Q: How did a nice Jewish boy from the Bronx end up a renowned Beverly Hills plastic surgeon?
Dr. Reiter: Originally I had not even thought of becoming a doctor. After graduating from the Bronx High School of Science, I thought I’d be a civil engineer and build bridges in Brazil, but thanks to a myriad of factors including my disinclination for advanced mechanical drawing and a much-needed scholarship to Columbia, I changed my career direction. When I was admitted to medical school, I fulfilled a Jewish mother’s dream— my son the doctor!
In my second year of general surgery training at the Mt. Sinai Medical Center in Manhattan, a fellow surgical resident in training encouraged me to look beyond the Hudson River (which does not come naturally to native New Yorkers!). With both hope and trepidation, I crossed the George Washington Bridge and headed westward. I stopped first in northern California to complete my training in head and neck and plastic and reconstructive surgery, and then traveled southward to the fabled Beverly Hills to transform into a “Beverly Hills Plastic Surgeon.”
Q: Most people think of plastic surgery as an elective cosmetic procedure, but in your practice, you have done life-saving work. Can you tell us about this little-known side of plastic surgery, and the work you have done?
Dr. Reiter: Plastic and reconstructive surgery is an ever-widening field that not only enhances beauty and, hopefully, confidence, but that also restores vital bodily functions and saves lives. My field primarily centers around structures of the head, face and neck, including both the physical appearance and the essential functions of these structures such as breathing, eyesight, hearing, and swallowing.
The first two people I encountered on my first day in training were a couple that had been assaulted and suffered fractured cheekbones. I quickly learned that vision, taste, and facial sensation are among the many bodily functions that fall under the domain of the plastic surgeon. Once, I was called to the ER to attend to a young man whose jaw was completely blown away by a gunshot. His life was saved after a twelve-hour surgery. Afterwards, in several staged procedures, I did a reconstructive procedure I proudly pioneered using the jaw of a cadaver. Years later, I led the team that reconstructed the face of Rodney King, after it had been shattered by the Los Angeles police. We restored his physical features and his vision as well as other critical functions.
Q: At one point in your life, you were simultaneously being treated for Non-Hodgkins Lymphoma, helping your wife through the various stages of her own cancer treatment, dealing with an FBI investigation, and maintaining your surgical practice. How were you able to handle this physical and emotional overload?
Dr. Reiter: My life started to fall apart in 1995 when I was diagnosed with an incurable blood cancer and given less than six years to live. I was never a gambler but I sure didn’t like the odds. The stress continued to build with Karen’s initial breast cancer diagnosis and its progression. While I always found my work to be immensely satisfying, it can’t be denied that there was a significant amount of job-related stress. I eliminated that by voluntarily closing my office, for what I intended to be a brief period, freeing me up to focus on my top priorities at that time: Karen’s well-being, and, secondarily, my own health.
I was able to cope with the emotional and physical overload by finding a support group. I got involved with the Lymphoma Leukemia Myeloma Support Group at UCLA, first as a participant, and eventually as a co-leader, which I remain to this day. By sharing that I was a long-term survivor, I was able to give hope to the newly diagnosed as well as get the support I myself needed. I was able to talk about Karen and the progression of her disease with a group of people whose compassion really touched me. I took great comfort from their telling Karen, when she first came to a meeting, “We never met you, but we all feel we really know and love you.” I no longer felt alone.
Q: In chronicling the story of your late wife’s treatment for metastatic breast cancer, you recount numerous examples of her doctors’ gross negligence that ultimately resulted in her death. Did you sue for malpractice?
Dr. Reiter: I tried. The medical negligence first started soon after Karen began chemotherapy, after the spread of the breast cancer to the liver and bones. Following a series of misdiagnoses and mistreatment over the course of four years, Karen realized that she had only months to live. She wanted to sue these so-called medical experts to prevent them from killing others. Leery of creating yet more stress in her life, I reluctantly called four highly respected malpractice attorneys, some of whom were also trained doctors. They all told me the same thing—that since her cancer had spread to the liver, she had less than a 5% chance of survival, and it would not pass the 50% survival hurdle, thus giving the doctors a full pass. The lawsuit would not be allowed by a judge to be heard in court. So much for justice.
Q: Karen’s final eight days of hospitalization in May 2003 cost a staggering $33,00. It’s been your experience that our medical system is very focused on end of life care, but that not enough attention is given those who need effective treatment for a better quality of life. What are the implications of this?
Dr. Reiter: Karen was in the hospital for the month of March 2003 for a total cost of well over $250,000. That was straight hospitalization—no OR, no ER, ICU, special tests, or sophisticated treatment measures. Since the nurses were overburdened, I paid for private duty sitters so that she could be assisted in normal activities, like going to the bathroom. Her final eight days of hospitalization in May cost $33,000 and during that time, she was in a coma on an IV drip with morphine –she was receiving no other treatment. The high cost of dying in Beverly Hills, I thought.
I have read that patients’ last two months of life cost Medicare $50 billion over the past year. Few questions are asked about these Medicare expenditures; costs that threaten to bankrupt the country. Without the ability to fully determine our own end of life care, we have little control over these costs and with technology today, physicians can prolong dying far longer than they provide quality living. The denial of death becomes a delusion and an obvious politically explosive issue—especially since millions are unable to afford basic health care.
Q: What other flaws do you see in our health care system?
Dr. Reiter: Medicine is not an exact science, despite what many people want to believe. It is essential for physicians to not only treat the disease, but to treat the patient with the disease. Unfortunately, doctors simply don’t have time to talk to their patients, to get to know them so they can prescribe the best treatment for that patient; not just for that patient’s illness. As a result, a lot of placebo medicine is practiced: for example, doctors often prescribe tests that aren’t necessary, which is not only costly, but which can also be very stressful for the patient.
Another flaw in the system that I experienced first-hand when Karen was being treated is that there is all too often a lack of communication or coordination of efforts between multiple doctors, a morass of disparate treatments, lab results, records, and the patient who stands in the middle of this bewildering mess. One morning shortly after her bilateral mastectomy, I realized that Karen was hemorrhaging into the almost empty mastectomy surgical space. (I can’t even imagine how much worse things could have become if I hadn’t been a doctor, myself.) We couldn’t track down her breast surgeon so we called the plastic surgeon who had inserted the saline bags for future breast implants. He told us to meet him at the hospital. We had to wait ten hours in a room without a bed between when Karen was admitted and when she was taken to the OR. During the ten-hour wait, I had gone repeatedly to the nurse on the ward but she was obviously annoyed by my pleas to save my wife, as were the rest of the staff and the operating room personnel. And this happened at one of the largest, best-respected private hospitals in the country!
Q: Having gotten involved on every level of your late wife’s care, you know from first-hand experience the physical, mental, and bureaucratic challenges that confront those being treated for cancer, and those who care for them. What advice do you have for cancer caregivers?
Dr. Reiter: When I first started attending support groups at UCLA as a cancer survivor, I was shocked by how many people were questioning their doctors, seeking second opinions, and doing their own research into cancer treatment. I have to admit that, as a doctor, I expected my patients to trust me, and so I couldn’t imagine second-guessing my own doctors. Then, as Karen’s own needs evolved, I soon realized the necessity for patients to be as well informed as possible, which includes seeking second opinions, and doing their own research. Being informed is a key to maneuvering the system.
A caregiver may get involved in domestic duties and/or hands-on care of the patient, including talking to the doctors and their staff. In limited doses, each of these tasks is manageable. It’s when they need to be juggled or when they increase in magnitude that challenges arise. The most important thing is for caregivers and cancer survivors alike not to become isolated. Online and in-person groups can be very helpful in connecting to others in similar circumstances, and in providing those in need not just with support but also in equipping them with essential information and resources.
Finally, there is a great deal of emotional stress involved in caregiving, and caregivers are all at risk for frustration, anxiety, exhaustion, anger, depression, and ultimately, poor physical health, which may become an influential factor in a caregiver’s decision to place an impaired relative in a long-term facility.
Q: What are your plans for the future?
Dr. Reiter: I was fortunate to be with a group of survivors at UCLA, where everyone worked toward wellness and optimal health. The group leader of the UCLA Support Team told me that by definition, “you are a survivor the first day of diagnosis.” So here I am, fifteen years later, truly a survivor. I am passionate about sharing with others my experience and knowledge as both a survivor and caregiver—it’s a unique perspective, and one that can benefit many, I believe. I continue to co-lead support groups at the UCLA and would like to broaden my reach by addressing groups nationwide.
I make it a priority to find time for activities that give me joy. I bless the day that I met Nancy, who most courageously consented to be my wife. We are finding love and happiness being together, sharing with our five cats a house that has once again been restored to warmth, passion, and love. Contact with nature and our award-winning garden has been, for the two of us, restorative and healing, and brings to mind, “to plant a garden is to believe in tomorrow.” We continue to plant, and I am pleased to report that our garden is flourishing!