[July 2007] It’s not unusual for Eugene D. Shapiro, MD, to receive calls at odd hours from around the world. As an expert in Lyme disease, he has found himself in demand to consult on cases from New Haven to Norway. Beyond his medical expertise, he also brings an understanding of the fears behind Lyme disease. “The anxiety is as large a problem, or larger, than Lyme disease itself,” he says. “There is a lot of misinformation in the lay press and on the Internet, and misdiagnosis is rampant.”
Luckily, Shapiro says, Lyme disease is fairly easy to diagnose and cure. But the improper use of diagnostic tests, which can give false positive results, has led to overdiagnosis. Some symptoms, such as fatigue, headaches and chronic pain, are widespread and most often are due to any number of other causes, so Shapiro tests for it only when objective findings suggest that someone has it. Those findings include an inflamed knee joint or facial palsy. “I have an additional problem as a pediatrician because this is the perfect disease for parental paranoia,” he says. Although some parents are under the impression that Lyme disease can ruin their child’s health, in reality he says that about 90 percent of all cases consist of a simple rash.
Shapiro went to medical school planning to become a psychiatrist but was drawn to pediatrics because of the way it incorporates psychosocial issues into health care. His interest in the human psyche has served him well; in treating infectious diseases, he often has to uncover the source of parental anxiety along with the roots of an illness.
A mother may not want to vaccinate her child because she says her neighbor got autism from a vaccine, or a father may be concerned about a fever because his parent died from lymphoma, which started with a fever. Shapiro’s job is to discover the underlying issue and quell parents’ fears by educating them. “You have to individualize care,” he says. “I think what you need to do is talk to the person and find out what their real concerns are.”
- Originally published in the July/August 2007 issue of Yale Practice.
Name: Eugene D. Shapiro, MD
Title: Professor of pediatrics, epidemiology and public health, and investigative medicine.
Areas of expertise: Pediatric infectious diseases (including Lyme disease and pediatric vaccines), general pediatrics.
Place of birth: Syracuse, N.Y.
College: Yale College.
Med School: University of California, San Francisco School of Medicine.
Training: Residency in pediatrics and fellowship in pediatric infectious diseases at Children’s Hospital of Pittsburgh, University of Pittsburgh; Robert Wood Johnson clinical scholar (clinical epidemiology fellowship) at Yale.
Family: Married to Susan Bowers, MD (ob-gyn);
children: Lauren, 28, Amy, 23, and Daniel, 21.
What is most challenging to you in academic medicine? Balancing research, teaching and patient care, along with family.
What is most rewarding? Mentoring young people, from residents to fellows to junior faculty.
What do you like most about your practice? I like the variety; the variety of patients that I treat, the variety of infectious diseases I see, and teaching and mentoring residents, fellows and junior faculty.
Personal interests or pastimes? Magic, which I do for patients and residents; and travel.
Last book read: The Kite Runner by Khaled Hosseini.
What would you do to improve our clinical environment if you had a magic wand? I think our health care system is a national tragedy, so I would have universal health insurance.