“Patients Have No Citizenship”
Emergency medicine physicians teach in three countries  

Peter E. Gordon, M.D., is a man on a mission. “I look forward to the day when people who are critically ill or injured, wherever they are in the world, can be treated by physicians who are specifically trained in emergency medicine,” says Dr. Gordon, Clinical Assistant Professor of Emergency Medicine. “Every day people suffer and die needlessly because there’s such a huge vacuum in quality emergency care. It’s not a Second World or Third World problem. It’s a global issue.”

Curt Dill, M.D., Assistant Professor of Emergency Medicine (left), teaches a procedure to Cristian Boeriu, M.D. an ER physician at Mures County Hospital in Romania.

Indeed, only a handful of locales (the United States, the United Kingdom, Australia, Canada, Hong Kong, and Singapore) have residency programs in emergency medicine. But thanks to a $65,000 grant from the Open Society Institute, Dr. Gordon launched a pilot training program in Mures County, Romania, in January 2000. Thus was born the International Society for Emergency Care (ISEC), a multidisciplinary group of NYU physicians, nurses, and social workers who strive to improve the quality of emergency care throughout the world. On March 19 at the School of Medicine, ISEC cosponsored the first annual New York Symposium on International Emergency Medicine.

Dr. Gordon serves as ISEC’s President as well as Director of the Bellevue-NYU Fellowship Program in International Emergency Medicine, founded in 2000, from which ISEC evolved. About half of NYU’s residents in emergency medicine participate in the program, the largest and most extensive of its kind at any medical school in the country. So far, more than 110 residents and dozens of other NYU healthcare professionals have served in Romania or one of ISEC’s other ongoing projects in Saint Elizabeth’s Parish in Jamaica and in Mexico City.

With their travel and living expenses covered by grants from various public and private sources, teams of two senior residents and a nurse or social worker typically visit a site for one month, bringing along nothing except their life-saving know-how. Dr. Gordon emphasizes that ISEC is not about disaster relief or crisis intervention, but rather cultivating partnerships with organizations in other nations that share NYU’s goals and commitments, and then teaching their members sustainable emergency skills.

“I went to Romania for the experience of sharing my training with people halfway around the world,” says Joanna Garritano, M.D., “but what I never anticipated was the inspiration I’d gain from the dedication and determination of the people at Mures County Hospital. Even the volunteers did 24-hour tours.”

“The biggest challenge is intellectual,” adds Dr. Gordon. “It’s a great educational experience to go somewhere for a month and solve very similar problems in a very different environment. You can’t just order an MRI or reach for any medication. You have to be more creative, more flexible.”

On one of Dr. Gordon’s first days there, for example, he joined Raed Arafat, M.D., Director of Emergency Medicine at Mures County Hospital, on a Romanian-style house call. Amid a blizzard, they took a helicopter ride to a tiny snowbound village, where an elderly woman in need of dialysis required transportation to the nearest hospital. Placing her on a donkey cart to traverse the 1-mile stretch to the nearest spot where the helicopter could land safely, they soon whisked her away for treatment. “When it comes to emergency medicine,” says Dr. Arafat, “patients have no citizenship.”