From Yale to Africa, an alumna finds her niche

A decade after her graduation, Rachel Bronzan studies malaria in Malawi.

On a typical morning in Malawi’s rainy season, which runs from November to May and brings mosquitoes out in force, Rachel N. Bronzan, M.D. ’95, M.P.H., sees patients with severe malaria. “It’s sort of a perverse lottery jackpot,” said Bronzan of the ward she works on at Queen Elizabeth Central Hospital in the city of Blantyre. “We can provide better care because we have fewer patients, but you have to be very, very sick to come to our ward.”

In the dry season, Bronzan puts on her public health hat—she works for the Centers for Disease Control and Prevention (CDC) on epidemiological studies and disease monitoring for Malawi’s National Malaria Control Program.

It is in Malawi that Bronzan has combined her love of Africa with an interest in science and a desire to use medicine to help others. Malawi, in southeastern Africa, has been her home since 2002, but Bronzan’s interest in Africa started long before. “When I was young I was always taken with the idea of Africa—its natural beauty, diverse indigenous cultures, exotic wildlife and vast expanses of land and sky,” she said.

She first traveled to Africa in 1991 as a Downs fellow studying HIV in Senegal. During her fourth year at Yale she went to Kenya for a clinical rotation and worked at a malaria research post. Now Bronzan lives in Blantyre, the commercial and industrial center of Malawi, a landlocked country of 94,000 square kilometers of rolling plains with meandering rivers, vibrant green tea plantations and peaked highlands bounded by Mozambique, Zambia and Tanzania.

Bronzan’s foray into medicine seems natural when you understand her beginnings. Her father, a theoretical particle physicist, taught at Rutgers, and her mother, a clinical social worker, counseled psychiatric inpatients. She absorbed her father’s methodical, logical approach to problem solving and her mother’s nurturance and respect for others. Growing up with a younger brother only a half-mile from their maternal grandparents, she was also inspired by her grandfather, a physicist who worked on the development of color television at RCA. In his basement workshop they blew glass, built and detonated small cannons using compressed gas to fire bits of pencils and erasers, and created electromagnetic fields with wire coils (like an MRI) in which Bronzan’s grandfather tested the effect on his vision.

In 1990, after graduating from Stanford with a degree in chemistry and working in an infectious disease lab, Bronzan began medical school. By her fourth year she still felt the lure of research, but during her travels in Kenya she saw the rewards of treating patients. “I was impressed by the great impact that the family physicians made, with broad training and simple interventions skillfully applied in a resource-poor setting. I realized that if I were to practice medicine I would most likely do it in a setting like that, where basic need is high,” she said. She spent a fifth year at Yale, during which she got an M.P.H. at Harvard, and in 1995 began a residency in California at the Community Hospital of Santa Rosa.

After working at hospitals in the Bay Area, Bronzan applied to the CDC’s Epidemic Intelligence Service (EIS), which provides on-the-job training in epidemiology. While waiting for her first posting, she traveled to Malawi to care for seriously ill children at Queen Elizabeth Central Hospital with Terrie Taylor, D.O., a professor of internal medicine at Michigan State University. For six months she received housing and a $100 weekly stipend. “I thought this was a fantastic offer, although some of my friends wondered why I would be so happy about such a dramatic salary cut,” she said.

In July 2000 Bronzan started her job at EIS, which over the next two years took her to Mali, Kazakhstan, South Africa and Florida for work in infectious diseases.

Now, along with her malaria research, Bronzan works as a part-time clinician-researcher for Taylor. “What is unique about my position is that it allows me the opportunity to do clinical care of severely ill children, clinically related research, as well as field surveys and public health-related projects,” said Bronzan.

Her epidemiological studies and program planning could affect malaria control in Africa and abroad, but she finds that caring for children afflicted with malaria is her true reward. “Although mortality is high—between 15 and 20 percent of comatose children die—those who survive tend to recover quite quickly, and the majority of them do not have long-term neurological or developmental problems. They come to the hospital in a severe coma and can walk home in as little as two or three days. That in itself is really exciting.”

—Kara Nyberg

A pediatrician who treated not just the children, but the whole family

As a research fellow at Yale in 1948, Morris A. Wessel, M.D. ’43, joined in the landmark “rooming-in” study by the late clinical professor Edith B. Jackson, M.D., which examined how keeping newborns in their mothers’ hospital rooms affected families. His participation in the study also helped Wessel decide what kind of pediatrician he wanted to be.

His role in the study was to interview parents during pregnancy. Mothers- and fathers-to-be often burst into tears as they recounted traumatic childhood incidents such as the death of a parent. “Is there any way that we as pediatricians could support families during a crisis like that?” he asked himself.

Jackson and Grover F. Powers, M.D., who headed Yale’s pediatric department in Wessel’s student days, also led him to a broader notion of his role as a pediatrician. “Anything that affects the child’s welfare is within the realm of the pediatrician’s responsibility,” Powers said. After graduating from the School of Medicine, Wessel worked at the Mayo Clinic under Benjamin M. Spock, M.D., Med ’29, whom Wessel considered a mentor throughout his career. Wessel’s training was informed by his own childhood experience. The loss of his father when he was only 11 months old and his own “various sicknesses and unhappinesses as a child” convinced him that young people needed friends and advocates whose commitment did not stop at the office door.

He found a like-minded partner in another young pediatrician, Robert G. LaCamera, M.D., FW ’56, and in 1951 started a practice marked by extraordinary involvement in the lives of families and by a commitment to improve the community.

“They were always late,” laughed Donna Sandillo, R.N., their longtime practice manager. They were late because they made house calls and dashed across the street to the hospital—the office was on Howard Avenue—when one of their patients was in trouble.

“People waited for them,” she said. “They understood.”

The doctors encouraged parents to call when they faced any major challenge—medical or not. Families appreciated touches like handwritten notes on the anniversary of a death and calls to check on teens adjusting to college. New Haven is a city of rich and poor families, and the practice saw both. They accepted homemade pies as payment for an office visit.

Wessel spread his philosophy as a clinical professor at Yale and through his writings. In 1963, he published “Why Can’t Mothers Stay in Hospital With Their Children?” in Redbook. Mothers across the country waved the magazine in hospital admitting offices demanding, “Where’s my bed? Dr. Wessel says I should stay!”

“I was not very popular,” he said, ducking his head to hide a grin.

Together with Anthony Dominski, Ph.D., a scientist from the School of Forestry & Environmental Studies, he investigated lead levels in children in the 1970s and recommended a level then thought to be unrealistically low. Eventually the American Academy of Pediatrics recommended an even lower level.

With former Yale School of Nursing Dean Florence S. Wald, R.N., he studied the treatment of terminally ill patients, which Wald believed was often futile and dehumanizing. Wald told Wessel his role would be to help her understand doctors’ thinking. “I can’t explain why doctors do what they do,” he told her. But he agreed to help. Their work led to the opening of the nation’s first hospice, in Connecticut, in 1974.

There he observed that friends and family were quick to comfort a surviving spouse. “Nobody paid attention to the children,” he said. Wessel now writes about childhood grief and has worked in schools, dealing with everything from the loss of a beloved teacher to the loss of the class guinea pig.

Wessel retired in 1993, as did LaCamera three years later. Their New Haven practice moved to the suburbs, though their successors were adamant about being on a bus line so that inner-city patients would have access. Wessel works two days a week at the Clifford W. Beers Child Guidance Clinic in New Haven.

Wessel’s daughter, Lois A. Wessel, R.N., M.S., a nurse practitioner working with underserved patients, said that both her father and mother, Irmgard Wessel, M.S.W., influenced her career. They “went out on a limb to help people have better lives,” by addressing issues, such as housing, that are not usually the province of a physician. But her parents were not grim saints. “They clearly enjoyed what they did and were very committed to it,” she said. As she accompanied them around the city, she saw patients and clients light up. “They were loved and liked and respected.” Upon his retirement, hundreds of people gathered in New Haven’s Edgerton Park for “Morris Wessel Day.”

With HMOs mandating shorter visits and with greater technical expertise expected of physicians, Wessel worries that pediatricians are discouraged from knowing their patients as deeply as he did. “There was something about our practice that was unique,” he said. “But it should not be unique at all.”

—Colleen Shaddox

Tap dancing through medicine, from surgeon to song-and-dance man

While a medical student at Yale, Brock Lynch, M.D. ’47, sang and tap danced in a hospital fund-raising play. He remembers thinking, “Should I be in show business or medicine?” But even though he’d started tap dancing when he was 8, Lynch wasn’t serious about changing careers. After World War II Navy service, he resumed his medical career and decided that someday he would return to the stage.

And he has. Since he retired in 1995 from practicing general medicine at the Northampton VA Medical Center in Leeds, Mass., he has been part of Young@Heart Chorus, a Massachusetts performing troupe, in which the average age is 80. Other men and women who sing in the group were engineers, insurance executives, building contractors and teachers in their younger days. Rather than croon Cole Porter songs or others of the same vintage, the 73- to 91-year-olds sing tunes from the Rolling Stones, Bruce Springsteen, U2, the Beatles, Jimi Hendrix, Led Zeppelin and the Clash—the same loud music that they once told their children to turn down.

In the last seven years, the 22-member group has toured Europe 10 times and visited Hawaii and Australia. Lynch sings tenor and dances, although there’s not much demand for tap when you’ve got an electric guitar and professional drum set. Young@Heart plays to sold-out audiences in Europe; in 2001, the King and Queen of Norway gave them a standing ovation.

Because of their age, choice of music and humorous and whimsical performances, last June they were written up in Time magazine. The group disco dances to the Bee Gees’ “Staying Alive,” and Lynch is one of three soloists in “Once in a Lifetime,” originally sung by the Talking Heads.

When they go abroad once a year, for a week or two, Young@Heart members face a grueling schedule, usually one performance each night over four nights. This fall, they traveled to London for two weeks, where the group performed 12 straight shows, including a matinee and evening event on a Saturday. These performances come after long plane rides and jet lag. (They always travel with three wheelchairs just in case.) The group pays tribute to each country it visits, so it may learn a song in Dutch while in Antwerp or perform Olivia Newton-John’s “Let’s Get Physical” in Australia.

Back in Northampton, there are weekly rehearsals, sometimes more, where Lynch and fellow members stand for two hours straight. That’s a feat for anyone, but particularly for septuagenarians, octogenarians and nonagenarians whose collective conditions include arthritis, heart disease, macular degeneration, hip replacements, high blood pressure and cancer. (There are chairs at the back of the stage for anyone who gets tired.) Lynch, who jogs three times a week for 10 minutes, doesn’t complain about the pace, however. “Young@Heart puts a schedule into my life,” said the 81-year-old, “and without it I’d be in a rocking chair.”

These days, the only rocking Lynch does is on the dance floor. But that’s nothing new. Everywhere he studied or practiced medicine, he would tap dance and sing in charity hospital shows. After his New Haven theatrical debut, Lynch performed during a surgical internship at the University of Cleveland Hospital and his residency at Malden Hospital in his hometown of Malden, Mass., and at New England Medical Center and St. Elizabeth’s Hospital in Boston. He tapped his way through Mitchell Air Force Base on Long Island while he was chief of surgery and also when he became a teaching fellow at Memorial Sloan-Kettering Cancer Center.

Then there was more performing while in private practice with his father in Malden for 18 years, followed by more dancing and singing when Lynch moved his work life in 1975 to the Veterans Administration hospital near Northampton as a general practitioner. During the 20 years he practiced there, his surgical skills were frequently requested in the emergency room, leading to the saying, “In a Pinch, Call Lynch.”

Within a month of retiring from his VA post in 1995, the self-taught tenor auditioned for Young@Heart. He danced and sang his way through “Button Up Your Overcoat” and “You’re the Cream in My Coffee”—a far cry from the rock and roll he would churn out as a group member. “In show business, when you audition, the director always asks what your talent is,” said Lynch. “In my case I said, ‘For you, I’m a singer who dances, but if you ask me what I really am, I’m a dancer who sings.’ ”

He is also a doctor who dances and sings.

—Sally Abrahms


			Originally published in Yale Medicine, Autumn 2005. Copyright © 2005 Yale University School of Medicine. All rights reserved.