Close call with dad inspires doctor's book on stroke care
When Elizabeth Pegg Frates heard a loud thud come from her bathroom that day six years ago, curiosity quickly turned to trepidation. She heard her 66-year-old father, who had gone to wash his hands before holding his new grandson, yell out, ``I can't move my foot."
Donald Pegg, had suffered a heart attack and a stroke 13 years before, but the possibility of another stroke hadn't occurred to him. Frates knew better. At the time, she was a physician at Spaulding Rehabilitation Hospital finishing her last year of residency.
``Can you move your leg? Where are you? Squeeze my hand. Who is the president? What's your name?" Frates asked her father as he lay on the bathroom floor.
Frates deduced that indeed her father was suffering another stroke, this time the type that blocked the blood supply to the region of the brain that controls the lower limbs.
Had Frates not been there, her father might have shrugged it off as a foot cramp or a pulled muscle. The stroke turned out to have been fairly limited, but if it had been caused by bleeding in the brain and not a blockage, he could have wound up in a coma.
Pegg, now 73 and still active as a financial consultant in New York, is not alone in missing the clues that could have alerted him to the stroke.
``The man is intelligent and very well educated," Frates said of her father, who attended Yale University and the Columbia School of Business. ``When he didn't recognize the signs, I knew I had to do something about it."
His close call prompted Frates to help write ``Life After Stroke: The Guide to Recovering Your Health and Preventing Another Stroke," part of a health series published by Johns Hopkins Press.
The book explains the importance of understanding the differences among strokes, and offers advice on treatment, rehabilitation, and lifestyle changes that will help prevent a reoccurrence. In the first year after a stroke, victims stand a 15 percent chance of suffering another one.
``With a stroke, time is neurons -- every minute counts," she said, with brain cells lost to any delay in treatment. Some stroke patients can benefit from a clot-busting drug known as tPA (or tissue plasminogen activator) if it is administered within three hours of the onset of symptoms.
Frates, 38, of Wellesley, a clinical instructor in the department of physical medicine and rehabilitation at Harvard Medical School, is a coauthor of ``Life after Stroke" with doctors Joel Stein of Sharon and Julie Silver of Northborough.
Frates says it was only natural that the three collaborated on the book, with Stein one of her mentors at Spaulding, where he is chief medical officer, and at Harvard Medical's physical medicine department, where he is an associate professor. And Frates also trained under Silver, an assistant professor in the Harvard department and medical director at the Spaulding-Framingham Outpatient Center.
Silver, too, has a personal connection to her work.
``Paralysis and disability were things I saw at home and were part of my childhood," she said, with both her father and his father contracting polio. From an early age, Silver said, she learned to see beyond people's physical capabilities.
``I was drawn to helping people function at the highest possible level, because I knew that it mattered in my own family," said Silver, the author of a number of medical books for lay people.
The three colleagues specialize in physical medicine, or physiatry, focusing on trauma to the central nervous and musculoskeletal systems such as that caused by spinal cord injuries, brain injury, amputation, or stroke.
In an effort to spread stroke awareness, Frates has also taken to the street. Last month she ran the Vermont Half Marathon as part of American Stroke Association's ``Train to End Stroke" team. She completed the 13.1 miles in two hours, raising nearly $5,500.
Cheering her on were her two sons, John, 6, and Peter, 4, and her husband, Jim Frates, an executive with
Pegg Frates, who was raised in Scarsdale, N.Y., said she had figured on a career in money, not medicine.
``I felt it was my destiny to be the third generation to take over the family business," she said. ``I always admired my dad , and I'd wanted to go to business school and follow in his footsteps."
During her first week at Harvard, her father had a heart attack. Three days later, his first stroke.
``We'd never even been to a hospital before," said Frates, recalling the day she arrived with her brother. ``We saw my father, who was the pillar of strength -- even beating me in tennis just the week before -- lying in the hospital bed connected to all sorts of machines and tubes."
Frates said the pivotal moment in her career choice came when the family sat down with a physician who explained what had happened, what to expect, and how they as family members could help.
``I was in charge of my father's therapeutic ball to help his hand increase strength," Frates said. ``We had little jobs that we could focus on to help him, which is so important when you feel so helpless."
The doctor's patience and encouraging bedside manner left a lasting impression, she said. Driving back to college that week, she remembers saying to herself: ``That's the kind of work I want to do. That's the kind of healing I want to be involved in. This is what I was meant to do."
A QUESTION OF SKILLS: ``Jeopardy!" may be a game of intellect, but David Rozenson points out it takes athletic skill as well.
``Part of the game is knowing the answers to questions; the other is the ability to ring in faster than the other two contestants," the Newton resident said, laughing. ``There is a bit of a whack-a-mole element involved."
If contestants ring in too late, they miss out on first crack at the answer -- too soon and they are locked out for a fraction of a second.
Rozenson, 51, said his problem was not being quick enough to the buzzer -- at least to take first place in last month's Tournament of Champions for the popular TV quiz show. But he did win three games and returned home with $76,000, a chunk of which he donated to the pediatric psychopharmacology department at Mass. General Hospital.
While Rozenson said he's not a die-hard "Jeopardy!" fan, he admits to watching the show if it pops up when he channel -surfs.
``I would wind up screaming the answers to the television and yelling, `I can do that!' to who m ever was in earshot," he said.
Alerted by a friend to a contestant search in Boston, Rozenson took the wide-ranging written test. ``Out of the 80 people in the room, only five of us passed," he said.
Four months later, he was called to go out to Culver City, Calif., where a Jeopardy van picked him up and took him to a hotel that had ``a special `Jeopardy rate.' " As all third -place contestants are allotted $1,000, they at least make enough to cover hotel and air fare.
Rozenson said most of the people at the hotel were contestants, as five shows are taped a day and at least 15 ``extras" are needed.
``As I was going through the lobby , people were eyeing each other wondering if an opponent was walking by," he recalled.
On his first day at the studio, the only categories Rozenson was able to choose between were fruits and vegetables, since he spent the afternoon by the buffet table and filling out forms and going over rules.
The next day, though, was show time.
``There's that first moment when you come out on set , and it's like visiting hallowed ground," he said, ``but that fades very quickly."
A few hundred people -- many from elementary school groups -- sat in the studio audience. ``I don't know if it's quite as edifying as going to the zoo or the natural history museum, but they seemed to be having fun," he said.
The toughest category for him: California Missions. The only one he knew was Capistrano. On the same board was Architecture, which he breezed right through.
``I tended to bet big. In some cases I looked at a category and felt if I didn't know the answer I didn't deserve to win."
Rozensen, who said he's naturally curious, has researched modern art, the history of baseball, geography, and history.
``To give you a sense of the magnitude of my nerdiness, when I was in grade school I would take a volume of the Britannica encyclopedia at random and look through it just for fun."
He was also one of those kids who knew the answers to obscure questions in class, causing others to roll their eyes. ``I might as well have branded my forehead with the word `OUTCAST' " he joked.
Looking back, he recalled with respectful envy the star athletes with strong grade-point averages. ``Those were the people I really hated," he said, laughing. ``I admire someone like Bill Bradley , who is a Rhodes scholar and an NBA all-star."
Having the ability to store information comes in handy for his job as a lawyer for
Born in Tel Aviv, he moved with his family to Queens, N.Y., when he was 3. His father was in the diamond business. Ten years later, they moved back to Israel , but by then, Rozenson said, he felt more American than Israeli. After high school and his obligation to the Israeli Army, he returned to the United States, majored in history at Brown University , and attended law school at Boston College.
If he had his druthers, he said, he'd have critic Roger Ebert's job and watch movies all day. And when movied out, he'd write jokes. He's already sent some to ``Late Night with Conan O'Brien."
``For a few months I faxed them jokes every day," Rozenson said. ``If money was no object , I'd spend my time writing jokes and not care that they only used one out of a thousand."
AROUND THE TOWNS: Robert Ernst of Needham was named 2005 Remodeler of the Year by the Builders Association of Greater Boston. Ernst is president of FBN Construction Co. in Boston. . . . The Massachusetts Medical Society has appointed Dr. Dale Magee of Shrewsbury as its president-elect and Dr. Lee S. Perrin of Southborough as speaker of its House of Delegates.
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