Who Am I?
Once upon a time, a blond, blue-eyed emigrant from the former Soviet
Union—that’s me—graduated from Cornell University and entered
Sackler Medical School to become a doctor, one of the most ancient and
holiest professions humankind has ever known.
I had always wanted to become a doctor since when I was six years old
and hospitalized for a suspected appendicitis. Back then, where I am
from, parents were not allowed to stay with their children in the
hospital, and very sick kids befriended one another. I made friends with
a leukemic boy who was sharing the room with me and eight other kids
with completely unrelated illnesses. We listened to my transistor radio
and told each other jokes to bide our time. My friend was pale but
beautiful, and his golden locks made him look like an angel. One night,
there was a lot of commotion, screeching sounds of machines and loud
voices, and in the morning, my friend’s bed was empty. He was
“gone,” the nurse told me dryly.
The boy’s passing had left me choking with tears and an overwhelming
desire to do something to avenge his death when I grew up. And what
better profession was there to fight sickness than being a doctor? And
so, when it was time to choose a career, my path was predetermined.
Despite my love for art history and languages, I headed for medical
school, driven by my childhood memories and the promises I made.
Medical school was an exhausting but fascinating journey inside the
human body. I was extremely lucky to be taught by some of the brightest
medical minds of our time. The academics required tons of dissections
and memorizations of Latin names and facts. That’s where my
linguistic gifts came in very handy. Our anatomy professor, Dr. Yoel
Rak, was a world-famous archaeologist, who had discovered the oldest
human skull on the planet. He tried to infuse the otherwise-dry anatomy
material with some refreshing evolutionary points of view. Another
stellar researcher, Professor Laron, who had discovered nothing less
than a syndrome of dwarfism, was trying to lighten up otherwise mundane
endocrinology, the science of hormones.
But my most memorable days of medical school were not spent in the
classrooms, of course, but in clinical rotations at the hospitals. This
was the real deal. My surgical preceptors were war veterans, and they
were tough as nails. They taught me how to think fast under pressure and
get things done with the minimum of help and resources available. I
would often scrub in with trauma surgeons for the late-night cases. One
day, around 3:00 a.m., I was very exhausted and ready to call it a
night. It was then that an eighteen-year-old boy was brought into our
operating room. He was a victim of a car accident; he had flown forward
from the backseat into the windshield of the car. The boy was
unconscious and rapidly losing blood pressure. A huge incision was
immediately made all the way from his solar plexus to the pelvis by the
on-call trauma surgeon, who then launched a hunt for the source of
bleeding, which if not stopped would’ve destroyed this boy’s life in
minutes. Without any CT scans, the source of bleeding was found swiftly
through sheer manual search. It was one of the worst kinds, and once
exposed, the depressurized blood burst out at us like a wave. After
clamping down all the visibly oozing vessels, the surgeon decided to
wash the entire content of the abdomen and to look for other squashed or
destroyed organs, which had to be removed. Before the aorta—the
largest blood vessel in the body—was clamped, he asked me to feel it,
and as I unwillingly placed my fingers on it, I felt this boy’s
pulsing life. It was very rapid and bounding, and it made me sick to my
stomach. The surgeon picked up the boy’s intestines and handed them
over to me. “Hold on tight,” he uttered firmly. “I am going to
clean up this mess.”
I gasped, as I felt overwhelmed under the weight of the warm and gooey
flesh in my arms. All of a sudden, the surrealism of this situation
dawned on me: it was 3:00 a.m., I was exhausted, the Yom Kippur
War–veteran surgeon next to me was taking out the crushed left kidney,
and I was barely standing there, dizzy and tired, ready to collapse,
with my arms full of an eighteen-year-old boy’s guts. I sensed a noise
in my ears and a familiar feeling of flying into the tunnel, the
classical vasovagal episode commonly known as “passing out” after
prolonged standing in one spot. To hell with everything, one of the
inner voices in my brain was screaming. I am gonna lay you down right
now. The other subconscious voice, however, was of a different opinion.
It had sent a sharply felt realization down my spine that, by collapsing
onto the floor, I would be taking this boy’s life by degutting him.
I don’t know what force kept me on my feet that night, but I stood
there until it was all over. The moment I stepped out of the OR, I
collapsed onto the floor in the cafeteria. In the morning I was
checking to see if the boy had survived, and to my joy, I discovered him
smiling in his bed: “Good morning, Doctor Kogan. I heard you guys
worked hard to save me last night.”
“I am not a doctor yet,” I mumbled, almost choking on the intense
feeling that came all over me. I knew I had avenged the death of my
childhood hospital friend.
Moments like these made all the sleepless nights worth it—like the
first night of my obstetric rotation in Labor and Delivery. I was
chasing an Ethiopian woman down the hallway. She had abandoned her bed
and stood in the corner, shaking with fear. Back where she was from,
babies were delivered only standing up. Delivering her baby in this
unusual-for-me position taught me that, in some parts of the world,
people prefer to do it this way. Great.
The second night in my new psychiatric rotation, I was held at gunpoint
by a psychotic soldier. He demanded to be injected with a sedative, and
having received what he wanted, he happily slumped onto the floor.
Marveling at the way the events of that day played out, I got lost on my
way home from Ichilov Hospital in Tel Aviv. It was a very long walk in
the pitch-black, and all I remembered was a cue that I lived close to
the museum of Israel. Lucky for me, I came upon a bonfire with a bunch
of young people sitting around it and smoking pot.
“Looks like you are lost,” they said. Tired and exhausted, I wanted
to ask them, “Where is the museum of Israel?” But what came out of
my mouth in broken Hebrew at that moment was this: “I am looking for
the land of Israel.” They all hopped to their feet and started bowing
to me, laughing hysterically, and said, “You have arrived!”
Time has a tendency to fly, and before I knew it, my four years were up,
and I was graduating from medical school. I was a proud bearer of the
Hippocratic oath, had all the empathy in the world, and was ready to
never sleep and to always be ready to help my patients.
My internal medicine residency at the New York City’s Lenox Hill
Hospital has been extremely rewarding and intense. All of a sudden, I
was not a student anymore—I was a medical intern. The nurses were
paging me for orders, and patient’s families were awaiting my care.
There was no place for hesitation or doubts. The stress was huge. Back
in those days, there was no cap on how long the residents could stay up
working, and I often worked eighty-five to ninety-five hours per week.
Two months into my internship, I was walking the hallways of the
hospital on my night duty, around 4:00 a.m., ready to “call it a
night,” which really meant retiring into the stinky, tiny room where I
would try to close my eyes on the bed until someone else would page me
for something to do. I had finished my rounds, and all the patients I
was covering were tucked in. But one patient kept popping up in my
mind: an elderly lady whom I had admitted earlier that night with
diagnosis of dizziness. I felt an overwhelming “itch” to check up on
her one more time, and my legs literally turned by themselves and led me
into the room where a feeble old lady was sitting on the floor,
clutching her hand to her chest and breathing heavily. Her eyes were
closed. She was unconscious. Lucky for Edith (this was her name), I had
instantly recognized the signs of pulmonary edema, a lethal condition
when untreated, and swiftly took care of it with my textbook-protocol-IV
treatments and oxygen.
When she opened her eyes, the first thing she saw was me standing above
her. Smiling with deep relief—we came very close to losing this woman
on my night watch—I went home to sleep in the morning, and when I came
back in seven hours, Edith had already been moved to a regular floor as
she felt much better. I was told that she was looking for her “angel
with a Russian name.” She probably convinced one of the nurses to give
her my home address. Little did I know that the feeble old patient of
mine was a renowned artist and still painting, despite being in her
eighties. Several weeks later I received a package from patient Edith
Meisl-Bernhard, which I opened with trembling hands, not knowing what to
expect. It was a painting of me as seen by Edith awakening from her
unconscious state. I was pondering for weeks about what led me into her
room that night...
My days as a medical resident were like an emotional roller coaster:
some patients were admitted for simple problems, but some never made it
out of the hospital. One young woman had refused to abort her dead fetus
and, as a consequence, wound up developing an unstoppable bleeding from
all the orifices in her body. As a senior resident, I was leading the
team of doctors and nurses trying to resuscitate this poor woman for
hours. Twenty weeks pregnant myself, I just could not allow myself to
let her go. Bags of blood, plasma, and platelets were going into her
body and bleeding right out. Intravenous medications were being pushed,
and chest compressions would not cease. I had not even noticed that we
were an hour and a half past the usual “allowance” for pronouncing
someone dead, when they cannot be resuscitated. One of the nurses gently
put her arms around me and pulled me away from the bloodbath, saying,
“You just have to let go. She is gone.”
That night, doubled over on a little bunk bed in my ICU on-call room, I
was choking from tears of inadequacy and hopelessness. I was grieving
and wailing so deeply that it was surprising I did not have a
miscarriage myself. I had learned that I could not save everyone.
Five months later, after what seemed like a sleepless mixture of drama,
horror movie, comedy, and tragedy, the residency experience was finally
One day before my due date, I was heading over to my two-day board
certification exam. I had a car waiting for me outside in case the baby
would insist on coming out pronto. The exam proctors were giving me
hateful looks—I was a pregnant menace to their peace and quiet. During
the exam contractions came and went, and I kept running to the bathroom,
accompanied by the outraged exam proctor, but some invisible force had
pulled me through these two days of board exams. The day after the board
exams, I found myself on the delivery floor of my hospital; only this
time I was the patient.
My delivery was bad. Everything that could go wrong went wrong. After
twenty hours of breathless pushing, with an oxygen mask on my face, I
was wheeled into the operating room and laid onto the bed, where that
poor lady patient whom I was telling you about on the previous page had
perished twenty weeks before. Doctors and nurses were running around
screaming. Forceps, a vacuum device, and curses were flying in the
air—but I was calm. I thought that this was my end. Right there. Right
where my patient passed away. I could not save her, and it just made
sense for me to die right there. Strangely, I was accepting whatever was
coming. But something or someone really wanted my baby and me to live on
that day, and we miraculously pulled through.
I even survived the forgotten pieces of placenta, which bled out of me
the next day, and the kidney infection that followed. I left the
hospital quietly, with a catheter in my lifeless bladder and a bag of
urine tied to my leg. No matter; I was thrilled to be alive and have my
baby. I knew that I was a survivor, and that meant that I had a mission
on this earth.
Eventually, my bladder started functioning again, and I was ready for
living out my mission. All the knowledge and experience that were
overflowing inside of me had to be expressed and shared. I called up the
management in my apartment building and asked them if they had a small
office to rent. They said that there was a one-bedroom apartment that
had been rented out by a now-retired surgeon. Perhaps, I would want to
convert that into a primary-care office. I scratched my head: Convert?
That would involve the construction people, right?
Someone recommended an inexpensive guy from Brooklyn. He had never done
medical offices, but who cares about a resume when you hardly have any
money to spend? “So, what are we doing?” he asked, toothpick in his
mouth, standing in the center of an old kitchen that was to become my
“Well for starters, let’s take down all the walls and build a
reception area right here by the door. We’ll figure it out from
there.” He shrugged and went to work on my office-to-be with his
two-men crew. I had no one to consult on the layout or design. There
were no doctors in my family, and no one in my graduating residency
class was opening his or her own office. The odds of new business
failure were too high—statistically 95 percent. But when you are
driven, nothing matters. I had randomly picked a medical-equipment guy
from the yellow pages and invited him into my “office under
It was a beautiful January afternoon when this seventy-five-year-old guy
named Norman Schor walked into my office-to-be and froze in his feet.
“What is this?” he asked, wide-eyed, referring to the overly high
countertop in the reception. “How am I supposed to reach this? Never
mind leaning on this to write something down. And what the hell is
this?” He was eyeballing the entrance door that was swinging open
into the office, straight into him standing at the counter. “This
thing is going to nail me dead to the countertop. Who built this?”
Frustrated, I conveyed Norman’s concerns to my construction guys and
asked them to lower the countertop and change the direction the door was
swinging. My request must have had devastating effects on their ego,
because they decided to just—leave. And they left with almost all of
my money that I had paid them forward. To highlight how pissed off they
were at my critique, they spilled liquid glue on my floor while leaving.
“In good riddance,” I was muttering to myself, as my family and I
were scrubbing the floor for two days with a razor blade, cleaning the
glue off the new Home Depot tiles.
Norman was my kind angel. He said, “This is not the end of the world,
Doc. I will bring in two new construction people and negotiate a decent
price for you.” He also advised me on the legal requirements for the
exam-room size and helped to pick the spots for all the electric outlets
and the air conditioner. Thanks to Norman’s kind suggestions and my
renewed hope and zest, the office construction was finally completed in
On the first day of spring, I announced the opening of the office to the
doorman of my building and proudly walked inside my fresh
paint–smelling office, wearing a crisp new white coat. Finally, a real
doctor! In my own office! My first and only employee, a lady
receptionist, gave me an encouraging nod, as I walked into my own
consultation room and sank into the furniture from Staples, which I had
finished putting together the day before, bolt by bolt. I proudly looked
at the diplomas displayed on the walls. The red mahogany of the frames
left me satisfied. And so I sat in my plush vinyl armchair—all day.
No one came in except the mailman. The same happened the next day—and
the next. The phone was silent, and there were no patients in sight.
People were not lining up to experience my valuable and fresh knowledge
and care. Gradually, restlessness and panic started creeping into my
head. I had never felt this way before.
On the one hand, I was overfilled with emotions of empathy for the sick
and wanted to share my experience and enthusiasm with the patients. On
the other hand, there were no patients to take care of. And what was
there, really? A newly built office with all the accompanying expenses
and leased-equipment bills, the university and medical-school loans of
astronomical sizes that had to be paid off, and the malpractice
insurance and babysitting expenses so that someone could stay with my
six-month-old child while I was at work.
I was thirty years old and had been in school for twenty-four out of
those thirty years. But no school and no one had ever prepared me for
the feeling I was experiencing right then—the state that I was in. How
was I supposed to act? What was I supposed to do to resolve my
At night, I could not fall asleep, my mind racing in a circular thought
of “what do I do?” By morning, I was getting out of bed with a sense
of doom and felt really fearful of what the new day was going to bring.
I felt hopeless…
Today, rewinding my life’s “movie” backward, I am grateful to my
fate for starting me off in my professional career by throwing me down
low and deep. If it wasn’t for having to think day and night about
finding my way out of the maze that I was in, I don’t think I could
ever evolve to become a real healer of the sick: the doctor who not only
knows how to treat the disease but also understands how to preserve the
health and how to prevent the illness in the setting of what we all live
through on a daily basis: real Life, with its trials and tribulations.
And so with time, I started to understand that every person’s life
script was somehow connected with the state of his or her health and
with the workings of their organ systems. This was the beginning of
Today I am forty-five years old. Sitting in front of my Mac, I often ask
myself, “What was it that really prompted me to write this book?”
The answer that comes out is unexpectedly simple: “That same
overwhelming desire to share my knowledge with and caring for the people
who need my help.” Though the knowledge and experience are now of a
different kind, on a different level.
In this book I address only one health concern. It may sound simple, but
as it turns out, this concern is much more difficult to treat than panic
attacks or smoking cessation or chronic fatigue syndrome or insomnia.
The problem we are going to tackle is this: How to live without diets
and be totally happy with oneself looking in the mirror and stepping on
the scale? I will let you follow in my footsteps, on my way to
understanding how to treat the problem of excessive weight. In order to
conquer your enemy, we will first have to identify who the enemy is and
then learn our enemy’s weaknesses. Only then can we try to fight this
Excerpted from "Diet Slave No More!" by MD, Svetlana Kogan. Copyright © 2016 by MD, Svetlana Kogan. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher. Excerpts are provided solely for the personal use of visitors to this web site.