Doctors Without Borders

UAB Alumni Practice Medicine in Unusual Settings

By Jo Lynn Orr

Robert Cosby
Robert M. Cosby has treated everyone from movie stars to circus performers to soldiers in the field during more than 35 years as a practicing physician.

Physicians are people, too. Like the rest of us, they dream of meeting Hollywood celebrities and sports stars, finding adventure in foreign lands, and getting paid to take tropical vacations. The difference is, doctors have the sought-after skills to turn those fantasies into reality—as several UAB graduates can testify.

 

Spirit of Adventure

Robert M. Cosby, M.D. (School of Medicine class of 1971), has always been drawn to doing common things in uncommon places. So when Mel Gibson’s film company came to Birmingham to shoot scenes for The River, Cosby contacted the production manager and was hired to be the physician on call at the movie set. “It was fun—something different,” he says. “It was also a learning experience. Everyone thinks being a movie star is glamorous and exciting, but in reality performers live a hard life. They often have to travel long distances and work long hours in difficult locations for months at a time.”

They’re also very dependent on appearance, Cosby says. “One actress called me to the set because she thought her eyes were becoming red, and she was afraid the camera would pick it up. Another actress who was feeling tired asked for a vitamin B-12 injection because she believed it would give her more energy. This seems to be a commonly held belief in entertainment circles, because I ended up being called to the set to give everyone—cast and crew, alike—B-12 injections.”

When another film company was in Birmingham shooting a gangster movie, some of the actors came to Cosby’s office with an unusual complaint. “They contracted bronchitis because they were trying to be true to the setting of the film,” Cosby recalls. “The story was supposed to take place in summer, but at the time they were filming, it was actually quite cold outside. So the actors put ice in their mouths between takes in order to cool down their respiratory tracts. That way moviegoers would not see their breath on screen. Regrettably, the icy inhalations also contributed to their bronchitis.”

Then there was the time Cosby was doctor on call for the Ringling Brothers circus. “It was a great experience watching the performers practice their routines,” he says. “Thankfully, considering some of the antics and daredevil feats that were performed, I only had to treat a clown’s sprained ankle.”

For all of the fun Cosby has had as a caregiver to the stars, there’s also a deadly serious side to his practice. He’s a colonel in the U.S. Army who has deployed to Iraq five times, including missions with the Special Forces. Although he can’t talk about certain aspects of his missions —“You know the old joke; I can tell you but then I would have to kill you”— he has experienced some situations straight out of a Hollywood war movie. “It was my first deployment to Iraq with a 12-man Special Forces A-team,” Cosby recalls. “We were on a mountaintop in the combat zone. While we were setting up camp, all of a sudden, over the rise of a hill, 10 heads appeared. It was a tense moment and my weapon was several yards away.” To his relief, Cosby found that the visitors were friendly: “The heads belonged to Peshmergas [Kurdish allies of the U.S.] who were all fit as buttons and carrying weapons pointing downward”—a sign of peace. Identifying threats in the field is a challenge, Cosby says. “Kurds don’t wear uniforms as we think of them and they don’t wear nametags.”

Cosby is now semiretired, but he’s still involved with the Army as a reserve officer. He also volunteers his time and medical skills at Birmingham’s M-POWER Health Clinic, which treats patients without medical insurance or the resources to pay for care. For Cosby, “the best thing about M-POWER is that it’s truly a Christian ministry,” he says. “The management actually encourages physicians to take spiritual histories of patients and pray with them. It’s a type of holistic medicine I appreciate.”

 

Adventure on the High Seas

Rodney Samaan
Rodney Samaan, right, was able to combine his love of travel with his job when Carnival Cruise Lines invited him to fill in as an on-board physician.

For years, Rodney Samaan, M.D., M.P.H., dreamed of combining travel and health care. But even in his wildest globetrotting fantasies, this School of Public Health alumnus (class of 1998) didn’t imagine that he would practice medicine while sailing the seas—until Carnival Cruise Lines contacted him with an irresistible offer: Their full-time physicians were attending an annual conference, and they needed some part-time help to fill the void. He happily accepted. “The ship I was assigned to set sail from San Juan and cruised the western Caribbean, stopping in places like Saint Lucia, Dominica, Saint Thomas, Antigua, and Barbados,” Samaan says. “There was another physician from San Francisco onboard, and we had a staff of three nurses.”

In addition to caring for passengers, Samaan and his colleague also were the primary-care physicians for the ship’s crew, who hailed from all over the world and had a wide range of medical problems. “This made creating a differential diagnosis challenging, since you had to consider where crew members grew up as part of the possible etiology for their illnesses,” he explains.

The medical care for passenger patients, on the other hand, was pretty straightforward, Samaan says. The two doctors alternated clinic days and saw an average of 10 to 15 patients during their seven-hour shifts. “The nurses also saw many patients independently and could make routine treatment decisions on their own,” he notes. “This was a much more liberal policy than you see in the United States. But I must admit that it was a model I can appreciate, considering how busy physicians are.” It is also a model that is “likely to be adopted in the future U.S. health-care system, with the shortage of physicians and the increase in people with insurance plans,” Samaan says.

Despite the relatively leisurely nature of the cruise, there were a few harrowing experiences. At one point, Samaan thought a passenger might have to be airlifted to Puerto Rico via a Coast Guard seaplane. “This possibility worried me because the family didn’t purchase travel insurance and would have been financially responsible for the required $8,000 Coast Guard travel fee. Fortunately, her symptoms had alleviated by the following day and she was fine.”

Samaan says he had a great time as a “Love Boat” doc—he even took a follow-up cruise and was able to invite one of his friends, an emergency room physician from New York, along as the second doctor. Samaan hopes to be back on the high seas again soon, although he says it is challenging to find time to get away from his day job during his allotted vacation time. He has been researching opportunities for physicians aboard other cruise lines, and has found a number of intriguing options—“even one that sails to Antarctica.”

 

Ringside Doc

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Patty Yoffe was named Ringside Physician of the Year by the American Association of Professional Ringside Physicians in 2008 after nearly 30 years providing medical care to boxers in the Boston area.

Providing medical care to boxers part-time wasn’t on Patty Yoffe’s to-do list when she graduated from the UAB School of Medicine in 1981. But when you marry a die-hard boxing fan and coach, such an opportunity becomes much more likely. Yoffe, who also holds undergraduate degrees in biology and physical therapy from UAB, did her residency at Cambridge Hospital in Boston. It was in Beantown that she met her husband, Doug; one day, when the regular doctor couldn’t make it to the ring, Doug Yoffe volunteered his wife for the job. From then on she was hooked, so to speak.

The Yoffes are veteran members of the Massachusetts fight scene. Doug Yoffe coaches the Harvard Boxing Club and himself competes in the sport’s over-35 Master’s division. Patty Yoffe, a primary-care physician and internist with the Harvard Vanguard medical group who also teaches at Harvard University’s medical school, has spent the past two decades monitoring fights as a ringside physician for amateur and professional boxing matches and mixed martial arts bouts around the state.

Yoffe says she is now a true boxing fan, especially of the young fighters she has seen rise through the amateur ranks. “I’ve been watching some of these kids since they were eight years old and now some of them are professional fighters,” she says. “I can appreciate a good boxing match—when people know what they’re doing. In a good boxing match you don’t get hurt because you have acquired the skills to prevent that.”

Boxers with serious injuries go directly to the hospital, Yoffe says. “What you worry about is head injuries, but there are also dislocated shoulders and lots of lacerations.” In mixed martial arts bouts, “you have a lot more knee and joint injuries,” she says.

There is no denying that boxing is a risky sport, Yoffe says. “Many doctors don’t approve of it, but I take the outlook that I’m there to keep boxing safe. Any sport where you’re trying to knock the other guy unconscious is dangerous. But football and some other sports are also dangerous; I try to minimize the risks.”

Yoffe has officiated several world title bouts in Massachusetts—and even gained some brief notoriety at a 1997 junior welterweight championship. “[Boston boxing legend] Micky Ward was going for a world title and I stopped the fight,” she says. “It was a problem; it was a televised fight, but Micky had an eye injury and I thought the fight needed to be stopped.” In 2008, Yoffe was named Ringside Physician of the Year by the American Association of Professional Ringside Physicians.

The boxing community is very colorful, and so are the physicians who treat boxers, Yoffe adds. “There are surgeons and quite a few emergency medicine doctors, but I’ve also seen psychiatrists, urologists, and gynecologists—whoever is interested in sports.” She has met many characters in and out of the ring—which is “definitely different than the academic setting”—but boxing will always remain a sideline, Yoffe says. “I don’t consider it my profession, just a hobby that I share with my husband.”