Clinic dedicated in honor of Lefkowitz
Recognition makes Dr. Lewis B. Lefkowitz Jr. uncomfortable.
He’d much rather do his work at Vanderbilt University Medical Center and in the community quietly, without being singled out for recognition. But sometimes he’s overruled.
The decision to dedicate Nashville’s Campus for Human Development’s new homeless respite care program at the Vine Hill Community Clinic in honor of Lefkowitz wasn’t what he preferred.
But to those at the Campus for Human Development, the dedication is a fitting way to recognize the Vanderbilt University Medical Center physician who has spent much of the past three decades learning about the city’s homeless and their medical needs.
Lefkowitz, professor of Preventive Medicine, will retire from the Vanderbilt faculty in June. Besides introducing Vanderbilt medical and nursing students to medical care of the homeless through the respite program, he has also served as medical consultant for the Campus for Human Development respite program since 1999. In that capacity, he has been in charge of being on call for problems that might require a physician’s guidance.
“I’ve just been a good neighbor,” Lefkowitz said, downplaying his role. “It’s been very gratifying to sign the charts, to be the backup person, but I do not have the day-to-day involvement with the Campus like many others who are physically there every day,” he said.
Fellow faculty member and friend Dr. Deborah C. German, senior associate dean for medical education, has known Lefkowitz since she came to VUSM in 1988.
“He embodies the true community spirit. You don’t meet too many people who are completely, truly selfless,” she said. “With his patients, he listens. He guides and he gives medical care. He’s open to whatever it is they bring to the encounter. With his students, he reads their interest, their passion, and guides them in areas they didn’t know existed.
“He’s a man who is about 20 years ahead of his time. He was into preventive medicine and community health before it was commonplace. He practiced it. He made home visits to his patients to see how they lived, enabling them to make changes that were real and practical. He’s a true interdisciplinary spirit. He has the ability to work with any kind of student with any kind of calling.”
Lefkowitz said he considers himself a lifelong learner and has enjoyed working with the homeless population.
“These are people who have no homes. And every one of them has a story about why they don’t have a home,” Lefkowitz said. “It’s very important to me to help the medical students understand the connection between the homeless population’s life circumstances and their illnesses and how it’s all one thing. And when our students see them in the hospital or in the emergency room, they know a little bit about where they came from and what their capacities are,” he said.
“Many of these patients have given up,” Lefkowitz said. “One of the things the Campus for Human Development does is offer some new alternatives for them for living and that’s really important.”
Bonnie N. Pilon, DSN, senior associate dean for practice at the Vanderbilt University School of Nursing, said that Lefkowitz has given valuable guidance to the nurse practitioners who have staffed the respite program and to nursing students who have learned from his teaching.
“Lewis has been enormously supportive of our clinical service and our outreach efforts,” she said.
Learning about how a patient’s lifestyle and home environment affects his or her health isn’t a new interest for Lefkowitz. It’s something he became interested in when he was a medical student at the University of Texas Southwestern in Dallas. Assigned to labor and delivery at Parkland Memorial Hospital in Dallas, Lefkowitz and a nursing student were asked to make house calls to mothers and newborns on the third postpartum day. Due to a bed shortage in the hospital, the new mothers were sent home earlier than normal.
It was an assignment that changed the young medical student, making him realize that he had as much to learn from his patients and their backgrounds, as they had to gain from his care.
“We took off in my car to west Dallas, a mostly black and Hispanic neighborhood, and did these examinations,” he said. “They helped me understand something I had only imagined – that where somebody lives and how they live is as important as the physiological part of their illness or their wellness. That’s when I got interested in teaching and learning in the community, not just working or volunteering, but learning.”
When Lefkowitz joined the Vanderbilt faculty in 1965, he was able to combine being an active faculty member with his outreach work into the community.
In addition to his work with the respite program for the Campus for Human Development, he has provided clinical services to the Cayce Homes Community Clinic, the Moore County Primary Care Center, Lifestyle Health Services (an STD clinic), Alive Hospice of Nashville, Vine Hill Community Clinic, Employee Health Service for the state of Tennessee, Tuberculosis Control Clinic and the HIV Clinic at the Regional Health Center for the state of Tennessee.
“I’ve always been a non-conformist, just skeptical,” Lefkowitz said. “I always found out that I would learn more if I didn’t believe everything I read in a book. And I always have.”
Lefkowitz has also led the medical school’s Introduction to Comprehensive Medical Care elective course, open to all medical and nursing students and to selected undergraduates headed for health careers. The course focuses on opening the students’ eyes to health and welfare facilities in Nashville’s neighborhoods and non-hospital health facilities in the Nashville area and serving populations with special needs or those who face particular obstacles to the receipt of medical care.
The course also includes home visits to patients of VUMC faculty members, where the students are asked to identify factors, which facilitate or impede the patient’s health.
Are Vanderbilt students better citizens and physicians or nurses because of the class?
“They say so,” he said, smiling. “The students indicate that this is really something important to them as well as to me and that’s very reassuring.
“I’ve always thought of myself as sort of a midwife for people who wanted to find the way to do things. In a sense, that’s what a teacher is – someone who is able to identify the avenues people can take to get where they want to go. A lot of things have happened because I brought two people together. So maybe I’m a matchmaker, not a midwife.”