The East Bay's Best Doctors
Defining Moments: True tales from five of the East Bay’s Best Doctors.
Stanley Fong, M.D., Kaiser
Being considered the best at anything often means taking on extraordinary challenges and succeeding—even if the odds aren’t in your favor. For the past 20 years, Best Doctors Inc., a company founded by two Harvard physicians, has conducted a peer-to-peer survey of the medical profession asking physicians, “If you or a loved one needed a doctor in your specialty, to whom would you refer them?”
Only doctors identified by their peers as “best doctors” in previous years receive the survey. In addition, the staff of Best Doctors reviews each physician nominee for current licensure, board certification, and any malpractice incidents, as well as their specific expertise including special research and published work.
This year, Best Doctors named more than 260 East Bay physicians as the best of the best (see p. 43). Spanning a wide variety of specialties including pediatrics, infectious diseases, and surgery, this list of local physicians is a guide to some of the finest medical care our area has to offer. We asked five doctors from the list to describe in detail some of the defining moments in their medical careers.
Susan Jacobson, M.D.
Kaiser Permanente Hayward Medical Center
Early on in my career, in the mid 1980s, I met a charming female patient who would unknowingly influence my career. Only in her mid 30s, the woman suffered from diabetes and had undergone a kidney transplant. Having faced death, she now wanted to embrace life, and she told me her greatest hope was to have a child.
She knew it would be a challenge to conceive and sustain a pregnancy when she had chronic kidney problems and was taking post-transplant immunosuppressants. However, she was successful in getting pregnant, which was quite an achievement.Unfortunately, her happiness was short-lived. Only weeks after delivering her child, she watched helplessly as her baby succumbed to opportunistic pneumonia. The mother had contracted HIV infection through a blood transfusion relating to her transplant and inadvertently passed the infection along to her unborn child.
For me, this tragedy underscored the insidious nature of AIDS and fueled my desire to pursue new strategies for the treatment of HIV/AIDS and other infectious diseases.
Over the past two decades, I’ve seen how the global fight against AIDS has progressed. In the early ’80s, AIDS was an automatic death sentence, and it wasn’t until 1985 that all blood products in the U.S. were screened for HIV antibodies. Today, early screening tests and improved antiretroviral treatments have transformed AIDS into a long-term chronic disease.
While I have seen AIDS care improve in the U.S., I have also seen access to HIV care improve in developing countries. In 2005, I joined the Matibabu Foundation that works to build community health care in rural Kenya. I often use my vacation time to travel to Kenya where we work to improve access to treatment and to work in a region that has the highest HIV/AIDS and malaria as well as tuberculosis prevalence in Kenya.
Although Kenya has achieved a remarkable feat in the AIDS fight by reducing the rate of infections by half over the last decade, the current challenge is getting a handle on TB—the biggest killer of people living with HIV.
Until 11 years ago, I worked in a community hospital. When I joined Kaiser Permanente, I joined an organization where HIV care results are way above the national average.
While there are 34 million people around the world living with HIV, there is now hope that the beginning of the end of AIDS may be within reach.
William Lewis, M.D.
Summit ENT Medical Associates
Several years ago, I had a patient referred to me who had a mass in his neck. He was in his early 60s and had recently remarried, and his wife had just given birth to a baby boy. After a series of tests, we found the mass in his neck was cancerous, and I scheduled a thyroidectomy.
During the surgery, I discovered the cancer had spread to his jugular vein and carotid artery. The challenge then became to surgically remove all of the cancer, without damaging his nerves or vocal cords. This had started as a routine surgery that should have lasted two hours, and it suddenly became one of the most complex procedures I’ve ever performed. It took almost eight hours to complete, and the entire time I kept thinking about the patient’s son, who was less than a year old and needed his father.
Immediately after the surgery, I found the patient’s entire family in the waiting room. They had been praying for a positive outcome, and while my patient came through the surgery, and went on to have radiation therapy, he had a recurrence of the cancer six months later. We scheduled a second surgery that was just as painstaking as the first, because this time there was a lot of scar tissue present. My patient had told me he wanted to live to see his son finish high school, and that became my mantra through the second operation, as I worked to remove the cancer. After the surgery, he went through another course of radiation. So basically, over the course of two years, he endured a lot of pain and suffering. He would undergo radiation, feel better, and then have radiation again. It’s like being mugged, getting up and dusting yourself off, and then getting mugged again. Yet despite it all, he never complained.
That was five years ago, and he’s now cancer free. We still keep in touch, and he recently referred another family member to me who needs surgery. That was a huge honor—to know he would refer a loved one. Today, his infant son is about ready to start kindergarten, and my patient is doing great. His case impressed me, not just because of its complexity, but because I gained so much respect for this man in the process. We would talk about our families and our lives without compromising the doctor-patient relationship. In many ways, he became like a mentor to me.
Stanley Fong, M.D.
Kaiser Permanente Oakland Medical Center
Twenty years ago, I saw a patient, a young man, who was morbidly obese and as the result, had numerous health problems. When we spoke, he told me how much he loved his children, and how his greatest fear was that he wouldn’t see them grow up. I encouraged him to make some changes in his health such as losing weight, quitting smoking, and limiting his consumption of alcohol, and he really took the advice to heart and over the course of several years made some drastic lifestyle changes.
I look at myself as an educator and coach to my patients. I offered some advice, but he was the one to make the positive changes in his life. Obesity has become an epidemic problem in medicine today, and can lead to many health conditions including heart disease and diabetes. I try to educate my patients on obesity’s causes and consequences, because in many cases, adapting some lifestyle changes can make a huge difference in their health.
I also appreciate the cohesiveness of working at Kaiser Permanente, and my ability to consult with specialists. I had a patient come in one morning with spinal pain and urinary obstruction. My concern was that his symptoms could be signs of a serious condition such as kidney failure or spinal-cord paralysis. I was able to get him in to see one of our urologists, and also one of our neurologists, the same day. He returned to my office within a couple of hours, and we were able to rule out any serious neurological problems and start him on a treatment plan.
James Betts, M.D.
Pediatric Surgeon and
Director of Trauma Services
Children’s Hospital & Research Center, Oakland
When the 1989 Loma Prieta earthquake hit, I was at Children’s Hospital. Hearing about the magnitude of the earthquake, we were surprised when we didn’t immediately see an influx of patients. Then we heard about the collapse of the Cypress Freeway, and how the 6.9 quake had caused a two-decker length of Interstate 880 to buckle and collapse on a lower tier during rush-hour traffic. We were told there were people trapped in cars on the lower deck, and a medical team from our hospital went to the site of the freeway collapse to offer our assistance. Early responders were able to extricate a young girl from one of the cars, but her 6-year-old brother was still trapped alongside the body of his mother and a family friend. The boy’s leg was pinned under a seat containing one of the adult’s bodies. The doctors who first arrived on the scene were able to stabilize the boy, but after about two hours of trying to free him with tools such as the Jaws of Life, it became apparent that the only way to extricate him from the wreckage was to amputate his right leg.
Crawling under the collapsed freeway, I found myself working in a space that was only about 4 feet high and extremely hot. We started some intravenous lines on the boy, who was unconscious. It took two to three hours to amputate his leg and to free him from the wreckage. The entire time we were there, we experienced hundreds of aftershocks. Caltrans wanted us to leave the structure, but none of us were leaving until we could take the boy with us.
The efforts that day were a true team effort between all the people who were there that day—law enforcement, first responders, people who just came to help out. We were able to take the boy to Children’s Hospital and to save his other leg. He was reunited with his sister and his father who had been frantically searching for his two children.
Three years before the earthquake, in 1986, Children’s Hospital was named the only Level 1 pediatric trauma center in Northern California. The 1989 earthquake showed us that we were prepared to handle any large-scale disasters that might occur in Northern California.
Arzou Ahsan, M.D.
Sutter East Bay Medical Foundation
I had a new patient several years ago, who was in her mid 50s and had just moved to the area. She was a very smart and funny woman with tons of character, but she didn’t like doctors very much, and as a result, she didn’t regularly see a physician. When my patients come in for their annual well-woman exam, I routinely check their thyroid, breasts, and abdomen, as well as their pelvic area, for any abnormalities. When I began doing a thyroid check on this particular patient, she asked why I was checking [there] when my specialty was obstetrics and gynecology. I didn’t want to alarm her but I noticed she had asymmetry in her thyroid, and one nodule felt much larger than the other. I recommended she see a specialist. The specialist confirmed my suspicions, and a needle biopsy confirmed she had thyroid cancer. Fortunately, the cancer was still in the earliest stages and was treatable through a thyroidectomy, a surgical operation to remove the thyroid gland. When she came back for her well-woman exam the next year, she thanked me and said I was “right about that thing,” which was big praise from someone who didn’t like doctors. During that exam, I felt a suspicious lump in one of her breasts and felt that she needed to follow up with a mammogram, which also revealed a suspicious mass. After having a biopsy, it was confirmed that she has breast cancer and needed a lumpectomy. Today, she comes to her annual exams like clockwork and always greets me by saying, “Dr. Ashan, I trust that you will give me a clean bill of health.”
Her case impressed me, not only because of the positive outcomes, but also because of the trust that was built. I think trust is formed as the result of good communication, and the patient’s ability to feel comfortable and confident with their physician.