A Decade of Hope

A Decade of Hope by Dennis Smith Page A

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Authors: Dennis Smith
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practice; I wanted to continue doing research and teaching and taking care of patients in a way that did not involve worrying about how much time I spent with them, or billing, and all of those things. I graduated in 1986, a pulmonary physician, and was offered by Einstein the standard rate for an academic pulmonary physician, which is fifty thousand dollars. That is not a lot of money today, and was not even a lot of money in 1986, especially if you have a wife and two children. So I was thinking about what other side jobs I could take, and I remembered that I knew these two Fire Department physicians. Wouldn’t that be interesting? The Fire Department must need a lung specialist, with all that smoke inhalation. So my FDNY doctor friends called up Dr. Cyril Jones, who ran the [FDNY’s] Bureau of Health Services at that time, and it seemed like [he had] the perfect job for me. I could see all of their pulmonary patients in one day. I could choose a weekend day, so it wouldn’t interfere with my work at Montefiore. It would supplement my income and allow me to provide some important service back to the city. And finally, it would enable me to help people in such a noble position as firefighting, where they get smoke inhalation, asthma, and other maladies in order to save lives.
    And so that is how I got the job with the FDNY. It was a phenomenal way to give something back to this great city.
    In the midnineties, Dr. Jones retired, and the Fire Department began looking for a more state-of-the-art facility, one that would be more actively monitoring and treating—things that I had been doing on my own but that most of the Bureau of Health Services was not doing. Dr. Kerry Kelly then became the chief medical officer, in 1994, and I became the deputy chief medical officer. Today . . . Dr. Kelly is chief medical officer of the Bureau of Health Services. I’m chief medical officer for EMS [Emergency Medical Services] and special adviser to the [fire] commissioner on all health matters. Both Dr. Kelly and I are codirectors of the World Trade Center Medical Monitoring and Treatment Program.
    Dr. Kelly’s specialty was family practice, and we formed a great partnership. She lives and breathes the Fire Department. Her grandfather was a fire chief, her father was a lieutenant, and she has many cousins on the job. I think of her almost as a Mother Teresa for the Fire Department. She really wants the best medical care for the firefighters, and she’s allowed me great latitude in my work. Sometimes a leader is really only interested in leading, but Dr. Kelly is interested in taking people along and allowing them to become the best they can be.
    I have a lot of interests, and she has encouraged all of them. Together we developed a medical group practice in an occupational health setting so that we could offer our firefighters state-of-the-art medical care. As a doctor in a large organization, you can easily be labeled the company doctor, and the only way to avoid that label is to constantly practice state-of-the-art medicine. We do not make duty-status decisions in favor of the patient or the department, but medical decisions, and then the duty-status decisions just follow.
    I got interested in protective equipment to reduce burns, because the major injury among firefighters was various degrees of burns. We did fascinating studies with bunker gear [outer protective clothing], showing that it reduced burns. These studies got me to know [both] management and [the labor unions] better and develop credibility with them. We did medical studies, and the union leaders, who were very savvy about safety, realized that if you practiced the best medicine it would benefit everyone in the long run.
    It was not a question whether I would respond to the World Trade Center on 9/11—it was just a fact. I’m a lung specialist, but when Dr. Kelly and I took over the leadership of the Bureau of Health Services, one of the

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