OLSON A DOCTOR WITHOUT BORDERS
By Peggy Peck

CNN
March 15 2006

Doctor’s practice is war, epidemics, disasters
MedPage Today Managing Editor

Editor’s note: CNN.com has a business partnership with
MedPageToday.com, which provides custom health content. A medical
profile from MedPage Today appears each Tuesday.

(MedPage Today) — Dr. David Olson has had patients in a remote
region between Armenia and Azerbaijan. He has treated people in the
breakaway Georgian republic of Abkhazia near the Black Sea and in a
gulag prison hospital in Siberia. He has had patients in a northwest
Uganda town called Arua.

He has lived or worked as a doctor in London, England; Paris, France;
Chicago, Illinois; and Brooklyn, New York. He bummed around Berkeley,
California, before medical school.

Olson, 46, has been around.

So it should come as no surprise that when the Texas native graduated
from Oberlin College in Ohio, his first goal was to “do a bit of
traveling.”

These days he rides his mountain bike over the Brooklyn Bridge to work
in New York. There he serves as medical adviser to Doctors Without
Borders, the U.S. affiliate of Medecins Sans Frontières.

MSF is the Nobel Prize-winning international independent medical
humanitarian organization that delivers emergency aid to people
affected by armed conflict, epidemics, natural or manmade disasters,
or exclusion from health care in more than 70 countries.

Following in Dad’s footsteps Olson, whose father was a general
internist in Fort Worth, Texas, says he decided on a career in medicine
while he was still in his teens.

“I used to go to the hospital with my father and go to his office with
him,” he recalled. “I even worked for him for one summer doing ECGs
(electrocardiograms).”

After Oberlin, a small liberal arts college, he hit the road in a
Volkswagen convertible. He drove to Maine, then eastern Canada, and
then headed west, landing in Berkeley, where he worked at a variety
of jobs, including pizza delivery.

After a year, he started medical school at the University of Texas
Medical Branch in Galveston. From there he went to the University of
Chicago, where he did residency training in internal medicine followed
by fellowship training in pulmonary and critical care medicine.

A non-traditional career choice In the last year in Chicago, he
rejected the two obvious options for the future of a young doctor,
academic medicine or private practice.

“Neither felt right for me,” he said.

He learned about a free clinic that some medical students had started
in a church that housed a shelter for battered women. They needed a
full-fledged doctor to oversee their work, and he did that while he
was still in fellowship training.

“At about that same time I read a book, “Not All of Us Are Saints,”
by a doctor living and working in inner-city Washington. It described
what he did and he wasn’t a perfect person. That humanized this type
of work and made it accessible and attractive to me.”

When he finished his fellowship, he got a job working at a free
clinic that had a federal grant to treat tuberculosis and HIV/AIDS,
which was a good fit for a newly minted pulmonologist and critical
care specialist.

Medicine knows no borders Olson worked at the clinic for two-and-a-half
years and then went to the London School of Tropical Medicine for a
special three-month postgraduate course. When his training in London
was complete, he headed to Paris.

“I got an apartment there and figured that I would spend a year
learning to speak French, because I thought you had to speak French
to join Medecins Sans Frontières,” which had become his goal.

After a year of eating through his savings, he had not only mastered
French but also roller-blading. He also spent some time traveling to
Ireland, England, and Iceland.

Finally, at age 40, he signed on with MSF, and — after a week of
intensive training — was sent on his first mission, to the area
between Armenia and Azerbaijan called Nagorno-Karabakh, which was a
hotbed of drug-resistant tuberculosis. Most such missions are limited
to 18 months, but Olson stayed for 24 months, so that he could be sure
the TB treatment plan he had introduced to local physicians worked.

At the gulag During his time there he also worked briefly in Abkhazia
in western Georgia near the Black Sea and made a two-week trip to a
gulag prison hospital in Siberia. Both areas had a number of patients
with drug-resistant TB, but his trip to Siberia was particularly
moving.

“It was interesting, and a bit shocking. One building for
drug-resistant TB had 30 to 35 people sleeping in triple bunks. We
had to step over a frozen body that was lying in the entrance. I
don’t speak Russian, so communication was difficult, but you can
imagine the looks that these people gave us. They were in prison
with a fatal disease and they give you a look that is a mixture of
hope and hopelessness and anger. This really stands out in my mind
because there are times when we just don’t have the resources to help.”

After his first mission, he went to a northwest Uganda town called
Arua. He arrived there in 2001, five days after 9/11. “My mission
was to start an HIV treatment program with the idea of introducing
antiretroviral therapy in a rural part of an African country.”

Ugandan mission He was in Arua for a year, during which time he helped
build a new clinic just for HIV. He returned there in January and
“it was great.

You see people that you started on antiretroviral therapy and they’re
still around. That is very satisfying.”

Less satisfying but nonetheless exciting was a short-term mission in
June 2003 that took him to the capital of Burundi in the final days
of the Hutu-Tutsi civil war.

He said he became inured to the sound of gunfire and mortars “so
that when you eat your dinner on a terrace you realize that when the
gunfire stops, you can hear the birds singing.”

Olson and his wife, Cecile, a French nurse who he met on his first
mission, fill the few empty corners of their lives with recreational
biking, such as a trip to Tucson and the Grand Canyon they have
planned for this spring.

And Olson continues to travel with a guitar, an instrument he has
been playing for 25 years.

le.olson/

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