Unexpected Expert

Doctor Diaries

Suddenly the dynamics of my medical practice changed. Instead of having young men in my waiting room holding cups of milky white fluid, I suddenly had hundreds of women holding urine containers.

Originally, I was a male infertility guy. After a fellowship in Urologic Endocrinology, I was hired at St. Luke's Roosevelt Hospital in New York to work with male infertility cases in the Urology Department. But as the junior member of the faculty, I took care of all the so-called "junk cases" that none of my associates wanted, and spent very little time working with male infertility problems. As it turned out, one of these cases completely changed the course of my career.

A young woman came to me one day with urinary symptoms so severe they were almost unbearable. Imagine your worst urinary tract infection and multiply the pain by one hundred, and you'll have an idea of what she was going through. She also had terrible pelvic pain, and pain with intercourse. This young woman had been looking for help for seven years, and had seen eight doctors. None had been able, or willing, to diagnose her. Some told her she was having too much sex. Some said she was having too little sex, or that her pants were too tight, or too loose. She was at her wit's end,to say the least.

When I saw her, I found myself wondering if this could be a rare disease called interstitial cystitis, which got very little attention at that time, I think in part because there were no treatments for it. It's very frustrating for physicians to be faced with a disease that they can't help. In fact, I only knew about the disease because I'd had a professor who made a point of telling us he didn't believe it existed.

But I went ahead and did the proper diagnostic tests, and it turned out that she did in fact have interstitial cystitis. And though there weren't any known treatments for the disease, I found a research protocol that was testing a drug called Elmiron, which I thought might be effective for her. Thankfully, it was. After seven years of living with these horrible symptoms, she got better, and I thought the story had ended. Then my phone started to ring off the hook.

The woman I had treated was a writer, and had written a story for Self Magazine about her seven-year search for a proper diagnosis. "It took seven years," she wrote, "to find a doctor who knew the difference between interstitial cystitis and a urinary tract infection." That doctor was me. The week after this article came out, my office was besieged by phone calls from women all over the world. Suddenly people were flying to New York to see this interstitial cystitis specialist named David Kaufman. My career changed completely, and suddenly.

I'm now considered a national expert on interstitial cystitis, and have lectured about the disease all around the country. I also sit on the National Advisory Board of the Interstitial Cystitis Association, and am closely involved in new drug treatment protocols for the disease. This one chance experience with a patient got me involved in something that I may never have been involved in, and has become one of the most rewarding aspects of my practice...particularly now that interstitial cystitis is treatable.


Dr. David Kaufman is an Assistant Professor of Clinical Urology at Columbia University's College of Physicians and Surgeons, attending in Urology at St. Luke's-Roosevelt Hospital Center, and attending in Urology at the Columbia-Presbyterian Medical Center in New York City.

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