Dr. Vatsala Parchuri: It's All About the Breath

Dr. Parchuri

 At the end of the long flight, Vatsala’s plane finally landed in India. She was tired as she rushed to the hospital to see her 78-year-old aunt before a scheduled knee replacement. She arrived as the gurney was being wheeled into the operating room and only had enough time to wish her aunt good luck. 

Her aunt and her aunt's 82-year-old husband lived by themselves; their children were in the States, and there was not a lot of support. Though she lived and worked in the U.S. in her forties, she and her husband returned home in retirement, and she did not want to leave for a routine medical procedure. Vatsala's aunt felt that breathing the Indian air gave her life.

Dr. Vatsala Parchuri was in her twenties when she came to the U.S. in 1997 to join her husband and for training in internal medicine. While India remains a great comfort, she has lived here long enough to feel that York is now home. And a place of healing, hope, love, and belonging. But she told me that she experienced terrible sadness while in her residency at the York Hospital. 

Attached to her Father

Though she has a younger brother, Vatsala said she was “raised as an only child” in Korukonda, a small enclosed schooling community in the district of Vizianagaram, Andhra Pradesh state, on the east coast of southern India. She said that she was very “attached” to her parents. Her father was a teacher. After he “retired,” he was recruited to be the principal of a boarding college. He was, Vatsala said, “a very active person” mentally, physically, and spiritually. He had a minor heart attack when his daughter was in medical school in India, but this didn’t slow him down, and he continued to work as the school principal. 

Young Vatsala with her father

But later, when Vatsala was in the second year of her residency in York, he had trouble breathing and began to wheeze. The local doctors saw that he had an enlarged thyroid gland, a goiter, and blamed the noisy breathing on that. Vatsala wanted her father to come to the States for the planned procedure, but he wanted to have the surgery in India; Vatsala relented.

When her beloved father was slow to awaken after surgery, and Vatsala was informed of this, she collected her three-year-old daughter and quickly booked flights to India to be with him.  She prayed intently throughout the long journey. When she arrived at the hospital, her father was awake and seemed okay. In time, he was eating and drinking. But he began to wheeze again two days later. Dr. Parchuri was by his side, and she was concerned as the upper airway was being blocked. 

The ENT doctor determined that he had vocal cord paralysis. So he was put back on the ventilator. Temporarily relieved, Vatsala went home for lunch. But her father had developed pneumonia, and he died after she left (and planned last words and final requests were left hanging). This was in 2003; her father was 75. Dr. Parchuri told me she has not fully recovered from that loss, even more than 20 years later. She said that “the brain blocks all unhappy, unpleasant things.”

She was tightly bonded to her father; Vatsala had a deep emotional need and intensity that she senses may be less common now (but she admits that she might be wrong).  She accepts that not everyone can feel attached to their parents in the way she did. After her father died, Dr. Parchuri and her mother were in deep grief, and Vatsala cried every day for a good while. 

To India to have her Green Card Stamped

When she took a brief time off work to return to India (with Raj) to have her Green Card stamped, Vatsala felt sick and nauseated the entire flight. She went to Chennai (formerly, Madras) to get the required chest X-ray to rule out tuberculosis for the immigration process. But “something” told her, she said, not to expose herself to radiation without a pregnancy test. Of course, the test was positive; she was carrying her second daughter.  

Parry's Corner in Chennai (Credit: moxon.net)

Pregnant, Dr. Parchuri returned to the States and brought her mother with her. The gestation went well, and she delivered her second child.

One-Year Anniversary

Two months later, it was time for the important Hindu rituals marking the one-year anniversary of her father’s death. This first-year Shraddha helps his soul make the transition to the ancestral realm.` Vatsala was happy; her mother was with her, and her baby was healthy.

Dr. Parchuri was considering doing a cardiac fellowship, and she went to Ohio to give a cardiology presentation at the prestigious Cleveland Clinic. By the time she drove home, the ceremony in India for her father had been done. She and her mother sat and cried for a short while. Dr. Parchuri was tired, and after she made sure that the kids were fine, she told her mother that she was going to bed. 

She slept in until around 9:30 and did her Sunday morning chores before realizing that her mother wasn’t up yet. Vatsala went into her mother's bedroom to check on her. Everything looked normal and peaceful, but her mother was absolutely still; her chest “didn’t rise and fall,” said Dr. Parchuri. Her mother had died in her sleep. 

No post-mortem was done, and the cause of her mother’s sudden death was never determined. (I wonder if it was due to the Takotsubo “broken heart” syndrome seen in post-menopausal women after acute emotional stress, as was told to me by Dr. Jay Nicholson when he sat for his interview a few years back.) 

Ballooned left ventricle resembling a Japanese octopus trap (Credit: Bri J Card)

Losing both parents in a year, the last year of her residency, was very difficult for Dr. Parchuri. She feels guilty for being so busy with her own life that she didn’t give enough support to her grieving mother. Both of her parents were special. She had no siblings at home, and as there was “nobody to play with,” said Vatsala, all she had was her mom and dad. She learned to be “happy and content” with “nobody around.”

Her parents were “peaceful and happy” in their “middle-class life,” noted Dr. Parchuri, and she said that she had “such a peaceful childhood.” She never saw her parents unhappy or complaining. They led a spiritual life in practice. (She remarked that while she was fearful of displeasing her mother, there were no such concerns regarding her doting father.)

The boarding school students, being away from home, treated her mother and father like second parents. Many of these former students have come to the States, and they “swarm around” Vatsala when they meet her, and her parents’ names come up. She knows now that her loving parents “touched people’s hearts.” She did not see this when she was a child. She believes that she receives help from others “every step of the way” because of how her parents were to others. (Transgenerational karma?)

“He loved me. She loved me. I loved them.”

Military School

Speaking of the highly competitive boys' military boarding school (the Sainik School Korukonda under the Ministry of Defence), young Vatsala passed the entrance exam with the top score. She was permitted to attend as the only girl in her class of 80 (and one of, at most, five girls in the entire school) because her father taught in the school. She went there from the 6th through the 12th grades. She (of course) liked math and biology. The always-courteous boys in the class saved the front seat for her, and she sat by herself.   Her parents lived in a home on campus. (By the way, girls were only officially admitted to the school in 2021.)

Sainik School Korukonda (Credit: Times of India)

Her strict, but progressive, home-schooled mother didn’t have the opportunity to go to college; she wanted more for her daughter. She wanted her to be an officer in the IAS, the Indian Administrative Service. She wanted her to be a leader. She wanted her to, said Vatsala, “have the knowledge to do good in all realms.” So Vatsala studied dance, classical Indian music, and knitting in addition to academics. But there were subtle (overheard) hints that being in medicine would be a good way to help others.

Medical School

So, following the military-style high school, she took the challenging Medical College Admission Test (MCAT). She did okay, but not well enough for admission. Not inclined to give up, she took the test again and did better. She attended the Guntur Medical College.

Entrance to Guntur Medical College (Credit: HandIndia)

While in medical school, she met her husband, Dr. Rajesh Nallapati, she said, through an intermediary, “a middle person.” The parents then got together and offered their approval. Vatsala said that she and Raj  “went out a little,” and since he was already here doing his residency, they “spoke on the phone for six months.” They were married in India in 1997. And Dr. Parchuri came here two months later with a degree, but without a job lined up. 

Dr. Landis

She wanted to study internal medicine before her planned fellowship in cardiology. She was permitted to “shadow” with the first-year interns at the York Hospital, where her husband trained. When she applied for a formal residency position, several influential attendings (especially Dr. Tex Landis) stood up for her, citing her obvious competence and knowledge of medicine (gained through the Indian educational system)

She enjoyed her training in York and is particularly grateful for having been taught and mentored by, among others, program director Dr. Wolf Blotzer, general internist Dr. Tex Landis, gastroenterologist Dr. Jim Srour, and rheumatologist Dr. David Francois.  She said that Dr. Blotzer was almost a father figure; she looked up to him.

After Residency

Dr. Parchuri started the three-year residency “off cycle” in January, so she finished up in December, two months after her mother passed away. Already grief-stricken before that, she had shelved her plans for a cardiology fellowship. Raj had stopped working briefly to focus on research and fellowship applications and to take care of the girls, so she needed to find a job. 

Vatsala found that her best opportunity was to take a position across the river at Lancaster General Hospital. So, after a few months off, she started working there. She stayed for four years before the forty-minute commute took a toll. She returned to York to do outpatient work with WellSpan while managing inpatients at the local orthopedic hospital (Orthopaedic and Spine Specialists or OSS). She enjoys the work.

Lancaster General Hospital (Credit: Blaine Shahan)

Negotiating a medical marriage and raising two daughters while working two jobs with her only family “on the other side of the globe” has been challenging, said Dr. Parchuri.

Her older daughter (24) is in her third year at the highly competitive Touro College of Osteopathic Medicine in New York. The focus of the innovative “holistic” school is on the training of minority students to serve in underserved rural and urban communities. Women make up the majority of the enrolled students. Vatsala’s younger daughter (now 20) is in Boston as a Chemistry major who has, as yet, shown no interest in medicine.  

Dr. Parchuri wants her children to do what makes them happy and to realize that “time is precious” and “you don’t know your exit date.” 

Spirituality

This awareness of the fragility and unpredictability of life raised the topic of spirituality. Vatsala said that she has always felt connected to Hinduism, but she is more concerned now with connecting with her inner self. Along this quest, she has tried several types of meditation and methods of using the breath. She has done online work and has gone on short retreats in Atlanta and at the Boone Center in rural North Carolina. She said experiences the “physicality” of the practices more readily than the mental effects per se.

A colleague and friend, Dr. Jayram Thimmipuran, practices and studies “Hearfulness” meditation. She had a few one-on-one meditation sessions with his father, who was here from India visiting his son.  When she went to India in 2024 (“for some reason”), Vatsala met Jay’s father and spent three days in group heartfulness meditation at Kanha Shanti Vanam outside of Hyderabad. The large ashram is (according to their website) “an ecological paradise, a place for spiritual retreat, where you can experience simple living in-tune with inner and outer nature."

Kanha Shanti Vanam (World headquarters for the Heartfulness Institute)
(Credit: telanganatoday.com)

Indeed, Vatsala so enjoyed the (massive), remarkably quiet group sessions that she later rented an apartment on the grounds (with the help of an old classmate who works at the center and lives there now). She stayed there by herself for a blissful week. She meditated, read a book, had pleasant, simple meals at the canteen, and was thrilled by the beauty of nature as she walked quietly throughout the large, serene plantation that reminded her of home.

Dr. Parchuri observed that some people seem to age more slowly than others and believes that negativity hastens the ageing process. So she strives to avoid negative thoughts as she navigates the challenges of life and solves problems of being a wife, a mother, and a busy physician. Being content, she believes, slows ageing.

She witnessed this calm tranquility in how her parents faced problems, and would like to emulate that. Vatsala is a perfectionist, and she wants to get it right, especially when it affects her family. But she feels that we know nothing, while we think we know a lot. And she feels that being alive, just waking up each day and taking a breath, may be a wonderful thing.

Suggested Readings:

1. Diaz-Navarro, Rienzi. "Takotsubo syndrome: the broken-heart syndrome." British Journal of Cardiology, 2021 28; 30-34. (This usually follows a benign course, but fatal arrhythmias may occur.) 

2. O'Connor, Mary-Frances O’Connor. The Grieving Brain: The surprising science of how we learn from love and loss. Harper One, New York, 2022. 

The brain devotes lots of effort to mapping where our loved ones are while they are alive, so that we can find them when we need them. And the brain often prefers habits and predictions over new information. But it struggles to learn new information that cannot be ignored, like the absence of our loved one. Grieving requires the difficult task of throwing out the map we have used to navigate our lives together and transforming our relationship with this person who has died. Grieving, or learning to live a meaningful life without our loved one, is ultimately a type of learning. (p. xiv)

3. Patel, Kamlesh, and Pollock, Joshua. The Heartfulness Way: Heart-based Meditations for Spiritual Transformation. New Harbinger Publications, Inc., Oakland, California, 2018.

Heartfulness is based on the ancient Indian spiritual practice of raja yoga, which recognizes that as sentient beings, our nature is inherently divine, and that the path to self-realization is inward, internal, and introspective. (p. vi)

 

By Anita Cherry 5/4/25

At a Flower Show (painting by AC)

  

Dr. Francine Camitta Butler: Endocrinologist and Diabetes/Obesity Specialist

Dr. Fran Butler

Early one Friday afternoon, two weeks after my stroke, a cerebral bleed of unidentified cause, my husband and I drove from York to a large retirement community on the outskirts of Philadelphia to interview Dr. Francine Camitta Butler.  

As a promising student, Francine went to Girls High in Philadelphia. After she graduated from there in January (instead of June) she started at Penn as a full-time student. She had planned to transfer to all-girls Bryn Mawr in the fall but decided to stay at the co-ed University of Pennsylvania instead. Her goal was to go into the medical field. As a young American woman in the 1950s, she could easily become a nurse or a medical technician, but becoming a doctor was a reach. 

As we talked, Francine Camitta recalled that her unenlightened high school physics teacher suggested that the women in his class would be better off studying English or a foreign language than science; physics was more suited for the men. This comment angered her, and she wanted to prove him wrong.

Girls High on Seventeenth and Spring Garden
 (before relocation in 1958) (Credit: px)

Her father was in the family shoe business and encouraged his daughter to do whatever she wanted to do. He wanted her to be happy. After college in the 1950s women were expected to marry and have kids. Francine’s unfailingly supportive dad carefully clipped articles from the newspaper about young women delaying marriage for a career and gave them to his daughter. (Francine’s mother was a milliner; she made and sold women’s hats.)

As young Francine felt drawn to work in medicine she volunteered at nearby Einstein Hospital  (formerly “The Jewish Hospital” and now part of Jefferson) one summer. She worked in the pathology lab cataloging slides. It seemed that the technicians (all women) were more interested in comparing diamond engagement rings than looking at the specimens. 

Postcard of The Jewish Hospital, Phila. (Credit: Stephanie Comfort)

Francine felt that this kind of job, without academic stimulation or inspiration, would not make her happy. Nursing was the other main option for women drawn to medicine, but this did not appeal to her either.  Becoming a doctor was a long shot and she knew no women physicians who could serve as role models.  So she had to look elsewhere. 

The general practitioner who delivered her (though he was not her family’s regular doctor), Dr. Morris Samitz, helped greatly. “He was the best mentor,” said Frannie as he gave her books to read and was “the father in medicine” she was “supposed to have.” 

She did well in college at Penn. When it was time to apply to medical school there was the obvious option of Women’s Medical College of Pennsylvania (the first American Medical School for women).  During her interview there, they proudly took her around and showed her where the nursery was, for when she would have a child of her own. Taken aback, she thought, “I didn’t even have a boyfriend yet!”

Women’s Medical College “didn’t seem right,” and Frannie decided that going to a co-ed medical school would be a healthier choice. 

When she interviewed at the University of Pennsylvania Dr. Mitchell, the head of admissions, told her she would make a wonderful doctor but that she could not join the incoming class since the five slots allocated to women (by a strict quota) were already filled. Undaunted, Francine walked out of his office feeling that everything would eventually be okay, though not at Penn. 

Hahnemann

When she was accepted to Hahnemann Medical College in Philadelphia she was, as noted above, one of five women in the starting class of 100 students. Fortunately, her male classmates were uniformly supportive and accepted her as an equal. When one of their teachers made a risqué remark, her colleagues let her know they were not happy about it. This kind of thing didn’t happen again.

She met York native Ivan Butler (the future neurosurgeon) in her sophomore year of medical school. He was a year ahead of her at Hahnemann and offered Frannie much support and encouragement in her studies. 

They were engaged the following year and were married in June of 1963, three days after she graduated. During their five-day honeymoon in Puerto Rico Ivan (finishing his rotating internship back home at the York Hospital) excitedly “presented” surgical cases to his new wife as they strolled along the beach. 

Dr. Woodward

While Ivan then did neurosurgical training at the University of Maryland in Baltimore, Frannie was able to do an internal medicine medicine residency there under Dr. Theodore Woodward. It was good for the two to be training at the same place. As residents, they worked in the hospital every other night and every other weekend, and they enjoyed close friendships with the other (tired) residents.

The neurosurgical trainees at the University of Maryland had the opportunity to spend three months at Queen Square Hospital in London learning the basics of classical British clinical neurology.  Ivan chose to go, and Frannie, of course, wanted to go along. By that time in her residency, her future career was beginning to take shape as she had become interested in endocrinology under Dr. Thomas Connor.  

Using his connections, Dr. Connor arranged for her to study in England with endocrine pioneers Dr. Russell Fraser at Hammersmith Hospital and Dr. Clara Lowy (who was especially interested in gestational diabetes) at King’s College. But only, said Dr. Woodward, if Frannie agreed to serve as Co-Chief Resident upon her return. (She couldn’t turn that honor down, could she?) 

Dr. Clara Lowy

Frannie told me that her experiences in England were quite inspiring and noted that there were many more women doctors in Great Britain than in the States, and she saw that they could more readily balance their medical careers with motherhood and family life. 

After the neurology training in London, Ivan spent a few weeks in Sweden learning aneurysm surgery techniques. However, it was way too expensive to stay there on a resident’s salary, said Frannie, compared to central London, and they returned home. 

(By the way, Frannie is still in touch with the 90-year-old Dr. Lowy, from whom she recently received a letter.)

After her residency, Dr. Francine Camitta-Butler had briefly toyed with the idea of doing obstetrics and gynecology but realized that “time management” would be a problem. She decided to do a fellowship in endocrinology with Dr. Connor.

As Ivan was completing his training with Dr. James Arnold he was slated to do the neurology and neurosurgery at the Fort Howard VA Hospital through the University but that opportunity suddenly fell through.

Fortunately, Dr. Frank W. Weaver (1909-2004), Chief of Surgery in York, “took care” of Ivan and brought him to the York Hospital to start a neurosurgical service. He would begin in July of 1968. By then, Frannie was pregnant and due to deliver in August. 

Sadly, the baby was stillborn. Frannie soon conceived again and while pregnant, she commuted from York to Baltimore (about 40 miles each way) to finish the second year of her fellowship.

When she opened her endocrinology practice in York in 1969 (mostly taking care of patients with diabetes and thyroid problems, but sometimes seeing rarer pituitary or adrenal disorders) there was only one other woman physician on the medical staff of the 500-bed hospital, Dr. Lois Kushner. (Dr. Kushner was the first woman physician Frannie met in the States!)  

This time ushered in the “second wave” of the feminist movement that developed in the context of other active social movements involving, for example, workers’ rights and damaging racial discrimination.  This brought progress in terms of women’s equity in medicine. In 1970 only 5% of American physicians were women; in 2025 that figure is currently 38%. 

Percentage of first-year medical students by gender
from 1965 to 2016
(Credit: Assoc. of American Medical Colleges)

Anyway, Franie’s second pregnancy went well and she delivered a healthy son. Since she and Ivan both had active medical practices (with meager coverage) they needed to find a live-in nanny to help out. A wise woman from Jamaica (who arrived here when their son Hank was six weeks old) turned out to be “a blessing from heaven,” said Frannie: this woman would be the “daytime mommy” while Dr. Camitta was the “nighttime mommy.” 

The kind Jamaican supplied abundant “lovin’” and was “wonderful” with Hank (and, eventually, with his two younger brothers, Scott and Matt). 

But when Hank was ten, the beloved nanny became ill. Frannie noted that “her color was pale” and that “her belly was sticking out.” In fact, her abdomen was (ominously) “rock hard.” It turned out that she had a very rare aggressive malignant endocrine tumor, a pheochromocytoma. She died soon after the diagnosis was made, and before any treatment could be offered. It was a terrible loss, but this was softened a bit when the nanny’s 16-year-old daughter left Jamaica to live with the Butlers for a while. 

Gloria Steinem

An interesting historical connection: The noted activist feminist Gloria Steinem came to York in the early 1970s as part of a speaking tour.  Frannie and Ivan were given the job of driving her to the airport after the session.  Ms. Steinem sat in the front passenger’s seat as Ivan drove.  In conversation, one of the things he mentioned was that in 1961, breaking into a male-dominated world, Ruth Kerr Jacoby became the first woman to be board-certified in neurosurgery. (Even now, only 8% of neurosurgeons are women.) 

Turning the gender tables, Gloria inquired as to when Ivan took time off to babysit his boys.  Frannie, seated in the back with a woman whose name she’s currently unable to recall, quickly spoke up for her weary husband: “He would if he had coverage!” (Fellow neurosurgeon Dr. Ronald Paul didn’t join Ivan until 1973.)                                   

Though she always maintained her own medical practice, Frannie enjoyed working with her colleagues, including reproductive endocrinologist Dr. Robert Filer and the multiple-boarded Dr. David Shearer. She said she and Dr. Shearer traveled south to Baltimore for weekly endocrine conferences at the University of Maryland and often went north to Hershey Medical Center to present interesting cases from York Hospital. This was way before cell phones, and Frannie had to know where the pay phones were along the way so if her beeper went off, she could respond.   

 Dr. Francine Camitta Butler said that her three sons were proud of what their busy mother did and that as she juggled the demands of family and work, she just tried to “keep things normal.”

Her practice, of course, evolved over the years. As the typical American diet changed and we gained weight, much of her work focused on the epidemics of obesity and type 2 diabetes. In the early 1960s, the rate of obesity in the US was 13%, with only 1% of adults being termed “morbidly obese.” The current rate of people living with obesity (as judged by BMI) is around 43%, with as many as 19% of those considered to be in the dangerous morbid obesity category.

US obesity rate by state 2022 (Credit: Joyce Ma)

And diabetes? In 1958, less than 1% of Americans were diabetic; that figure is now at least 10%, many of whom are undiagnosed. This shocking ten-fold increase in a formerly relatively uncommon disease happened in a generation. What happened? Our genetics didn't change; the food environment, the food landscape, did.

Dr. Camitta Butler said that a substantial part of the increase in obesity occurred after the food industry replaced the fat content of processed foods with lots of sugar. This was in response to the developing (and still incomplete) narrative connecting types of blood lipids (circulating fats) and diet with coronary heart disease. 

Unfortunately, more added sugar in food leads to more calories consumed overall (sugar is tasty but not satiating). The storage of excessive calories results in swollen and leaky fat cells with more fat in the “wrong” places, such as in the liver and muscle and around other internal organs, where it does damage. This contributes to an impaired response to insulin, insulin resistance, a forerunner of diabetes.

[Some science (with help from my husband): Adipose tissue (fat) is a highly active endocrine “organ” that regulates many metabolic pathways through the release of hormones and cytokines.  The most well-known of these circulating factors is leptin. This informs the brain (by way of the hypothalamus and hippocampus) about the body’s total energy stores; it regulates hunger, satiety, and energy expenditure. But it also affects, among other things, the immune system and inflammatory response, the heart and vascular system, the reproductive system, and bone growth. Lack of a response to the signaling actions of leptin is common in obesity.] 

Back to Frannie. At one point, she tried to address the problem of overweight by offering her patients a dietary plan with pharmaceutical (Sandoz) backing. The novel OPTIFAST very low-calorie total meal replacement (TMR) program promised quick results. Like all diets that severely restrict daily calorie intake (it now starts at 800-1200 calories but was even more limited initially), patients lose weight quickly. 

But it turned out that the weight loss is maintained only if patients continue to use some TMRs and have ongoing behavioral intervention, including engaging in 150-180 minutes of moderate or vigorous physical activity weekly. 

Dr. Camitta-Butler told me that (as there was virtually no formal instruction about nutrition in medical school) she learned a lot from the registered nutritionists at the York Hospital, especially Marta Smith, who worked closely with her on the OPTIFAST program.

I asked Frannie about Ozempic and other GLP-1 receptor agonists for weight loss (rather than for diabetes, as they were designed to be used and for which they are very helpful and game-changing).  She thought these weren’t good solutions for the treatment of obesity alone. She said that we don’t yet know the extent of the long-term effects (both positive and negative) of these drugs since many tissues have GLP-1 receptors.  She was wary of people getting information about these highly active medicines from TV advertising or the internet rather than their doctor.   

Effects of GLP-1 or GLP1R agonists
(Credit: cardiab.biomedcentral.com)

After retirement, Frannie volunteered for a while with the international health and human rights organization "Doctors of the World.” Their stated mission is to “provide emergency and long-term medical care to vulnerable people, wherever they are.” Along with Dr. Wolfe Blotzer, she helped evaluate the torture claims of asylum seekers detained in the York County prison while awaiting deportation. 

In 2019, Frannie and Ivan planned to move from York to a retirement community outside of Philadelphia. Ivan died suddenly at 83, just before the move, and Frannie had to make the transition by herself. Nearly five years later, she has enjoyed the community and has remained active.  She has been able to continue to exercise and she learned to play the ukulele and duplicate bridge. The retirement community offers a variety of classes and lectures as well as field trips.

Her time is filled with new friendships and new challenges. She feels blessed that her sons and their families (she has seven grandchildren) live within a two-hour drive, allowing for frequent visits. She is proud of her sons' accomplishments in non-medical fields. One is in real estate law, one is an executive at Warner/Disney, and the third is the executive director of the PA Jewish Coalition and is a lobbyist for a few other entities. 

The extended Butler family (Credit: York Dispatch)

She remains connected to her Jewish faith and has enjoyed a leadership role in the Shannondell community. She noted that it has been enlightening to bring together people with different approaches to the observances of the Sabbath.

And as we ended the pleasant visit, Frannie walked us out of the building and carefully showed us some of the amenities of the beautiful facility. The wintry low sun was beginning to set, and she would soon get to celebrate Shabbat, the sacred day of rest, with others.

Suggested Readings: 

1. Coelho, Marisa. "Biochemistry of adipose tissue: an endocrine organ." Archives of Medical Science 2013; 9(2): 191-200. (Fat is a complex active tissue.)

2. DeAngelis, Catherine, MD, MPH. Pursuing Equity in Medicine: One Woman's Journey. CreateSpace Independent Publishing Platform, North Charleston South Carolina, 2016. (The story of a remarkable career and a plea for equity and impartiality; freedom from bias or favoritism. Dr. DeAngelis was the founder of the Hopkins General Pediatrics and Adolescent Medicine Division and the first woman editor-in-chief of JAMA.)

3. Yeo, Giles, PhD.The Science of Obesity and the Truth About Dieting. Pegasus Books, Ltd. New York, 2019.  (An entertaining but rigorous read. As a research geneticist, Dr. Giles has said that "we have evolved to eat when we are hungry and when there is food, not to stop." And in the 21st-century food environment, "we are preparing ourselves for a famine... that is never ever going to arrive." p. 22.)

By Anita Cherry 03/16/25

(March is Women's History Month in the US, UK, and Australia.)

Dr. Ken Woerthwein's Medical Education and Practice

Dr. Woerthwein

When he was about 13 years old, his family began to ask Ken what he wanted to become; he had “no idea”.  But as he watched the 1950s documentary TV series “The Twentieth Century” (narrated by Walter Cronkite) and learned about “new and inventive” medical breakthroughs, he began to think about becoming a doctor.  

When he was a high school junior, Ken read “Arrowsmith” (as he recalls) published in 1925 by Sinclair Lewis; a story about the challenges faced by an idealistic physician-scientist.  From these two experiences, Ken then knew he wanted to be a doctor to serve others.

[A Wikipedia entry notes that the fictional Martin Arrowsmith of a hundred years ago was a bright young boy in a small mid-western town.  After spending time with a local general practitioner, he became aware of the “societal forces of ignorance, greed, and corruption that were as life-threatening as the plague.”]

[As an interesting aside, Sinclair Lewis famously said that “when fascism comes to America it will be wrapped in a flag carrying the cross.”]

After High School

From the suburbs of Chicago, Ken went to Princeton University in New Jersey.  While applying to colleges, he was naive about Eastern schools and asked others if such schools offered a good college education.  Ken told me that the elite Ivy League college was actively recruiting students from public schools to complement its traditional prep school applicants.  He was interviewed locally, was accepted, and went there “sight unseen”.

Beautiful Princeton Campus (Credit: depositphotos.com)

At Princeton, Ken majored in biochemistry.  He always loved sports and went out for the football team, but decided “it was too rough” at the college level.  He was well prepared academically by his high school education and did well in his freshman year.  In his sophomore year, he stumbled (like many premeds do) in organic chemistry.  He passed but did not do well in the course.  Ken moved on, enjoyed college and thrived in the other sciences and liberal arts courses. He did research and wrote his senior thesis on the regeneration of limbs in newts.

Introduction to Quakerism

Ken dated his late-wife, Wicky (Francine Willmore), in high school.  Wicky went to Beaver College (now Arcadia University) just north of Philadelphia.  Wicky was invited to attend a Quaker Meeting (The Religious Society of Friends) where she felt immediately at home with the form of worship, basic principles, and testimonies for daily living.  She introduced Ken to Quakerism, which slowly resonated with him.  They were married in a Friends ceremony at the Princeton Stony Brook Meeting House in November 1963, a week after President Kennedy’s assassination.

Stony Brook Meeting House (Credit: Princeton Friends Meeting)

[My experience, as a child, of sitting quietly on a hard wooden bench at the Frankford Friends School in Philadelphia during an hour-long worship Meeting left a lasting impression, as noted in my previous post.] 

After Princeton, back to Chicago

Ken was looking forward to going to medical school after graduating from Princeton in 1964, but he didn’t receive an acceptance letter, which he thought was due to his poor grade in organic chemistry.  A rabbi his wife knew thought Ken did not receive an acceptance letter because his last name may be Jewish.  (At that time, there was an unspoken quota of accepting Jews into medical schools.)  

When another opportunity opened, Ken returned to Chicago where he attended the University of Illinois in Chicago and studied for a Master’s degree in anatomy under Dr. Anthony Schmidt who also did research on the regeneration of limbs in newts.  (Ken’s Master’s degree included this research.)

Ken reapplied to medical school and was accepted in 1966 at the University of Illinois School of Medicine in Chicago.  Ken greatly enjoyed medical school where he rotated through three major hospitals in the area during his four years as a medical student.  One hospital was the Research and Education hospital of the medical school, another was the West Side VA and the third was Cook County Hospital, a government-run (free) hospital serving the poor (and mostly Black) community in the county.  Cook County Hospital is now called the John H. Stroger, Jr. Hospital of Cook County.

Cook County Hospital reborn as Hyatt House Chicago/University 
(adjacent to Stroger) (Credit: SOM)

It was at the Cook County Hospital that Ken had intense and formative exposure to low-income individuals. He was struck by the racial and class differences in health care, including patients placed in beds in large wards with little to no privacy.  As a student at this hospital, all the doctors, including him, were very busy, not only taking care of many patients but also doing lab work that could be performed on the patient's floor. (It is said that Cook County Hospital was the inspiration for the TV show “E.R.”)

Lead Poisoning

During his pediatric rotation at the pediatric building of the Cook County complex, he helped care for a young child who suffered brain damage from lead poisoning after eating chips of crumbling lead-based paint found in slum housing.  Ken and a fellow colleague (a Black student) encouraged the parents to go to the liberal newspaper, the “Chicago Sun-Times,” to tell their story.  They eventually did, and some initial efforts were then made to address the risks of lead poisoning in the inner city.  (It wasn’t until 1978 that use of lead-based paint was finally banned in the US. There is no safe level of exposure to this intense neurotoxin.)

There are many potential sources of lead poisoning

[In the 1960s, lead in paint was not the only source of the dangerous metal; the war in Vietnam, with millions of lead bullets fired from Soviet AK-47s and American M-16s, weighed heavily on our society, especially young men.  (We will get back to this later.)]

Project House and the AFSC                                           

Ken became a member of the Friends Meeting in Princeton in 1965 while living in Chicago.  Wicky was a social justice activist. She was invited to become the Young Adult representative to the board of the American Friends Service Committee’s (AFSC) regional office in Chicago. 

The AFSC owned a house in East Garfield Park called Project House from which many community programs were initiated. People from the community were the employed leadership.  (As Ken recalls, the first Tenants Rights Union was founded out of Project House.)

Project House in the 1960s (now an abandoned empty lot)
 (Credit: Jim Ralph)

Ken and Wicky took part in the AFSC’s PREP (preadolescent enrichment program) program out of Project House. After an assault of a Quaker by a member of the Southside Black Stone Rangers street gang, PREP was conceived as a way to break down racial barriers in the city by having white and Black families get to know one another through an experiential enrichment activities program for their young children.  On many weekends, the Woerthweins took mostly low-income, white and Black, elementary schoolgirls to a variety of new places and activities throughout the city.  

Ken recalled that a white girl from rural Kentucky lived with her family in a condemned building near Wrigley Field.  She was the poorest child in the group. This was eye-opening for everyone, including the rest of the children in the group.  The young girl had inadequate outerwear for the winters in Chicago; this needed protection was soon obtained for her.

The War on Poverty and the Chicago Riots 

During the summer before his junior year in medical school, Ken took part in the Student Summer Health Project (SSHP) funded by President Lyndon B. Johnson’s massive “War on Poverty” (that also created Medicare and Medicaid). 

Ken interacted with a Black teenage youth group in East Garfield Park who asked him to talk about sex education including anatomy, sexually-transmitted diseases, and contraceptive methods available at that time.  Through the SSHP, Ken became more informed about poverty, racism, and poor healthcare which led to the terrible living conditions in the Black ghettos in Chicago.

During the 1968 riots in Chicago, one of their PREP families was burned out of their apartment in East Garfield Park. The Woerthweins collected donated clothing and brought it to the family who had moved in with their grandmother in the North Lawndale section of Chicago (another poor Black neighborhood that had also suffered extensive burned-out residences and businesses during the riots).

Fires burning in the West Side of Chicago 1968 (Credit: Chicago Sun-Times)

[The urban riots are now referred to as "uprisings" by a York historian.]

These early experiences of social inequality and the effects of longstanding racism in the turbulent 1960s had lasting impacts on the young doctor-in-training. (Recall the sweeping Civil Rights Act of 1964 and the important Voting Rights Act of 1965.)

After Medical School

After four years of medical school, Ken was intrigued by the scientific basis of Internal Medicine and needed to find a residency. One of the students who graduated ahead of him from medical school (a friendly and jovial guy) went to York Hospital for training and touted its many values. Ken visited in September 1969, shortly after a second series of summer riots triggered by racial turmoil in the ongoing wake of the April 4, 1968 assassination of Dr. Martin Luther King Jr. (the day after his famous “I’ve Been to the Mountaintop" speech in Memphis).

Ken’s visit was extended for a few days when Wicky needed medical care.  As Ken met several York physicians (including Dr. Dave Jones), he was struck by the atmosphere of collegiality at the large comprehensive hospital. Impressed by what he experienced, Ken applied to the program, was accepted, and started his internship in July 1970.  Following that busy year, he began his formal residency, but he was emotionally exhausted by the many years of education he had completed and left the program early.  Ken knew he would be drafted.

[The first of two random draft lotteries for the Vietnam War was held in December 1969.  Men attending college were still exempt until 1971, but those studying medicine kept their protected status.]                                           

(As a junior in high school, Ken read the anti-war novel “All Quiet on the Western Front.”  It affected him deeply; he decided then that he did not want anything to do with war of any kind.)

While doing a rotation at the West Side VA Hospital, he helped care for a wounded Vietnam soldier who developed an infected, deep open wound, extending down to the bone of his lower leg. The soldier said that because his infection was so grotesque, his wife wanted nothing to do with him, and all he wanted as treatment was an amputation.  This experience further convinced Ken that he was not going to serve as a doctor in Vietnam if it meant caring for soldiers so that they could return to war.

West Side VA Hospital (Now the Jesse Brown Medical Center)
(Credit: Dept. of Veteran Affairs)

Since he was no longer in training, Dr. Woerthwein notified his local draft board of his eligibility and the decision he made, as a Quaker and a pacifist, that he wished to be considered a Conscientious Objector to war.  The board assigned him to two years of alternative service.  

As a physician, he could provide healthcare to an underserved population.  Where would he be assigned?

In the aftermath of the riots in York, to address the causes and other concerns, there was a week-long open community forum or public workshop called a Charrette.  According to a newspaper story years later, “The York Charrette explored the unleashed use of police dogs, lack of affordable and suitable housing, health care for the poor, and public transportation, among other community issues.”

One result of the Charrette was that in July 1970 the WE Group of the health committee (members from the community and health providers from various organizations) founded and incorporated the Community Health Center. It was staffed by volunteer healthcare and community providers.

Alternative Service

Since downtown York City was identified as a medically underserved area and was a “displacement” from Ken’s home environment in Chicago, the draft board felt it was a suitable option for Ken’s alternative service.  During this time, Ken discussed with Dr. Dave Jones at York Hospital his decision and desire. And in late July 1971 (through grant funding), he became the first full-time physician at the (free) Community Health Center (CHC) in York City.  

Dr. Piper

The initial medical facility was situated in the back of the VNA building at 218 East Market Street.  The York CHC was one of the first of the free health clinics in the US.  Some of the volunteer physicians were Drs. Pete Piper (1927-2013), Gary Ardison, John Trimmer, and many others, including interested York Hospital Residents.

As the CHC grew, it moved to 116 N. George St., a much larger facility remodeled in part by the staff and patients.  There were unmet healthcare needs for the poor beyond the city limits, as well.  With the help of the Community Progress Council, other make-shift offices were opened in rural Felton, Red Lion, and Dillsburg, and later on in Hanover and Lewisberry.  Ken saw patients at all of these centers. 

During one summer, Dr. Woerthwein saw patients at the Migrant Health Clinic run by the State Health Department. It was set up in the basement of Gettysburg Hospital. The patients were seasonal migrants who worked the vast apple orchards in Adams County. While there, they lived in poor housing.

Dr. Woerthwein greatly enjoyed the work at the various health centers and the people he worked with. He stayed on for an additional year beyond the two that satisfied his Selective Service requirement.

Switch to Family Medicine and Serving the Poor

While at the CHC, Dr. Piper saw that Ken’s nature was more attuned to family medicine than hospital-based internal medicine.  He urged him to do a family practice residency.  Dr. Woerthwein agreed.  He applied to and was accepted into the Family Practice residency program at York Hospital.  Through this residency, he broadened his medical education experience by being exposed to and caring for many patients with complex and common medical problems. 

During his residency, he was allowed to continue to care for his office patients at the CHC.  He said he owes a special debt of gratitude to general internist Dr. Jack Kline who guided him carefully and gave him appropriate responsibilities as he helped care for Dr. Kline’s patients in the hospital. 

Dr. Mulligan

After Ken finished his Family Practice residency in 1976, he returned to the Community Health Center where his future partner, Jim Mulligan (1944-2017) was now practicing.  (Jim completed his internship at York Hospital in 1970, followed by his Indian Health Service at an Indian Reservation in Washington, and then did a Family Practice residency in Rockford, Illinois.)  

About this time, the CHC needed additional funding sources.  The Board of the CHC sought federal funds to become a Federally Qualified Health Center.  As such, they were required to use National Health Service doctors from then on. The Community Health Center became today’s Family First Health.

Ken and Jim wanted to continue to serve low-income patients in York City so they rented an office on West Market Street for one or two years. They then purchased and remodeled a building at 462 W. Market Street, a former car dealership.  While at the CHC and at their office, they supplemented their income by serving as doctors at the old York County Prison (another eye-opening experience), the old Pleasant Acres Nursing Home, and for several years in the York Hospital inpatient alcohol and detox unit.  (Ken noted Dr. Dave Jones was a “silent partner” during this time to help find sites where they could earn additional income.)

[Dr. Woerthwein admitted openly to me that he was initially “prejudiced” against people with addictions, believing that addiction was a moral issue.  His time caring for such patients made him realize that addiction is a complex medical problem and not a question of moral weakness.]

Dr. McMillan

By the 1980s, Drs. Woerthwein and Mulligan decided that their practice should seek out employees “who reflected and looked like the patients they were serving.” They needed a diverse staff.  They hired additional front office staff and a nurse assistant. They later recruited Dr. Deborah McMillan (a York native working in North Carolina at the time), and Roland Williams (a physician’s assistant who trained at Hershey Medical Center).

In addition to their office practice, they took care of their patients when they were hospitalized and made home visits where they got first-hand experience of their patients and their living conditions.

Although their practice grew, the income lagged.  They decided to partner with an HMO (prepaid health plans designed to control cost) which began to move into the York area in the early 1980s.  This provided guaranteed monthly income, although their decision was not looked upon favorably by many of the other practicing doctors in York.

Healthcare continued to change.  In 1994, as large regional health systems were becoming the prevailing model, Ken’s and Jim’s group was the second family practice bought by the newly-named, Wellspan Health System.  The office was moved to West Bannister Street in West York.  (Dr. Mulligan left the practice in 1998 to do addiction medicine) 

Retirement from Practice 

Dr. Woerthwein continued to work at the Bannister Street office until he retired from clinical practice in 2009. He very much enjoyed working with his diverse and caring staff.  (He was employed by Wellspan for another 15 years doing insurance appeals. This work allowed him to stay in contact with the changing field of medicine.)

The practice that he and Jim started is still manned by a diverse staff adhering to the ideals and goals of the founders.  Poverty and the effects of systemic racism remain the most critical of the “social determinants of health” and well-being that Dr. Woerthwein confronted daily.  Ken told me, frankly, that he doesn’t believe there has been significant improvement in these issues over the years.

According to the American Academy of Family Physicians (AAFP) 2022:

The social determinants of health (SDoH) are the conditions under which people are born, grow, work, and age, and include factors such as socioeconomic status, education, employment, social support networks, and neighborhood characteristics. These social factors have a more significant collective impact on health and health outcomes than health behavior, health care, and the physical environment, SDoH, especially poverty, structural racism, and discrimination, are the primary drivers of health inequities (italics added).

Reflecting on the years he spent in medical education and his practice, Ken feels that so many things that happened to him were a matter of chance opportunities that occurred at just the right time.

(Ken and Wicky raised four children, three of whom were adopted. The children in the tri-racial family experienced personal and racial discrimination while growing up in the York area.  Wicky died in 2018.)

Reference and Suggested Readings:

1.  AAFP. "Poverty and Health-The Family Medicine Perspective" (Position Paper) AAFP, January 2022. (accessed at https://www.aafp.org/about/policies/all/poverty-health.html)

2. Kendi, Ibram X. Stamped from the Beginning: The Definitive History of Racist Ideas in America. Bold Type Books, New York, 2016. ( Detailed, heavily-referenced, timely, and chilling essential reading.)

3. Smith, Robert Lawrence. A Quaker Book of Wisdom: Life Lessons in Simplicity, Service, and Common Sense. William Morrow and Company, Inc., New York, 1998.  (An enjoyable reflection on the core Quaker values of simplicity, peace, integrity, community, and equality.  And that "there is that of Good in every man.")

Along the Old Field Trail at Richard Nixon Park and Nature Center (Photo by SC)

By Anita Cherry 1/30/25

So I had a Stroke...

I often wondered how I would feel if one of the stories I had worked on could not be posted online and shared. After more than fifty tales about local doctors, I found out. It did not feel good. I was deflated. But as I read the story again I realized that simply working through it was a gift. It brought back the warm childhood memory of sitting on a plain wooden bench in complete silence during an hour-long Quaker Meeting for Worship at the Frankford Friends School in Northeast Philadelphia.

The quiet meditative experience fit with who I wanted to be; that is, someone who tried to do good. And I recalled that the gathering for lunch after worship was special. It felt as if I was offered a seat at the United Nations as I (white and Jewish from a heavily Jewish neighborhood) shared a meal with Asian, Italian, and African-American kids from other parts of the city. 

I prefer to sit in silence in a synagogue, temple, church, or congregation service, and now I know why. (I simply ignore my husband when he points to the proper line in the prayer book.)

But there is more. While still working on the last bit of the (now-unpublished) story not quite two weeks ago I had a stroke. Earlier in the day I had trouble reading and had mild head pain. These vague symptoms passed, but I awoke in the middle of the night with a start. I had a severe headache, intense nausea, odd confusion, and trouble speaking. What came out of my mouth was pure gibberish, total nonsense. Naturally, my neurologist-husband quickly helped me dress. 

Within five minutes, and as light snow began to fall, we were off to the ER. The stat CT showed a round 2 cm left posterior brain hemorrhage.  Off to the ICU, an experience I don’t really recall (though they say I was a hoot). A transfer to Tower 3 was made in the late morning and over the next hours, a few words began to come out right. 

The follow-up CT late that evening was stable, my blood pressure finally came down by the next morning, and I left the hospital barely 29 hours after arrival. My speech miraculously returned to normal during the day and I was back to the gym the next day. I am still tired, but ready (and grateful) to be able to begin work on another story, with an interview tomorrow afternoon.

Anita 01/23/25