Hooked on Rheum with Brett Smith, DO
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As a kid, I would always say, “When I grow up, I’m going to be a doctor.”
Why? Who knows? Maybe it was trendy on TV or I heard it somewhere else, but it stuck for more than a decade and then came to fruition.
When I entered medical school, I intended to pursue a surgical career, but I altered this path as a fourth-year medical student, desiring more cognitive than procedural aspects in my career. During internal medicine residency, I had the intention of specializing in cardiology to combine the cognitive and procedural aspects.
As a second-year medical resident, on an elective rotation, I encountered the field of rheumatology, which immediately shifted my career goals for a variety of reasons.
First was the depth of medicine I was able to practice — rheumatologists treat nearly every organ system of unique conditions.
The second reason was the patients. The patients were extraordinarily grateful for the diagnostic skills of rheumatologists and the available therapeutics.
My mom is an example of this — she carries a diagnosis of psoriasis and psoriatic arthritis that is now controlled with a TNF inhibitor. For years while on methotrexate, she complained about neck pain after playing basketball with me as a kid. Then, poof! The introduction of a TNF inhibitor evaporated her psoriasis and axial psoriatic arthritis.
In addition to these events, I had a number of important mentors as a medicine resident who were able to plant the seed of interest in rheumatology and allow it to flourish. Two of those mentors were Leslie J. Crofford, MD, and Kristine M. Lohr, MD.
From my experiences as a resident and from the influence of Drs. Crofford and Lohr, my interest in rheumatology grew over time. It has been solidified by continued engagement with the people — the patients, the staff and other physicians.
Most things in life are multifactorial and, for me, the choice to enter rheumatology was no different. Today, I manage an adult and pediatric rheumatology clinic and have never looked back.
Brett Smith, DO
Tennessee Direct Rheumatology
East Tennessee Children's Hospital