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November 19th, 2010
09:04 AM ET

Human Factor: A doctor, his injury, and healing insights

In the Human Factor, Dr. Sanjay Gupta introduces you to a survivor who has overcome tremendous odds. Confronting a life obstacle – injury, illness or other hardship – they tapped their inner strength and found resilience they didn’t know they possessed. Be inspired by their successes, as we have been.

Although I have been a practicing physician for 30 years, and always cared compassionately for my patients, this past year and a half as a spinal cord injury patient has made me rethink my approach to health care.

After having walked a mile in the shoes of my patients, I now have a unique perspective as the CEO of the University of Rochester Medical Center, a physician and a patient with chronic illness. As CEO I can work with physicians and employees to champion the kind of medicine that will benefit patients, families, and providers alike. It is this rare opportunity that has driven me to work so hard to come back from my injury.

On the Sunday before Memorial Day of 2009, I was riding my bicycle near my Canandaigua Lake home, when rounding a hairpin turn, I was surprised by an oncoming car. Swerving onto the shoulder, my bike’s back tire blew out, and I flew over the handlebars. I heard a crack as my head hit the ground and was thankful that I did not lose consciousness. However, I instantly became aware that my arms and legs had lost sensation and could not move. I was panting and diagnosed a broken neck and high cervical spinal cord injury. In fact, I had fractured the fourth cervical vertebrae, an injury similar to the type suffered by Christopher Reeve.

Within minutes of my fall, I was airlifted to my own institution, where I would spend the next 13 days in intensive care learning how to be a patient. I would be completely dependent on my family and the hospital staff for every need, an unnatural position for someone accustomed to being independent.

You think you can imagine what it is to be paralyzed, but the actual experience was more terrifying than any nightmare. With no sensation below my neck, I floated in space unaware of where my limbs were, tethered to a breathing tube, and communicating by nodding when people pointed to letters on an alphabet pad. It was frustrating, exhausting, disorienting, painful, and frequently overwhelming. But the hope that my family and providers offered enabled me to believe that I would return to my job as CEO.

While I lay in bed in the URMC’s Kessler Burn and Trauma ICU I began to think of what I would say to my colleagues when I returned. I wanted to make sure that I could tell them what the real meaning of my experience was. I realized that it was the simple things that affected me the most profoundly- a gentle voice, the sight and voice of a family member, a nurse who took the time to wash my hair, and a physician who took the time to explain to my wife and me that the movement in my left big toe was a positive sign.

On June 12, I was airlifted to the Kessler Rehabilitation Institute in New Jersey, where I began an intensive, three-month regimen of physical and occupational therapy. During this time, I took every opportunity to connect with my caretakers, learning about their families, why they chose their careers and what motivated them. However, I wasn’t an easy patient. I expected to be consulted and involved in every decision. I insisted that my family be part of the decision-making process. After all, this injury happened to my entire family, not just to me. A positive outcome of this accident is that I grew closer to my own family. This “time out” gave me the opportunity to spend more time with my wife, Mary, my children Sarah, David, Mariah and her husband, Anthony, and my three wonderful grandsons. Their love gave me the strength and another reason to fight for my recovery.

I regained strength in my legs and recovered considerable control of my left arm and limited use of my right. In September of 2009, I returned to Rochester to complete my rehabilitation. Despite major limitations in strength and sensation that force me to use a motorized wheelchair and require assistance to get showered and dressed in the morning and ready for bed at night, I’ve enjoyed a degree of recovery that’s well beyond what many patients with similar injuries experience. I can’t help but think of the patients I met in New Jersey who were far younger than I, had more serious injuries, and could not do what I can do today. I owe my progress to the remarkable care I received, from the emergency medical technicians who first stabilized my spine and loaded me aboard a Mercy Flight to URMC, to the doctors and staff in URMC’s Emergency Department, ICU, and Physical Medicine and Rehabilitation departments, to the caregivers at the Kessler Rehabilitation Center.

On March 1, 2010, I officially resumed my position as CEO at the Medical Center. Together with a core of deeply committed physicians and staff, I am leading an effort to establish a culture in which patients and families are an integral part of the health care team. A culture in which patients feel safe asking questions of their caregivers, where they experience the highest quality care. A culture where providers have the courage to talk openly about even the most difficult subjects. A culture that promotes compassionate and attentive care for patients and for each other.

I’ve been granted a rare opportunity to make a difference for our patients, their families, our faculty, and our staff. How can I not wake up each day determined to make the most of it?


soundoff (38 Responses)
  1. Rick W

    This is a really great story of a really gifted man, seeing the other side. I wish everyone would really see the benefits of marriage and family as did Dr. Brad.

    This world is going to be a sad case in 20 years with the family structure dieing. Invest in nursing homes!

    November 19, 2010 at 09:34 | Report abuse | Reply
    • RichCat

      I'd rather blowup nursing homes, I've been through many, in my former carieer in phamacuticals. My nightmares sometimes take me back there. Alone no one to listen no one to care, You get more human contact in prison. They always hire 3rd world rejects half the time I couldn't communicate that a patient needed care. Please god let me die without ever having to be in a nursing home as a patient!

      November 19, 2010 at 21:51 | Report abuse |
    • Rose

      I agree the family unit has never been so under attack as it is these days. Having suffered terrible back pain myself I know the agony of constant pain. how fortunate to receive good treatment.

      November 20, 2010 at 15:28 | Report abuse |
    • Jesse Lieberman

      Brad, welcome to the club of physicians with SCI. There are not too many of us, but we are around and are practicing medicine with a touch of empathy

      November 20, 2010 at 16:52 | Report abuse |
    • Tampa

      I'm sure you meant well but your comment suggests that families are always good, always healing, always supportive. When your family is abusive, controlling and hateful, you run away from that. It took decades to get over the abuse my grandparents dealt out; I could not conceivably take care of them and I won't be guilted into it. I have no children by choice so I realize I am relegated to a nursing home should I become unable to care for myself. I accept that, and I cannot help but find those who insist that their families take care of them to be at least a bit selfish. And those who feel obligated/guilty must live with that, I suppose. Anyhow, it's a complicated issue that cannot be summed up by the supposed "decline of the family structure." Just because you're related to someone doesn't mean that it's healthy.

      November 20, 2010 at 18:47 | Report abuse |
    • Avin

      I guess this opinion piece is more about the way health care is delivered today in the 'Grand US healthcare System' despite what we as healthcare providers learn in school, to always put the patient's choices/opinions first. The family support system, however important, is only a part of the whole story here. Obviously, my suggestion is to take your pro-family advocacy somewhere else.

      November 22, 2010 at 08:55 | Report abuse |
    • Ethan Do

      The articles and comments about nursing homes really touched me. I lost my IT job to outsourcing and decided to pursue my childhood dream of running a nursing home. I'm back in school and started a degree in Kinesiology. I'm not sure how yet, but when the time comes, will find a way to run a nursing home centered around dignity, family and qualified care. Thank you for sharing your comments. Ethan Do.

      November 22, 2010 at 11:23 | Report abuse |
  2. charles s

    I would not wish this injury upon anyone. Just reading about the tremendous care that he received, I wonder if he realize that the level of care that he received is beyond what the average person gets? He has the financial resources well beyond the average person. Nowhere in this article is the tremendous cost mentioned. For the average person even with so called good medical insurance, this accident would have destroyed his family financial life. This accident would have probably led to their bankruptcy. My sister-in-law died of cancer and my brother had two medical insurance policies, Even with both insurance policies, his out of pocket expense was in excess of $100,000. I wish that part of Dr. Brad change in heart would also be a concern for the tremendous cost that average people face in such a situation.

    November 19, 2010 at 10:41 | Report abuse | Reply
    • Xilo

      I understand your point. Unfortunately quality of care (or at least extent of care) is often based on financial resources instead of medical need. However, that's the subject matter of a different article. In this case I think we can all appreciate the suffering this man endured and be grateful that he can use his experience to inform the care that patients at his medical center receive. Many doctors are simply out of touch with the patient experience. Being on the other side, being completely dependent on the expertise of others, gives him a unique perspective to help tackle problems in one, if not many, aspects of care.

      November 21, 2010 at 18:20 | Report abuse |
    • marco mauas

      I agree with charles s's questions. It was hard for the Doctor, but what was the thing he missed the most during his illness? In the narcissistic society, media, image & aggression oriented, difficult not to see and read the CEO word 4 times in his text. A doctor may be also a patient with less dramatic circumstances. Some of the terrible drama could be appeased if the CEO word would be taken as a simple vanity of life.

      November 22, 2010 at 02:17 | Report abuse |
    • Karissa J

      I am a student at the U of R, and have heard Dr. Brad speak about his ordeal many times. Please do not mistake his financial status as a golden key to get what he needs. He has had to fight with insurance companies for equipment and procedures just like the rest of us. One example he gave was a special bed to prevent pressure ulcers, which was declined by insurance, even though it is quite obvious that the upfront expense was well worth it, compared to the cost of treating a single pressure ulcer. Same went for his wheelchair. He recognizes that insurance companies do not see the long term benefits of equipment that are expensive up-front.

      Yes, he has hit roadblocks, despite his profession and financial status. And those roadblocks have impacted him.

      November 23, 2010 at 09:33 | Report abuse |
  3. no name

    What a brilliant statement at the end of that video:

    "Courage is not the roar you that you make when you go into battle, but it's the quiet voice that helps get up every day and try again!"

    It would be great if doctors and politicians were required to watch stories like that, which is basically the classic case of "if the shoe was on the other foot"... Better yet, require them spend at least one night in ICU as patients!

    The earlier post by Charles S about the costs is hard to argue with. Add to that the recent battles regarding US Health Reform, and it's pretty scary! I wonder if there is any place in the world that is safe to run to for help!

    Thank you to Dr. Sanjay Gupta, CNN! If only all media had such integrity!

    November 19, 2010 at 11:35 | Report abuse | Reply
  4. no name

    Typo Correction:

    "Courage is not the roar that you make when you go into battle, but it's the quiet voice that helps you get up every day and try again!"

    - Brad Berk M.D. http://bit.ly/aneZUu

    November 19, 2010 at 11:40 | Report abuse | Reply
  5. m

    Well I'm glad for his remarkable recovery and wonderful care. And it's great that he is using his experience to better train his staff but nowhere does he mention that he must've had great health insurance. The stress and anxiety of worrying about medical bills is a tremendous burden when the patient and family should only be working toward recovery. The fear of financial ruin and homelessness destroys families and probably hinders full recovery.

    Dr. Berk never had to worry about losing his job and along with it his health insurance and becoming homeless due to being unable to keep up with expenses.

    No one is fooled by his good fortune. Everyone can read between the lines and know they might not be so lucky.

    November 19, 2010 at 12:29 | Report abuse | Reply
    • RichCat

      People in his caste never do worry about bills. and they even held his job wow! if it was me they'd have my desk cleared before the phone got cold! Talk about care, I'm sure as an insider he knew about and how to get treatment we can only dream of.

      November 19, 2010 at 21:57 | Report abuse |
  6. Lr

    Dr. Berk, all the best to you and yours. But your experience does not begin to describe all of the ways families are torn apart because of a medical crisis. I'm really glad you didn't have to travel that road.
    I only hope that as a new member of our "class of chronically ill," you will keep all the comments displayed here on your front burner, as well as the front burners of your colleagues.

    November 19, 2010 at 13:40 | Report abuse | Reply
  7. Lisa

    I do hope this doctor realizes after reading the comments that he was given extra special treatment by his doctors and the staff of the hospital and rehab because he was a doctor. His experiences and his ability to pay for his stellar care are not typical of the average American. I thoroughly applaud his commitment to improving communication and involvement between patients, their families, and the health care team and would respectfully request that he also take the financial aspect of health care into consideration.

    November 19, 2010 at 14:12 | Report abuse | Reply
  8. Chris

    Dr. Berk's description of his experience – & how powerfully he was impacted by empathic, genuine concern demonstrated by caregivers at a crucial time when experiencing previously unknown level of extreme vulnerability – is a fascinating account, and will hopefully be instructive for physicians caregivers, as well as other healthcare decision makers. Quality outcomes (i.e., best possible results) are prerequisite for high quality care, but genuine, competent, empathetic care is what patients seem to remember & value most highly.

    November 19, 2010 at 16:06 | Report abuse | Reply
  9. Lynn V

    While some may compare the care Dr. Berk received to "usual and customary services;" and others may comment on his ability to withstand the financial impact of his injury, we miss some major points, if we don't realize that life altering trauma is life alterning for anyone. No two people or families will experience the impacts in the same ways. But the salient point in this story is what Brad Berk chose to do with his experience. Rather than go into a major depression related to the drastic changes in his personal and professional life circumstances, he began immediately to take note of the things that made the most difference in the quality of his care and the quality of his life. He began to think about how these things can be taught to change the way that health care is delivered. I'd like to suggest that most assessment tools that are used to assess patient's clinical progress, their care needs etc. don't begin to capture the type of data that Dr. Berk reports was most healing to him and his family. We talk a lot about patient centered care, but when will our assessment tools and reimbursement systems capture the heart of the matter, the mountains beyond the obvious mountains, of what it really takes to address the real life giving needs of the patient and the family. Those things that provide the meaning and the energy to get up each morning.
    In another story Dr. Berk talked about how frustrating it was to eat by himself with other patients in rehab early in his recovery. He felt the frustration and the humiliation and the fatigue. But being trained in medicine he knew that without certain muscle groups having recovered, the task was next to impossible. He refused to engage in the activity until he knew he had the muscles he needed to accomplish the task. I couldn't help but wonder, whether there are other ways health care professionals set care plan expectations prematurely with the result that patients become frustrated and depressed, in situations where critical analysis might show that it wasn't the patient that was failing to be compliant, but the professional who didn't take a little more time to see why the treatment was not compatible with the patient's life at the time.

    November 19, 2010 at 16:36 | Report abuse | Reply
  10. Christy

    As a young adult, I was hit by a drunk driver and suffered similar disabilities. The care given to me at the ER was awful. However, once I was sent to a rehab center with occupational and physical therapies, I improved immensely. I know some of the trials and humiliation this Dr. went through. Dr. Berk's story is an encouragement to me.

    November 19, 2010 at 21:40 | Report abuse | Reply
  11. Maritza Pitaluga

    My son was injured last year and became a quadraplegic. I can actually pinpoint which are the individuals that made a difference. Unfortunately in 3 months of meeting different people taking care of him, I can pick no more than 5 individuals that really cared. What a shame compassion and caring is so lacking the medical field. And yet overall the profession does not see it unless they personnaly experinece it.

    November 19, 2010 at 23:51 | Report abuse | Reply
  12. Jackl

    I have been riding for 7 years now, started up again at 57. My daughter wants to know why I take the same old boring route. Wide shoulders and I know the route. Having had back surgery (L5) 25 years ago I know all about cronic pain is all about luckily not requiring too much medication. More power to the good Doctor. Tough thing to go through but sometimes you have to walk a mile in someone else's shoes.

    November 20, 2010 at 08:07 | Report abuse | Reply
  13. Reflecting Pool Discourse Blog

    It's a good story . . . BUT . . . Why do we always have to wait for our own ox to get gored before we manifest compassion for others "as a paramount concern?" This hospital CEO obviously had a "Golden Parachute" health insurance plan. Can this CEO appreciate how terribly different and horrific this debilitating event would have been for someone who is dirt poor and without insurance? Or does this CEO have to also become poor himself before he can "see" and commiserate with the plight of the poor and the uninsured? We seem to be imprisoned in a world of sociopathic gold-diggers who manifest an inability (more like "refusal") to care about anyone's ox except their own. And it's a iron-clad formula for guaranteeing the demise of their own ox. It's dishonest to selectively and selfishly pick-and-choose which oxen are worthy of compassion and empathy, based on a gambler's hunch as to whether "I" am likely to fall within the empathized protected class (the circle of compassion) that reaps the benefits. That kind of society is fundamentally unfit for human consumption - regardless of class we come from.

    November 20, 2010 at 17:22 | Report abuse | Reply
  14. Scott Spann, MD

    Dr. Berk,

    My name is Scott Spann and I’m an orthopedic surgeon in Austin, Texas. When I came upon your story I must tell you, I was stopped short. First, I am moved and touched by your experience, by the compassionate initiative you’ve begun, and by your extreme courage. Also, I am stunned because our stories are so similar. In 2005, while riding my bike, I ran into an SUV abandoned on the highway, and endured, as you did, a spinal cord injury which left me a quadriplegic. Reading your story, I remember so vividly my own responses after the accident, my difficulty in being a patient, and the people and moments that gave me the strength to fight. After months of therapy I returned to work, even to performing surgery.

    Obviously we have both been blessed – given the fortune of excellent care and the opportunity to learn what we otherwise might never have known about being a patient and about the journey of recovery. Upon returning to my practice, I found myself listening and understanding at a whole new level, tapping more deeply into my own capacity for compassion. I, like you, am committed more than ever to supporting, educating and empowering patients and their families. I’m even looking into filming a documentary and am currently writing a book to help get the word out about the very issues you bring up in your article and video.

    Perhaps we could connect, compare our experiences and see how we might work together to use our combined knowledge and personal experiences to reach and help others. You can find me at http://www.scottspannmd.com.
    Again, thank you for sharing your story, for the work you are doing to change the very face of patient care.

    Scott Spann, MD

    November 20, 2010 at 19:02 | Report abuse | Reply
  15. Anita

    I also understand chronic pain. I was 23 when I got my back injury, a bulging disk between my L4 and L5 vertebrae. Unfortunately I didn't have a good doctor, they didn't even believe there was anything wrong with me, but still kept pushing the meds. I finally pushed and got a CT scan, which showed there was an issue, after two and a half years with nothing helping and having to quit my job, I opted to speak with a surgeon about it. He operated and it was a success, but I still have chronic pain, the surgery was over a year ago now and I still am unable to do many of the things I did before, at least without it causing me a lot more pain.

    November 20, 2010 at 23:06 | Report abuse | Reply
  16. javier

    forgive me for my English good good a year ago I had surgery back and from that day I have much pain I had to quit my job now I'm looking for I can do is hard to saw your story this is very good but if all you saw this deal out very good not as I do that every day that I had an appointment with the doctor just to be able to say it is bas pear but now my pain increased more than 4 children uninsured and jobless but I know God will help me with this and your report is a light on the way thanks

    November 21, 2010 at 03:40 | Report abuse | Reply
  17. Internist in Massachusetts

    It is increasingly difficult in today's hurried, bottom line medical world to spend the necessary time to take care of the person behind the patient. Most patients do not have a title that elicits the "extra mile" from all their medical providers.

    November 21, 2010 at 09:32 | Report abuse | Reply
  18. haarkonen

    a humbling story

    November 21, 2010 at 09:42 | Report abuse | Reply
  19. YounanMarketingAndManagementAssociatesInc, Int'l Intst'r

    In perspective this was in memorium somewhat of those who died at the hands of doctors who were paraplegics.
    theresa noelle younan ymma-iii i-pic interpole galactica y-research management

    November 21, 2010 at 15:05 | Report abuse | Reply
  20. YounanMarketingAndManagementAssociatesInc, Int'l Intst'r

    All my life and beyond from finite and to now that ricky retardo spy leader who won't quit extorting my income and intelligence is going to wind up a doctor himself. He's not cuban exactly and i'm the furthest thing from a lucille ball act that you can find. theresa noelle younan ymma-iii i-pic interpole galactica y-research management world ruler Lord Spirit Madonna Monarch.

    November 21, 2010 at 15:20 | Report abuse | Reply
  21. YounanMarketingAndManagementAssociatesInc, Int'l Intst'r

    All my life and beyond from finite and to now that ricky retardo spy leader who won't quit extorting my income and intelligence is going to wind up a doctor himself. He's not cuban exactly and i'm the furthest thing from a lucille ball act that you can find. theresa noelle younan ymma-iii i-pic interpole galactica y-research management world ruler Lord Spirit Madonna Monarch.
    who is the bobby racket duo in new york stealing my best dressed windows exhibition assets as well

    November 21, 2010 at 16:38 | Report abuse | Reply
  22. chakto

    chaktoooo

    November 21, 2010 at 17:43 | Report abuse | Reply
  23. Dr Bill Toth

    I had a similar experience after a little sky diving misadventure and I know my experience ultimately made me a more compasionate physician. As CEO he will have a much greater impact on both patients and the docs and staff he connects with and is responsible for. Exponential learning for all. Thank you for sharing! Live With Intention, DrBillToth.com/blog

    November 21, 2010 at 19:48 | Report abuse | Reply
  24. sonia

    happy to hear about this story. My story is a little different but in some ways the same. I am a mother of two in tx. My and my boyfriend both worked. I worked at a daycare making 7.50 an hr. I was burned by a bottle warmer w second degree burns on my left thigh. I had to go to the texas med clinic because of my boss. It was a complete joke besides the man who i saw to take care of me. One appt i saw a woman who made me want to report her. He told me i never had to see her again and allowed me to see him only. He told me he knew what i was going threw since he had got a burn on his arm. I didnt have insurance and he treated me like a daughter. He was a real doctor who cared. I lost my job due to the fact that they were not willing to pay my bill. But i had my eyes open to burn victims especially children. I make sure my children know how to stay safe.

    November 22, 2010 at 00:06 | Report abuse | Reply
  25. Kyle

    Funny how people feel this story of a doctor becoming a patient is good and inspiring, while they criticize the medical industry. To those people complaining about doctors, how many know what it is like to be one? How many understand the ridiculous sacrifices doctors make. Let me ask some questions for people who feel like criticizing.

    If you think medical costs are too high....
    How should we develop new medical technology? pharmacuiticals? Should we skimp on the clinical trials required to make sure they are safe? Should we regulate and cap the profit companies can make on their research? Should we not pay our doctors a reasonable compensation for their education and responsibilities? Should we regulate and force hospitals to be non-profit businesses?

    What about insurance? The fact is that with the quality of health care, most people are going to require some type of health care for a chronic condition in their life. With the price of health care, the only way health insurance companies can make a profit is by denying coverage to their customers. Health care at the moment is completely unsustainable in our society, there is no magic fix, no simple solution. A complete comprehensive change to every aspect of medical care is needed, and even that might not be enough.

    November 22, 2010 at 00:51 | Report abuse | Reply
  26. Katie

    It is the little things that mean so very much to a patient – the nurse who recognized that my growing discomfort after four hours in post-op was due to the fact that I needed to use the bathroom, not that I needed more ped meds. The CNA who used a small flashlight and a hushed voice in the middle in the of the night, instead of flipping on the room lights and cheerily greeting me at full volume. The doctor who sat down to wait out the uncharacteristic rush of tears instead of clicking his pen or eyeing his watch. The physacal therapist who recognized that my pain level had more to do with whole body wellness (the horrible rash from the surgical soap nobody thought to wash off the non-surgical sites, the constipation, the nausea and headache from the pain medication) than from the procedure itself. I too have a medical background and wish to be treated as an intelligent person, not just a body part. I am also learning to be a good patient, but as a patient, I am learning that we are ALL team members working toward the same goal..

    November 22, 2010 at 11:43 | Report abuse | Reply
  27. Martha

    bottemline is luck, some docters are wonderfull and others should not even be docters.

    November 22, 2010 at 22:53 | Report abuse | Reply
  28. Edward Nieshoff MD

    Dr. Berk-

    I too was rendered quadriplegic, at age 21, C6 complete, back in 1978. Thereafter, finished a bachelors degree, some grad school, then went to med school/internship/residency – no PA, no assistant in the classroom and wards. Lived alone during medical training, much in public housing, with an attendant at home several times a week.

    Married 1999, twin sons 2006, 20 years of practice... a good run, albeit with some health issues along the way. I hope you too have a supportive family, and commensurate success and happiness.

    Nice to hear of a comrade. Good luck in all your endeavors.

    All the best.

    Edward C. Nieshoff MD
    rimdoc@earthlink.net or try me on Facebook, check the video of my SCI Medicine practice

    December 5, 2010 at 17:29 | Report abuse | Reply

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.