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these days “many of us outlive our money” and will become Medicaid clients.

A larger issue at the root of health care, she believes, is indi- vidual responsibility. “How do we motivate people to take care of themselves, so they don’t burden the health care system with diabetes, heart disease, and other chronic conditions asso- ciated with obesity and unhealthier lifestyle choices? I’m not real optimistic here.” —Helen S. Edelman ’74


REHAB FOR THE WHOLE PERSON “Surgery just wasn’t for me,” Rob Skerker ’82 recalls. “The training is very competitive and intense, and the relationship with each patient is so short.” Still, he liked orthope- dics, so he gravi- tated to rehabili- tation medicine. After completing med school at U - Mass and several years of intern- ship, residency, and fellowship

training, he’s an expert in physical and sports medicine, rehab, and wound care. His practice ranges from younger patients, often accident victims, who need rehab in conjunction with orthopedic surgery or prosthetic fittings, to older patients re- covering from strokes, falls, or joint replacements. While simple cases may require just outpatient physical

therapy, he’s brought in for more complex cases. He works with a team of doctors, nurses, and therapists to address every- thing a patient might need for rehab—say, diabetes or heart meds, antibiotics for a wound infection, speech and occupa- tional therapy, and prosthetics training. From intake to dis- charge planning, he says, “I work closely with colleagues on each case to coordinate care, and that collaboration is very gratifying.” Likewise, he enjoys working with patients for weeks or even months, developing a relationship with them and their families, “and often watching them make remarkable recoveries,” he says. “It’s pretty cool to see somebody who was badly injured eventually walk again.” On the down side, Skerker says, “We’re seeing patients in rehab who used to be kept in hospitals—they’re on oxygen or they’ve got infections or unhealed wounds—but for insurance

28 SCOPE FALL 2012

and cost reasons they’re already out of the hospital.” As small hospitals lose money and large health systems keep growing, cost cutting becomes a stronger drive than ever. At this rate, he laments, “hospitals are going to become nothing but intensive- care units.” (His employer is Atlantic Health, which has several hospitals and centers in metropolitan New Jersey.) Along with getting more bureaucratic, medicine is becoming so high-tech, he says, that he sees the caring, personal touch disappearing. With financial and technology imperatives making health care “so fast-paced, I always advise my patients to have their loved ones on scene and involved as their advocates.” His advice on health care careers? “You’d be crazy to be- come a physician; be a nurse instead.” He says med school is so expensive that only those entering very lucrative specialties can pay off their debts in reasonable time (“I was naive and just focused on the learning; I didn’t realize I was choosing one of the lower-paying fields”), years of postdoc training delay the start of one’s practice, and then “you become pigeonholed in your field.” But nurses have flexibility: “you’ll always have a job, and you can choose to be a practitioner or an administra- tor, in a huge range of fields and settings.” He adds that “nurs- es are great people, and actually have enormous influence on patient care and outcomes.” He says he was pleased to win a state award for wound care recently, but even more pleased that “I was nominated by my nurses.” —SR

SAFE SEX IN THE CITY Our nation’s capital may have the highest HIV rate in the country, but that doesn’t deter Mariel Cedeño Edge ’02 from tackling the issue head-on. As a public

health analyst at the D.C. Depart- ment of Health’s HIV/ AIDS, Hep- atitis, STD, and Tuberculosis Ad- ministration, she runs the city’s condom-distri- bution program. Her work in- volves every- thing from pur- chasing con- doms in bulk to providing sexual health education to high school students and doing communi- ty outreach. Washington,



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