Douglas Dieterich, M.D., reports:
I had no idea when I went to medical school back in the mid-’70s that I would become the embodiment of the phrase “Physician, heal thyself.” But that’s precisely what happened.
I was a third-year med student – barely able to tie a simple suture, let alone diagnose any disease beyond the common cold – when I stuck myself with a needle. Back then, we didn’t have a name for hepatitis C. My doctor told me I had non-A, non-B hepatitis. It was a disease without a name and without a cure.
I had a terrible time of it. At one point I was so debilitated by this no-name disease, I had to put my life on hold – something that is not so easy to do when you’re in medical school. All I wanted to do was sleep. Even after I returned to my training, I would go through periods of time when I was absolutely incapacitated with fevers, jaundice and exhaustion.
Once, after I had a liver biopsy, a medical student was asked to draw my blood, and he came at me, dressed in one of those level 4 biohazard suits you see in those contagion movies. He was so nervous and his hands were shaking so much he couldn’t even hold the needle still enough to draw my blood. I ended up sticking the needle in my own arm and drawing the blood myself.
I learned to live with what became known as hepatitis C, even as my liver grew more scarred and diseased. I figured I would end up on one of those lists for a liver transplant. But each day I was sick, I grew more and more determined that I was going to beat this thing before it beat me.
So I became a hepatologist – which is a fancy term for someone who focuses on the liver. I have had the good fortune – if you can call it that – to be a hepatologist during a period of time when enormous progress has been made in the understanding, diagnosis and cure of hepatitis C.
In the late 1970s, there was no treatment for most liver diseases except steroids. So for several years, I took prednisone and then, after its approval, interferon. The side effects of this treatment were just awful. So when I had a relapse of the virus after taking interferon for 15 months, I was actually relieved to be off the stuff. It took a large toll on my family. My wife was pregnant with our son at the time, so I feel like I missed a lot of those magical moments and was not able to be as supportive as I should have been!
By 1997, under the guidance of my supervising physician, I entered a clinical trial for ribavirin, which I took in conjunction with daily interferon injections. Both my family and I paid a large psychological price from the interferon side effect, but it had a happy ending. By 1999, I was virus free six months after stopping treatment and finally cured.
More than a decade later, I am delighted to have the tools available, in the form of antiviral agents for hepatitis C virus, to be able to treat and cure many, many more people in the next few years. I also know that I benefited from clinical trials and believe strongly that all our patients should have the opportunity to participate in clinical trials. I try very hard every day to be able to offer the finest therapy available, experimental or not to all of our patients.
Dr. Dieterich is a professor of medicine specializing in liver diseases at Mount Sinai Medical Center in New York City.