THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Tuesday, August 27, 1996 TAG: 9608261199
SECTION: DAILY BREAK PAGE: E1 EDITION: FINAL
SOURCE: BY DEBRA GORDON, STAFF WRITER
LENGTH: 223 lines
It is a battered black leather bag, its handles worn down to metal, its zipper ripped. A small card in the plastic window holds a name, faded and barely legible - Dr. William Fink.
When this bag was new, kids died of diphtheria and polio. Babies born eight weeks early were called stillborn, not premature. Disposable diapers didn't exist, new moms spent 10 days in the hospital after giving birth, and the danger of too much television wasn't an issue - no one had TV sets.
It was 1946. Returning veterans and their wives were busy making up for lost years. The result: the baby boom.
There was no better time to start a career as a pediatrician.
In a small back room of a Wards Corner pharmacy, Herbert William Fink, just 30 years old and still living at home with his parents, began a solo pediatric practice.
He saw his young patients between 11 a.m. and 1 p.m. - after the geriatric doctor finished with his elderly patients, and before the general practitioner took over the makeshift clinic.
An office visit was $3, a house call $5, and everyone paid in cash.
Destitute families paid in coins and crumpled dollar bills - if they paid at all. There was no health insurance or Medicaid.
Half a century later, the practice Fink began is one of the largest pediatric groups in Virginia, with three offices, 10 doctors and more than 25,000 active patients. Two of doctors in the practice are his sons, Robert and Fred. But the medicine they practice today looks far different than it did when their father started out.
Vaccines have eradicated most childhood illnesses. Even chicken pox is now preventable. Medical records are computerized, most people have health insurance and a procedure that once required a three-week hospital stay is now likely to be done in the doctor's examining room.
But some things remain the same.
Dr. H. William Fink, now 80 years old and one of the country's oldest practicing pediatricians, still spends his days diagnosing strep throat, comforting worried new mothers and soothing crying babies.
Adam Christopher Williams, exactly one-week-old, is not happy. He screws up his tiny face, takes a deep breath and lets loose with a wail.
His mother flinches. ``He's hungry,'' she says apologetically to Fink.
But the cries don't faze Fink. He tunes out screaming babies like a traffic cop tunes out blaring horns.
He gently turns the infant over, puts his stethoscope on the baby's back and listens.
By now, the baby is howling. Still, Fink continues his slow, methodical exam.
``You know,'' he finally says in a quiet voice. ``It's good he's crying. It helps me hear his breathing better.''
He is unflappable.
At an age when most doctors have long since retired, whether because of age or frustration with the sea of changes that have hit medicine, Fink has persevered.
``He's like the EverReady bunny,'' said Betti Prentice, executive director of the Virginia chapter of the American Academy of Pediatrics. ``He just keeps going and going and going.''
The stories of Fink's dedication are legion. There are the cerebral palsy patients - most of them adults now - that he started treating when they were kids and still cares for.
The boy with a deadly bacterial infection whom he carried to the hospital in his own car.
He used to open his office early to care for an extremely overweight, disabled child, so the boy wasn't exposed to the stares of other children in the waiting room.
Fink's dedication is not confined to his medical practice. This spring, he worked to get a law passed in Virginia that requires insurance companies cover longer hospital stays for mothers and their newborns. If there's a law related to children's health, say his sons, then their father is involved with it.
Last year, in honor of his medical and legislative work over the past half-century, the pediatric academy's Virginia chapter honored Fink with its first-ever lifetime achievement award.
``He is just wonderful, wonderful, wonderful,'' Prentice says. ``Whenever there's a job to be done, he's there to do it.''
He does it with the energy of a doctor just out of med school. He still takes the stairs to the second-floor pediatric clinic at DePaul Medical Center, where he spends weekday mornings treating Medicaid patients and supervising medical residents.
Afternoons are for his private practice kids - some the grandchildren of his original patients. In 50 years of practice, he's missed only one day because of illness.
His only concession to time came this July. He finally resigned as CEO of the practice, passing the mantle to his son, Robert, who joined him in 1983.
It was time, the elder Fink said, that someone else knew what it took to run the practice.
His routine extends to the evening: Early dinner at home with his artist wife of 48 years, Lorraine, then a five-minute nap in his easy chair before settling in for an evening of work at the cluttered desk in the couple's Wards Corner home.
Physically, say his sons, their father is in incredible shape. Up every morning at 5:30, he swims three miles in the summer, jogs in the winter, ear phones clamped to his head as he listens to half-hour medical tapes.
Wednesday and Saturday afternoons are for golf - he walks the 18 holes. Sunday mornings find him on the tennis court.
It's a regimen he's followed for most of his life, broken only by vacations - and the times one of his five children had to call him off the golf course to stitch a split chin garnered in a pick-up football game.
Every few months, he and Lorraine take a trip.
No cushy cruises for them, however. Two years ago, they explored the jungles of New Guinea. Next on the list is Turkey, or Greece.
Fink's philosophy of life was set early on, when an older practitioner told him about the trips he planned after his retirement.
Six months after retiring, the older doctor was dead. Fink vowed never to put things off.
``He's just such a great role model,'' says Robert Fink. ``How could you pick anything else to do if you could follow in the footsteps of someone who had worked for 50 years, wants to work for another 50 years, and enjoys so much on a day-to-day basis - his work, his family, his vacations. I don't know anything he doesn't enjoy.''
A mastoid operation when he was 11 introduced William Fink to the world of medicine and convinced him that he wanted to be a doctor. But it was a baseball game and an empty savings account that propelled him into the still-new field of pediatrics in 1940.
He'd finished his internship in Boston and been offered an allergy residency in Wisconsin. But the hospital there expected him to pay his own way west - something he couldn't afford on an intern's $10-a-month salary.
Then, while at a baseball game at Fenway Park, he bumped into a friend who told him about an opening in the pediatric residency program at a Boston hospital. No travel required.
The early years of his practice were the days of the house call. Fink's home phone started ringing at 7:30 a.m. with anxious parents. He'd visit as many children as he could before office hours, then finish up in the evening.
He traveled with a spotlight mounted to the side of his car so he could read addresses. Those visits often took him to the slums of Norfolk, where children ran naked in the streets in summer and the World War I-era cinderblock apartments lacked heat and running water.
He carried a metal can of ether in his bag, in case a child had convulsions. The practice in those days was to pop the can and put a drop over the child's nose. The child would stop breathing temporarily, but also stop convulsing.
Then there was the worst house call of all. His own.
Just a few years after starting his practice, Fink came home from a meeting in California to find his six-month-old daughter extremely pale. He did a blood count, finding it frighteningly low. The diagnosis: leukemia.
Today, childhood leukemia has a 90 percent-or-better cure rate. But in those days, it was a death sentence.
Three months later, his daughter died.
``It was a blow,'' Fink says with typical restraint. ``But you have to steel yourself to the fact that this is something that happened.''
By 2:30 p.m. in the cramped Norfolk offices of Pediatric Specialists, Inc., Fink's practice, the office is rocking. A baby is screaming behind an examining room door, an 8-year-old is trying to read an eye chart posted in the hall, phones are ringing, nurses are scurrying.
But William Fink calmly exits the exam room, plucks a piece of yellow paper with the number ``7'' written on it from the door handle, and, oblivious to the pandemonium, heads toward examining room 7.
Inside is 18-year-old John Marroni of Norfolk. He's been a Fink patient since he was born. Now taller than the slight, wiry Fink, he needs a hepatitis shot and his acne checked.
After examining Marroni, Fink punches a button on the phone and calls over the intercom for a nurse to give Marroni his shot.
Certain benefits have come with age. Fink is the only member of the practice who uses the old intercom system. The nurses tape the number of the room he should go to next on the door of the exam room he's in. He gets to write out his notes, instead of dictating. Best of all, he doesn't have to take night or weekend calls.
But it hasn't allowed him to escape the relentless changes that have overtaken medicine in the past decade. Managed care. HMOs. Shorter hospital stays.
``He's embraced it kicking and screaming, but he's embraced it,'' says Regenia Regambal, who has managed the Fink practice since 1987. She is now executive director of Children's Medical Group, which owns the Fink practice and several other pediatric groups.
``It bothers him because of how the practice of medicine has changed,'' says Robert Fink. ``But it hasn't affected him one iota in how he treats patients.''
In addition to Robert and Fred, a third son, Edward, also chose medicine. He is an orthopedic surgeon in Boston and has completed a fellowship in pediatric orthopedics.
A fourth son, Andrew, is a local architect, and Joni Borshtein, the lone Fink female sibling, is a health-care consultant in Boston.
Their father never pushed them into pediatrics, say Robert and Fred Fink. In fact, he tried to talk Fred out of it.
Practicing with his father has its minefields, admits Dr. Robert.``I have to be careful, if I see a patient and disagree with what they're doing, not to say, `who told you to do this?' ''
The elder Fink constantly challenges his sons, Fred says. For instance, he'll call one of them in to ``take a look at this rash.''
``I'll look at it, give him my opinion, he'll just nod and go back into the exam room. And I'm not sure if he needs my help with a diagnosis, or he's just testing me to see if I know what it is.''
It's been an uncomfortable summer for the modest, reticent Bill Fink. A summer of parties and special recognition. Of plaques and interviews.
Told the American Academy of Pediatrics wants to write an article about him, he asks: ``Is that really necessary?''
Yes, say his sons. It is. Fifty years is an amazing achievement, they tell him.
But to Bill Fink, 50 years is nothing special. Another 50 wouldn't be bad.
There's no point in retiring, he says. ``It wouldn't improve my golf game.''
His sons think there's another reason.
``He said he would practice until we got it right,'' says Robert, looking over at his brother Fred. ``And he's still here.'' ILLUSTRATION: Color photos
CANDICE C. CUSIC/The Virginian-Pilot
TOP: Jessica Casey, 5, sits still as Dr. Fink examines her.
ABOVE: The doctor chats with brothers, left, Justin Freeman, 11, and
Brandon, 9.
LEFT: Dr. Fink examines Brandon Williamson, 7.
Photo
LORRAINE FINK
Two years ago, Dr. H. William Fink and his wife Lorraine explored
the jungles of New Guinea. The Finks take a trip every few months.
When an acquiantance died six months after retirement, Dr. Fink
vowed never to put anything off.
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