By Doug Brunk, San Diego Bureau
As a young child growing up in Venezuela, Dr. Julieta Bleichmar Holman would peer out the window when patients would approach the first-floor home office of her parents, who are both psychiatrists and psychoanalysts.
“I had a whole fantasy world about whom these people were and what occurred behind closed doors,” recalled Dr. Holman, who is now a 3rd-year psychiatry resident at Massachusetts General Hospital/McLean Hospital in Boston. “Naturally, there was a jealousy about the time my parents were spending with these strangers as opposed to me. But I also recognized that people did get better. My parents would receive gifts and thank-you cards, and we would run into people in the supermarket who would come up to them and say things like, 'you saved my son's life.' … It's a very powerful message for a young child to see that what your parents do really matters.”
She also listened to her parents about how formative their medical school training was, so by age 12, she set a goal to become either a medical doctor or a scientist. “Doctors were idealized in my family,” said Dr. Holman, who has a long lineage of psychoanalysts in her family. “If you're in a doctor's family, there's no higher aspiration in life than to become a doctor.”
But during her freshman year at Harvard College in Cambridge, Mass., she had a change of heart after taking premed courses surrounded by “highly competitive, ambitious” peers. So she veered away from the natural sciences and earned a bachelor's degree in women's studies.
After working in Europe for 2 years, Dr. Holman reversed her change of heart and began training for a career in psychiatry and psychoanalysis. “If I was going to do anything in medicine, it was going to be psychiatry because by then I had really come to terms with the fact that what my parents did was wonderful and I wanted to do something similar,” she said.
She emphasized that her parents, who are both university professors and run a psychoanalytic institute in Madrid, did not pressure her into the career choice. She described her decision as self-discovery “based on a profound identification with them as professionals, as people whom I wish to emulate.”
Still, she acknowledged an underlying tension as she follows in their footsteps, such as how she can chart her own course while being true to their legacy? “It can be a double-edged sword,” Dr. Holman noted. “You often have large shoes to fill, [and] an additional challenge of figuring out how you are going to do the same thing but do it differently.”
For now, she'll settle for their influence. “I often compare the belief in psychotherapy to a religious belief, where if you grow up with it, it's in the structure of your mind and how you view the world,” she explained. “From my parents, I obtained a belief in the power of psychotherapy to transform people's lives.”
She believes that people who become the first physicians in a family have it easier, because they “have this automatic special standing that we children of physicians don't get to have. But we on the flip side benefit from having had role models.”
A Heart for Elder Care
The line of physicians in Dr. Richard G. Stefanacci Jr.'s family includes his father, 12 uncles, and about 20 cousins and other relatives. So, as the firstborn son named after his father, “It was pretty well determined that I would become a physician,” joked Dr. Stefanacci, a geriatrician who is the founding executive director of the Health Policy Institute at the University of the Sciences in Philadelphia.
His father, a retired general surgeon who also practiced geriatric medicine, started taking him on hospital rounds and house calls in northern New Jersey when he was about 10 years old.
While shadowing his father as a youngster, he saw firsthand “how appreciative people were for a physician doing house calls, and how beneficial the house call experience is over seeing somebody in the office setting.” Young Richard also spent summers and weekends working at a nursing home that his grandfather built in Passaic, N.J., tending to residents and helping in the physical therapy department.
“Richard followed my footsteps quickly,” the elder Dr. Stefanacci said. Both attended the Kirksville College of Osteopathic Medicine in Kirksville, Mo., and both share an affinity for working with the elderly.
“But I probably did something that turned Richard away from surgery,” his father confessed. During one of the hospital visits, young Richard witnessed an appendectomy. “I think he realized then that he didn't want to become a surgeon and was more interested in internal medicine.” The younger Dr. Stefanacci said he prefers “the chronic, continuing care aspect of geriatric medicine” to the acute nature of surgery.