode Transcription

Dr. Steven Rockower (00:00):

Welcome to MedCast, the podcast from MedChi, the Maryland State Medical Society. Each episode we'll be doing a deep dive into medicine and taking an insider's view on issues facing Maryland's physicians and patients and healthcare more broadly. I'm your host, Dr. Steven Rockower. Today my guest is Dr. Martin Rusinowitz. He is the Chief Medical Officer of the Physician's Health Program of the Center for Healthy Maryland. Welcome, Dr. Rusinowitz.

Dr. Martin Rusinowitz (00:29):

Thank you. It's good to be here.

Dr. Steven Rockower (00:31):

Well, I'm very glad to have you. I think because of the nature of what we're talking about, the first thing I wanna say is if anybody listening to this has a problem, the number to call is (800) 992-7010, or email to I will say that again toward the end of the program. Well, so again, thank you so much for being with us. I know that you're a neurologist and you've been involved with the program for a while. Why don't you give us a little bit of background of where you grew up, where you went to medical school and how you got involved.

Dr. Martin Rusinowitz (01:21):

Sure. I grew up in a rural area of New York. It's now a commuter suburb, but back when I was born, it was farm country in Rockland County in New York. It's just along the Hudson, on the west side of the Hudson. I think my reasons for wanting to be a doctor after some deep introspection are not the best reasons in the world. I really didn't like myself, and I figured the only way for me to be liked would be to take on another a facade a difference. And in the, a small rural community I grew up in, our local doctor was, you know, in terms of societal status was number one. This is an area that, you know, didn't have any specialist. It was a primary care doctor and a general surgeon. In fact, a general surgeon delivered me and my sister, delivered my sister when my mother had a gallbladder attack. Back nowadays, my mother would've been an intensive care unit with Neonatologists. Back then, just the general surgeon who did his job. And she did great. And my sister did great. So, I always wanted to be a doctor just 'cause I really didn't like myself. And, you know, I went to college in Philadelphia. Temple University did reasonably well.

Dr. Steven Rockower (02:48):

Oh, I didn't know you were a Temple grad, so am I.

Dr. Martin Rusinowitz (02:51):

I know you are. And I went to medical school and the school that accepted me, Wayne State in Detroit. I'd never heard of it before, but you know, this is a long time ago, and my first choice became the one that said, welcome. And in medical school I really enjoyed surgery. My father's a cabinet maker and I grew up learning cabinetry. And I really wanted to be an orthopedic surgeon and actually matched for orthopedic surgery and did in my year of general surgery I was very impressionable. I spent a month with a local neurosurgeon, just he and I, and in fact, it was such crazy hours. I stayed at his house and just lived the life like the old days of a apprenticeship. And I thought, boy, that was great. And so I switched from orthopedic surgery to neurosurgery. I did three months of neurosurgery, and that was my introduction to neurology. I realized that the thing that interested me the most was the workings of the brain and not so much you know, the, the detailed physical stress that it takes to operate on brain tumors. So I then switched again to neurology at the University of Illinois in Chicago. Stayed on a couple years after that as an attending. Things went pretty well. And then moved to the Washington area in 1986. Long time ago.

Dr. Steven Rockower (04:22):

Yes, I remember sharing patients with you at that time in Montgomery County. So, tell me about the Physician's Health Program and how you got involved.

Dr. Martin Rusinowitz (04:36):

Well, I got involved through the backdoor. I mean, I am a recovering drug addict. I just celebrated 28 years, so I guess it's taking, but it's interesting. I can tell the story in retrospect. When I was a resident in Chicago I needed a root canal, and the dentist did the root canal, the endodontist, and gave me 30 Tylenol number threes, 30 milligrams in each tablet, and said, you know, it's gonna hurt for a while. So if Motrin doesn't work, take one or two of these every four hours. I was very naive about the whole thing, but it did hurt. And so I decided to take one of the Tylenol number three. I remember the night I took it in my little flat in Lincoln Park in Chicago, and my entire world changed. They talked about, you know, I think addiction is a, a biological medical issue, and I think I have receptors in my brain that have been looking for a narcotic for years, kind of the lock and key mechanism.

And I took that very low dose of a narcotic of codeine, and I was in heaven. I've never felt that good in my entire life. So, the first sign of an addict in the works was that I decided I would not waste these Tylenol with codeine. When I'm feeling bad, I'll wait until I feel better and enjoy the high I got. So I toughed it out with Motrin and put the Tylenol number three aside. And over the years, I would use an occasional one with a glass of scotch. And it did to me things that, you know, drugs, you know, I smoked pot at, at a younger age, and certainly drank beer. Nothing ever gave me that feeling. I mean, it was just total peace and wellbeing. And I parceled them out until they were done, and probably used them over a period of a year.

I stayed in Chicago another for years, and that was the end of it. I had no access. I didn't think about it. And then moving forward, maybe 10 years, I was in my first office in Rockville. And I had a horrible headache. And I always had a headache from dictating charts. I loved playing Doctor, but I hated doing the, the paperwork. And every patient I saw was referred by another doctor, some of them by Steve. And, you know, I, I loved playing doctor, but I would, the time would always fill up whatever there was, and I'd save the charts for later. So I was always dictating charts at the end of the day or on the weekend. And one weekend I was dictating on a Saturday, and I had, I just had headaches all the time from doing this, probably out of boredom.

And I would take something from the medicine closet. We had all kinds of samples back then. But I never took anything that was really of an addictive nature. Well, the normal pill that I was taking, we ran out of. And the only thing there was fiorinal or Fiora set with codeine, which is 30 milligrams of codeine, as I had taken years earlier in Chicago with another headache preparation, which probably not all that relevant. But when I took that first pill instantly, I was back in Chicago sitting on my couch in that little suite. And the world was good. And it was incredible. My brain had remembered, and maybe that's part of my interest in neurology, but you basically start where you left off, and it takes very little, you know, I deal with many alcoholics, and not consistently, but many alcoholics have told me that they remember when they had their first drink.

Most people don't remember that. it is, so I remember the day I took my first drug, and they remember the day they took their first drink. You know we are not earthlings, we're different people, but a significant percentage of the population. And I realized that I much more enjoy dictating these charts when I had these pills. And I started taking samples until eventually I built up a tolerance to the drug and dependence on the drug. I wasn't quite addicted yet, but I did this over a period of two or three years. And the amount I needed to take kept increasing. Eventually we ran out of samples. And to show how deranged my thinking was, I immediately blamed it on the cleaning people. They must be taking these drugs. That's why we don't have any left. The fact that I was pilfering many per day had nothing to do with it.

And I got to the point where I was truly addicted. I needed the drug just to function, and there were no more samples. So I did the next best thing. I started writing a prescription. I would make up a name and sign it as myself. So I was literally diverting drugs from somebody who didn't exist which turns out is better than diverting drugs for somebody who is really a patient. But you know, I would go to a local pharmacy. I always wrote it for number 30, dispense number 30 of these, and I never gave refills. And these can be going for about, you know, 24 hours. And I'd go to another pharmacy. And eventually I found my drug of choice, which was hydrocodone, which is just another narcotic. Why some people enjoy scotch and some bourbon. I'll never know. But I was addicted to a narcotic as an alcoholic, as the alcohol, regardless of, of the preparation.

And eventually I got to the point where I needed people offering guess this 50 to 60 Vicodin a day just to feel normal. It was a miserable, miserable time in my life since I only wrote 30 at a time, I had to basically go to two pharmacies every day to fill these made up prescriptions. And eventually you know, it's, it's fascinating the process. After a couple of years of this, I really lost all sense of pride. I was still practicing. I was still voted, you know, as one of the best neurologists in Washington and the Washingtonian. Every year. There's no evidence that patients suffered. But I was miserable. My wife thought I was bipolar because at work I did fine, and when I came home or when we were on vacation, I would try and stop taking the drugs so I would withdraw.

And she eventually thought I was allergic to vacation. 'cause every vacation I was sick. It was a horrible way to live. And I got very sloppy with the writing the prescriptions. And I didn't wanna die. But if it happened, I guess I'd be okay with it. That was sort of my bottom. And ultimately a local pharmacist thought. She recognized me and thought I'd been there before, called the police. And suddenly it took on a life of its own. I was questioned. And my life turned around, around then. I, I denied this among two with two lawyers. you know, when I was, when the Montgomery County Police spoke to me they never arrested me, but I was in the lockup room in the back, and with the chains hooked the tables, and it was a different world. And they said, you need an attorney.

I said, well, I have a, a attorney that closed on our house. Closed what kind of attorney? He said, no, no, you need a criminal attorney. You're being accused of a felony. You could go to jail for this. I lied to everyone, including the attorney. And then another attorney was hired at Rockville and I was spending fortunes, and still taking the drug. But eventually I got off 'cause I knew that, you know, that it, that part was over. And you can also tell the sign of somebody who's in a horrible drug recovery. When anyone that met me, I would always volunteer to give my urine. They, 'cause it was clean then. People don't, normally, when you first meet them, ask if you'd like a sample of their urine. Yeah. So and eventually things were falling apart. I was blessed to be part of a large practice where they really were years ahead of their thinking and light years ahead, frankly, because I was valued.

And they said to me, this, you have a disease. you need to go and get better. And when your doctors say you can come back to practice, we'll take you back. And then I spoke with my first person at the MedChi was Michael Free with whom I work with every day now. And Mike was the beginning of, of the connection to MedChi that certainly saved my life. They told me it was very tough love. They told me I needed to go to the center in Virginia, the Farley Center, and when they discharged me, give him a call and tell him I was back home. So I went there and they told me that the program was 90 days for physicians. And I said, well, that suburban hospital I work, they have a program that's only 30 days. And they explained to me that, oh, the program is 30 days, but it takes us 60 days to get doctors' attention.

So I was there for three months and they saved my life. There's no doubt. If I had the same active addiction now that I had then, I'd be dead. I was probably days away from injecting the drugs 'cause I couldn't get even a feeling of neutrality by taking the pills anymore. I was getting sick from all the Tylenol. My liver enzymes were creeping up probably from all the Tylenol I was consuming. And I began, you know, the program that began the rest of my life. And I can go into how the program, the physicians health program works at MedChi-very much the same as most states in the country, although I think we do a better job. A contract was formed. They took random urine. I had to see many psychiatrists and therapists and my life revolved around that. But I then started practicing again.

And there were a lot of, lot of hurdles along the way, and many that I can talk about, you know, with insurance companies. I was on probation, but ultimately I just did what they said. And every time I would come up with something that was my own idea, anytime I would say, I think we should do this, they would explain to me that my own thinking got me into this mess. So let them do the thinking. And I let go. And I did remarkably well. After the five-year contract they asked me to be a member of the committee that reviews these cases. You know, if you complete the contract and do well and bring an apple to the teacher, I guess they asked you to stay on. And anyway, so I've been on the committee for 23 years. The head of the committee a wonderful guy was, anyway, I won't go into the history of the committee.

It started in 1978, long before I needed them. He was getting older and asked if I would be sort of the vice chair of the committee in case he was late or whatever. And a month later he died of a heart attack. And suddenly I was chairman of the committee and did that for many years. You know, these are all voluntary positions. And ultimately, I was asked to stay on, in a part-time paid position as the medical director of the PHP program. So, you know, I've earned my degree in a long way. And, and my path has been rather unusual. I was in private practice as I said in Montgomery County. I was burning out for all kinds of other reasons. The, the hassles of medicine, the problems with reimbursement, the time spent. So I really in 2007 after running into a patient who was doing this, I decided to get out of clinical medicine.

I went to the Food and Drug Administration in neurology. And after being there a couple years, there was an opening in the Controlled Substance Division. And I applied for it and got it. So, you know, 15 years after I was, you know, essentially arrested and almost going to jail for narcotics, I was regulating them for the US government. And it's a journey that's taken me in a large circle and doing what I do now helps to keep me clean. I don't think about it on a, on a daily basis, but, you know, my life has become infinitely better. And we could talk about it later, there's a big difference between not taking drugs or not drinking alcohol and being in recovery. Recovery is a process where you're, it's a capital R. People are getting better in many aspects of their lives, and often the drugs or alcohol are just a, a symptom of the situation they're in. So you need to earn your keep Steve and ask some questions. So I will shut up.

Dr. Steven Rockower (18:21):

Well, no, no, no. I'm, I'm letting you go. I'm, I'm, I'm amazed at the, the strength and you know, fortitude that you've had to be able to go through all this over the years. I do want to note that the physician's health program began in 1978. And we are now celebrating our 45th anniversary of it. And all because of, you know, people like you who have been part of it and help to A. work on getting yourself in order, but also helping other people to get an order. What other kinds of, you know, going away from you into other physicians. Now, I don't wanna do any HIPAA violations here, but what other kinds of problems do physicians get into that get them into the physician's health program?

Dr. Martin Rusinowitz (19:22):

Yeah. Well, it, when I started doing this, I'd say that probably 80% of the physicians we saw had substance use, substance use problems. Physicians are a little different than the general population, the percentage of addiction and when I, and again, I, I know that alcohol's a drug and I often talk about alcoholism and addiction. It's the same process. So we'll talk about general addiction, including alcoholics. Probably 80% of the docs we saw were addicted to something or some substance. That's changed a great deal 'cause we're now seeing physicians who have other problems, often behavioral problems. And one of the exceptional things about our program, and it is different than other states, and I can explain how it's different, is we work very much on the medical models, which is pretty good since that's what I'm trained in. So it was natural.

Dr. Steven Rockower (20:20):

And this is MedChi

Dr. Martin Rusinowitz (20:22):

Yes. This is MedChi and the Physician's Health Program, the primary thing we do when we meet somebody, whether the hospital reports them or they're self-reported, or the Board of Medicine reports them, and there are different ways they can get in, but once they're with us is we try and establish a diagnosis. As a neurologist, I, you know, if you, if if you don't have a diagnosis you're lost in space. Even if the diagnosis is wrong, then you have to be ready to change it. So we see docs that have behavioral problems, and during these behavioral bouts, they, they tend to drink too much. And we've seen so many docs who have turned out to have bipolar disorder and they're going through a manic phase when they drink too much. But their primary problem is not alcohol. Their primary problem is they have a bipolar affective disorder.

And if you don't treat that primarily, you have no chance of addressing their alcohol. We also are asked to evaluate docs. You know, very often the Board of Medicine, the State Board of Medicine will refer a doctor who has gotten a DUI. Not everyone who gets a DUI gets pulled over, is an alcoholic. Many are. But we see numerous physicians who don't have a drinking problem. And they were at a Christmas party, you know, off campus or near the hospital and they had a couple of drinks and they normally don't drink at all. And they drove home, you know, on Christmas Eve or the, you know, new Year's Eve and there was a, a roadblock, you know, set up by the local police and they were found to be intoxicated. Now, to send somebody like that for alcohol rehab therapy, which can be weeks or months, or in my case, you know, three months is just a waste of resources. And it accomplishes nothing. These people often have poor judgment and they need to be educated about what their limits are, but their problem is stupidity, not alcoholism. So, you know, we have different ways. So we first established a diagnosis and we're seeing many, many more behavioral issues. There are certain behaviors, physicians, and often surgeons, no offense, Steve, have had for years that have been tolerated. You know, throwing scalpels and telephones and all kinds of things is no longer tolerated.

Dr. Steven Rockower (22:45):

I make no excuses for my compatriots. Right. . But, but I understand completely,

Dr. Martin Rusinowitz (22:50):

Right? I mean, but generally, if, if, you know, I remember my mother talking about this general surgeon in our small town. She would say he is a terrible bedside manner, but he is a great surgeon. Well, I don't know how she judged his surgical capabilities 'cause she has no training, but she did well. So he is a great surgeon, but, you know, you can't get away with those kinds of things. And they do actually impact patient care. And I won't go into examples, but we've seen a number of examples in the committee where a doctor will just have such poor communication and such arrogant behavior that the nurses are afraid to contact him or her about the status of the patient. And they may not, and the patient then suffers. The doctor says, nobody called me. Well, nobody called because of the situation that this doctor created.

So we, we see a good deal of that. So right now, I would say of, of all the patients, the doctors we see I'd say 60% are substance use disorders and the rest are psychiatric disorders and things that are really quite manageable. Sometimes it's, it's other things. A surgeon may have a tremor, and the question is, you know, is it affecting their working? But we do not see issues of standards of care. That's another part of the state board. And that's delegated to another group. We see docs who have a problem that may or may not interfere with the practice of medicine. And our job is to remediate those before they harm a patient, which is really our, our number one goal. And we see, unfortunately, a tiny percentage of the doctors in the state who statistically have these problems.

Dr. Steven Rockower (24:35):

Do doctors get to you by hospital referrals? By their own referrals? By the board of Medicine, the board of physicians?

Dr. Martin Rusinowitz (24:47):

We, we have two programs, and Maryland is unique in the country for that. We have two programs. One is a program where physicians come in on their own or hospitals report them. Now, again, these are not, in fact, the ones I've seen are not egregious type things. Those would've gotten to the board already or would eventually get there. But, you know, a lot of behavioral issues or another doc will maybe smell alcohol on a doctor's breath. And we'll report them to one program. The, it is called the Physician's Health Program. If they are already being followed by the Board of Medicine, in a sense, they have been caught. I, I don't wanna use that term, but, you know, they, they are under control of what the board does. Then they enter what's called the Professional Rehabilitation Program. And what we do with both groups is identical.

The only difference is in the first group that is voluntary. we recommend in the second group, we tell them what to do because we have the, the State Board of Medicine behind us. But frankly, the recommendations and what we do and everything else is the same. And some docs, we don't let practice until they sort this out. 'cause we, we feel that they are potentially dangerous. And T hat's, that's quite common. The state will send them to us, the State Board of Medicine and ask if, if we think their behavior is affecting the practice of medicine. And which is why, you know, there are two, two medical directors of our program. I'm a neurologist and the other is Art Hildreth, who's a psychiatrist. We work together a great deal. But between both of our understandings of the brain and other bodily functions, and having each spent many years in clinical medicine, we can usually decide pretty well whether somebody is safe to practice or we need to stop them from practicing.

And of course, we helped a great deal. We have a staff of about eight people. They're all certified social workers, psychiatric social workers, with great deal of training and experience. And you know, it's not a minor event. When we see docs come in, you know, there is a chance they could lose their license. And, you know, with all the training that we go through, if, if we can't practice medicine, there's nothing left for us to do. So our recovery rate is, is pretty much the same as airline pilots, which is, it's hard to know the exact number, but it's probably in the 90th percentile, meaning after five years, give or take, 90% of our participants are drug or alcohol free. , the number in the general population is somewhere between five and 15% after five years.

Dr. Steven Rockower (27:48):

Are there worries? Are there worries about suicide in, in any of this? You know, we've, you know, had a lot of problems. you know, the Lorna Breen case in, in New York and among others.

Dr. Martin Rusinowitz (28:03):

Yeah. You know, we, we, as it's often said, we stand on the shoulders of giants. And she was a giant in that. It's horrible. But her suicide and, and her family has magnified the problem so that we can all learn from it. And the rate of suicide among physicians is much higher than the general public. And we have had on my watch, we've had one suicide, but we're very much aware of that. And I tell you, there are many doctors I know, you know, and myself individually, I became, I was not a recreational drug addict. I was a vocational drug addict because in my mind, it, in my distorted mind, I was doing a better job with the drug than without it. When I saw patients and when I was not seeing patients, I stopped taking the drug. You know, that. So there are many docs, including myself, who would rather die than say that they're not competent or fit to practice medicine.

That's how invested we become in what we do. You know, when I first was as this rehab program, I met many other docs who were in the program. And one of them I remember distinctly, was an OBGYN. And he said, well, tell me about yourself. And I said, well, I'm a neurologist. He said, well, I didn't ask you what you did for a living. I said, tell me about yourself. I had nothing to tell. You know, that's what I did. That's what I was full stop. So suicide is a great potential risk, and I, I think we're aware of it every day. And sometimes people have to be institutionalized to avoid this. And, you know they often say that drug addicts certainly have to reach their bottom before they can get help. Well, sometimes their bottom is death. And we do everything we can to not let it get that far. It's very sad.

Dr. Steven Rockower (30:01):

Let's take a quick break. before we go to break, I want to again reiterate if anybody listening has problems or knows of a physician that has problems and is in need of our services of the Physician's Health Program, 800-9920-7010 or email Funding for this podcast has been made possible by Mid-Atlantic Medical Collection Services. Mid-Atlantic works with your patients to help them understand their bills, review charges, and consider repayment options. When it's easy for patients to make payments, they're more likely to pay you and pay you sooner. That's the Mid-Atlantic approach. To find out if Mid-Atlantic can help you, email

Welcome back to MedCast, the podcast from MedChi, the Maryland State Medical Society. We're continuing our discussion with Dr. Marty Rusinowitz as he discusses the Physician's Health Program and mental and substance abuse problems with physicians. As we left, we were talking about the, the problem or the potential of suicide in physicians. Do you wanna speak more about that?

Dr. Martin Rusinowitz (31:32):

Yeah, I, I, so we were alluding to earlier, the practice of medicine and the image of oneself as a physician carries weight in our personalities. That's often much, much more important or much greater than it should be. I mean, most of us have worked so long and hard with blinders on and have missed many of the joys in life to do what we're doing. And I think some of us just, it is such an important part of who we are, that it defines who we are. I was mentioning earlier that, you know, when I first was in a treatment program, I was asked by a OBGYN that I met. He just said, well, tell me about yourself. And first thing I said to him is, I'm a neurologist. And he said, well, I didn't ask you what you do for a living.

Tell me about yourself. I didn't know where to go. I had nothing left to tell that, that pretty much defined me. Yeah, I had a wife and all that, but it, it was overwhelming. And so when one takes that away or waves the possibility of losing your license to do that, it is devastating. It's like having one's arms or legs cut off. And the suicide rate is, is very high among physicians and physicians who are put in this kind of situation. It's very great. and we often talk about in recovery and drugs that somebody will not seek help until they seek their bottom. But sometimes the bottom is death. And we try and prevent that from happening. So people and docs who have gone through the stress of, of covid and been on the front lines and, and just have burnt out. Burnout is very different than some of the things we're talking about. But it's a spectrum and it's a continuum. And many docs who become burnt out, start drinking and drugging and doing all those other things to just feel better because they feel so bad. So it's a huge problem. And it has to be handled, you know, with kid gloves gently as with anyone who may be thinking about suicide. But it's something that we question inversely every participant we see.

Dr. Steven Rockower (33:53):

And, and all of the treatment that is given through the program is all confidential, isn't that correct?

Dr. Martin Rusinowitz (34:02):

Yes. our program is actually HIPAA compliant, which is, if any of us have had to face family issues, you know, my wife has hospitalized once, and as her husband, I had trouble getting the information. HIPAA has, in many ways has created such a barrier to any information that might be confidential, but that's the level we're at. So nobody can find out about it. Obviously, if the physician is referred by the Board of Medicine, the board knows, and the board may decide to publish it somewhere else, but it's not our doing. And in fact, I mentioned earlier that we have two programs. One is voluntary, one might say, and I've had this brought up at national meetings where we present the unique program we have in Maryland. Then they'll say, well, aren't you missing some doctor who's dangerous? Most of the docs who referred to us are referred by hospitals and the hospital so it's, it's confidential.

The board may not know yet, but we make recommendations to these physicians. And if they don't do what they're told we report it back to the hospital. The hospital usually terminate them. And hospitals in Maryland are required to notify the board of medicine if any physician is terminated for any reason, even retirement or pregnancy. They'll sort out the details later. But if one's participation in the hospital as an attending physician or whatever's ended, the board is notified. So there are many safeguards in the system. I've been working in this system for 28 years. I have never seen a case where I said, I wish we had reported this sooner. I think there are enough checks and balances that that has not happened. We've not seen patients harmed. I've seen patients who may have been harmed, but it occurred historically on the first day we met these folks. So, and how was that our, our number one, you know, we want to take care of doctors, but our number one mission as being part of the state healthcare system and a Center for a Healthy Maryland is to make sure patients are not harmed. And we have to remind ourselves every day because we don't deal with them directly, but we think about them all the time.

Dr. Steven Rockower (36:27):

Wow. What a, what a fascinating discussion. I'm so thankful that you've been able to bring all these things to us. Let's switch gears a little bit. what would you be doing if you weren't a physician?

Dr. Martin Rusinowitz (36:43):

Dr. Steven Rockower (37:15):

As many of us are, are less .

Dr. Martin Rusinowitz (37:17):

Yeah, that's probably the reason that I, I, my introduction to the neurosciences was through neurosurgery. But clearly I was not meant to be a neurosurgeon who could focus on something three millimeters wide for eight hours. I'd be lost in space. And I, besides loving to drive and loving cars, I cannot believe the skill of focusing in concentration that these folks have. They almost never look in their rear view mirror. They don't have to turn their heads. They know what's behind them. They just passed it. It's there. It's a skill that so if I had the skill, I would do that. But I guess if I didn't, and I don't, I'd probably be a cabinet maker like my father. You know, I was grew up in the, in the late sixties and in high school. And you know, it's interesting. When I was sort of in junior high school and high school, I thought my father was an idiot. And as I got older, he seemed to get a lot smarter.

Dr. Martin Rusinowitz (38:20):

He must have taken some pills or something, but I think I didn't wanna do what he did because he did it. And in retrospect, you know, my first interest in orthopedic surgery, that was my initial, you know, chosen field of medicine. you know, I was floundering all over the place. But I think now, you know, one of the things I enjoy most is mowing the lawn. Because as a neurologist, you don't get to see ins, you don't fix a bone. And patients are helped and they improve with medicine or diagnosis, but they don't come in a wheelchair and, and walk out of the office an hour later. It just doesn't happen. And when you mow the lawn, it's after one hour, it's different. And so I probably do something very physical that doesn't involve medicine at all. I have no regrets. But if I had to, that's probably what I'd do.

Dr. Steven Rockower (39:17):

What are you currently reading or watching or listening to, or distracting yourself outside of work?

Dr. Martin Rusinowitz (39:24):

Yeah. the thing I've actually gotten interested, maybe it's after being at, at MedChi for a while, and our, our building, our office as a virtual museum of medicine, I've gotten much more interested in reading the history of medicine. How things were done years ago. And, you know, people had, you know, every time we have a procedure nowadays, like, you know, a heart catheterization, somebody did that on, probably not an animal, probably on themselves. I mean they took incredible gonadal fortitude as I would say for some of these people. They stuck their necks out, literally. And it's fascinating to see how ideas are disseminated. And that's a major issue in medicine. You know, they talk about things, how long it takes to go from the bench to the bedside. You know, I worked at the FDA and the time it takes for a, a new medication or whatever to get to fruition is horribly long, particularly if it works. And it's just interesting before all the regulation, which I think is very much needed, people just did what they thought was right. And I think we have an incredible legacy behind us because most physicians even back when they were just bloodletting, were doing it for the right reasons and really had a conscience. Some didn't. But I'm always impressed by the, the level of giving that these folks had, that few of us are asked to do.

Dr. Steven Rockower (41:03):

And along those lines, what's the best advice you've ever received?

Dr. Martin Rusinowitz (41:09):

Wow. I guess it's an old one, but I guess I keep it simple, stupid. That's what this is an acronym for. I tend to make things more complicated than they are. I, I tend to talk to my wife and I will use a metaphor or assembly that it's so absurdly distant what we're talking about, that it's easier to grab the concept of the issue, forgetting about the metaphor, which takes on a life of its own. So, you know, I've, somebody once said to me that if they ask me what time it is, I'll tell them to build a watch or show them how to do it. I think that's the best advice I've had. And but I guess the best advice is you know, you learn in recovery and it's, it's really rather simple. Most of us know what's right and what's wrong, and I think recovery is, if you do the next right thing, you'll be fine.

I think there, you know, there are many people in prison and whatever who, who make, choose the wrong path and, and make the wrong choice. But I think deep down inside, most of us who are reasonably normal know what's right and what's wrong. And every time we pick up a drug or drink too much or do anything in excess, most of us, again, not everyone, but most of us know that we're breaking sort of an inherent rule that we have as, as good people. So I think doing the next right thing has guided me since I got into this mess, which is, you know, it's turned out to be an incredible blessing. It's, you know, it's changed my life. I, I think I've, I've retired from practice, I still do what I'm doing now for MedChi. If I were, if I had not, I mean, I think my life now is better because I am a drug addict in recovery.

It's taken a long time to say that. And a number of years ago I would've said, this guy is crazy. But I think it's very true, and we see this every day. I mean, in medicine, one of the things that motivates all of us is we see people get better. And when you see a doctor who is on verge of losing his or her license and are so desperate, they may be contemplating suicide, and then they get back to the joys of just being a good doctor and a good person, you really walk away thinking it's been a good day. So I guess that keeps me going.

Dr. Steven Rockower (43:47):

Wow. Well, thank you so much for spending time with us and sharing your story. I also wanna reiterate, if anybody has any problems and wants to talk, 800-992-7010 or email I wanna thank Dr. Marty Rosinowitz, who has been our guest on MedCast, the podcast for MedChi, the Maryland State Medical Society.